Objective:To understand the efficacy and safety of bivalirudin for perioperative use in elderly patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).Methods:Clinical data of elderly patients with STEMI who were anticoagulated with bivalirudin (observation group) and the same number of consecutive cases who were anticoagulated with heparin (control group) during the perioperative period of PCI in Cangzhou Central Hospital from May 2018 to June 2020 were collected according to the catheterization room record. The information included patients′ demographic information, previous disease history, preoperative examination and intraoperative findings, thrombolysis in myocardial infarction (TIMI) flow grade before and after operation, as well as all-cause death, major adverse cardiac and cerebrovascular event (MACCE), bleeding events, and stent thrombosis events within 30 days after operation. The improvement of TIMI blood flow grade after PCI and the incidence of all-cause death, MACCE, bleeding events, and stent thrombosis within 30 days after PCI were compared between the 2 groups.Results:A total of 85 patients who were treated with bivalirudin during PCI were entered in the observation group, including 51 males and 34 females, and 85 patients who were treated with heparin during PCI were entered in the control group in the same period, including 50 males and 35 females. The differences in age, gender, previous history of cardiovascular-related diseases, smoking history, heart rate before PCI, estimated glomerular filtration rate, left ventricular ejection fraction, Killip grading, TIMI blood flow grading before the PCI, infarct-related artery, use of intra-aortic balloon pump during operation, PCI procedure route, vascular lesions, and stent implantation between the 2 groups were not statistically significant (all P>0.05). The TIMI blood flow grade in the observation group and the control group after PCI treatment was significantly improved compared with that before treatment, and the difference was statistically significant (all P<0.001). But the difference in TIMI blood flow grade after treatment between the 2 groups was not statistically significant ( P=0.278). The incidence of MACCE within 30 days after PCI in the observation group was lower than that in the control group ( P=0.026), but the differences in all-cause death, cardiogenic death, myocardial infarction, stroke, and target vessel revascularization events, and stent thrombosis within 30 days after PCI were not statistically significant (all P>0.05). Conclusions:The efficacy of anticoagulation with bivalirudin during PCI in elderly patients with STEMI is similar to that of heparin. Compared with heparin, bivalirudin can reduce the overall incidence of MACCE within 30 days after PCI, and does not increase the occurrence risk of stent thrombosis.

Objective:To understand the efficacy and safety of bivalirudin for perioperative use in elderly patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).Methods:Clinical data of elderly patients with STEMI who were anticoagulated with bivalirudin (observation group) and the same number of consecutive cases who were anticoagulated with heparin (control group) during the perioperative period of PCI in Cangzhou Central Hospital from May 2018 to June 2020 were collected according to the catheterization room record. The information included patients′ demographic information, previous disease history, preoperative examination and intraoperative findings, thrombolysis in myocardial infarction (TIMI) flow grade before and after operation, as well as all-cause death, major adverse cardiac and cerebrovascular event (MACCE), bleeding events, and stent thrombosis events within 30 days after operation. The improvement of TIMI blood flow grade after PCI and the incidence of all-cause death, MACCE, bleeding events, and stent thrombosis within 30 days after PCI were compared between the 2 groups.Results:A total of 85 patients who were treated with bivalirudin during PCI were entered in the observation group, including 51 males and 34 females, and 85 patients who were treated with heparin during PCI were entered in the control group in the same period, including 50 males and 35 females. The differences in age, gender, previous history of cardiovascular-related diseases, smoking history, heart rate before PCI, estimated glomerular filtration rate, left ventricular ejection fraction, Killip grading, TIMI blood flow grading before the PCI, infarct-related artery, use of intra-aortic balloon pump during operation, PCI procedure route, vascular lesions, and stent implantation between the 2 groups were not statistically significant (all P>0.05). The TIMI blood flow grade in the observation group and the control group after PCI treatment was significantly improved compared with that before treatment, and the difference was statistically significant (all P<0.001). But the difference in TIMI blood flow grade after treatment between the 2 groups was not statistically significant ( P=0.278). The incidence of MACCE within 30 days after PCI in the observation group was lower than that in the control group ( P=0.026), but the differences in all-cause death, cardiogenic death, myocardial infarction, stroke, and target vessel revascularization events, and stent thrombosis within 30 days after PCI were not statistically significant (all P>0.05). Conclusions:The efficacy of anticoagulation with bivalirudin during PCI in elderly patients with STEMI is similar to that of heparin. Compared with heparin, bivalirudin can reduce the overall incidence of MACCE within 30 days after PCI, and does not increase the occurrence risk of stent thrombosis.

In this study, we used next-generation sequencing methods to screen 300 individuals for BRCA1 and BRCA2. A novel mutation (c.849dupT) in BRCA2 was identified in a female patient and her unaffected brothers. This mutation leads to the truncation of BRCA2 functional domains. Moreover, BRCA2 mRNA expression levels in mutation carriers are significantly reduced compared to noncarriers. Immunofluorescence and western blot assays showed that this mutation resulted in reduced BRCA2 protein expression. Thus, we identified a novel mutation that damaged the function and expression of BRCA2 in a family with breast cancer history. The pedigree analysis suggested that this mutation is strongly associated with familial breast cancer. Genetic counsellors suggest that mutation carriers in this family undergo routine screening for breast cancer, as well as other malignancies, such as prostate and ovarian cancer. The effects of this BRCA2 mutation on drug resistance should be taken into consideration during treatment.
Blotting, Western ; BRCA2 Protein ; Breast Neoplasms* ; Breast* ; Drug Resistance ; Female ; Fluorescent Antibody Technique ; Genes, BRCA2 ; High-Throughput Nucleotide Sequencing ; Humans ; Mass Screening ; Nonsense Mediated mRNA Decay* ; Ovarian Neoplasms ; Pedigree ; Prostate ; RNA, Messenger ; Siblings

Aim To investigate the protective effects of dihydroquercetin(DDQ) against myocardial ischemis reperfusion injury(MIRI) in rats.Methods Male Sprague-Dawley rats were randomly divided into 4 groups(n=10):normal,control,I/R model, and I/R model+DDQ(5,10 mg·L-1).This study used an isolated Langendorff rat heart model.The left ventricu-lar developed pressure(LVDP),heart rate(HR) and the maximum rise and fall rate of the left ventricular pressure(±dp/dtmax) were monitored and documented using a physiological recorder.The levels of lactate dehydrogenase(LDH) and creatine kinase(CK) were analyzed using enzyme-linked immunosorbent assay(ELISA).Infarct size was measured using 2,3,5-triphenyltetrazolium chloride staining.The levels of superoxide dismutase(SOD) and malondialdehyde(MDA), as well as the ratio of glutathione/glutathione disulfide(GSH/GSSG) were measured via ELISA.HE staining was used to observe the pathological changes of myocardial tissue.Results Compared with the I/R model group, the I/R model+DDQ groups raised hemodynamic parameters, SOD level, and GSH/GSSG ratio;and reduced the amount of CK, LDH, MDA levels.Moreover, the I/R model+DDQ groups had lower infarct size and pathological changes in myocardial tissue than I/R model group.Conclusion DDQ exertes cardioprotective effects against I/R via improving the oxygen free radical scavenging ability, the inhibition of oxygen free radical and reducing lipid peroxidation.

Through the deep study of the surgical relident training of our country,we discover that the self-administration mode of surgery resident team is an effective way of optimizing resident standard training. In this mode,human resources and organization are effectively set up with modern management strategy. And with the characteristic training of the mode,we have got a good training effect.