Purpose To evaluate the predictive value of left atrial appendage(LAA)morphological assessment by preoperative left atrial CT imaging in the risk of peri-device leak(PDL)after left atrial appendage occlusion(LAAO)in atrial fibrillation.Materials and Methods Seventy-one patients with atrial fibrillation who successfully underwent LAAO in Nanchong Central Hospital from January 2020 to February 2024 were retrospectively analyzed.According to the results of left atrial CT imaging after LAAO,all patients were divided into the PDL group(n=26)and the non-PDL group(n=45).The long diameter,short diameter,long diameter/short diameter ratio,area,perimeter of both the LAA orifice and landing area,and LAA length and LAA depth were compared between the two groups.Univariate and multivariate Logistic regression analysis were used to explore the risk factors leading to the differences between the two groups.Results The long diameter,long diameter/short diameter ratio,area,perimeter of both the LAA orifice and landing area in the PDL group were statistically higher than those in the non-PDL group(t/Z=4.952,-5.570,-2.912,3.191,6.757,-6.462,-3.318,3.733,all P<0.05).The LAA orifice short diameter,LAA length,LAA depth and the short diameter of landing area in the PDL group were higher than those in the non-PDL group,but there were no statistically significant differences between the two groups(t/Z=-1.773,1.765,1.509,-1.415,all P>0.05).Univariate Logistic regression analysis showed that the long diameter,long diameter/short diameter ratio,area and perimeter of LAA orifice and landing area before operation were correlated with postoperative PDL(P<0.05).Multivariate Logistic regression analysis showed that,the long diameter/short diameter ratio of LAA landing area was an independent risk factor for postoperative PDL.Conclusion Preoperative evaluation of the morphology of LAA orifice and landing zone by left atrial CT imaging can predict the occurrence of PDL after LAAO in atrial fibrillation in advance.When the long/short diameter of the landing area is large,it is necessary to be highly alert to the occurrence of PDL,which provides a basis for selecting and customizing the occluder before LAAO in patients with atrial fibrillation.

Purpose To explore the feasibility of coronary CT angiography to predict major adverse cardiovascular events(MACE)in patients with grey zone of CT-derived fractional flow reserve(CT-FFR).Materials and Methods The imaging and clinical features of patients with suspected coronary heart disease who underwent coronary CT angiography examination and had a CT-FFR within 0.76-0.80 in Beijing Anzhen Hospital Affiliated to Capital Medical University from March 2017 to October 2018 were retrospectively collected.The incidence of MACE after coronary CT angiography was assessed by telephone at follow-up.The Cox regression model was used for feature selection,and the area under the receiver operating characteristic curve(AUC)was plotted to evaluate the predictive performance.Results The study included a total of 105 subjects,with an observed incidence rate of MACE at 31.4%(33/105).Multivariate Cox regression,adjusted for relevant parameters,indicated that △CT-FFR(HR=1.217,P=0.008),pericoronary fat attenuation index(HR=1.052,P=0.029)and plaque length(HR=1.068,P=0.047)were independent risk factors of MACE,and AUC were 0.705,0.656 and 0.701,respectively.The AUC of the combined model was 0.793,its predictive ability was higher than △CT-FFR(Z=-2.001,P=0.048),pericoronary fat attenuation index(Z=-2.402,P=0.016)and plaque length(Z=-2.004,P=0.045),respectively.Conclusion △CT-FFR,pericoronary fat attenuation index and plaque length are independent risk factors for predicting MACE in patients with grey zone of CT-FFR,and the combined model has best predictive efficacy.

Purpose To evaluate the predictive value of left atrial appendage(LAA)morphological assessment by preoperative left atrial CT imaging in the risk of peri-device leak(PDL)after left atrial appendage occlusion(LAAO)in atrial fibrillation.Materials and Methods Seventy-one patients with atrial fibrillation who successfully underwent LAAO in Nanchong Central Hospital from January 2020 to February 2024 were retrospectively analyzed.According to the results of left atrial CT imaging after LAAO,all patients were divided into the PDL group(n=26)and the non-PDL group(n=45).The long diameter,short diameter,long diameter/short diameter ratio,area,perimeter of both the LAA orifice and landing area,and LAA length and LAA depth were compared between the two groups.Univariate and multivariate Logistic regression analysis were used to explore the risk factors leading to the differences between the two groups.Results The long diameter,long diameter/short diameter ratio,area,perimeter of both the LAA orifice and landing area in the PDL group were statistically higher than those in the non-PDL group(t/Z=4.952,-5.570,-2.912,3.191,6.757,-6.462,-3.318,3.733,all P<0.05).The LAA orifice short diameter,LAA length,LAA depth and the short diameter of landing area in the PDL group were higher than those in the non-PDL group,but there were no statistically significant differences between the two groups(t/Z=-1.773,1.765,1.509,-1.415,all P>0.05).Univariate Logistic regression analysis showed that the long diameter,long diameter/short diameter ratio,area and perimeter of LAA orifice and landing area before operation were correlated with postoperative PDL(P<0.05).Multivariate Logistic regression analysis showed that,the long diameter/short diameter ratio of LAA landing area was an independent risk factor for postoperative PDL.Conclusion Preoperative evaluation of the morphology of LAA orifice and landing zone by left atrial CT imaging can predict the occurrence of PDL after LAAO in atrial fibrillation in advance.When the long/short diameter of the landing area is large,it is necessary to be highly alert to the occurrence of PDL,which provides a basis for selecting and customizing the occluder before LAAO in patients with atrial fibrillation.

Purpose To explore the feasibility of coronary CT angiography to predict major adverse cardiovascular events(MACE)in patients with grey zone of CT-derived fractional flow reserve(CT-FFR).Materials and Methods The imaging and clinical features of patients with suspected coronary heart disease who underwent coronary CT angiography examination and had a CT-FFR within 0.76-0.80 in Beijing Anzhen Hospital Affiliated to Capital Medical University from March 2017 to October 2018 were retrospectively collected.The incidence of MACE after coronary CT angiography was assessed by telephone at follow-up.The Cox regression model was used for feature selection,and the area under the receiver operating characteristic curve(AUC)was plotted to evaluate the predictive performance.Results The study included a total of 105 subjects,with an observed incidence rate of MACE at 31.4%(33/105).Multivariate Cox regression,adjusted for relevant parameters,indicated that △CT-FFR(HR=1.217,P=0.008),pericoronary fat attenuation index(HR=1.052,P=0.029)and plaque length(HR=1.068,P=0.047)were independent risk factors of MACE,and AUC were 0.705,0.656 and 0.701,respectively.The AUC of the combined model was 0.793,its predictive ability was higher than △CT-FFR(Z=-2.001,P=0.048),pericoronary fat attenuation index(Z=-2.402,P=0.016)and plaque length(Z=-2.004,P=0.045),respectively.Conclusion △CT-FFR,pericoronary fat attenuation index and plaque length are independent risk factors for predicting MACE in patients with grey zone of CT-FFR,and the combined model has best predictive efficacy.

Objective:To investigate the efficacy of Sishen pill compound combined with mesalazine in the treatment of mild to moderate ulcerative colitis and its effect on the circadian rhythm of symptoms. Methods:A total of 136 patients with mild to moderate ulcerative colitis who received treatment in Hospital of Chengdu University of Traditional Chinese Medicine from January 2018 to December 2020 were included in this prospective randomized controlled trial. These patients were divided into a treatment group ( n = 68) and a control group ( n = 68). The treatment group was treated with Sishen pill compound combined with mesalazine. The control group was treated with mesalazine alone. All patients were treated for 12 weeks. Clinical efficacy, as well as morning abdominal pain grade, morning diarrhea score, fecal trait score, Mayo score, hemoglobin, and hypersensitive C-reactive protein pre- and post-treatment, were compared between the two groups. Results:Total response rate in the treatment group was significantly higher than that in the control group [91.18% (62/68) vs. 72.06% (49/68), χ2 = 8.28, P < 0.05]. After treatment, morning diarrhea score, morning abdominal pain score, fecal trait score, Mayo score, hemoglobin, and hypersensitive C-reactive protein in the treatment group were (0.47 ± 0.56) points, (0.53 ± 0.56) points, (3.01 ± 0.72) points, (7.13 ± 1.38) points, (108.04 ± 12.21) g/L, (4.00 ± 2.19) mg/L, respectively, and they were (0.84 ± 0.56) points, (1.12 ± 0.56) points, (4.40 ± 0.76) points, (3.25 ± 1.44) points, (102.15 ± 12.61) g/L, and (6.07 ± 3.66) mg/L respectively in the control group. There were significant differences in these indexes between the treatment and control groups ( t = 3.59, 5.95, 10.06, 9.62, 2.78, 3.99, all P < 0.05). Conclusion:Sishen pill compound combined with mesalazine can effectively reduce clinical symptoms of active ulcerative colitis, increase hemoglobin level, decrease C-reactive protein level, improve the efficiency of treatment, reduce symptoms and the number of diarrhea rhythms, and improve stool symptoms of mild to moderate ulcerative colitis patients.