Background/Aims: Liver transplantation (LT) following total hepatectomy is a life-saving treatment for hepatocellular carcinoma (HCC). The HCC recurrence after LT hinders the effectiveness of the procedure. The objective of this study is to develop a pre-operative risk stratification model based on a liquid biopsy. Methods: We conducted a comprehensive multi-omics study of 260 HCC patients from three centers, including clinical data, low-coverage whole-genome sequencing of cell-free DNA (cfDNA) from plasma, as well as whole-exome, single-nucleus RNA, and spatial transcriptomics from matched tumor and non-tumor tissues. Results: We identified cfDNA-derived copy number alteration (CNA) signatures associated with post-transplant recurrence. By integrating cfDNA-derived CNA profiles with single-cell transcriptomic data, we traced recurrence-associated cfDNA to a distinct subpopulation of malignant cells within the primary tumor. These cells were embedded in a pro-metastatic microenvironment of specialized endothelial subtypes and cancer-associated fibroblasts. Notably, most recurrence-associated lesions were detectable in cfDNA prior to liver transplantation (LT). Building on these insights, we developed the ZJU Criteria based on CNA fragments and tumor markers, a pre-LT risk prediction tool that integrates conventional clinical factors with cfDNA-derived CNA signatures, and validated it using internal and independent external cohorts. Conclusion Our findings suggest that post-transplant recurrence commonly originates from advanced subclones that emerge late during tumor evolution. The ZJU Criteria provides an accurate, non-invasive strategy that significantly improves pre-LT risk stratification and clinical decision-making for patients with HCC.

Objective To investigate the histological and cellular bases for the improvement of portal hypertension(PH)by observing liver histopathological changes after treatment in patients with cirrhotic portal hypertension,and to provide a basis for clinical drug development.Methods A total of 322 patients with hepatitis B cirrhosis who completed 48 weeks of antiviral therapy or combined anti-fibrotic treatment in 20 hospitals across 12 provinces in China from September 2014 to October 2018 were enrolled,and the noninvasive diagnostic criteria for clinically significant portal hypertension(CSPH)from Baveno Ⅶ were used to assess the severity of PH;43 patients with a confirmed diagnosis of CSPH were identified based on liver stiffness measurement(LSM)≥25 kPa before treatment,and according to whether the severity of PH was reduced by≥2 grades after treatment,the patients were divided into PH improvement(n=19)group and PH non-improvement group(n=24).Related data were collected,including demographic data,laboratory tests.Liver fibrosis were assessed,including HE staining and reticular fiber staining;liver microvascular lesions were assessed,including obliterative portal venopathy(OPV),nodular regenerative hyperplasia(NRH),and incomplete septal fibrosis(ISF).Single immunohistochemical staining was performed for von Willebrand factor(vWF),and fibronectin;multiplex immunohistochemical staining was performed for fibrinogen,CD32b,CD31,alpha-smooth muscle actin(α-SMA).The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups.Results After 48 weeks of treatment,43 patients had significant improvements in red blood cell count,alanine aminotransferase,aspartate aminotransferase,aspartate aminotransferase-to-platelet ratio index score,liver fibrosis grade,and PH grade(all P<0.05),among whom 19 patients showed a reduction in PH severity by≥2 grades(PH improvement group),while the remaining patients were enrolled as the PH non-improvement group.There was no significant difference in the outcome of liver fibrosis between the two groups(χ2=3.380,P=0.066).Microvascular lesion assessment showed that compared with the PH non-improvement group,the PH improvement group had significantly lower OPV severity,microvascular density(the expression level of vWF),and expression of fibronectin(all P<0.05),while there were no significant differences in NRH severity,ISF severity,and the expression level of fibrinogen between the two groups(all P>0.05).Cytological evaluation showed no significant differences in the expression levels of CD32b,CD31,and α-SMA between the two groups before and after treatment(all P>0.05),and comparison of the expression levels before and after treatment showed that the PH improvement group had a significant increase in the expression level of CD32b(t=-2.007,P=0.045)and a significant reduction in the expression level of α-SMA(t=2.628,P=0.013).Conclusion The pathological features of PH improvement are associated with liver fibrosis regression and the improvement in liver microvascular lesions,and at the cellular level,PH improvement is associated with the dedifferentiation of liver sinusoidal endothelial cells and the activated phenotype of hepatic stellate cells.

Objective To analyze the distribution characteristics of comorbid diseases in patients with atrial fibrillation(AF)and the current status of their medical intervention.Methods A retrospective cohort study was conducted using clinical data from AF patients at the AF center of Hainan Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine between October 2020 and September 2022.The data included information on hospitalizations,diagnoses and treatments,health assessments,physical examinations,tests,laboratory results,and medication treatments.Descriptive research methods were used to analyze the clinical distribution characteristics,comorbid diseases,and stroke intervention status.A Logistic regression model was employed to analyze the impact of comorbid diseases on the type of AF.Receiver operator characteristic curve(ROC curve)analysis was performed to evaluate the predictive value of comorbid diseases in AF for the development of persistent AF.Results Among the 667 AF patients,89.21%(595 cases)had comorbidities,with a total of 64 different comorbidity combinations observed.These combinations consisted of AF coexisting with 1-5 diseases,72.44%had 1-2 comorbidities.The top 5 most frequent comorbidity patterns,in descending order,were hypertension,hypertension and chronic heart failure,hypertension and coronary heart disease and chronic heart failure,hypertension and coronary heart disease,hypertension and diabetes.These 5 patterns accounted for 49.41%(294/595)of the total cases.All 8 diseases were associated with high abnormality rates in four key indicators:the CHA2DS2-VASc score,brain natriuretic peptide/N-terminal pro-brain natriuretic peptide(BNP/NT-proBNP),creatinine clearance rate(CCr),and left atrial diameter.The highest medication rates were observed for anticoagulants in valvular heart disease(84.62%),for antiarrhythmics in thyroid disease(70.97%),and for blood pressure control agents across all other diseases.For the 4 disease comorbidity combinations,the monitoring rates were highest for hypertension(100.00%)and lowest for diabetes mellitus(83.12%).The treatment rates were as follows:hypertension(highest 63.16%,lowest 60.91%),coronary heart disease(CHD,highest 73.96%,lowest 44.44%),diabetes mellitus(highest 75.29%,lowest 64.94%),chronic heart failure(highest 67.63%,lowest 62.50%).For stroke intervention in the 4 disease comorbidity combinations,the proportion of high-stroke-risk population was highest in patients with diabetes(98.46%)and lowest in those with chronic heart failure(92.18%).The anticoagulation therapy rate was highest in the chronic heart failure(56.25%)and lowest in the diabetes(46.88%).The proportion of patients with high bleeding risk was highest in the diabetes group(44.53%)and lowest in the chronic heart failure group(32.59%).Multivariate binary Logistic regression analysis revealed that AF comorbid with coronary heart disease[odds ratio(OR)=1.499,95%confidence interval(95%CI)was 1.016-2.214,P=0.042],valvular heart disease(OR=3.362,95%CI was 1.473-7.674,P=0.004),and chronic heart failure(OR=1.903,95%CI was 1.309-2.767,P=0.001)were all independent risk factors for the development of persistent AF.ROC curve analysis showed that coronary heart disease,valvular heart disease,and chronic heart failure all had certain predictive value for persistent AF,with areas under the curve(AUC)of 0.538,0.536,and 0.572,respectively.Combined assessment demonstrated an AUC of 0.654(95%CI was 0.610-0.698,P<0.001),sensitivity 54.50%,and specificity 69.20%.Conclusions The distribution of high-frequency comorbidity combinations in AF patients is highly clustered and warrants focused attention.In this center,patients with comorbidities exhibited high abnormality rates in comorbid disease detection and elevated stroke risk scores,yet targeted interventions remain insufficient and require optimization.AF combined with coronary artery disease,valvular heart disease,and chronic heart failure were identified as independent risk factors for persistent AF.

Objective To investigate the histological and cellular bases for the improvement of portal hypertension(PH)by observing liver histopathological changes after treatment in patients with cirrhotic portal hypertension,and to provide a basis for clinical drug development.Methods A total of 322 patients with hepatitis B cirrhosis who completed 48 weeks of antiviral therapy or combined anti-fibrotic treatment in 20 hospitals across 12 provinces in China from September 2014 to October 2018 were enrolled,and the noninvasive diagnostic criteria for clinically significant portal hypertension(CSPH)from Baveno Ⅶ were used to assess the severity of PH;43 patients with a confirmed diagnosis of CSPH were identified based on liver stiffness measurement(LSM)≥25 kPa before treatment,and according to whether the severity of PH was reduced by≥2 grades after treatment,the patients were divided into PH improvement(n=19)group and PH non-improvement group(n=24).Related data were collected,including demographic data,laboratory tests.Liver fibrosis were assessed,including HE staining and reticular fiber staining;liver microvascular lesions were assessed,including obliterative portal venopathy(OPV),nodular regenerative hyperplasia(NRH),and incomplete septal fibrosis(ISF).Single immunohistochemical staining was performed for von Willebrand factor(vWF),and fibronectin;multiplex immunohistochemical staining was performed for fibrinogen,CD32b,CD31,alpha-smooth muscle actin(α-SMA).The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups.Results After 48 weeks of treatment,43 patients had significant improvements in red blood cell count,alanine aminotransferase,aspartate aminotransferase,aspartate aminotransferase-to-platelet ratio index score,liver fibrosis grade,and PH grade(all P<0.05),among whom 19 patients showed a reduction in PH severity by≥2 grades(PH improvement group),while the remaining patients were enrolled as the PH non-improvement group.There was no significant difference in the outcome of liver fibrosis between the two groups(χ2=3.380,P=0.066).Microvascular lesion assessment showed that compared with the PH non-improvement group,the PH improvement group had significantly lower OPV severity,microvascular density(the expression level of vWF),and expression of fibronectin(all P<0.05),while there were no significant differences in NRH severity,ISF severity,and the expression level of fibrinogen between the two groups(all P>0.05).Cytological evaluation showed no significant differences in the expression levels of CD32b,CD31,and α-SMA between the two groups before and after treatment(all P>0.05),and comparison of the expression levels before and after treatment showed that the PH improvement group had a significant increase in the expression level of CD32b(t=-2.007,P=0.045)and a significant reduction in the expression level of α-SMA(t=2.628,P=0.013).Conclusion The pathological features of PH improvement are associated with liver fibrosis regression and the improvement in liver microvascular lesions,and at the cellular level,PH improvement is associated with the dedifferentiation of liver sinusoidal endothelial cells and the activated phenotype of hepatic stellate cells.

Objective To analyze the distribution characteristics of comorbid diseases in patients with atrial fibrillation(AF)and the current status of their medical intervention.Methods A retrospective cohort study was conducted using clinical data from AF patients at the AF center of Hainan Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine between October 2020 and September 2022.The data included information on hospitalizations,diagnoses and treatments,health assessments,physical examinations,tests,laboratory results,and medication treatments.Descriptive research methods were used to analyze the clinical distribution characteristics,comorbid diseases,and stroke intervention status.A Logistic regression model was employed to analyze the impact of comorbid diseases on the type of AF.Receiver operator characteristic curve(ROC curve)analysis was performed to evaluate the predictive value of comorbid diseases in AF for the development of persistent AF.Results Among the 667 AF patients,89.21%(595 cases)had comorbidities,with a total of 64 different comorbidity combinations observed.These combinations consisted of AF coexisting with 1-5 diseases,72.44%had 1-2 comorbidities.The top 5 most frequent comorbidity patterns,in descending order,were hypertension,hypertension and chronic heart failure,hypertension and coronary heart disease and chronic heart failure,hypertension and coronary heart disease,hypertension and diabetes.These 5 patterns accounted for 49.41%(294/595)of the total cases.All 8 diseases were associated with high abnormality rates in four key indicators:the CHA2DS2-VASc score,brain natriuretic peptide/N-terminal pro-brain natriuretic peptide(BNP/NT-proBNP),creatinine clearance rate(CCr),and left atrial diameter.The highest medication rates were observed for anticoagulants in valvular heart disease(84.62%),for antiarrhythmics in thyroid disease(70.97%),and for blood pressure control agents across all other diseases.For the 4 disease comorbidity combinations,the monitoring rates were highest for hypertension(100.00%)and lowest for diabetes mellitus(83.12%).The treatment rates were as follows:hypertension(highest 63.16%,lowest 60.91%),coronary heart disease(CHD,highest 73.96%,lowest 44.44%),diabetes mellitus(highest 75.29%,lowest 64.94%),chronic heart failure(highest 67.63%,lowest 62.50%).For stroke intervention in the 4 disease comorbidity combinations,the proportion of high-stroke-risk population was highest in patients with diabetes(98.46%)and lowest in those with chronic heart failure(92.18%).The anticoagulation therapy rate was highest in the chronic heart failure(56.25%)and lowest in the diabetes(46.88%).The proportion of patients with high bleeding risk was highest in the diabetes group(44.53%)and lowest in the chronic heart failure group(32.59%).Multivariate binary Logistic regression analysis revealed that AF comorbid with coronary heart disease[odds ratio(OR)=1.499,95%confidence interval(95%CI)was 1.016-2.214,P=0.042],valvular heart disease(OR=3.362,95%CI was 1.473-7.674,P=0.004),and chronic heart failure(OR=1.903,95%CI was 1.309-2.767,P=0.001)were all independent risk factors for the development of persistent AF.ROC curve analysis showed that coronary heart disease,valvular heart disease,and chronic heart failure all had certain predictive value for persistent AF,with areas under the curve(AUC)of 0.538,0.536,and 0.572,respectively.Combined assessment demonstrated an AUC of 0.654(95%CI was 0.610-0.698,P<0.001),sensitivity 54.50%,and specificity 69.20%.Conclusions The distribution of high-frequency comorbidity combinations in AF patients is highly clustered and warrants focused attention.In this center,patients with comorbidities exhibited high abnormality rates in comorbid disease detection and elevated stroke risk scores,yet targeted interventions remain insufficient and require optimization.AF combined with coronary artery disease,valvular heart disease,and chronic heart failure were identified as independent risk factors for persistent AF.

Objective To discuss the perioperative blood transfusion strategy of patients with hereditary coagulation fac-tor deficiency through the perioperative blood coagulation management of a patient with coagulation factor Ⅺ deficiency and hemangioma of knee joint.Methods Coagulation factor activity test and gene test were used to confirm the patients with co-agulation factor Ⅺ antecedent deficiency.Perioperative bleeding risk assessment,thromboela-stogram(TEG)and coagula-tion factors detection were performed to detect the coagulation status of the patients.400 mL fresh frozen plasma was trans-fused before surgery and first day after surgery,200 mL daily for 3 days thereafter.Results The level of APTT was con-trolled from 97.1 s before operation to 36.9 s after operation.There was no obvious bleeding during operation,and the wound healed well after operation.Conclusion In the situation of lack of commercial coagulation factors,transfusion of blood products such as fresh frozen plasma can significantly improve the coagulation function and reduce the risk of intraoperative bleeding in patients with hereditary coagulation factor deficiency during perioperative period.

Objective To understand the distribution characteristics and stroke risk of hospitalized patients in single center atrial fibrillation in traditional Chinese medicine hospitals for guidance in prevention and treatment of atrial fibrillation.Methods A total of 667 clinical diagnosis and treatment data from Guangdong Provincial Hospital of Chinese Medicine,Hainan Hospital from October 2020 to September 2022 in the data filling platform of China Atrial Fibrillation Center through retrospective investigation was collected[including hospitalization information,diagnosis and treatment,demographic information symptoms,European Heart Rhythm Association(EHRA),health assessment].Descriptive epidemiological methods were employed to analyze the distribution characteristics of different populations,and a Logistic regression model was used with CHA2DS2-VASc score as the dependent variable to analyze the risk factors of stroke in men and women with non-valvular atrial fibrillation respectively.Results Among patients with atrial fibrillation,valvular atrial fibrillation accounted for 5.85%(39/667),while non-valvular atrial fibrillation accounted for 94.15%(628/667).Persistent atrial fibrillation was the main type at 65.52%(437/667),with a higher proportion of patients in males than that in females(1.22∶1).The average age of patients was 75.14±11.23 years,mainly aged 71-80 years and 81-90 years,accounting for 33.28%(222/667)and 28.78%(192/667)respectively.Clinical symptoms mainly include palpitations(51.27%)and chest discomfort(45.43%),79.01%(527/667)of patients had EHRA symptom rating below gradeⅡ,while 20.99%(140/667)had ratings above gradeⅢ.The highest incidence of comorbidities of atrial fibrillation was hypertension at 64.62%(431/667),followed by chronic heart failure at 36.43%(243/667).The proportion of high-risk stroke population in the CHA2DS2-VASc score was significantly higher than that of the medium to low-risk stroke population[89.17%(560/628)vs.10.83%(68/628)].In contrast,the proportion of people with low risk of bleeding in the HAS-BLED score was significantly higher than that of people with high risk of bleeding[69.27%(462/667)vs.30.73%(205/667)].A univariate analysis was conducted on 628 patients with non-valvular atrial fibrillation by gender.The results showed that among 279 female patients with CHA2DH2-VASc score≥3 as the dependent variable,univariate analysis showed that there were significant differences in age,hypertension,coronary heart disease,cardiomyopathy,chronic heart failure,cerebrovascular disease,and thyroid disease between the two groups(all P<0.05).A total of 349 male patients with CHA2DH2-VASc score≥2 as the dependent variable,statistically significant differences were showed in age,education level,EHRA and whether had hypertension,coronary heart disease,chronic heart failure,cerebrovascular disease,and thyroid disease(all P<0.05)by univariate analysis.Multivariate Logistic regression analysis showed that the high-risk factors for stroke were age,systolic blood pressure,thyroid disease and cerebrovascular disease in women[female>75 years old:odds ratio(OR)=42.270,95%confidence interval(95%CI)was 9.130-195.800;systolic blood pressure>160 mmHg(1 mmHg≈0.133 kPa):OR=3.530,95%CI was 1.420-8.760,and thyroid disease:OR=0.140,95%CI was 0.040-0.460,cerebrovascular disease:OR=9.400,95%CI was 2.130-41.440;all P<0.05].While age,education level,systolic blood pressure,chronic heart failure,cerebrovascular disease,and thyroid disease in men were high-risk factors(male>75 years old:OR=81.270,95%CI was 27.730-238.210;education level:OR=0.250,95%CI was 0.120-0.530;systolic blood pressure>160 mmHg:OR=14.110,95%CI was 7.250-27.460;patients with chronic heart failure:OR=23.780,95%CI was 7.850-71.970;thyroid disease:OR=0.240,95%CI was 0.110-0.540;patients with cerebrovascular disease:OR=0.580,95%CI was 0.360-0.940;all P<0.05).Conclusions The proportion of male hospitalized patients with atrial fibrillation at Guangdong Provincial Hospital of Chinese Medicine,Hainan Hospital is greater than that of females.The majority of these patients are elderly,with an average age higher than recently reported.They face a more prominent of stroke,especially those with high blood pressure,chronic heart failure,cerebrovascular disease,and thyroid disease.It is crucial to strengthen targeted prevention and treatment efforts in this population.

Objective:To measure the overall and lobulated volume of the liver with different degrees of liver fibrosis and to further observe pathological changes such as liver microvasculature, hepatocyte apoptosis, and regeneration in order to understand the macroscopic volume changes of the liver during liver fibrosis and its relationship with liver tissue microscopic pathology in patients with chronic liver disease.Methods:53 patients with chronic hepatitis B, alcoholic fatty liver disease, autoimmune liver disease, nonalcoholic fatty liver disease, and drug-induced chronic liver disease who underwent both liver biopsy tissue and abdominal magnetic resonance imaging were collected. Patients were divided into early (F1-2), middle (F3-4), and late (F5-6) in accordance with the Ishak fibrosis stage and Masson stain. The liver and spleen volumes were measured using ITK-SNAP software. CD31 immunohistochemical staining was used to reflect intrahepatic angiogenesis. Ki67 and HNF-4α multiplex immunohistochemical staining were used to reflect hepatocyte regeneration. GS staining was used to determine parenchymal extinction lesions. TUNEL staining was used to observe hepatocyte apoptosis. Spearman correlation analysis was used to analyze the relationship between liver volume changes and liver histopathological changes.Results:As liver fibrosis progressed, the total liver volume and right lobe liver volume gradually decreased ( P<0.05), while the spleen volume gradually increased ( P<0.05). The expression of CD31 and GS gradually increased ( P<0.05), and the expression of Ki67 first increased and then decreased ( P<0.05). The positivity rate of CD31 was negatively correlated with the right lobe liver volume ( r=-0.609, P<0.001) and the total liver volume ( r=-0.363, P=0.017). The positivity rate of Ki67 was positively correlated with the right lobe liver volume ( r=0.423, P=0.018), while the positivity rate of apoptotic cells was significantly negatively correlated with the total liver volume ( r=-0.860, P<0.001). The positivity rate of GS was negatively correlated with the right lobe liver volume ( r=-0.440, P=0.002), and the number of PELs was negatively correlated with RV ( r=-0.476, P=0.013). The CD31 positive staining area was negatively correlated with the Ki67 positive staining area( r=-0.511, P=0.009). Conclusion:As liver fibrosis progresses, patients with chronic liver disease have a depletion in total liver volume and right lobe liver volume, and this is mainly in correlation with fewer liver cells and liver tissue microvasculature disorders.

Objective To analyze the population distribution pattern of inpatients in the China Atrial Fibrillation Center of Hainan Traditional Chinese Medicine Hospital to guide clinical diagnosis and treatment.Methods Clinical diagnosis and treatment(including hospitalization information,diagnosis and treatment,symptoms,health assessment,physical examination,examination,testing,therapeutic drugs),European Heart Rhythm Association(EHRA)symptom score,CHA2DS2-VASc score for predicting stroke risk stratification in atrial fibrillation,HAS-BLED score for predicting bleeding risk in anticoagulated were collected from Hainan Traditional Chinese Medicine Hospital from October 2020 to September 2022 in the data filling platform of China Atrial Fibrillation Center through retrospective investigation.The normal reference values of various examination indicators set for analysis are heart rate 60-100 beats/min,QTc interval <480 ms for males and<470 ms for females,ejection fraction(EF)0.50-0.75 for B-ultrasound,left atrial anteroposterior diameter <35 mm,left ventricular end-diastolic diameter(LVEDD)<55 mm for males and <50 mm for females,no left atrial thrombosis,International normalized ratio(INR)0.85-1.20,brain natriuretic peptide(BNP)0-100 ng/L,N-terminal pro-brain natriuretic peptide(NT-proBNP)0-125 ng/L in cardiology,0-250 ng/L in non cardiology.Results Among 667 patients,there were 39 cases of valvular atrial fibrillation and 628 cases of non valvular atrial fibrillation.The completion rate of various diagnostic(physical examination/examination/testing)indicators was 19.94％-100.00％.Statistically significant differences were showed in every EHRA symptom score,HAS-BLED score,BMI,hypertension,heart rate,EF,left atrial diameter,LVEDD,left atrial thrombus,INR(Warfarin user),BNP,NT-proBNP and atrial fibrillation treatment methods(all P<0.01).No statistically significant difference was shown in CHA2DS2-VASc scores for each gender,QTc and NT-proBNP(all P>0.05).409 patients were treated with antiarrhythmic drugs,with a treatment rate of 61.32％.Statistically significant difference was showed in the proportion of medication use among different populations with heart rates of<60,60-100,and ≥100 beats/min,respectively[46.51％(20/43)vs.54.60％(196/359),72.83％(193/265),P<0.01],and the highest drug usage rate was β receptor blockers.Statistically significant difference was shown in the use rate of different antiarrhythmic drugs(P<0.01).There were 342 patients treated with anticoagulant therapy,with a treatment rate of 51.27％,the treatment rate of valvular atrial fibrillation was significantly higher than that of non-valvular atrial fibrillation[84.62％(33/39)vs.49.20％(309/628)],with a statistically significant difference(P<0.01).No statistically significant difference was shown in treatment rates between individuals with CHA2DS2-VASc scores of ≥2 for males and ≥3 for females of non-valvular atrial fibrillation,and between individuals with CHA2DS2-VASc scores of <2 for males and <3 for females,as well as between individuals with HAS-BLED scores of ≤2 and ≥3 for treatment rates(all P>0.05).Statistically significant differences were shown in the usage rates of different anticoagulants,antiplatelet aggregation drugs,blood lipid control(statins)drugs,and blood pressure control drugs(all P<0.01).The types of medication used for blood pressure control are angiotensin converting enzyme inhibitor(ACEI),angiotensin Ⅱ receptor blocker(ARB),calcium channel blocker(CCB),β receptor blockers and diuretics.The single drug composition ratio of the medication plan was the highest(39.75％),and the diuretics composition ratio of drug use was the highest(48.00％),with statistically significant differences(all P<0.01).Conclusions The operation of the Atrial Fibrillation Center of Hainan Traditional Chinese Medicine Hospital has covered all clinical diagnosis and treatment projects,and the treatment plan is consistent with the guidelines.At present,the control of blood pressure,BMI,and heart rate of hospitalized patients needs to be further strengthened,especially the proportion of high-risk people with stroke,and there is insufficient anticoagulation treatment.The training of the guidelines should be improved to promote standardized treatment.

Objective To explore the effects of nicorandil on cardiac function and clinical outcomes in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Method Sixty-six patients with AMI were randomized into a control group and nicorandil group (n = 33 for each group). In the nicorandil group, nicorandil (4 mg as a bolus injection followed by constant infusion at 8 mg/hour for 24 hours) was administered immediately after admission. Reactive oxygen species (ROS) formation was assessed by measuring urinary excretion of 8-epi-prostaglandin F2α (PGF2α) and compared between the two groups; cardiac function and cardiac events were also compared. Results Urinary 8-epi-PGF2αexcretion was increased 2-fold at 60 to 90 minutes after PCI in the control group, whereas it was unchanged in the nicorandil group (P < 0.001). Left ventricular ejection fraction and cardiac index immediately after PCI and at 6 months were greater in the nicorandil group than in the control group(P < 0.05). Rates of total inhospital cardiac events and rehospitalization were lower in the nicorandil group than in the control group (P<0.05). Conclusions Nicorandil improves cardiac function and clinical outcomes in patients with AMI undergoing primary percutaneous coronary intervention. Suppression of ROS formation may be involved in the potential mechanism.