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Tianjin Medical Journal

Table of Content

    15 September 2025, Volume 53 Issue 9 Previous Issue    Next Issue
    Cell and Molecular Biology
    Experimental Research
    Clinical Research
    Applied Research
    New Technology
    Multidisciplinary Diagnosis and Treatment
    Review
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    Cell and Molecular Biology
    Research on the anti-tumor mechanism of toosendanin combined with olaparib in triple negative breast cancer
    HUANG Huiqi, WU Qiuyuan, ZHANG Kun, LI Peixian, XIONG Yaming, YE Guolin, ZHOU Dan
    2025, 53 (9):  897-902.  doi: 10.11958/20250238
    Abstract ( 539 )   HTML ( 6 )   PDF (1353KB) ( 73 )  

    Objective To investigate the anti-tumor mechanism of natural compound toosendanin (TSN) combined with olaparib in triple-negative breast cancer (TNBC). Methods Human TNBC cell line MDA-MB-231 was cultured in vitro. Effects of TSN combined with olaparib on autophagy levels and cell viability in MDA-MB-231 cells were evaluated using 0.5, 1.0, and 5.0 μmol/L olaparib alone or in combination. Surgical specimens from four TNBC patients who had residual tumors after neoadjuvant chemotherapy were selected to establish patient-derived organoid (PDO) models. The drug sensitivity of TSN combined with olaparib in TNBC patients was detected. Whether TSN combined with olaparib can exert autophagy inhibitory effects and tumor-killing effects in organoid model was verified. Results Olaparib induced autophagy in MDA-MB-231 cell line, and the combination of TSN and olaparib inhibited the proliferation of MDA-MB-231 cells (P<0.01). In the TNBC PDOs model, the therapeutic effect of olaparib combined with TSN can significantly reduce the proliferation ability of tumor cells compared with olaparib alone. Conclusion The tumor-killing effect of TSN combined with olaparib is superior to that of olaparib alone, and the mechanism may be related to autophagy inhibition.

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    The effect of LncRNA SNHG14 on high glucose induced podocyte injury by targeting miR-30a-5p
    KONG Cuiwen, LU Yanshuang, SUN Liping, YU Fenfen
    2025, 53 (9):  903-909.  doi: 10.11958/20251830
    Abstract ( 111 )   HTML ( 6 )   PDF (1176KB) ( 95 )  

    Objective To investigate the effect of long non-coding RNA small nucleolar RNA host gene 14 (LncRNA SNHG14) on high glucose-induced podocyte injury by targeting microRNA-30a-5p (miR-30a-5p). Methods Podocytes were cultured in vitro and were divided into the following groups: the standard glucose (NG) group, the high glucose (HG) group, the si-NC+HG group, the si-SNHG14+HG group, the miR-NC+HG group, the miR-30a-5p mimics+HG group, the si-SNHG14+inhibitor NC+HG group and the si-SNHG14+miR-30a-5p inhibitor+HG group. Quantitative real-time polymerase chain reaction (RT-qPCR) was performed to detect expression levels of LncRNA SNHG14 and miR-30a-5p. Flow cytometry was used to determine cell apoptosis. Enzyme-linked immunosorbent assay (ELISA) was applied to measure levels of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6 and IL-1β. Xanthine oxidase method, ammonium molybdate colorimetry and thiobarbituric acid method were respectively used to detect superoxide dismutase (SOD), catalase (CAT) and malondialdehyde (MDA). Dual-luciferase reporter gene was conducted to verify the targeting relationship between LncRNA SNHG14 and miR-30a-5p. Western blot assay was performed to detect expression levels of apoptosis-related proteins. Results Compared with the NG group, the HG group exhibited increased expression levels of LncRNA SNHG14, cell apoptosis rate, as well as levels of TNF-α, IL-6, IL-1β and MDA, whereas the expression level of miR-30a-5p and levels of SOD and CAT were decreased (P<0.05). Compared with the HG group and the si-NC+HG group, the si-SNHG14+HG group exhibited decreased expression levels of LncRNA SNHG14, apoptosis rate, levels of TNF-α, IL-6, IL-1β and MDA, as well as expression levels of Bax and cleaved caspase-3 proteins, while the expression level of miR-30a-5p, levels of SOD and CAT and the expression level of Bcl-2 protein were increased (P<0.05). Compared with the HG group and the miR-NC+HG group, the miR-30a-5p mimics+HG group showed no significant difference in the expression level of LncRNA SNHG14 (P>0.05). Meanwhile, the expression level of miR-30a-5p, levels of SOD and CAT, and expression level of Bcl-2 protein were increased, whereas the cell apoptosis rate, levels of TNF-α, IL-6, IL-1β and MDA, as well as expression levels of Bax and cleaved caspase-3 proteins were decreased (P<0.05). Compared with the si-SNHG14+HG group and the si-SNHG14+inhibitor NC+HG group, the si-SNHG14+miR-30a-5p inhibitor+HG group showed no significant difference in the expression level of LncRNA SNHG14 (P>0.05), meanwhile, the expression level of miR-30a-5p, levels of SOD and CAT, and expression level of Bcl-2 protein were reduced, whereas the cell apoptosis rate, levels of TNF-α, IL-6, IL-1β and MDA, as well as expression levels of Bax and cleaved caspase-3 proteins were increased (P<0.05). The dual-luciferase reporter gene assay confirmed that LncRNA SNHG14 targeted and negatively regulated miR-30a-5p. Conclusion The inhibition of LncRNA SNHG14 can target miR-30a-5p to alleviate high glucose induced podocyte injury.

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    Experimental Research
    The effect of sevoflurane on neuronal inflammation in rats with spinal cord injury by regulating the ROS/TXNIP/NLRP3 pathway
    ZHOU Yuke, SUN Wei, GAO Qing, HE Jun
    2025, 53 (9):  910-915.  doi: 10.11958/20251781
    Abstract ( 98 )   HTML ( 3 )   PDF (1064KB) ( 63 )  

    Objective To investigate the effect of sevoflurane on neuroinflammation in rats with spinal cord injury by regulating the reactive oxygen species (ROS)/thioredoxin-interacting protein (TXNIP)/nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) pathway. Methods Seventy-two rats were randomly divided into six groups using a random number table method, with 12 rats in each group: the model group (establishing the rat model of spinal cord injury), the sham operation group, the low-, medium- and high-concentration sevoflurane groups (1%, 2% and 4% sevoflurane, respectively) and the combination group (4% sevoflurane + 3.7 mg/kg reactive oxygen species (ROS) activator trimethylamine N-oxide). Spinal cord injury behavior (BBB) score and footprint imprint test were used to evaluate motor function. ELISA method was used to detect the levels of IL-18, TNF-α and IL-1β in spinal cord tissue. HE staining was used to detect pathological changes in spinal cord tissue. TUNEL method was used to detect cell apoptosis. In addition, the expression of TXNIP and NLRP3 mRNA were detected by qRT-PCR. ROS activity was detected by ROS kit. Western blot assay was used to detect the expression of ROS/TXNIP/NLRP3 pathway proteins. Results The sham operation group showed normal gait, normal cell morphology with orderly arrangement and intact spinal cord structure. The model group presented with toe dragging, severe spinal cord tissue injury and inflammatory cell infiltration. The BBB score was lower in the model group compared to that of the sham surgery group, while IL-18, TNF-α, IL-1β levels, apoptosis rate, ROS activity, TXNIP, NLRP3 mRNA and protein expression were increased (P<0.05). The above indexes were improved in the low-concentration, medium-concentration and high-concentration sevoflurane groups compared with those in the model group. However, the combined group reversed the improvement results of the high-concentration sevoflurane group. Conclusion Sevoflurane can alleviate neuroinflammation in rats with spinal cord injury by inhibiting the ROS/TXNIP/NLRP3 pathway.

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    The in vivo and in vitro effects of Eriodictyol on metabolic dysfunction-associated steatotic liver disease by regulating UBA52 expression
    LIN Yiwei, WEI Tanjun, CHEN Fei, XIAO Cheng, YUAN Lie, WANG Yi
    2025, 53 (9):  916-922.  doi: 10.11958/20252251
    Abstract ( 123 )   HTML ( 4 )   PDF (1463KB) ( 41 )  

    Objective To investigate the effect of Eriodictyol (ERI) on the development of metabolic dysfunction-associated steatotic liver disease by regulating the expression of ubiquitin A 52 (UBA52) at both in vivo and in vitro levels. Methods A mouse metabolic dysfunction-associated steatotic liver disease model was established using a high-fat diet induction. The mice were randomly separated into the normal control group (normal group), the model group, the low-dose ERI group (ERI-L group, 50 mg/kg ERI) and the high-dose ERI group (ERI-H group, 100 mg/kg ERI), with 12 mice in each group. Oil red O staining was applied to observe lipid deposition in mouse liver tissue. HE staining was applied to observe pathological changes in mouse liver tissue. ELISA method was applied to detect serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC) and triglycerides (TG) in mice. The expression of UBA52 protein in liver was detected by Western blot assay. HepG2 cells were treated with 0.5 mmol/L oleic acid to induce an in vitro metabolic dysfunction-associated steatotic liver disease model. HepG2 cells were randomly divide into the control group, the oleic acid induced group, the low concentration ERI group (ERI low group, 50 μmol/L ERI), the high concentration ERI group (ERI high group, 100 μmol/L ERI), the high concentration ERI+si-NC group (ERI high+si-NC group, 100 μmol/L ERI+transfected with si-NC) and the high concentration ERI+si-UBA52 group (ERI high+si-UBA52 group, 100 μmol/L ERI+transfected with si-UBA52). Oil red O staining was applied to detect lipid deposition in HepG2 cells of each group. ELISA method was applied to detect the levels of TG, TC, SOD and MDA in HepG2 cells in each group. Immunoblotting was used to detect the expression levels of UBA52, p62 and autophagy related proteins in HepG2 cells. Results Compared with the normal group, serum levels of ALT, AST, LDL-C, TC, TG and the expression of UBA52 protein in liver tissue were increased in the model group (P<0.05), and the lipid deposition in liver increased, pathological damage was severe, and the proportion of lipid deposition area and non-alcoholic fatty liver disease (NAFLD) activity score were also increased (P<0.05). Changes in the corresponding indicators in the ERI-L group and the ERI-H group were opposite to those of the model group (P<0.05), and the ERI-H group was even lower (P<0.05). The lipid deposition in liver decreased and the pathological damage was alleviated. Compared with the control group, the levels of TG, TC, MDA, the proportion of lipid droplet area and the expression of UBA52 protein were increased in HepG2 cells of the oleic acid-induced group, while the levels of SOD, p62 and LC3Ⅱ/LC3Ⅰ decreased (P<0.05). Changes in the corresponding indicators of the low-concentration ERI group and the high-concentration ERI group were opposite to those of the oleic acid-induced group (P<0.05), and the therapeutic effect of ERI on metabolic dysfuntion-associated steatotic liver disease was enhanced after knocking down the expression of UBA52. Conclusion ERI may slow down the progression of metabolic dysfuntion-associated steatotic liver disease by down-regulating the expression of UBA52 at both in vivo and in vitro levels.

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    Clinical Research
    Analysis of macular retinal thickness characteristics in diabetic kidney disease patients with different blood pressure levels
    MA Liang, HU Liying, SHI Yu, ZHAO Yongan, SUN Yasi, SUN Guangdong
    2025, 53 (9):  923-926.  doi: 10.11958/20252128
    Abstract ( 98 )   HTML ( 1 )   PDF (744KB) ( 87 )  

    Objective To compare the macular retinal thickness characteristics of diabetic kidney disease (DKD) patients with different blood pressure levels and explore the relationship between blood pressure and macular retinal damage in DKD patients. Methods A total of 435 DKD patients were selected and divided into four groups based on medical history and blood pressure: the non-hypertensive group (NH group, n=100), the well-controlled blood pressure group (G0 group, n=176), the grade 1 hypertension group (G1 group, n=118) and the grade 2 hypertension group (G2 group, n=41). General information, routine laboratory test results as well as the average thickness of the macular retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), ganglion cell complex (GCC), choroidal layer (CL) and central macular retinal thickness (CMT) were compared between the four groups. The correlation between macular retinal thickness in both eyes and clinical data was analyzed. Results Compared with the G1 group and the G2 group, the G0 group had a longer duration of hypertension. Compared to the NH group, the G2 group had higher fasting plasma glucose (FPG). Compared to the G0 group, the G1 group and the G2 group had higher FPG, and the G2 group had higher glycated hemoglobin (HbA1c) and lower estimated glomerular filtration rate (eGFR). Compared to the NH group, the G0 group had decreased thickness in the GCL and GCC (P < 0.05). The macular retinal thickness of the GCL and GCC in both eyes was negatively correlated with diastolic blood pressure (r = -0.158 and -0.195, respectively, P < 0.05). Conclusion Macular retinal thickness is helpful in assessing the long-term effects of hypertension on optic nerve and microvascular damage in DKD patients.

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    Correlation of vascular endothelial growth factor with the severity of cystoid macular edema in patients with diabetes mellitus
    XIE Pengliang, ZHENG Lufang, LI Yan, ZHENG Yanjin, BAI Lingdi, ZHAO Xia, LU Yinglong
    2025, 53 (9):  927-931.  doi: 10.11958/20250186
    Abstract ( 103 )   HTML ( 1 )   PDF (819KB) ( 50 )  

    Objective To investigate the correlation between serum vascular endothelial growth factor (VEGF) level and the development and severity of diabetes mellitus cystoid macular edema (CME). Methods A total of 57 patients (57 eyes) with diabetic CME (the case group) and diabetes without eye complications (the control group) admitted to the Vitreoretinal Surgery Department of Tangshan Eye Hospital from June 2023 to June 2024 were prospectively selected, and all of them underwent systematic ophthalmic specialty examination and serum VEGF detection. Multivariate Logistic regression analysis was used to identify the risk factors of diabetes mellitus CME. The diagnostic value of VEGF in patients with diabetes CME was analyzed by receiver operating characteristic (ROC) curve. Spearman correlation was used to analyze the relationship between VEGF levels and the severity of CME in patients with diabetes, such as corrected visual, number of cystoid edema and non-round index of macular foveal avascular zone (FAZ). Results Compared with the control group, the course of diabetes in the case group was longer, the incidence of hypertension was higher, levels of glycosylated hemoglobin (HbA1c), serum creatinine and serum VEGF were higher, and the estimated glomerular filtration rate (eGFR) was lower (P<0.05). Multivariate Logistic regression results showed that long duration of diabetes, increased levels of HbA1c and VEGF were risk factors for CME in diabetes mellitus patients, while elevated eGFR was protective factor (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of VEGF in diagnosing diabetes mellitus CME was 0.758 (95%CI：0.669-0.834). The AUC of the combined application of diabetes duration, HbA1c, eGFR and VEGF in the diagnosis of diabetes mellitus CME was 0.916 (95%CI：0.877-0.941), which was significantly higher than that of the application of VEGF alone (P<0.05). The VEGF level was negatively correlated with the corrected visual acuity [0.34 (0.24, 0.44)] in patients with diabetic CME, and positively correlated with the detection of cystoid macular edema [3 (2,5)] and FAZ non-roundness index [1.16 (1.08, 1.20)] (rs were 0.771, 0.700, respectively, P<0.05). Conclusion Serum VEGF levels are closely related to the onset and severity of CME, and which can be used as a reliable reference index for the diagnosis of CME.

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    The relationship between the systemic immune-inflammation index and the clinical pathological characteristics of patients with IgA nephropathy
    LI Shuo, ZHANG Yunpeng, HUANG Yan, CAO Meiran, JIA Lanfang, HU Guicai, HUANG Lan, DUAN Shuzhong
    2025, 53 (9):  932-936.  doi: 10.11958/20251184
    Abstract ( 92 )   HTML ( 1 )   PDF (833KB) ( 167 )  

    Objective To explore the correlation between the systemic immune-inflammation index (SII) and the clinical and pathological characteristics of patients with IgA nephropathy (IgAN). Methods A total of 350 patients who underwent renal biopsy and were initially diagnosed with primary IgAN were selected. The clinical and pathological data of the patients were collected, and SII was calculated. According to the median SII level of 554.78 in peripheral blood, the IgAN patients were divided into the low SII group (SII ≤ 554.78, 175 cases) and the high SII group (SII > 554.78, 175 cases). Based on the presence or absence of endocapillary hyperplastic (E) lesion, 350 patients were also divided into the E0 group (279 cases, 79.7%) and the E1 group (71 cases, 20.3%). Multivariate Logistic regression analysis was conducted to determine the influencing factors of E1 in IgAN patients. A predictive model was established, and the predictive value of the model was evaluated using the receiver operating characteristic (ROC) curve. Results There were higher systolic blood pressure (SBP), platelet count (PLT), neutrophil count (NEU), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), total cholesterol (TC), serum creatinine (Scr), serum C3 and 24-hour urine protein levels in the high SII group than those of the low SII group, while the lymphocyte count (LYM) was lower (P<0.05). In terms of pathological manifestations, the proportion of E1 was higher in the high SII group than that of the low SII group (P<0.05). There were lower PLT, NEU, NLR, PLR, Scr and 24-hour urine protein in patients of the E0 group than those of the E1 group, while higher Hb, LYM and ALB levels in the E0 group than those of the E1 group (P<0.05). Multivariate Logistic regression analysis showed that elevated SII, Scr and 24-hour urine protein levels were independent risk factors for E1 lesion in IgAN patients (P<0.05). The area under the curve (AUC) of the predictive model for E1 lesion in IgAN patients was 0.781（95%CI：0.722-0.840）. Conclusion SII can reflect the clinical and pathological severity in IgAN patients, providing new insights for clinical evaluation of the disease progression in IgAN patients.

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    Analysis of risk factors for hypokalemia caused by piperacillin/tazobactam
    ZHOU Lijun, ZENG Wenjing, HU Qin
    2025, 53 (9):  937-941.  doi: 10.11958/20252000
    Abstract ( 104 )   HTML ( 1 )   PDF (784KB) ( 123 )  

    Objective To analyze risk factors of hypokalemia after treatment with piperacillin-tazobactam (PTZ) and to provide a reference for safe clinical medication. Methods A retrospective collection of 1 355 inpatients treated with PTZ was conducted. Patients were assigned to the hypokalemia group (serum potassium < 3.5 mmol/L, 374 cases) and the non-hypokalemia group (serum potassium ≥ 3.5 mmol/L, 981 cases) based on whether they suffered from hypokalemia after PTZ treatment. Clinical data were collected and compared in both groups of patients. Multifactorial Logistic regression analysis was used to identify the influencing factors of hypokalemia induced by PTZ. Results In the hypokalemia group, there were 308 cases of mild hypokalemia (82.3%), 63 cases of moderate hypokalemia and 3 cases of severe hypokalemia. The incidence of moderate to severe hypokalemia was 4.9%, with the lowest serum potassium concentration recorded at 2.1 mmol/L. The proportion of females, treatment duration, cumulative dosage, age-adjusted Charlson Comorbidity Index ( aCCI )，the percentage of patients with platelets (PLT) <100×109/L and the proportion of patients using glucocorticoids were all higher in the hypokalemia group than those of the non-hypokalemia group (P<0.05). Conversely, baseline serum potassium levels and red blood cell (RBC) were lower in the hypokalemia group than those of the non-hypokalemia group (P<0.05). Multivariate Logistic regression analysis indicated that female, increased cumulative dosage, elevated aCCI and lower baseline serum potassium concentration were risk factors for PTZ induced hypokalemia (P<0.05). Conclusion Female, lower basline serum potassium level, long-term high-dose use of PTZ and high comorbidity index are risk factors for the occurrence of PTZ-induced hypokalemia. The changes in serum potassium during the medication period of this type of patients should be closely monitored to ensure the safety of drug use for patients.

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    The clinical significance of Th17 cell heterogeneity in myelodysplastic neoplasms
    WANG Yichen, ZHOU Wenguang, YAN Yanwen, YI Fang, QIN Lingsha, LI Wei, LI Yuquan, ZENG Xiangzong
    2025, 53 (9):  942-945.  doi: 10.11958/20250670
    Abstract ( 86 )   HTML ( 1 )   PDF (793KB) ( 73 )  

    Objective To investigate the proportion of Th17 cells, Th1-like Th17 cells and FoxP3+ Th17 cells in bone marrow of patients with myelodysplastic syndrome (MDS), the expression of interleukin-17A (IL-17A) in bone marrow supernatant and its clinical significance. Methods Forty MDS patients (MDS group) and 18 patients with nutritional anemia (control group) were selected. MDS patients were classified into the low blast (MDS-LB) group (19 cases) and the increased blast (MDS-IB) group (21 cases, including 11 cases of type IB1 and 10 cases of type IB2) based on morphological definition. The MDS patients were scored according to the revised International Prognostic Scoring System (IPSS-R), with 18 cases in the low-risk group (≤4.5) and 22 cases in the high-risk group (>4.5). Flow cytometry was used to detect the proportion of Th17 cells, Th1-like Th17 cells and FoxP3+ Th17 cells in bone marrow of the MDS group and the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the level of IL-17A in bone marrow supernatant of the above samples. Results The proportion of Th17 cells and the level of IL-17A were higher in patients of the MDS group than those in the control group (P<0.05). According to the median expression level of IL-17A, the MDS group was divided into the low-expression group (<13.71 ng/L, 20 cases) and the high-expression group (≥13.71 ng/L, 20 cases). Compared with the low-expression group, there were higher proportion of patients with blast cells <5% and low-risk patients (P<0.05) in the high-expression group. Compared with the IL-17A low-expression group, the IL-17A high-expression group had a higher proportion of patients with blast cells <5% and relatively low-risk patients (P<0.05). Compared with the low-risk patients, high-risk patients had a lower proportion of Th17 cells, IL-17A levels and Th1-like Th17 cells, and a higher proportion of FoxP3+ Th17 cells (P<0.05). Compared with the MDS-LB group, the MDS-IB group had a lower proportion of Th17 cells, IL-17A levels and Th1-like Th17 cells, and a higher proportion of FoxP3+ Th17 cells (P<0.05). Conclusion The proportion of Th17 cells and the level of IL-17A are significantly increased in MDS patients. The decreased proportion of Th1-like Th17 cells and the increased proportion of FoxP3+ Th17 cells may be related to the increased proportion of blast cells and higher risk stratification in patients.

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    Multi-omics analysis of the causal relationship and mediation mechanisms between obstructive sleep apnea and atrial fibrillation
    CHEN Miaomiao, ZHANG Yazheng, ZHAO Fang, YANG Liheng, JIAO Lina, ZHAO Xiaoyun
    2025, 53 (9):  946-951.  doi: 10.11958/20250987
    Abstract ( 122 )   HTML ( 2 )   PDF (888KB) ( 70 )  

    Objective To analyse the causal relationship between obstructive sleep apnea (OSA) and atrial fibrillation (AF) by Mendelian randomization (MR) method, and to explore the role of inflammatory factors, immune cells, blood metabolites and circulating proteins in it. Methods In this study, MR analysis was used to investigate the causal link between OSA and AF. Inverse variance weighting (IVW), MR-Egger and other methods were used for sensitivity analysis. Additionally, the study also explored the effects of 91 inflammatory factors, 731 immune cells, 1 400 blood metabolites and 4 907 circulating proteins on AF. Results MR analysis revealed a significant causal relationship between OSA and AF (OR = 1.078, P<0.05). Conversely, reverse MR analysis did not find causal relationship between AF and OSA (P>0.05). Further analysis revealed that 5 inflammatory factors, 19 immune cells, 15 blood metabolites and 67 circulating proteins were risk factors for AF. Among them, OSA was the risk factor for one inflammatory factor, one blood metabolite and 12 circulating proteins. There was no significant causal association between OSA and 19 immune cells. Conclusion This study demonstrates that OSA increases the risk of AF. Meanwhile, it is found that inflammatory factors, immune cells, blood metabolites and circulating proteins have potential impacts on the pathogenesis of AF.

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    Preoperative immune factors in patients with primary hepatocellular carcinoma and their relationship with pathological characteristics
    ZHOU Pengpeng, DING Shuo, YAO Weikang, LUO Yi
    2025, 53 (9):  952-956.  doi: 10.11958/20251548
    Abstract ( 91 )   HTML ( 2 )   PDF (790KB) ( 42 )  

    Objective To analyze changes of preoperative T lymphocyte immunity and humoral immunity, and their relationship with pathological characteristics in patients with primary hepatocellular carcinoma (HCC). Methods A total of 150 patients with primary HCC underwent elective surgical treatment were enrolled as the HCC group, while 150 healthy controls during the same period were enrolled as the control group. Before surgery, the levels of peripheral blood CD3+, CD4+ and CD8+ were detected by flow cytometry, and CD4+/CD8+ was calculated. The levels of IgA, IgG and IgM in peripheral blood were detected by immunoturbidimetry. The pathological characteristics of HCC patients were collected, and the differences of preoperative immune indexes in patients with different pathological characteristics were compared. The receiver operating curve (ROC) was used to evaluate the predictive value of immune indicators for pathological characteristics. Results The levels of CD3+, CD4+ and CD4+/CD8+ were lower in the HCC group than those in the control group, while levels of CD8+, IgA, IgG and IgM were higher in the HCC group than those in the control group (P<0.05). The levels of CD3+, CD4+ and CD4+/CD8+ were lower in patients with lymph node metastasis than those of patients with distant lymph non-metastasis (P<0.05). The levels of CD8+, IgA, IgG and IgM were higher in patients with lymph node metastasis than those of patients without metastasis (P<0.05). The results of receiver operating characteristic (ROC) curves showed that area under the curve (AUC) values of CD3+, CD4+, CD8+, CD4+/CD8+, IgA, IgG, and IgM for predicting lymph node metastasis in HCC patients were 0.810, 0.741, 0.770, 0.707, 0.756, 0.738 and 0.727. Conclusion There are abnormal changes of preoperative T lymphocyte immunity and humoral immunity in patients with primary HCC, which are closely related to lymph node metastasis.

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    Influence of low-frequency repetitive transcranial magnetic stimulation combined with brain-computer interface rehabilitation robot on stroke patients with upper limb motor dysfunction
    ZHEN Tingting, HU Shunting, WANG Zheng, XU Mi, RUAN Chenglong
    2025, 53 (9):  957-962.  doi: 10.11958/20251930
    Abstract ( 147 )   HTML ( 5 )   PDF (765KB) ( 45 )  

    Objective To explore the influence of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with brain-computer interface rehabilitation robot in patients with upper limb motor dysfunction after stroke. Methods A total of 126 patients with upper limb motor dysfunction after stroke were divided into the combined group (61 cases, low-frequency rTMS combined with brain-computer interface rehabilitation robot on the basis of routine rehabilitation treatment) and the magnetic stimulation group (65 cases, low-frequency rTMS on the basis of routine rehabilitation treatment) according to different treatment methods, and both groups were continuously treated for 3 weeks. The upper limb motor function[upper-extremity Fugl-Meyer scale (UFMA), action research arm test (ARAT)], hand Brunnstrom staging, upper limb surface electromyography indicators [root mean square (RMS) and integrated electromyography (iEMG) of biceps brachii, triceps brachii, deltoid anterior bundle and deltoid middle bundle], cerebral artery hemodynamics [systolic blood flow velocity (Vs), resistance index (RI), mean blood flow velocity (Vm)] and ratio of fractional anisotropy (FA) of central region of brain lesion and FA of mirror-image region of healthy cerebral hemisphere (rFA) were observed before and after treatment in the two groups. Results Compared with the magnetic stimulation group, the UFMA score, ARAT score, hand Brunnstrom staging, Vs, Vm and rFA were higher after treatment in the combined group (P<0.05). The RMS and iEMG of biceps brachii, triceps brachii, deltoid anterior bundle and deltoid middle bundle were higher in the combined group compared with those of the magnetic stimulation group (P<0.05),while the RI was lower (P<0.05). Conclusion Combined treatment can more effectively improve the upper limb motor function of patients, enhance hand activity ability, promote the recovery of upper limb muscle and nerve function, and regulate the hemodynamics of cerebral arteries.

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    Diagnostic value of epicardial adipose tissue thickness combined with serum ADAM10 and STIM1 for coronary heart disease
    XU Peilu, QIAO Jianmin, LI Jing, LIU Jianrong, CHEN Shujun, JI Chunpeng
    2025, 53 (9):  963-966.  doi: 10.11958/20250781
    Abstract ( 76 )   HTML ( 1 )   PDF (826KB) ( 42 )  

    Objective To explore the diagnostic value of epicardial adipose tissue (EAT) thickness combined with serum disintegrin metalloprotease 10 (ADAM10) and stromal interaction molecule 1 (STIM1) in coronary heart disease (CHD). Methods A total of 119 CHD patients were included as the study group, and 100 non-CHD patients in the same period were selected as the control group. The clinical data of the patients were collected. Serum ADAM10 and STIM1 levels were detected by enzyme-linked immunosorbent assay (ELISA). Color Doppler ultrasonography was applied to detect EAT thickness. Multivariate Logistic regression was used to analyze influencing factors of CHD occurrence. The diagnostic value of EAT thickness combined with serum ADAM10 and STIM1 levels in the diagnosis of CHD was analyzed by subject work characteristics (ROC) curves. Results The levels of triglycerides, low-density lipoprotein cholesterol (LDL-C), EAT thickness, serum ADAM10 and STIM1 were higher in the study group than those in the control group (P<0.05). Logistic regression analysis showed that elevated EAT thickness, serum ADAM10, STIM1, triglyceride and LDL-C levels were independent risk factors for the occurrence of CHD (P<0.05). ROC curve analysis showed that the area under the curve of EAT thickness combined with serum ADAM10 and STIM1 for the diagnosis of CHD [0.864 (95%CI: 0.811-0.907)] was higher than that of their respective individual diagnoses [0.801 (95%CI: 0.741-0.851), 0.750 (95%CI: 0.687-0.806), respectively, 0.799 (95%CI: 0.740-0.850)], and the sensitivity and specificity of the combined diagnosis were 82.35% and 83.00%, respectively. Conclusion EAT thickness, serum ADAM10 and STIM1 levels are obviously elevated in CHD patients, and the combination of the three tests has a high diagnostic value for CHD.

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    The predictive value of preoperative CALLY index for the short-term prognosis in patients undergoing radical gastrectomy
    GAO Zhengjie, MENG Tao, ZHANG Qiao, CHEN Binghe, HOU Dong, ZHU Shaohui
    2025, 53 (9):  967-971.  doi: 10.11958/20250589
    Abstract ( 124 )   HTML ( 3 )   PDF (859KB) ( 244 )  

    Objective To explore the predictive value of the preoperative C-reactive protein-albumin-lymphocyte ratio (CALLY index) for short-term prognosis in patients undergoing radical gastrectomy. Methods The clinical data of 228 gastric cancer patients who underwent radical gastrectomy were retrospectively analyzed. Based on follow-up results, patients were divided into the good prognosis group (n=205) and the poor prognosis group (n=23). The differences in clinical characteristics and laboratory test results between the two groups were compared. Cox proportional hazards regression model was used to analyze the impact of CALLY index on poor prognosis in patients. The receiver operating characteristic (ROC) curve was used to determine the clinical value and optimal cutoff value of CALLY index in predicting poor prognosis of patients. Kaplan-Meier method was used to analyze the difference in disease-free survival (DFS) between patients with different CALLY index levels. Results After a follow-up of 3 to 53 months (median follow-up of 36 months), 23 patients developed poor prognosis (including 3 deaths and 20 recurrences or metastases). Compared with the good prognosis group, tumors in the poor prognosis group were larger, the proportion of poorly differentiated tumors was higher and white blood cell count (WBC), neutrophil count (NEU), C-reactive protein (CRP) were higher, and lymphocyte (LYM), albumin (ALB), prealbumin, total cholesterol (TC) and CALLY indexl were lower. Multivariate Cox regression analysis showed that the elevated CALLY index (HR=0.306, 95%CI: 0.102-0.921, P=0.035) was an independent protective factor for poor prognosis, while larger tumors and poorly differentiated tumors were independent risk factors for poor prognosis. ROC curve analysis showed that the area under the curve for predicting poor prognosis in gastric cancer patients undergoing radical gastrectomy was 0.862 (95%CI: 0.810-0.904), with a sensitivity of 95.65%, specificity of 69.76%, and an optimal cutoff value of 2.21. Kaplan-Meier analysis showed that patients with a CALLY index > 2.21 had a longer disease-free survival than those with a CALLY index ≤2.21 (mean DFS: 48 months vs. 42 months, Log-rank χ2=4.123, P=0.042). Conclusion The preoperative CALLY index is a simple, effective and easily accessible predictor for predicting short-term prognosis in patients undergoing radical gastrectomy. A high CALLY index indicates a better prognosis of patient.

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    Application value of thyroid nodule fine needle aspiration cytology combined with BRAF gene detection in the differential diagnosis of benign and malignant thyroid tumors
    YANG Tao, QUAN Yan, ZHANG Jiameng, XIE Qingyun, HUANG Linzhou
    2025, 53 (9):  972-975.  doi: 10.11958/20241258
    Abstract ( 111 )   HTML ( 2 )   PDF (839KB) ( 103 )  

    Objective To explore the value of thyroid nodule fine needle aspiration cytology (FNAC) combined with B-Raf proto-oncogene, serine/threonine kinase (BRAF) gene detection in the differential diagnosis of benign and malignant thyroid tumors. Methods According to the results of pathological examination, 198 patients with thyroid nodules were divided into the benign lesion group (n=107) and the malignant lesion group (n=91). All patients underwent ultrasound-guided FNAC, and expression of BRAF gene was detected by real-time fluorescence quantitative polymerase chain reaction. The value of FNAC, BRAF gene detection and combined detection in the differential diagnosis of benign and malignant thyroid tumors was analyzed by Kappa consistency test and receiver operating characteristic (ROC) curves. Results The nodules were mostly under envelope in the malignant lesion group, while in the benign lesion group, which were mostly located within glands (P<0.05). FNAC results showed that 62 cases with type II Bethesda, 26 cases with type III Bethesda, 29 cases with type IV Bethesda, 14 cases with type V Bethesda and 67 cases with type VI Bethesda. There were significant differences in diagnostic positive rates between FNAC, BRAF gene detection, combined detection and pathological examination (P<0.05). The area under ROC curve (AUC) of FNAC combined with BRAF gene detection for differentiating benign and malignant thyroid tumors was 0.871 (95%CI：0.816-0.914), sensitivity was 90.11%, specificity was 84.11% and Kappa value was 0.737. The AUC of FNAC diagnosis was 0.833 (95%CI: 0.774-0.882), sensitivity was 76.92%, specificity was 89.72% and Kappa value was 0.672. The AUC of BRAF gene detection was 0.829（95%CI：0.770-0.879), sensitivity was 78.02%, specificity was 87.85% and Kappa value was 0.663. Conclusion FNAC combined with BRAF gene detection can improve differential diagnosis efficiency for benign and malignant thyroid lesions, especially enhancing the diagnostic sensitivity.

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    Construction of a prediction model for prolonged hospital stay in children with pneumonia and its clinical application value
    CAI Miao, LIANG Shuang, LIU Yang
    2025, 53 (9):  976-980.  doi: 10.11958/20251021
    Abstract ( 108 )   HTML ( 2 )   PDF (838KB) ( 35 )  

    Objective To construct a prediction model for the length of hospitalization in children with pneumonia based on clinical characteristics. Methods A retrospective analysis of the clinical data of 1 255 children with pneumonia was conducted. The patients were divided into two groups based on the median length of hospitalization: the ≤7 days group (628 cases) and the >7 days group (627 cases). The differences between the two groups in demographic characteristics, past medical history, clinical manifestations, laboratory test results, imaging findings, treatment plans and other clinical data were compared. A multivariate stepwise Logistic regression analysis was performed to identify the factors influencing hospitalization for >7 days and to construct a prediction model. The model was evaluated using the receiver operating characteristic (ROC) curve and the clinical decision curve. Results Compared to the ≤7 days group, children in the >7 days group were younger in gae, had higher height, a higher proportion of preterm infants, a higher proportion of previous pneumonia history, and a higher body temperatures at admission. Furthermore, in the >7 days group, white blood cell count, neutrophil count, platelet count, C-reactive protein (CRP) and procalcitonin levels were elevated. The proportion of bilateral lesions, oxygen therapy, respiratory support and pleural effusion were higher, while lymphocyte count and hemoglobin levels were lower (P < 0.05). The results of the multivariate Logistic regression analysis showed that age (OR=0.979, 95% CI: 0.972-0.987), history of prematurity (OR=1.751, 95% CI: 1.216-2.521), previous history of pneumonia (OR=1.520, 95% CI: 1.037-2.228), admission temperature (OR=1.290, 95% CI: 1.097-1.518), serum CRP (OR=1.019, 95% CI: 1.013-1.025), pleural effusion (OR=1.980, 95% CI: 1.309-2.994) and oxygen therapy (OR=2.849, 95% CI: 1.851-4.385) were independent risk factors for a hospital stay >7 days in children with pneumonia. The model had an accuracy of 79.2%, and the area under the curve (AUC) was 0.919 (95% CI: 0.854-0.961). Conclusion The regression model constructed based on clinical characteristics can effectively predict the length of hospitalization in children with pneumonia. It provides scientific evidence for the early identification of high-risk children, optimization of treatment plans and shortening of hospital stays.

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    Analysis of risk factors for parenteral nutrition related water-soluble vitamin accumulation
    WANG Jingjing, WANG Ying, SHI Linlin, TIAN Xiaoxiao, QI Yumei, LI Guoxun
    2025, 53 (9):  981-986.  doi: 10.11958/20242415
    Abstract ( 103 )   HTML ( 1 )   PDF (841KB) ( 29 )  

    Objective To explore the influencing factors of abnormal increase of plasma water-soluble vitamins in patients with parenteral nutrition (PN). Methods A total of 862 hospitalized patients receiving nutritional diagnosis and treatment were enrolled. Daily water-soluble vitamin supply and total urine output were monitored. If patients underwent renal replacement therapy (RRT), the ultrafiltration volume was recorded. Plasma concentrations of nine water-soluble vitamins (Vit-C, B1, B2, B3, B5, B6, B7, B9 and B12) were measured. According to the test results, patients were divided into the accumulation group and the non-accumulation group. Renal function (BUN, Cr, UA), inflammatory indicators (CRP, WBC, NEU, SII) and nutritional indicators (ALB, PA, Hb, LYM) were compared between the two groups. Logistic regression was used to analyze the independent risk factors for the accumulation of water-soluble vitamins. Results There was a high incidence of abnormal plasma water-soluble vitamin levels, including Vit-B2 (36.08%), Vit-B6 (16.01%) and Vit-B5 (13.81%). Compared with the non-accumulation group, the Vit-B2 accumulation group had higher levels of age, BUN, Cr, UA and NEU, and lower levels of ALB, PA and urine volume. The Vit-B5 accumulation group had higher levels of BUN, Cr, UA and NEU, and lower levels of LYM, Hb, ALB, PA and urine volume. Patients in the Vit-B6 accumulation group was older, with increased levels of BUN, Cr and UA, and decreased levels of LYM, Hb, ALB, urine volume and vitamin intake (P<0.05). Multivariate Logistic regression analysis showed that the elevated level of BUN was independent risk factors for Vit-B2 accumulation, the elevated BUN and reduced urine volume were independent risk factors for Vit-B5 accumulation, and elevated BUN and Cr, as well as reduced urine volume, were independent risk factors for Vit-B6 accumulation. Receiver operating characteristic curve analysis showed that the area under the curve for BUN in predicting Vit-B2, B5 and B6 accumulation were 0.659 (95%CI: 0.620-0.697), 0.728 (95%CI: 0.675-0.781) and 0.785 (95%CI: 0.738-0.831), respectively, with high specificity but low sensitivity. Conclusion The serum levels of water-soluble vitamins are affected by renal function. When implementing parenteral nutrition water-soluble vitamins supplementation, the patient's renal function status should be evaluated, and the risk of abnormal elevation of Vit-B2, B5 and B6 should be vigilantly monitored.

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    Applied Research
    Correlation between Furin promoter methylation levels and blood pressure of non-diabetic population in a community
    JIA Wei, TIAN Zhi
    2025, 53 (9):  987-992.  doi: 10.11958/20251552
    Abstract ( 92 )   HTML ( 2 )   PDF (825KB) ( 42 )  

    Objective To investigate the correlation between Furin promoter methylation level and blood pressure in a community-based non-diabetic population. Methods A secondary analysis was conducted on the research data from a study in the Dryad open database regarding the methylation rate of Furin promoter and the risk of diabetes. After including the participants from the original data and excluding those with a history of cardiovascular disease, diabetes or diagnosed diabetes at the time of enrollment, those lacking blood samples, those who refused to participate in follow-up examinations, those who died during the follow-up period and those with missing data, a total of 1 832 subjects formed the community non-diabetic population. The methylation rates of 8 CpG sites in the Furin promoter region, fasting blood glucose, lipid and blood pressure were collected at baseline. The subjects were divided into the normal systolic blood pressure (SBP) group (1 388 cases) and the elevated SBP group (444 cases) based on whether SBP was ≥140 mmHg, the diastolic blood pressure (DBP) was ≥90 mmHg and the hypertension diagnostic criteria (SBP≥140 mmHg or DBP≥90 mmHg. There were 1 341 cases in the normal DBP group, 491 cases in the elevated DBP group and 1 218 cases in the normal blood pressure group. A multivariate linear regression model was used to observe the correlation between the methylation rate of the Furin promoter and changes of SBP and DBP. For the Furin promoter methylation sites independently related to SBP/DBP. Linear regression models adjusted for confounding factors were used to fit the curve to observe whether there was a non-linear relationship between SBP or DBP and the methylation rate of the Furin promoter, respectively. Unadjusted and adjusted Logistic regression models were used to observe the correlation between the methylation rate of the Furin promoter and the risk of hypertension. The adjustment factors in the adjusted Logistic regression model were identical to those in the linear regression fitting curve. Results Compared with the normal SBP group, the methylation rates of CpG1, CpG2 and CpG4 were decreased in the elevated SBP group, while the methylation rate of CpG8 was increased (P<0.05). Compared with the normal DBP group, the methylation rates of CpG2 and CpG4 were decreased in the elevated DBP group, while the methylation rate of CpG8 was increased (P<0.01). Compared with the normal blood pressure group, the methylation rates of CpG1, CpG2, CpG4 and CpG6 were decreased in the hypertension group, while the methylation rate of CpG8 was increased (P<0.05). Multivariate linear regression analysis showed that the decreased methylation rate at the CpG2 site and the increased methylation rate at the CpG8 site were independently associated with elevated SBP and DBP. The linear regression model fitting curves indicated that the increased methylation rate at the CpG2 site was linearly related to the decrease in SBP/DBP (P values for non-linearity were 0.143 and 0.481, respectively), and the increased methylation rate at the CpG8 site was linearly related to the increase in SBP/DBP (P values for non-linearity were 0.727 and 0.940, respectively). Unadjusted Logistic regression analysis showed that the methylation rates of CpG2 and CpG8 were influencing factors of hypertension (P<0.01). Adjusted Logistic regression analysis showed that the increased methylation rate at the CpG2 site was independent protective factors, and the increased methylation rate at the CpG8 site was independent risk factor for hypertension (P<0.01). Conclusion The methylation levels at the CpG2 and CpG8 sites of the Furin promoter are independent factors associated with blood pressure changes in the non - diabetic population in the community.

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    New Technology
    Analysis of the safety and efficacy of transcatheter mitral valve-in-valve replacement for the bioprosthetic mitral valve failure
    NIU Shulin, WANG Zhouming, LIU Mingyu, GUAN Xin, LI Mengqi, TIAN Yikui, YANG Zhenwen, DU Xin
    2025, 53 (9):  993-999.  doi: 10.11958/20251926
    Abstract ( 119 )   HTML ( 6 )   PDF (1228KB) ( 28 )  

    Objective To evaluate the safety and efficacy of transcatheter mitral valve-in-valve replacement (ViV-TMVR) in the treatment of bioprosthetic mitral valve failure. Methods Seventeen patients with bioprosthetic mitral valve failure who required ViV-TMVR were selected. Preoperative data including age, gender, body mass index (BMI), usage time of bioprosthetic mitral valve, comorbidities (hypertension, coronary heart disease, old cerebral infarction, atrial fibrillation and diabetes) and New York Heart Association (NYHA) functional class were recorded, and left ventricular end-diastolic diameter (LVEDD), right atrial diameter (RA), pulmonary artery systolic pressure (PASP), left ventricular ejection fraction (LVEF), type of bioprosthetic mitral valve failure, degree of bioprosthetic mitral valve regurgitation and stenosis, peak velocity and mean transvalvular pressure gradient of the bioprosthetic mitral valve, and Society of Thoracic Surgeons (STS) score were also collected. Intraoperative data included puncture route, valve type, intraoperative complications, operation time and immediate postoperative transesophageal echocardiography (TEE) assessment (peak velocity and mean transvalvular pressure gradient of the valve-in-valve, valve-in-valve regurgitation or paravalvular regurgitation) were collected. Postoperative data included time in the intensive care unit (ICU)/cardiovascular intensive care unit (CCU), total postoperative hospital stay and 30-day postoperative echocardiographic results and NYHA functional class were recorded. Patients were divided into the domestic NewMed valve group (10 cases) and the imported Edwards valve group (7 cases) based on the type of valve used. The safety and efficacy of ViV-TMVR were analyzed, and the efficacy of domestic valves and imported valves was compared. Results All 17 patients successfully underwent ViV-TMVR via the transseptal approach without serious complications, and the 30-day readmission rate was 0%. There were no significant differences in operation time of domestic valves and imported valves, mild paravalvular regurgitation of the valve-in-valve, peak velocity and mean transvalvular pressure gradient of the valve-in-valve immediately after surgery and at 30-day postoperatively, time in ICU/CCU, total postoperative hospital stay and the proportion of patients with NYHA functional class Ⅲ-Ⅳ at 30-day postoperatively between the domestic valve group and the imported valve group. During the 30-day follow-up, one patient died of cerebral hemorrhage, and one patient had major adverse cardiovascular events (MACE, cerebral hemorrhage). Compared with before the operation, the peak velocity and mean transvalvular pressure gradient of the valve-in-valve, LVEF, and PASP decreased immediately after surgery and at 30 days after surgery. Compared with immediately after surgery, the peak velocity and mean transvalvular pressure gradient of the valve-in-valve increased at 30 days postoperatively (P < 0.01), while there were no significant differences in LVEF and PASP. Conclusion Transseptal ViV-TMVR is safe and effective in the short term for patients with bioprosthetic mitral valve failure who are at high risk of re-thoracotomy, and the efficacy of domestic valves is comparable to that of imported valves.

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    Multidisciplinary Diagnosis and Treatment
    MDT treatment strategy for organophosphorus and anticoagulant rodenticide poisoning in an elderly patient with depression
    FU Shasha, JIA Yue, SHAO Hongxia, GUO Yu, MA Longyan, HAN Tong, SUN Hao, YU Hongzhi
    2025, 53 (9):  1000-1004.  doi: 10.11958/20252004
    Abstract ( 107 )   HTML ( 2 )   PDF (1035KB) ( 52 )  

    Organophosphorus pesticide (OP) is one of the most widely used pesticides in the world with the largest dosage. Acute organophosphorus pesticide poisoning (AOPP) is a common clinical disease, and AOPP accounts for 20%-50% of poisoning cases in China every year, with case fatality rate of 3%-40%. Bromophos (BDF) is a long-acting anticoagulant rodenticide, which inhibits vitamin K epoxide reductase and interferes with the synthesis of coagulation factors Ⅱ, Ⅶ, Ⅸ and Ⅹ, leading to coagulation dysfunction. This article discusses the multidisciplinary diagnosis and treatment (MDT) process of a patient with combined poisoning of dichlorvos and bromadiolone. The article explores blood purification, management of coagulation abnormalities, secondary infection, atropinization and altered consciousnes in patients with organophosphorus poisoning and anticoagulant rodenticide compound poisoning, with the aim of providing clinicians with references for early diagnosis and treatment.

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    Review
    Advances in the mechanism of left auricular thrombosis in patients with atrial fibrillation
    LI Wenxiu, ZHU Zhenyu, CHAI Hui, ZHENG Xiaoxuan, LU Jing, LI Runqin
    2025, 53 (9):  1005-1008.  doi: 10.11958/20251816
    Abstract ( 240 )   HTML ( 3 )   PDF (737KB) ( 206 )  

    Atrial fibrillation (AF) is one of the most common clinical arrhythmias and a significant risk factor for thromboembolism. The left atrial appendage (LAA) is the primary site of thrombus formation in AF patients. Recent studies have explored the mechanisms of LAA thrombosis from multiple dimensions, including anatomical structure (LAA morphology and architecture), functional indicators (hemodynamic alterations), pathophysiological mechanisms (endothelial injury, inflammatory activation), systemic diseases (renal dysfunction) and genetic factors (gene polymorphisms), providing critical evidence for precise clinical anticoagulation. This article systematically reviews the latest research advances in the mechanisms of LAA thrombosis in AF patients, aiming to offer theoretical support for the accurate assessment of thromboembolic risk and the formulation of individualized anticoagulation strategies. Additionally, it lays the foundation for exploring the intrinsic relationship and mechanisms between LAA hemodynamics and heart failure as well as thromboembolic events.

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