Abstract:Objective To evaluate the effects of different cerebral perfusion methods on neurological complications during cardiopulmonary bypass in aortic arch surgery.Methods The clinical data of 241 patients who underwent aortic arch surgery in Beijing Anzhen Hospital,Capital Medical University from July 2019 to May 2022 were retrospectively analyzed.According to different cerebral perfusion methods,they were divided into bilateral cerebral perfusion group and unilateral cerebral perfusion group.The operation conditions,30-day in-hospital mortality and incidence of neurological complications were compared between the two groups.Results A total of 119 patients with mild hypothermic circulatory arrest combined with bilateral antegrade cerebral perfusion(bilateral cerebral perfusion group)and 122 patients with moderate hypothermic circulatory arrest combined with unilateral antegrade cerebral perfusion(unilateral cerebral perfusion group)were enrolled in this study.The duration of cardiopulmonary bypass was longer in the unilateral cerebral perfusion group than that in the bilateral cerebral perfusion group[187(155,207)min vs 176(143,198)min],and cerebral perfusion flow,minimum intraoperative temperature,and perioperative plasma consumption were lower in the bilateral cerebral perfusion group[6(5,7)ml/(kg·min)vs 8(7,10)ml/(kg·min),25(24,25)℃ vs 28(27,30)℃,0(0,400)ml vs 0(0,400)ml](all P＜0.05).There was no significant difference in 30-day in-hospital mortality between the two groups(P=0.168).There was no significant difference in the incidence of permanent neurological complications and temporary neurological compli-cations between the two groups(P=0.951,0.843).Conclusion In aortic arch surgery,unilateral cerebral perfusion and bilateral cerebral perfusion have no effect on the incidence of neurological complications,but bilateral cerebral perfusion can tolerate higher temperature and reduce cardiopulmonary bypass time.

Abstract:Objective To investigate the analgesic effects of hydromorphone and dezocine in patients with non-mechanical ventilation in intensive care unit(ICU).Methods A total of 94 ICU patients with non-mechanical ventilation admitted to the Second Affiliated Hospital of Guizhou Medical University from October 2021 to April 2024 were selected as the research objects.The patients were divided into control group and observation group by single-blind test method,with 47 cases in each group.The control group was treated with dezocine injection,and the observation group was treated with hydromorphone hydrochloride injection.The analgesic effect,sedative effect,comfort,pain factor levels,incidence of adverse events,and treatment safety were compared between the two groups.Results After treatment,the visual analogue scale score and Ricmond agitation sedation score at 12,24,48 and 72 h in the observation group were lower than those in the control group(all P＜0.05).After treat-ment,the physiological comfort,psychological comfort,environmental comfort,social and cultural comfort scores of the observation group were higher than those of the control group(all P＜0.05).After treatment,the levels of cyclooxygenase-2,bradykinin and prostaglandin E2 in the observation group were lower than those in the control group(all P＜0.001).The total incidence of adverse events in the observation group was lower than that in the control group[6.4％(3/47)vs 21.3％(10/47)](x2=4.376,P=0.034).There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.726).Conclusion Compared with dezocine,hydromorphone has better analgesic and sedative effect for ICU patients without mechanical ventilation,which can improve the comfort of patients,reduce the level of pain factors,reduce the incidence of adverse events,and has good safety.

Abstract:This article reviews the application of bone organoids in osteoarthritis diseases,and prospects the future development trend.Firstly,the definition,treatment status and challenges of osteoarthritis are sorted out to fully understand the background and importance of this disease.Then,the definition,concept and characteristics of bone organoids are described,and the research progress of bone organoids in the field of osteoarthritis was intro-duced in detail.Finally,the potential value and future development trend of bone organoids in the treatment of osteoarthritis are analyzed,in order to provide reference for related research and practice.

Abstract:Traditional Chinese medicine pediatrics play a great role in clinical work.It is of great signifi-cance to unearth the advantages and characteristics of traditional Chinese medicine pediatrics,sort out,select,and promote the advantage disease categories of traditional Chinese medicine pediatrics for clinical work.The Chinese Society of Traditional Chinese Medicine organizes a series of youth forums on the clinical advantage diseases to explore the advantages and features of traditional Chinese medicine diagnosis and treatment,condense the scientific problems related to traditional Chinese medicine solving clinical problems,and provide support for the precise development of traditional Chinese medicine.This expert discussion paper discusses the scope,significance,and suggestions for building the advantage disease categories of traditional Chinese medicine pediatrics from three perspectives.It is hoped that fellow practitioners and administrative departments will pay attention to and promote the progress of the advantage disease categories of traditional Chinese medicine pediatrics.This will greatly benefit the people's health and the revitalization and development of traditional Chinese medicine pediatrics.

Abstract:Objective To investigate the relationship between systolic pulmonary arterial pressure(SPAP)and prognosis in pregnant women with shunt-related congenital heart disease-associated pulmonary hyper-tension(PH).Methods The clinical data of 254 pregnant women with shunt-related congenital heart disease-associated PH in Beijing Anzhen Hospital,Capital Medical University from January 2010 to July 2020 were retro-spectively analyzed.The patients were divided into non-drug treatment group(131 cases)and drug treatment group(123 cases)according to whether they needed postoperative drug treatment.The basic characteristics and perioperative management data of the two groups were compared.SPAP was estimated by echocardiography,and the correlation between SPAP and postoperative medication was evaluated by regression model,curve fitting and threshold saturation effect analysis.Results The body mass index and gestational age of the drug treatment group were less than those of the non-drug treatment group,the intraoperative infusion volume was less than that of the non-drug treatment group,and the proportion of New York Heart Association heart function grades Ⅲ-Ⅳ,SPAP levels,and the proportion of tricuspid valve regurgitation were higher than those in the non-drug treatment group(all P＜0.001).After adjusting for possible confounding factors,there was a non-linear correlation between SPAP and postoperative medication,and the turning point of SPAP was 90 mmHg.When SPAP≤90 mmHg,the risk of postoperative drug therapy increased with the increase of SPAP(odds ratio=1.06,95％confidence interval:1.02-1.09,P=0.001).When SPAP＞90 mmHg,there was no significant correlation between SPAP and postoperative medication(odds ratio=0.99,95％confidence interval:0.96-1.02,P=0.478).Compared with women with SPAP≤90 mmHg,those with SPAP＞90 mmHg have a higher risk of postoperative drug therapy(odds ratio=3.06,95％confidence interval:1.14-8.06,P=0.023).Conclusions Puerperae with severe PH have a high risk of requiring drug therapy after surgery.For mild to moderate patients,it is necessary to be vigilant,prepare for drug treatment and improve pulmonary artery pressure as soon as possible to reduce the risk of pregnancy.For these patients,individualized assessment of multiple factors is more important.

Abstract:Objective To investigate the relationship between serum fetuin A,fatty acid binding protein 4(FABP4)and microRNA-31(miR-31)with gestational diabetes mellitus(GDM)and their predictive value for pregnancy outcome.Methods A total of 120 GDM patients admitted to Xinjiang Uygur Autonomous Region People's Hospital from January 2022 to March 2023 were selected as the observation group,and 120 healthy pregnant women were selected as the control group.The serum levels of fetuin A,FABP4 and miR-31 in the two groups were detected,and the correlation between the levels of fetuin A,FABP4 and miR-31 and insulin resistance index(HOMA-IR)in patients with different clinical characteristics was analyzed,and the value of predicting adverse pregnancy outcomes was analyzed.Results The levels of serum fetuin A,FABP4 and miR-31 in the observation group were higher than those in the control group[(40±10)μg/L vs(30±7)μg/L,(27.1±3.6)mg/L vs(15.6±2.9)mg/L,(2.03±0.41)vs(1.00±0.26)](all P＜0.001).In the observation group,the levels of fetuin A,FABP4 and miR-31 in patients with HOMA-IR ≥5 and adverse pregnancy outcomes were higher than those in patients with HOMA-IR＜5 and without adverse pregnancy outcomes(all P＜0.05).Serum fetuin A,FABP4 and miR-31 were positively correlated with HOMA-IR in the observation group(all P＜0.001).The areas under the receiver operating characteristic curve of serum fetuin A,FABP4 and miR-31 for predicting adverse pregnancy outcomes were 0.733,0.831,and 0.824,respectively.Conclusion Serum fetuin A,FABP4 and miR-31 levels are increased in patients with gestational diabetes mellitus,which are positively correlated with HOMA-IR,and have certain application value in predicting adverse pregnancy outcomes.

Abstract:Objective To explore the relationship between intensive care unit memory and post-traumatic stress disorder(PTSD)in elderly patients with sepsis transferred from intensive care unit(ICU),and to explore the mediating effect of rumination thinking between ICU memory and PTSD.Methods From January 2020 to December 2023,240 elderly patients with sepsis transferred from ICU in the 305th Hospital of the Chinese People's Liberation Army and the Eighth Medical Center,Chinese PLA General Hospital were selected as the research objects.The general status questionnaire,post-traumatic stress disorder symptom checklist-Chinese version(PCLC),the intensive care unit memory assessment tool(ICUMT)and multidimensional rumination response scale(MRIS)were used to conduct a cross-sectional survey.The effects of patients'general data on rumination thinking,ICU memory and PTSD scores were analyzed.Pearson method was used to analyze the correlation of the three scores,and structural equation model was used to analyze the mediating effect of rumination thinking between ICU memory and PTSD of patients.Results The scores of those with sleep disorders,ventilator assisted ventila-tion,analgesics,and sedatives were higher than those of the other group(all P＜0.05).There was a positive correlation between ICUMT score and MRIS score and PCLC score in elderly patients with sepsis(r=0.550,P＜0.001;r=0.650,P＜0.001),and there was also a positive correlation between MRIS score and PCLC score(r=0.781,P＜0.001).ICU memory had a positive effect on PTSD,and the direct effect value was 0.840.The positive effect of rumination thinking on PTSD was also confirmed,and the direct effect value was 0.100.ICU memory also had an indirect effect on PTSD by affecting rumination thinking,and the effect value was 0.329.Conclusion ICU memory in elderly patients with sepsis has a direct effect on PTSD,and also an indirect effect through rumination thinking.

Abstract:Objective To investigate the relationship between serum brain natriuretic peptide(BNP),ferritin and insulin-like growth factor-1(IGF-1)levels and bronchopulmonary dysplasia(BPD)in preterm infants,in order to provide a scientific basis for the diagnosis of BPD.Methods A total of 80 premature infants admitted to the First Affiliated Hospital of Hebei North University from May 2021 to May 2023 were selected.According to the presence or absence of BPD within 28 days after birth,the preterm infants were divided into BPD group(38 cases)and non-BPD group(42 cases).According to the severity of BPD,the infants in the BPD group were divided into mild group(14 cases),moderate group(13 cases),and severe group(11 cases).Blood samples were collected from each subject,and their basic clinical information was collected.Serum levels of BNP,ferritin and IGF-1 were measured by enzyme-linked immunosorbent assay.The differences between BPD group and non-BPD group and between different severity subgroups of BPD were compared.Logistic regression was used to analyze the risk factors for BPD in preterm infants.Results The levels of serum BNP and ferritin in BPD group were higher than those in non-BPD group[(1 429±408)mg/L vs(137±33)mg/L,(372±120)μg/L vs(160±50)μg/L],and the level of IGF-1 was lower than that in non-BPD group[(26±8)μg/L vs(37±12)μg/L](all P＜0.05).The serum levels of BNP and ferritin in preterm infants with different severity of BPD rised with the severity of the disease,with mild group＜moderate group＜severe group;the level of IGF-1 reduced with the severity of the disease,with mild group＞moderate group＞severe group,and the differences between any two groups were statistically significant(all P＜0.05).The duration of mechanical ventilation,length of hospital stay,duration of continuous positive airway pressure,and the proportion of neonatal pneumonia and neonatal asphyxia in BPD group were higher than those in non-BPD group(all P＜0.05).Logistic regression analysis showed that serum levels of BNP and ferritin,duration of mechanical ventilation,and duration of continuous positive airway pressure were risk factors for BPD in preterm infants,while IGF-1 level was a protective factor(all P＜0.05).Conclusions The levels of serum BNP and ferritin in preterm infants with BPD are increased,and the level of IGF-1 is decreased.The three levels can be used as indicators of BPD,which are of great significance in evaluating the condition of preterm infants with BPD.

Abstract:Objective To investigate the clinical effect of Xiongdan Jiuxin pills combined with sacubitril/valsartan in the treatment of chronic heart failure with reduced ejection fraction.Methods A total of 120 patients with chronic heart failure with reduced ejection fraction admitted to Lianyungang Municipal Oriental Hospital Affiliated to Xuzhou Medical University from October 2020 to October 2023 were selected.According to the random number table method,they were divided into the control group and the observation group,with 60 cases in each group.All patients were given conventional treatment,the control group was given sacubitril/valsartan,and the observation group was given Xiongdan Jiuxin pills on the basis of the control group.The 6 min walk test distance,maximum exercise time,cardiac function indexes,serum indexes,and adverse reactions were compared between the two groups.Results After treatment,the 6 min walk test distance and maximum exercise time of the two groups were longer than those before treatment,and those of the observation group were longer than those of the control group(all P＜0.001).After treatment,left ventricular ejection fraction,stroke volume,cardiac output,nitric oxide and nitric oxide synthase in the two groups were higher than those before treatment,and those in the observation group were higher than those in the control group;the levels of left ventricular end-diastolic diameter,endothelin-1,laminin,hyaluronic acid and N-terminal procollagen type Ⅲ in the two groups were lower than those before treat-ment,and those in the observation group were lower than those in the control group(all P＜0.05).During the treatment,there was no significant difference in the incidence of adverse reactions between the observation group and the control group[10.0％(6/60)vs 6.7％(4/60)](x2=0.436,P=0.509).Conclusion Xiongdan Jiuxin pills combined with sacubitril/valsartan has a significant effect on chronic heart failure with reduced ejection fraction,which can improve the exercise tolerance,cardiac function and vascular endothelial function of patients,slow down myocardial fibrosis,and has good safety.

Abstract:Currently,transcatheter aortic valve replacement(TAVR)has emerged AS a high-yield treatment option for symptomatic patients with severe aortic stenosis(AS)and moderate-to-high surgical risk.In patients with severe AS and concomitant small aortic annulus(SAA),its unique aortic root anatomical characteristics increase the challenge of surgery,and the choice of treatment strategy has become a hot topic in recent years.Previous studies have shown that such patients show better hemodynamic characteristics and prognosis after TAVR.This article mainly reviews the prevalence and population characteristics of SAA in patients with severe AS,and the application of echocardiography in the evaluation of aortic root condition before TAVR in SAA patients.

Abstract:Objective To evaluate the efficacy,safety and economy of porcine fibrin sealant in coronary artery bypass grafting(CABG).Methods The clinical data of 143 patients who underwent off-pump CABG in the Coronary Surgery Center,Beijing Anzhen Hospital,Capital Medical University from March to October 2023 were retrospectively analyzed.Among them,67 patients were treated with porcine fibrin adhesive during the operation(observation group),and 76 patients were not treated(control group).The intensive care unit(ICU)stay time,postoperative drainage volume,drainage tube indwelling time,postoperative hospital stay,postoperative blood product usage rate,coagulation function and drug allergy were analyzed.Results There was no significant differ-ence in ICU stay time,postoperative drainage volume and postoperative blood product usage between the two groups(all P＞0.05).The postoperative drainage tube indwelling time and hospitalization time of the observation group were shorter than those of the control group[44(38,49)hvs46(41,65)h,5(4,6)dvs5(5,6)d](both P＜0.05).There was no significant difference in prothrombin activity,activated partial thromboplastin time and fibrinogen level between the two groups before operation and on the first day after operation(all P＞0.05).On the first day after operation,the level of fibrin degradation products in the observation group was higher than that in the control group(P＜0.05).There was no drug-related allergic reaction in the two groups,and there was no significant difference in hospitalization costs between the two groups(P＜0.05).Conclusion The use of porcine fibrin adhesive during CABG has good biocompatibility,which can shorten the postoperative drainage tube indwelling time and postoperative hospital stay,but does not reduce the postoperative drainage volume and blood transfusion rate,and has no significant effect on the hospitalization cost of patients.

Abstract:Objective To analyze and summarize the clinical data of patients with pulmonary Tropheryma whipplei(TW)infection,and further improve the understanding of pulmonary TW infection.Methods The clinical data(including basic information,test results,chest CT,treatment and outcome)of 7 patients with pulmonary TW infection admitted to the Department of Respiratory Medicine,Civil Aviation General Hospital from September 1,2021 to January 31,2023 were collected and retrospectively analyzed.Results Among the 7 patients with pulmonary TW infection,there were 3 males and 4 females,with age of 67(45,73)years.All patients had at least one underlying disease in their past medical history that may lead to abnormal immune function,the most common being coronary atherosclerotic heart disease.The white blood cell counts of all patients were in the normal range,but the percentage of neutrophils in 2 patients with mixed infection was significantly increased,which reached 86.9％and 95.9％,respectively.Chest CT showed ground glass density shadow,diffuse small nodular shadow or patchy shadow.All the 7 patients were diagnosed by pathogen targeted next-generation sequencing of bronchoalveolar lavage fluid,and TW was the only pathogen in 2 patients.All the 7 patients received antimicrobial therapy,of which 6 patients had significant improvement in clinical symptoms and imaging after treatment,and 1 patient was lost to follow-up.Conclusion Patients with pulmonary TW infection are often accompanied by diseases with abnormal immune function,and it is difficult to be diagnosed by routine laboratory tests,and most of them are diagnosed by next-generation sequencing.Chest CT can show a variety of non-specific changes.Antimicrobial therapy can significantly improve the condition.

Abstract:Objective To investigate the clinical effect of oxycodone hydrochloride sustained-release tablets on neuropathic pain in patients with primary lung cancer during radiotherapy and chemotherapy.Methods From June 2019 to June 2022,108 patients with neuropathic pain who were treated in 3201 Hospital were collected for prospective study,and they were divided into control group(54 cases),12 h titration group(26 cases)and 24 h titration group(28 cases)according to random number table method.The control group was given oral morphine hydrochloride tablets,12 h titration group and 24 h titration group were given oral oxycodone hydrochloride sustained-release tablets.General data,pain relief rate and number of breakthrough pain at different time points after treatment,quality of sleep and quality of life before and after treatment,and incidence of adverse reactions were compared among the three groups.Results There were all no statistically significant differences in gender,age,TNM stage and numerical rating scale score among the three groups(all P＞0.05).The pain relief rates in the 12 h titration group and the 24 h titration group 1 d after treatment were both higher than that in the control group(both P＜0.05).There were statistically significant differences in the numbers of breakthrough pain 1,2 and 3 d after treatment among the three groups(all P＜0.05),the numbers of breakthrough pain 2,3 and 7 d after treatment were all less than that 1 d after treatment(all P＜0.05).The numbers of breakthrough pain in 12 h titration group and 24 h titration group were both less than those in control group 1,2 and 3 d after treatment,and that in the 12 h titration group was less than that in the 24 h titration group(all P＜0.05).There were no statistically significant differences in comparison of Pittsburgh sleep quality index(PSQI)and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative(EORTC QLQ-C15-PAL)scores among the three groups before treatment(both P＞0.05),but there were statistically significant differences in comparison of PSQI and EORTC QLQ-C15-PAL scores 7 d after treatment(both P＜0.05).There were no significant differences in the incidences of adverse reactions among the three groups(P＞0.05).Conclusion Oxycodone hydrochloride sustained-release tablets for neuropathic pain during radiotherapy and chemotherapy in patients with primary lung cancer,especially 12 h as titration dose adjustment treatment,can achieve good pain relief rate,reduce the number of breakthrough pain,and do not increase the incidence of adverse reactions,with high safety.

Abstract:Objective To investigate the application effect and dose-effect relationship of oxycodone in CT-guided micro-coil puncture localization of pulmonary nodules.Methods A total of 125 patients who underwent CT-guided micro-coil puncture localization of pulmonary nodules in Jiangsu Cancer Hospital from December 2023 to June 2024 were selected.The patients were divided into control group and oxycodone 1,2,3 and 4 groups by random number table method,with 25 cases in each group.In the control group,the same volume of 0.9％sodium chloride solution was injected intravenously before the operation,and 1 mg/ml oxycodone hydrochloride injection 0.025 mg/kg,0.05 mg/kg,0.075 mg/kg,and 0.1 mg/kg were injected intravenously in oxycodone 1,2,3,and 4 groups before operation,respectively.The visual analogue scale(VAS)score during the peri-puncture period,the incidence of moderate and severe pain during the peri-puncture period,the basic vital signs at admission,before puncture,during puncture and at the end of puncture,the incidence of irritating symptoms during puncture,the success rate of one-time puncture and the incidence of adverse drug reactions were compared among the five groups.Results One patient in the oxycodone 2 group and one in the oxycodone 4 group were excluded from the study.The VAS scores of the control group and oxycodone 1,2,3,4 groups were(4.7±1.6),(3.9±1.5),(2.9±1.7),(1.6±1.4),and(1.4±1.1),respectively.The incidences of moderate and severe pain were 64.0％(16/25),56.0％(14/25),37.5％(9/24),8.0％(2/25),and 4.2％(1/24),respectively.The VAS scores of oxycodone 3 group and oxycodone 4 group were significantly lower than those of control group,oxycodone 1 group and oxycodone 2 group(all P＜0.05).The incidence of moderate to severe pain in oxycodone 3 group was significantly lower than that in control group and oxycodone 1 group(both P＜0.05).At the time of puncture,the heart rates of the oxycodone 3 groupand oxycodone 4 group were significantly lower than those of the control group and oxycodone 1 group(all P＜0.05).The incidences of respiratory incompliance and body movement in oxycodone 3 group and oxycodone 4 group were significantly lower than those in control group(all P＜0.05).The incidences of dizziness,nausea and vomiting in oxycodone 4 group were significantly higher than those in the other four groups(all P＜0.05).Conclusion Intravenous injection of 0.075 mg/kg and 0.1 mg/kg oxycodone during CT-guided micro-coil puncture positioning of pulmonary nodules can effectively reduce the pain of patients,reduce the incidence of moderate and severe pain during puncture,and significantly improve the cooperation of patients,among which 0.075 mg/kg oxycodone has fewer adverse drug reactions.

Abstract:Objective To explore the influencing factors of electronic health literacy and pulmonary nodule detection in health check-up population.Methods A total of 730 healthy people who underwent chest CT examination in the Department of Health Management,the First Affiliated Hospital of Guangxi Medical University from February to August 2023 were selected as the research objects.The general situation and the electronic health literacy scale(eHEALS)questionnaire survey were conducted to obtain research data,and the data of the two groups of people with or without eHEALS scores were compared to analyze the related influencing factors of pulmonary nodule detec-tion.Results The eHEALS qualified group was younger and had higher education level than the unqualified group.The proportions of being single,paying great attention to physical and mental health,exercising occasionally or often and searching online health information were higher than those in the unqualified group(all P＜0.05).The results of univariate binary Logistic regression analysis suggested that age[odds ratio(OR)=1.02,95％confidence interval(CI):1.01-1.03,P=0.001]and married(OR=1.71,95％CI:1.11-2.64,P=0.015)were the risk factors for pulmonary nodule detection.The results of multivariate binary Logistic regression analysis suggested that age was an independent risk factor for pulmonary nodule detection(OR=1.02,95％CI=1.01-1.03,P=0.001).Conclusion The overall age of the eHEALS score eligible population was younger and the education level was relatively higher.Age is an independent risk factor for the detection of pulmonary nodule.

Abstract:Depressive disorder and anxiety disorder are closely related to insomnia,which is the most common cause of insomnia and brings serious trouble to patients' family,society,work or study.It is very impor-tant to accurately evaluate the sleep status of patients with depression and anxiety disorders and give corresponding treatment measures in time.This article reviews the latest research progress on the pathogenesis of depression,anxiety disorder and insomnia,in order to deepen the clinicians' understanding of depression,anxiety disorder and insomnia,and provide references for clinical diagnosis and treatment.

Abstract:Carotid artery dissection is a relatively rare disease in clinical practice,and reports of serious adverse cardiovascular events during this procedure are even rarer.Carotid artery stenting(CAS)is widely used in the treatment of carotid artery dissection because of its small trauma and few complications.Once acute circulatory failure occurs,the implementation of effective anesthesia management is particularly key to save the patient's life.This article reports a case of carotid artery dissection patient with complex underlying diseases.Anesthesia management plan for sudden malignant arrhythmia,cardiac arrest,and acute circulatory failure during CAS was implemented.Through the implementation of goal-directed individualized anesthesia management program,the patient was finally rescued and discharged.

Abstract:Objective To investigate the current situation of differences in bleeding risk and risk perception in elderly patients with atrial fibrillation during anticoagulant therapy in the community,so as to provide reference for precise prevention of bleeding in patients.Methods A total of 487 elderly patients with atrial fibrillation who were accepted diagnosis and treatment guidance in Guangdong Provincial People's Hospital from June 2018 to July 2023 were selected as the research objects.The bleeding risk score and disease risk perception level at enrollment were investigated.Multiple linear regression method was used to analyze the influencing factors of bleeding risk and disease risk perception in elderly patients with atrial fibrillation receiving anticoagulant therapy in the community.Results Multivariate linear regression analysis showed that age,etiology of atrial fibrillation and medication were independent influencing factors for bleeding risk of community anticoagulant therapy in elderly patients with atrial fibrillation(standardized regression coefficients were 0.558,0.140,and 0.096,respectively,all P＜0.05).Age,family per capita monthly income,medication,comorbidity of hypertension and comorbidity of hyperglycemia were independent influencing factors of disease risk perception of community anticoagulation therapy in elderly patients with atrial fibrillation(standardized regression coefficients were 0.341,-0.482,0.064,0.059,and 0.100,respectively,all P＜0.05).Conclusion Elderly patients with atrial fibrillation have a high risk of bleeding during anticoagulant therapy in the community,and there is a bias in disease risk perception.The patients are affected by age,medication and comorbidities,which increase the risk of bleeding and reduce the ability of disease risk perception.

Abstract:Objective To explore the value of magnetocardiography in the evaluation of coronary artery in patients with coronary atherosclerotic heart disease.Methods A total of 165 patients who were hospitalized with chest tightness and/or chest pain in the Department of Cardiology,Beijing Jishuitan Hospital,Capital Medical University from April 1,2024 to December 30,2024 and were suspected of coronary atherosclerotic heart disease were collected.Finally,55 patients were diagnosed with coronary heart disease and 110 patients were excluded from coronary heart disease.All the selected patients completed magnetocardiogram,coronary CT angiography(CTA)and coronary angiography.Taking the results of coronary angiography as the gold standard,the efficacy of magnetocardiogram and coronary CTA in the diagnosis of coronary atherosclerotic heart disease was compared.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of magneto-cardiogram in the diagnosis of coronary atherosclerotic heart disease were 86.7％,83.3％,81.2％,88.2％and 84.8％,respectively;the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of coronary CTA in the diagnosis of coronary atherosclerotic heart disease were 69.9％,65.6％,65.6％,63.6％and 57.7％,respectively.Conclusion Magnetocardiography may become a new method to judge the severity of coronary atherosclerotic heart disease,which can provide more reliable information for patients before coronary angiography.

Abstract:Objective To investigate the curative effect of Wenyang Busui decoction combined with Ludangshen oral liquid on cancer-related fatigue(CRF).Methods A total of 146 patients with CRF admitted to Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College from January 2021 to January 2023 were selected.According to the random number table method,they were divided into the observation group and the control group,with 73 cases in each group.The control group was treated with Ludangshen oral liquid on the basis of conventional cancer treatment,and the observation group was treated with Wenyang Busui decoction on the basis of the control group.Both groups were treated for 1 month.The Piper fatigue scale score,fatigue degree classification,traditional Chinese medicine syndrome score and curative effect were compared between the two groups before and after treatment.Results After treatment,the scores of behavior,emotion,feeling and cognition of the two groups were lower than those before treatment,and the scores of the observation group were lower than those of the control group(all P＜0.05).After treatment,the degrees of fatigue in the observation group and the control group were lower than those before treatment(all P＜0.001),and that in the observation group was lower than that in the control group(P=0.004).After treatment,the traditional Chinese medicine syndrome scores of the two groups were lower than those before treatment(all P＜0.05),and that in the observation group was lower than that in the control group[(14.4±2.3)vs(19.7±3.4)](P＜0.001).The total effective rate of the observation group was higher than that of the control group[91.8％(67/73)vs 75.3％(55/73)](P=0.007).Conclusion Wenyang Busui decoction combined with Ludangshen oral liquid can effectively improve the clinical symptoms of patients with CRF,reduce the degree of fatigue,and has a definite clinical effect.