Objective To investigate clinical characteristics of patients with ST-elevation myocardial infarction (STEMI) and hypokalemia and the effects of hypokalemia on prognosis. Methods Consecutive 216 cases with STEMI who underwent emergency PCI were divided into group A (serum potassium ＜ 3.5 mmol/L) and group B (serum potassium＞3.5 mmol/L). Infarct site, infarct interrelated artery, peak level of CK-MB and cTnT were compared between two groups. Post-infarctional angina pectoris, arrhythmia, heart failure and cardiac death were compared. Results (1 )The percentage of anterior wall myocardial infarction , left anterior descending artery (LAD) lesions in group A were significantly higher than those in group B [61.2%(41/67) vs. 44.3%(66/149),55.2%(37/67)vs. 38.9%(58/149),P = 0.022,0.026]. The peak levels of CK-MB and cTnT in group A were significantly higher than those in group B [(194.39 ± 101.27) μg/L vs. (115.35 ±78.62)μg/L,(19.16 ±11.48)μg/L vs. (9.07 ±7.65) μg/L,P = 0.004,0.002].(2)Left ventricular ejection fraction in group A was significant lower than that in group B (P - 0.003). The incidence rates of post-infarctional angina pectoris, ventricular tachycardia, ventricular fibrillation and heart failure were significantly higher in group A [43.3%(29/67),32.8%(22/67), 11.9%(8/67),37.3%(25/67)] than those in group B [24.8%(37/149),18.1%(27/149),4.0%(6/149),20.8%(31/149)](P = 0.006, 0.017, 0.029, 0.010). Conclusions Hypokalemia is associated with infarct site and infarct interrelated artery. Hypokalemia has bad effect on prognosis of STEMI.

OBJECTIVETo assess the complications of percutaneous tansluminal septal myocardial ablation (PTSMA) for the treatment of hypertrophic obstructive cardiomyopathy (HOCM).

METHODSSeventy-two patients with symptomatic left ventricular outflow tract obstruction were diagnosed by echocardiography or catheterization procedures. Absolute ethanol was injected into the target coronary artery branch (branches) for septal myocardial ablation. Documented complications were recorded.

RESULTSSixty-nine patients had severe chest pain, 19 developed different degrees of heart block during the periprocedural period, but only one developed a complete AV block, requiring permanent pace-maker implantation. Temporary right bundle branch block occurred in 50% of patients and permanent block occurred in 38.9% of patients. Acute inferior myocardial infarction occurred in six patients (8.3%) and acute anterior myocardial infarction occurred in one patient. During two-year follow-up of 24 cases, there were no deaths. All patients had improvement in heart function and none experienced heart failure.

CONCLUSIONThe most common complication of PTSMA is right bundle branch block. The most significant complication of the procedure is heart block. PTSMA is a good technical, non-surgical treatment for HOCM.

Adolescent ; Adult ; Arrhythmias, Cardiac ; etiology ; Cardiomyopathy, Hypertrophic ; surgery ; Catheter Ablation ; adverse effects ; Female ; Heart Block ; etiology ; Heart Septum ; surgery ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; etiology ; Postoperative Complications ; etiology

Objective:To investigate the value of CT findings in predicting thetransformation of clinical types of COVID-19.Methods:From January 24 to February 6, 2020, the clinical and chest CT data of patients with common COVID-19 were analyzed retrospectively. A total of 64 patients were enrolled, including 32 males and 32 females, aged 18-76 (45±15) years. Based on the fact whether patients’ conditions had deteriorated into severe type, all the cases were divided into common type group (51 cases) and deteriorated type group (13 cases). Differences of CT findings in the two groups of patients were analyzed, and visual semi-quantitative scores were introduced to evaluate the pneumonia.Results:Compared with the common type group, the deteriorated type group was more likely to involve the left upper lobe, the right middle lobe and the lung far away from the pleura. The differences between the two groups were statistically significant (χ2= 5.897, P=0.027; χ2=8.549, P=0.005; χ2=10.169, P=0.002). The median of the involved lobes were 2 (1,5) in the common type group and 5 (4,5) in the deteriorated type group. The difference between the two groups was statistically significant (Z =-3.303, P=0.001). Taking the involved lobes ( n=4) as the threshold, the sensitivity and specificity of the diagnosis of the common type to the deteriorated type patients were the highest, 76.9% and 74.5% respectively, and the area under the ROC curve was 0.787. Pneumonia score of the deteriorated group was 10 (4,16), higher than that of the common group [4 (1,13)], and the difference was statistically significant ( Z=-4.040, P<0.001). Pneumonia score 8 as the threshold, the sensitivity and specificity of the general severe group were the highest, 69.2% and 86.3% respectively, and the area under ROC curve was 0.863. Conclusions:CT imaging has a profound value in the early prediction of deterioration in clinical type of COVID-19. It can help evaluate the severity of pneumonia in early stage. Range of lesions might be an important indicator for prognosis of common type COVID-19.

Objective TodetecttheCTfindingsofinterstitialpneumoniainacquiredimmunodeficiencysyndrome (AIDS)patients andtoanalyzedifferentialdiagnosisofdifferenttypesofinterstitialpneumonia.Methods Atotalof168 AIDSpatientswithinterstitial pneumoniabetweenOctober2016andJune2018 wereretrospectivelystudied.PulmonaryCTfindingsweredescribed.Results Among 168cases,44caseswerediagnosedaspneumocystiscariniipneumonia (PCP),40casesascytomegalovirus(CMV)pneumonia,and 84casesasPCPaccompaniedwithCMVpneumonia.Statisticallysignificantdifferenceswerefoundamong3groupsonsignsofpure groundglassopacity,accompaniedwithdistortedfibrousstripes,andaccompaniedwithconsolidationandmultiplecysts(P＜0.05). PuregroundglassopacitiesweremorelikelytobeseeninPCPpatients,whiledistortedfibrousstripeswerelesslikely,comparedto theothertwogroups.Militarynodules,consolidationandmultiplecystspresentedlessinpatientswithPCPcomparedtopatientswith PCPaccompaniedwithCMVpneumonia.ForPCPpatients,lesionsweremorelikelytobetotallyabsorbedaftertreatment,whilefor patientswithCMVpneumoniaandPCPaccompaniedwithCMVpneumonia,fibrousstripesandemphysema/airsacsweremorelikelyto present.Conclusion CTfindingsofinterstitialpneumoniavaryinAIDSpatients,however,signsofdistortedfibrousstripes,multiple cysts,remainingfibrousstripesandemphysema/airsacsaftertreatmentsuggestco-infectionofCMV.