Objective To explore the influencing factors for poor prognosis in patients with acute myocardial infarction(AMI)complicated by heart failure(HF),construct a nomogram prediction model,and validate its performance.Methods A total of 252 patients with AMI complicated by HF were selected as training set and divided into poor prognosis group(60 patients)and good prognosis group(192 patients)based on 1-year follow-up results.Additionally,86 patients with AMI compli-cated by HF,with a ratio approximately 1∶3 to the training set,were selected as validation set.Cox regression models were used to analyze the influencing factors for poor prognosis.A nomogram model was constructed based on the screening results and underwent internal and external validation[Hos-mer-Lemeshow test was used to assess goodness of fit,calibration curves were plotted to evaluate cali-bration,receiver operating characteristic(ROC)curves were drawn to analyze discriminative ability,and decision curve analysis(DCA)was conducted to assess clinical utility].Results There were no statistically significant differences in clinical data between the training set and validation set(P＞0.05).The poor prognosis group had higher levels of serum creatinine and cardiac troponin T(cTnT),higher proportions of patients aged≥60 years,with time from onset to admission ≥4 hours,with heart function grades Ⅲ to Ⅳ,and a lower left ventricular ejection fraction(LVEF)compared with the good prognosis group(P＜0.05).Multivariate Cox regression analysis showed that time from onset to admission,heart function grade,serum creatinine,cTnT,and LVEF were independent influen-cing factors for poor prognosis in patients with AMI complicated by HF(P＜0.05).Based on these results,a nomogram model was constructed.Internal validation results showed that the model had good goodness of fit(x2=13.966,P=0.083),excellent calibration,and good discriminative abili-ty[area under the curve(AUC)was 0.831].External validation results also showed that the model had good goodness of fit(x2=6.465,P=0.136),excellent calibration,and good discriminative a-bility(AUC was 0.884).DCA results indicated that the nomogram model had good clinical net benefit within a high-risk threshold range of 0.02 to 0.98.Conclusion Influencing factors for poor prognosis in patients with AMI complicated by HF include time from onset to admission,heart func-tion grade,serum creatinine,cTnT,and LVEF.The constructed nomogram model has high predic-tive value for poor prognosis in these patients.

Objective To evaluate the efficacy and safety of CT-guided percutaneous celiac plexus block (NCPB) using 25 G controllable curved needle together with 22 G straight needle in treating refractory carcinomatous upper abdominal pain. Methods A total of 18 patients with advanced refractory carcinomatous upper abdominal pain were enrolled in this study. The carcinomatous upper abdominal pain failed to the three-step analgesic therapy. Guided by CT scan, percutaneous injection of ethanol with a 25 G controllable curved needle to destroy celiac plexus was carried out in all patients. According to WHO pain relief standards, the relieving degree of pain was evaluated before NCPB and 2 weeks, one, 2, 3 and 6 months after NCPB. The results were analyzed. Results The technical success rate was 100%. The short-term (within 2 weeks) efficacy rate was 88.8%and the complete remission rate was 38.8%. The long-term (over 3 months) efficacy rate was 50% and the complete remission rate was 20%. No severe complications occurred. Conclusion For refractory carcinomatous upper abdominal pain, CT-guided percutaneous celiac plexus block is a simple, safe and effective treatment.

The ultrasonographic appearances of osteosarcomas and the roles of ultrasonography in the diagnosis and surgical staging of osteosarcomas were investigated. A comparative study was performed on 45 cases of osteosarcomas by ultrasonography and radiography. Bony changes, periosteal reaction and soft tissue mass were evaluated for each lesion. The results showed that ultrasonography revealed a solid mass around bone in 42 patients, bone destruction in 24 patients and periosteal reaction in 16 patients. Plain radiographs showed bony changes in 44 patients and no bony change in remaining one patient, shadowing of soft tissue swelling in 30 patients, and pulmonary metastases in 3 patients. Surgical biopsy and pathological examination confirmed osteosarcoma in all 45 patients. Soft tissue mass was confirmed in 42 patients surgically. The diagnostic accuracy of soft tissue masses by ultrasonography and radiography was 100 % (42/42) and 71.4 % (30/42), respectively. The positive rate of ultrasonography and radiography in displaying bony changes was 53.3 % (24/45) and 97.8 % (44/45), respectively. In conclusion, in the detection of soft tissue mass of osteosarcoma, ultrasonography is superior to radiography, and in displaying bony changes of osteosarcomas, radiography is superior to ultrasonography. So it may come to a conclusion that plain radiography combined with ultrasonography can completely display the bony and soft tissue lesion of osteosarcomas.

The ultrasonographic appearances of osteosarcomas and the roles of ultrasonography in the diagnosis and surgical staging of osteosarcomas were investigated. A comparative study was performed on 45 cases of osteosarcomas by ultrasonography and radiography. Bony changes, periosteal reaction and soft tissue mass were evaluated for each lesion. The results showed that ultrasonography revealed a solid mass around bone in 42 patients, bone destruction in 24 patients and periosteal reaction in 16 patients. Plain radiographs showed bony changes in 44 patients and no bony change in remaining one patient, shadowing of soft tissue swelling in 30 patients, and pulmonary metastases in 3patients. Surgical biopsy and pathological examination confirmed osteosarcoma in all 45 patients.Soft tissue mass was confirmed in 42 patients surgically. The diagnostic accuracy of soft tissue masses by ultrasonography and radiography was 100 % (42/42) and 71.4 % (30/42), respectively. The positive rate of ultrasonography and radiography in displaying bony changes was 53.3 % (24/45) and 97.8 % (44/45), respectively. In conclusion, in the detection of soft tissue mass of osteosarcoma, ultrasonography is superior to radiography, and in displaying bony changes of osteosarcomas, radiography is superior to ultrasonography. So it may come to a conclusion that plain radiography combined with ultrasonography can completely display the bony and soft tissue lesion of osteosarcomas.