Aim: To develop an assessment tool to predict invasive mechanical ventilation (IMV) among influenza-related pneumonia (Flu-p) patients within 14 days of admission. Methods: In total, 1107 Flu-p patients from five teaching hospitals were retrospectively enrolled from January 2012 - December 2019 and used to develop a predictive model. Results: Overall, 10.6% (117/1107) of patients underwent IMV within 14 days of admission. Multivariate regression analyses revealed that the following factors were associated with IMV: early neuraminidase inhibitor use (-2 points), lymphocytes < 0.8×109/L (1 points), multi-lobar infiltrates (1 point), age ≥ 65 years old (2 points), systemic corticosteroid use (2 points), PaO2/FiO2 < 300 mmHg (2 points), respiratory rate ≥ 30 breaths/min (3 points), and arterial PH < 7.35 (3 points). A total score of six points was used to identify patients at risk of IMV. This model had a sensitivity of 88.79%, a specificity of 87.55%, and exhibited better predictive performance than the ROX index (AUROC = 0.927 vs 0.688, p < 0.001), modified ROX index (AUROC = 0.927 vs 0.747, p < 0.001), and HACOR scale (AUROC = 0.927 vs 0.524, p < 0.001). Conclusions: Flu-IV scores can be used to reliably predict 14-day IMV rates in Flu-p patients.

The asymmetric sulfoxidation of the omeprazole thioether to synthesize esomeprazole catalyzed by immobilized cells of a mutant of Rhodococcus rhodochrous ATCC 4276 in the chloroform–water biphasic system was carried out at a high substrate concentration (200mM) and optimized using response surface methodology (RSM). The optimal yield of esomeprazole obtained was 94.8% with e.e. (>99%) without the formation of the sulfone. A quadratic polynomial model was developed with R2 of 0.9998, which indicates that the model predicts the observed data with very high accuracy. The mutant exhibited a high enantioselective, activity and substrate and product tolerance. The significant improvement of substrate tolerance may mainly be contributed by employing the chloroform–water biphasic system because almost all substrates may partitioned in the organic phase, resulting in little damage and inhibition to cells by substrates.

High-heat-flux heat removal is critical for the long-term safety of the high-power electronic device, while the precise and uniform temperature control is challenging due to various uncertainties. To this end, active disturbance rejection controller (ADRC), hybrid with feed-forward flow-rate/sub-cooling controller, is introduced for the temperature regulation of a multiple degree-of-freedom mechanically pumped two-phase loop. Based on the proposed experimental setup, the optimal references of sub-cooling and flow-rate are identified and used as the feed-forward law for auxiliary loop control, and ADRC is used in the primary loop to control the evaporator wall temperature. The experimental results indicate the efficiency of thermal control for the mechanically pumped two-phase loop via combination of primary and auxiliary loop. In addition, ADRC performs better in both temperature tracking and disturbance rejection when compared with the conventional PI controller, and its superiority consists in faster tracking and stronger robustness to disturbances and couplings.

The bubble motion behavior in viscoelastic fluid is very important the in related gas-liquid processes. Thus, the emphasis of this review is to discuss the three peculiar phenomena of bubbles rising in viscoelastic fluids, i.e. the formation of the cusp, negative wake and velocity jump discontinuity and to highlight the possible future directions of the subject. The mechanism as well as influence factors on the three peculiar phenomena is discussed in detail. The comparison of results has shown that the change of bubble shape is mainly related to the viscoelasticity of the fluid. However, the mechanism of two-dimensional cusp, the tip-streaming, “blade-edge” tip, “fish-bone” tip and the tail breaking into two different threads phenomena in some special viscoelastic fluids is not very clear. For bubble velocity jump discontinuity phenomenon, viscoelasticity is the most critical factor, and the cusp of bubble, surface modification only played ancillary role.

In this paper, we present a finite difference and a compact finite difference schemes for the time fractional nonlinear diffusion-wave equations (TFNDWEs) with the space fourth order derivative. To reduce the smoothness requirement in time, the considered TFNDWEs are equivalently transformed into their partial integro-differential forms with the classical first order integrals and the Caputo derivative. The finite difference scheme is constructed by using Crank-Nicolson method combined with the midpoint formula, the weighted and shifted Gr$\ddot{u}$nwald difference formula and the second order convolution quadrature formula to deal with the temporal discretizations. Meanwhile, the classical central difference formula and fourth order Stephenson scheme are used in spacial direction. Then, the compact finite difference scheme is developed by using the fourth order compact difference formula for the spatial direction. The stability and convergence of the proposed schemes are strictly proved by using the discrete energy method. Finally, some numerical experiments are presented to support our theoretical results.

The current analytical examination supports nanofluids with peristaltic flow motion in a confined length of non-uniform horizontal tube with an endoscope using Buongiorno’s nanofluid model. The consideration based on three geometries of Gold –blood MHD nanoparticles (sphere, cylinders and blades) in addition to wall properties, thermal and velocity slip affects. This model is studied for biomedical applications in various fields. Equations and boundary conditions are modeled and formed in some dimensionless control equations for the realistic study of the model. Exact solutions with nanoparticle shape effects on temperature, velocity, heat transfer and stream function expression are obtained. Visual depiction for these solutions under the study of variation of various parameters are demonstrated. Few observations illustrate that platelet shape nanoparticles attain highest thermal conductivity. Maximum and increasing behavior of temperature experienced for sphere shape nanoparticles and for higher values of thermal slip parameter. Increasing conduct of velocity profile is also seen for large values of velocity slip parameter and sphere shape nanoparticles shows dominance as compared to brick and platelet shape particles. Trapping phenomenon is also discussed for the desirability of present study. Design of micro peristaltic pump for the transport of nanofluids and drug delivery system that offers various drug geometries are the main use of this model.

Ga species with high dehydrogenation capability were prepared by H2-O2 atmosphere treatment, and efficient matching of bifunctionality (dehydrogenation/cracking) was realized between Ga species and ZSM-5 over Ga/ZSM-5 based catalysts. Compared with parent Ga/ZSM-5, the conversion rate of n-butane was increased from 0.53 to 2.59 mmol·g-1·min-1 on Ga/ZSM-5 with H2-O2 treatment. Kinetic analysis revealed that the apparent activation energy of n-butane catalytic cracking decreased largely from 141 to 47 kJ·mol-1, which is attributed to the formation of new interaction between Ga species and ZSM-5 upon such an atmosphere treatment. It was also found butane-O2 treatment acts as a similar role with H2-O2 treatment in enhancing the catalytic performance. On this basis, different Ga species were correlated with activity and kinetic data, and the effect of practical reaction atmosphere on Ga species was also investigated.

In this paper, ZSM-5@MnOx catalyst was firstly prepared by in situ growth for the selective oxidation of benzyl alcohol to benzaldehyde. The coating effects of MnOx on ZSM-5 and OV formation mechanism at the ZSM-5-MnOx interface were investigated. Results showed that the sodium ions of ZSM-5 are found to be conducive to the better coating for MnOx. Hydrogen protons of zeolite can dehydrate with the OH groups on MnOx to generate the OVs where the oxidation of benzyl alcohol occurs. Besides, the deep dehydration at the ZSM-5-MnOx interface via increasing post-treatment temperature can further enrich the OV concentrations. The ~100% benzyl alcohol conversion and ~100% benzaldehyde selectivity over the ZSM-5@MnOx catalyst can be obtained within 3 h at 383 K. The findings of the structure-activity relationship of zeolite’s surface properties and OVs over MnOx can provide important guiding principles for the rational design of oxidation catalysts.

Background: A landmark genome-wide association study has linked mutations in the plasma lipoprotein complex lipoprotein(a) [Lp(a)] and aortic stenosis. We attempted to determine whether Lp(a) is a key upstream mediator of aortic stenosis. Methods: Male, Lp(a) transgenic (N=10) and control mice (N=10) were fed a high cholesterol diet for 6 weeks, then hearts were sectioned for histological analysis. Human stenosis (N=8) and non-stenotic (N=7) aortic valve leaflets were obtained intraoperatively and submitted for histologic and immunohistochemical analyses. All histological sections were semi-quantitatively graded in a blinded manner (0-3/3+ units). Results: Aortic valves from Lp(a) transgenic mice fed a high-cholesterol diet demonstrated significant aortic valve changes including fibrosis (2.0/4 vs 0.5/4), calcification (1.9.4 vs 0.1/4) units, angiogenesis (1.1/4 vs 0.3/4) and inflammatory infiltration (1.0 vs 0.1/4) compared with control aortic valves (all p<0.001). Human stenotic aortic valve leaflets expressed greater Lp(a) (2.4/4 vs 1.7/4) in areas of fibrosis, inflammatory infiltration and angiogenesis, compared with non-stenotic aortic valve leaflets (p=<0.005) Conclusion: Our proof-of-concept studies offer evidence for a potential causative role of Lp(a) as a trigger of aortic stenosis. Further work is needed to confirm these results. Therapeutic strategies targeting Lp(a) levels may serve as a novel strategy to limit progressive calcification in aortic stenosis.

Background: Surfactant Protein D (SP-D) is a pattern recognition molecule belonging to the collectin family expressed in multiple human organ systems including the lungs. Previous studies have shown that SP-D concentrations in bronchoalveolar lavage samples decreases and serum concentrations increases in patients with asthma possibly attributable to a combination of induced SP-D synthesis and decreased air-blood barrier integrity. The aims of this study were to investigate if the serum level of SP-D and common variations in the SP-D gene were associated to asthma in adolescents and young adults. Methods: Prospective observational study including 449 adolescents and young adults (age 11-27 years) previously diagnosed with asthma during a two-year period from 2003 to 2005 (0-16 years). At follow-up from 2016 to 2017 314 healthy controls with no medical history of asthma were recruited. Serum SP-D was analyzed on samples obtained at baseline as well as samples obtained at follow-up. SP-D genotyping was performed for rs721917, rs2243639 and rs3088308. Results: No differences were found in mean levels of sSP-D and SFTPD genotype among subjects with current asthma, no current asthma and controls. Serum SP-D and SFTPD genotype were not associated to any clinical parameters of asthma. Furthermore, baseline sSP-D was not associated to asthma at follow-up. Conclusion: Serum surfactant protein D and common SP-D gene variants were not associated with asthma in Danish adolescents and young adults with mild to moderate asthma. Serum surfactant protein D did not demonstrate any value as a clinical biomarker of asthma.

Necrotizing enterocolitis (NEC) has a multifactorial etiology and predominantly affects preterm infants, with only 13% of cases occurring in term infants. Hypoxia, sudden cardiovascular changes can also affect mesenteric perfusion. It is assumed that decreased mesenteric blood flow, followed by reperfusion, can contribute to intestinal damage, thereby increasing NEC incidence rates in term infants. This report presents a case of NEC development during follow-up for atrial flutter (AF). Repeated cardioversion caused sudden hemodynamic changes, causing NEC.

Objective To investigate the effect of induced labor on maternal and fetal pregnancy outcome. Methods This is a retrospective case-control study.In this study, a total of 4386 pregnant women with singleton low-risk who underwent regular prenatal examination and successful vaginal delivery at or more than 41 weeks 0 days of gestation in Fujian Maternal and Child Health Hospital from January 2014 to December 2018. Review the clinical data,according to the mode of labor initiation, they were divided into induced labor group (2007 cases) and spontaneous onset of labor group (2361 cases). Further stratified analysis was carried out according to age and parity. Results The total duration of labor in the induced labor group was significantly longer than that in the spontaneous onset of labor group[ (9.37±5.37)vs (8.82±5.13) h,P＜0.001],associated with more postpartum blood loss[ (219.18±188.32)vs (199.95±124.69) mL,P=0.01], and the incidence of severe postpartum hemorrhage(sPPH) was significantly higher[0.8%(16/2007) vs 0.33% (8/2361),P =0.041];increase but no significant difference in the incidence of postpartum hemorrhage(PPH) [3.8 %(77/2007) vs 2.8% (66/2361),P =0.054]. After adjusting for age, the operation of induced labor in nulliparous is more likely to occur PPH[2.74 %(55/2007) vs 1.65 %(39/2361);OR=1.557;95%CI:1.039~2.332,P＜0.05]. Conclusion Selective induction of labor increases the postpartum blood loss,especially primary parturients to increase the risk of postpartum hemorrhage, may be related to the prolongation of the total stage of labor.Low-risk nulliparous women should try to avoid induction without medical indication

Aims Periprocedural pulmonary vein isolation (PVI) anticoagulation requires balancing between the risk of bleeding and thromboembolism. Intraprocedural anticoagulation is monitored by activated clotting time (ACT) and there are no guidelines which specify an initial unfractionated heparin (UFH) dose. We aimed to assess differences in ACT values and UFH dosage during PVI in patients on different oral anticoagulants. Methods We conducted international, multi-centre, registry-based study. Consecutive patients with atrial fibrillation (AF) undergoing PVI, on uninterrupted anticoagulation therapy, were analysed. Before the transseptal puncture, UFH bolus of 100 U/kg was administered regardless of the anticoagulation drug. Results A total of 873 AF patients were included (median age 61 years, IQR 53-66; female 30%). There were 248, 248, 189, 188 patients on warfarin, dabigatran, rivaroxaban, and apixaban, respectively. Mean initial ACT was 257±50 sec, overall procedural ACT 295±45 sec and total UFH dose 158±60 IU/kg. Patients who were receiving warfarin and dabigatran compared to patients receiving rivaroxaban and apixaban had: (i) significantly higher initial ACT values (262±57 and 270±48 vs. 248±42 and 241±44 sec, p<0.001), (ii) significantly higher ACT throughout PVI (309±46 and 306±44 vs. 282±37 and 272±42 sec, p<0.001), and (iii) needed lower UFH dose during PVI (140±39 and 157±71 vs. 171±52 and 172±70 IU/kg). Conclusion There are significant differences in ACT values and UFH dose during PVI in patients receiving different anticoagulants. Patients on warfarin and dabigatran had higher initial and overall ACT values and needed lower UFH dose to achieve adequate anticoagulation during PVI than patients on rivaroxaban and apixaban.

AIMS: SARS-CoV-2 infection (COVID-19) is a potentially lethal disease that may progress into severe respiratory distress syndrome requiring ventilatory support. While azithromycin (AZI) and hydroxychloroquine (HCQ) are considered similar to placebo in COVID-19, other drugs such as ivermectin (IVER), are being repurposed to treat this pandemic. This study was designed to assess the effects of ivermectin on duration of febrile illness and disease outcomes in mild-to-moderate COVID-19 infection in a community setting. METHODS: In this case-control study 95 suspected patients of mild-to-moderate COVID-19 were included. The controls (Group-A) received AZI+HCQ for seven days while the cases (Group-B) received IVER+AZI+HCQ for six days. RESULTS: A total of 41 patients were in Group-B, while 54 patients were in Group-A. Group-B had consistently and significantly shorter span of fever on days 5, 7, 10 and 14, where the logistic regression showed IVER as the major (Exp B 49•55; p<0•001) underlying factor. The Kaplan-Meier survival analysis showed that Group-A had a prolonged febrile illness (p<0•001). CONCLUSIONS: Ivermectin use is associated with reduced duration of febrile illness in COVID-19 in outpatient setting, thus potentially saving precious lives, reducing direct load on healthcare facilities and preventing high cost of management in a community setting.

We present an interesting case where electrocardiogram (ECG) recording in a patient with tremors mimics atrial flutter. A 77 -year-old south Asian lady with history of hypertension and Parkinson‘s disease presented to a tertiary care hospital in Pakistan with cough and fever. On second day of admission she started having pleuritic chest pain, Initial ECG was interpreted as atrial flutter. When her ECG was reviewed by a cardiologist, several features questioned the diagnosis of atrial flutter. A repeat 12 lead ECG clearly demonstrated normal sinus rhythm and the patient remained completely asymptomatic throughout the hospital stay. Tremor induced artifacts can be mistaken for arrhythmias. Correct diagnosis is critically important, in order to avoid wrong treatment and unnecessary interventions.

Background: According to current guidelines, non-vitamin K antagonist oral anticoagulants (NOACs) should be used at least 3 weeks before planned ECV. In accordance with international atrial fibrillation (AF) guidelines, transoesophageal echocardiography (TOE) is a pre-procedural examination recommended as an alternative to the adequate oral anticoagulation. Hypothesis: The strategy related to qualifying patients treated with NOACs for pre-procedural TOE differs in individual centers. Therefore, it is necessary to create an algorithm that will standardize estimation of left atrial appendage thrombus (LAAT) prevalence risk and thereby qualify NOAC treated patients to TOE in the most effective way. Methods: We assessed the available studies on LAAT predictors. Results: Risk factors for LAAT formation are not necessarily the same as the risk factors for thromboembolic events in patients with AF. The main risk factor for LAAT are: previous intracardiac thrombus, irregular use of NOAC, inappropriate dose reduction of NOAC, previous stroke, CHA2DS2-VASc score ≥ 3 points, GFR <60 ml/min/1.73m2, reduced left ventricular ejection fraction or left atrial enlargement. Conclusion: Based on available evidence, we proposed algorithm guarantees more systematic approach to performing TOE in patients undergoing ECV.

In this paper, the process of natural convection heat transfer (NCHT) and production of entropy (POF) in a portion of a tube has been modeled two-dimensionally. The examined problem is a quarter-tubular enclosure (quarter of a tube) which is filled with water-alumina nanofluid and subjected to a magnetic field (MF) of strength B0 at angle relative to horizon. Lattice Boltzmann Method (LBM) is used to simulate this problem. The ranges of parameters used in this investigation are: 0 < ω < 90, 0 < Ha < 60, and 0.1 < L, H < 0.5, and the obtained results include the Nusselt number (Nu), generated entropy, and Bejan number (Be). The results of thermal and dynamic analyses indicate that by growing the Hartmann number (Ha), the NCHT and POF values go up and the Bediminishes. Heat transfer is also improved by increasing the length of the enclosure’s hot walls. The highest amount of heat transfer occurs at the MF angle of 60º, and it is 10.3% greater than the amount of heat transfer occurring at horizontal MF. Finally, an artificial neural network (ANN) was used to simulate the cavity performance based on these parameters. An optimization is performed on the parameters of heat source length and Ha. The optimization is aimed at finding suitable parameter values that lead to the highest heat transfer rate and lowest POF. A table listing a number of optimal points has been presented at the end of the paper.

Background The COVID-19 pandemic has changed the face of primary care delivery in the NHS. Consultations have largely moved from face-to-face to remote, forcing practitioners to modify the ways in which they deliver care to patients. Aim In this study, we aim to investigate the appropriateness of antibiotic prescribing in tonsillitis, which is typically guided by clinical findings, during the COVID-19 pandemic Design and Setting: An observational quantitative analysis in the North Wales primary care setting Method: Retrospective review of computer records across five GP centres from March 2020 until end of October 2020. Data was extracted and analysed using chi-square or fisher exact rank and Man-Whitney test. Results Our results have shown no significant difference in antibiotic prescribing behaviour comparing face-to-face and remote consultations. Conclusion Remote consultation is as effective as face-to-face consultation with regards to the assessment of tonsillitis and the appropriateness of antibiotic prescription in primary care.

BACKGROUND. Invasive fungal disease (IFD) is a significant cause of morbidity and mortality in immunosuppressed children. We aim to describe the epidemiology and clinical parameters of IFD in a Pediatric Hematology-Oncology Unit (PHOU) with an increasing activity during the last 14 years. METHODS. We retrospectively reviewed the medical records of children (up to 18 years old) admitted for IFD to the PHOU of a tertiary hospital in Madrid (Spain), between 2006-2019. Epidemiological, diagnostic and therapeutic parameters were compared according to the type of infection, study period (considering 3 equivalent time fractions) and outcome. RESULTS. Twenty-eight episodes of IFD occurred in 27 out of 471 children at risk (13 males, median 10 years old). Five episodes of candidemia (all in the first period) and 23 bronchopulmonary mold diseases were registered. Six (21.4%), eight (28.6%) and 14 (50%) episodes met criteria for proven, probable and possible IFD, respectively. Most episodes (71.4%) occurred in high-risk children receiving antifungal prophylaxis. Eight children required intensive care and six died during treatment. Mold infections occurred in older children (126 vs. 21 months; p=0,045), increased over time (p=0.002) and were more common in high-risk compared to low-risk children (87% vs. 0%; p=0.001). There were no differences in mortality rates between periods, types of infection or underlying conditions. CONCLUSIONS. Yeast infections decreased within the study time and mold infections were more frequent in high-risk patients. A rising activity in our PHOU and an increase in the complexity of pathologies were not followed by an increase in mortality rates.

Background: Non-specific lipid transfer protein (nsLTP) food allergy is a major problem in the Spanish Mediterranean area. Different clinical presentations of this syndrome and their relationship with laboratory test results have not been clearly described. The objective of this study was to describe a systematic work plan to serve as a basis for the identification of analytical sensitization profiles and their relationship with clinical symptoms. Methods: Samples from 210 patients, analysed by ImmunoCAP® ISAC 112, with at least one positive result for any LTP component were selected. Patients were classified into three main groups according to the type of symptoms: food-related (F), respiratory (R), and combined (FR). Results: Two subsets of specific IgE recognition were described according to clinical features (food and respiratory) and in vitro findings. In the food subset, four main sensitization profiles with clinical implications related to LTP components with higher IgE levels were identified: peach, walnut, peanut and hazelnut. No single LTP component was related to severity of symptoms. A total of 65 different LTP component patterns were detected; only one pattern in peach profile was associated with anaphylaxis severity. Par j 2 was a severity marker of respiratory allergy. Ole e 7 was considered a food allergy marker in patients with multiple LTP recognition, but it was marker for respiratory allergy when it was the only positive LTP and associated with Ole e 1. Conclusion: A new systematic work plan to identify nsLTP sensitization profiles is described, allowing more individualized and accurate treatment of patients.

Background: The majority of egg-allergic children outgrow hypersensitivity against heated egg and then raw egg over time. The roles of ovomucoid (OVM)- and ovalbumin (OVA)-specific IgD in children who naturally outgrow egg allergy are uncertain. We investigated whether specific IgD to egg white (EW), OVM, and OVA correlate with allergen-specific IgE and can predict the development of immune tolerance to egg allergens. Methods: The tolerated doses of cooked egg white, which were determined by oral food challenge and/or an episode of accidental ingestion and corresponding specific IgE, IgG4 and IgD levels were evaluated in 57 children with egg allergy and 23 non-egg allergic children. Results: Patients avoiding all forms of egg had lower EW-, OVM-, and OVA-specific IgD and IgG4 than those partially avoiding egg, those that had outgrown egg allergy, and non-egg allergic children. The ratio of OVM-specific IgD to OVA-specific IgD increased depending on the ingestible amounts of boiled EW, whereas the ratio of OVM-specific IgG4 to OVA-specific IgG4 did not change. Receiver operating curve analysis revealed that the ratio of OVM-specific IgE to OVM-IgD was the best index to discriminate intolerant from tolerant egg-allergic patients. Conclusion: The production of OVM-specific IgD differs from OVM-specific IgG4 as children naturally outgrow egg allergy. The ratio of OVM-specific IgE to OVM-specific D is useful in distinguishing egg-sensitized patients with clinically reactive egg allergy from those who naturally outgrow egg allergy.

Background: Allergic diseases may play a role as a predisposing factor for coronavirus disease 2019 (COVID-19). The aim of this study was to investigate the allergy comorbidity and their association with the patients with COVID-19. Methods: Demographic data, clinical symptoms, laboratory and radiologic findings and having underlying diseases of the patients were resgistered. Allergic diseases were identified by using the standard GA2LEN questionnaire. The severity of COVID-19 was assessed by visual analog scale (VAS) and ICU admission. Results: Of 400 COVID-19 patients, 158 (39.5%) had allergic diseases. And, there was a reversely association beween an having allergy comorbidity and the severity of COVID-19 infection (P= 0.005, relative risk, 0.96; 95% CI, 0.77-1.19). The frequency of asthma, allergic rhinitis (AR), chronic rhinosinusitis, atopic dermatitis, chronic urticaria, and food or drug allergy was 7.3%, 16%, 1.8%, 5%, 10% and 13.3%, respectively. Importantly, only AR was reversly associated with the severity of COVID-19 (P= 0.02, relative risk, 0.96; 95% CI, 0.77-1.19). Additionally, 43% of the patients presented hypoxemia, and 93.5% had chest CT scan involvement. Interestingly, patients with allergic than non allergic diseases had significantly lower hypoxemia and chest CT involvement (P= 0.002 and P= 0.003, respectively). Conclusion: This study showed that allergic diseases were not found to be a predisposing factor for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Importantly, the patients with AR developed mild symptoms of COVID-19 and they were admitted to ICU significantly less than the non-AR patients.

Objective: To evaluate the effects of Baduanjin on quality of life (QOL), psychological status and cardiac function of patients with coronary heart disease after percutaneous coronary intervention (PCI). Methods: PubMed, The Cochrance Library, Embase, Web of Science, China Biology Medicine disc, CNKI, VIP and Wanfang were searched by a computer for any randomized controlled trials of Baduanjin intervention in patients with coronary heart disease after PCI, including relevant conference articles and academic papers published in journals. The retrieval time was from the database creation time to September 7, 2020. After two evaluators independently screened the literature, extracted relevant data and evaluated the bias risk for the included studies, RevMan5.3 software was used for a data analysis. Results:A total of 9 articles and 846 patients were included. The meta-analysis showed that the Baduanjin group was superior to the conventional western medicine treatment group in physical hunctioning、role-physical 、general health、role-emotional 、mental health、 anxiety、 anxiety、left ventricular ejection fraction、blood pressure、stroke volume，and the differences were statistically significant.But the Baduanjin group was not superior to the control group in bodily pain、vitality、social functioning,and the differences were not statistically significant. Conclusion: Baduanjin can improve the cardiac function, regulate the psychological state and improve the QOL among patients with coronary heart disease after PCI.

Aortitis, in its simplest definition, is an inflammation of the aorta. It can be divided into two groups as infectious and non-infectious. Noninfectious aortitis can be an involvement of multisystemic and autoimmune diseases as well as being diagnosed incidentally. In our case, in which we planned elective coronary bypass surgery, we encountered an ascending aorta with a pearlish color, dilated and firm consistency intraoperatively. Histopathological examination showed extensive lymphoplasmocytic infiltration and strotiform fibrosis. In the laboratory tests performed for etiology in the postoperative period, no abnormalities were observed in the early and long term. Even when detected isolated and incidentally, aortitis may be a component of a multisystemic and/or autoimmune disease. The time of diagnosis may coincide with the asymptomatic period of the systemic disease. We wanted to present this case because it was detected incidentally during coronary bypass surgery and was diagnosed histopathologically immunoglobulin-G4 related aortitis, although it was not found in clinical and laboratory evaluations.