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.

OBJECTIVE To summarize the clinical characteristics and diagnosis and treatment experiences in dealing with non-severe Chlamydia psittaci pneumonia.METHODS The clinical data were collected from 34 patients who were diagnosed with non-severe C.psittaci pneumonia through quantitative polymerase chain reactiong(qPCR)for sputum in fever clinic of the First Medical Center of Chinese PLA General Hospital from Mar.2023 to Mar.2024 and were retrospectively analyzed.The clinical characteristics and treatment outcomes were evaluated.RESULTS The average age of the patients was(44.82±13.74)years old,the ratio of male to female was 1∶1.83;all of the patients had fever;major symptoms were cough(70.59％),pharyngodynia(44.12％),and flu-like symptoms(41.18％);82.35％of the patients had the history of contact with poultry.The C-reactive pro-tein(CRP)level,interleukin-6(IL-6),systemic inflammatory response index(SIRI)and aggregate index of sys-temic inflammation(AISI)were higher among the patients aged no less than 44 years old than among the patients less than 44 years old(P＜0.05);the percentage of lymphocytes of the patients aged no less than 44 years old was lower than that of the patients aged less than 44 years old(P＜0.05).As for the imaging findings,73.53％of the patients had consolidation shadows,26.47％had ground-glass opacities,and 32.35％involved both lungs.All of the patients received quinolones or tetracyclines for treatment of 7-14 days and all symptoms relieved.CT reexami-nated 1 month after the treatment showed that 55.88％of the cases had complete absorption of pulmonary infec-tious lesions,and 35.29％had partial absorption.CONCLUSIONS The patients with non-severe Chlamydia psitta-ci pneumonia are characterized by the history of contact with poultry,fever complicated with respiratory tract symptoms,rise of inflammatory markers(more significant among patients of advanced age)and lower lobe con-solidation shadow/ground-glass opacities.Early identification and standardized treatment may facilitate the favora-ble treatment outcomes.

OBJECTIVE To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia(MPP)after COVID-19 epidemic so as to offer help for early clinical diagnosis and treatment.METHODS The clinical data that were collected from the MPP patients who were treated in the fever clinic of the First Medical Center of Chinese PLA General Hospital from Jul.2023 to Aug.2024 were retrospectively analyzed.The results of laboratory tests for the different age groups of patients complicated with other pathogens were statistically analyzed.RESULTS Of totally 161 MPP patients who were enrolled in the study,78(48.85％)were male,and 83(51.55％)were fe-male;the average age was(32.98±14.35)years old,and the patients aged between 20 and 40 years old accoun-ted for 43.48％(70 cases).The enrolled patients were divided into the simple MPP group with 92(57.14％)ca-ses and the MPP+mixed group with 69(42.86％)cases according to the result of etiological test of sputum;the patients of MPP+mixed group were divided into the MPP+bacteria group with 42(60.87％)cases,the MPP+fungi group with 10(14.49％)cases,and the MPP+viruses group with 17(24.64％)cases.There was significant difference in the age among the groups(P＜0.05);there were no significant differences in the sex,white blood cell counts and percentage of mononuclear cells among the groups,the percentage of lymphocytes was highest in the simple MPP group,the levels of C-reactive protein(CRP)and interleukin-6(IL-6)were highest in the MPP+bacteria group,and there were significant differences(P＜0.05).All of the patients were divided into three groups:the ≤20-year-old group the＞20-40-year old group and the＞40-year-old group.There were no sig-nificant differences in the white blood cell counts,percentage of lymphocytes,percentage of mononuclear cells and IL-6 level among the three groups,and the CRP level was highest in the＞20-40-year old group(P=0.025).Ran-dom forest model analysis showed that the weight of CRP was highest(22.65％)among the clinical characteristics of the MPP patients,which played a key role in construction of model.As for other factors,the weight of age was 17.02％,the percentage of lymphocytes 15.34％,the white blood cells counts 14.86％,the percentage of mono-nuclear cells 14.39％,the IL-6 13.61％,the gender 2.13％.CONCLUSION MPP maintains common among the patients aged less than 40 years old after the COVID-19 epidemic,nearly half of the patients are complicated with the infections of other pathogens,and CRP is more helpful for the clinical diagnosis and treatment of the MPP in early stage.

OBJECTIVE To summarize the clinical characteristics and diagnosis and treatment experiences in dealing with non-severe Chlamydia psittaci pneumonia.METHODS The clinical data were collected from 34 patients who were diagnosed with non-severe C.psittaci pneumonia through quantitative polymerase chain reactiong(qPCR)for sputum in fever clinic of the First Medical Center of Chinese PLA General Hospital from Mar.2023 to Mar.2024 and were retrospectively analyzed.The clinical characteristics and treatment outcomes were evaluated.RESULTS The average age of the patients was(44.82±13.74)years old,the ratio of male to female was 1∶1.83;all of the patients had fever;major symptoms were cough(70.59％),pharyngodynia(44.12％),and flu-like symptoms(41.18％);82.35％of the patients had the history of contact with poultry.The C-reactive pro-tein(CRP)level,interleukin-6(IL-6),systemic inflammatory response index(SIRI)and aggregate index of sys-temic inflammation(AISI)were higher among the patients aged no less than 44 years old than among the patients less than 44 years old(P＜0.05);the percentage of lymphocytes of the patients aged no less than 44 years old was lower than that of the patients aged less than 44 years old(P＜0.05).As for the imaging findings,73.53％of the patients had consolidation shadows,26.47％had ground-glass opacities,and 32.35％involved both lungs.All of the patients received quinolones or tetracyclines for treatment of 7-14 days and all symptoms relieved.CT reexami-nated 1 month after the treatment showed that 55.88％of the cases had complete absorption of pulmonary infec-tious lesions,and 35.29％had partial absorption.CONCLUSIONS The patients with non-severe Chlamydia psitta-ci pneumonia are characterized by the history of contact with poultry,fever complicated with respiratory tract symptoms,rise of inflammatory markers(more significant among patients of advanced age)and lower lobe con-solidation shadow/ground-glass opacities.Early identification and standardized treatment may facilitate the favora-ble treatment outcomes.

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.

OBJECTIVE To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia(MPP)after COVID-19 epidemic so as to offer help for early clinical diagnosis and treatment.METHODS The clinical data that were collected from the MPP patients who were treated in the fever clinic of the First Medical Center of Chinese PLA General Hospital from Jul.2023 to Aug.2024 were retrospectively analyzed.The results of laboratory tests for the different age groups of patients complicated with other pathogens were statistically analyzed.RESULTS Of totally 161 MPP patients who were enrolled in the study,78(48.85％)were male,and 83(51.55％)were fe-male;the average age was(32.98±14.35)years old,and the patients aged between 20 and 40 years old accoun-ted for 43.48％(70 cases).The enrolled patients were divided into the simple MPP group with 92(57.14％)ca-ses and the MPP+mixed group with 69(42.86％)cases according to the result of etiological test of sputum;the patients of MPP+mixed group were divided into the MPP+bacteria group with 42(60.87％)cases,the MPP+fungi group with 10(14.49％)cases,and the MPP+viruses group with 17(24.64％)cases.There was significant difference in the age among the groups(P＜0.05);there were no significant differences in the sex,white blood cell counts and percentage of mononuclear cells among the groups,the percentage of lymphocytes was highest in the simple MPP group,the levels of C-reactive protein(CRP)and interleukin-6(IL-6)were highest in the MPP+bacteria group,and there were significant differences(P＜0.05).All of the patients were divided into three groups:the ≤20-year-old group the＞20-40-year old group and the＞40-year-old group.There were no sig-nificant differences in the white blood cell counts,percentage of lymphocytes,percentage of mononuclear cells and IL-6 level among the three groups,and the CRP level was highest in the＞20-40-year old group(P=0.025).Ran-dom forest model analysis showed that the weight of CRP was highest(22.65％)among the clinical characteristics of the MPP patients,which played a key role in construction of model.As for other factors,the weight of age was 17.02％,the percentage of lymphocytes 15.34％,the white blood cells counts 14.86％,the percentage of mono-nuclear cells 14.39％,the IL-6 13.61％,the gender 2.13％.CONCLUSION MPP maintains common among the patients aged less than 40 years old after the COVID-19 epidemic,nearly half of the patients are complicated with the infections of other pathogens,and CRP is more helpful for the clinical diagnosis and treatment of the MPP in early stage.

Objective To investigate the effect of laser engraving personalized nasal patch applied to patients with nasal catheter indentation.Methods A total of 124 patients who underwent esophageal cancer surgery in the First Hospital of Lanzhou University from February 2022 to February 2023 and required indwelling nasal catheter were selected as study objects,and were divided into experimental group and control group according to random number table method,with 62 cases in each group.The control group used conventionally cut nasal patches to fix the nasal catheters,and the experimental group used laser engraved personalized nasal patches.Catheter displacement or slippage under the fixation device,nasal patch rolled edges and number of replacement,nasal medical device-related pressure injury,medical adhesive-related skin lesions and patients'comfort were observed in two groups.Results The rate of catheter displacement,number of rolled edges of nasal patches and numbers of replacement in experimental group were significantly lower than those in control group(P<0.05).The incidence of nasal mucosal indentation,nasal pain,nasal pressure injury and medical adhesive related skin lesions in experimental group were significantly lower than those in control group(P<0.05).The comfort of patients at the physiological level of experimental group was significantly better than that of control group(P<0.05).Conclusion Laser engraved personalized nasal patches can reduce the frequency of clinical nasal catheter displacement,nasal patch rolled edges and number of replacement,reduce the occurrence of nasal medical device related pressure injuries and medical adhesive-related skin lesions,and increase patients'comfort.

Autoimmune hepatitis(AIH)is a type of chronic hepatitis caused by the attack of hepatocytes by the autoimmune system,and with the prolongation of disease course,it may gradually progress to liver cirrhosis and even hepatocellular carcinoma.Although great achievements have been made in the understanding and treatment of AIH,its etiology and pathogenesis still remain unclear.T cells play a crucial role in the development and progression of AIH,and by focusing on follicular helper T cells,this article elaborates on the research advances in follicular helper T cells in AIH,in order to provide new ideas and strategies for the clinical treatment of AIH.

Objective To study the influence of serum containing Fuzheng Toudu Qudu Recipe, a Chinese formula with the actions of supporting healthy qi to expel and remove toxicity, on serum levels of interleukin 2 (IL-2) and soluble interleukin 2 receptor (sIL-2R) at different stages of CD34+derived dendritic cells (DC) of patients with minimal residual disease of myelogenous leukemia ( MRD-L) , and to explore the biological mechanism of Fuzheng Toudu Qudu Recipe in promoting CD34+ to transform into DC in MRD-L patients. Methods Bone marrow mononuclear cells ( BMMC) were separated from the bone marrow of acute myeloid leukemia patients at complete remission stage by using Ficoll centrifugation. CD34+ cells were isolated by using immuno-magnetic mircobeads method, and then were cultured with various concentrations of Chinese medicine medicated serum and cytokines in vitro for the induction of DC. The morphologic characteristics of DC were observed with the inverted phase contrast microscope, and the expression levels of DC surface molecules such as CD83, CD80, CD86, CD1a and HLA-DR were detected by using flow cytometry. On culturing day 0, 6 and 9, serum levels of IL-2 and sIL-2R of each group were measured by enzyme-linked immunosorbent assay ( ELISA). Results ( 1) Chinese medicine medicated serum combined with cytokines was effective on promoting CD34+ to differentiate into DC with typical morphology, and inducing DC to have high expression of CD80, CD83, CD86 and HLA-DR, which differed from those in fetal calf serum (FCS) group and blank rabbit serum group (P<0.01). Middle- and low-dose combination groups increased expression of CD1a, which differed from high-dose combination group and cytokines group ( P<0.01). ( 2) Content of IL-2 in combination groups was higher than that in blank rabbit serum group on culturing day 0. In the combination groups, IL-2 was higher on culturing day 6 and 9 than that on culturing day 0. Middle and high-dose combination groups had higher IL-2 content on culturing day 9 than on culturing day 6 ( P<0.05 or P<0.01). At the same time point, combination groups had higher IL-2 content than the blank rabbit serum group (P<0.05 or P<0.01). (3) Content of sIL-2R in the combination groups was lower than that in blank rabbit serum group on culturing day 0. In the combination groups, sIL-2R was lower on culturing day 9 than that on culturing day 0 and 6 ( P<0.01) . High-dose combination group had lower sIL-2R content on culturing day 6 than that on culturing day 0 (P<0.05), and the difference of sIL-2R in other groups was insignicant between on culturing day 6 and on culturing day 0 ( P>0.05) . At the same time point, combination groups had lower IL-2 content than the blank rabbit serum group (P<0.05 or P<0.01). Conclusion Fuzheng Toudu Qudu Recipe is effective on increasing serum content of IL-2 and reducing sIL-2R content, and the changes of cytokine contents are more obvious along with the maturity of DC, which indicates that the recipe plays positive effect in the process of promoting CD34+cells to differentiate into DC.

Objective: To explore the relationship between left coronary plaque character with the bifurcation angle and diameter by 256-slice CT angiography (CTA). Methods: A total of 387 consecutive patients who received CTA in our hospital were retrospectively studied. There were 102 patients with normal image including 60 male and 42 female at the mean age of (52.10 ± 9.65) years and 285 patients with left coronary plaque including 166 male and 119 female at the mean age of (55.65 ± 10.40) years. All patients were divided into 4 groups according to the plaque condition, Normal group,n=102 patients without plaque, Non-calciifcation group,n=137, Calciifcation group,n=79 and Mixed group,n=69. The patients with non-calciifcation plaque included 73 of mild stenosis and 57 of moderate to severe stenosis in proximal LDA. Left coronary bifurcation angle, proximal diameter and area were measured by multi-planar reconstruction (MPR) and the maximum density projection (MIP) techniques to analyze the relationship between the above indexes and plaque position, character, degree of local stenosis. Results: Left coronary bifurcation angle, the proximal diameter, area in LDA and LCX in 3 plaque groups were all larger than those in Normal group,P<0.05. In Non-calciifcation group, the above indexes were similar between the patients with mild stenosis and moderate to severe stenosis,P>0.05, while in patients with moderate to severe stenosis, the bifurcation angle and diameter were larger in male than those in female patients,P<0.05. Conclusion: 256-slice CTA could objectively evaluate left coronary bifurcation angle, stenosis degree and plaque character, which are valuable for coronary artery disease prevention, diagnosis and treatment in clinical practice.