Objective To construct a prediction model for the long-term prognosis of elderly pa-tients heart failure with preserved ejection fraction(HFpEF)based on two-dimensional speckle tracking technology.Methods A total of 312 elderly HFpEF patients admitted in our hospital from January 2017 to December 2018 were prospectively enrolled,and then randomly divided into a training set(218 cases)and a validation set(94 cases)in a ratio of 7∶3.After 5 years of follow-up,they were divided into a death group(n=128)and a survival group(n=184)according to having experienced cardiovascular death events or not.The main clinical characteristics were com-pared between the two groups,and the risk factors for cardiovascular death events were analyzed.A clinical prediction model was constructed based on the relevant risk factors with R4.0.3 statisti-cal software.Results The age,age ≥80 years,atrial fibrillation,chronic obstructive pulmonary disease(COPD),and early strain rate of global systole(GSRs)in the death group were signifi-cantly higher than those in the survival group,with statistical significances[(76.68±8.73)years vs(70.98±7.74)years,P＜0.01;34.4％vs 20.7％,P＜0.01;25.0％vs 11.4％,P＜0.01;26.6％vs 9.2％,P＜0.01;(-0.84±0.24)/s vs(-1.24±0.31)/s,P＜0.01].Multivariate logistic regression analysis showed that age ≥80 years,atrial fibrillation,COPD and GSRs＞-1.035 1/s were inde-pendent risk factors for cardiovascular death events(RR=2.196,95％CI:1.217-3.962,P=0.009;RR=2.242,95％CI:1.136-4.424,P=0.020;RR=3.631,95％CI:1.787-7.377,P=0.000;RR=6.199,95％CI:3.624-10.602,P=0.000).The AUC value of the training set was 0.822(95％CI:0.765-0.879),and that of the validation set was 0.790(95％CI:0.698-0.882).Conclusion Our constructed nomogram prediction model has high predictive value and reliability in predicting cardiovascular death events.

This study was performed to determine the metabolic profile of four amide synthetic cannabinoids that recently abused, i.e., ADB-4en-PINACA, 4CN-CUMYL-BUTINACA, 5F-EMB-PICA and 4F-MDMB-BUTICA, in human liver microsomes (HLMs). The four amide synthetic cannabinoids were added to the microsomal incubation model, being incubated for 10 min, 60 min or 3 h to simulate human hepatic metabolism.Liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) analytical instrument was employed to determine and speculate the structure of phase I metabolites and their possible metabolic pathways.The results showed that there were 27 phase I metabolic pathways for the four amide synthetic cannabinoids, including hydroxylation, carboxylation, N-dealkylation and ester hydrolysis, with the main phase I metabolic pathways of ester hydrolysis, dihydrodiol (pentenyl tail), oxidative defluorination to carboxylic acid, monohydroxylation (alkyl side chain or indole/indazole ring) and N-dealkylation.The results of this study may provide potential detection markers for forensic identification and sewage abuse assessment of the four amide synthetic cannabinoids.

Objective To analyze risk signals of liver injuries related to nonsteroidal anti-inflammatory drugs( NSAID)and application of reporting odds ratio( ROR)in data mining. Methods A search of adverse drug reaction( ADR ) reports in Beijing of national monitoring system of adverse drug reaction from January 1st 2013 to December 31st 2013 was conducted using keywords "liver" and "gallbladder" . Of these filtered reports,the cases whose causal relationship of drugs and liver injuries was judged as"positive","likely",or "possible" were enrolled into liver injury group and the rest cases were all enrolled into non-liver injury group. Using NSAID as the target drugs and the other drugs as non-target, ROR and its 95% confidence interval( CI)of liver injuries related to NSAID were calculated according to formula of ROR. The lower limit of 95% CI >1 was regarded as suggestive of ADR signal. Results After removing duplication,14 657 patients were enrolled in the study,which comprised liver injury group 626 patients including 35 cases of liver injuries due to NSAID and non-liver injury group 14 031 patients. Of the 35 patients with liver injuries related to NSAID,30 patients were associated with single-preparation NSAID and 6 patients were associated with compound-preparation. The ROR levels and their 95% CI of single-preparation NSAID,compound-preparation NSAID,and general NSAID were respectively 1. 78 (1. 22-2. 61),1. 80(0. 78-4. 15),and 1. 76(1. 24-2. 51). Both of the lower limits of 95% CI of live injuries related to single-preparation NSAID and general NSAID were higher than 1 and there were ADR signals. Thirty-seven kinds of drugs were involved by 35 cases of liver injuries. Of them,the ROR levels and their 95% CI of single-preparation parecoxib, single-preparation aspirin, compound-preparation ibuprofen and pseudoephedrine,and compound-preparation parace-tamol and amantadine hydrochloride were respectively 8. 00(2. 03-27. 78),2. 45(1. 43-4. 21),22. 00(1. 40-359. 32),and 11. 22(1. 02-123. 94) and there were ADR signals. Conclusions Attention should be paid to liver injuries related to NSAID. The method of ROR can help analyze ADR signals and provide useful early-warning of drug safety.

Objective To analyze risk signals of liver injuries related to nonsteroidal anti-inflammatory drugs( NSAID)and application of reporting odds ratio( ROR)in data mining. Methods A search of adverse drug reaction( ADR ) reports in Beijing of national monitoring system of adverse drug reaction from January 1st 2013 to December 31st 2013 was conducted using keywords "liver" and "gallbladder" . Of these filtered reports,the cases whose causal relationship of drugs and liver injuries was judged as"positive","likely",or "possible" were enrolled into liver injury group and the rest cases were all enrolled into non-liver injury group. Using NSAID as the target drugs and the other drugs as non-target, ROR and its 95% confidence interval( CI)of liver injuries related to NSAID were calculated according to formula of ROR. The lower limit of 95% CI >1 was regarded as suggestive of ADR signal. Results After removing duplication,14 657 patients were enrolled in the study,which comprised liver injury group 626 patients including 35 cases of liver injuries due to NSAID and non-liver injury group 14 031 patients. Of the 35 patients with liver injuries related to NSAID,30 patients were associated with single-preparation NSAID and 6 patients were associated with compound-preparation. The ROR levels and their 95% CI of single-preparation NSAID,compound-preparation NSAID,and general NSAID were respectively 1. 78 (1. 22-2. 61),1. 80(0. 78-4. 15),and 1. 76(1. 24-2. 51). Both of the lower limits of 95% CI of live injuries related to single-preparation NSAID and general NSAID were higher than 1 and there were ADR signals. Thirty-seven kinds of drugs were involved by 35 cases of liver injuries. Of them,the ROR levels and their 95% CI of single-preparation parecoxib, single-preparation aspirin, compound-preparation ibuprofen and pseudoephedrine,and compound-preparation parace-tamol and amantadine hydrochloride were respectively 8. 00(2. 03-27. 78),2. 45(1. 43-4. 21),22. 00(1. 40-359. 32),and 11. 22(1. 02-123. 94) and there were ADR signals. Conclusions Attention should be paid to liver injuries related to NSAID. The method of ROR can help analyze ADR signals and provide useful early-warning of drug safety.