Objective To examine the relationship between hematocrit and risk of long term mortality among patients with acute myocardial infarction. Methods A total of 274 patients with acute myocardial infarction were recruited and divided into two groups by death after long term follow-up, the relationship between hematocrit and mortality was evaluated through the methods of independent t-test,chi-square test and multivariate regression analysis. Results The mean age was 69. 79 ± 7.45 years, with 73. 0% of male. The average of followup was 44. 4± 10. 7 months, with mortality of 38.7% . Comparison of baseline data showed that NYHA classification, smoking history, hemoglobin, hematocrit, mean red cell volume, glomerular filtration rate, ejection fraction,left ventricular diastolic diameter and right ventricular diameter was significantly different between the two groups( Ps ＜ 0. 05), Multivariable logistic analysis showed that hematocrit ,glomerular filtration rate, ejection fraction and smoking history were independently predicted factors, with OR of 0. 904 (95% CI: 0. 832 - 0. 982,P =0. 016) ,0. 983 (95% CI: 0. 969 -0. 996,P =0. 014) ,0. 932 (95% CI: 0. 887 -0. 979,P =0. 005) and 3. 230 (95% CI: 1.468 - 7. 106, P = 0. 004), respectively. The power of hematocrit to predict mortality was examined by ROC curves, the area under the curve was 0. 669(P ＜ 0. 001,95% CI: 0. 603 - 0. 736) Conclusion Hematocrit is a significant independent predictor for long term death among patients with acute myocardial infarction.

Objective To determine the prognostic value of fight ventricular end-diastollc diameter (RVDD)in patients with chronic heart failure(CHF).Methods The clinical data of the in-hospital patients diagnosed as CHF were analyzed retrospectively.Telephone follow-up was carried out for all participants.The patients were divided into the survival group and death groups according to their clinical outcomes.The relationship between RVDD and death was evaluated by independent t-test and multivariate Logistic regression analysis.Results 1552 in-hospital patients were enrolled into the study.The mean age was 64.62 ± 10.45 years old,with 879(56.64％)male.After 3 years' follow-up,439(28.29％)patients died.Comparison of baseline data showed that gender,age,SBP,NYHA classification,the serum level of creatinine,LVEF,LVDD and RVDD were significantly different between the two groups(P ＜ 0.01);Multivariable logistic analysis showed that RVDD(OR=1.11,95％ CI:1.07-1.14,P ＜0.01),age(OR =1.03,95％ CI:1.02-1.05,P ＜0.01),creatinine(OR =1.02,95 ％ CI:1.01-1.04,P ＜ 0.01),LVEF(OR =0.93,95 ％ CI:0.92-0.97,P ＜ 0.01),LVDD(OR =1.13,95％ CI:1.09-1.17,P ＜0.01)and NYHA classification(OR =1.17,95％ CI:1.12-1.24,P ＜ 0.01)were independent predicting factors for the death of CHF patients.The power of RVDD to predict mortality was examined by ROC curves.The area under the curve was 0.805(95％ CI:0.798-0.812,P ＜ 0.01).Conclusion RVDD increases the risk of death in patients with CHF.RVDD is a significant independent predictor for death among patients with CHF.

Objective To investigate the prognostic value of right ventricular end-diastolic diameter (RVDD) in patients with chronic systolic heart failure (CHF).Methods A retrospective study was conducted with clinical data of inpatients from 12 third-grade class-A hospitals of Hubei Province between 2000 to 2010,followed up by phone calls.Based on RVDD,patients diagnosed with chronic systolic CHF were divided into four groups:＞38 mm,31-38 mm,25-30 mm and ＜25 mm groups;based on prognosis,patients were divided into the death group and the survival group.Of the death group,patients were further divided into the heart failure death subgroup and the sudden cardiac death subgroup.Single-factor and multi-factor Cox survival analyses were conducted to analyze the relationships between RVDD and mortality,including all-cause mortality,CHF mortality and sudden cardiac death (SCD).Results A total of 16681 patients were enrolled in this study.They were followed up for 1-4 years,during which 6453 died.Multivariate Cox survival analysis showed that the mortality risk for patients with RVDD between 25-30 mm,between 31-38 mm,and ＞38 mm groups was 1.87,2.41,3.95 times that for patients with RVDD＜25 mm,respectively (95％CI:1.64-2.13,2.06-2.80,3.61-4.32,all P＜0.01).The risk of sudden cardiac death for patients with RVDD＞38mm was 3.82 times that for patients with RVDD＜25 mm (95％CI:2.27-5.94,P＜0.01).The areas under the ROC curve for death by the best prediction model alone and RVDD combined with the best respectively.RVDD increased the areas under the ROC curve for all cause mortality,CHF mortality and sudden cardiac death.The best prediction model combined with RVDD could discriminate between total mortality,heart failure mortality and sudden cardiac death for patients with different causes of death in multivariate analysis.Conclusions RVDD has a predictive value in the prognosis of patients with chronic systolic heart failure.RVDD increases the sensitivity and specificity of the best prediction model for total mortality prediction in patients with chronic systolic heart failure.RVDD increases the sensitivity and specificity of the best prediction model to discriminate between all-cause mortality,heart failure mortality and sudden cardiac death in patients with different causes of death.RVDD＞38 mm can serve as an indicator for the assessment of sudden cardiac death in CHF patients.

Objective:To explore influence of nasal continuous positive airway pressure (nCPAP)on maximal oxygen uptake (V · O2 max )etc.in patients with chronic congestive heart failure (CHF)complicated moderate-to-severe ob-structive sleep apnea-hypopnea syndrome (OSAHS)and explore its significance.Methods:A total of 83 CHF com-plicated moderate-to-severe OSAHS patients were selected and randomly divided into routine treatment group (n=40)and nCPAP group (n = 43).Both groups were treated for six months.Left ventricular ejection fraction (LVEF),apnea hyponea index (AHI)and V · O2 max were measured and compared between two groups before and af-ter treatment.Results:Compared with routine treatment group after six-month treatment,there was significant re-duction in AHI [(27.5±6.2)vs.(6.8±1.2)],and significant rise in LVEF [(0.45±0.07)vs.(0.48±0.05)]and · V O2 max [(16.5±3.5)ml·kg-1 ·min-1 vs.(19.2±3.4)ml·kg-1 ·min-1 ]in nCPAP group,P <0.05 all.Con-· clusion:The nCPAP can improve ventilation function,heart function and V O2 max in patients with CHF complicated moderate-to-severe OSAHS,who have received basic medication.

Screening for diabetes and its complications contributes to slowing the progression of diabetes mellitus. Based on the setting of grass-roots diabetes complication screening workstation with the concept of two stages of screening and three levels of prevention, we proposed a hospital-community-family integrated diabetes management strategy. This article discusses the background, organization structure, operation mechanism and implementation process of this strategy, aiming to provide reference for constructing a suitable and practical grass-roots diabetes management model.

OBJECTIVE: To evaluate the short-term efficacy and safety of propranolol for problematic infantile hemangiomas. METHODS: Oral propranolol was administered to 68 infants with heamngiomas diagnosed by clinical evaluation and adjuvant examination at 1.0~2.0 mg per kilogram of body weight per day, divided to 2 or 3 times. The patients revisited once a month. The changes of the tumor size, texture, and color were monitored and recorded at a regular interval.The adverse effects after medication were observed and managed accordingly.The short-term results were evaluated using a 4-grade system. RESULTS: All the 68 infants were followed up for 3-13 months, except that 1 infants combined with other diseases and 4 withdrew.The overall response was Scale 1 in 8 infants, Scale II in 13, Scale III in 29, and Scale IV in 13. No serious adverse effects were seen, but none cured entirely as well. CONCLUSION Oral propranolol is safe and effective for infantile heamngioma with good short-term result. It could be used as the primary drug for problematic infantile hemangiomas at the rapid growth stage of hemangiomas.
Female ; Hemangioma ; drug therapy ; Humans ; Infant ; Male ; Propranolol ; therapeutic use ; Prospective Studies ; Skin Neoplasms ; drug therapy ; Subcutaneous Tissue

OBJECTIVE: To review the current applications of machine learning in orthopaedic trauma and anticipate its future role in clinical practice. METHODS: A comprehensive literature review was conducted to assess the status of machine learning algorithms in orthopaedic trauma research, both nationally and internationally. RESULTS: The rapid advancement of computer data processing and the growing convergence of medicine and industry have led to the widespread utilization of artificial intelligence in healthcare. Currently, machine learning plays a significant role in orthopaedic trauma, demonstrating high performance and accuracy in various areas including fracture image recognition, diagnosis stratification, clinical decision-making, evaluation, perioperative considerations, and prognostic risk prediction. Nevertheless, challenges persist in the development and clinical implementation of machine learning. These include limited database samples, model interpretation difficulties, and universality and individualisation variations. CONCLUSION The expansion of clinical sample sizes and enhancements in algorithm performance hold significant promise for the extensive application of machine learning in supporting orthopaedic trauma diagnosis, guiding decision-making, devising individualized medical strategies, and optimizing the allocation of clinical resources.
Artificial Intelligence ; Orthopedics ; Machine Learning ; Algorithms