Objective To evaluate the left ventricular and right ventricular systolic function by two‐dimensional speckle tracking echocardiography ( 2D‐STE) in patients with rheumatoid arthritis ( RA ) . Methods Fifty five patients with RA and 50 healthy subjects were received echocardiography . 2D‐STE were applied for all the subjects to obtain left ventricular global longitudinal strain ( LVGLS) and right ventricular global longitudinal strain ( RVGLS) .Tricuspid annular plane systolic excursion ( TAPSE) and the change ratio of right ventricular area ( RVACR) were measured by echocardiography . The anti‐cyclic citrullinated peptide antibodies ( anti‐CCP‐II) ,rheumatoid factor ( RF) ,C‐reactive protein ( CRP) and erythrocyte sedimentation rate ( ESR) were detected in both group . The LVGLS and RVGLS in RA group were used to conduce correlation analysis with the level of anti‐CCP‐II ,RF ,CRP , ESR and the duration of disease . Results There was a significant decrease in RVGLS and LVGLS in RA group compared with control group( P <0 .05) . However there was no statistical differenc in TAPSE and RVACR between RA and control group( P > 0 .05) . The anti‐CCP‐II ,RF ,CRP and ESR in RA group increased significantly compared with control group ( P < 0 .001 ) . The result of correlation analysis showed there was no correlation between RVGLS ,LVGLS and anti‐CCP‐II ,RF ,CRP ,ESR in RA group . However ,RVGLS and LVGLS were negatively correlated with the duration of disease . Conclusions LVGLS and RVGLS in RA patients were lower than those in healthy people ,strain decreases with the extension of disease duration ,2D‐STE may be an efficacious assessment to assess left ventricular and right ventricular systolic function in patients w ith RA .

Objective To evaluate the value of serum B-cell activating factor (BAFF) level in predicting cardiovascular events in patients with ST segment elevation myocardial infarction (STEMI). Methods A total of 166 patients with coronary angiography for STEMI in the Nantong Third Hospital Affiliated to Nantong University from January 2020 to June 2022 were selected as research objects, and general materials, medical history, echocardiography and laboratory data were collected. Patients were followed up for 12 months to record the incidence condition of major adverse cardiac events (MACE). The predictive value of serum BAFF level for MACE was evaluated by Cox proportional hazard model; the receiver operating characteristic (ROC) curve of serum BAFF level for prediction of MACE was drawn, and the area under curve (AUC) was calculated. The optimal cut-off value for serum BAFF level was determined by the ROC curve, the patients were grouped based on this optimal cut-off, and the Log-rank test was used to draw the Kaplan-Meier curve for analyzing the incidence of MACE. Results Among the 166 patients, 26 cases had MACE within 12 months of follow-up, and the incidence rate of MACE was 15.7 %. In the MACE group, the age and levels of triglycerides, low-density lipoprotein, cardiac troponin Ⅰ, creatine kinase isoenzyme, and serum BAFF were significantly higher than those in the non-MACE group (P < 0.05). Cox proportional hazard model analysis revealed that there was a significant positive correlation between age and incidence of MACE (HR=1.267, 95 %CI, 1.126 to 1.426, P < 0.001) as well as a significant positive association between serum BAFF level and incidence of MACE (HR=1.020, 95 %CI, 1.003 to 1.038, P=0.024). The sensitivity of serum BAFF level in predicting MACE was 76.2 %, and the specificity was 82.9 %. ROC curve analysis identified the optimal cut-off value of serum BAFF was 1.07 ng/mL, patients were divided into a group with serum BAFF>1.07 ng/mL and another with serum BAFF ≤ 1.07 ng/mL, and the cumulative survival rate in the group with serum BAFF ≤ 1.07 ng/mL was significantly higher than that in the group with serum BAFF>1.07 ng/mL (P < 0.001). Conclusion The increase of serum BAFF level is significantly positively correlated with the increased incidence of MACE in STEMI patients, and serum BAFF level can be used as a predictor of cardiovascular events in STEMI patients.

Objective    To analyze the value of structured electronic medical records for pulmonary nodules in increasing the ability of outpatient service and hospital management by resident physicians. Methods    We included 40 trainees [94 males and 26 females aged 22-31 (26.45±2.81) years] who were trained in the standardized training base for surgical residents in our hospital from January 2018 to January 2021. The trainees were randomly divided into two groups including a structured group using the structured electronic medical record for pulmonary nodule and an unstructured group using unstructured electronic medical record designed by our department. The time of completing hospitalization records and first-time course records, the quality of course records, the accuracy of issuing admission orders, the quality of teaching rounds, and patient’s satisfaction between the two groups were analyzed and compared. Results    (1) The average time in the structured group to complete inpatient medical records was significantly shorter than that of the unstructured group (53.61±8.12 min vs. 84.25±16.09 min, P<0.010); the average time in the structured group to complete the first-time course record was shorter than that of the unstructured group (13.20±5.43 min vs. 27.51±8.62 min, P<0.010), and there was a significant statistical difference between the two groups. (2) The overall teaching round quality score of the students in the structured group was significantly higher than that in the unstructured group (84.21±15.61 vs. 70.91±12.28, P<0.010). (3) The score of the medical record writing quality of the structured group was significantly higher than that of the unstructured group (80.25±9.22 vs. 74.22±5.40, P<0.010). Conclusion    The structured electronic medical record specific for pulmonary nodules can effectively improve the training efficiency in the standardized training of surgical residents, improve the clinical ability to deal with pulmonary nodules, improve the integrity and accuracy of key clinical data collected by students, and improve doctor-patient relationship.