Objective To explore the change of serum chloride ion(Cl-)level and its relationship with prognosis in patients with acute heart failure(AHF).Methods A total of 289 patients with AHF admitted to the hospital from September 2020 to March 2023 were included in the study.Clinical and laboratory data of patients were collected,serum Cl-levels were detected at admission and discharge,and the difference of Cl-levels was calculated(△Cl-).Patients with AHF were divided into poor prognosis group and good prognosis group according to the incidence of adverse cardiovascular events during follow-up.Clinical and laboratory data of the two groups were compared.Logistic regression analysis was used to analyze the relationship between se-rum △Cl-level and poor prognosis of AHF by using restricted cubic spline(RCS)curve drawn by the func-tions in the rms package.Receiver operating characteristic(ROC)curve was plotted to analyze the value of△Cl-levels in predicting the risk of adverse cardiovascular events within 1 year of discharge from hospital in patients with AHF.Results The age and the proportion of patients with atrial fibrillation in the poor progno-sis group were higher than those in the good prognosis group,and the difference was statistically significant(P＜0.05).The levels of left ventricular ejection fraction(LVEF)and Cl-at discharge in the poor prognosis group were lower than those in the good prognosis group,and the levels of brain natriuretic peptide(BNP)and △Cl-in the poor prognosis group were higher than those in the good prognosis group,with statistical sig-nificance(P＜0.05).Logistic regression analysis showed that LVEF was an independent protective factor for poor prognosis of AHF,and age,BNP and △Cl-levels were independent risk factors for poor prognosis of AHF(P＜0.05).RCS curve analysis showed a significant linear association between △Cl-levels and the risk of adverse cardiovascular events in patients with AHF within 1 year of discharge.ROC curve analysis showed that the area under the curve of △Cl-level in predicting the risk of adverse cardiovascular events in AHF pa-tients within 1 year after discharge was 0.857,the sensitivity was 88.37％,and the specificity was 69.46％.Conclusion The change of serum Cl-level of patients with AHF is related to the prognosis of patients with AHF,and monitoring the serum Cl-level of patients with AHF can guide the early clinical intervention.

Objective:To establish an HPLC fingerprint and determine five compounds in Zhengtian pills to provide reference for the effective quality control.Methods:The analysis was carried out on an Agilent XDB-C18analytical column (250 mm × 4.6 mm,5 μm) with gradient elution by acetonitrile (A) -0.19% phosphoric acid solution (B) (0-8 min,10 % A→15% A;10-23 min,15 % A→45 % A;23-50 min,45 % A;50-60 min,45 % A→70 % A;60-70 min,70 % A),the detection wavelength was 310 nm and the flow rate was 1.0 ml/min. The column temperature was 30 ℃. Similarity evaluation was used to evaluate the fingerprints of 12 batches of Zhengtian pills,and five marker components were quantified. Results:There were 33 common peaks in the fingerprints of twelve batches of Zhengtian pills, and five of them (ferulic acid, prim-O-glucosylcimifugin, 5-O-methylvisammioside,imperatorin and isoimperatorin) were identified by comparison with the reference. The similarity of the 12 batches of samples was over 0.99. The linear ranges were 0.050-0.605 μg(r = 0.999 8),0.008-0.100 μg(r = 0.999 2), 0.013-0.150 μg(r = 0.998 6), 0.171- 2.049 μg(r = 0.999 7)and 0.113- 1.352 μg(r = 0.999 6) for ferulic acid, prim-O-glucosylcimifugin,5-O-methylvisammioside, imperatorin and isoimperatorin, respectively. The content of ferulic acid, prim-O-glucosylcimifugin,5-O-methylvisammioside,imperatorin and isoimperatorin was 0.78-0.84 mg/g,0.10-0.13 mg·g-1, 0.18-0.20 mg·g-1,2.44-2.51 mg·g-1and 1.70-1.78 mg·g-1in the 12 batches of samples, respectively. Conclusion:The established method has high sensitivity and specificity,which can be used for the quality control of Zhengtian pills.

OBJECTIVETo analyze the magnetic resonance imaging (MRI) features of endometrial carcinoma and their value in endometrial carcinoma staging according to the International Federation of Gynecology and Obstetrics (FIGO 2009) staging criteria.

METHODSFifty-four patients with pathologically confirmed endometrial carcinoma and complete clinical data underwent preoperative MRI examination. According to FIGO 2009 staging criteria of endometrial carcinoma, the MRI features of the tumor lesions were evaluated for assessment of myometrial invasion and cervical involvement and preoperative staging.

RESULTSThe 54 cases included 27 stage Ia cases, 9 stage Ib cases, 10 stage II cases, 5 stage III cases, and 3 stage IV cases. The total lesion display rate by MRI was 94% (51/54). With an isointensity or hypo-intensity on T1WI, the tumor lesions showed a moderate hyper-intensity on T2WI. In enhanced MRI scanning, the lesions showed a moderate heterogeneous enhancement, which had a lower intensity than the marked enhancement of the myometrium. Combination of T2WI and T1WI in fat suppression sequence enhanced scan had a diagnostic accuracy of 91% (49/54) for myometrial invasion, and the sensitivity, specificity and accuracy of MRI for detecting cervical involvement were 77%, 89%, and 83%, respectively. The accuracy of preoperative MRI-based staging of endometrial carcinoma was 89% (48/54), showing no significant difference from the results of postoperative FIGO 2009 staging and pathological examination (P>0.05).

CONCLUSIONMRI has a high accuracy in the diagnosis, evaluation of myometrial and cervical invasion depth, and preoperative staging of endometrial carcinoma, and serves as an important modality in assisting clinical decisions on the optimal therapeutic protocols and in prognostic estimation.

Adult ; Aged ; Endometrial Neoplasms ; diagnosis ; pathology ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Middle Aged ; Neoplasm Staging

Objective To study and evaluate the MRI findings and their diagnostic value for breast carcinoma.Methods Preoperative contrast-enhanced MR imaging and mammography were performed in 12 patients who underwent surgery and were histopathologically proved with breast carcinoma.MR imaging findings were compared with clearly mammography.Results Twenty-one breast lesions in 12 cases were detected with MR imaging.Seventeen of the twenty-one lesions were detected with mammography.Contrast-enhanced MR imaging was superior to mammography to demonstrate lesions in these dense breasts.It could clearly indicate the extension of posterior breast carcinoma into the pectoralis major muscle and the metastases of parasternal lymphatic node,while it was difficult to evaluate with mammography.The "rim enhancement sign" might be valuable to diagnose breast carcinoma.Conclusion The sensitivity and accuracy of MR imaging is superior to that of mammography.Contrast-enhanced imaging of the breast is helpful not only in early diagnosis of breast carcinoma but also in staging breast carcinoma and planning therapy.