Adenosine receptor agonists can activate adenosine receptors A 1 and A 3, thus trigger delayed preconditioning signal pathway and induce high expression of protective proteins and some ionic channel opening in myocardial cells, which reduces myocardial ischemia/reperfusion injury.

Objective To discuss the experience of open heart operation on beating in complex and severe congenital heart diseases. Method This kind of operation was put to use in 48 cases of the heart diseases in order to observe the effect of myocardial protection, prevention from air embolism,exposure of the operative field, and cardiopulmonary bypass. Results Operation field exposure was clear enough to finish the manipulation. One cases was eventiful postoperatively and died(2.08%). Conclusion Open heart operation on beating with slight hypothermia might have much feasibility in the part of complicated and severe congenital heart diseases.

Objective To establish a macrophage-specific KLF2 gene knockout mouse model,and explore the regulatory effect of KLF2 on the macrophage inflammatory response.Methods KLF2flox/+mice were constructed using CRISPR/Cas9 gene editing technology.Target genotype mice were obtained by breeding with Lyz2-Cre+/+mice and screening genotypes through polymerase chain reaction,and KLF2 knockout efficiency was verified using genotyping,qRT-PCR,and Western Blot.Bone marrow-derived macrophages(BMDMs)were isolated and cultivated and mRNA levels of inflammation-related factors in lipopolysaccharide-induced BMDMs were detected.Results A KLF2flox/flox/Lyz2-Cre+mouse model was established.KLF2 mRNA and protein levels in mouse bone marrow and BMDMs were significantly lower in KLF2 knockout mice compared with the findings in control mice,while expression levels of KLF2 in the heart,liver,and kidney showed no significant changes compared with levels in the control group.There were no significant differences in body weight,diet,drinking water,and appearance between the two groups.The group receiving lipopolysaccharide stimulation showed significantly reduced interleukin(IL)-6 mRNA expression and significantly increased IL-1,iNOS,and CD86 mRNA expression in KLF2-deficient BMDMs compared with the control group.Conclusions We constructed a macrophage-specific KLF2 knockout mouse model,thus laying the foundation for further research on the regulatory effect and mechanism of macrophage KLF2 in clinical inflammatory-related diseases.

Objective:To investigate the current status of anticoagulant therapy and the incidence of ischemic and bleeding events in hospitalized patients aged 90 years and over with non-valvular atrial fibrillation(NVAF).Methods:We retrospectively collected clinical data, antithrombotic treatment strategies, in-hospital ischemic stroke and bleeding events from NVAF patients(≥90 years)who were admitted to our hospital from June 2014 to August 2018.Based on the CHA 2DS 2-VASc score(2, 3, and ≥4 respectively), patients were divided into three ischemic risk groups, and antithrombotic treatment strategies and in-hospital ischemic stroke events were compared between the three groups.Alternatively, patients were divided into the high bleeding risk group(HAS-BLED score ≥3, )and the non-high bleeding risk group(HAS-BLED score ≤2), and antithrombic treatment strategies and the major bleeding events were compared between the two groups. Results:Among the 223 hospitalized NVAF patients aged 90 years and over, 42.6% of them received anticoagulant treatment, 25.6% received antiplatelet drugs, and 31.8% received non-antithrombotic treatment.With the increase of the CHA 2DS 2-VASc score, there was a trend of declined rates of non-antithrombotic treatment among the three ischemic risk groups(47.4%, 42.9%, 26.4%, P=0.06), and the rates of in-hospital ischemic stroke were similar among groups(10.5%, 12.2%, 15.5%, P=0.75). Moreover, compared with the non-high bleeding risk group, patients in the high bleeding risk group more frequently received anticoagulant treatment(47.2% vs.38.3%)and less frequently received non-antithrombotic therapy(28.7% vs.34.7%). There was no significant difference in antithrombotic treatment strategies( P=0.39)or rate of in-hospital major bleeding events(13.0% vs.10.2%, P=0.51). However, the rate of in-hospital major bleeding events was significantly higher in those with concurrent infections(16.8% vs.6.4%, P=0.02)or respiratory failure(21.3% vs.8.0%, P=0.01). Conclusions:The rate of anticoagulant use in NVAF patients aged 90 years and over is too low during hospitalization, and anticoagulant therapy should be standardized.In addition to the HAS-BLED score, we should consider the complications that increase the bleeding risk, such as infections and respiratory failure, when evaluating the bleeding risk.

Objective:To investigate clinical features and risk factors for pulmonary embolism in elderly patients with tumor-associated venous thromboembolism(VTE).Methods:Patients aged ≥65 years with malignant tumors combined with deep venous thromboembolism(DVT)in our hospital from June 2014 to November 2018 were enrolled retrospectively.General information such as age, sex, date of hospitalization, primary tumor location, tumor metastasis, concomitant disease, thrombosis type and site were collected.The Charlson comorbidity index was calculated.According to the site of deep vein thrombosis, patients were divided into the DVT group and the pulmonary embolism(PTE)group.Risk factors for PE were analyzed statistically on the indicators in the two groups.Results:Of the 318 patients, 281(88.4%)were in the DVT group and 37(11.6%)were in the PE group.There were no statistically significant differences in age, sex, smoking history, length of hospital stay, primary tumor type or tumor metastasis between the two groups( P>0.05). The main comorbidities included hypertension, diabetes mellitus, atherosclerotic coronary disease, chronic obstructive pulmonary disease, heart failure, cerebrovascular disease, chronic kidney disease and chronic liver disease, and there was no statistically significant difference in the number of patients with the above diseases between the two groups( P>0.05). Charlson comorbidity index scores were higher in the PE group than in the DVT group(7.22±3.95 vs.5.69±2.89, P=0.028). Logistic regression analysis showed that age( OR=0.9, 95% CI: 0.846-0.985, P=0.001), tumor metastasis( OR=0.006, 95% CI: 0.001-0.032, P=0.000), and Charlson comorbidity index score( OR=2.278, 95% CI: 1.772-2.929, P=0.000)were all independent risk factors for PTE. Conclusions:Age, tumor metastasis and Charlson comorbidity index score are independent risk factors for PE in elderly tumor patients.