Objective To construct subsystem of picture archiving and communicating system (PACS) based on video database of ophthalmology and to evaluate on effectiveness of applying PACS system in postgraduate teaching.Methods PACS subsystem were constructed by collecting audiovisual materials of ophthalmology surgery videos,retinal photography,B-ultrasonography,OCT,UBM of patients.A total of 24 postgraduates were divided into control group (n =12) and experimental group (n=12) by random number table.Students in control group was taught by traditional cases,books and literature while those in experimental by network teaching from PACS subsystem.Two teaching methods were assessed subjectively and objectively.Objective indicators including ophthalmology examination results,operational skill ratings and paper reviewing results as well as subjective indicators including efficiency to accept the knowledge,satisfaction degree of teaching,influencing degree of papers were employed to assess the effectiveness of the two teaching methods.Independent samples t-test and twosample rank sum test were used for statistical analysis,P ＜ 0.05 was considered statistically significant.Results Students in experimental group done better in operation scores and in the assessment of the efficiency of knowledge accepting,satisfaction of teaching and papers effect than control group(P =0.000、0.000、0.000、0.003).The two groups had no significant difference in professional exam achievements and paper review scores (P =0.625、0.354).Conclusions PACS subsystem based on video database of ophthalmology are benefit for postgraduate teaching.

Objective To investigate the diognostic value of multi-sllce helical CT(MSCT) in spinal tuber-culosis, and making a further understanding of this disease. Methods The MSCT and post-processing films manifes-tations of 23 spinal tuberculosis proved by operation and pathology were reviewed retrospectively. Results MSCT could show the bone destructions location, range, relationships with neighbor tissues, osseous vertebral narrowing and para-vertebral abscess,etc. MPR, CPR, SSD and VR could more completely and stereoscopically show these character-istics of spinal tuberculosis. Conclusion MSCT post-processing techniques could make up for the lack of axial CT scan. It has high value in elevating the diagnosis accuracy of spinal tuberculosis.

ObjectiveTo compare X-ray,spiral CT and low does digital subtr,action angiongraphy technology of three dimensional reconstruction in 30 cases of the applications in the joint fractures,to study the application value of the digital subtraction angiography three- dimensional reconstruction in joint fracture.MethodsA retrospective analysis was made on 30 cases with joint fracture in Guangdong Provincial Guangzhou Development District Hospital,who were confirmed by the X-ray and spiral CT three-dimensional reconstruction and digital subtraction angiography three-dimensional reconstruction and the demonstrations three-dimensional reconstruction,spiral CT three-dimensional reconstruction and X-ray were compared.ResultsAll 30 cases fractures showed clear line,line of walk line,of the number of fracture,source and separation shift condition.Digital subtraction angiography could be clearly shows 30 cases in spiral CT could clearly show in 20 cases,10 cases not clearly show in,while X-ray clearly show in 10 cases,not show in 20 cases.Spiral CT showed clearly joint capsule and soft tissue.The SPSS 11.0 statistical soft package was used.Spearman correlation analysis,the single factor analysis of variance and the independent t test and the chi-square test were employed for data analysis,P ＜ 0.05 was considered statistical significance.Conclusions Digital subtraction angiography three-dimensional reconstruction can more clearly display fracture line,fracture pieces,walk line,source and separation shift condition compared with spiral CT and Xray essaminations,which is helpful for treatment options and prognosis estimation.

Percutaneous coronary intervention(PCI) has been widely used in the current treatment of coronary heart disease.Intraoperative or perioperative medical therapy is often emphasized, while concomitant long-term optimal medical therapy(OMT) when they have received PCI is ignored.OMT can improve the clinical symptoms of patients, reduce mortality and improve the quality of life.This article will give a review about the definition of OMT after PCI in patients with coronary heart disease, its effect on prognosis and its current application status.

Objective:To explore the mechanism of the alternation of RR interval length in atrioventricular reentrant tachycardia (AVRT).Methods:From August 2009 to August 2016, 317 patients with AVRT were treated by radiofrequency catheter ablation in cardiology department of TEDA International Cardiovascular Hospital were analyzed retrospectively.During AVRT, 5 mg of verapamil was given slowly intravenously for 10 min.After administration, the changes of RR interval, AH interval, HV interval and VA interval were observed and the time of changes was also observed.Results:After administration of verapamil, there were 8 patients with RR interval alternation and QRS wave alternation.When RR interval alternation occurred, the difference of AH interval between adjacent heart beats was gradually extended, without AH jump, and the HV interval and VA interval were constant.This phenomenon occurred 6-17 minutes after administration, and the average cycle of tachycardia was 16-42 ms longer than before administration.In 3 patients, RR interval alternation occurred.When the phenomenon disappeared, the difference of AH interval between adjacent heart beats was gradually shortened, there was no AH jump, and the interval between HV and VA was constant until AH interval was equal, the disappearance time was 19-57 min after administration; AVRT was terminated in 5 patients after administration.Conclusion:It can be concluded that the mechanism is due to the frequency dependent decreasing conduction of AH interval in tachycardia, which can not be induced by program stimulation.

Objective To explore the characteristics of electrocardiogram(ECG) and target potential features of premature ventricular contraction (PVC) in patients with complete left/right bundle branch block (CL/RBBB) and compare with those without CL/RBBB. Methods A retrospective analysis was done in 8 outflow tract PVC patients with CL/RBBB, who successfully underwent radiofrequency ablation from August 2009 to June 2017. According to the bundle branch block chamber, patients were divided into the complete right bundle branch block (CRBBB) group (n=4) and the complete left bundle branch block (CLBBB) group (n=4). The control group were those who successfully underwent ablation at the same position as the above two groups but without CL/RBBB. The characteristics of ECG and target potential features were compared among groups. Results One case in the CRBBB group was successfully ablated in the great cardiac vein with precordial R/S>1 transition at V1 and one case in the CLBBB group was successfully ablated in the right coronary cusp with precordial R/S>1 transition at V2, while other 6 cases were all with precordial R/S>1 transition at lead V4. Precordial R/S>1 transition was not later than sinus rhythm (SR) in the CLBBB group. No statistical difference was found in the QRS complex duration between SR and PVC in the CL/RBBB patients [(134.38 ± 23.80)ms vs (156.75 ± 25.93)ms, P>0.05], while statistical difference was shown in the control group [ (92.63 ± 5.76)ms vs (140.25 ± 15.97)ms,P<0.05]. Conclusion Bundle branch block can lead to misjudgment of PVC origin with CL/RBBB during sinus rhythm, thus the origin chamber of the PVC should be determined according to the mapping and ablation result.

Objective: To analyze the percentage of myeloperoxidase (MPO)-positive acute myeloid leukemia (AML) blast cells, and to explore the correlation of MPO expression with the clinical features, gene alterations, therapeutic response and prognosis of AML. Methods: The expressions of MPO in BM blasts cells of 233 newly diagnosed AML were retrospectived analyzed, they were divided into two groups using the percentage of MPO-positive blast [low (≤70%) and high (>70%)], clinical features, gene alterations, chemotherapy efficacy and prognosis were compared between the two groups. Results: ①Of the 233 patients, 121(51.9%) were in the low MPO group, and the rest 112(48.1%) in the high MPO group. Favorable-risk group according NCCN guidelines of AML was always MPO-high (χ²=32.773, P<0.001), while MPO-low was closely related to poor-risk (χ²=7.078, P=0.008); ②DNMT3A mutation (χ²=6.905, P=0.009), spliceosome genes mutation (SF3B1/SRSF2/U2AF1) (χ²=5.246, P=0.022), RUNX1 mutation (χ²=4.577, P=0.032), ASXL1 mutation (χ²=7.951, P=0.005) and TP53 mutation (P=0.004) were more likely to be seen in the low MPO group, while C-KIT mutation (χ²=8.936, P=0.003) and CEBPA mutation (χ²=12.340, P<0.001) were more frequent in the high MPO group, especially CEBPA double mutation; ③The rates of first complete remission in the low MPO group were significantly lower than that in the high MPO group (38.8% vs 68.1%, χ²=15.197, P<0.001). Multivariate analysis showed that low MPO positivity significantly affected the CR₁ unfavourably. ④The overall survival (OS) and the progression-free survival (PFS) were significantly worse in the low MPO group (18.0% vs 89.4% for OS, and 11.5% vs 56.7% for PFS, P<0.001). Multivariate analysis disclosed that the low number of MPO was significantly unfavourable prognostic factor. ⑤The low MPO group still showed a worse survival even when restricted to the patients with normal karyotype, the OS and the PFS were 31.1% and 18.8% respectively. Conclusions AML with different MPO expression percentage had a unique gene mutation spectrum. Low expression of MPO was an independent risk factor for CR₁, OS and PFS in AML patients, which may be a simple and highly significant factor for AML patients when evaluating the therapeutic efficacy and prognosis.

Objective:To investigate the relationship between transcription factors (TFs) and the prognosis of colon cancer, and to construct a prognosis model through TCGA and GEO dual databases, so as to quantify the risk of patients and guide clinical treatment decisions.Methods:The transcriptome and clinical data of colon cancer in TCGA and GEO databases were used in this study. The transcriptome data were annotated and the gene expression was calculated. The difference analysis of TFs in TCGA and GEO (log2FC > 1, P-value (Fdr) < 0.05) was performed. The difference TFs of double data intersection were used for correlation prognosis analysis ( P<0.01). The risk coefficient and risk value of prognosis-related TFs were calculated by COX multivariate analysis, and the prognosis model of TFs was constructed by COX model with "survival" and "glmnet" package. The survival curve ( P<0.001) and ROC curve (AUC>0.75) of the sequence set and verification set were drawn, and the distribution of risk value was visualized. After grouping according to risk value, GSEA enrichment analysis was calculated, gene set grid was constructed, target genes were predicted, and finally, pathway enrichment analysis of GO and KEGG was carried out. Results:387 TFs with different expressions in TCGA and GEO databases were used to draw heat map, volcanic map and TFs-related forest map, and the prognosis model of colon cancer was constructed according to COX multivariate analysis=0.310×HSF4+0.137×IRX3-0.127×ATOH1+0.290×OVOL3+0.137×HOXC6+0.155×SIX2+0.092×ZNF556-0.444×CXXC5+0.429×TIGD1+0.413×TCF7L1. Through enrichment analysis, our results showed that these prognostic factors may directly or indirectly act on cancer pathways, such as basic cell carcinoma and cancer signaling pathway, local tissue-cell adhesion, and extracellular matrix.Conclusions:The constructed TFs prognosis model of colon cancer can quantify the prognostic risk of colon cancer, and its high-risk group is an independent risk factor of colon cancer prognosis. This model is a new way to evaluate the prognosis of colon cancer.

Objective:To study the clinical prognosis and related factors affecting optimal medical therapy (OMT) compliance of patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI).Methods:A prospective study was conducted to select 3 818 patients who were diagnosed with CAD and successfully underwent PCI in TEDA International Cardiovascular Hospital from October 2016 to September 2017. The clinical information and application of OMT during hospitalization and 1 year later were collected for research.The patients were divided into OMT group and non OMT group according to whether they adhered to OMT during follow-up one year after discharge. After comparing the imbalance baseline data of hypertension,diabetes and hyperlipidemia with propensity score,demographic characteristics, coronary revascularization history, CAD, laboratory related laboratory examinations,and the use of OMT drugs were compared between the two groups. Cox regression model was used to analyze the relationship between long-term OMT and clinical prognosis in patients with CAD.Multivariate binary logistic regression was used to analyze the related factors affecting long-term OMT compliance.Results:A total of 3 818 cases of CAD patients were matched by propensity score and 2 596 patients were included in the study. There were 1 609 males and 987 females. The age was (62.51±9.56) years old.One year later,1298 patients (50%) insisted on OMT,including dual antiplatelet therapy(DAPT), statins, β-blockers and ACEI/ARB were 97.0% (2 517/2 596),94.5%(2 454/2 596),69.6% (1 806/2 596) and 64.2% (1 666/2 596), especially angiotensin converting enzyme inhibitors / angiotensin receptor blockers and β Receptor blockers decreased the most.Cox regression analysis showed that after adjusting for other factors, compared with non-adherence to OMT group,OMT after PCI was associated with better prognosis ( HR=0.416,95% CI 0.270-0.641, P<0.001). The prognosis of CAD patients with history of old myocardial infarction ( HR=1.804,95% CI 1.070-3.041, P=0.027),cardiac insufficiency ( HR=2.074,95% CI 1.161-3.702, P=0.014),multivessel coronary disease ( HR=2.211,95% CI 1.228-3.983, P=0.008) and BMI>24 ( HR=1.570,95% CI 1.037-2.377, P=0.033) were related to worse clinical outcomes. Multi-factor binary Logistic regression showed that OMT at hospitalization was a strong influencing factor of long-term adherence to OMT ( OR=41.278,95% CI 29.961-56.871, P<0.001). Patients with higher education,employee medical insurance and with history of PCI tend to persist in OMT. Conclusion:The medication compliance of patients with long-term OMT after PCI is still poor,while the high compliance of OMT is related to the lower incidence of adverse cardiovascular events,including death, nonfatal myocardial infarction and stroke. If there is no obvious contraindication,all patients after PCI should adhere to OMT.

Objective:This study aims to investigate the characteristics of gene mutation and clinical prognosis in de novo acute myeloid leukemia (AML) patients with myelofibrosis (MF) .Methods:From January 1, 2016, to February 1, 2020, 103 newly diagnosed AML patients in Henan Provincial People’s Hospital who simultaneously underwent bone marrow biopsy examination were included. They were divided into the AML-MF group (MF grades 1-3) and the AML without MF group (MF grade 0) , and the clinical features, gene alterations, chemotherapy efficacy, and prognosis were compared between the two groups retrospectively.Results:①MF was confirmed in 44.7% of AML patients (46/103) , of which 84.8% (39/46) were MF-1 and 15.2% (7/46) were MF-2/3, while MF was not confirmed in 55.3% (57/103) of AML patients. The median of WBC in the AML-MF group was significantly higher than in the AML without MF group [11.205 (0.69-191.82) ×10 9/L vs 4.64 (0.18-95.10) ×10 9/L, P=0.024]. More patients in the AML-MF group had nucleated erythrocytes in the peripheral blood (43.5% vs 24.6% , χ2=4.119, P=0.042) . All four AML-M 0 patients were in the AML-MF group, while AML without MF group had a higher proportion of AML-M 2 ( P=0.014) . ②FLT3-ITD and NPM1 mutations were more frequent in the AML-MF group ( P=0.021 and 0.039) , while CEBPA mutation was more frequent in the AML without MF group ( P=0.029) . ③The CR rate in the AML-MF group was significantly lower than in the AML without MF group (69.7% vs 93.2% ) ( χ2 =7.412, P=0.006) . Multivariate analysis showed that MF, especially the grade of fibrosis, was an independent risk factor for CR in de novo AML. ④The 3-year OS of patients in the AML-MF group was significantly lower than in the AML without MF group (20.5% vs 72.2% , χ2=4.032, P=0.045) . Subgroup analysis showed that OS and PFS of AML-MF1 and AML-MF 2/3 groups were also significantly worse than those of the AML without MF group ( P=0.001) and MF, especially MF ≥2, was an independent marker for inferior OS and PFS in de novo AML ( P=0.021 and 0.044) . Conclusion:AML-MF has unique laboratory and clinical characteristics. MF is an independent risk factor for CR, OS, and PFS in AML. Evaluation of MF is very significant for therapy efficacy and prognosis judgment in de novo AML.