Objective To evaluate the effect of full-volume three-dimensional echocardiography in evaluation of left heart function of patients with coronary heart disease. Methods A total of 50 normal controls and 50 patients with coronary heart disease were enrolled, and underwent threedimensional echocardiography. The three-dimensional ultrasound images were collected and analyzed.The left ventricle and the 17-segment volume-time curve were obtained. The local ejection fraction (REF), local stroke volume (RSV), local end-systolic volume (RESV), left ventricular 17-segment local end-diastolic volume (REDV) were compared. Results The levels of RESV and REDV in the coronary heart disease group were higher, and the REF level was lower than that in the normal group (P ＜ 0. 05). The levels of RESV and REDV in the coronary heart disease group were significantly decreased, and the postoperative REF was significantly increased (P ＜ 0. 05). The preoperative REF of the coronary heart disease group was significantly lower than that of the normal group (P ＜0. 05), and the postoperative REF level was increased to different extents to normal range (P ＜0. 05). Conclusion Full-volume three-dimensional ultrasonography can be used to accurately assess the cardiac volume and cardiac function of ischemic remodeling in coronary heart disease.

Objective To evaluate the effect of full-volume three-dimensional echocardiography in evaluation of left heart function of patients with coronary heart disease. Methods A total of 50 normal controls and 50 patients with coronary heart disease were enrolled, and underwent threedimensional echocardiography. The three-dimensional ultrasound images were collected and analyzed.The left ventricle and the 17-segment volume-time curve were obtained. The local ejection fraction (REF), local stroke volume (RSV), local end-systolic volume (RESV), left ventricular 17-segment local end-diastolic volume (REDV) were compared. Results The levels of RESV and REDV in the coronary heart disease group were higher, and the REF level was lower than that in the normal group (P ＜ 0. 05). The levels of RESV and REDV in the coronary heart disease group were significantly decreased, and the postoperative REF was significantly increased (P ＜ 0. 05). The preoperative REF of the coronary heart disease group was significantly lower than that of the normal group (P ＜0. 05), and the postoperative REF level was increased to different extents to normal range (P ＜0. 05). Conclusion Full-volume three-dimensional ultrasonography can be used to accurately assess the cardiac volume and cardiac function of ischemic remodeling in coronary heart disease.

OBJECTIVETo explore the related factors of anastomotic leakfollowing anterior resection for the rectal cancer and the association of the preoperative nutritional risk screening 2002(NRS2002) score.

METHODSClinical data of 396 rectal cancer patients who underwent elective anterior resection from January 2010 to July 2015 at Affiliated Lu'an Hospital of Anhui Medical University were collected. Patient's nutritional risk score on admission was calculated by NRS2002 scoring system according to original medical records. NRS2002 score less than 3 was defined as nutritious risk. Chi-squared test, or Fisher exact test and multivariate logistic regression wereused to analyze the association of the clinical pathological factors and NRS2002 risk factor with anastomotic leak.

RESULTSOf the 396 patients, NRS2002 score≥3, and anastomotic leak occurred in 157(39.6%) and 13(3.3%), respectively. In univariate analysis, different ages, NRS2002 score, preoperative intestinal obstruction, distance from anastomosis to anal vergeand tumor TNM stage were significantly associated with postoperative anastomotic leak(all P<0.05). The incidence of postoperative anastomotic leak among patients with NRS2002 score≥3 was significantly higher than those with NRS2002 score<3[6.4%(10/157) vs. 1.3%(3/239), χ(2)=7.806, P=0.005]. Multivariate analysis showed that NRS2002 score≥3(OR=3.988, 95% CI:1.004-15.837, P=0.049), existence of preoperative intestinal obstruction(OR=5.780, 95% CI:1.320 ~ 25.311, P=0.020),distance from anastomosis to anal verge≤5 cm(OR=0.236, 95% CI: 0.071 ~ 0.785, P=0.019) were the independent risk factors of anastomotic leak following anterior resection for the rectal cancer.

CONCLUSIONRectal cancer patients undergoing anterior resection with preoperative NRS2002 score≥3 should receive reasonable perioperative nutritional support to prevent anastomotic leak.

Anastomotic Leak ; epidemiology ; prevention & control ; Chi-Square Distribution ; Humans ; Logistic Models ; Multivariate Analysis ; Nutritional Support ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Risk Factors

Objective: To investigate routine blood test results and secular changes among Tibetan children and adolescents aged from 3 to 19 in the plateau, and to provide the basis for reference range of routine blood test for this population. Methods: A total of 1 568 Tibetan children and adolescents aged from 3 to 19 living in Shigatse, Tibet were selected by cluster random sampling method. Routine blood test results and its secular trends were compared by age and gender. Results: Significantly differences were found in red blood cell(RBC), hemoglobin(HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin(MCH), white blood cell(WBC), neutrophil(NEU), neutrophil percentage (NEU%), lymphocyte(LYM), lymphocyte percentage(LYM%)，monocyte percentage(MON%)，eosinophil percentage(EOS%),basophil percentage(BAS%) and platelet(PLT) among the four age groups of 3-5, 6-12, 13-15, and 16-19 years ( F/H =60.22, 179.41, 249.45, 115.03, 74.90, 14.33 , 33.46, 78.90, 49.20, 97.29, 24.45,24.28,42.65,20.10, P <0.05). Among red blood cell indexes, RBC, HGB, HCT,MCH increased with age in boys( F =148.77, 493.04, 623.14, 249.92, P <0.05), but there was no similar trend in girls( F =1.37, 0.15, 2.94, 0.11, P >0.05). HCT showed significant sex differences among the four age groups of 3-5 years, 6-12 years, 13-15 years, and 16-19 years [(41.33±2.31)% vs (41.98±2.40)%; (43.28±2.60)% vs ( 43.75 ±2.36)%; (46.20±3.11)% vs (44.83±2.67)%; (51.10±4.15)% vs (43.61±4.70)%, t =-2.10, -2.88, 3.50, 10.82, P <0.05]. WBC, NEU, NEU%, LYM, LYM%, monocyte(MON), and MON% increased significantly with age in both boys and girls ( P <0.05). From the age of 12 to 13, RBC, HGB and HCT in Tibetan male and female adolescents showed an opposite trend and widened gradually. Conclusion Red blood cell index shows significantly different trends among Tibetan adolescents and children of different ages and genders. Regional nationality, age, gender, and other factors should be considered when developing the reference value range of blood routine index.

Objective To investigate the changes in blood microbiota in patients with high altitude polycythemia(HAPC)and the correlation with the risk of HAPC.Methods A cross-sectional trial was carried out among 41 HAPC patients(HAPC group)and 41 healthy plateau individuals(control group)who took physical examination in the Health Management Department of No.953 Hospital of PLA Army in 2021.High-throughput sequencing technology was used to detect the V3-V4 variable region of the 16S ribosomal RNA(16S rRNA)gene in the blood smaples,and the composition and difference of the blood microbiota were compared and analyzed between the 2 groups.Results All the participants were male and Han people,and there were no significant differences in baseline data such as age,body mass index and plateau migration time between the 2 groups(P＞0.05).The α-diversity of blood microbiota in the HAPC group,including the Simpson index(0.931±0.005 vs 0.907±0.008,P＜0.05),Goods Coverage index(0.998±0.001 vs 0.997±0.001,P＜0.001)and Pielou index(0.597±0.011 vs 0.567±0.009,P＜0.05)were significantly higher than those in the control group.Meanwhile,obvious difference was observed in the β diversity between the 2 groups(P＜0.01).The relative abundance analysis of bacteria showed that Pelomonas(0.046±0.004 vs 0.033±0.003,P＜0.05),Azospirillum(0.046±0.006 vs 0.021±0.003,P＜0.01),Acidovorax(0.032± 0.003 vs 0.019±0.002,Azospirillum(0.046±0.006 vs 0.021±0.003,P＜0.01)and Acidovorax(0.032± 0.003 vs 0.019±0.002,P＜0.05)were statistically higher in the HAPC group than the control group.LEfSe analysis showed that the characteristic blood microbiota of the HAPC group were α-Proteobacteria,and those of control group were Trichospiridae.Conclusion Significant changes are found in diversity,relative abundance and characteristic bacteria of the blood microbiota between the HAPC patients and healthy people at the high altitude,which might be closely associated with the occurrence and development of HAPC.