Objectives:To investigate the prognostic value of the CHA2DS2-VASc and R2CHA2DS2-VASc scores in patients with atrial fibrillation(AF)and heart failure(HF).Methods:Patients with AF and HF from hospitals diagnosed by the Heart Failure Center in Guangdong Province between January 2017 and December 2021 were selected.Major adverse cardiovascular events(MACE)were used as the follow-up endpoint.Statistical methods such as the area under the receiver operating characteristic(ROC)curve(AUC),net reclassification index(NRI),and integrated discrimination improvement(IDI)were applied to evaluate the predictive value of the CHA2DS2-VASc and R2CHA2DS2-VASc scores in patients with AF and HF.Results:A total of 1 839 patients were enrolled in this study,comprising 703 patients in the MACE group and 1 136 patients in the non-MACE group.Compared with the non-MACE group,the MACE group exhibited significantly advanced age,higher prevalence of New York Heart Association class Ⅳ and coronary artery disease,lower diastolic blood pressure and estimated glomerular filtration rate levels,and elevated serum N-terminal pro-B-type natriuretic peptide concentrations(all P<0.05).Additionally,significantly lower proportions of patients in the MACE group received angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitors,beta-blockers,mineralocorticoid receptor antagonists,or anticoagulant therapy(all P<0.05).Multivariable logistic regression analysis revealed that each 1-point increment in both CHA2DS2-VASc and R2CHA2DS2-VASc scores was associated with approximately 10%increased risk of MACE.ROC curve analysis demonstrated that the AUC values for predicting MACE in AF patients with HF were 0.555(95%CI:0.528-0.582,P<0.001)for CHA2DS2-VASc and 0.576(95%CI:0.549-0.608,P<0.001)for R2CHA2DS2-VASc,indicating marginally superior discriminatory capacity of the R2CHA2DS2-VASc score.Delong's test confirmed statistically significant differences between the two scoring systems(P=0.001).The R2CHA2DS2-VASc score demonstrated a NRI of 0.259(95%CI:0.166-0.352,P<0.001)and an IDI of 0.007(95%CI:0.005-0.010,P<0.001)compared with the conventional CHA2DS2-VASc score.Although the R2CHA2DS2-VASc score exhibited slightly better predictive accuracy and outcome discrimination capacity than the original scoring system,both scores demonstrated suboptimal clinical predictive performance.Conclusions:Both the R2CHA2DS2-VASc and CHA2DS2-VASc scores show suboptimal performance for predicting the risk of MACE in patients with AF and HF,and the predicting performance of R2CHA2DS2-VASc score is marginally superior to CHA2DS2-VASc score in this patient cohort.

Objectives:To investigate the prognostic value of the CHA2DS2-VASc and R2CHA2DS2-VASc scores in patients with atrial fibrillation(AF)and heart failure(HF).Methods:Patients with AF and HF from hospitals diagnosed by the Heart Failure Center in Guangdong Province between January 2017 and December 2021 were selected.Major adverse cardiovascular events(MACE)were used as the follow-up endpoint.Statistical methods such as the area under the receiver operating characteristic(ROC)curve(AUC),net reclassification index(NRI),and integrated discrimination improvement(IDI)were applied to evaluate the predictive value of the CHA2DS2-VASc and R2CHA2DS2-VASc scores in patients with AF and HF.Results:A total of 1 839 patients were enrolled in this study,comprising 703 patients in the MACE group and 1 136 patients in the non-MACE group.Compared with the non-MACE group,the MACE group exhibited significantly advanced age,higher prevalence of New York Heart Association class Ⅳ and coronary artery disease,lower diastolic blood pressure and estimated glomerular filtration rate levels,and elevated serum N-terminal pro-B-type natriuretic peptide concentrations(all P<0.05).Additionally,significantly lower proportions of patients in the MACE group received angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitors,beta-blockers,mineralocorticoid receptor antagonists,or anticoagulant therapy(all P<0.05).Multivariable logistic regression analysis revealed that each 1-point increment in both CHA2DS2-VASc and R2CHA2DS2-VASc scores was associated with approximately 10%increased risk of MACE.ROC curve analysis demonstrated that the AUC values for predicting MACE in AF patients with HF were 0.555(95%CI:0.528-0.582,P<0.001)for CHA2DS2-VASc and 0.576(95%CI:0.549-0.608,P<0.001)for R2CHA2DS2-VASc,indicating marginally superior discriminatory capacity of the R2CHA2DS2-VASc score.Delong's test confirmed statistically significant differences between the two scoring systems(P=0.001).The R2CHA2DS2-VASc score demonstrated a NRI of 0.259(95%CI:0.166-0.352,P<0.001)and an IDI of 0.007(95%CI:0.005-0.010,P<0.001)compared with the conventional CHA2DS2-VASc score.Although the R2CHA2DS2-VASc score exhibited slightly better predictive accuracy and outcome discrimination capacity than the original scoring system,both scores demonstrated suboptimal clinical predictive performance.Conclusions:Both the R2CHA2DS2-VASc and CHA2DS2-VASc scores show suboptimal performance for predicting the risk of MACE in patients with AF and HF,and the predicting performance of R2CHA2DS2-VASc score is marginally superior to CHA2DS2-VASc score in this patient cohort.

A pair of father-son Crohn′s disease (CD) patients with NOD-like receptors family pyrin domain containing 12 ( NLRP12) gene c.1382 mutation was reported. Through the relevant literature review, we summarize the other CD patients complicated with NLRP12 genetic variation at home and abroad and the mechanism of NLRP12 in inflammatory bowel disease. This study aims to provide reference for the subsequent exploration of individulized treatment.

A pair of father-son Crohn′s disease (CD) patients with NOD-like receptors family pyrin domain containing 12 ( NLRP12) gene c.1382 mutation was reported. Through the relevant literature review, we summarize the other CD patients complicated with NLRP12 genetic variation at home and abroad and the mechanism of NLRP12 in inflammatory bowel disease. This study aims to provide reference for the subsequent exploration of individulized treatment.

Objective: To analyze the CT manifestations of the 2019 novel coronavirus pneumonia (NCP) combined with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) literature review, and to summarize the characteristics of CT imaging, so as to improve the ability of rapid and accurate diagnosis. Methods: CT manifestations of two confirmed cases of NCP were reported, meanwhile the literatures on SARS and MERS imaging performance were reviewed and summarized. Results: The two cases of NCP were both in acute stage, the CT imaging showed multiple and scattered ground-glass opacity (GGO) in both lungs, which is similar to the CT performance of SARS and MERS in acute stage. Conclusions The CT features of 2019 novel coronavirus pneumonia are similar to SARS and MERS. It has certain characteristics and changes rapidly with the course of the disease. In the acute stage, GGO and paving stone sign were the main manifestations. In the acute phase, GGO and crazy paving are the main manifestations. In the progress stage, the interlobular septal thickening and consolidation appeared. During the absorption period, the lesions disappeared or fibrosis was left behind, with lung structure distortion and bronchiectasis. Lymphadenopathy and hydrothorax were rare.

Objective To investigate the expressions of epidermal growth factor receptor (EGFR),heat shock protein 90A (HSP90A) and cathepsin D in nasopharyngeal carcinoma and their relationship with tumor invasion and metastasis.Methods From January 2014 to December 2015,58 patients with nasopharyngeal carcinoma (group A) in the First Affiliated Hospital of University of South China were selected,and the positive expression rates of EGFR,HSP90A and cathepsin D in biopsy specimens of nasopharyngeal carcinoma were detected by immunohistochemistry method.The positive expression rates of EGFR,HSP90A and cathepsin D in biopsy chronic rhinitis tissues of 30 patients with chronic rhinitis (group B) were also detected.T staging,N staging and lymphatic vessel density (LVD) of patients in group A were analyzed.In group A,the T staging,N staging and LVD of between patients with positive expression of EGFR,HSP90A and eathepsin D and those with negative expression of these indicators were compared,and the correlations of the expression of EGFR,HSP90A and cathepsin D to T staging,N staging and LVD were analyzed.Results The positive expression rates of EGFR,HSP90A and cathepsin D in group A were 86.21％,82.76％ and 87.93％ respectively,which were higher than 30.00％,26.67％ and 33.33％ in group B (P＜0.05).In group A,the percentages of patients on T3-T4 and N2-N3 stages and LVD of patients with positive expression of EGFR,HSP90A and cathepsin D protein respectively were higher than those of patients with negative expression of corresponding protein (P ＜ 0.05).Spearman correlation analysis showed that the positive expression rates of EGFR,HSP90A and cathepsin D in nasopharyngeal carcinoma were positively correlated with the T staging,N staging and LVD (EGFR:r=0.844,0.795,0.785;HSP90A:r=0.862,0.825,0.822;eathepsin D:r=0.842,0.815,0.863,P＜0.05).Conclusion EGFR,HSP90A and cathepsin D expression in nasopharyngeal carcinoma are closely related to invasion and metastasis of tumor,which may be used as reference indexes for the evaluation of tumor invasion and metastasis in nasopharyngeal carcinoma.

Objective To observe the effects of simultaneous bilateral central venous intubation on chest drainage for bilateral malignant pleural effusion induced by primary non-small lung cancer and summarize the nursing measures. Methods Totally 65 patients with bilateral malignant pleural effusion were randomized into experiment group and control group. In the former group, chest drainage was done using bilateral central venous intubation and in the latter, unilateral chest drainage was used. The two groups were compared in terms of effectiveness rate, time for intubation, remission duration and hospitalization. Results The time for remission duration, hospital stay and time for intubation were all significantly shorter than those of the control group (all P<0.05). There were no significances in curative effect and adverse reactions between the two groups. Conclusion Chest drainage using simultaneous bilateral intubation for bilateral malignant pleural effusion induced by primary non-small lung cancer can be effective in shortening the time for remission, intubation and hospitalization. But it causes no more adverse reaction.

Objective To investigate the anti-inflammatory and analgesic effects of toothache drop pills. Methods The acute inflammatory models such as xylene-induced ear edema and egg white-induced paw edema and the chronic inflammatory model granuloma induced by cotton pellet implantation were used in researching the inflammatory effects of toothache drop pills. Meanwhile, the analgesic effects of toothache drop pills were observed by hot plate and acetic acid writhing test. Results Compared with the blank control group,the degree of ear swelling in mice in the positive control group, toothache drop pills middle and high dose group (2.56 ± 1.35 mg, 4.26 ± 1.21 mg, 3.23 ± 1.25 mg vs. 8.25 ± 1.21 mg) were lower than the blank control group (P<0.05). 120 minutes after administration,compared with the blank control group, the degree of paw swelling in mice in the positive control group, toothache drop pills middle and high dose group (23.54 ± 9.12 mg, 27.58 ± 9.14 mg, 21.25 ± 8.45 mg vs.39.54 ± 8.89 mg) were lower than the blank control group (P<0.05). Granuloma swelling quality in mice caused by cotton in the positive control group, toothache drop pills middle and high dose group (6.51 ± 2.58 mg, 7.82 ± 1.57 mg, 6.58 ± 3.47 mg vs. 13.58 ± 3.25 mg) were lower than the blank control group (P<0.05). The threshold of pain in mice in the positive control group, toothache drop pills middle and high dose group (20.86 ± 2.58 s, 20.25 ± 2.14 s, 20.75 ± 1.78 s vs.17.21 ± 3.31 s) were increased (P<0.05). The number of mice writhing in the positive control group, toothache drop pills middle and high dose group (23.47 ± 7.57, 28.65 ± 6.54, 24.36 ± 7.78 vs. 40.96 ± 6.58) were decreased(P<0.05). Conclusion Toothache drop pills had obvious anti-inflammatory and analgesic effects.

Objective To explore the effects of therapeutic communication skills on violent behaviors in patients with schizophrenia. Methods From January to December 2014 in one level three class A psychiatric hospital, 267 hospitalized male schizophrenic was selected as experimental group undergoing therapeutic communication skills, while another 258 hospital male schizophrenic who had homogenesis as patients in the experimental group at the same time in another ward were chosen as control group receiving routine nursing. The indexes of violent behaviors incidence and protective constraint usage rate were used to assess nursing effects. Results Violent behavior incidence was 32. 58% in the experimental group which was apparently lower than 65. 12% in the control group (χ2 =55. 59, P<0. 01);the usage rate of protective constraint was 73. 56% of the experimental group lower than 85. 71% in the control group (χ2 =5. 63, P<0. 01). Conclusions Therapeutic communication skills effectively reduce the incidence of violent behaviors in patients with schizophrenia and the usage of protective constraints. Therapeutic communication skills also can relieve the complications and tensions between doctors and patients, thus deserve the promotion in psychiatry nursing.