ObjectiveTo investigate the predictive value of heart rate turbulence(HRT) in patients with diabetes mellitus (DM) after acute myocardial infarction (AMI).MethodsNinety-two AMI patients combined with DM (DM group) and 120 AMI patients without DM (non-DM group) were selected.Turbulence onset (TO) and turbulence slope (TS) were two indexes of HRT.HRT was considered positive when TO was ≥0 and TS was ≤2.5 ms/R-R.The differences in clinical data between HRT-positive and HRT-negative patients were compared.And the related risk factors after AMI were analyzed.ResultsAge,left ventricular ejection fraction (LVEF) level,renal insufficiency,LVEF＜40％,standard deviation of sinus cardiac cycle (R-R interval)(SDNN),heart rate variability (HRV) positiveand HRT indexes (TO,TS) between HRT-positive and HRT-negative patients in DM group had significant differences (P ＜ 0.05 ).Age,LVEF level,SDNN and HRT indexes(TO,TS) between HRT-positive and HRT-negative patients in non-DM group had significant differences(P ＜ 0.05).Multivariate Cox regression analysis showed that renal insufficiency (OR=4.8,95％ CI:1.8 - 10.7,P=0.008) and HRT positive (OR=3.7,95％ CI:1.5 - 8.6,P=0.070) in DM group had statistical significance.And HRT positive in non-DM group had statisticalsignificance(OR=23.0,95％ CI:5.2 ～ 86.0,P ＜ 0.01 ).ConclusionsHRT,an index of dynamic electrocardiogram,can predict the risk in patients with DM or without DM after AMI.

Objective: To explore the diagnostic value of ultrasound imaging for fetal central nervous system(CNS) malformation in early pregnancy. Methods: From January 2017 to January 2018, a total of 190 cases of CNS malformation in early pregnancy, who were diagnosed by ultrasound imaging in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine were selected to analyze the clinical value of ultrasound imaging in the diagnosis of fetal CNS malformation in early pregnancy. Results: Of the 190 pregnancies, 184 patients had satisfactory median sagittal section of the head and chest, horizontal cross section of the lateral ventricle, long axis of the spine, and cerebellum and posterior fossa pool.In 184 cases, the probability of display from 1 to 11^{+ 6} weeks was 93.33%, the probability of display from 12 to 12^{+ 6} weeks was 97.20%, and the probability of display from 13 to 13^{+ 6} weeks was 97.06%.Compared the display rates of CNS ultrasound examinations at different gestational weeks, the difference was not statistically significant (χ²=0.981, P>0.05). Three cases of 6 cases of CNS malformation diagnosed in early pregnancy were combined with other malformations.One case considered Cantrell's hypothyroidism with CNS malformation, 1 case with left iliac crest and right circumflex, 1 case with median cleft lip and palate, single atrioventricular with pulmonary atresia.The bilateral humerus was missing, in addition, 4 fetuses had an NT value more than 3 mm.The specificity of diagnosis of fetal CNS malformation in early pregnancy was 100.00%, the sensitivity was 85.71%, the specificity was 100.00%, and the positive predictive value was 99.46%. Conclusion Ultrasound imaging in the diagnosis of fetal CNS malformation in early pregnancy can improve the diagnosis rate and has high clinical value.