Objective To investigate the effect of non humidification,200 ml and 100 ml distilled water humidification on oxygen output flow of Venturi mask,and to provide basis and reference for clinical application of Venturi mask oxygen therapy.Methods In August 2024,the output end of an oxygen flow meter installed with a water humidification device was connected with a Venturi mask and an external flow sensor of a ventilator in turn.The oxygen output flow of the Venturi mask was measured under the conditions of no humidification,200 ml distilled water humidification and 100 ml distilled water humidification,respectively,at oxygen concentration set of 24％,26％,28％,31％,35％,40％and 50％.The measured output flow data of the 3 groups were statistically analyzed.Results The oxygen output flow of the Venturi mask ranged from 7.6 to 45.6 L/min,and the input flow was 3 L/min or 6 L/min.The higher the oxygen concentration,the lower the oxygen output flow of the Venturi mask.Under the same oxygen concentration,the average output flow of 200 ml distilled water humidification group was lower than that of 100 ml distilled water humidification group and non humidification group(P＜0.05).When the oxygen concentration was set at 24％,26％,31％and 35％,the oxygen output flow of non humidification group was higher than that of 100 ml distilled water humidification group(P＜0.05).At 40％and 50％oxygen concentration,the oxygen output flow of 100 ml distilled water humidification group was higher than that of non humidification group(P＜0.05).Conclusion The overall output flow of the Venturi mask is low,and the input flow is the same.The higher the oxygen concentration,the lower the output flow.The humidification of 200ml distilled water may lead to insufficient oxygen flow in patients,while the humidification of 100ml distilled water has little effect on the output flow of Venturi mask.

Objectives:To explore the relationship between epicardial adipose tissue(EAT),left atrium and left atrial appendage(LAA)structures and LAA thrombosis in patients with non-valvular atrial fibrillation.Methods:Clinical data from non-valvular atrial fibrillation patients who underwent cardiac computed tomography angiography(CTA)and transesophageal echocardiography(TEE)at the Second Hospital of Hebei Medical University between November 2019 and October 2024,were retrospectively collected.Twenty-eight patients diagnosed with LAA thrombus by both CTA and TEE were enrolled as the LAA thrombus group(20 males,8 females,average age[65±9]years).Using an individual matching method,56 non-valvular atrial fibrillation patients without LAA thrombus,matched for gender and age(±3 years),were sequentially enrolled at a ratio of 1:2 as the no-thrombus group(40 males,16 females,average age[65±8]years).CTA was used to measure the epicardial adipose tissue volume(EATV),left atrial epicardial adipose tissue volume(LA-EATV),and structural parameters of the left atrium and LAA in both groups.The correlation between EAT,structural parameters of the left atrium/LAA and LAA thrombosis was evaluated.Results:In the LAA thrombus group,the proportions of patients with persistent atrial fibrillation and atrial fibrillation rhythm were significantly higher than in the no-thrombus group(both P<0.001).There were no statistically significant differences between the two groups in terms of age,gender composition,body mass index,duration of atrial fibrillation,and the proportions of patients with hypertension,diabetes,dyslipidemia,coronary heart disease,ischemic stroke,heart failure,vascular disease,and CHA2DS2-VASc scores(all P>0.05).Compared to the no-thrombus group,the EATV,LA-EATV,left atrial volume(LAV),LAA volume(LAAV),and LAA orifice area were significantly higher in the LAA thrombus group(all P<0.05).There was no significant difference between the two groups in the LAA depth(P=0.076).Conditional logistic regression analysis showed that LA-EATV(OR=1.092,95%CI:1.004-1.187,P=0.040)and LAV(OR=1.022,95%CI:1.003-1.041,P=0.025)were independent predictors of LAA thrombosis in non-valvular atrial fibrillation patients.The LA-EATV threshold for predicting LAA thrombosis was 27.16 cm3,with an area under the receiver operating characteristic curve(AUC)of 0.843(sensitivity 85.7%,specificity 76.8%);the LAV predictive threshold was 118.45 ml(AUC=0.853,sensitivity 82.1%,specificity 80.4%).Conclusions:LA-EATV and LAV measured by cardiac CTA are independent predictors of LAA thrombosis in patients with non-valvular atrial fibrillation.

Purpose To explore the predictive value of fetal cardiothoracic ratio(CTR)and their Z-scores for homozygous α-thalassemia major in early pregnancy.Materials and Methods Retrospective analysis was conducted on fetuses at high risk of α-thalassemia major(at 11-13?? weeks of gestation)who received prenatal care at the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from June 2016 to December 2023.Ultrasound examinations were performed on these fetuses to measure the CTRs[including cardiothoracic diameter ratio(CTDR),cardiothoracic circumference ratio(CTCR)and cardiothoracic area ratio(CTAR)],which were simultaneously converted into Z-scores.The receiver operating characteristic curve was used to evaluate the predictive efficacy of each group of CTRs and their corresponding Z-scores for fetal α-thalassemia major.Results ①A total of 363 high-risk fetuses were included,including 91(25.1%)in the affected group and 272(74.9%)in the control group.②All the CTRs(including CTDR,CTCR and CTAR)and their corresponding Z-scores in the affected group were significantly higher than those in the control group(t=3.705-21.320,all P<0.001).③The area under the curve(AUC)analysis showed that the AUCs of cardiothoracic ratio Z-scores were higher than those of the corresponding cardiothoracic ratios.The AUCs were ranked from largest to smallest as CTDR Z-score,CTDR,CTAR Z-score,CTCR Z-score,CTAR,CTCR,and the CTDR Z-score had the highest predictive efficacy(when the optimal cut-off value was 1.10,AUC=0.959,with a sensitivity of 94.5%and a specificity of 90.4%).Conclusion The predictive efficacy of fetal CTR Z-scores is higher than that of the corresponding CTRs,which are new indicators for effectively predicting homozygous α-thalassemia major in early pregnancy.Among them,the CTDR Z-score has the highest predictive efficacy,which can improve the prenatal diagnosis rate of this disease and reduce some unnecessary invasive procedures.

Objective:To explore the relationship between suicide attempts,school bullying,and psychological resilience in children and adolescents with major depressive disorder(MDD)and school bullying and psychological resilience.Methods:A total of 784 patients with MDD aged 10 to 18 years were included.The Chinese version of the Olweus Bullying Victimization Questionnaire,Adolescent Psychological Resilience Scale,and a suicide attempt assessment were utilized to evaluate school bullying,psychological resilience,and suicide attempt.Stepwise logistic regression was applied to identify the associated factors of suicide attempts.Results:The occurrence of suicide at-tempts in children and adolescents with MDD was positively associated with physical bullying(OR=1.85,95％CI:1.14-3.02)and indirect bullying(OR=1.48,95％CI:1.06-2.04),and negatively associated with higher levels of goal focus(OR=0.62,95％CI:0.45-0.85)and positive cognition(OR=0.62,95％CI:0.45-0.85)at higher levels.Conclusion:Bullying significantly increases the risk of suicide attempts in children and adolescents with MDD,while higher psychological resilience could mitigate this risk.

Objective To investigate the effect of non humidification,200 ml and 100 ml distilled water humidification on oxygen output flow of Venturi mask,and to provide basis and reference for clinical application of Venturi mask oxygen therapy.Methods In August 2024,the output end of an oxygen flow meter installed with a water humidification device was connected with a Venturi mask and an external flow sensor of a ventilator in turn.The oxygen output flow of the Venturi mask was measured under the conditions of no humidification,200 ml distilled water humidification and 100 ml distilled water humidification,respectively,at oxygen concentration set of 24％,26％,28％,31％,35％,40％and 50％.The measured output flow data of the 3 groups were statistically analyzed.Results The oxygen output flow of the Venturi mask ranged from 7.6 to 45.6 L/min,and the input flow was 3 L/min or 6 L/min.The higher the oxygen concentration,the lower the oxygen output flow of the Venturi mask.Under the same oxygen concentration,the average output flow of 200 ml distilled water humidification group was lower than that of 100 ml distilled water humidification group and non humidification group(P＜0.05).When the oxygen concentration was set at 24％,26％,31％and 35％,the oxygen output flow of non humidification group was higher than that of 100 ml distilled water humidification group(P＜0.05).At 40％and 50％oxygen concentration,the oxygen output flow of 100 ml distilled water humidification group was higher than that of non humidification group(P＜0.05).Conclusion The overall output flow of the Venturi mask is low,and the input flow is the same.The higher the oxygen concentration,the lower the output flow.The humidification of 200ml distilled water may lead to insufficient oxygen flow in patients,while the humidification of 100ml distilled water has little effect on the output flow of Venturi mask.

Objective:To explore the relationship between suicide attempts,school bullying,and psychological resilience in children and adolescents with major depressive disorder(MDD)and school bullying and psychological resilience.Methods:A total of 784 patients with MDD aged 10 to 18 years were included.The Chinese version of the Olweus Bullying Victimization Questionnaire,Adolescent Psychological Resilience Scale,and a suicide attempt assessment were utilized to evaluate school bullying,psychological resilience,and suicide attempt.Stepwise logistic regression was applied to identify the associated factors of suicide attempts.Results:The occurrence of suicide at-tempts in children and adolescents with MDD was positively associated with physical bullying(OR=1.85,95％CI:1.14-3.02)and indirect bullying(OR=1.48,95％CI:1.06-2.04),and negatively associated with higher levels of goal focus(OR=0.62,95％CI:0.45-0.85)and positive cognition(OR=0.62,95％CI:0.45-0.85)at higher levels.Conclusion:Bullying significantly increases the risk of suicide attempts in children and adolescents with MDD,while higher psychological resilience could mitigate this risk.

Objectives:To explore the relationship between epicardial adipose tissue(EAT),left atrium and left atrial appendage(LAA)structures and LAA thrombosis in patients with non-valvular atrial fibrillation.Methods:Clinical data from non-valvular atrial fibrillation patients who underwent cardiac computed tomography angiography(CTA)and transesophageal echocardiography(TEE)at the Second Hospital of Hebei Medical University between November 2019 and October 2024,were retrospectively collected.Twenty-eight patients diagnosed with LAA thrombus by both CTA and TEE were enrolled as the LAA thrombus group(20 males,8 females,average age[65±9]years).Using an individual matching method,56 non-valvular atrial fibrillation patients without LAA thrombus,matched for gender and age(±3 years),were sequentially enrolled at a ratio of 1:2 as the no-thrombus group(40 males,16 females,average age[65±8]years).CTA was used to measure the epicardial adipose tissue volume(EATV),left atrial epicardial adipose tissue volume(LA-EATV),and structural parameters of the left atrium and LAA in both groups.The correlation between EAT,structural parameters of the left atrium/LAA and LAA thrombosis was evaluated.Results:In the LAA thrombus group,the proportions of patients with persistent atrial fibrillation and atrial fibrillation rhythm were significantly higher than in the no-thrombus group(both P<0.001).There were no statistically significant differences between the two groups in terms of age,gender composition,body mass index,duration of atrial fibrillation,and the proportions of patients with hypertension,diabetes,dyslipidemia,coronary heart disease,ischemic stroke,heart failure,vascular disease,and CHA2DS2-VASc scores(all P>0.05).Compared to the no-thrombus group,the EATV,LA-EATV,left atrial volume(LAV),LAA volume(LAAV),and LAA orifice area were significantly higher in the LAA thrombus group(all P<0.05).There was no significant difference between the two groups in the LAA depth(P=0.076).Conditional logistic regression analysis showed that LA-EATV(OR=1.092,95%CI:1.004-1.187,P=0.040)and LAV(OR=1.022,95%CI:1.003-1.041,P=0.025)were independent predictors of LAA thrombosis in non-valvular atrial fibrillation patients.The LA-EATV threshold for predicting LAA thrombosis was 27.16 cm3,with an area under the receiver operating characteristic curve(AUC)of 0.843(sensitivity 85.7%,specificity 76.8%);the LAV predictive threshold was 118.45 ml(AUC=0.853,sensitivity 82.1%,specificity 80.4%).Conclusions:LA-EATV and LAV measured by cardiac CTA are independent predictors of LAA thrombosis in patients with non-valvular atrial fibrillation.

Purpose To explore the predictive value of fetal cardiothoracic ratio(CTR)and their Z-scores for homozygous α-thalassemia major in early pregnancy.Materials and Methods Retrospective analysis was conducted on fetuses at high risk of α-thalassemia major(at 11-13?? weeks of gestation)who received prenatal care at the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from June 2016 to December 2023.Ultrasound examinations were performed on these fetuses to measure the CTRs[including cardiothoracic diameter ratio(CTDR),cardiothoracic circumference ratio(CTCR)and cardiothoracic area ratio(CTAR)],which were simultaneously converted into Z-scores.The receiver operating characteristic curve was used to evaluate the predictive efficacy of each group of CTRs and their corresponding Z-scores for fetal α-thalassemia major.Results ①A total of 363 high-risk fetuses were included,including 91(25.1%)in the affected group and 272(74.9%)in the control group.②All the CTRs(including CTDR,CTCR and CTAR)and their corresponding Z-scores in the affected group were significantly higher than those in the control group(t=3.705-21.320,all P<0.001).③The area under the curve(AUC)analysis showed that the AUCs of cardiothoracic ratio Z-scores were higher than those of the corresponding cardiothoracic ratios.The AUCs were ranked from largest to smallest as CTDR Z-score,CTDR,CTAR Z-score,CTCR Z-score,CTAR,CTCR,and the CTDR Z-score had the highest predictive efficacy(when the optimal cut-off value was 1.10,AUC=0.959,with a sensitivity of 94.5%and a specificity of 90.4%).Conclusion The predictive efficacy of fetal CTR Z-scores is higher than that of the corresponding CTRs,which are new indicators for effectively predicting homozygous α-thalassemia major in early pregnancy.Among them,the CTDR Z-score has the highest predictive efficacy,which can improve the prenatal diagnosis rate of this disease and reduce some unnecessary invasive procedures.

Objective:To establish the normal reference range of the ratio of fetal umbilical venous flow rate to umbilical artery pulsatility index (VAI).Methods:A total of 816 normal fetuses underwent prenatal examination and delivery were randomly selected from October 2018 to December 2020 in Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. Fetal weight was obtained by measuring fetal biparietal diameter, head circumference, abdominal circumference, and femoral length.Umbilical venous flow (Quv) was measured. Umbilical artery pulsatility index (UA-PI) was obtained in the free segment of amniotic fluid. Quv was standardized according to fetal size to calculate the umbilical venous flow rate (nQuv) and VAI. The association between Quv, nQuv, UA-PI, VAI and the fetal gestational week were analyzed using correlation analysis. VAI was presented as ± s, the upper limit of 95% reference value and the lower limit of 5% reference value were taken as the standards of VAI increase and decrease, respectively. Twenty-six fetuses whose VAI were lower than limit of 5% and 20 fetuse whose VAI were than limit of 95% were chosed as the case group. Results:①Fetal Quv was positively correlated with gestational week ( r=0.893, P<0.001), nQuv and UA-PI were negatively correlated with gestational week ( r=-0.552, -0.827; all P<0.001), and VAI had no significant correlation with gestational week ( r=0.000, P=0.758); ②The mean, standard deviation, lower 5% reference value, and upper 95% reference value of VAI were 195.81, 55.61, 105.95, and 293.33, respectively; ③In the cases with abnormal VAI, 26 fetuses with reduced VAI, of whom there were 16 cases of maternal hypertension, and 13 cases complicated by severe preeclampsia; 1 case with 40 turns of umbilical cord torsion, 3 cases of stillbirth, 16 cases of preterm delivery, 19 cases of low neonatal birth body weight, 4 cases of 1-min Apgar score ≤7, 6 cases of umbilical artery blood pH<7.2, and 1 case without abnormalities in fetus during pregnancy and follow-up newborn. Among the 20 fetuses with increased VAI, there were 10 cases of fetal severe thalassemia, 2 cases of thalassemia, 1 case of sacrococcygeal teratoma, 1 case of portal venous shunt, 3 cases of placental chorioangioma, and 3 cases without abnormalities in fetus during pregnancy and follow-up newborn. Conclusions:The measurement and calculation of fetal VAI is simple and easy to perform. As a comprehensive index, fetal VAI remains constant in mid and late pregnancy, facilitates the follow-up of abnormal fetuses, and has potential clinical application.

Objective:To explore the values of Z-scores of fetal heart circumference (HC) and heart area (HA) in prediction of homozygous α-thalassemia.Methods:From February 2014 to March 2019, 233 fetuses of 15 to 23 gestation weeks with risk of homozygous α-thalassemia were examined by prenatal ultrasound in the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. HC, HA and cardiothoracic ratio (CTR) were measured. HC and HA were converted into Z-scores, respectively. The ROC curves were established and analyzed based on HC Z-score, HA Z-score or CTR respectively to compare their predicting efficacies for fetal homozygous α-thalassemia. Finally, the sensitivity, specificity, positive predictive value and negative predictive value were obtained by the best cutoff values.Results:①Sixty-five fetuses were diagnosed as homozygous α-thalassemia and classified as α-thalassemia group. One hundred and sixty-eight fetuses were mild and normal and were classified as control group. ②HC Z-score, HA Z-score and CTR in the α-thalassemia group were significantly higher than those in the control group, and the differences between the two groups were statistically significant ( P<0.001). ③The area under ROC curve of HA Z-score was the largest compared with HC Z-score and CTR, and the prediction efficacy was the highest ( Z test=2.144 and 2.517 respectively, P<0.05). ④The best cutoff values were HC Z-score>1.67, HA Z-score>2.06 and CTR>0.53. Sensitivities of predicting homozygous α-thalassemia in 15 to 23 gestation weeks were 92.31%, 100% and 89.23%, respectively. Specificities were 94.05%, 95.83% and 93.45%, respectively. Positive predictive values were 84.43%, 89.00% and 84.05%, respectively. Negative predictive values were 96.91%, 100% and 95.57%, respectively. Conclusions:Fetal heart HC Z-score and HA Z-score are safe and effective novel ultrasonic indexes for predicting homozygous α-thalassemia. Especially compared with traditional CTR, HA Z-score has a significantly higher predicting efficacy, which can improve the detection rate of homozygous α-thalassemia and reduce the need for invasive examination.