Left atrial appendage ( LAA) arises from the left atrial free wall. It is the remnant of the original embryonic LA, distinct from the rest of the left atrium. It has a unique anatomical structure, physiological function, hemodynamic characteristics. LAA has complex surrounding structures, great variability, and close relation with thrombosis. This paper reviews the morphological and functional characteristics of LAA. Familiar with adjacent relationship of LAA and correlation between LAA and thrombus formation has important clinical significance that can reduce the risk of postoperative complications in interventional procedures, the incidence of car?dioembolic stroke, the clinical misdiagnosis on LAA thrombosis.

[Objective] To explore the bone histomorphology effect of QiangGuYin on neck of femur of ovariectomized rats.[Methods]Ninety femal SD rats,weight 230～280 gram,were rangdonmized into three groups:QiangGuYin group(treatment group),Miacalcic group(contrast group)and control group.All rats were variectomized.After 10 weeks,the osteoporosis model succeed,the treatment group,contrast group were given QiangGuYin,Miacalcic respectively.The treatment group used QiangGuYin everyday,1ml/g.The contrast group used Miacalcic 0.72u/kg,everyday hyodermic.And 3,4.5,6 months after the treatment,kill 10 rats to explore.The neck of femur were cut and stined with Masson Golder Trichrome for bone histomorphomemetric contrast group analysis.[Result]The treatment group ovariectomized rats' in 3m,BV/TV compared with statistical significance;compared with control group in Tb.sp,BV/TV,Tb.Th with statistical significance.After 4.5m treatment group Tb.Th compared with contrast group have statistical significance.Give the medicine 6m,Tb.sp,Tb.Th compared with contrast group all have statistical significance.[Conclusion]Giangguyin can effectively improve the histomorphometry index.The mechanism probably is stimulating osteogenesis and supperssing the cytoactive of osteoclast and trend of the high bone transform.

Objective To evaluate effect of humanized nursing on psychological state of patients with chronic urticaria receiving autohemotherapy. Methods 58 cases with chronic urticaria in our hos-pital were randomly divided into the observation group and the control group with 29 cases in each group, the control group was treated with conventional care, the observation group received conventional care combined with humanized nursing. The anxiety, depression and satisfaction degree were compared for these two groups and the data went through χ2 test and t test. Results The score of self- rating anxiety scale (SAS) and serf-rating depression scale (SDS) of the observation group was significantly lower than that of the control group, the satisfaction rate of the observation group was significantly higher than that of the con-trol group. Conclusions Application of humanized nursing in patients with chronic urticaria receiving autohemotherapy can reduce their anxiety and depression and has pivotal significance on treatment of pa-tients with chronic urticaria.

[Objective]To study whether Cervus and Cucumis Polypeptide(CCP ,Lugua polypeptide) can treat osteoporosis or not. [Methods]Forty 4-month-old female SD rats were randomized into four groups(10 in each group) ,including SHAM,0VX, OVX+CCP1 and OVX+CCP2 groups. Male rats in OVX groups take the ovariectomized surgery. Since the 13th week, rats in groups A and B got 0.9% physiological saline injection once in a day, group C was treated with CCP 0.4mL/(kg·d)injection and group D treated with CCP0.8mL/(kg·d) injection once one day. Twelve weeks later, al rats were sacrificed for obtaining specimen. Took right femurs, measured the bone biomechanical properties. [Results ]After 12 weeks since injection, the biomechanical property of right femurs in group OVX was significantly lower than that of the SHAM group( P<0.01); parameters such as maximum load and elastic load in group OVX+CCP1 and OVX+CCP2 were higher than that of group OVX(P<0.05), but lower than that of group SHAM(P<0.05). The distinction of the above parameters was significant( P<0.05)between group OVX+CCP1 and OVX+CCP2. [Conclusion]1.CCP can significantly im-prove the bone internal biomechanical properties in ovariectomized(OVX) rats, so it has function to treat osteoporosis caused by drop in estrogen level. There are differences of bone biomechanical properties aspects when treated with different dosage of CCP, which shows the tendency of dose-dependent effect. So we can conclude that CCP may have dose-dependent effect.

Objective To explore the clinical characteristics and treatment of infants with cytomegalovirus(CMV)pneumonia.Methods The clinical and auxiliary examination data of 24 patients with CMV pneumonia,which were diagnosed by detection of serum CMV-IgM used enzyme immunodot technique.All patients were treated with ganciclovir (GCV).Results The most common clinical manifestations of CMV pneumonia were cough,breathlessness,fever,crackles and wheezing rale.Chest X-ray findings predominately revealed increased and thickened bilateral lung markings and patchy areas of increased opacity in both lungs.Sixteen cases were cured,8 cases improved.Conclusions Clinical manifestations of infant CMV pneumonia lack specificity.The presence of serum CMV-IgM antibody is a laboratory diagnostic evidence.GCV is the best choice of drug in treatment of infants with CMV pneumonia.

AlM: To observe the therapeutic effects of improved external dacryocystorhinostomy.
METHODS:Retrospective analysis on 94 patients with monocular chronic dacryocystitis in our hospital from October 2010 to December 2013 were taken the improved external dacryocystorhinostomy. The improved surgery which was based on the traditional surgery including: 1. Nasal packing after anesthesia to relieve the pain and bleeding; 2. Not cut the medial palpebral ligament; 3. Suture the upper membrane of the nasal mucosa only;4. Pipe placement;5. Skin layered hairdressing suture. The patients were follow-up 3mo-2a after operation.
RESULTS: Ninety-three cases of patients cured with completely asymptomatic, no epiphora or mucopurulent secretion flow out from the lacrimal punctum, unobstructed lacrimal irrigation, the efficiency is 99%, 1 case of patient was epiphora, obstructed lacrimal irrigation, 1% was invalid.
CONCLUSlON:The improved external dacryocystorhinostomy is an effective surgical method which is easy to operate with high cure rate and its long term effect is precise.

Objective To explore the role of intercellular adhesion molecule-1(ICAM-1)and lym- phocyte function-associated antigen-I(LFA-1)in the pathogenesis of Sjgren's syndrome(SS)and provide a theoretical basis for clinical therapy.Methods Immunohistochemical method was used to detect these two cellular adhesion molecules in labial salivary glands of primary Sjgren's syndrome patients and 15 healthy controls.Semiquantitative analysis was performed by image analysis software.Results①In salivary gland samples,the expression of both ICAM-1 and LFA-1 was significantly higher compared to that of controls(P

Objective　To provide data support for the prevention and control of melioidosis by analyzing epidemiological characteristics of melioidosis bloodstream infection and antibiotic resistance of its pathogen in Hainan Province from 2012 to 2021. Methods Data was collected from Hainan Antimicrobial Resistance Surveillance System, and WHONET 5.6 software was used to merge and analyze data. Results The case numbers of melioidosis bloodstream infection showed an increasing trend year by year from 2012 to 2021. The ratio of male to female patients was 4.6∶1, with 347 cases (58.91%) of patients aged 40-<60, the age group with the highest incidence. The number of cases from July to November were 424 cases (72.0%). Haikou and Sanya reported the largest case number, with 261 and 116 cases respectively. But there were no case reported from central area including Chengmai, Tunchang, Qiongzhong and Baoting. Burkholderia pseudomallei strains were isolated from both blood and other specimens in 105 of the 589 patients, with respiratory tract and wood specimens being the sites with the highest number of strains isolated other than blood; the resistance rates of Burkholderia pseudomallei to five antibiotics showed no obvious trend of change, with the lowest resistance rate to imipenem among the five drugs at 0.6%, followed by ceftazidime at 2.2%. Conclusion During the typhoon season, elderly, middle-aged male in coastal areas should pay attention to avoid or reduce their contact with mud and water. For patients with melioidosis bloodstream infection, imipenem or ceftazidime should be selected as early as possible for initial treatment.

Objective To determine the levels of plasma histamine and oxidative status in patients with dermatographism before and after the treatment with anti-histamine drugs. Methods Totally, 85 patients with dermatographism were randomly divided into two groups to receive oral desloratadine and cetirizine respectively for 4 weeks. Enzyme linked immunosorbent assay (ELISA) was performed to detect the plasma level of histamine, superoxide dismutases (SOD), glutathion peroxidase (GSH-PX) and malondialdehyde (MDA) in all the patients before and after the treatment and in 15 normal human controls. The efficacy of desloratadine and cetirizine for dermatographism was estimated. Results The response rate was 83.72% and 78.57% in patients treated with desloratadine and those with cetirizine, respectively (x2 = 0.369, P> 0.05). The untreated patients with dermatographism showed an elevation in the plasma level of histamine (3.87 ± 1.21 ng/ml vs. 1.76 ± 0.56 ng/ml, P< 0.05) and MDA (3.86 ± 1.03 nmol/ml vs. 2.19 ± 0.82 nmol/ml, P< 0.05), but a decline in the activity of SOD (86.29 ± 19.9 U/ml vs. 112.12 ± 27.88 U/ml, P< 0.05) and GSH-PX (74.52 ± 47.67 vs.915.06 ± 115.96, P< 0.05) compared with the normal human controls. The treatment with antihistamine induced a reduction in the plasma level of histamine (1.61 ± 0.47 ng/ml vs. 3.87 ± 1.21 ng/ml, P< 0.05) and MDA (2.65 ± 0.77 nmol/ml vs. 3.86 ± 1.03 nmol/ml, P< 0.05), but an increment in the activity of GSH-PX (921.46 ± 157.37 vs.74.52 ± 47.67, P < 0.05) with no changes of SOD in patients with dermatographism. Conclusions In patients with dermatographism, plasma histamine is increased and there is an imbalance of oxidation-antioxidation.Desloratadine and cetirizine are effective for the treatment of dermatographism.