Objective To define the clinical characteristics and outcome of patients with dilatedhypertrophic cardiomyopathy (D-HCM).Methods Clinical data of HCM patients hospitalized from January 2002 to December 2015 in our hospital were retrospectively analyzed.Patients were divided into D-HCM and classic HCM patients.The D-HCM patients were followed up by phone.Results A total of 616 consecutive HCM patients were evaluated.Twenty one patients (3.4％) were diagnosed with D-HCM (average age (58.8 ± 10.4) years,13 males).It took (14.2 ± 7.1) years for classic HCM patients to develop D-HCM.Compared to classic HCM patients,D-HCM patients were younger at the time of first HCM diagnosis ((39.7 ± 10.4) years old vs.(48.5 ±9.5) years old,P ＜0.001) and had higher ratio of sudden cardiac death family history (19.0％ (4/21) vs.2.5％ (14/558),P =0.003),more patients of future D-HCM patients had ventricular tachycardia (38.1％ (8/21) vs.5.7％ (32/558),P ＜0.001) and higher TroponinⅠ(66.7％ (14/21) vs.9.3％ (52/558),P ＜ 0.001) before the left ventricular cavity enlargement.Moreover,MLVWH ((24.8 ± 4.2) mm vs.(17.2 ± 3.5) mm,P ＜ 0.001) was significantly thicker and LAD ((39.8 ±5.9) mm vs.(35.2 ± 3.3) mm,P ＜ 0.001) was significantly larger in D-HCM patients than in classical HCM patients.During the(3.8 ± 1.9) years follow up period,12 out of 21 D-HCM patients died (57.1％),5 cases(23.8％)died of severe heart failure and 7 cases(33.3％) died of sudden cardiac death.One patient received heart transplantation.Conclusions Few classical HCM patients progressed into D-HCM in this cohort.Patients diagnosed as HCM at young age,HCM patients with abnormal Troponin Ⅰ and ventricular tachycardia are at higher risk of developing D-HCM.The prognosis of D-HCM is very poor,and heart failure and sudden cardiac death are the main causes of death.

Objective:To investigate the value of sedation in colonoscopy.Methods:A retrospective cohort study of colonoscopy procedures was performed in our institution. Inclusion criteria: (1) colonoscopy procedures were performed by well-trained gastrointestinal surgeons our institution; (2) medical records were complete and colonoscopy was documented properly by notes, videos, photographs, and traceable pathological reports. Those with incomplete records or performed in other institution were excluded. According to above criteria, clinical data of 49 057 cases of clinic and hospitalization receiving diagnostic or therapeutic colonoscopyat Department of Gastric and Colorectal Surgery, Daping Hospital from July 2007 to February 2017 were collected. Among them, there were 24 638 (50.2%) males and 24 419 females, with mean age of (50.6±14.1) (4 to 98) years. Based on the application of sedation during colonoscopy, patients were divided into the sedation group (39 412 cases, 80.3%) and the non-sedation group (9 645 cases, 19.7%). Clinical characteristics of two groups were compared.Results:The sedation rate increased from 45.6% (369/810) to 94.8% (917/967) from 2007 to 2017. As compared to non-sedation group, a higher proportion of females [51.0% (20 095/39 412) vs. 44.8% (4 324/9 645), χ 2=117.422, P<0.001] and younger median age (50.0 years vs. 51.0 years, Z=-4.774, P<0.001) were found in the sedation group, whose differences were statistically significant. In all the 9645 cases in the non-sedation group, about 5.5% (534) of them terminated the examination because of unbearable discomfort, including 244 (4.6%) males and 290 (6.7%) females (χ 2=20.522, P<0.001). Among all the screening population who were ≥50 years old, there was no significant difference in the polyp detection rate (PDR) between the sedation group and the non-sedation group [26.7% (4 737/17 753) vs. 27.4% (1 093/3 984), χ 2=0.937, P=0.330]. The cecal intubation rate (CIR) in the sedation group was significantly higher than that in the non-sedation group [(85.2% (14 422/16 933) vs. 76.1% (2 803/3 682), χ 2=180.032, P<0.001]. Five cases in the sedation group developed iatrogenic colonic perforation (ICP), with none in the non-sedation group. Conclusions:The application of sedation in colonoscopy is increasingly popular. Sedation can significantly improve CIR in colonoscopy, while it has no positive influence on PDR. Meanwhile, sedation increases the medical expense and may result in higher ICP rate.

Objective:To investigate the value of sedation in colonoscopy.Methods:A retrospective cohort study of colonoscopy procedures was performed in our institution. Inclusion criteria: (1) colonoscopy procedures were performed by well-trained gastrointestinal surgeons our institution; (2) medical records were complete and colonoscopy was documented properly by notes, videos, photographs, and traceable pathological reports. Those with incomplete records or performed in other institution were excluded. According to above criteria, clinical data of 49 057 cases of clinic and hospitalization receiving diagnostic or therapeutic colonoscopyat Department of Gastric and Colorectal Surgery, Daping Hospital from July 2007 to February 2017 were collected. Among them, there were 24 638 (50.2%) males and 24 419 females, with mean age of (50.6±14.1) (4 to 98) years. Based on the application of sedation during colonoscopy, patients were divided into the sedation group (39 412 cases, 80.3%) and the non-sedation group (9 645 cases, 19.7%). Clinical characteristics of two groups were compared.Results:The sedation rate increased from 45.6% (369/810) to 94.8% (917/967) from 2007 to 2017. As compared to non-sedation group, a higher proportion of females [51.0% (20 095/39 412) vs. 44.8% (4 324/9 645), χ 2=117.422, P<0.001] and younger median age (50.0 years vs. 51.0 years, Z=-4.774, P<0.001) were found in the sedation group, whose differences were statistically significant. In all the 9645 cases in the non-sedation group, about 5.5% (534) of them terminated the examination because of unbearable discomfort, including 244 (4.6%) males and 290 (6.7%) females (χ 2=20.522, P<0.001). Among all the screening population who were ≥50 years old, there was no significant difference in the polyp detection rate (PDR) between the sedation group and the non-sedation group [26.7% (4 737/17 753) vs. 27.4% (1 093/3 984), χ 2=0.937, P=0.330]. The cecal intubation rate (CIR) in the sedation group was significantly higher than that in the non-sedation group [(85.2% (14 422/16 933) vs. 76.1% (2 803/3 682), χ 2=180.032, P<0.001]. Five cases in the sedation group developed iatrogenic colonic perforation (ICP), with none in the non-sedation group. Conclusions:The application of sedation in colonoscopy is increasingly popular. Sedation can significantly improve CIR in colonoscopy, while it has no positive influence on PDR. Meanwhile, sedation increases the medical expense and may result in higher ICP rate.