Objective  To investigate the mechanism of microRNA (miRNA)-145 regulation of EPS15 mediated cellular autophagy involved in the occurrence of atrial fibrillation (AF), and to find the potential biomarkers during the development of AF providing new ideas for the prevention and treatment of AF. Methods  The right atrial appendage tissues were collected from 58 patients undergoing valve replacement surgery due to rheumatic heart disease. These patients were divided into sinus rhythm (SR) group (16 cases) and AF group (42 cases). The rat model of AF was constructed by tail vein injection of Ach-CaCl2 mixture solution, while normal saline was injected as the SR group. We detected the expression levels of miRNA-145 in the right atrial appendage tissues of patients and the atrium of the rats in the two groups, as well as the RNA and protein expression levels of EPS15, Cx43, LC3 and p62. The in vitro autophagy model was established, in order to explore the mechanism of miRNA-145 targeted regulation of EPS15 mediated cellular autophagy involved in the occurrence of AF.Results  The relative expression levels of RNA, and protein of miRNA-145 and Cx43 in the right atrial appendage of patients in the SR group and in the atrium of rats in the SR group were separately higher than those of patients in the AF group and rats in the AF group (all P<0.05), while the relative expression levels of RNA and protein of EPS15 were separately lower than those of patients in the AF group and rats in the AF group (all P<0.05). In vitro experiment results showed that miRNA-145 could regulate the degree of autophagy of H9c2 cells through EPS15 (P<0.05).  Conclusion  MiRNA-145 participates in the occurrence of AF by regulating EPS15 mediated autophagy, which is manifested by significantly down-regulated miRNA-145, up-regulated EPS15, enhanced autophagy and degraded Cx43.

Objective  To investigate the ECG signs and their diagnostic value in patients with non-ST-segment elevation myocardial infarction (NSTEMI) complicating culprit vessel occlusion. Methods  A total of 113 NSTEMI patients were selected, and divided into vascular occlusion group (50 cases) and non-vascular occlusion group (63 cases) according to the presence or absence of vascular occlusion. We analyzed the ECG signs of patients in the two groups, including the number of leads with ST-segment depression (STD), the maximum value of STD (STDmax), the amplitude of ST-segment in lead aVF, aVR and aVL, and the proportion of patients with pathological Q-wave, isolated STD and poor R-wave progression. We also analyzed the coronary angiography features ［the left anterior descending branch (LAD), left circumflex branch (LCX), right coronary artery (RCA), and others］. ROC curve analysis was used to explore the diagnostic value of ECG parameters for NSTEMI with culprit vessel occlusion. Results  The sex, age, time of onset, diabetes and other general data did not vary signifiantly between the two groups (all P>0.05). There were statistically significant differences in the proportion of hypertension, hyperlipidemia and culprit vessels between the two groups (all P<0.05). Compared with the non-vascular occlusion group, the number of STD leads, STDmax, the amplitude of ST-segment in lead aVF and aVR, and the proportion of patients with pathological Q-wave or isolated STD in the vascular occlusion group were greater, all with statistically significant differences (all P<0.05). The AUC values of the number of STD leads, STDmax, the amplitude of ST-segment in lead aVF, the amplitude of ST-segment in lead aVR, and the combined examination in the diagnosis of NSTEMI with culprit vessel occlusion were 0.662 (0.560-0.764), 0.814 (0.734-0.893), 0.691 (0.594-0.788), 0.673 (0.572-0.774) and 0.864 (0.799-0.929), respectively; the sensitivity was 58.00%, 84.00%, 88.00%, 70.00% and 92.00%, respectively; the specificity was 68.30%, 73.00%, 54.00%, 63.50% and 69.80%, respectively. Conclusion  Among the NSTEMI patients with culprit vessel occlusion, the number of STD leads was greater, while the proportion of patients with pathological Q-wave or isolated STD was higher. The sensitivity of the combined ECG signs is relatively high in the diagnosis of NSTEMI with culprit vessel occlusion, which could provide important references for the detection, diagnosis and treatment of NSTEMI with culprit vessel occlusion in clinical practice.

Objective  To evaluate the efficacy of radiofrequency ablation and antiarrhythmic drugs (AADs) therapy in patients with atrial fibrillation (AF) recurrence after cryoablation of AF. Methods  Non-valvular AF patients who had relapsed after cryoablation and met the inclusion criteria were selected. According to different treatment strategies, they were divided into ablation group (n=28) and AADs group (n=37). Propensity score matching analysis was used, and 28 cases were selected from each group for the final analysis of therapeutical effect. Results  The ablation group had significantly lower incidence rates of AF-related rehospitalization, anticoagulant use, and AADs use than those of the AADs group. During follow-up, there was significant reduction in the long and short axis of the right atrium in the ablation group, and the improvement of cardiac remodeling was more obvious in the ablation-sinus rhythm group. In addition, compared with those before operation, the severity of mitral and tricuspid regurgitation were significantly reduced in the ablation group, while the physical and mental health status were both improved. Conclusion  Compared with AADs therapy, re-ablation can significantly reduce the risk of occurrence of clinical endpoint events including recurrent AF, AF-related rehospitalization, and the use of anticoagulant and AADs. Additionally, this treatment significantly improves cardiac remodeling and valve regurgitation due to AF recurrence, and has a positive impact on the physical and psychological status of the patients.

Objective  To explore the interaction of neutrophil to lymphocyte ratio (NLR) and fasting blood glucose (FBG) with the prognosis of acute myocardial infarction (AMI) patients. Methods  A total of 436 patients diagnosed with AMI were included. They were followed up through clinic or telephone contact for a period of 48(45, 53) months. The effect of NLR and FBG on cardiac mortality was investigated respectively, and their additive and multiplicative interaction on cardiac mortality were calculated. Results  During the follow-up, 26 patients (6.0%) had cardiac mortality. There was no multiplicative interaction between NLR and FBG, however, the positive additive interaction on cardiac mortality was observed. The synergetic index showed that the risk of cardiac death exposed to these two risk factors at the same time was 5.894 times of the sum of the cardiac death risk exposed to either of the two risk factors alone (P<0.05). Attributable proportion showed that 77.9% of cardiac death could be attributed to the interaction between NLR and FBG (P<0.05). It indicated that the influence of concurrent high NLR and high FBG was greater than that of either of the two risk factors alone. Conclusion  High NLR and high FBG have a positive synergistic effect, providing additional information for the prognosis identification of AMI patients.

Objective  To investigate the correlationship between 25 hydroxyvitamin D ［25-(OH)D］ level and insulin resistance in patients with type 2 diabetes mellitus (T2DM) complicating left ventricular diastolic dysfunction (LVDD). Methods  A total of 109 T2DM inpatients with LVDD were selected, and divided into two groups according to the serum 25-(OH)D level: G1 group (insufficient or deficient) ［25-(OH)D<20 ng/mL, n=64］, and G2 group (normal) ［25-(OH)D≥20 ng/mL, n=45］. The general data and biochemical indexes were compared between the two groups; the correlationship between 25-(OH)D level, and other indexes and homeostatic model assessment of insulin resistance (HOMA-IR) was analyzed. Results  The disease course of diabetes mellitus, fasting blood glucose (FBG), LDL-C, TC, TG and A/C in the G1 group were significantly higher than those in the G2 group, while HDL-C and estimated glomerular filtration rate (eGFR) in the G1 group were significantly lower than those in the G2 group (all P<0.05). Spearman correlation analysis showed that 25-(OH)D was negatively correlated with course of disease, HbA1c, TC, TG, LDL-C and HOMA-IR, while it was positive correlated with HDL-C and eGFR. The level of 25-(OH)D in T2DM patients was negatively related with HOMA-IR (P<0.01). Conclusion  The level of 25-(OH)D is correlated with HOMA-IR in T2DM patients complicating LVDD. Appropriate supplementation of exogenous vitamin D could improve the degree of insulin resistance in these patients.

Objective  To investigate the effect of nicotinamide injection combined with bisoprolol on cardiac function and oxidative stress response in patients with acute myocardial infarction (AMI). Methods  A retrospective study was conducted on 97 patients with AMI who had undergone percutaneous coronary intervention. These patients were divided into control group (n=47) and combination group (n=50) based on different treatment methods. The control group was treated with bisoprolol, while the combination group was treated with nicotinamide combined with bisoprolol. The two groups were continuously treated for 2 weeks. The clinical efficacy, and total incidence of adverse reactions were compared between the two groups, as well as cardiac function indicators ［ejection fraction, cardiac index, left ventricular end-diastolic volume (LEDV) and left ventricular end-systolic volume (LESV)］, oxidative stress response indicators ［malondialdehyde (MDA) and superoxide dismutase (SOD)］, serum indicators ［NT-proBNP, cTn I, endothelin and CK-MB］ before and after the treatment. ResultsThe total clinical efficacy rate of the combination group was higher than that of the control group (P<0.05); there was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). After treatment, the cardiac function indicators of ejection fraction, cardiac index, LEDV, and LESV in the combination group were all higher than those in the control group (all P<0.01); the level of the oxidative stress response indicator of MDA was lower than that in the control group, while SOD level was higher (P<0.01). After treatment, the levels of the serum indicators of NT-proBNP, cTn I, endothelin, and CK-MB all reduced in both groups, with greater reduction amplitude in the combination group (P<0.05). Conclusion  The treatment regimen of nicotinamide injection combined with bisoprolol for patients with AMI is safe and effective, which could significantly improve cardiac function, reduce oxidative stress response, and alleviate myocardial injury.

Objective  To explore the effect of sodium phosphocreatine combined with levocarnitine on patients with viral myocarditis (VMC). Methods  A prospective study was conducted on 96 patients with VMC. They were randomly divided into a control group and an observation group by using the random number table method, each with 48 cases. Among them, the control group was given levocarnitine, while the observation group was given sodium phosphocreatine combined with levocarnitine. Both groups were continuously treated for two weeks. The clinical efficacy and adverse reaction rates between the two groups were compared, as well as the levels of myocardial enzyme spectrum markers ［creatine phosphokinase (CK) and creatine kinase MB (CK-MB)］, relevant serum factors ［tumor necrosis factor (TNF)-α, C-reactive protein (CRP) and interleukin (IL)-6］, and oxidative stress indicators ［malondialdehyde (MDA), advanced oxidation protein products (AOPP) and superoxide dismutase (SOD)］ before and after treatment. Results  The difference of the total clinical effective rate was statistically significant between the two groups (P<0.05). The improvement of myocardial enzyme spectrum, related serum factors, and oxidative stress indicators in the observation group after treatment was all superior to that in the control group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion  The combination of sodium phosphocreatine and levocarnitine has a significant therapeutic effect on VMC, which could regulate myocardial enzyme spectrum, improve oxidative stress response, and inhibit inflammatory response in vivo with relatively high safety.

Objective  To investigate the therapeutic effect and safety of nicorandil combined with metoprolol succinate for treating patients with coronary heart disease angina pectoris. Methods  We retrospectively selected 196 patients with coronary heart disease angina pectoris as research subjects. They were divided into control group (n=98, treated with metoprolol succinate), and observation group (n=98, treated with nicorandil and metoprolol succinate) according to different treatment plans. Both groups received continuous medication for 8 weeks. We compared the clinical efficacy, incidence of adverse reactions, and the attacks of angina pectoris (its duration and frequency), heart rate and blood pressure, hemorheology indexes ［fibrinogen (FIB), low-shear whole blood viscosity (LWBV), plasma viscosity (PV) and high-shear whole blood viscosity (HWBV)］ and serum inflammatory mediators ［nuclear factor-κB (NF-κB), interleukin-18 (IL-18), high-sensitivity C-reactive protein (hs-CRP) and chitinase-3-like protein 1 (CHI3L1, also known as YKL-40)］ levels before and after treatment between the two groups. Results  The total effective rate of the observation group was higher than that of the control group (P<0.05). Compared with the control group, patients in the observation group had fewer episodes of angina pectoris and shorter attack duration after treatment (both P<0.01). Among the patients of the observation group, their systolic and diastolic blood pressure, and heart rate were lower than those of the control group after treatment; the reduction amplitued of LWBV, PV, HWBV, and FIB levels in the observation group after treatment was greater than those in the control group; the levels of serum IL-18, NF-κB, hs-CRP, and YKL-40 in the observation group were lower than those in the control group after treatment (all P<0.01). There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group (P>0.05). Conclusion  The efficacy of nicorandil combined with metoprolol succinate in the treatment of patients with coronary heart disease angina pectoris is superior to that of single-drug therapy. The combined medication could effectively improve the attack of angina pectoris and hemorheology indexes, reduce heart rate, blood pressure and serum inflammatory mediator levels, which proves to be safe and reliable.

Objective  To investigate the efficacy of recombinant human brain natriuretic peptide (rh-BNP) and spironolactone on cardiac function and myocardial injury indexes in patients with ischemic cardiomyopathy and heart failure. Methods  A total of 106 patients with ischemic cardiomyopathy and heart failure were selected, and divided into spironolactone group (n=53, spironolactone tablets taken orally) and combination medication group (n=53, rh-BNP+spironolactone tablets) in the random number table method. Both groups were treated continuously for 14 days. The clinical efficacy, and the incidence of adverse reactions were compared between the two groups, as well as cardiac function, myocardial injury indexes, exercise tolerance, and quality of life before and after the  treatment. Results  After treatment, the overall effectiveness rate of the combination medication group was significantly higher than that of the spironolactone group (94.34%vs. 81.13%; χ²=4.296, P<0.05). Left ventricular ejection fraction (LVEF) and quality of life score of the combination medication group were significantly higher than those of the spironolactone group, while left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were significantly lower than those of the spironolactone group (P<0.05). The cardiac troponin I (cTn I), lactate dehydrogenase (LDH) and NT-proBNP levels in the combination medication group were all significantly lower than those in the spironolactone group (all P<0.05), while the 6-minute walking test distance was longer than that in the spironolactone group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion  Compared with the medication of spironolactone alone, rh-BNP combined with spironolactone has more obvious therapeutic effect on ischemic cardiomyopathy and heart failure, with significant improvement of cardiac function, exercise tolerance and quality of life.

Objective  To explore the diagnostic value of low-dose coronary CT angiography (CCTA) examination based on the technology of iterative model reconstruction (IMR) for coronary artery stenosis in coronary heart disease (CHD). Methods  Seventy-eight patients suspected with CHD and coronary artery stenosis were selected. All patients underwent low-dose CCTA examination based on IMR technology. The image quality score of CCTA examination was analyzed, while the CT, contrast noise ratio (CNR) and standard deviation (SD) values of each coronary artery segment separately by using IMR, iDose4 and FBP algorithms were compared. Taking coronary angiography (CAG) diagnosis results as the gold standard, the diagnostic value of low-dose CCTA examination using IMR technology for coronary artery stenosis in CHD was analyzed, and its consistency with the diagnosis results of the gold standard was discussed. Results  A total of 310 images of the main branches of coronary arteries were obtained in this examination, and 300 of them met the standard for the quality of coronary artery images. There were 10 images with a score of 1, 11 images with 2 points, 44 images with 3 points, and 235 images with 4 points. There was no statistically significant difference in CT values of each coronary artery segment by using different algorithms (P＞0.05). The CNR values of each segment of coronary arteries obtained by lowdose CCTA examination based on IMR technology were all higher than those based on iDose4 and FBP, while the SD values of each segment of coronary arteries were all lower than those based on iDose4 and FBP, all with statistically significant differences (all P<0.05). Based on the calculation of coronary artery segments, there were 765 out of the obtained 780 segments in all, which met the diagnostic criteria for anomalous coronary artery. The diagnostic accuracy rate, sensitivity, specificity, and positive and negative predictive values of low-dose CCTA examination using IMR technology for coronary artery stenosis were 89.02%, 92.48%, 82.31%, 91.03% and 84.92%, respectively. The consistency of this examination was good in the diagnosis of coronary artery stenosis (Kappa=0.753, P＜0.05). Conclusion  Low-dose CCTA scanning based on IMR technology could effectively detect coronary artery stenosis in CHD, with relatively high diagnostic accuracy rate and consistency. It provides effective references for clinical diagnosis of coronary artery stenosis in CHD, and is worthy of promotion and application.

Objective  To explore the diagnostic value of color Doppler echocardiography combined with carotid artery ultrasound on coronary heart disease (CHD). Methods  A total of 90 cases suspected with CHD were included, and all underwent color Doppler echocardiography and carotid artery ultrasound examinations. Taking coronary angiography results as the gold standard, we compared the ultrasound parameters of patients between the CHD group (with positive angiography results) and the non-CHD group (with negative angiography results). We also analyzed the changes of each ultrasound parameter in CHD patients with different numbers of diseased coronary arteries. The diagnostic value of myocardial work index (Tei index), plaque score, intima-media thickness (IMT), and the combination of the above three indexes for CHD were all assessed. Results  In the CHD group, the values of Tei index, plaque score, and IMT were all significantly higher than those in the non-CHD group (all P<0.01). Among the 52 patients with CHD, there were 30 cases with single-vessel disease,14 cases with double-vessel disease, and 8 cases with multi-vessel disease. There were statistically significant differences in Tei index, plaque score, and IMT among CHD patients of subgroups with different numbers of diseased coronary arteries (all P<0.01); and the values of the above indexes in the multi-vessel lesion subgroup were all significantly higher than those in the double- or single-vessel lesion subgroups (all P<0.05). ROC curve analysis showed that the AUC,Youden index, sensitivity, and specificity of IMT in the diagnosis of CHD was the highest among the above three ultrasound indicators; the values of AUC and sensitivity of the combination of the above three indexes were both significantly higher than those of any single index for the diagnosis of CHD. Conclusion  The combination of color Doppler echocardiography and carotid artery ultrasound examinations help to determine the degree of coronary artery disease, and improve the diagnostic efficiency of CHD. It has relatively high value of popularization and application.

Objective  To explore the correlation of serum endothelin-1 (ET-1), Klotho protein and Rho associated coiled coilforming protein kinase 2 (ROCK2) levels with the severity and prognosis of IgA nephropathy. Methods  The clinical data of 95 patients with IgA nephropathy were retrospectively selected. They were categorized into mild, moderate, and severe groups based on the disease severity. Patients were divided into good and poor prognosis groups according to their prognosis after 2 years. Another 95 healthy physical examinees in the same period were selected as the control group. The levels of serum ET-1, Klotho and ROCK2 were compared between the two groups, patients with different disease severity, and patients with different prognosis. The correlation of the levels of the above indicators with the disease severity and prognosis was analyzed, as well as the predictive value for poor prognosis of patients. Results  The levels of serum ET-1 and ROCK2 in the IgA nephropathy group were significantly higher than those in the control group, while the level of serum Klotho was significantly lower than that in the control group (all P<0.05). The serum ET-1 and ROCK2 levels were significantly higher in severe patients than those in moderate and mild patients, while the levels in moderate patients were also significantly higher than those in mild patients. The serum Klotho level in severe patients were significantly lower than that in moderate and mild patients, while its level in moderate patients was also significantly lower than that in mild patients (all P<0.05). Compared with the good prognosis group, the levels of serum ET-1 and ROCK2 in the poor prognosis group were both significantly increased, while the level of serum Klotho protein was significantly decreased (all P<0.01). The levels of serum ET-1 and ROCK2 were positively correlated with the severity and prognosis of the disease, while the level of serum Klotho was negatively correlated with the severity and prognosis (all P<0.01). The AUC value of the combined detection of serum ET-1, Klotho, and ROCK2 levels for predicting poor prognosis of patients was 0.826, and the Youden index was 0.560, significantly higher than the AUC value and Youden index of either of the above three indicators (all P<0.01). Conclusion  The levels of serum ET-1, Klotho and ROCK2 are closely related to the severity and prognosis of patients with IgA nephropathy. The combined detection of these indicators could provide references for prognosis prediction in clinical practice.

Objective  To explore the application effect of Qili Qiangxin Capsule developed based on the pulse collateral theory in patients with heart failure with reduced ejection fraction (HFrEF). Methods  A total of 110 patients with HFrEF were randomly divided into two groups by using the random number table method. Among them, the control group (55 cases) was treated with oral sacubitril/valsartan, while the observation group (55 cases) was treated with oral sacubitril/valsartan and Qili Qiangxin Capsule. Both groups were continuously treated for 8 weeks. The clinical efficacy, and incidences of adverse drug reactions were compared between the two groups, as well as the traditional Chinese medicine syndrome score, cardiac function indicators, myocardial fibrosis indicators ［connective tissue growth factor (CTGF) and transforming growth factor-β1 (TGF-β1)］, and N-terminal pro-brain natriuretic peptide (NT-proBNP) before and after treatment. Results  The total effective rate of the observation group was significantly higher than that of the control group (90.91% vs. 76.36%, P<0.05). After treatment, each cardiac function indicator in the observation group was significantly better than that in the control group (P<0.05), while the myocardial fibrosis indicators, NT-proBNP, and traditional Chinese medicine syndrome score in the observation group were all significantly lower than those in the control group (all P<0.05). There was no statistically significant difference in the incidence of adverse drug reactions between the two groups (P>0.05). Conclusion  The addition of Qili Qiangxin Capsule to sacubitril/valsartan in HFrEF patients achieves significant therapeutic effects, which are beneficial for reducing myocardial fibrosis and apoptosis of myocardial cells, protecting patients cardiac function, improving traditional Chinese medicine syndrome scores, with good patient tolerability and high safety.

Objective  To explore the therapeutic effect of metoprolol combined with clopidogrel on coronary heart disease (CHD) and angina pectoris. Methods  A prospective randomized controlled study was performed, and 100 patients with CHD and angina pectoris were selected as research objects. They were divided into clopidogrel group and combined medication group, with 50 cases in each group. Clopidogrel group was treated with clopidogrel, while the combined medication group was treated with metoprolol based on the medication of the clopidogrel group. The distance of 6-minute walk test (6MWT), duration of angina pectoris, cardiac function, adverse drug reactions, and quality of life were compared between the two groups before and after treatment. Results  After treatment, the 6MWT distance was significantly longer than that in the clopidogrel group, while the duration of angina pectoris in the combined medication group was significantly shorter (both P<0.01). After treatment, the cardiac index, ejection fraction and cardiac output of the combined medication group were all significantly higher than those of the clopidogrel group (all P<0.01), while the scores of physical activity limitation, frequency of angina pectoris attack, stable state of angina pectoris, treatment satisfaction and disease cognition in the combined medication group were also significantly higher than those in the clopidogrel group (all P<0.05). There were no adverse drug reactions in either of the two groups. Conclusion  Compared with clopidogrel used alone, metoprolol combined with clopidogrel is more effective in shortening the duration of angina pectoris among CHD patients, improving the levels of cardiac function and quality of life, with relatively high safety.

Objective  To explore the application value of ECG network system in determining the nature of ST-T changes in the ECGs of occupational health examination population. Methods  Sixty physical examinees who had undergone occupational health examinations from August 2023 to March 2024 and showed ST-T changes in their ECGs were selected as research objects. The ECG network system was used for dynamic observation of all physical examinees, and the nature of ST-T changes was analyzed through re-examination and the propranolol test. Results  In the 60 physical examinees with ST-T changes, ST-T changes recovered in 21 cases after re-examination while 39 cases still had ST-T changes through examination based on ECG network system and comprehensive evaluation. Of the 39 patients with remained ST-T changes, 30 cases were qualified for the propranolol test, among whom 27 cases were determined to be normal after the test. We made comparison before and after re-examination, and the propranolol test; organic lesions were excluded in 48 out of 51 cases, regarded as functional changes, 3 cases were suspected with organic changes, and 9 cases can not be evaluated for special reasons. Conclusion  Re-examination by ECG network system and the propranolol test are helpful to strengthen the preliminary judgment of the nature of ST-T changes in ECGs of the occupational health examination population, providing an important basis for early clinical intervention and occupational health management.

This paper selects 7 patients implanted with Abbott permanent cardiac pacemakers after parameter adjustment as research objects. Combining with the Lorenz scatter plot, time scatter plot and retrograde playback technology of ambulatory electrocardiography, and the postoperative routine follow-up data, it systematically investigates the individualized adjustment schemes of common working parameters of pacemakers, which include parameters related to pacing frequency, sensing sensitivity, atrioventricular interval, special functions, working mode, energy output and lead polarity. By optimizing the setting of the above parameters, patients’ quality of life is improved, and the service life of pacemakers is prolonged.

Objective  To explore the effect of comprehensive geriatric assessment (CGA) nursing interventions on exercise tolerance and cardiac function in elderly patients with chronic heart failure (CHF). Methods  Sixty elderly patients with CHF were divided into two groups by using the random number table method, with 30 cases in each group. The control group received routine nursing intervention, while the observation group received nursing intervention based on CGA. Both groups received continuous intervention until discharge, and were made follow-up observation for 3 months. The exercise tolerance ［6-minute walk test (6MWT) distance］ and cardiac function indexes were compared between the two groups. Results  After intervention, LVEF in the observation group was significantly higher than that in the control group, while the left ventricular end-diastolic and end-systolic diameters were lower than those in the control group (all P<0.01). After intervention, the 6MWT distance of the observation group was longer than that of the control group (P<0.01). Conclusion  CGA based nursing intervention can effectively improve the exercise tolerance, cardiac function, and prognosis of elderly patients with CHF.

Objective  To retrospectively analyze the impact of targeted nursing intervention based on goal management theory on negative emotions and self-efficacy of children with thrombocytopenia. Methods  A total of 101 children with thrombocytopenia were selected, and divided into control group (51 cases) and observation group (50 cases) by admission sequence. The control group received routine nursing intervention, and on this basis, the observation group additionally adopted targeted nursing intervention based on goal management theory. The incidence of complications, self-efficacy ［general self-efficacy scale (GSES)］, medication adherence ［Morisky medication adherence scale (MMAS-8)］, negative emotions ［screen for child anxiety related emotional disorders (SCARED) and depression self-rating scale for children (DSRSC)］, and family satisfaction with care ［Newcastle satisfaction with nursing scales (NSNS)］ were compared between the two groups. Results  Compared with the control group, the incidence of complications in the observation group after intervention was lower, while family satisfaction with care was higher (both P<0.05). Compared with the control group, the observation group had higher scores of GSES and MMAS-8 after intervention, while the scores of SCARED and DSRSC in the observation group were lower after intervention (all P<0.01). Conclusion  Targeted nursing intervention based on goal management theory could reduce negative emotions and the incidence of complications in children with thrombocytopenia, enhance their self-efficacy, improve medication adherence, and increase family satisfaction with care.

Objective  Based on the perspective of health ecology, to analyze the influencing factors of self-care level in patients with chronic heart failure (CHF). Methods  A total of 231 patients with CHF were selected from the community health service centers of medical association of Zhongda Hospital Affiliated to Southeast University by convenience sampling method. Health ecology was used as the theoretical framework of influencing factors classification. In terms of personal characteristics, behavior style, interpersonal network, working and living environments, and policy aspects, we used the general information questionnaire, self-care of heart failure index (SCHFI), social support rating scale (SSRS), 7-item generalized anxiety disorder scale (GAD-7), and patient health questionnaire-9 (PHQ-9) to perform investigation. Univariate analysis and linear regression analysis were used to explore the influencing factors. Results  The overall self-care level of patients with CHF was not high, and the average total score of self-care was (46.73±8.29) points. Linear regression analysis showed that LVEF at the level of individual characteristics, anxiety, depression and the number of knowledge acquisition pathways at the level of behavior style,and the level of social support at the interpersonal network level were independent influencing factors for self-care level in patients with CHF (P<0.05), which could explain 64.5% of the variation in self-care level. Conclusion  The self-care ability of patients with CHF still needs to be strengthened. Nursing staff should pay attention to the influencing factors of self-care level of CHF patients from the perspective of health ecology, and should give systematic intervention from multi-dimensions and multi-layers, so as to enhance the self-care ability of patients.

Continuous renal replacement therapy (CRRT) is an extracorporeal blood purification method used for critically ill patients with conditions such as acute kidney injury. The therapeutic effect of CRRT is influenced by the blood flow rate in the extracorporeal circuit. Low blood flow rate is significantly associated with circuit clotting and treatment interruption, while excessively high blood flow rate may lead to elevated circuit pressure, similarly impair therapeutic outcomes. At present, the optimal extracorporeal blood flow rate for CRRT remains unclear. Additionally, the special needs of different populations should be considered during the treatment, and how to set blood flow rate in various treatment scenarios is still an unresolved issue. This article provides a review of the current research status and future prospect of blood flow rate in CRRT, aiming to offer references for clinical practice and further research in this area.

In recent years, the prevalence of cardiovascular diseases has been rising, creating a pressing need for innovative diagnostic and management solutions. Artificial intelligence (AI)-assisted heart sound analysis, powered by electronic stethoscopes and computer-aided algorithms of heart sound analysis, has become a prominent area of research. This technology enables precise quantitative analysis, and classification and identification of heart sound signals, demonstrating significant utility in valvular heart disease, coronary artery disease, congenital heart defects, heart failure, and blood pressure assessment. AI systems not only enhance the sensitivity and specificity of heart sound analysis, but also promote the improvement of primary care diagnostics in medical resource-limited settings. Advance in algorithmic aspects include deep learning-based feature extraction, denoising and enhancement of heart sound signals, and development of prediction models for cardiovascular risk assessment. This review explores the current applications and progress of AI heart sound analysis systems in the diagnosis of cardiovascular diseases, providing insights into future clinical applications and research directions.

P-wave terminal force in V1 (PtfV1) also known as the Morris index, plays a significant role in the risk assessment of stroke associated with atrial fibrillation (AF). PtfV1 also has certain correlations with the diagnosis and prognostic prediction of acute ischemic stroke, new-onset AF after acute myocardial infarction, coronary artery disease, heart failure, left ventricular diastolic dysfunction, sleep-related breathing disorders, acute mental stress, diffuse large B-cell lymphoma, and other diseases. This article mainly reviews the latest research progress of PtfV1 applied in the diagnosis and prognostic prediction of various clinical diseases.

Atrial fibrillation (AF) is one of the most common arrhythmias, and thromboembolism is the most serious complication of AF. Electrocardiogram (ECG) as a non-invasive diagnostic tool is used for the diagnosis and prediction of various cardiovascular diseases. This article reviews the current research status and progress on the correlation between the ECG characteristics of AF (such as coarse f-wave, P-wave parameters, T-wave changes, PR interval and heart rate), and the occurrence of thromboembolism in patients with AF.