In-stent thrombosis after cessation of antiplatelet medications in patients with drug-eluting stents (DES) is a significant problem in medical practice, particularly in the perioperative period. We report a case of an 87-year-old man with a medical history of hypertension, coronary artery disease and chronic atrophic gastritis. Very late thrombosis of a sirolimus-eluting stent occurred 1207 days after implantation, seven months after discontinuation of clopidogrel, and the interruption of aspirin 13 days in preparation of an elective endoscopic gastroin-testinal procedure presented with acute myocardial infarction. The patient was treated with thrombectomy and successfully revascularized with superimposition of two sirolimus-eluting stents. Medications administered in the catheterization laboratory included low molecular weight heparin and nitroglycerin. Flow was defined as grade 2 according to the thrombolysis in myocardial infarction scale. Electrocardio-gram after the procedure revealed persistent, but decreased, ST-segment elevation in the anterolateral leads. The patient recovered and was discharged on aspirin and clopidogrel indefinitely. There was no cardiac event during the two year follow-up period. This case underlines the importance of maintaining the balance of thrombosis and bleeding during perioperation of non-cardiac procedure and the possible need for continuation of aspirin therapy during periendoscopic procedures among patients with low bleeding risks who received DES.

Objective To investigate the complications related factors in infants with mycoplasma pneumonia pulmonary(MPP). Methods According to the condition of pulmonary complications, 105 cases of infants MPP were divided into pulmonary complication group and no pulmonary complication group with 72 cases and 33 cases respectively,and the general related factors and disease related factors of two groups were analyzed. Results The incidence rate of pulmonary complication was 68.6% (72/105) in infants MPP, and the main involved extra-pulmonary systems were digestive system (54.2%), cardiovascular system (44.4%) and blood system(33.3%). Among 20 factors associated with pulmonary complications of MPP, age, feeding method (including artificial, mixing and milk three classification), season of onset, fever days, the titer of mycoplasma pneumonia (MP)-IgM, C-reaction protein, erythrocyte sedimentation rate and the initial time of using macrolides had significant differences between two groups (P<0.05). Multivariate Logistic regression analysis showed that age≥2 years, fever days≥7 d, titer of MP-IgM≥1∶160, increased C-reaction protein levels and accelerated erythrocyte sedimentation rate were the risk factors for pulmonary complications of infants MPP, while breastfeeding and using macrolides within 7 d were the protective factors. Conclusions The incidence rate of pulmonary complications in infants MPP is high, which can affect multiple systems. For children with older age, longer thermal process, higher titer of MP-IgM, and increased C-reaction protein , accelerated erythrocyte sedimentation rate and more past medical history, more attention should be paid for their higher pulmonary complications incidence.

Objective To construct the RNA interference eukaryotic expression vector targeting human centromere protein-I (CENP-I) and to observe its effect on the growth of human embryo kidney 293 cells (HEK 293). Methods The expression vectors of pGenesil-1/CENP-I-siRNA-1. pGenesil-1/CENP-I-siRNA-2 and pGenesil-1/CENP-I-siRNA-3 were constructed by gene recombination and then were transfected into the HEK293 cells by liposome. The expressions of CENP-I at the protein and mRNA levels were detected by Western blotting and fluorescence quality PCR (FQ-PCR). The effective vector and the best transfection time were selected. The growth and the cell cycle of the transfected cells were assessed by MTT assay and flow cytometry. Giemsa was used to stain the transfected cells to calculate the mitotic index. Results Sequence-specific siRNAs targeting CENP-I significantly down-regulated the expression of CENP-I in HEK293 cells. The recombinant plasmid of pGenesil-1/CENP-I-siRNA-3 was the effective vector. After transfecting for 72 h the best inhibited efficiency was achieved. In CENP-I-siRNA transfected cells,the rate of cell growth was decreased markedly. Cells at G 2/M phase and the mitotic index were increased conspicuous compared with the cells transfected with the blank vector or untransfected. Conclusion Down-regulation of CENP-I in HEK293 cells by sequence specific siRNA delays the cell growth and postpones the cell division.