OBJECTIVE:To explore the effect of dabigatran etexilate on coagulation indexes and safety of elderly patients with persistent atrial fibrillation. METHODS:52 elderly patients with persistent atrial fibrillation were randomly divided into obser-vation group and control group by random number table,26 cases in each group. Creatinine clearance rate in observation group was higher than 30 ml/min,110 mg Dabigatran etexilate capsule was orally given,bid;when 15-30 ml/min,55 mg capsule was orally given,bid. Control group orally received Warfarin sodium tablet with initial dose of 2.5 mg,qd,according to international normal-ized ratio (INR) after 3-5 days till maintained in 2.0-3.0. After 3 months,coagulation indexes [prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),INR,platelet count (PLT),fibrinogen (FIB)] before and after treat-ment,incidences of clinical events (cerebral embolism,cerebral hemorrhage,fatal bleeding,the remaining parts of embolism, death)and adverse reactions in 2 groups were compared. RESULTS:There was no significant difference in PT,APTT,TT,PLT and FIB between 2 groups before treatment(P>0.05);after treatment,PT and INR in 2 groups significantly increased,and obser-vation group was obviously better than control group,the difference was statistically significant(P<0.05). No cerebral hemorrhage or fatal hemorrhage occurred in the two groups. There was no significant difference in the incidence of cerebral embolism between 2 groups (P>0.05);the incidence of remaining parts of embolism,death in observation group significantly lower than control group,the difference was statistically significant(P<0.05). The incidence of adverse reactions in observation group was significant-ly lower than control group,the difference was statistically significant (P<0.05). CONCLUSIONS:Dabigatran etexilate shows good coagulation effect on elderly patients with persistent atrial fibrillation,which can effectively improve PT and INR levels and reduce the incidences of clinical events,with good safety.

Objective　To investigate the relationship between sperm anomalies and chromosomal aberrance and to further understand the pathological changes of anomalous spermatozoa.Methods　Light and electronic (SEM or TEM) microscopes were used for morphological analysis. Fluorescence in situ hybridization(FISH) with chromosome X-,Y-specific probes were used for aneuploidy detection in sperms of the patient. Results　Ninety eight point seven five per cent of the Papanicolaou stained sperms were observed to be abnormal; 100% of the sperm heads were abnormal, measured under oil objective (1000×); 60.25% of the sperms had two or more tails (the maximum being eight tails). SEM and TEM demonstrated that the heads contained a large amount of cytoplasmic structure, the surfaces of heads were uneven, the nuclei were of much irregular shape; besides aberrance in quantity, anomalies occurred with centromeres, mitochondria and flagella in the tails. The results of FISH showed that the aneuploidy rate of sex chromosomes was 61.41% which was parallel to the rate of polytails.Conclusion　Even though the chromosomes in somatic cells are normal, the chromosomes in anomalous sperms may be abnormal.