Objective To analyze the anticoagulation in patients with atrial fibrillation.Methods A retrospective analysis of anticoagulant therapy situation in 926 patients with atrial fibrillation was conducted,in order to sum up experience and improve the understanding of atrial fibrillation.Results In 926 patients with atrial fibrillation,there were no anticoagulant therapy in 675 patients,accounting for 72.89%,while only 251 cases received the treatment of anticoagulation,accounting for 27.11%.Only 66 patients aged>75 years were treated with anticoagulant therapy,accounting for 33.17%.The patients with coronary heart disease,in 17.60% and with anticoagulation treatment,the patients with diabetes in 28.37% and received anticoagulation therapy,28.32% patients with anticoagulation therapy in patients with hypertension,30.77% patients with cardiac insufficiency with anticoagulant therapy.Choice of treatment of aged>75,hypertension,coronary heart disease,clinical treatment strategies and patients were the main factors that affected the use of warfarin,but only>75 years of age,coronary heart disease,choice of treatment factors with statistical significance of three factors(OR=7.02,12.73,4.79,all P<0.05).675 cases without anticoagulant therapy in 101 patients with non warfarin treatment indications without the use of warfarin anticoagulation treatment,accounted for 14.96%.In addition,there were 574 AF patients with warfarin treatment indications and treatment with warfarin,analysis of its causes:63 cases had anticoagulant contraindications,172 cases for the doctor too much about bleeding complications,440 patients were not in accordance with the requirements of the detection of INR.Conclusion The positive effect of warfarin in prevention of ischemic stroke,but in basic hospital application of warfarin anticoagulation in patients with severe AF deficiency,should raise the awareness of risk of grassroots medical staff and patients of atrial fibrillation complicating embolism,do a good job of educating patients,to reduce the incidence of embolic events in patients with atrial fibrillation.

Objective To compare the value of 7 different thyroid imaging reporting and data systems(TI-RADS)for differentiating benign and malignant thyroid nodules under the context of Hashimoto thyroiditis(HT).Methods A total of 338 thyroid nodules in 200 HT patients were enrolled,including 167 benign and 171 malignant ones.Kwak-TIRADS,American Thyroid Association(ATA)guideline,American Association of Clinical Endocrinologists(A ACE)/American College of Endocrinology(ACE)/Associazione Medici Endocrinologi(AME)guideline,K-TIRADS of Korean Society of Thyroid Radiology,EU-TIRADS of European Thyroid Association,American College of Radiology(ACR)-TIRADS and 2020 Chinese guidelines for malignant risk stratification of thyroid nodules by ultrasound proposed by the superficial organs and vessels group of the ultrasound medicine branch of the Chinese Medical Association(C-TIRADS)were used for grading of benign and malignant thyroid nodules.Taken pathological results as gold standards,the diagnostic efficacy of 7 kinds of TI-RADS were analyzed.Results The sensitivity of Kwak-TIRADS,ATA guideline,A ACE/ACE/AME guideline,K-TIRADS,EU-TIRADS,ACR-TIRADS and C-TIRADS for differentiating benign and malignant thyroid nodules under the context of HT was 97.08％,98.25％,99.42％,95.91％,99.42％,90.06％and 99.42％,respectively,the specificity was 88.02％,83.23％,82.04％,88.02％,82.04％,86.83％and 84.43％,respectively,and the area under the curve(AUC)was 0.946,0.913,0.907,0.934,0.909,0.916 and 0.960,respectively.The sensitivity of C-TIRADS,EU-TIRADS and A ACE/ACE/AME guideline were all higher than that of K-TIRADS and ACR-TIRADS(all P＜0.05),and the specificity of Kawk-TIRADS and K-TIRADS were both higher than that of C-TIRADS,ATA guideline,EU-TIRADS and AACE/ACE/AME guideline(all P＜0.05),while AUC of C-TIRADS and Kawk-TIRADS were both higher than that of the rest 5 kinds of TI-RADS(all P＜0.05).According to Kwak-TIRADS,ATA guideline,AACE/ACE/AME guideline,K-TIRADS,EU-TIRADS,ACR-TIRADS and C-TIRADS,the malignant rate of different grades nodules identified with the same TI-RADS were significant different(all P＜0.05),which all raised with the increase of TI-RADS grade.Conclusion C-TIRADS and Kawk-TIRADS had better value for differentiating benign and malignant thyroid nodules under the context of HT,among which C-TIRADS had higher sensitivity and Kawk-TIRADS had higher specificity.