Objective:To compare the clinical application of aspirin and low molecular weight heparin in pulmonary lobectomy after percutaneous coronary intervention(PCI), and to explore the effect of aspirin monotherapy in anti-platelet therapy.Methods:From January 2018 to December 2019, the clinical data of 48 patients with coronary atherosclerotic heart disease(coronary heart disease) who underwent lobectomy in the Thoracic Surgery Department of Beijing Anzhen Hospital within 12 months after PCI were retrospectively analyzed. There were 37 males and 11 females. The age ranged from 41 to 76(67.6±10.4) years. There were 22 cases with hypertension, 18 cases with diabetes and 2 cases with cerebrovascular disease. Iliac artery stents were inserted in 2 cases and vertebral artery stents in 1 case. Preoperative atrial fibrillation in 2 cases. There were 46 patients with gradeⅠand 2 patients with gradeⅡcardiac function(NYHA). According to the preoperative antiplatelet treatment, the patients were divided into aspirin group(25 cases) and low molecular weight heparin group(LMWH group, 23 cases). In the aspirin group, clopidogrel or ticagrelor was stopped 5 days before lobectomy, and aspirin single drug antiplatelet therapy was used, orally 100 mg every day until the morning of operation. In the LMWH group, aspirin, clopidogrel or ticagrelor were stopped 7 days before surgery, and 0.6 ml LMWH calcium was injected subcutaneously, once every 12 hours, and stopped 12 hours before surgery. Perioperative clinical data of the two groups were recorded and analyzed, and major adverse cardiac event(MACE) and bleeding events were observed.Results:There was no death in all groups. MACE and bleeding occurred in 1 case respectively in LMWH group. There were no significant differences between the two groups in length of hospital stay, duration of operation, diameter of lesion, total postoperative thoracic drainage and retention time of thoracic drainage tube( P>0.05). The intraoperative blood loss and chest drainage in the aspirin group were significantly lower than those in the LMWH group in the first 3 days after surgery, with statistical significance( P<0.05). Conclusion:The incidence of MACE increases after lobectomy for coronary heart disease within 12 months after PCI, and aspirin monotherapy is safe and effective in antiplatelet therapy.

Objective To explore the molecular genetic characteristics of primary and recurrent glioblastomas (GBMs) from the same patient in vivo, primary glioma stem cells cultured in vitro, and patient-derived xenograft (PDX). Methods (1) The primary and recurrent GBM specimens from one patient during surgical resection were collected; and the expressions of glial fibrillary acidic protein (GFAP), nestin and Ki-67 were detected by immunohistochemical staining; the methylation of O6-methylguanine DNA methyltransferase (MGMT) gene, mutation of isocitrate dehydrogenase (IDH) gene and amplification of epidermal growth factor receptor (EGFR) gene were analyzed. (2) The primary and recurrent GBM stem cells were cultured in vitro and named as SU5-1 and SU5-2 cells, respectively; the expressions of nestin and CD133 were detected by immunohistochemical staining; GFAP expression was detected by immunohistochemical staining after induced differentiation, and the growth curve was detected by CCK-8 assay; Transwell invasion assay was used to detect the invasion ability; cell resistance to temozolomide (TMZ), carboplatin (CBP), cisplatin (DDP) and adriamycin (ADM) was detected by CCK-8 assay; the protein expression of programmed death receptor-ligand 1 (PD-L1) was detected by Western blotting. The rate of PD-L1 positive cells was detected by flow cytometry; genetic testing analysis was as above. (3) The primary and recurrent in situ PDX models in nude mice were established, and the expressions of nestin, GFAP and Ki-67 were detected by immunohistochemical staining. Results (1) As compared with the primary GBM, the recurrent GBM had significantly higher percentages of Ki-67 and nestin positive cells, while statistically lower percentage of GFAP positive cells (P<0.05); genetic analysis showed that there was no mutation in IDH gene in the primary GBM tissues and recurrent GBM tissues; the MGMT gene in the primary GBM tissues was methylated and EGFR gene was not amplified, while the MGMT gene in recurrent GBM tissues was demethylated and EGFR gene amplification was positive. (2) Both SU5-1 and SU5-2 cells expressed nestin and CD133, and GFAP was expressed after induced differentiation; the growth curve showed that the proliferation of SU5-2 cells started earlier than that of SU5-1 cells, the two were equal on the 3rd, 4th, and 5th d, and the proliferation of SU5-1 cells was faster than that of SU5-2 cells from the 6th d; the invasion ability of SU5-2 cells was statistically stronger than that of SU5-1 cells (P<0.05); the inhibition rates of SU5-2 cells treated with 5, 10, and 15 mmol/L CBP, 0.3125, 1.25, and 5 mmol/L DDP, 0.5 and 2 mmol/L ADM, and 125 and 500 mmol/L TMZ were significantly lower than those of SU5-1 cells treated with the same concentrations and same drugs (P<0.05); the protein expression of PD-L1 in SU5-2 cells was higher than that in SU5-1 cells; the positive rate of PD-L1 in SU5-2 cells was statistically higher than that in SU5-1 cells (P<0.05); the results of genetic analysis were consistent with those of the primary and recurrent GBM samples. (3) As compared with those in the primary PDX model, the nestin and Ki-67 expressions were significantly higher and GFAP expression was significantly lower in the recurrent PDX model (P<0.05); the results of genetic analysis were consistent with those of the primary and recurrent GBM samples. Conclusions Genetic differences are detected between primary and recurrent GBMs; recurrent GBM has stronger invasive capacity and multi-drug resistance. The primary stem cells derived from surgical specimens and corresponding PDX models could replicate the molecular genetic characteristics of original tumors, which provide a reliable experimental platform for both tumor translation researches and screening of molecular therapeutic targets.

Objective To construct large medical model named by "Huaxi HongYi"and explore its application effectiveness in assisting medical record generation. Methods By the way of a full-chain medical large model construction paradigm of "data annotation - model training - scenario incubation", through strategies such as multimodal data fusion, domain adaptation training, and localization of hardware adaptation, "Huaxi HongYi" with 72 billion parameters was constructed. Combined with technologies such as speech recognition, knowledge graphs, and reinforcement learning, an application system for assisting in the generation of medical records was developed. Results Taking the assisted generation of discharge records as an example, in the pilot department, after using the application system, the average completion times of writing a medical records shortened (21 min vs. 5 min) with efficiency increased by 3.2 time, the accuracy rate of the model output reached 92.4%. Conclusion It is feasible for medical institutions to build independently controllable medical large models and incubate various applications based on these models, providing a reference pathway for artificial intelligence development in similar institutions.