ABSTRACT
Objective:To investigate the association between abnormal left atrial appendage function and thrombotic events in patients with non-valvular atrial fibrillation, and the independent risk factors affecting left atrial appendage function.Methods:Patients with non-valvular atrial fibrillation, who visited the Atrial Fibrillation Center of the First Affiliated Hospital of Xinjiang Medical University from June 1, 2019 to June 1, 2021, were selected. According to left atrial appendage flow velocity (LAAFV), they were divided into normal left atrial appendage function group (297 patients with LAAFV ≥ 40 cm/s) and abnormal left atrial appendage function group (85 patients with LAAFV<40 cm/s). Baseline data and transesophageal echocardiography images were collected from all the patients. The occurrence of thrombotic events was recorded. Univariate and multivariate unconditional logistic regression analyses were conducted to investigate the correlation between abnormal left atrial appendage function and the occurrence of thrombotic events.Results:There were significant differences in gender, type of atrial fibrillation, CHA 2DS 2-VASc score, anticoagulant therapy, total cholesterol, low-density lipoprotein cholesterol, international normalized ratio (INR), left atrial diameter, proportion of patients with right atrial enlargement, left ventricular ejection fraction, inner diameter, sum of inner diameter, depth, and sum of depth of all angles of the left atrial appendage, and incidence of thrombotic events between the two groups (all P<0.05). After adjusting for confounders, multivariate unconditional logistic regression analyses showed that abnormal left atrial appendage function was closely associated with thrombotic events (β=1.168 P=0.002), and left atrial diameter ( OR=1.084, 95% CI 1.019-1.153, P=0.011) and persistent atrial fibrillation ( OR=2.323, 95% CI 1.226-4.403, P=0.010) were independent risk factors affecting left atrial appendage function. Conclusions:Abnormal left atrial appendage function is closely associated with thrombosis. The left atrial diameter and persistent atrial fibrillation were independent risk factors affecting left atrial appendage function.
ABSTRACT
More and more clinical trials have proved the efficacy of targeted drugs in the treatment of hepatocellular carcinoma (HCC).With the development of science and technology,more and more targeted drugs have appeared.In recent years,targeted drugs such as regorafenib and ramucirumab have shown great potential in related clinical trials.In addition,there are ongoing clinical trials for second-linecandidate drugs,such as c-Met inhibitors tivantinib and cabozantinib and a VEGFR-2 inhibitor ramucirumab.This article summarizes the advances in targeted drug therapy for HCC and related trial data,which provides a reference for further clinical trials and treatment.
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Objective To study community morbidity of gastroesophageal reflux cough (GERC),and then establish its procedure of diagnosis. Methods For the patients with chronic cough, on the basis of inquiring medical history and physical examination, chest radiograph, induced sputum, pulmonary ventilation function and airway hyperresponsiveness, blood eosinophilic, IgE,allergens skin test, nose, throat examination,sinus X-ray or pharyngoscope etc was managed. On the basis of the results,patients suspecting GERC was screened out, and then RDQ was performed, extra-esophageal symptoms related performance was inquired and scores were recorded. The patients with scores ≥ 12 were diagnosed as GERC; the patients with scores ＜ 12 were performed diagnosing treatment with proton pump inhibitor (PPI),and patients with positive results were diagnosed as GERC. The materials was analyzed statistically. Results The patients with chronic cough were 430 cases,and the community morbidity of GERC was 22.79%(98/430). RDQ ≥12 scores was 68.37%(67/98),and RDQ ＜ 12 scores was 31.63%(31/98).There was significant difference in extra-esophagus manifestation (P ＜0.01);26 cases with RDQ ＜12 scores were diagnosed as GERC (83.87%),and the rate of GERC in chronic cough was 21.63% (93/430). Conclusions RDQ is a favourable screening test in diagnosing GERC. PPI diagnosing treatment has high sensibility in GERC. It is necessary to establish community diagnosis procedure.