Objective To determine the biomechanical parameters of left ventricular by using velocity vector imaging (VVI),and to indirectly assess the coronary artery stenosis with VVI in the patients with coronary artery disease (CAD).Methods 52 patients who had one coronary artery lesions at least diagnosed by coronary angiography (CAG)were divided into coronary artery mild stenosis group and severe stenosis group;2 1 patients in mild stenosis group had one coronary stenosis <75%;31 patients in severe stenosis group had one coronary artery stenosis ≥75% at least.At the same time,20 cases of normal people without coronary artery stenosis showed by CAG were selected as normal control group. VVI was used to detect the left ventricular wall segments of the overall longitudinal strain (GLS ), the overall circumferential strain (GCS ) and the overall radial strain (GRS ). Results The absolute values of GLS,GRS,GCS of the patients in mild and severe coronary artery stenosis groups were significantly decreased than those in normal control group(P<0.05),and the strain parameters in severe stenosis group were decreased more significantly, there were significant differences compared mild stenosis group (P<0.05 ). The distribution of the segments with decreased longitudinal strain matched the LV myocardial segment with the coronary stenosis rate ≥ 75%,and GLS had the most sensitivity.The GLS in normal control group,mild stenosis group and severe stenosis group were negatively correlated to left ventricular ejection fraction (LVEF)(r=-0.58,P<0.05;r=-0.51,P<0.05;r=-0.43,P<0.05).GLS-16.14 % was used to assess the severe coronary artery stenosis with requiring the implementation of PTCA treatment as the diagnostic cut-off point with sensitivity 96.8%, specificity of 70%, the highest Yuedden index 0.668. Conclusion The decreasing of left ventricular strain could be detected by VVI, which suggests that severe coronary artery stenosis exists in coronary artery;the distribution of the segments with significantly decreased strains can be used to assess the coronary lesions and stenosis degrees.

Objective: To analyze the causes of death in Keqiao District, Shaoxing City in 2020, so as to provide the evidence for formulating the disease control strategy. Methods: The dead cases' gender, age and causes of death in Keqiao District, 2020, were collected from Shaoxing Municipal Public Health Information System, and the mortality was estimated and standardized by the 2020 Chinese standard population. The gender- and age-specific mortality and distribution of causes of death were analyzed, and the years of potential life lost (YPLL), average years of potential life lost per death (AYLL) and YPLL rate (YPLLR) were calculated to evaluate the life lost. Results: The crude and standardized mortality rates of registered residents in Keqiao District were 636.97/105 and 494.72/105, respectively. The crude and standardized mortality rates were 712.67/105 and 512.23/105 in men and 564.75/105 and 473.25/105 in women, and a higher mortality rate was seen in men than in women (χ2=59.628, P<0.001). The mortality reduced and then increased with age, and peaked among residents at ages of 85 years and older (13 910.90/105). Chronic disease was the main cause of death, accounting for 85.60% of all causes of death and showing a mortality rate of 545.27/105. Cancer, cardiopathy, cerebrovascular disease, injury and poisoning, and respiratory diseases were the five leading causes of death, and lung cancer, gastric cancer, colorectal cancer, liver cancer and pancreatic cancer were the five leading causes of cancer-related mortality. The highest YPLL was caused by cancers (13 015.00 person-years), with a YPLLR of 1.88%, and the highest AYLL was caused by injury and poisoning (10.37 years). Conclusion Chronic non-communicable diseases, such as cancer and cardio-cerebrovascular diseases, were main causes of death among residents in Keqiao District in 2020. The management of chronic diseases requires to be reinforced to improve the quality of life.

Objective To explore the relationship among the disease - syndrome - formula of type 2 diabetes.Methods Based on the clinical data of 2501 cases of type 2 diabetes, to study the relationship among the disease - syndrome - formula of type 2 diabetes by making use of association rules.Results Three formulas, Shengmai Yin (Pulse-activating Fluid), Liuwei Dihuang Decoction (Decoction of Six Herbs Including Rehmannia), and Sijunzi Decoction (Decoction of Four Noble Herbs), were selected from 122 ones to analyze the relationship between the formula and symptoms. The occurrence of fatigue with weakness, dry mouth with thirst, frequent urination with increased volume of urine, numbness of limbs, blurred vision, thirst with preference of drinking water, frequent nocturnal urination, and shortness of breath with inactive talking was in high frequency in those patients who were prescribed Shengmai Yin. The occurrence of fatigue with weakness, thirst with preference of drinking water, blurred vision, frequent nocturnal urination, dry mouth with thirst, numbness of limbs, shortness of breath with inactive talking, and soreness and weakness of lumbus and legs was in high frequency in those patients prescribed Liuwei Dihuang Decoction, and there existed a multi-association among these symptoms. The occurrence of fatigue with weakness, soreness and weakness of lumbus and legs, frequent nocturnal urination, shortness of breath with inactive talking, numbness of limbs, insomnia, and blurred vision was in high frequency in those patients who were prescribed Sijunzi Decoction, and there existed a multi-association among these symptoms.Conclusion The association rule can be adopted to analyze the relationship between formula and syndrome, and to explore the multi-association relationship among the symptoms of type 2 diabetes.

Objective To explore characteristics of the elements of syndrome, the disease position and the relationship between chemical indicators and TCM syndromes of type 2 diabetic encephalopathy. Methods 2 501 cases of type 2 diabetes clinical data were collected from Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Beijing University of Chinese Medicine, Dongzhimen Hospital, Dongfang Hospital, etc. in nearly 3 years, among which, 342 cases were type 2 diabetic encephalopathy. The original clinical data were double entried in epidata by two people, establishment forms in excel, factor analysis and Bayesian networks were used as data mining research methods. Results 20 elements which characteristic root more than 1 were derived by factor analysis, 68.4% were covered. Of all 20 elements, five factors belong to Yin, five factors belong to blood stasis; lassitude, shortness of breath, stool frequency were appeared when fasting glucose abnormalities; lassitude, hemiplegia were appeared when 2-hour postprandial blood glucose abnormalities;lassitude, feverish palms and soles, stool frequency, more nocturnal enuresis when glycated hemoglobin abnormalities by Bayesian networks. Conclusion The Elements of the syndrome of type 2 diabetes encephalopathy were deficiency of Yin and blood stasis; and the main positions for diabetic patients were liver, spleen and kidney. Patients with impaired fasting glucose were Qi deficiency; Patients with impaired 2-hour postprandial glucose were Qi deficiency or pathogenic wind attacking collaterals; Patients with abnormal hemoglobin were Qi deficiency and Yin deficiency.

Objective:To establish a prognostic Nomogram model for predicting the risk of early death in polytrauma patients.Methods:Data extracted from a polytrauma study on Dryad, an open access database, was selected for secondary analysis. Patients from 18 to 65 years old with polytrauma in the original data were included. All patients with missing variables, such as blood lactic acid (Lac), Glasgow coma score (GCS) and injury severity score (ISS) at admission, were excluded. The differences of gender, age, Lac, ISS and GCS scores between the patients who died within 72 hours and those who survived were analyzed. The risk factors for 72-hour death were analyzed by Logistic regression, and the Nomogram prediction model was established using R software. The receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of the model, and the Bootstrap method was used for internal verification by repeating sample for 1 000 times. Decision curve (DCA) was applied to analyze the clinical practical value of the model.Results:A total of 2 315 polytrauma patients were included. Logistic regression analysis showed that Lac, GCS score and age > 55 years old were the risk factors for early death in polytrauma patients [Lac: odds ratio ( OR) = 1.36, 95% confidence interval (95% CI) was 1.29-1.42, P < 0.001; GCS score: OR = 0.76, 95% CI was 0.73-0.79, P < 0.001; age > 55 years old: OR = 1.92, 95% CI was 1.37-2.66, P < 0.001]. The prediction model was established by using the above risk factors and displayed by Nomogram. ROC curve analysis showed that the area under the ROC curve (AUC) of Nomogram model to predict the risk of death within 72 hours was 0.858, and the predictive ability of Nomogram model was significantly higher than that of Lac (AUC = 0.743), GCS score (AUC = 0.774) and ISS score (AUC = 0.699), all P < 0.05. The model calibration chart showed that the predicting probability was consistent with the actual occurrence probability, and the DCA showed that Nomogram model presented excellent clinical value in predicting the 72-hour death risk for polytrauma patients. Conclusions:The prognostic Nomogram model presents significantly predictive value for the risk of death within 72 hours in polytrauma patients. Prognostic Nomogram model could offer individualized, visualized and graphical prediction pattern, and provide physicians with practical diagnostic tool for triage system and management of polytrauma according to precision medicine.

Objective To observe the anti-relapse and anti-graft versus host disease (GVHD) effects and side effects of ruxolitinib on patients who have relapsed leukemia after allo-hematopoietic stem cell transplantation (HSCT).Methods The clinical data of four patients sufferring from relapsed leukemia were collected and analyzed retrospectively.Three cases had a positive gene and 1 case had a extramedullary recurrence.All of them had serious GVHD involving multiparts,as the result of attenuating immunosuppressant aggressively.One case had central nervous system leukemia before allo-HSCT.Those patients were treated with ruxolitinib,according to the degree of GVHD,the treatment strategy and curative effect of GVHD,and the residual condition of original leukemia.Then,the degree of GVHD,the residual condition of original leukemia and the side effects of ruxolitinib were revaluated once a month after taking ruxolitinib.Results One case achieved completer remission (CR) and there partial remission (PR) in consideration of GVHD.Up to date,2 cases had no relapse in any level and 2 cases replased according to any of the results related to bone marrow aspiration.Conclusion Ruxolitinib is effective in patients with GVHD after allo-HSCT and doesn't influence GVL effect or increase the risk of relapse at the same time.Ruxolitinib doesn't have obvious side effects when treating GVHD.

Objective:To investigate the application of post-mortem tissue sampling under ultrasonography guidance in the autopsy of COVID-19 cases.Methods:Ultrasound-guided post-mortem tissue sampling of heart, lungs, liver, kidneys, and spleen were performed in 24 confirmed COVID-19 cases in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from Feb 20 to Mar 28, 2020. Seventeen males and seven females aged 39-91(66.6±10.6) years old were enrolled. The total time required for each post-mortem sampling was recorded, and the size of the samples collected from each organ was measured. The success rate of ultrasound-guided post-mortem tissue sampling for each organ was calculated.Results:Ultrasound images could clearly show the needle path and enabled accurate placement of the needle within the target organs, including heart, lung, liver, kidney, and spleen. The total time required for sampling was about 32-54 (39.8±5.7)min. The lengths of heart, lung, liver, kidney, and spleen tissues collected by ultrasound-guided sampling were 10(8, 14)mm, 13(12, 15)mm, 14(13, 15)mm, 13(11, 15)mm, 14(13, 15)mm, respectively. The success rates of heart, lung, liver, kidney, and spleen tissue sampling under ultrasound guidance were 87.5% (21/24), 91.7%(44/48), 100%(24/24), 89.6%(43/48) and 83.3%(20/24), respectively.Conclusions:Post-mortem sampling under ultrasonography guidance may be a rapid and reliable method for collecting of heart, lung, liver, kidney, and spleen tissues in the autopsy of COVID-19 cases.

Objective : To quantitatively evaluate the left ventricular myocardial work index (MWI) of patients with end-stage renal disease (ESRD) with preserved ejection fraction using left ventricular pressure-strain loop (PSL) ， and group them according to left ventricular mass index( LVMI) ，in order to compare the effect of different LVMI levels on left ventricular MWI． Methods: 81 patients with stage 5 chronic kidney disease，including 43 males and 38 females，were divided into left ventricular hypertrophy group ( LVH group) ( n = 44) and non-left ventricular hypertrophy group (NLVH group) ( n = 37) according to LVMI，and 37 healthy people matched in age and sex with the ESRD groups were randomly selected as the control group．The general clinical data，conventional echocardiographic parameters，global longitudinal strain ( GLS) ，and MWI namely global work index ( GWI) ，global constructive work ( GCW) ，global wasted work ( GWW) and global work efficiency ( GWE) of the three groups were compared．The correlation between MWI and various parameters were analyzed，and the independent predictors of MWI were analyzed too. Result : The results showed that there were no significant differences in age，gender，height，weight and other general clinical data as well as left ventricular ejection fraction ( LVEF) among the three groups．In two ESRD groups，GWW was higher than that in control group，GWE was lower than that in control group，and were more significant in LVH group (P＜0. 05) ．LVMI was positively correlated with GWW，and negatively correlated with GWE ，respectively ，with specific independent correlation． Conclusion GWW and GWE can detect early impairment of left ventricular systolic function in ESED patients，and myocardial function impairment in LVH group is more serious than that in NLVH group．LVMI is an independent positive factor of GWW and an independent negative factor of GWE.

Since December 2019, a novel coronavirus (2019-nCoV, SARS-CoV-2) pneumonia (COVID-19) outbreak has occurred in Wuhan, Hubei Province, and the epidemic situation has continued to spread. Such cases have also been found in other parts of the country. The spread of the novel coronavirus pneumonia epidemic has brought great challenges to the clinical practice of thoracic surgery. Outpatient clinics need to strengthen the differential diagnosis of ground glass opacity and pulmonary plaque shadows. During the epidemic, surgical indications are strictly controlled, and selective surgery is postponed. Patients planning to undergo a limited period of surgery should be quarantined for 2 weeks and have a nucleic acid test when necessary before surgery. For patients who are planning to undergo emergency surgery, nucleic acid testing should be carried out before surgery, and three-level protection should be performed during surgery. Patients who are planning to undergo emergency surgery in the epidemic area should be confirmed with or without novel coronavirus pneumonia before operation, and perform nucleic acid test if necessary. Surgical disinfection and isolation measures should be strictly carried out. Among postoperative patients, cases with new coronavirus infection were actively investigated. For the rescue of patients with novel coronavirus infection, attention needs to be paid to prevention and treatment and related complications, including mechanical ventilation-related pneumothorax or mediastinal emphysema, and injury after tracheal intubation.