Objective:To investigate the relationship between the changes of electrocardiogram QRS duration features and the occurrence of adverse cardiac events in patients with heart failure.Methods:The clinical data of 298 patients with heart failure who received treatment in Lishui City People's Hospital from June 2021 to June 2022 were retrospectively analyzed. According to the type of heart failure, they were divided into the diastolic heart failure group ( n = 158) and the systolic heart failure group ( n= 140). According to whether having cardiac events, they were divided into a cardiac event group ( n = 97) and a non-cardiac event group ( n = 201) group. An additional 120 patients who concurrently received health examinations were included in the control group. QRS wave duration and cardiac function indicators were analyzed. QRS wave duration and cardiac function indicators were compared between heart failure and control groups. Changes in QRS wave duration and cardiac function indicators were compared between diastolic heart failure and systolic heart failure groups. Changes in QRS wave duration and cardiac function indicators were compared between cardiac event and non-cardiac event groups. The value of the receiver operating characteristic curve in predicting adverse cardiac events was analyzed. Pearson correlation analysis was performed to analyze the correlation between QRS wave duration and cardiac function. Results:QRS wave duration in the heart failure group was (125.42 ± 14.35) ms, which was significantly longer than (78.82 ± 6.49) ms in the control group ( t = 34.17, P < 0.001). Left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) in the heart failure group were (156.24 ± 21.42) mL and (78.28 ± 9.43) mL, respectively, which were significantly higher than (107.48 ± 19.23) mL and (45.62 ± 5.42) mL, respectively in the control group ( t = 21.66, 35.63, both P < 0.01). Left ventricular ejection fraction (LVEF) in the heart failure group was (46.98 ± 4.25)%, which was significantly lower than (67.94 ± 5.46)% in the control group ( t = 41.88, P < 0.001). QRS wave duration in the systolic heart failure group was (140.21 ± 18.57) ms, which was significantly longer than (112.31 ± 13.42) ms in the diastolic heart failure group ( t = 16.29, P < 0.001). LVESV and LVEDV in the systolic heart failure group were (183.36 ± 27.67) mL and (95.39 ± 12.13) mL, respectively, which were significantly higher than (132.21 ± 18.98) mL and (63.12 ± 7.84) mL in the diastolic heart failure group ( t = 20.30, 29.61, both P < 0.001). LVEF in the systolic heart failure group was (38.19 ± 4.61)%, which was significantly lower than (54.77 ± 4.92)% in the diastolic heart failure group ( t = 34.18, P < 0.001). QRS wave duration in the cardiac event group was (169.37 ± 17.43) ms, which was significantly longer than (104.21 ± 12.49) ms in the non-cardiac event group ( t = 36.91, P < 0.001). LVESV and LVEDV in the cardiac event group were (199.30 ± 23.41) mL and (105.22 ± 15.64) mL, respectively which were significantly higher than (135.46 ± 15.46) mL and (65.28 ± 6.92) mL in the non-cardiac event group ( t = 28.04, 30.57, both P < 0.001). LVEF in the cardiac event group was (32.97 ± 5.16)%, which was significantly lower than (53.74 ± 4.52)% in the non-cardiac event group ( t = 35.46, P < 0.001). The receiver operating characteristic curve analysis showed that the sensitivity and specificity of QRS wave duration in predicting adverse cardiac events were 88.7% and 86.6%, respectively. Pearson analysis showed that QRS wave duration, LVESV, and LVEDV were positively correlated with the occurrence of adverse cardiac events ( r = 0.684, 0.546, 0.518, all P < 0.05), while LVEF was negatively correlated with the occurrence of adverse cardiac events ( r = -0.627, P < 0.05). Conclusion:QRS wave duration in patients with heart failure is significantly prolonged, and it is obviously related to the occurrence of adverse cardiac events.

PurposeTo evaluate the significance of ultrasonic elastography strain ratio, MRI and the combination of both in diagnosis of breast tumor.Materials and MethodsFifty-four cases with single breast tumor underwent preoperative ultrasound elasticity imaging and MRI. Accuracy of ultrasound elastography strain rate ratio (SRR) of the tumor and surrounding normal breast tissue was measured by quantitative ultrasound elastography, and its combination with MRI were analyzed. ResultsThere was signiifcant differences on SRR between the benign group and the malignant group (2.24±1.28vs 4.96±1.73, t=2.648,P<0.05). Optimal threshold of ultrasonic elastography SRR in differential diagnosis of breast benign from malignant tumor was 2.41 determined by ROC curve. The accuracy of SRR, MRI and the combination of both in differentiating benign from malignant breast tumor was 81.48% (44/54), 85.19% (46/54) and 96.30%(52/54), respectively. There was no statistic difference between SRR and MRI in diagnostic accuracy (χ2=0.267,P>0.05). Combined both had higher diagnosis accuracy when compared with SR and MRI separately (χ2=6.000 and 3.967,P<0.05).Conclusion Ultrasonic elastography strain ratio is accurate and objective in differentiating benign from malignant breast tumors. It is a valuable quantitative index in clinical practice. Moreover, SRR combined with MRI can reduce the misdiagnosis rate.

Objective To explore the clinical curative effect of pidotimod on patients with respiratory tract infection and effect on immune function. Methods 120 children with recurrent respiratory tract infection in the Third Hospital of Qinhuangdao,the Third Staff Hospital of Baogang Group,the Third Hospital of Wulanchabu were selected,and were divided into two groups according to random number table.60 cases in control group were treated with routine treatment of anti-infection,relieving cough,eliminating phlegm,antipyretic;60 cases in experimental group were treated with pidotimod on the basis of routine treatment,oral with boiled water,0.4g per times,2 times a day,with a course of 60 days.Clinical curative effect after treatment and serum immunoglobulin (IgG,IgA,IgM)levels,T lymphocyte subsets (CD3+,CD4+,CD8+)levels and NK cells relative activities before and after treatment were compared between two groups.Results After treatment,the total effective rate of experimental group (95.00%)was significantly higher than that of control group (81.67%),and the difference was statistically significant (P<0.05);the immune indexes before treatment had no significant difference,and levels of serum immunoglobulin and T lymphocyte subsets were improved,and levels of serum immunoglobulin (IgG,IgA,IgM)and T lymphocyte subsets (CD3+,CD4+,CD8+)of experimental group were more higher than those of control group,and the difference was statistically significant (P<0.05 );relative activity of NK cells in both groups improved after treatment,but relative activity of NK cells in experimental group was significantly higher than that in control group,and the difference was statistically significant (P<0.05 );adverse reactions according minor rashes and anemia were observed in two groups,and there was no significant differece in the incidence of adverse reactions,and ADR was tolerable after symptomatic treatment.Conclusion Pidotimod could significantly improve the clinical curative effect of patients with respiratory tract infections and effectively improve the immune function of patients with recurrent respiratory tract infections with high security,which has a clinical significance.