Objective To evaluate the left ventricular systolic function of patients with type 2 diabetes mellitus(T2DM)combined with renal insufficiency(CKD)by applying automated myocardial motion quantifica-tion(aCMQ)and to investigate its correlation with clinical biochemical indexes.Methods 80 patients with T2DM were enrolled,divided into DM group(without CKD,n=40)and DN group(with CKD,n=40),and 40 healthy volunteers were selected as the control group.The general clinical data of all subjects were recorded,and routine echocardiography and aCMQ were performed to obtain routine ultrasonographic measurements and aCMQ-related parameters.Results Comparison of aCMQ-related parameters:The differences in LV global longitudinal strain(LVGLS),LV apical 2-chamber longitudinal strain(LVAP2LS),LV apical 3-chamber longitudinal strain(LVAP3LS),and LV apical 4-chamber longitudinal strain(LVAP4LS)among the three groups were all statistically significant(P<0.05).The differences in LV global circumferential strain(LVGCS)between the DN group and the other two groups were statistically significant(P<0.05).The differences in LV short-axis basal segment cyclic strain(LVSAXBCS),LV short-axis middle segment cyclic strain(LVSAXMCS),and LV short-axis apical segment cyclic strain(LVSAXACS)were not statistically significant(P>0.05).LV strain was negatively correlated with Hs-CRP,GA,HbA1c,creatinine,urea,and uric acid,and positively correlated with eGFR.Correlation.High-sensitivity C-reactive protein(Hs-CRP),glycated albumin(GA)and eGFR showed good correlation with LV strain parameters.Conclusion The aCMQ technique can detect the deterioration of left ventricular function in patients with type 2 diabetes mellitus combined with renal insufficiency at an early stage,and the correlation between left ventricular strain parameters and hs-CRP,GA and eGFR can help to better assess their cardiac involvement.

Objective:To explore the application effects of continuous and intermittent suturing of blood vessels under microscope in the repair of limb vascular injuries.Methods:A total of 110 patients with limb vascular injuries admitted to Kaifeng 155 Hospital from Feb 2023 to May 2024 were selected as the research subjects.According to the different methods of vascular suturing,they were divided into two groups,55 patients who underwent intermittent suturing of blood vessels under microscope were selected as the control group,while 55 patients who underwent continuous suturing of blood vessels under microscope were selected as the observation group.The perioperative indicators(arterial and venous suture time,blood circulation recovery time,hospitalization time,total blood loss),blood electrolyte levels(serum potassium ion,sodium ion,and plasma carbon dioxide binding capacity),and coagulation function indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)]before surgery,2 h and 1 d after surgery,and the incidence of complications were compared between the two groups.Results:The perioperative related indicators in the observation group were better than those in the control group(P＜0.05).The serum potassium ion,sodium ion,plasma carbon dioxide binding capacity,PT,APTT and TT in the two groups at 2 h and 1 d after operation were significantly higher than those before operation(P＜0.05).And these indicators in the observation group at 2 h after surgery were significantly higher than those in the control group(P＜0.05).However,there was no statistically significant difference in the levels of these indicators between the two groups before surgery and at 1 d after surgery(P＞0.05).The incidence of complications in the observation group was significantly lower than that in the control group(P＜0.05).Conclusion:In the repair of limb vascular injuries,continuous suturing of blood vessels under microscope can effectively shorten the time of vascular suture,reduce blood loss,improve coagulation function and blood electrolyte level,promote postoperative recovery,improve limb motor function,and reduce complications.

Objective To evaluate the impact of Jixiong Jiedu decoction on the efficacy of diabetic kidney disease in mice and its influence on intestinal flora and trimethylamine oxide(TMAO)levels.Methods Twelve 7-week-old male db/db mice were randomly assigned to the model group or Jixiong Jiedu decoction group(6 mice per group),while 6 male db/m mice were designated as the control group.Following 8 weeks of continuous gavage,we monitored the body weight and blood glucose levels of the mice at weeks 0,4,and 8.Additionally,we assessed urinary microalbumin,kidney injury molecule-1(KIM-1),creatinine(Scr),and urea nitrogen(BUN)levels in urine.Renal pathology was evaluated using HE and PAS staining.Furthermore,fecal samples underwent 16s RNA sequencing,and the serum TMAO levels were determined.Results Compared with the control group,the blood glucose,body weight,8-hour urinary microalbumin,KIM-1 and Scr in the model group were significantly increased,and the renal pathology showed that glomerular segmental mesangial matrix increased,glomerular volume hypertrophy and renal tubular epithelial cell swelling.The abundance of Lactobacillaceae and Lactobacillus in the model group was significantly increased(P<0.01).The abundance of Lachnospiraceae,Helicobacter and Oscillospira decreased significantly(P<0.01),the abundance of each bacterial group changed,and the serum TMAO content increased significantly.Compared with the model group,the 8h urinary microalbumin,KIM-1(P<0.01)and Scr(P<0.05)in the Jixiong Jiedu decoction group were significantly decreased,and there was no significant difference in BUN(P>0.05),and the renal pathological damage was significantly improved.The abundance of Lactobacillaceae and Lactobacillus in intestinal flora decreased significantly(P<0.01),while the abundance of Lachnospiraceae and Oscillospira increased significantly(P<0.01,P<0.05).The structure of gut microbiota,the abundance of dominant and non-dominant bacteria were positively adjusted,and the serum TMAO content was significantly decreased(P<0.01).Conclusion Jixiong Jiedu decoction effectively ameliorates intestinal flora disorders in db/db mice and regulates serum TMAO levels,thereby exerting a nephroprotective effect.

Objective:To investigate the optimization of inferior vena cava imaging using dual-layer spectral detector CT (DLCT) virtual monoenergetic images (VMI) combined with multiphase scanning.Methods:A retrospective analysis was conducted on the imaging data of 184 patients who underwent inferior vena cava imaging using dual-layer detector spectral CT at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2021 to October 2024. Each patient underwent multiphase scanning (60, 80, and 120 s after contrast injection were referred to as the first, second, and third phases, respectively). The images were reconstructed into conventional 120 kVp polyenergetic image (PI) and VMIs at 40, 50, 60, 70, and 80 keV. Image quality of 120 kVp PI and VMI for each phase was evaluated. The objective image quality indicators included CT value, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and noise. Comparisons of the above indictors within the same phase were performed using repeated measures ANOVA or the Friedman test, while comparisons between different phases were conducted using one-way ANOVA or the Kruskal-Wallis test.Results:At the same phase, the CT value, SNR, and CNR of the 40 keV VMI were higher than those of other energy level VMIs and PI (all P<0.001). The SNR of the 40 keV VMI in the third phase was significantly higher than in the first phase ( P<0.05), while there was no significant difference between the first and second phases ( P>0.05). The standard deviation (SD) of the 40 keV VMI in the third phase was significantly lower than that in the first and second phases (all P<0.05). The subjective scores for the 40 keV VMI were higher than those for other energy level VMIs and PI at the same phase ( P<0.001). The subjective scores for the 40 keV VMI in the third phase were higher than those in the second and first phases ( P<0.001). The percentage of scores≥4 in the third phase (77.17%,142/184) was significantly higher than those in the first phase (28.26%,52/184) and second phase (61.96%,114/184) ( P<0.001). Conclusion:In inferior vena cava imaging, the 40 keV VMI, combined with the optimal phase (120 s delay), effectively optimizes image quality.

Objective To evaluate the value of left ventricular(LV)systolic function impairment in patients with different activity levels of systemic lupus erythematosus(SLE)by applying automatic myocardial motion quantification(aCMQ)technique,and to explore the correlation between left ventricular strain parameters and clinical laboratory indexes,systemic lupus erythematosus disease activity index(SLEDAI).Methods A total of 80 patients diagnosed with SLE from November 2023 to August 2024 in the First Afticiated Hospital of Jinzhou Medical University were selected and divided into two groups:40 cases with SLEDAI＜10points were in mild lupus group,34 cases with SLEDAI ≥ 10points were in moderately severe lupus group.Forty healthy volunteers for physical examination at the same time were randomly selected as control group,relevant parameters were obtained by conventional echocardiography and aCMQ technique respectively.Results aCMQ technique related parameters were compared,and the differences in left ventricular global longitudinal strain(LVGLS),apical two-chamber longitudinal strain(AP2LS),apical three-chamber longitudinal strain(AP3LS),and apical four-chamber longitudinal strain(AP4LS)were statistically significant in all three groups(P＜0.05).The differences in left ventricular global circumferential strain(LVGCS)in lupus moderate-severe group were statistically significant when compared with other two groups(P＜0.05),Pearson correlation analysis showed LVGLS,AP2LS,AP3LS,AP4LS and LVGCS were positively correlated with complement 3 and complement 4,and negatively correlated with anticardiolipin antibody(ACA)IgA,IgG,IgM,and sedimentation,and ultrasensitive C-reactive protein,and the SLEDAI was correlated with LVGLS,AP2LS,AP3LS,AP4LS were negatively correlated,and there was no significant correlation with LVGCS.Conclusion aCMQ technique can detect changes in LV systolic function in SLE patients at an early stage,and the impairment of LV systolic function is more severe with higher disease activity.Better correlation between LV strain parameters and clinical laboratory indexes and SLED AI may help to better assess cardiac involvement in SLE patients.

Objective:To explore the application effects of continuous and intermittent suturing of blood vessels under microscope in the repair of limb vascular injuries.Methods:A total of 110 patients with limb vascular injuries admitted to Kaifeng 155 Hospital from Feb 2023 to May 2024 were selected as the research subjects.According to the different methods of vascular suturing,they were divided into two groups,55 patients who underwent intermittent suturing of blood vessels under microscope were selected as the control group,while 55 patients who underwent continuous suturing of blood vessels under microscope were selected as the observation group.The perioperative indicators(arterial and venous suture time,blood circulation recovery time,hospitalization time,total blood loss),blood electrolyte levels(serum potassium ion,sodium ion,and plasma carbon dioxide binding capacity),and coagulation function indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)]before surgery,2 h and 1 d after surgery,and the incidence of complications were compared between the two groups.Results:The perioperative related indicators in the observation group were better than those in the control group(P＜0.05).The serum potassium ion,sodium ion,plasma carbon dioxide binding capacity,PT,APTT and TT in the two groups at 2 h and 1 d after operation were significantly higher than those before operation(P＜0.05).And these indicators in the observation group at 2 h after surgery were significantly higher than those in the control group(P＜0.05).However,there was no statistically significant difference in the levels of these indicators between the two groups before surgery and at 1 d after surgery(P＞0.05).The incidence of complications in the observation group was significantly lower than that in the control group(P＜0.05).Conclusion:In the repair of limb vascular injuries,continuous suturing of blood vessels under microscope can effectively shorten the time of vascular suture,reduce blood loss,improve coagulation function and blood electrolyte level,promote postoperative recovery,improve limb motor function,and reduce complications.

Objective To evaluate the impact of Jixiong Jiedu decoction on the efficacy of diabetic kidney disease in mice and its influence on intestinal flora and trimethylamine oxide(TMAO)levels.Methods Twelve 7-week-old male db/db mice were randomly assigned to the model group or Jixiong Jiedu decoction group(6 mice per group),while 6 male db/m mice were designated as the control group.Following 8 weeks of continuous gavage,we monitored the body weight and blood glucose levels of the mice at weeks 0,4,and 8.Additionally,we assessed urinary microalbumin,kidney injury molecule-1(KIM-1),creatinine(Scr),and urea nitrogen(BUN)levels in urine.Renal pathology was evaluated using HE and PAS staining.Furthermore,fecal samples underwent 16s RNA sequencing,and the serum TMAO levels were determined.Results Compared with the control group,the blood glucose,body weight,8-hour urinary microalbumin,KIM-1 and Scr in the model group were significantly increased,and the renal pathology showed that glomerular segmental mesangial matrix increased,glomerular volume hypertrophy and renal tubular epithelial cell swelling.The abundance of Lactobacillaceae and Lactobacillus in the model group was significantly increased(P<0.01).The abundance of Lachnospiraceae,Helicobacter and Oscillospira decreased significantly(P<0.01),the abundance of each bacterial group changed,and the serum TMAO content increased significantly.Compared with the model group,the 8h urinary microalbumin,KIM-1(P<0.01)and Scr(P<0.05)in the Jixiong Jiedu decoction group were significantly decreased,and there was no significant difference in BUN(P>0.05),and the renal pathological damage was significantly improved.The abundance of Lactobacillaceae and Lactobacillus in intestinal flora decreased significantly(P<0.01),while the abundance of Lachnospiraceae and Oscillospira increased significantly(P<0.01,P<0.05).The structure of gut microbiota,the abundance of dominant and non-dominant bacteria were positively adjusted,and the serum TMAO content was significantly decreased(P<0.01).Conclusion Jixiong Jiedu decoction effectively ameliorates intestinal flora disorders in db/db mice and regulates serum TMAO levels,thereby exerting a nephroprotective effect.

Objective:To investigate the optimization of inferior vena cava imaging using dual-layer spectral detector CT (DLCT) virtual monoenergetic images (VMI) combined with multiphase scanning.Methods:A retrospective analysis was conducted on the imaging data of 184 patients who underwent inferior vena cava imaging using dual-layer detector spectral CT at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2021 to October 2024. Each patient underwent multiphase scanning (60, 80, and 120 s after contrast injection were referred to as the first, second, and third phases, respectively). The images were reconstructed into conventional 120 kVp polyenergetic image (PI) and VMIs at 40, 50, 60, 70, and 80 keV. Image quality of 120 kVp PI and VMI for each phase was evaluated. The objective image quality indicators included CT value, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and noise. Comparisons of the above indictors within the same phase were performed using repeated measures ANOVA or the Friedman test, while comparisons between different phases were conducted using one-way ANOVA or the Kruskal-Wallis test.Results:At the same phase, the CT value, SNR, and CNR of the 40 keV VMI were higher than those of other energy level VMIs and PI (all P<0.001). The SNR of the 40 keV VMI in the third phase was significantly higher than in the first phase ( P<0.05), while there was no significant difference between the first and second phases ( P>0.05). The standard deviation (SD) of the 40 keV VMI in the third phase was significantly lower than that in the first and second phases (all P<0.05). The subjective scores for the 40 keV VMI were higher than those for other energy level VMIs and PI at the same phase ( P<0.001). The subjective scores for the 40 keV VMI in the third phase were higher than those in the second and first phases ( P<0.001). The percentage of scores≥4 in the third phase (77.17%,142/184) was significantly higher than those in the first phase (28.26%,52/184) and second phase (61.96%,114/184) ( P<0.001). Conclusion:In inferior vena cava imaging, the 40 keV VMI, combined with the optimal phase (120 s delay), effectively optimizes image quality.

Objective To evaluate the value of left ventricular(LV)systolic function impairment in patients with different activity levels of systemic lupus erythematosus(SLE)by applying automatic myocardial motion quantification(aCMQ)technique,and to explore the correlation between left ventricular strain parameters and clinical laboratory indexes,systemic lupus erythematosus disease activity index(SLEDAI).Methods A total of 80 patients diagnosed with SLE from November 2023 to August 2024 in the First Afticiated Hospital of Jinzhou Medical University were selected and divided into two groups:40 cases with SLEDAI＜10points were in mild lupus group,34 cases with SLEDAI ≥ 10points were in moderately severe lupus group.Forty healthy volunteers for physical examination at the same time were randomly selected as control group,relevant parameters were obtained by conventional echocardiography and aCMQ technique respectively.Results aCMQ technique related parameters were compared,and the differences in left ventricular global longitudinal strain(LVGLS),apical two-chamber longitudinal strain(AP2LS),apical three-chamber longitudinal strain(AP3LS),and apical four-chamber longitudinal strain(AP4LS)were statistically significant in all three groups(P＜0.05).The differences in left ventricular global circumferential strain(LVGCS)in lupus moderate-severe group were statistically significant when compared with other two groups(P＜0.05),Pearson correlation analysis showed LVGLS,AP2LS,AP3LS,AP4LS and LVGCS were positively correlated with complement 3 and complement 4,and negatively correlated with anticardiolipin antibody(ACA)IgA,IgG,IgM,and sedimentation,and ultrasensitive C-reactive protein,and the SLEDAI was correlated with LVGLS,AP2LS,AP3LS,AP4LS were negatively correlated,and there was no significant correlation with LVGCS.Conclusion aCMQ technique can detect changes in LV systolic function in SLE patients at an early stage,and the impairment of LV systolic function is more severe with higher disease activity.Better correlation between LV strain parameters and clinical laboratory indexes and SLED AI may help to better assess cardiac involvement in SLE patients.

Objective To evaluate the left ventricular systolic function of patients with type 2 diabetes mellitus(T2DM)combined with renal insufficiency(CKD)by applying automated myocardial motion quantifica-tion(aCMQ)and to investigate its correlation with clinical biochemical indexes.Methods 80 patients with T2DM were enrolled,divided into DM group(without CKD,n=40)and DN group(with CKD,n=40),and 40 healthy volunteers were selected as the control group.The general clinical data of all subjects were recorded,and routine echocardiography and aCMQ were performed to obtain routine ultrasonographic measurements and aCMQ-related parameters.Results Comparison of aCMQ-related parameters:The differences in LV global longitudinal strain(LVGLS),LV apical 2-chamber longitudinal strain(LVAP2LS),LV apical 3-chamber longitudinal strain(LVAP3LS),and LV apical 4-chamber longitudinal strain(LVAP4LS)among the three groups were all statistically significant(P<0.05).The differences in LV global circumferential strain(LVGCS)between the DN group and the other two groups were statistically significant(P<0.05).The differences in LV short-axis basal segment cyclic strain(LVSAXBCS),LV short-axis middle segment cyclic strain(LVSAXMCS),and LV short-axis apical segment cyclic strain(LVSAXACS)were not statistically significant(P>0.05).LV strain was negatively correlated with Hs-CRP,GA,HbA1c,creatinine,urea,and uric acid,and positively correlated with eGFR.Correlation.High-sensitivity C-reactive protein(Hs-CRP),glycated albumin(GA)and eGFR showed good correlation with LV strain parameters.Conclusion The aCMQ technique can detect the deterioration of left ventricular function in patients with type 2 diabetes mellitus combined with renal insufficiency at an early stage,and the correlation between left ventricular strain parameters and hs-CRP,GA and eGFR can help to better assess their cardiac involvement.