Objective To investigate the effect of complete revascularization strategy on the prognosis of elderly patients suffering from acute ST-segment elevated myocardial infarction(STEMI)complicated with multivessel disease(MVD). Methods A total of 390 elderly patients(over 60 years old)suffering from acute STEMI with MVD treated by clinical revascularization administration were enrolled for the study and divided into complete revascularization group(CR group,n=139)and non-complete revascularization group(NCR group,n=251). The effect of complete re-vascularization strategy on the prognosis was then analyzed by COX regression analysis. Results Compared with the NCR group,the patients of the CR group are younger and with a higher ratio of old myocardial infarction ,as well as the average number of stents ,and the mean value of total stent length is larger. The application of calcium channel blocker for post-operation patients is rarer as well. No significant difference can be found between the two groups on the ratio of post-operation all-cause mortality,cardiac mortality,nonfatal myocardial infarction,unplanned repeat revas-cularization. Multivariate COX analysis showed that the complete revascularization had no obvious difference on the prognosis of these patients be-tween the two groups. Conclusion There is individual diversity in the revascularization strategy choosing for elderly patients of acute STEMI alongside MVD;however,the prognosis is not significantly improved.

Objective To establish a mouse model of acute liver failure induced by lipopolysaccharide /D-galac-tosamine ( LPS/D-GalN) .Methods The optimum dose of LPS/D-GalN was determined by i .p.injection of eight differ-ent doses of LPS and D-GalN into 40 female C57BL/6 mice and observation of their survival time .Then, 32 female C57BL/6 mice were i.p.injected with the optimal dose of LPS/D-GalN and sacrificed at 0, 1, 4, 8 hours after the injec-tion, 8 mice in each group.The control mice received saline injection .Hepatic changes were observed by pathology and se-rum ALT, IL-6, MCP-1 and TNF-αwere measured by biochemistry or flow cytometry .Results LPS (2.5 mg/kg) and D-GalN (0.3 g/kg) were determined as the optimal dose for the establishment of mouse model of acute liver injury .Com-pared with the control group , the hepatocellular damages were progressing in a positive correlation with the time course after LPS/D-GalN administration .The level of serum ALT was significantly increased after LPS/D-GalN administration ( P <0.001).The levels of inflammatory cytokines IL-6, MCP-1 and TNF-αwere increased and reached a peak at one hour after LPS/D-GalN administration and then decreased almost to that of the control group 8 hours later(P<0.001).Conclusions The mouse model of acute liver injury is successfully established by LPS /D-GalN administration , and provide an effective animal model for the study of pathogenic mechanisms of acute liver failure and evaluation of therapeutic drugs .

Objective To investigate the clinical features and risk factors for chronic heart failure in elderly patients.Methods The 2,407 chronic heart failure patients were enrolled,including 1,513 elderly patients (62.9％) (aged≥≥65 years).Risk factors for chronic heart failure,clinical features,biochemical and physical examination were retrospectively analyzed.The effects of different factors on patients with different age were analyzed by Logistic regression analysis.Results Compared with the young and middle-aged patients,the higher prevalences of New York Heart Association functional classification (NAFC),diabetes,ischemic heart disease,hypertension,anemia,renal insufficiency and hyperuricemia were found,but the percentages of males,smoker,patients with dilated cardiomyopathy,valvular heart disease and hyperlipidemia were reduced in elderly patients.The levels of blood creatinine,high density lipoprotein (HDL),serum potassium,hemoglobin,albumin,pre-albumin,total cholesterol (TC),lower density lipoprotein (LDL),triglyceride (TG) and diastolic blood pressure were lower,but left ventricular ejection fraction (LVEF) and systolic blood pressure were higher,in the elderly patients than in young and middle-aged patients.Elderly patients had higher usage rates of stain and angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blocker (ARB),but lower usage rate of β-blocker as compared with young and middle-aged patients.In elderly patients,logistic regression analysis revealed that gender (OR=1.89,95％CI:1.566-2.285),a history of ischemic heart disease (OR=1.81,95％ CI:1.457-2.243),hypertension (OR=1.87,95％CI:1.462-2.389),anemia (OR=2.66,95％ CI:2.197-3.211),hyperuricemia (OR =1.41,95％ CI:1.186-1.678) were significantly related with chronic heart failure,whilein young and middle-aged patients,dilated cardiomyopathy (OR=0.49,95％ CI 0.351-0.689),hyperlipidemia (OR=0.53,95 ％ CI:0.433-0.641),smoking (OR=0.79,95 ％ C I:0.652 0.966) were significantly related with chronic heart failure.Conclusions Gender,ischemic heart? disease,hypertension,anemia,hyperuricemia are the independent risk factors for chronic heart failure in elderly patients.

Objective To analyze the differences in clinical characteristics and risk factors in patients with diastolic heart failure and systolic heart failure. Methods A total of 2 088 patients with heart failure were divided into two groups, diastolic heart failure group (EF≥0.45,n=1 356) and systolic heart failure group (EF<0.45,n=732), according to ejection fraction (EF). The clinical features and related factors affecting the two types of heart failure were compared between two groups. Results There were higher age, higher proportion of women and higher proportion of hypertensive patients in dia?stolic heart failure group than those of systolic heart failure group, but lower rates of hypoalbuminemia, anemia, renal insuffi?ciency and hyperuricimia. There was higher incidence of functional class I and II in diastolic heart failure group. And com?pared with systolic heart failure group, there were higher levels of systolic blood pressure, albumin, prealbumin, cholesterol, sodium and serum chloride in diastolic heart failure group, but lower levels of heart rates, creatinine, blood uric acid, potassi?um and brain natriuretic peptide. Compared with systolic heart failure group, there were lower left ventricular end diastolic volume (LVEDV) and left ventricular end systolic volume (LVESV) in diastolic heart failure group. And there were lower RAS blocker andβ-blocker usage, higher statin usage in diastolic heart failure group. Logistic regression analysis showed that gender and hypertension were significantly correlated with diastolic heart failure, and hypoalbuminemia and hyper?uricimia were significantly correlated with systolic heart failure. Conclusion Our results show that there are differences in clinical features and risk factors in patients with diastolic heart failure and systolic heart failure. We should take the differ?ent treatment and prevention programs for the two kinds of heart failures.

Objective To investigate the clinical and laboratorial characteristics of patients with myelodysplastic syndrome ( MDS) and erythroid hyperplasia.Methods MDS patients whose bone marrow was hypercellular with erythroid lineage more than 50% and blasts account for less than 20% of non-erythroid cells were enrolled in this study.The ratio of mature erythrocytes to nucleated erythrocytes was no more than 20, namely MDS patients with erythroid hyperplasia ( MDS-E ).The retrospective analysis comprised 102 patients with MDS-E from the First Affiliated Hospital of Suzhou University.Clinical characteristics , karyotype , and the prognostic significance of erythroid hyperplasia were evaluated.Results A total of 48 MDS-E patients (47.1%) presented a variety of cytogenetic abnormalities.The most frequently involved chromosomes were chromosome 8 (39.5%of all abnormal karyotypes ), chromosome 7 (22.9%), followed by chromosome 5 ( 18.8%) , chromosome 1 ( 16.7%) and chromosome 20 ( 16.7%) .Hemoglobin ( Hb) level affected the prognosis by survival analysis.The overall survival ( OS) of MDS-E patients with Hb equal or more than 70 g/L was longer than that of patients less than 70 g/L ( P<0.001).Allogeneic hematopoietic stem cell transplantation (HSCT) significantly improved the OS compared with best supportive care (P<0.001) and chemotherapy (P<0.001).The extent of erythroid hyperplasia in bone marrow did not impact on prognosis ( P=0.187 ).Conclusions Compared with previous reports of MDS patients, MDS-E patients have higher level of erythroid hyperplasia , more common erythroid dyshematopoiesis , more frequent 8 and 1 chromosome abnormalities .The degree of erythroid hyperplasia is not correlated with prognosis.Allogeneic hematopoietic stem cell transplantation improves the prognosis.

Objective: To evaluate the feasibility of texture analysis on non-contrast-enhanced T1 maps of cardiac magnetic resonance (CMR) imaging for the diagnosis of myocardial injury in acute myocardial infarction (MI). Materials and Methods: This study included 68 patients (57 males and 11 females; mean age, 55.7 ± 10.5 years) with acute ST-segment-elevation MI who had undergone 3T CMR after a percutaneous coronary intervention. Forty patients of them also underwent a 6-month follow-up CMR. The CMR protocol included T2-weighted imaging, T1 mapping, rest first-pass perfusion, and late gadolinium enhancement. Radiomics features were extracted from the T1 maps using open-source software. Radiomics signatures were constructed with the selected strongest features to evaluate the myocardial injury severity and predict the recovery of left ventricular (LV) longitudinal systolic myocardial contractility. Results: A total of 1088 segments of the acute CMR images were analyzed; 103 (9.5%) segments showed microvascular obstruction (MVO), and 557 (51.2%) segments showed MI. A total of 640 segments were included in the 6-month follow-up analysis, of which 160 (25.0%) segments showed favorable recovery of LV longitudinal systolic myocardial contractility.Combined radiomics signature and T1 values resulted in a higher diagnostic performance for MVO compared to T1 values alone (area under the curve [AUC] in the training set; 0.88, 0.72, p = 0.031: AUC in the test set; 0.86, 0.71, p = 0.002).Combined radiomics signature and T1 values also provided a higher predictive value for LV longitudinal systolic myocardial contractility recovery compared to T1 values (AUC in the training set; 0.76, 0.55, p < 0.001: AUC in the test set; 0.77, 0.60, p < 0.001). Conclusion The combination of radiomics of non-contrast-enhanced T1 mapping and T1 values could provide higher diagnostic accuracy for MVO. Radiomics also provides incremental value in the prediction of LV longitudinal systolic myocardial contractility at six months.

Objective: To evaluate the feasibility of texture analysis on non-contrast-enhanced T1 maps of cardiac magnetic resonance (CMR) imaging for the diagnosis of myocardial injury in acute myocardial infarction (MI). Materials and Methods: This study included 68 patients (57 males and 11 females; mean age, 55.7 ± 10.5 years) with acute ST-segment-elevation MI who had undergone 3T CMR after a percutaneous coronary intervention. Forty patients of them also underwent a 6-month follow-up CMR. The CMR protocol included T2-weighted imaging, T1 mapping, rest first-pass perfusion, and late gadolinium enhancement. Radiomics features were extracted from the T1 maps using open-source software. Radiomics signatures were constructed with the selected strongest features to evaluate the myocardial injury severity and predict the recovery of left ventricular (LV) longitudinal systolic myocardial contractility. Results: A total of 1088 segments of the acute CMR images were analyzed; 103 (9.5%) segments showed microvascular obstruction (MVO), and 557 (51.2%) segments showed MI. A total of 640 segments were included in the 6-month follow-up analysis, of which 160 (25.0%) segments showed favorable recovery of LV longitudinal systolic myocardial contractility.Combined radiomics signature and T1 values resulted in a higher diagnostic performance for MVO compared to T1 values alone (area under the curve [AUC] in the training set; 0.88, 0.72, p = 0.031: AUC in the test set; 0.86, 0.71, p = 0.002).Combined radiomics signature and T1 values also provided a higher predictive value for LV longitudinal systolic myocardial contractility recovery compared to T1 values (AUC in the training set; 0.76, 0.55, p < 0.001: AUC in the test set; 0.77, 0.60, p < 0.001). Conclusion The combination of radiomics of non-contrast-enhanced T1 mapping and T1 values could provide higher diagnostic accuracy for MVO. Radiomics also provides incremental value in the prediction of LV longitudinal systolic myocardial contractility at six months.

Objective To analyze and compare the pathological changes of lung tissue in mice infected with the novel H7N9 influenza virus and 2009 pandemic H1N1 influenza virus, respectively, and to preliminarily study the mecha-nisms of acute lung injury induced by those virus infection .Methods SPF 6-week old BALB/c mice ( body weight 18-20 g, male∶female=1∶1) (n=3 in each subgroup) were intranasally infected with H7N9 virus and H1N1 virus, respec-tively.The behavior and survival time of mice after virus infection were observed and the survival rates were analyzed .The heart, liver, spleen, lung, kidney, intestines, and brain were collected at indicated time points for histopathological exami-nation using H&E staining .The distribution of virus antigen was detected by immunohistochemistry .The neutrophil infiltra-tion was also observed .The correlation of lung injury with virus replication and host immune responses was analyzed .Re-sults The lung and spleen injury of mice infected with H 7N9 virus was slighter and their survival rate (100%) was high-er than those of mice infected with H1N1 virus.The damages of the lung and spleen in H1N1virus-infected mice were more severe than that in H7N9 virus-infected mice, and all the 10 mice in this group died within 9 days after virus inoculation . The distributions of both the virus antigens were mainly in the bronchial epithelial cells , a few stromal cells and alveolar ep-ithelial cells .The levels of virus replication in the two groups were not significantly different .There were more intense neu-trophil infiltration in the lung and inflammatory response in the H 1N1 virus-infected mice than those in the H7N9 virus-in-fected mice .Conclusions There are some differences of the pathological characteristics and extent of lung injury in the mice infected with H7N9 virus and H1N1 virus, respectively.The virus replication is a precipitating factor but not the deci-sive factor of the lung injury , and there is a close relationship between the host immune responses and acute lung injury .

Objective:To investigate the therapeutic efficacy of venetoclax combined with avapritinib in treatment of refractory/relapsed acute myeloid leukemia (AML) with KIT gene mutation.Methods:The clinical data of 2 AML patients with KIT gene mutation who received venetoclax combined with avapritinib admitted to Canglang Hospital of Suzhou in October 2022 and November 2022 were retrospectively analyzed, and the relevant literature was reviewed.Results:Both patients with high-risk relapsed/refractory AML and KIT gene mutation were females; the one was 53 years and the other was 17 years. Case 1 was diagnosed with AML-M 2, and genetic testing revealed positive mutations in ASXL1, KIT, and RUNX1. The patient relapsed after transplantation and then was treated with venetoclax combined with avapritinib achieving morphologic leukemia-free status (MLFS). Case 2 was diagnosed with AML, and RUNX1-RUNX1T1 (AML1-ETO) fusion gene and KIT and DX15 gene mutations were detected. The patient was treated with venetoclax combined with avapritinib regimen after relapse, and the treatment regimen significantly reduced the tumor load. Complete remission was achieved after bridging to allogeneic hematopoietic stem cell transplantation. Conclusions:AML with KIT gene mutation is heterogeneous and some patients are difficult to treat with very poor prognosis. Bridging (secondary) hematopoietic stem cell transplantation can be the better treatment choice for relapsed patients achieving MLFS or complete remission after venetoclax combined with avapritinib treatment regimen.