Objective To investigate the correlation of right ventricular (RV) to left ventricular (LV) volume ratio (RVv/LVv) measured by chest CT with pulmonary arterial pressure estimated by echocardiography before lung transplantation.Methods We reviewed 104 cases of lung transplant.According to the mean pulmonary arterial pressure (mPAP) exceeding 25 mmHg by right heart catheterization,hypertensive group (n =74) and normotensive group (n =30) were set up.Risk factors were assessed individually and adjusted for confounding by a multivariable logistic regression analysis.The area under the curve (AUC) for predicting pulmonary hypertension on chest CT and echocardiography was calculated.Results RVv/LVv and echocardiography-derived ptlmonary arterial systolic pressure (PASP) were significantly different between the two groups (P ＜ 0.05).In the hypertensive group,there was strong correlation between the RVv/LVv and PASP from catheterization (R =0.82,P＜0.001),also between the P ASP from echocardiography and catheterization (R =0.60,P＜ 0.001).The ROC curve displayed that with 0.85 as the cutoff for RVv/LVv,the sensmitivity,specificity and accuracy rate for predicting mPAP over 25 mmHg were 87.5％,91.8％ and 90.9％,respectively.The ROC curve also displayed that based upon an echocardiography-derived PASP of 35 mmHg as the cutoff point,the sensitivity,specificity and accuracy rate for predicting mPAP over 25 mmHg were 91.2％,90.8％ and 88.4％,respectively.Conclusion RV/LV volume ratios on chest CT and echocardiographic evaluation correlate well with PASP assessed by right heart catheterization and can be used to predict pulmonary hypertension with high sensitivity and specificity.

Objective: To explore the prevalence and risk factors of mitral regurgitation (MR) in the population ≥35 years in China in order to provide prevention reference for high risk crowd. Methods: The residents ≥35 years were taken by a stratified multistage sampling method. General information of crowd was collected by predesigned questionnaire and physical examination including life style, disease history, body weight and height. Echocardiography was conducted, fasting blood glucose and blood lipid levels were measured. Results: A total of 28814 subjects were enrolled. The overall MR detection rate was 18.4%, the detection rate in male and female were both 18.4%. The detection rates of moderate and severe MR were 0.3% in the paticipants at (35-50) years, 0.9% at (51-64) years and 2.2% at ≥65 years. MR prevalence showed an increasing trend with aging. Multivariate Logistic regression analysis indicated that age, systolic blood pressure, urban and rural, district, left atrial front and back diameter, left ventricular end diastolic front and back diameter, left ventricular ejection fraction, stroke, atrial fibrillation and heart failure were the risk factors for MR occurrence. Conclusion: MR detection rate was rather high in China. Specific prevention action should be taken for those with theabove risk factors.

Objective To investigate the selection of recipients,operative technique,and perioperative management of lung transplantation for chronic thromboembolic pulmonary hypertension.Methods This article reviews the clinical data of 6 patients with chronic thromboembolic pulmonary hypertension receiving lung transplantation from January 2012 to June 2016.From January 2012 to June 2016,6 patients with chronic thromboembolic pulmonary hypertension underwent lung transplantation at Department of Thoracic Surgery,Affiliated Wuxi People's Hospital,Nanjing Medical University.There were 4 male and 2 female patients aged from 34 to 59 years.Chest enhancement of CT or CTPA in 6 patients prior to transplantation suggests a different degree of pulmonary embolism.The mean pulmonary artery pressure (mPAP) was＞30 mmHg,NYHA 11Ⅰ or Ⅳ.Four patients received bilateral sequence lung transplantation (BSLT) under extracorporeal membrane oxygenation (ECMO) support.Two patients received single lung transplantation (SLT).We analyzed the differences of oxygenation index,pulmonary systolic pressure,pulmonary artery diastolic pressure,mean pulmonary arterial pressure,and central venous pressure before and after treatment.Using paired t test to compare these indicators,P＜0.05 was considered statistically significant.Results The oxygenation index increased from (195 ± 85) to (440 ± 140) mmHg after treatment,the difference was statistically significant (P＜0.05).the The systolic pressure of pulmonary artery was decreased from (108 ± 28) mmHg to (56 ± 16) mmHg,and the difference was statistically significant (P＜0.05).the The diastolic pressure of pulmonary artery was decreased from (72 ± 18) mmHg to (25 ± 10) mmHg,and the difference was statistically significant (P＜0.05).the The mean pulmonary artery pressure was decreased from (84 ± 27) mmHg to (36 ± 10) mmHg,and the difference was statistically significant (P＜0.05).the The central venous pressure was decreased from (17.5 ± 4.5) mmHg to (8.5 ± 1.5) mmHg,and the difference was statistically significant (P＜0.05).Finally,5 patients were discharged from the hospital,and the pulmonary valve? functioned? well.1 patients died of shock and systemic failure 3 days after operation.Conclusion Lung transplantation is effective in the treatment of chronic thromboembolic pulmonary hypertension,and long-term survival requires further investigations.

Objective:To evaluate the value of B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutation detection in the differentiating malignant from benign with Bethesda system for reporting thyroid cytopathology (BSRTC) categories Ⅰ and Ⅲ nodules. Methods:From January 2019 to December 2020, a total of 264 nodules from 263 patients (79 males, 184 females; median age 46 years) were retrospectively enrolled and all patients underwent BRAF V600E mutation detection, fine-needle aspiration cytology (FNAC) and thyroid nodulectomy in the Affiliated Drum Tower Hospital of Nanjing University Medical School. Thirteen nodules of 12 patients had repeat aspirate samples and 51 nodules were examined with multiple genes assay in formalin fixed paraffin embedded tissues. Taken the postoperative histopathological results as the gold standard, the diagnostic efficiency of BRAF V600E mutation was analyzed by comparing the results of multiple genes assay and BRAF V600E mutation detection of repeated puncture samples. Results:Of 264 nodules, 230 were malignant (papillary thyroid cancer (PTC)) and 34 were benign, with BSRTC categories Ⅰ (nondiagnostic) and Ⅲ (follicular lesion) nodules of 58 and 206. The sensitivities of BRAF V600E mutation detection in BSRTC categories Ⅰ and Ⅲ nodules were 77.1%(37/48) and 78.0%(142/182), the specificities were 9/10 and 91.7%(22/24), the positive predictive values were 97.4%(37/38) and 98.6%(142/144), the negative predictive values were 45.0%(9/20) and 35.5%(22/62), and the accuracy rates were 79.3%(46/58) and 79.6%(164/206). The diagnostic concordance of BRAF V600E mutation detection was 90.2%(46/51) in the preoperative and postoperative samples of 51 nodules with preoperative BRAF V600E wild type but postoperative pathology confirmed as PTC and was 11/13 in repeat puncture samples. Conclusion:BRAF V600E mutation detection is an effective diagnostic method for BSRTC categories Ⅰ and Ⅲ nodules.

Objective To investigate the association between types of obesity and the 10-year-coronary heart disease risk in Tibet and Xinjiang of China.Methods Using the multi-stage random sampling method,7 631 participants aged 35 or older were examined under the International Standardized Examination process but with only 5 802 were eligible for analysis,in the 2015-2016 season.Results The prevalence rates of general obesity,central obesity,visceral obesity and compound obesity were 0.53％,12.62％,10.08％ and 42.35％,respectively.Out of all the compound obesity cases,58.65％ (1 441/2 457) of them appeared as having all types of obesity in our study.Risk related to the 10-year-coronary heart disease was higher in men than in women [(3.05 ± 4.14)％ vs.(1.42-2.37) ％,P＜0.000 1.Compound obesity (30.16％) showed the highest proportion on the risk of 10-year-coronary heart disease than central obesity (28.01％),visceral obesity (18.46％) or the general obesity (19.35％).After adjustment for confounding factors,results from the multivariate analysis showed the risk in compound obesity was higher than central obesity,visceral obesity or general obesity and was associated with the highest risk on the 10-year-coronary heart disease (OR=2.889,95％CI:2.525-3.305).People with anomalous BMI and WC seemed to have had the higher risk (OR=3.168,95％CI:2.730-3.677).Conclusions Obesity was popular in the residents of Tibet and Xinjiang areas of China.Men and people with compound obesity (especially both BMI and WC were abnormal) seemed to carry greater risk on the 10-year-coronary heart disease.

Objective To investigate the association between body fat percentage (BFP),visceral fat index (VFI) and Cardiometabolic Risk Factor Clustering (CRFC),among population aged 35 or older in Tibet and Xinjiang areas.Methods Using the stratified multi-stage random sampling method,7 571 residents aged 35 or above were examined with international standardized examination between 2015 and 2016.Of the eligible 5 643 participants,association of BFP and VFI with CRFC was defined as having two or more of the four risk factors:hypertension,diabetes mellitus,high TG and low HDL-C,at the same time.Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were employed to further explore the relationships.Results The overall prevalence of CRFC among aged 35 and older population in Tibet and Xinjiang areas was 9.78％.BFP and VFI were divided into four groups by quartile.After adjustment for age,gender,race,cigarette smoking,alcohol consumption,education attainments,and altitude of residence,ORs of CRFC seemed to have increased with BFP and VFI.Compared with people having BFP of 5.0％-27.0％,the OR(95％CI) were 1.15(0.86-1.54),1.48(1.05-2.07) and 1.72(1.10-2.68) for the ones who presented 27.1％-31.7％,31.8％-36.6％ and 36.7％-50.0％ of BFP.Compared to people of having 1-6 of VFI,with OR (95％CI) as 1.20(0.81-1.79),1.91(1.30-2.80) and 3.91(2.64-5.77) for the ones having 7-9,10-13 and 14-30 of VFI.Areas under the curve (AUC) of CRFC appeared as 0.55 for BFP and 0.70 for VFI,respectively,with statistically significant difference (P＜0.01).Conclusion Both BFP and VFI levels were closely associated with CRFC while VFI seemed to have a better predictive value than the BFP.