Leukemia is a critical disease with a high incidence and extremely high fatality rate.Immune escape by leukemia stem cells(LSC)is the main factor for recurrence and progression after remission.Clinical diagnosis and treatment by Traditional Chinese Medicine(TCM)have distinct advantages of syndrome differentiation and treatment.Based on the purpose of diagnosis and treatment,leukemia treatment by TCM emphasizes the harmony of yin and yang to restore human functions,which is conducive to improve autoimmunity and conforms to the mechanism of intervention for tumor cell immune escape.This article discusses the mechanism and research progress of TCM interventions in LSC immune escape based on literature and TCM theory.

Objective To observe the value of cardiac CT angiography(CCTA)for left atrial appendage closure(LAAC).Methods Twelve Labradors were enrolled and underwent LAAC.CCTA examinations were performed before and 7,45 and 90 days after LAAC,and the left atrial appendage(LAA)parameters before and post LAAC occluder compression ratio were recorded.Ninety days after LAAC,the dogs were euthanized for gross anatomical observation,micro CT imaging and pathological examination,and the value of CCTA for LAAC was analyzed.Results Based on CCTA before LAAC,LAA opening depth was(18.8±2.6)mm,the minimum diameter was(16.3±2.0)mm and the maximum diameter was(22.6±3.2)mm,so 28 mm diameter occluders were selected for LAAC.Seven,45 and 90 days after LAAC,no displacement of occluder,thrombi nor device leakage was found on CCTA,while no significant difference of compression ratio was found among different time points(P＞0.05),nor between those measured with CCTA and micro CT 90 days after LAAC(P＞0.05).Ninety days after LAAC,gross dissection revealed complete endothelialization of occlude in 11 dogs and incomplete endothelialization in 1 dog.Pathological examination showed that collagen fibers arranged neatly,with endothelial cells covering the surface,and no inflammatory cell infiltration was observed.Conclusion CCTA could be used to observe LAA and surrounding structures before LAAC,hence guiding to select appropriate occluder,evaluate occlusion effect and monitor complications of LAAC in dogs.

Objective:This study was performed to assess the effect of glycemic control on atrial fibrillation recurrence rates after heart surgery concomitant with Cox-Maze Ⅳ ablation.Methods:A retrospective analysis was performed on 317 diabetic patients with atrial fibrillation who underwent cardiac surgery combined with Cox-Maze Ⅳ ablation in our hospital from May 2016 to February 2020. The patients were followed up for(37.7±27.7) months, and the data of atrial fibrillation recurrence and clinical outcome were collected and compared. The limited cubic spline model was used to analyze the dose-relationship between HbA1c level and the recurrence of atrial fibrillation. The univariate and multivariate Cox proportional regression analysis was used to explore the risk factors of recurrent atrial fibrillation after Cox-Maze Ⅳ ablation. Results:Higher glycated hemoglobin(HbA1c) at the time of ablation was associated with higher post-ablation recurrence rates. The cumulative survival freedom from atrial fibrillation recurrence for patients with HbA1c ≥7.4% at time of operation at 12, 24, 36 and 48 months were 96.3%、75.8%、52.7% and 35.7%, respectively( P<0.001). Besides, the rates of all-cause mortality, cardiac mortality and rehospitalization were significantly lower in patients with HbA1c<7.4%(1.7% vs. 6.3%, P=0.03; 1.1% vs. 5.6%, P=0.02 and 5.7% vs. 20.4%, P=0.01). The multivariate Cox regression model showed that HbA1c was an independent risk factor for atrial fibrillation recurrence( P<0.05). Conclusion:Higher preoperative HbA1c levels were associated with increased recurrence of atrial fibrillation and adverse clinical outcomes in patients undergoing cardiac surgery combined with Cox-Maze Ⅳ ablation.

Objective:To simulate the spot characteristics of light emitting diode (LED) array light sources used in non-invasive phototherapy at different distances and to provide reference for the formulation of clinical non-invasive phototherapy treatment schemes.Methods:The ray tracing module in Comsol software was used to simulate the spot characteristics of LED light sources with different power and arrays at different distances, and the fitting curve was analyzed. The model was verified by the actual LED spot measurement, and the feasibility of the treatment scheme was verified by the mouse back wound model.Results:Under the irradiation of 2×2 LED light source array, with the increase of the vertical distance from the light source, the area of the effective area and the treatment area gradually increased, the power density value in the area gradually decreased, and the uniformity gradually increased. These changes showed a linear or binomial correlation with the vertical distance. The model was improved based on the actual LED light spot, and the new model consisted of an array of 18 LEDs as the light source, and the treatment area showed better uniformity and power density values. The simulated optical parameters were used to treat mice’s wounds with light, and the results showed that light treatment could promote wound healing.Conclusions:The established medical LED array light source spot characteristics simulation can provide a reference for the development of clinical non-invasive phototherapy protocols, thus helping the clinic select the appropriate LED power and array distribution according to the treatment needs and also providing a basis for the development of medical LED array light sources.

Objective:To investigate the factors for and prevention of muscular calf vein thrombosis (MCVT) after unilateral total knee arthroplasty (TKA).Methods:Between January 2018 and October 2020, 551 patients were admitted to Department of Orthopedics, The First Affiliated Hospital to Zhengzhou University for unilateral TKA. They were 187 males and 364 females, aged from 32 to 90 years (average, 64.6 years) and with 234 left and 317 right knees affected. They were assigned into a MCVT group ( n=77) and a non-MCVT group ( n=474) according to whether or not MCVT had happened at 7 days after operation. Recorded were the patients’ baseline information, tourniquet time, intraoperative blood loss, postoperative prothrombin time (PT), postoperative thrombin time (TT), postoperative fibrinogen (FIB), D-dimer, platelet count (PLT), postoperative bed time, knee society score (KSS), erythrocyte sedimentation rate (ESR) fall time, and C-reactive protein (CRP) fall time so as to analyze the risk factors for MCVT. Results:There were significant differences between the 2 groups in age [(66.8±7.0) versus (64.2±9.6) years], body mass index (BMI) [(28.7±2.2) versus (25.0±2.4) kg/m 2], smoking (20/57 versus 41/433), diabetes (56/21 versus 172/302), primary hypertension (45/32 versus 174/300), coronary heart disease (50/27 versus204/270), hyperlipidemia (33/44 versus 149/325), varicosity (50/27 versus 166/308), tourniquet time [(97.9±22.6) versus (83.1±10.6) min], intraoperative blood loss [(73.2±40.6) versus (62.4±11.5) mL], postoperative PT [(10.7±0.8) versus (11.9±1.0) s], TT [(15.2±1.3) versus (17.2±2.4) s], FIB [(3.7±0.8) versus (3.2±0.5) g/L], D-dimer [(1.1±1.0) versus (0.8±0.3) μg/L], PLT [(233.4±68.5) versus (178.5±27.8) 10 9/L], postoperative bed time [(17.3±2.6) versus (14.6±3.8) h], KSS [(3.32±0.7) versus (3.61±0.56) points], ESR fall time [(2.90±0.74) versus (1.55±0.64) d] and CRP fall time [(2.90±0.74) versus (1.55±0.64) d] (all P<0.05). Multivariate logistic regression analysis showed that old age (95% CI: 0.890 to 1.112, P=0.034), high BMI (95% CI: 1.012 to 1.214, P=0.046), diabetes (95% CI: 1.002 to 2.590, P=0.020), D-dimer (95% CI: 1.239 to 10.292, P=0.001) and postoperative PLT (95% CI: 1.012 to 1.112, P=0.014) were independent risk factors for MCVT. Reduced postoperative bed time (95% CI: 1.009 to 1.469, P=0.040) was a protective factor. Conclusions:As old age, high BMI, diabetes, and high postoperative levels of D-dimer and PLT may be independent risk factors for MCVT, patients with such characteristics should be alert to MCVT. Early ambulation should be encouraged in patients after unilateral TKA to reduce postoperative bed time for prevention of the disease.

Objective Through bibliometrics and visual analysis of the related studies on traditional Chinese medicine (TCM) treatment of immune thrombocytopenia (ITP), this study aims to sort out the overall research progress, hotspots, and trends in this field, and provide reference for further research in ITP. Methods The articles on ITP treated by TCM were retrieved from China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), Web of Science Core Collection (WOSCC), and PubMed. The retrieval time was from the establishment of the databases to July 31, 2022. VOSviewer, CiteSpace, Carrot2, and NoteExpress were used for data analysis of the articles in terms of their quantities, types, and journals, and for visualization of research hotspots, authors, institutions, and keywords. Results 1 493 Chinese articles and 40 English articles were included. The articles in Chinese mainly focus on clinical trial research and clinical experience summary, while the English articles mainly focus on clinical trial research and animal research. The Chinese articles were published in 317 Chinese journals, while English articles were published in 29 English journals. Research hotspots include the clinical syndrome differentiation of ITP, the therapeutic effect of TCM compounds on ITP, and the mechanism of ITP treatment. Keyword analysis shows that there are many research achievements in integrated traditional Chinese and western medicine treatment, clinical research, famous doctors’ experience, TCM treatment, cellular immunity, and humoral immunity. The authors with the most articles in Chinese and English are Professor CHEN Xinyi and Professor MA Rou, respectively, and the research institutions with the most articles are Dongzhimen Hospital of Beijing University of Chinese Medicine and Xiyuan Hospital of China Academy of Chinese Medical Sciences. Chinese herbs often used to treat ITP clinically include Xianhecao (Agrimoniae Herba), Nvzhenzi (Ligustri Lucidi Fructus), Mohanlian (Ecliptae Herba), Zhongjiefeng (Sarcandrae Herba), etc., and the prescription usually used to treat ITP include Guipi Decoction (归脾汤), Xijiao Dihuang Decoction (犀角地黄汤), Bazhen Decoction (八珍汤), Erzhi Pill (二至丸), and Xiaochaihu Decoction (小柴胡汤). The main development trends toward retrospective study, TCM treatment mechanism, and data mining. Conclusion The research on TCM treatment of ITP has progressed steadily, but in-depth studies and close cooperation between research institutions are necessary for the modernization of TCM in treating ITP.

Objective:To explore the value of blood lipids, serum interleukin-6 (IL-6) and thyroid-stimulating hormone (TSH) detection in patients with differentiated thyroid cancer.Methods:From Mar. 2016 to Oct. 2021, 120 cases of DTC were admitted to the DTC group, 138 patients with benign thyroid nodules were included in the benign group, and 100 healthy people undergoing the physical examination in our hospital during the same period. were enrolled in the control group. Triglyceride (TG) , total cholesterol (TC) , high density liptein cholesterol (HDL-C) , low density lipoprotein (LDL-C) , IL-6, and TSH were compared between groups, and statistically significant indexes were included for multivariate analysis of the occurrence of DTC. The sensitivity, specificity and optimal cut-off value were analyzed, and their relationship with the clinicopathological characteristics of DTC patients was analyzed.Results:Serum TSH and IL-6 levels from high to low were malignant group, benign group and control group, and HDL-C levels from high to low were control group, benign group and malignant group ( P<0.05) . There was no significant difference in the levels of TC, TG or LDL-C ( P>0.05) . Multivariate Llogistics regression analysis indicated that TSH and IL-6 may be risk factors for the occurrence of differentiated thyroid cancer (all OR>1, P<0.05) . HDL-C may be a protective factor for the occurrence of differentiated thyroid cancer ( OR<1, P<0.05) . The ROC curve was drawn to determine the optimal cut-off value of TSH for the diagnosis of differentiated thyroid cancer, AUC: 0.985, sensitivity was 93.25%, specificity was 96.34%, 95% CI: 0.949-1.000 ( P<0.001) ; the best cut-off value of IL-6 for the diagnosis of differentiated thyroid cancer was 48.96 ng/L, AUC: 0.980, sensitivity was 96.98%, the specificity was 91.53%, 95%CI: 0.956-1.000 ( P<0.05) ; the best cut-off value of HDL-C for the diagnosis of differentiated thyroid cancer was 1.441 mmol/L, AUC: 0.0.691, the sensitivity was 85.10%, the specificity was 48.06%, 95%CI: 0.563-0.812 ( P<0.05) . The serum levels of TSH and IL-6 in patients with lymph node metastasis were significantly higher than those in patients without lymph node metastasis, and the level of HDL-C was significantly lower than those in patients without lymph node metastasis ( P<0.05) . TNM staging The serum levels of TSH and IL-6 in patients with stage III and IV were significantly higher than those in patients with stage I and II, and HDL-C was significantly lower than that in patients with stage I and II ( P<0.05) . Conclusions:Serum IL-6, TSH and HDL-C are closely related to the occurrence of differentiated thyroid cancer. The detection of serum IL-6, TSH and HDL-C is helpful for the differentiation of benign and malignant thyroid nodules. The presence or absence of lymph node metastasis in patients with differentiated thyroid cancer is related to TNM staging, and the detection value is high.

Objective: To explore the relationship between pubertal knowledge-attitude-practice(KAP) and quality of life (QoL) of left-behind children in adolescence, and to provide a scientific reference for making measures to improve QoL of left-behind children. Methods: In December 2017, 3 524 left-behind children from 5 primary schools and 5 middle schools in Chongqing were selected by stratified cluster sampling method carry out the Quality of Life Scale of adolescent children and the Questionnaire of Adolescent Knowledge and Belief. Results: The scores of total QoL, physicaland social dimensions of left-behind children[(140.81±17.19)(30.05±5.07)(50.99±8.32)points, respectively]were lower than those of non-left-behind children[(141.81±17.53)(30.35±5.06)(51.73±8.44)point, respectively](P<0.05). Gender, School period, puberty timing, family rearing pattern and economic status had significant influence on the QoL of left-behind children (P<0.05). The adolescent attitude and behavior had a positive effect on total QoL and the scores of physical, psychological, social and adolescent dimensions of left-behind children(B=0.62, 0.08, 0.11, 0.30, 0.13；0.77, 0.11, 0.20, 0.26, 0.19, P<0.01); and knowledge had a positive effect on the adolescence of QoL(B=0.04, P<0.01). Conclusion The adolescent attitude, behavior and quality of life of left-behind children were positively correlated. Strengthening adolescent health education for left-behind children, focusing on conveying correct adolescent attitude to students, and promoting the transformation of correct attitude to positive practice, can improve the QoL of adolescent left-behind children.

Objective: To determine the relationship between peer attachment and quality of life among adolescents in Chongqing, to provide scientific basis for intervention of quality of life. Methods: A total of 6 073 respondents were selected from 5 middle schools and 6 primary schools in a district of Chongqing in December 2017 by stratified cluster sampling method. The revised Chinese version of Adolescent Attachment Questionnaire (IPPA-R) Peer Attachment Subscale and Adolescent Children s Quality of Life Scale were used to conduct the survey. Results: The total score of life quality of students with secure attachment type (144.97±17.39) was significantly higher than that of students with insecure attachment type(136.45±17.75)(t=18.90，P<0.01). The scores of four dimensions of life quality of students with secure attachment[(30.40±5.11)(39.42±6.42)(53.45±7.99)(21.73±3.69)] were significantly higher than those of students with insecure attachment[(29.54±5.15)(37.87±6.66)(49.02±8.69)(20.02±3.60)](P<0.05). Multivariate stepwise regression analysis showed that peer attachment was correlated with physical, psychological, social, adolescent dimensions and the total score of life quality(B=0.28，0.03，0.05，0.14，0.05，P<0.05). Conclusion Adolescent peer attachment is positively correlated with the total score and specific dimensions of life quality. Improving the safety of peer attachment is helpful to improve life quality among adolescents.

Evaluate the effect of the fresh air purification system on the improvement of indoor PM 2.5 levels in a primary school classroom in Jinan City, Shandong Province. Our purpose is to explore the optimal operating time of the fresh air system and the main factors that affect the fresh air purification system to improve indoor air quality. From December 9, 2019 to December 10, 2019, two classrooms of the same area on the third floor of a primary school building in Jinan City, Shandong Province were selected as monitoring points. During the operation of the fresh air purification system, the PM 2.5 concentration in the classroom is reduced by an average of 48.1%-61.5% compared to the outdoor PM 2.5 concentration. After running for about 2 hours, the indoor PM 2.5 concentration decreased to a relatively stable concentration level. The operating time of the fresh air purification system, student activities between classes, indoor temperature, indoor relative humidity, and outdoor PM 2.5 concentration are important factors that affect the indoor particulate removal rate. In the case of a certain amount of fresh air and indoor area, closing doors and windows and appropriately extending the operation time of the fresh air purification system can improve the air quality in the classroom to a certain extent and protect the health of students.