Objective:To observe the relationship between non -dipper heart rate and morbidity of coronary heart disease (CHD) in patients with hypertension .Methods :According to Holter monitored results ,a total of 130 pa‐tients with essential hypertension were divided into dipper heart rate group (n= 77 ) and non -dipper heart rate group (n=53) .Ambulatory blood pressure and dynamic ECG were monitored in two groups ,and CHD was diag‐nosed according to coronary angiography results .Ambulatory blood pressure ,ambulatory heart rate and incidence rate of CHD were compared and analyzed between two groups .Results:Compared with dipper heart rate group , there was significant reduction in daytime mean heart rate [ (73.45 ± 9.57) beats/min vs .(68.77 ± 12.61) beats/min] ,but significant rise in nighttime mean heart rate [ (61.30 ± 7.62) beats/min vs .(65.49 ± 12.97) beats/min] , P<0.05 both ;there were significant reductions in 24h mean diastolic blood pressure (DBP) [ (75.77 ± 10.91) mm‐Hg vs .(71.92 ± 9.30) mmHg] and daytime mean DBP [ (77.16 ± 11.11) mmHg vs .(72.81 ± 9.61) mmHg] , P<0.05 both in non -dipper heart rate group ,there were no significant difference in other blood pressure indexes be‐tween two groups (P>0.05);.Morbidity rate of CHD in non -dipper heart rate group was significantly higher than that of dipper heart rate group (71.70% vs .29.87% ,P=0.001) .Conclusion:Compared with dipper heart rate pa‐tients ,morbidity rate of CHD significantly rises in patients with hypertension and non -dipper heart rate .It may help to reduce occurrence of CHD by monitoring circadian changes of heart rate and recover circadian heart rate rhythm while treating hypertension .

Objective: To explore correlation between QRS complex duration and left ventricular ejection fraction (LVEF) in patients with complete left bundle branch block (CLBBB).Methods: A total of 213 patients, who were diagnosed as left bundle branch block by ECG in our hospital from Feb 2012 to Jun 2013, were selected.According to QRS complex duration, patients were divided into CLBBB group (n=182) and incomplete left bundle branch block (ICLBBB) group (n=31).Linear correlation analysis was used to analyze the correlation between QRS complex duration and LVEF, and receiver operating characteristic curve (ROC) was used to analyze optimal cutoff point of QRS complex duration for predicting LVEF<50%.Results: Compared with ICLBBB group, there was significant rise in QRS complex duration [(104.61±8.85) ms vs.(149.36±17.25) ms] and significant reduction in LVEF [(54.26±4.96)% vs.(45.22±12.57)%] in CLBBB group, P<0.01 both.Linear correlation analysis indicated that QRS complex duration was significant inversely correlated with LVEF (r=-0.55, P=0.001) in CLBBB patients.ROC analysis indicated that optimal cutoff point of QRS complex duration for predicting LVEF<50% was 151ms, the area under the curve was 0.79 (P=0.001),its sensitivity was 68.1% and specificity was 83.5%.Conclusion: QRS complex duration is significant inversely correlated with LVEF in CLBBB patients, which can be used as a simple index predicting reduced LVEF.

Objective To explore the pathological features affecting the prognosis by observing lung adenosquamous carcinoma overall survival after surgical treatment.Methods Totally 59 cases of lung ASC from 2531 surgically treated lung cancer patients in the First Hospital of Jilin University,from January 2000 to June 2012,were retrospectively analyzed to study their clinical characteristics,survival condition and the related factors influencing the prognosis.Using log-rank test and Cox multiple factors analysis for statistical analysis.Results (1) The 59 patients with ASC were mostly the male patients (62.7％).The median age was 57.2 years.Median survival time was 409 days(13.6 months).1-,3-,5-year survival rates were 59.9 ％,36.4％ and 31.2 ％.(2) Among the 59 patients (52 cases of pathological specimens),11 cases were EGFR mutation positive,positive rate was 21.2％,2 cases of patients were KRAS mutations positive,positive rate was 3.8％ ;(3) Single factor and multiple factors analysis showed that the pathological subtype,adjuvant treatment,pleural invasion and tumor stage were associated with prognosis as independent factors (P ＜ 0.05).Conclusion Compared with the simplex lung squamous carcinoma and lung adenocarcinoma,lung adenosquamous carcinoma has poorer prognosis.Early diagnosis and given comprehensive treatment were the keys to prolong its survival.

Objective:To analyze the value of three-dimensional speckle tracking echocardiography (3D-STE) in evaluation of left ventricular diastolic function in elderly patients with heart failure (HF).Methods:130 elderly patients with heart failure (HF pEF) with preserved left ventricular ejection fraction in Gulou Hospital Affiliated to Medical College of Nanjing University from January 2018 to October 2019 were studied. All of them were examined by conventional ultrasound, 3D-STE and left-heart catheterization. Their cardiac three-dimensional full-volume dynamic images were collected and then analyzed with three-dimensional speckle tracking technique. The global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), and global area strain (GAS) were measured. According to the detected left ventricular end diastolic pressure (LVEDP), the patients were divided into the normal left ventricular diastolic function group (LVEDP≤15 mmHg) and the left ventricular diastolic dysfunction group (LVEDP>15 mmHg). The GLS, GRS, GCS and GAS of the two groups were compared. Pearson correlation analysis was performed to analyze the correlation between GLS, GRS, GCS, GAS and LVEDP, and ROC curves were used to analyze efficiencies of GLS, GRS, GCS and GAS in prediction of left ventricular diastolic dysfunction.Results:The absolute values of GLS, GRS, GCS and GAS of the left ventricular diastolic dysfunction group were lower than those of the normal left ventricular diastolic function group ( P<0.05). The GLS, GCS and GAS were positively correlated with LVEDP ( P<0.05), while GRS was negatively correlated with LVEDP ( P<0.05). The AUC values of GLS, GRS, GCS and GAS for predicting left ventricular diastolic dysfunction were 0.667, 0.775, 0.762 and 0.840, respectively. The sensitivities were 79.17%, 72.22%, 69.44% and 80.56%, specificities were 48.28%, 70.69%, 82.76% and 77.59%, accuracy rates were 65.38%, 71.54%, 75.38% and 79.23%, respectively. Conclusions:The 3D-STE-related strain parameters GLS, GRS, GCS and GAS can be used as ultrasound indexes for assessment of left ventricular diastolic function in elderly patients with HF pEF, which is helpful for early detection of changes in left ventricular diastolic function in elderly patients with HF.

Objective To explore the value of deep learning(DL)models semi-automatic training system for automatic optimization of clinical image quality control of transthoracic echocardiography(TTE).Methods Totally 1 250 TTE videos from 402 patients were retrospectively collected,including 490 apical four chamber(A4C),310 parasternal long axis view of left ventricle(PLAX)and 450 parasternal short axis view of great vessel(PSAXGv).The videos were divided into development set(245 A4C,155 PLAX,225 PSAXGV),semi-automated training set(98 A4C,62 PLAX,90 PSAXGV)and test set(147 A4C,93 PLAX,135 PSAXGV)at the ratio of 5:2:3.Based on development set and semi-automatic training set,DL model of quality control was semi-automatically iteratively optimized,and a semi-automatic training system was constructed,then the efficacy of DL models for recognizing TTE views and assessing imaging quality of TTE were verified in test set.Results After optimization,the overall accuracy,precision,recall,and F1 score of DL models for recognizing TTE views in test set improved from 97.33％,97.26％,97.26％and 97.26％to 99.73％,99.65％,99.77％and 99.71％,respectively,while the overall accuracy for assessing A4C,PLAX and PSAXGV TTE as standard views in test set improved from 89.12％,83.87％and 90.37％to 93.20％,90.32％and 93.33％,respectively.Conclusion The developed DL models semi-automatic training system could improve the efficiency of clinical imaging quality control of TTE and increase iteration speed.