[Objective]The clinical characteristics and the possible risk factors were explored for the low triiodothyronine syndrome(LTS)in elderly patients with chronic heart failure(CHF),and the risk prediction model of LTS was established.[Methods]For this research,291 elderly patients with CHF were selected as sample and retrospectively reviewed was used as analytical method.According to the thyroid function of admission patients,two groups including LTS group(n=107)and normal thyroid function group(n=184)were divided.The general information and biochemical indicators of patients were collected and recorded,and the risk factors for LTS were assigned scores,in which numerical variables(except age)were grouped by median.The chi-squared test was used for statistical analysis of each variable,and multivariate regression model was used to analyze the independent risk factors of LTS in elderly patients with CHF,then the nomogram model for LTS was established based on the results from the final regression analysis.Furthermore,the prediction model was evaluated using C-index,calibration curve and receiver operating characteristic(ROC)curve.[Result]Serum creatinine(Scr),C-reactive protein(CRP),interleukin-6(IL-6)and the cardiac functional grading according to the New York Heart Association(NYHA)were positively correlated with LTS(OR values were 1.893,2.356,1.021 and 1.815,respectively,P<0.05),serum Albumin(Alb)was negatively correlated with LTS(OR=0.412,P<0.05).This means that,the LTS was easily occurred as the serum Alb level declined.When introduce the above statistically significant variables into nomogram obtained the C index with 0.807[95%CI=(0.757,0.856)].The calibration curve verified by internal verification showed that the calibration degree of this prediction model was well calibrated.ROC curve analysis showed that the prediction model was well differentiated.[Conclusion]The Scr,CRP,IL-6,Alb and cardiac functional grading in elderly CHF patients may be risk factors for incidence of LTS,while serum Alb may be a protective factor for LTS.Based on the above risk factors,the nomogram model for predicting the occurrence of LTS in elderly CHF patients had good differentiation and accuracy,and can provide guidance for clinical individualized prevention and treatment.

Objective To explore the factors that affect the coordinated development of blood banks and apheresis plas-ma collection banks(hereinafter referred to as plasma banks),and explore feasible measures for the coordinated develop-ment of blood banks and plasma banks.Methods The blood information management system and blood source information management system were used to retrieve related data of blood and plasma donation from 9 cities in Shandong province from 2017 to 2021.The number of blood donors and plasma donors and the intersection of them were analyzed.The data analysis was performed using chi-square test,and a questionnaire survey was conducted to investigate the policies and information status,as well as expectations for coordinated development for blood and plasma donation.Results From 2017 to 2021,the total number of blood donors in 9 cities was higher than that of plasma donors,both have been increasing year by year,and the increase in plasma donors was significantly higher than that of blood donors(131.78%vs 23.90%,P<0.05).The inter-section proportion of blood and plasma donors had increased from 0.45%in 2017 to 1.04%in 2021,with an increase of 131.11%.Among the administrative regions where the participating blood and plasma banks located,94.2%have not re-leased relevant policy to promote the coordinated development of blood and plasma donation.The majority(63%)expected blood banks and plasma banks to be set at a distance more than 50 km apart.The top four functional requirements for the in-terconnection between blood banks and plasma banks management information system were blood test results(94.61%),ID number(87.54%),blood and plasma donation records(85.51%)and health consultation/examination results(82.15%).The top four elements of coordinated development between blood and plasma banks were policy support(96.25%),informa-tion networking(92.36%),top-level design(87.44%)and cultural construction(86.58%).Conclusion The number of donors who donate both blood(mainly whole blood)and plasma has been increasing year by year,which deserves our close attention.To achieve the coordinated development of blood donation and plasma donation,policy support is the most crucial and fundamental means.Establishment of a standard system and the share of blood and plasma donation information is neces-sary for blood informatization construction.It was critical to promote the coordinated development of blood and plasma dona-tion and ensure blood safety with improving legislation,formulating policies for coordinated development,strengthening top-level design,standardizing the publicity of blood and plasma donation and establishing the idea that blood and plasma dona-tion are equally honorable.

An epidemiological investigation was carried out on a local cluster of outbreak caused by imported cases of Coronavirus Disease 2019 (COVID-19) in rural areas of Chengdu in December 2020, to find out the source of infection and the chain of transmission. According to
COVID-19 ; Disease Outbreaks ; Epidemics ; Humans ; Quarantine ; SARS-CoV-2

Objective:To investigate the clinical effect of laparoscopic assisted removal of greater omentum free transplantation combined with skin grafting for the repair of large area refractory wounds.Methods:From June 2013 to June 2018, 18 cases of lower extremity skin and soft tissue defects with multiple bone, joint, tendon and internal plants exposure were admitted to Hanzhong Central Hospital, including 12 males and 6 females, aged from 15 to 50 years old, with an average age of 32.6 years old. The area of skin and soft tissue defect: 30 cm×12 cm-53 cm×21 cm. The operation was divided into two stages. In the first stage, the greater omentum was acquired with the assist of laparoscope and free transplanted to cover the wound. After the greater omentum free transplantation was confirmed to survive, the split-thickness skin graft was applied for wound repair.Postoperative survival of the greater omentum and skin grafting, complications, appearance and function of lower limbs were observed and followed up.Results:The 18 operations were performed successfully, the area of omentum resection was 25 cm×10 cm-35 cm×15 cm, all the greater omentums survived after operation without complications such as intestinal adhesion, volvulus and peritonitis. The area of the skin grafting was 36 cm×8 cm-45 cm×22 cm. 16 cases skin grafting survived completely, 2 cases skin grafting were necrosis just local small area, and scar healed after dressing change. Postoperative follow-up of 6-12 months showed good appearance and function of lower limbs and satisfactory results.Conclusions:For the large area soft tissue defect wound of lower extremity, complicated with multiple deep tissues such as bone, joint and internal materials exposed, the greater omentum free transplantation under laparoscope combined with medium thick skin graft second stage has the advantages of good appearance and function after wound healing, less donor injury and fewer postoperative complications.

Objective:To investigate the clinical effect of laparoscopic assisted removal of greater omentum free transplantation combined with skin grafting for the repair of large area refractory wounds.Methods:From June 2013 to June 2018, 18 cases of lower extremity skin and soft tissue defects with multiple bone, joint, tendon and internal plants exposure were admitted to Hanzhong Central Hospital, including 12 males and 6 females, aged from 15 to 50 years old, with an average age of 32.6 years old. The area of skin and soft tissue defect: 30 cm×12 cm-53 cm×21 cm. The operation was divided into two stages. In the first stage, the greater omentum was acquired with the assist of laparoscope and free transplanted to cover the wound. After the greater omentum free transplantation was confirmed to survive, the split-thickness skin graft was applied for wound repair.Postoperative survival of the greater omentum and skin grafting, complications, appearance and function of lower limbs were observed and followed up.Results:The 18 operations were performed successfully, the area of omentum resection was 25 cm×10 cm-35 cm×15 cm, all the greater omentums survived after operation without complications such as intestinal adhesion, volvulus and peritonitis. The area of the skin grafting was 36 cm×8 cm-45 cm×22 cm. 16 cases skin grafting survived completely, 2 cases skin grafting were necrosis just local small area, and scar healed after dressing change. Postoperative follow-up of 6-12 months showed good appearance and function of lower limbs and satisfactory results.Conclusions:For the large area soft tissue defect wound of lower extremity, complicated with multiple deep tissues such as bone, joint and internal materials exposed, the greater omentum free transplantation under laparoscope combined with medium thick skin graft second stage has the advantages of good appearance and function after wound healing, less donor injury and fewer postoperative complications.

Prostate cancer is one of the most common cancers in adult men. Heat shock proteins (HSPs),as molecular chaperones widely involved in the pathogenesis,diagnosis,treatment and prognosis of various cancers,play crucial biological functions in prostate cancer and it can be considered as valuable biomarkers for cancer therapy, such as prostate-specific membrane antigen. As a member of the heat shock protein family, HSP27 is related to prostate cancer castration resistance,and its expression can promote tumor resistance,invasion and bone metastasis,making prostate cancer more invulnerable to treatments. Therefore,targeting HSP27 in prostate cancer can be perceived as one promising cancer treatment strategy. This article reviews the structure and function of HSP27,and its potential role on castration resistance and targeted therapy in order to provide a new theoretical basis for the clinical treatment of prostate cancer.

Objective: To summarize the experience of surgical treatment of 18 cases of severe aortic stenosis with ventricular septum hypertrophy. Methods: Clinical data of 18 patients with severe aortic stenosis admitted to the first affiliated hospital of zhengzhou university from January 2013 to December 2016 were collected. There were 7 males and 11 females. The mean age was (50.4±4.2) years old. All patients were diagnosed with severe stenosis of main artery valve by echocardiography before surgery, with mean aortic valve orifice area (0.57±0.11) cm^2, cardiac function (NYHA classification) grade Ⅱ in 4 patients, grade Ⅲ in 9 patients, and grade Ⅳ in 5 patients. There were 8 patients with mild aortic valve insufficiency, 4 patients with mild to moderate mitral valve insufficiency, 2 patients with moderate to severe aortic valve insufficiency, 3 patients with ascending aorta dilatation (ascending aorta inner diameter>4.5 cm), and 1 patient with atrial fibrillation. Interventricular septum thickness (15.82±2.04)mm, left ventricular posterior wall thickness (14.04±1.28)mm, ratio of interventricular septum thickness to left ventricular posterior wall thickness (IVS/LVPW) 1.12±0.91, inner diameter of left ventricular outflow tract (19.01±1.74)mm, cross-lobe differential pressure (102±8.40) mmHg (1 mmHg=0.133 kPa), left ventricular ejection fraction (LVEF) mean 0.49±0.05. Left ventricular end-diastolic diameter (LVEDD) (53.33±4.00) mm, left ventricular end-systolic diameter (LVESD) (27.11±1.99) mm, and left ventricular mass index (277.1±37.3) g/m². All patients underwent aortic valve replacement (AVR) and partial interventricular septum resection under general anesthesia and conventional extracorporeal circulation, 2 patients underwent mitral valve formation (artificial valve ring), 2 patients underwent ascending aorta formation, and 1 patient underwent ascending aorta wrapping. During the operation, the time of extracorporeal circulation, aortic occlusion, number of defibrillation during the operation, type of valve implantation and postoperative complications were recorded. Regular follow-up was conducted to analyze the changes of various indexes at different preoperative and postoperative time. Results: There was no death in the whole group. 2 patients were treated with temporary pacemakers. After drug treatment, sinus rhythm was restored on the 3rd and 6th day after surgery, and temporary pacemakers were removed. Echocardiography reexamination 1 week after the operation showed that all patients had a good artificial valve function and 2 patients had minor regurgitation of mitral valve. The difference in pressure across the valve, inner diameter of the left ventricular outflow tract, cardiac function classification, ventricular septum thickness, valve orifice area, and left ventricular mass index were significantly improved compared with the preoperative level (P<0.05). LVEF, LVEDD, and LVESD were compared with the preoperative level (P<0.05). After 6 months of follow-up, the difference in LVEF and LVEDD was statistically significant compared with the preoperative level (P<0.05). Conclusion Severe aortic stenosis combined with ventricular septum hypertrophy and partial ventricular septal muscle resection is a simple additional procedure in the AVR process, which does not increase the surgical risk and has a significant effect, and is conducive to postoperative left ventricular function recovery.

Objective To compare the patency of the postoperative vessel bridge grafts between the notouch technique and the conventional technique for saphenous vein harvest in the coronary artery bypass grafting. Methods A total of 70 patients underwent coronary artery bypass grafting from January 2014 to January 2015 in the First Affiliated Hospital of Zhengzhou University. They were randomly divided into a conventional technique group (saphenous vein obtained by traditional technique) and a no-touch technique group (saphenous vein obtained by notouch technique). There were 34 patients in the conventional technique group, including 16 males and 18 females with an average age of 61.6±6.4 years. There were 36 patients in the no-touch technique group, including 16 males and 20 females with an average age of 62.2±6.6 years. The 1-year postoperative coronary CT angiography (CTA) results were compared. Results Seventy patients underwent coronary CTA examination 1 year postoperatively. The patency rate of the conventional technique group and no-touch technique group were 83/116 (71.6%) and 113/122 (92.6%). Logistic regression analysis showed a statistical difference between the non-touch technique and the conventional technique (P<0.05). Conclusion The short-term patency rate of vessel bridge grafts is higher when the no-touch technique is used.

Objective To evaluate the efficacy and safety of oprinon hydrochloride in increasing cardiac pump function and stabilizing hemodynamics and preventing common complications after cardiac valve replacement. Methods Sixty-two patients were admitted to the First Affiliated Hospital of Zhengzhou University from January to August 2018 to undergo cardiac valve replacement operation, post-operatively, 32 patients using oprinon hydrochloride were in the observation group and 30 patients using milrinone were in the control group. Both groups received basic treatment, additionally the observation group was given oprinon hydrochloride intravenous pump injection for 48 hours and the control group was given milrinone intravenous pump injection for 48 hours. The changes of vital signs (blood pressure, heart rate, respiratory rate), cardiac function, hemodynamics, biochemical indexes, electrocardiogram, cardiac color Doppler ultrasound and adverse reactions were observed before and after treatment in the two groups. The incidence of cardiovascular events (worsening, re-hospitalization and death) was followed up 1 month after discharge. Results The left ventricular ejection fraction (LVEF), central venous pressure (CVP), arterial oxygen saturation (SaO2), arterial partial pressure of oxygen (PaO2), N-terminal B-type natriuria (NT-proBNP), lactic acid, serum creatinine (SCr), blood sodium and potassium of the two groups after treatment were not statistically significant compared with those before treatment [LVEF: the control group was 0.52±0.09 vs. 0.60±0.09, the observation group was 0.62±0.12 vs. 0.50±0.11;CVP (mmHg, 1 mmHg = 0.133 kPa): the control group was 11.2±2.8 vs. 13.0±2.9, the observation group was 13.0±2.5 vs. 10.5±3.6; SaO2: the control group was 0.98 (0.90, 0.99) vs. 0.99 (0.98, 1.00), the observation group was 0.95 (0.94, 0.98) vs. 0.96 (0.90, 1.00); PaO2(mmHg): the control group was 100.5 (63.8, 135.3) vs. 99.5 (82.3, 179.5), the observation group was 95.0 (85.5, 129.0) vs. 75.5 (59.0, 138.3); NT-proBNP (pg/L): the control group was 1.45 (1.34, 3.31) vs. 0.92 (0.42, 1.81), the observation group was 0.47 (0.35, 1.37) vs. 2.07 (1.27, 4.44); lactic acid (mmol/L): the control group was 3.6 (2.4, 4.5) vs. 1.4 (1.2, 3.1), the observation group was 1.3 (1.1, 2.1) vs. 3.1 (1.4, 3.7); SCr (μmol/L): the control group was 106.7±35.9 vs. 84.4±20.3, the observation group was 96.5±40.7 vs. 77.1±23.1; sodium (mmol/L):the control group was 141.4±7.2 vs. 143.6±4.2, the observation group was 142.9±3.6 vs. 140.5±4.5; potassium (mmol/L): the control group was 4.6±0.9 vs. 4.8±0.6, the observation group was 4.8±0.6 vs. 4.1±0.6, all P > 0.05];the comparisons between the following indicators in levels before and after treatment in the two groups had statistical significant differences: the peripheral arterial pressure (PAP), white blood cell count (WBC), hemoglobin (Hb), platelet count (PLT), alanine aminotransferas (ALT) and aspartate aminotransferase (AST) [PAP (mmHg): the control group was 33.0 (24.0, 59.3) vs. 38.0 (34.8, 46.0), the observation group was 30.0 (25.0, 32.0) vs. 53.5 (29.3, 66.5); WBC (×109/L):the control group was 12.2 (10.4, 13.9) vs. 5.7 (4.4, 8.6), the observation group was: 8.4 (3.7, 11.8) vs. 8.6 (5.7, 12.4); Hb (g/L): the control group was 95.6±12.9 vs. 130.3±15.0, the observation group was 111.1±22.6 vs. 112.4±24.6; PLT (×109/L): the control group was 95.2±21.3 vs. 168.7±32.6, the observation group was 146.3±68.1 vs. 132.7±45.1;ALT (U/L): the control group was 36.5 (15.3, 80.5) vs. 14.0 (11.0, 19.0), the observation group was 15.0 (10.0, 32.3) vs. 20.3 (12.0, 35.8); AST (U/L): the control group was 33.0 (20.0, 83.0) vs. 16.5 (16.7, 28.8), the observation group was 35.5 (12.3, 56.8) vs. 75.5 (45.3, 140.3), all P < 0.05]; after treatment, the urea nitrogen (BUN) level in control group was higher than that before treatment (mmol/L: 11.4±4.7 vs. 7.1±2.5), while BUN in the observation group was decreased (mmol/L: 6.5 ±3.3 vs. 9.1±3.8), there was statistical significant difference in BUN level between the two groups after treatment (P < 0.05). The levels of systolic blood pressure and respiratory rate after treatment in the two groups were significantly higher than those before treatment (all P < 0.05). After treatment, the diastolic blood pressure in the observation group was increased, but there was no significant difference in the control group before and after treatment, and the diastolic blood pressure in the observation group after treatment was higher than that in the control group (mmHg: 67.8±9.9 vs. 62.0±10.5, P < 0.05). According to the New York Heart Association Heart (NYHA) function efficacy assessment score, the total effective rate of the observation group was higher than that of the control group [93.7% (30/32) vs. 83.3% (25/30), P > 0.05]. There was no statistical significant difference in the incidence of adverse reactions between the observation group and the control group [12.5% (4/32) vs. 30.0% (9/30), P > 0.05]. The patients in the two groups were followed up for one month after discharge, 9 cases (30.0%) in the control group were re-hospitalized due to heart failure, and 3 cases (9.4%) in the observation group were re-hospitalized due to heart failure, there was no statistical significant difference between the two groups in re-hospitalization rate (P > 0.05). Conclusion Oprinone hydrochloride can effectively improve cardiac function and maintain hemodynamic stability of patients after heart valve replacement surgery.

Objective To analyze the efficacy of no-touch technique and traditional technique in drawing great saphenous vein during coronary artery bypass grafting. Methods We searched the literatures on no-touch technique versus traditional technique in drawing great saphenous vein during coronary artery bypass grafting in PubMed, Cochrane Library, Chinese Journal Full-text Database, Wanfang database between January 1997 and November 2017. Jadad scale was used for quality verification. RevMan 5.0 was used for analysis. Results Six studies were included. Jadad scale for both 6 randomized controlled trials was 5 points. Meta-analysis showed that there was no statistical difference in postoperative mortality between the two groups with RR=0.68 and 95%CI 0.11 to 4.11(P=0.67). There was no statistical difference in leg wounds with RR=1.46 and 95%CI 0.23 to 9.16 (P=0.68). There was no statistical difference in short-term cardiogenic death with RR=0.33, 95%CI 0.10 to 1.03 ( P=0.06). The no-touch group’s long-term cardiogenic death was significantly lower than the traditional group withRR=0.36, 95%CI 0.16 to 0.79(P=0.01). Postoperative no-touch group’s short-term patency rate was significantly better than that of the traditional group with MD=3.08 and 95%CI 1.58 to 5.99 (P<0.01). The long-term patency rate in the no-touch group was also higher than that of the traditional group withMD=3.08 and 95%CI 1.58 to 5.99 (P<0.01). Conclusion Compared with the traditional group, the no-touch group increases postoperative long-term survival rate, short-term and long-term patency rate.