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The effect of antiaggregants on the system of regulation of the aggregative state of the whole blood in healthy volunteers has been studied using the global test of low-frequency piezothrombelastography. It is established that specific effects of antiaggregants are manifested in all stages of fibrinogenesis (initiation/amplification and propagation). According to the results of the global test at initial stages of hemocoagulation (initiation/amplification), a pronounced specific antiaggregative effect of COX-1 blockers and ADP receptors is accompanied by the intensification of thrombin activity and the formation of chronometric hypercoagulation. The blocker of phosphodiesterase, while losing a specific antiaggregative effect, has a lower influence on the change of thrombin activity, thus ensuring hronometric and structural hypocoagulation at the subsequent stages of fibrinogenesis. The proposed method can be used for real-time monitoring of the results of pharmacotherapy and drug effects at various stages of fibrinogenesis in the program of personalized antiaggregant therapy.

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Functional status of hemostatic system was assessed in 75 gastric cancer patients and 40 healthy volunteers. Hemostatic potential of blood flowing off tumor was evaluated in 38 patients whereas fibrinolytic activity of tumor tissue samples--in 35. The results showed the degree and pattern of functional disorders occurring in the hemostatic system to depend upon the extent and procoagulant and fibrinolytic activity of tumor. The evaluation of status of hemostasis as functional test elicited depletion of fibrinolytic and antiaggregation activity of the vascular wall in patients with locally advanced and disseminated cancer of the stomach.

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It was established that in patients with local spread of carcinoma of the stomach the hemostasis system makes danger of thrombogenesis due to lowered reserved possibilities of fibrinolysis and aggregation activity of the vessel wall. The state of danger of thrombogenesis under such conditions realizes itself in thrombi of profound veins of lower extremities detected by the method of radioisotope phlebography at the preoperative stage of treatment in 32.5% of the patients. Radioindication with fibrinogen125 has shown that the progressing development of preoperative thromboses is observed in the postoperative period. Complex medicamentous treatment (heparin, rheopolyglucin, nicotinic acid, aspirin) in combination with the graded physical exercise of the lower extremity muscles in the postoperative period eliminates the danger of thrombogenesis and prevents the development of venous thrombotic complications.

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The effects of various schedules of local hypoxia of the upper limb on the vascular wall antiaggregation activity have been studied in healthy volunteers. A double 5-minute local hypoxia with a 30 min interval, as well as a single occlusion of the limb vessels permit a judgement on the antiaggregation activity of the vessel wall; therefore this test may be recommended for the assessment of the vascular wall anti-aggregation activity.

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The advancement of Pliss' lymphosarcoma in rats was shown to be associated with disorders of platelet-mediated hemostasis presenting with either lowered or increased aggregation activity of platelets. In the latter case, a direct correlation was observed between functional activity of thrombocytes, on the one hand, and degree of tumor advancement and its metastatic activity, on the other. Extract of Scutellaria baicalensis Georgi was shown to produce a normalizing effect on platelet-mediated hemostasis whatever the pattern of alteration which points to the adaptogenic activity of the drug. This activity is thought to be responsible for the drug's antitumor and, particularly, metastasis-preventing effect.

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The blood complement and fibrinolytic activities were examined in 89 patients with Stages III-IV pulmonary and gastric carcinomas. The studies have revealed that local hypoxia of the upper limb as a test stimulant evokes similar reactions of the examined systems, which evidences their functional relationship. Three reaction types of the complement and fibrinolytic systems were singled out: increased, decreased, or unchanged activities. These reactions qualitatively and quantitatively differ in normal subjects and patients with the disseminated forms of pulmonary and gastric carcinomas. The results permit a conclusion that use of a local hypoxia functional test makes the measurements of the blood complement and fibrinolytic activities more informative and permits a judgement on the reserve potentials of these systems.

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An all-round study of hemostasis functioning conducted in 60 patients with gastric cancer established depletion of the compensatory potential of the fibrinolytic system of blood and antiaggregant capacity of the vascular system. This condition created the risk of thrombosis. Those at risk revealed thrombotic disorders in the deep veins of the legs in preoperative period, their frequency being in correlation with the stage of tumor (stage III-28.8 and stage IV-81.8%).

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The experience with application of gangliolytic drugs in the surgical treatment of 1,380 cancer patients is discussed. It was found that cancer patients' increased sensitivity to the said drugs is due to disorders in neuro-humoral regulation of adaptation and vascular tension as well as occult hypovolemia. These disturbances are intensified with tumor advancement. Recommendations to improve preoperative premedication are given. The dosage of gangliolytic drugs used for anesthesia in cancer patients should be 20-30% lower than that in general surgical cases.

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