Objective To evaluate the patterns of intracardiac flow of left ventricle (LV) in patients with premature ventricular complexes (PVCs) from the right ventricular outflow tract (RVOT) by analyzing the vortex during isovolumetric contraction phase and the distribution rules of flow-time curves in each layer of LV.Methods Twenty-seven patients with frequent isolated PVCs from RVOT were involved and 25 healthy subjects as control.The color Doppler image of LV at apical four-chamber view was acquired.Vector flow mapping (VFM) was performed to assess the parameters of vortex during isovolumic contraction phase, including diameter (transverse and vertical diameter), velocity (maximal positive and negative velocity) and the number of vortex rings.Positive flow during systole and negative flow during diastole of LV in each layer were measured by flow-time curve.All values of patients with PVCs were recorded during sinus beats (PVC-S) and PVC (PVC-V) respectively.Results Significant differences were demonstrated in all parameters of vortex between the PVC-V and control subjects.And the flow-time curves disarrayed in PVC-V.The velocity of vortex in PVC-S was lower than that in control subjects.And the distribution pattern of flow-time curves in LV of PVC-S differed from that of control subjects.Conclusions Alternation of intracardiac fluid pattern in LV was demonstrated in patients with PVCs from RVOT during both sinus beats and PVC.VFM can be used to analyze the intracardiac flow field in normal and pathological electrical activation.

Objective To investigate the relationship between glutathione S-transferases P1(GSTP1)Ile105Val and glutathione S-transferases M1(GSTM1)single nucleotide polymorphisms(SNP) and the sensitivity to chemotherapy among patients with ad-vanced non-small cell lung cancer(NSCLC) .Methods We used gene sequencing analysis to determine the SNP of GSTP1 Ile105Val and PCR analysis to GSTM1 in DNA from peripheral lymphocytes of NSCLC patients .Totally 89 patients with NSCLC were trea-ted with platinum-based chemotherapy ,and clinical response was evaluated after 2 cycles .The association between GSTP1 Ile105Val and GSTM1 SNP and chemosensitivity were analyzed .Results The overall response rate was 29 .2% .Chemotherapy re-sponse did not show statistically significant differences between the wild genotypes and the variant genotypes for the GSTP1 Ile105Val and GSTM1 gene(P>0 .05) .Conclusion The polymorphisms of GSTP1 Ile105Val and GSTM1 may be not associated with sensitivity to chemotherapy in NSCLC patients .

Objective To assess left ventricular(LV)twisting parameters in different layers with velocity vector imaging(VVI)in both healthy subjects and premature ventricular contraction(PVC)bigeminy from right ventricle(RV)patients,and investigate the rules of LV myocardium dynamics in sinus rhythm and PVC from RV.Methods Ten patients with PVC bigeminy from RV and twelve healthy subj ects underwent the examination of two-dimensional ultrasound,in which the standard LV mitral valve(MV)and apical short-axis views were acquired.The twisting angle(TA)and untwisting starting time(UST)were measured.Results In healthy subjects myocardium of LV MV short-axis twisted in clockwise,while the myocardium of LV apical short-axis twisted in counter-clockwise.TA of endocardium was higher than that of epieardium(P＜0.01).In PVC bigeminy from RA patients,their TA during sinus contraction was lower than that of healthy subjects both in MV and apical short axis respectively(P＜0.05),and UST was earlier(P＜0.05).In PVC the TA curve is bidirectional.and in early systolic TA twisted reversely compared with that of healthy subjects and sinus contraction in PVC patients.Conclusions Twisting parameters could be used to assess myocardium dynamics during different ventricular mechanical activation.VVl was a novel tool to analyze myocardium twisting.

Objective To evaluate left ventricular(LV) systolic synchrony and sequence in patients with premature ventricular complexes(PVCs) from right ventricular outflow tract (RVOT).Methods Thirty patients with frequent isolated PVCs from RVOT and 30 healthy subjects as control were included.Speckle tracking imaging (STI) was performed to assess the time-to-peak segmental systolic strain in longit udinal(TsL), circumferential (TsC) and radial (TsR) direction.The standard deviation (SD) of TsL,TsC and TsR of 18 LV segments were calculated respectively.All values of patients with PVCs were recorded during sinus beats(PVC-S) and PVC beats(PVC-V) respectively.LV systolic sequence in PVC-V was analyzed.Results Significant differences were observed in the SD values between the PVC-V and control subjects in three directions,as well as between the PVC-S and control subjects in circumferential and radial direction.In PVC-V significance difference was seen in TsL and TsR from apical to basal level,as well as in TsL and TsC in different walls.Conclusions LV systolic synchrony was demonstrated in patients with PVCs from RVOT during both sinus beats and PVC beats.Systolic sequence in PVC beats from RVOT exhibit certain rules.

Objective To appraise the clinical value of velocity vector imaging(VVI) by analyzing the peak systolic velocities,strain and strain rate of ventricular segments in patients with DDD pacing. Methods eventeen patients with DDD pacing were enrolled in this study. The peak systolic velocities, strain andstrain rate of ventricular segments were measured with VVI. The difference at baseline and after pacemaker implantation was analyzed. Results Left and right ventricular (LV and RV) longitudinal peak velocities at baseline and after DDD pacing were significantly decreasing from basal, mid to apical segments. But no significant difference was found in longitudinal strain,strain rate and radial motion characteristic of LV. The mean systolic velocities and strain rate at baseline and after pacemaker implantation and strain with pacing of RV posterior septum and free wall were higher than those of posterior septum and lateral segment of LV respectively. The mean strain and strain rate of RV after pacing were higher than that of LV. Compared with the values at baseline, mean strain of LV with pacing was lower significantly. Conclusions VVI can accurately assess ventricular systolic function in patients with DDD pacing, and can become a powerful means in assessing the regional myocardial function.

Objective To analyze the complete genome sequence of Guangxi HEV isolate swGX32 and to compare it with other HEV isolates. Methods The overlapping fragments of HEV isolate swGX32 were amplified with reverse-transcription nested polymerase chain reaction (RT-nPCR),and the 5′ and 3′ ends of viral genome were amplified with rapid amplification of cDNA ends (RACE). The PCR products were cloned and sequenced. The sequence and phylogenetic analysis of swGX32 was performed. Results The genome of swGX32 consisted of 7240 nt excluding the polyA tail, with 4 nt overlapping between ORF1 and ORF2. ORF3 is contained in the sequence of ORF2. The complete genome sequence of swGX32 shared identity of 73%-74%, 73%, 74%-75%,83%-94% with HEV genotype 1,2,3 and 4, respectively. Among all these HEV reference sequences, swGX32 showed the highest identity with the human isolate JKO-ChiSai98C (94%). Phylogenetic tree showed that swGX32 belonged to genotype 4 and clustered with JKO-ChiSai98C in the branch of HEV subtype 4a. Conclusion The swine HEV isolate swGX32 is closely related to human strain JKO-ChiSai98C genetically and phylogenetically, which further provides molecular biology evidence of hepatitis E as a zoonosis.

Objective To evaluate left ventricular(LV)myocardial contraction patterns and function when pacing in different right ventricular(RV)sites and discuss echocardiogarphic method to evaluate physiologcal pacing mode.Methods This study included 26 patients with paroxysmal supraventricular tachycardia without organic heart disease.Four pacing modes including right atrium pacing(AAI),RV apex pacing(VVI-RVA),RV septal pacing(VVI-IVS)and RV outflow tract pacing(VVI-RVOT)were performed on the patients in a random order after succussful radiofrequency ablation.The parameters measured in each pacing mode included(1)LV systolic function parameters:LV twist angle(Twist),aortic systolic velocity-time integral(VTIAo)and LV global strain(Gε)；(2)LV contracting pattern:segmental peak systolic strain(Sε),the time to peak value(TPε),and the distribution of segmental Sε,TPε in each layer or wall.The relationship between Sε,TPε of each wall was analyzed.[Results]Pacing from RV sites showed lower Twist,VTIAO and Gε than AAI mode.Gε demonstrated significant difference in three RV sites pacing mode(VVI-RVOT＞VVI-IVS＞VVI-RVA,P＜0.05).Compared with the AAI mode,the distribution of segmental Sε,TPε in the each layer or wall alerted significantly in three RV sites pacing mode,especially in VV1-RVA.The distribution pattern was similar in VVI-RVOT and VVI-IVS.Furthermore,the wall Sε collated negtively with wall TPε(r =-0.51,P＜0.001).[Conclusions]Compared with AAI mode,RV pacing,especially the VVI-RVA induced the alternation of LV contraction patterns and reduction of systolic function.Longitudinal strain parameters can be used to assess the myocardial contraction patterns and function in different pacing mode.

Objective To assess the left ventricular(LV)contraction synchrony in patients with DDD pacing by velocity vector imaging(VVI).Methods Acoustic clip capture was performed in 13 patients before and after pacemaker implantation and obtained high-frame rate B-mode echocardiographic images.VVI was done in all three standard LV apical views and parasternal LV short axis(SAX)views.The time to peak systolic longitudinal velocity(Tvl)and systolic longitudinal strain(Ts1)in the LV apical views and the time to peak systolic radial velocity(Tvr)and systolic circumferential strain(Tsc)in the LV SAX views were measured bv VVI.The standard deviation of Tvl,Tsl,Tvr and Tsc(Tvl-SD,Tsl-SD,Tvr-SD and TscSD)and the maximal temporal difference of Tvl,Tsl,Tvr and Tsc(Tvl-d,Tsl-d,Tvr-d and Tsc-d)of 18 segments were calculated.Results Compared with the values at baseline,Tvr-SD,Tsc-SD,Tsl-d,Tvr-d and Tsc-d increased significantly in patients after pacemaker implantation(P＜0.05).Conclusions The longitudinal,radial and circumferential systolic asynchrony of the LV was commonly existed in patients after DDD pacing.VVI can be used to evaluate the systolic synchrony of the LV in patients with DDD pacing.

Objective To observe the characteristics of patients with extra long-term hospital stays at an infectious dis-eases hospital,formulate corresponding strategies,and effectively control the length of stays so as to improve the efficiency of medical resource utilization.Methods Data of all discharged patients in 2023,including age,gender,disease name,discharge department,and length of stay,were retrieved from the hospital's medical record management system.Statistical analysis was conducted using Excel and SPSS.Results The analysis indicated that the proportion of male patients with excessively long hos-pital stays was significantly higher than that of female patients.Additionally,prolonged hospital stays were correlated with age,and elderly patients exhibited a higher proportion of extended stays.Most patients were covered by employee medical insurance and resident medical insurance,while only a small portion relied on self-funded medical insurance.Over half of the excessively hospitalized patients were affected with specific infectious and parasitic diseases(A00-B99).Controlling the length of these hos-pitalizations could reduce costs and alleviate patient burdens.Conclusion Controlling excessive hospital stays is effective through strengthened medical quality management,enhanced patient management in key departments,and a focus on specific dis-eases.Additional strategies for controlling extended hospital stay include improving doctor-patient communication,increasing comprehensive patient information sharing,reducing medical disputes,attaching importance to information technology,and rea-sonably utilize medical resources.

Objective To study the application effects of timely regional vascular occlusion in primary liver cancer(PLC) surgery. Methods Eighty-eight patients with PLC who underwent surgery in the Department of General Surgery of Yan'an University Affiliated Hospital from January 2014 to December 2016 were selected for prospective study, and they were divided into the experimental group and the control group by the random number table method, 44 cases of each group. In the experimental group, the blood supply was blocked with timely regional vascular occlusion while in the control group, the blood supply was blocked with half hepatic vascular occlusion. The occurrence of postoperative complications, and surgical indexes(surgical time, intraoperative blood loss, the time of hepatic portal occlusion, blood transfusion volume, abdominal drainage volume and hospital stay), levels of alanine aminotransferase, albumin and total bilirubin, levels of CD3+, CD4+, CD8+ and CD4 + /CD8 +, effective rate, control rate, and clinical efficacy were compared between the two groups. Measurement data with normal distribution were represented as (x) ± s and analyzed using the independent-sample t test between the two groups; within the groups, paired t-tests were used. Comparison of count data were represented as n(％ ), and analyzed using the chi-square test. Results The intraoperative blood loss, time of hepatic portal occlusion, blood transfusion volume and hospital stay of the experimental group were(331. 48 ±30.65) ml, (14.78土2.27) min, (132.61 ±13.87) ml, (9.29土1.19) d, and the control group were (500.61 ±50.62) ml, (23.96±2.89) min, (305.76 ± 30.64) ml, (12.10 ± 1.22) d, with statistically significant differences in above indexes between the two groups(all P< 0.05). The operation time and abdominal drainage volume in the experimental group were(146.86 ± 15.87) min and(321.77 ±33.65) ml respectively, while those in the control group were (143.07土15.35) min and(335.18 ±33.82) ml respectively, there was no significant difference between the two groups(P> 0.05 ). After surgery, the levels of alanine aminotransferase, total bilirubin and albumin of the experimental group were(54.86 ±5.61) U/L, (20.65 ± 2.32) U/L, (41.95土4.32) ng/ml, and the control group were(120.75 ± 13.03) U/L, (35.42+3.21) U/L, (70.25 ±7.45) ng/ml, with statistically significant differences in above indexes between the two groups(all P <0.05). After surg;ery, the levels of CD3 +, CD4+, CD8 + and CD4 + /CD8 + of the experimental group were 0.63 ±0.16, 0.52 ± 0.11, 0.20 ±0.04, 1.70 ±0.17 and the control group were 0.56 ±0.14, 0.45±0.12, 0.26 ± 0.05, 1.46土0.22, with statistically significant differences in above indexes between the two groups (all P< 0.05 ). There were no differences between the experimental group and the controlg roup in the response rate and the control rate(75.00％ vs.79.55％; 88. 64％ vs.90.91％ ) (P>0.05). Conclusions The application of timely regional vascular occlusion in PLC surgery can reduce the intraoperative blood loss, the time of hepatic portal occlusion, blood transfusion volume and hospital stay, improve the immune level and liver function. And there is no difference in response rate and control rate compared with half hepatic vascular occlusion, therefore it is worthy of clinical application.