Aim To analyze the risk factor of the cardiac rupture(CR)in patients with acute ST-segment eleva-tion myocardial infarction(STEMI).Based on this,the nomogram model of acute STEMI patients with CR was estab-lished.Methods Through Ningxia Medical University General Hospital's big data research platform and hospital in-formation system retrieval,5 412 patients with acute STEMI from January 2015 to December 2019 were continuously includ-ed in the study,of which 91 patients with CR were included as CR group;5 321 patients non-combined with CR were in-cluded as non-CR group.LASSO regression,univariate and multivariate Logistic regression were used to analyze the risk factors of CR in patients with acute STEMI,and the CR nomogram predictive model was established.The nomogram mod-el was validated and evaluated by using receiver operating characteristic(ROC)curve,Hosmer-Lemeshow test and clinical decision curve analysis(DCA).Results LASSO regression results showed that age,female,hypertension history,first medical contact time,shock index,Killip grade,white blood cell count,d-dimer,lactic acid,anterior myocardial in-farction,β-blocker administration within 24 hours,angiotensin converting enzyme inhibitor/angiotensin receptor antagonist(ACEI/ARB)administration within 24 hours,emergency percutaneous coronary intervention(PCI)were 13 risk factors of CR(P＜0.05).The screened 13 risk factors were analyzed by univariate and multivariate Logistic regression,the results suggested that age,Killip grade,first medical contact time,white blood cell count,not undergoing emergency PCI and not taking ACEI/ARB drugs within 24 hours were the risk factors of CR in patients with acute STEMI.The acute STEMI with CR nomogram model was established according to the above 6 risk variables.The area under the ROC curve before and after the internal verification of the nomogram model was 0.946(95％CI:0.927～0.961),0.947(95％CI:0.927～0.959),and the sensitivity was 0.957 and 0.904,respectively,the specificity was 0.858 and 0.876,respectively,which indicated that the model had good discrimination degree.The Hosmer-Lemeshow test showed that the deviation between the predicted value and the observed value was not statistically significant(x2=12.70,P=0.122),indicating that the no-mogram model had a good calibration.The DCA curve indicated that the predictive probability threshold of the model was from 0.00 to 0.40,and the clinical net benefit was the highest,indicating that the model had good clinical efficacy.Conclusion The nomogram model established in this study has better distinction,calibration and clinical effectiveness.It can effectively predict the probability of acute STEMI with CR,and provide some help for clinical diagnosis and treat-ment,so as to reduce the incidence of CR.

Numerous clinical practices and case studies have found that thickening of the nuchal transparent layer (NT) in fetuses is not only related to chromosomal diseases, but also closely related to adverse pregnancy outcomes such as chromosomal microdeletion/microduplication syndrome, fetal structural abnormalities, certain genetic syndromes, and intrauterine fetal death. With the introduction of new genetic testing techniques, for fetuses with NT thickening detected by ultrasound, the genetic causes of NT thickening in fetuses can be identified at the prenatal single gene level, accurately assessing fetal condition and prognosis, and providing a theoretical basis for couples to have another child. In order to further clarify the clinical significance and corresponding diagnostic pathways of fetal NT thickening in prenatal diagnosis, this article reviews the progress of fetal NT thickening in prenatal diagnosis in domestic and foreign literature.

Objective: To investigate the relationship between exposure to famine in fetus and infant period and the risks for hypertension in adulthood. Methods: A total of 5 960 participants born between 1956 and 1965 were included in the study and were divided into unexposed group (1963-1965), fetal exposed group (1959-1961), early- childhood exposed group (1956-1958) and transitional group (1962). Logistic regression model was used to explore the association between famine exposure in early life and the risk for hypertension in adulthood. Results: Both the fetal exposure and the early-childhood exposure were the risk factors for hypertension in adulthood (OR=1.249, 95%CI: 1.049-1.486 and OR=1.360, 95%CI: 1.102-1.679). Meanwhile, in rural area, compared with unexposed group, the fetal exposure (OR=1.401, 95%CI: 1.091-1.798) and the early-childhood exposure (OR=1.460, 95%CI: 1.145-1.862) were also associated with a greater risk of hypertension in adulthood. In addition, fetal exposure and early-childhood exposure to famine in women were associated with 36.0% and 31.9% increased risks for hypertension (95%CI: 7.8%-71.7% and 95%CI: 4.8%-66.0%) according to the stratified analysis. Conclusion Fetal exposure to famine might increase the risk for hypertension in adulthood.

Systemic lupus erythematosus (SLE) is a complex autoimmune syndrome characterized by various co-existing autoantibodies (autoAbs) in patients' blood. However, the full spectrum of autoAbs in SLE has not been comprehensively elucidated. In this study, a commercial platform bearing 9400 antigens (ProtoArray) was used to identify autoAbs that were significantly elevated in the sera of SLE patients. By comparing the autoAb profiles of SLE patients with those of healthy controls, we identified 437 IgG and 1213 IgM autoAbs that the expression levels were significantly increased in SLE (P < 0.05). Use of the ProtoArray platform uncovered over 300 novel autoAbs targeting a broad range of nuclear, cytoplasmic, and membrane antigens. Molecular interaction network analysis revealed that the antigens targeted by the autoAbs were most significantly enriched in cell death, cell cycle, and DNA repair pathways. A group of autoAbs associated with cell apoptosis and DNA repair function, including those targeting APEX1, AURKA, POLB, AGO1, HMGB1, IFIT5, MAPKAPK3, PADI4, RGS3, SRP19, UBE2S, and VRK1, were further validated by ELISA and Western blot in a larger cohort. In addition, the levels of autoAbs against APEX1, HMGB1, VRK1, AURKA, PADI4, and SRP19 were positively correlated with the level of anti-dsDNA in SLE patients. Comprehensive autoAb screening has identified novel autoAbs, which may shed light on potential pathogenic pathways leading to lupus.

Objective To investigate the clinical significance of bone marrow immunopathogenesis in the diagnosis and staging of lymphoma. Methods Clinical data of 266 patients with newly diagnosed lymphoma admitted to Department of Hematology in the First Hospital of Jilin University from August 2015 to December 2017 were retrospectively analyzed. The results of lymphoma diagnosis and staging in different bone marrow detection methods were compared, SPSS 22.0 software was used to make statistical analysis and χ2 test was used to compare the positive rates of lymphoma bone marrow infiltration in different methods. Results In the 266 patients, 64 cases (24.1 %) were diagnosed with lymphoma by using bone marrow detection on the condition that no lymph node pathology was available and all the immunophenotypes of 64 cases were identified by bone marrow immunopathology. Bone marrow infiltration was identified in 121 patients (45.5 %), among which the rate of bone marrow infiltration was 0 (0/12) in Hodgkin lymphoma (HL) and 47.6 % (121/254) in non-Hodgkin lymphoma (NHL). The rate of bone marrow infiltration was 50.0 % (105/210) and 36.4 % (16/44) in B type and T type NHL respectively. The positive rate of bone marrow infiltration detected by bone marrow smear, bone marrow biopsy, bone marrow flow cytometry and bone marrow immunopathology were 78.5 % (95/121), 87.6 % (106/121), 89.3 % (108/121), 96.7 % (117/121) respectively. Bone marrow immunopathology was more advantageous than any other methods, and there was a statistical difference (χ2＝18.38, 9.09, 3.76; all P < 0.05). Among 121 patients who were identified with bone marrow infiltration by bone marrow detection, the staging of 42 patients (34.7 %) were amended, including the staging of 39 amended patients (32.2 %) through bone marrow immunopathologic detection. Conclusion Bone marrow immunopathology can be used for the diagnosis and classification of lymphoma, which has an obvious advantage in detecting bone marrow infiltration of lymphoma compared with bone marrow smear, bone marrow biopsy, bone marrow flow cytometry, and it can be used to amend the clinical staging.

Objective To investigate six-minute walk distancc (6MWD) of inpatients underwent cardiac surgery before discharge and to identify its influencing factors,and to provide references for further studies of hospital rehabilitation.Methods Using convenience sampling,from August 2016 to June 2017,167 eligible patients underwent cardiac surgery were recruited from a cardiovascular hospital in Beijing.General and disease-related intormation were collected.According to requirements of six-minute walk tcst (6MWT) from American Thoracic Society,patients' rehabilitation was evaluated using 6MWD.Results After discharge from intensive care unit(ICU),6MWD of patients increased along with hospital stays.On the day before discharge,mean 6MWD of patients was (213.86±75.87).The influencing factors of 6MWD included types of surgery (P=0.019),cardiopulmonary bypass (P=0.004),postoperative left ventdcular ejection fraction (LVEF)(P=0.015),and hospital stays after discharge from ICU (P=0.003).Conclusion During hospitalization,6MWD of patients underwent cardiac surgery increased along with hospital stays.On the day before discharge,6MWD of patients tended to be stable,and ready for further rehabilitation process.Patients could have different rehabilitation differences in types of surgery,using cardiopulmonary bypass,LVEF and hospital stays after discharge from ICU.

Objective: In comparison with thrombus aspiration, to study the safety and effcacy of precise intracoronary retrograde thrombolysis during primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI).
Methods: A total of 123 consecutive patients with acute STEMI received primary PCI in our hospital from 2014-01 to 2015-12 were enrolled.The patients were randomly divided into 2 groups: RT group, the patients received precise intracoronary retrograde thrombolysis (RT),n=60 and TA group, the patients received thrombus aspiration (TA),n=63, among them, 3 patients with failed TA were excluded. Primary end points included occurrence rates of no-lfow after PCI and ST-segment resolution (STR)≥50% at (60-90) min after PCI; primary safety end points included occurrence rates of in-hospital stroke and TIMI-hemorrhage events.
Results:①Compared with TA group, RT group showed decreased no-lfow rate after PCI (1.7% vs 15.0%),P=0.008 and increased rate of STR≥50% after PCI (65.0% vs 45.0%),P=0.028, improved LVEF by echocardiography (50.7±8.6) % vs (46.7±8.3)%,P=0.011. The in-hospital MACE occurrence rate was similar between 2 groups,P>0.05.②No in-hospital stroke or TIMI-hemorrhage events occurred in neither group.
Conclusion: Intracoronary retrograde precise thrombolysis had the similar safety to thrombus aspiration during primary PCI in patients with acute STEMI, it may reduce no-relfow rate and improve left ventricular function after PCI.

OBJECTIVETo explore the correlation between metabolic tumour volume (MTV) and microvessel density (MVD) and blood-borne metastasis in colorectal carcinoma.

METHODSThirty-six patients with CRC conformed by pathology underwent PET-CT examination before operation. SUVmax and MTV were obtained by PET VCRA software. The blood vessels were identified with CD34 immunohistochemical staining, and the MVD was recorded. The correlation between SUVmax and MTV with histological differentiation, T stage, MVD and blood-borne metastasis was analyzed.

RESULTSThe SUVmax, MTV and MVD in patients with blood-borne metastasis were 5.15 ± 5.41, (22.99 ± 18.63) cm³ and 14.17 ± 3.63, and were 10.65 ± 3.79, (16.95 ± 11.82) cm³ and 11.27 ± 3.69, respectively, in patients with non-blood-borne metastasis. The differences of SUVmax, MTV and MVD between blood-borne metastasis and non-blood-borne metastasis patients were statistically significant (all P > 0.05). Pearson correlation analysis found that there was no linear correlation between SUVmax and MVD, and the SUVmax was not statistically significant between high and low MVD groups (t = 0.919, P = 0.364). But there was a linear correlation between MTV and MVD (r = 0.621, P = 0.000), and the MTV was statistically significant between high and low MVD groups (t = 3.567, P = 0.001). The receiver-operating characteristic curves showed that MTV could be used to predict blood-borne metastasis of CRC, and the best cutoff value for MTV was 14.975 cm³, and the sensitivity, specificity, negative predictive value and positive predictive value were 85.7%, 54.5%, 72.3% and 64.2%, respectively. There were no significant relationships between SUVmax, MTV, MVD, blood-borne metastasis and histological differentiation (P > 0.05). With the increased T stage, the MTV, MVD and the probability of blood-borne metastasis were also increased (all P < 0.05).

CONCLUSIONSThere are correlations between MTV and MVD and blood-borne metastasis in CRC. The risk of blood-borne metastasis in patients with MTV > 14.975 cm³ is higher, and needs to take more effective intervention.

Colorectal Neoplasms ; blood supply ; diagnostic imaging ; pathology ; Fluorodeoxyglucose F18 ; Humans ; Microvessels ; pathology ; Multimodal Imaging ; Neoplasm Staging ; Neoplastic Cells, Circulating ; Positron-Emission Tomography ; ROC Curve ; Radiopharmaceuticals ; Sensitivity and Specificity ; Tomography, X-Ray Computed

Objective To explore the correlation between metabolic tumour volume ( MTV ) and microvessel density ( MVD ) and blood?borne metastasis in colorectal carcinoma. Methods Thirty?six patients with CRC conformed by pathology underwent PET?CT examination before operation. SUVmax and MTV were obtained by PET VCRA software. The blood vessels were identified with CD34 immunohistochemical staining, and the MVD was recorded. The correlation between SUVmax and MTV with histological differentiation, T stage, MVD and blood?borne metastasis was analyzed. Results The SUVmax, MTV and MVD in patients with blood?borne metastasis were 5.15±5.41, (22.99±18.63) cm3 and 14.17± 3.63, and were 10.65±3.79, (16.95±11.82)cm3 and 11.27±3.69, respectively, in patients with non?blood?borne metastasis. The differences of SUVmax, MTV and MVD between blood?borne metastasis and non?blood?borne metastasis patients were statistically significant( all P>0.05) . Pearson correlation analysis found that there was no linear correlation between SUVmax and MVD, and the SUVmax was not statistically significant between high and low MVD groups (t=0.919,P=0.364). But there was a linear correlation between MTV and MVD (r=0.621,P=0.000),and the MTV was statistically significant between high and low MVD groups ( t=3.567, P=0.001) . The receiver?operating characteristic curves showed that MTV could be used to predict blood?borne metastasis of CRC, and the best cutoff value for MTV was 14.975 cm3, and the sensitivity, specificity, negative predictive value and positive predictive value were 85. 7%, 54. 5%, 72.3% and 64. 2%, respectively. There were no significant relationships between SUVmax, MTV, MVD, blood?borne metastasis and histological differentiation (P>0.05). With the increased T stage, the MTV, MVD and the probability of blood?borne metastasis were also increased ( all P<0.05) . Conclusions There are correlations between MTV and MVD and blood?borne metastasis in CRC. The risk of blood?borne metastasis in patients with MTV>14.975 cm3 is higher, and needs to take more effective intervention.

Objective To explore the correlation between metabolic tumour volume ( MTV ) and microvessel density ( MVD ) and blood?borne metastasis in colorectal carcinoma. Methods Thirty?six patients with CRC conformed by pathology underwent PET?CT examination before operation. SUVmax and MTV were obtained by PET VCRA software. The blood vessels were identified with CD34 immunohistochemical staining, and the MVD was recorded. The correlation between SUVmax and MTV with histological differentiation, T stage, MVD and blood?borne metastasis was analyzed. Results The SUVmax, MTV and MVD in patients with blood?borne metastasis were 5.15±5.41, (22.99±18.63) cm3 and 14.17± 3.63, and were 10.65±3.79, (16.95±11.82)cm3 and 11.27±3.69, respectively, in patients with non?blood?borne metastasis. The differences of SUVmax, MTV and MVD between blood?borne metastasis and non?blood?borne metastasis patients were statistically significant( all P>0.05) . Pearson correlation analysis found that there was no linear correlation between SUVmax and MVD, and the SUVmax was not statistically significant between high and low MVD groups (t=0.919,P=0.364). But there was a linear correlation between MTV and MVD (r=0.621,P=0.000),and the MTV was statistically significant between high and low MVD groups ( t=3.567, P=0.001) . The receiver?operating characteristic curves showed that MTV could be used to predict blood?borne metastasis of CRC, and the best cutoff value for MTV was 14.975 cm3, and the sensitivity, specificity, negative predictive value and positive predictive value were 85. 7%, 54. 5%, 72.3% and 64. 2%, respectively. There were no significant relationships between SUVmax, MTV, MVD, blood?borne metastasis and histological differentiation (P>0.05). With the increased T stage, the MTV, MVD and the probability of blood?borne metastasis were also increased ( all P<0.05) . Conclusions There are correlations between MTV and MVD and blood?borne metastasis in CRC. The risk of blood?borne metastasis in patients with MTV>14.975 cm3 is higher, and needs to take more effective intervention.