Objective  To investigate the risk factors for poor prognosis in sudden sensorineural hearing loss (SSNHL), and to establish a nomogram prediction model for the prognosis of SSNHL and verify its accuracy. Methods  Clinical data of 255 patients with SSNHL were retrospectively analyzed. The patients were randomly divided into a training set (n=170) and a validation set (n=85) at a ratio of 2∶1. All patients received conventional treatment, and were subsequently classified into an effective  group and an ineffective group according to the results of repeated hearing tests. Binary Logistic regression was used for univariate and multivariate analyses to screen out risk factors for treatment ineffectiveness in SSNHL patients. Based on the identified risk factors, a prediction model for the prognosis of SSNHL patients was established using R software. ROC curve was plotted, and the area under the curve (AUC) was calculated to evaluate model discrimination. Calibration curves were plotted to assess model calibration, while clinical decision curves were used to evaluate the clinical net benefit of the model. Results  Disease duration, dizziness and audiogram configuration were identified as influencing factors for poor prognosis in SSNHL patients. A nomogram model was constructed based on these factors. The AUC value of the model was 0.798 (95%CI 0.733-0.864) for the training set and 0.677 (95%CI 0.564-0.791) for the validation set. The calibration curve of the training set showed a calibration slope of 1 and an intercept of 0, indicating good consistency between the model-predicted probability and the actual probability. The clinical decision curve indicated that the model provided a net benefit for patients. ConclusionDisease duration ≥7 days, presence of dizziness, and audiogram configuration (high-frequency descending type, flat type, and total deafness type) are risk factors for poor prognosis in SSNHL patients. The constructed prediction model demonstrates good accuracy, and can serve as a reference for clinical diagnosis and treatment.

Objective  To observe the effect of circumferential pulmonary vein isolation (CPVI) on heart rate variability (HRV) in patients with paroxysmal atrial fibrillation (PAF) using ambulatory electrocardiography (AECG). Methods  A retrospective analysis was conducted on 100 patients with PAF who had undergone CPVI for the first time. All patients underwent 24-hour AECG before surgery, and at 1-3, 6, 12 and 18 months after surgery. Changes in HRV parameters at each time point were analyzed and compared, including SDNN, SDANN, SDNN index, rMSSD, pNN50, low-frequency power (LF), high-frequency power (HF), and the LF/HF ratio. Results  Finally, results of HRV indexes from 67 patients were included in the statistical analysis. At 1-3 months after surgery, all HRV indexes were significantly lower than preoperative values (all P<0.01): SDNN ［(75.91±13.34) ms vs. (107.44±11.38) ms］, SDANN ［(66.18±11.99) ms vs. (92.59±11.84) ms］, SDNN index ［(27.41±4.04) ms vs. (52.32±8.12) ms］, rMSSD ［(21.47±2.94) ms vs. (35.91±3.66) ms］, pNN50 ［(2.49±0.35)% vs. (5.72±0.72)%］, LF ［(86.31±13.80) Hz vs. (250.18±22.04) Hz］, HF ［(118.61±17.82) Hz vs. (225.28±28.36) Hz］, and LF/HF ［(0.93±0.21) vs. (1.68±0.27)］. At 6 months, 1 year, and 18 months after surgery, SDNN, SDANN, SDNN index, rMSSD, pNN50, and LF/HF ratio gradually increased over time, reaching nearly preoperative levels at 18 months after surgery. LF and HF values showed a trend of an initial increase followed by a decrease at 6 months, 1 year, and 18 months after surgery. Conclusion  CPVI can transiently affect autonomic nervous function in patients with atrial fibrillation, but HRV time-domain indexes gradually recover from 3 months after surgery.

Objective  To analyze the predictive value of P-wave terminal force in lead V1(PtfV1) on electrocardiogram for adverse cerebrovascular events among patients with coronary heart disease (CHD). Methods  Seventy-five CHD patients (CHD group) and 75 healthy subjects undergoing physical examinations during the same period (control group) were selected as study subjects. All subjects underwent standard 12-lead electrocardiogram examination, and PtfV1 values were calculated. NYHA classification was used to assess cardiac function in the CHD group. Patients were followed up for 12 months, and the incidence of adverse cerebrovascular events was recorded. Correlations of PtfV1 with cardiac function and cerebrovascular events were analyzed. Results  The PtfV1 value in the CHD group was significantly higher than that in the control group ［(13.40±1.15) mm·s vs. (1.12±0.38) mm·s; t=87.81, P<0.05］. Within the CHD group, higher NYHA classification was associated with higher PtfV1 values (F=123.75, P<0.05). The incidence of adverse cerebrovascular events gradually increased with increasing PtfV1 value, and the difference was statistically significant (χ2=9.722, P<0.05). Conclusion  PtfV1 value is positively correlated with the degree of cardiac function impairment in patients with CHD, and it can independently predict the risk of adverse cerebrovascular events. It is relatively simple to perform, non-invasive, and cost-effective, making it suitable for routine screening in long-term risk stratification of CHD patients.

Objective  To investigate the predictive value of corrected QT interval (QTc) combined with fragmented QRS complex (fQRS) on electrocardiogram (ECG) for major adverse cardiovascular events (MACEs) in patients with acute myocardial infarction (AMI). Methods  Clinical data of 180 patients with AMI were retrospectively collected. All patients underwent ECG examination after admission to measure QTc and observe the presence of fQRS. Based on the occurrence of MACEs during follow-up, patients were divided into a MACEs group (n=50) and a non-MACEs group (n=130). The influencing factors for MACEs in AMI patients and the predictive value of QTc combined with fQRS for MACEs were analyzed. Results  The QTc in the MACEs group was significantly longer than that in the non-MACEs group (P<0.05); the positive rate of fQRS in the MACEs group was significantly higher than that in the non-MACEs group (P<0.05). After adjusting for confounding factors such as the use of antiarrhythmic drugs, multivariate Logistic regression analysis showed that prolonged QTc and positive fQRS were both independent risk factors for MACEs in AMI patients (both P<0.05). The AUC value of QTc combined with fQRS for predicting MACEs in AMI patients was 0.856, with a sensitivity of 82.5% and a specificity of 80.0%. Its predictive performance was significantly better than that of either single indicator. Conclusion  The combination of QTc and fQRS has a high predictive value for MACEs in AMI patients. It can serve as an important indicator for prognostic assessment and provide a basis for clinical treatment decisions.

Objective  To compare and observe the efficacy of different intracanal disinfection protocols combined with bioceramic material iRoot SP paste for root canal obturation in the treatment of acute apical periodontitis. Methods  Clinical data of patients with acute apical periodontitis were collected for a retrospective study. According to different intracanal disinfection protocols, these patients were divided into a calcium hydroxide group and a triple antibiotic paste (TAP) group. To eliminate selection bias and ensure baseline comparability between the two groups, propensity score matching method was performed at a 1∶1 ratio, with matching variables including age, sex, and affected tooth position. After matching, 119 patients were successfully included in each group. In the calcium hydroxide group, root canal filling with iRoot SP paste combined with intracanal disinfection using calcium hydroxide paste was applied, while in the TAP group, root canal filling with iRoot SP paste combined with intracanal disinfection using TAP was applied. Therapeutic effects, as well as preoperative and postoperative pain degrees ［visual analogue scale (VAS) and masticatory function score］, gingival crevicular fluid inflammatory factors ［C-reactive protein (CRP), interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α)］, and periodontal indicators ［periodontal pocket depth (PD), sulcus bleeding index (SBI) and gingival index (GI)］ were compared between the two groups. The incidence of adverse reactions was also recorded. Results  The total effective rate in the TAP group was higher than that in the calcium hydroxide group (96.64% vs. 84.87%, P<0.05). At 1 week and 3 months postoperatively, the TAP group showed lower VAS scores, higher masticatory function scores, and lower levels of CRP, IL-8 and TNF-α in gingival crevicular fluid, as well as lower PD, SBI and GI compared with the calcium hydroxide group (all P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the TAP group (3.36%) and the calcium hydroxide group (7.56%, P>0.05). Conclusion  Compared with calcium hydroxide, the use of TAP for intracanal disinfection combined with iRoot SP for obturation in the treatment of acute apical periodontitis proves to be more effective in controlling inflammatory and improving clinical symptoms in the short term.

Objective  To investigate the causal associations between specific gut microbiota and the risk of atrial fibrillation (AF), and to evaluate the potential reverse effects of AF on gut microbiota. Methods  A two-sample Mendelian randomization (MR) approach was employed to analyze bidirectional relationships between 19 gut microbial taxa and AF, based on the Genome-Wide Association Study (GWAS) summary statistics from the FinnGen consortium. Forward analysis included Bacillus group C, Bifidobacterium, unnamed strain sp003534295 of CAG-273, Cyanobacteria, Fimbriimonadia, Firmicutes group A, and Jiangellaceae. Reverse analysis included unnamed strain sp000435175 of CAG-245, CAG-245 group, Coprobacillus cateniformis, Coprobacillus, Megasphaera, Phocea sp., Propionibacterium freudenreichii, Succinivibrio, Thermococcaceae, Thermococci, and unnamed strain sp900313925 of UBA2922. Robustness was assessed using inverse variance weighted, MR-Egger regression, and weighted median methods, with multiple comparisons corrected using a false discovery rate (FDR) threshold of <0.05. Results  Higher abundances of Bifidobacterium, unnamed strain sp003534295 of CAG-273, Cyanobacteria, Fimbriimonadia, and Jiangellaceae were associated with a reduced risk of AF; Bacillus group C and Firmicutes group A showed positive associations with AF. AF led to increased abundances of Coprobacillus, Coprobacillus cateniformis, Phocea sp., Propionibacterium freudenreichii, and Thermococcaceae, while the abundances of unnamed strain sp000435175 of CAG-245, CAG-245 group, Megasphaera, and Succinivibrio decreased. Conclusion  Multiple gut microbial taxa exhibit genetically predicted causal relationships with AF in different directions, and AF itself can reshape the gut microbiome. The “gut-heart axis” may be involved in the pathogenesis and progression of AF, offering potential targets for microbiota-based interventions.

Objective  To compare the clinical efficacy of transcervical resection of myoma (TCRM) and laparoscopic myomectomy (LM), and their effect on estradiol (E2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels. Methods  A total of 118 patients with uterine fibroids were enrolled, and randomly assigned to a TCRM group (n=59) and an LM group (n=59) by using random number table method. Operative indicators, ovarian reserve function parameters (E2, LH and FSH), endometrial receptivity indicators ［pulsatility index (PI), resistance index (RI) and endometrial thickness (ET)］, micro-inflammatory status indicators ［IL-1β, IL-6 and tumor necrosis factor-α(TNF-α)］, and complication rate were compared between the two groups. Results  Compared with the LM group, the TCRM group had significantly shorter operative time, postoperative flatus time, and hospital stay, as well as significantly less intraoperative blood loss (all P<0.001). No statistically significant differences were found in E2, LH, or FSH levels between the two groups before surgery or at 6 months postoperatively (all P>0.05). At 1 month postoperatively, both groups showed significantly decreased PI and RI, and significantly increased ET compared with preoperative values (all P<0.05), with greater improvements in the TCRM group (all P<0.001). On postoperative day 3, IL-1β, IL-6, and TNF-α levels were significantly higher in both groups compared with preoperative values (all P<0.05), and these levels were significantly lower in the TCRM group than those in the LM group (all P<0.001). There was no statistically significant difference in complication rate between the two groups. Conclusion  In the short-term observation of patients with uterine fibroids, TCRM and LM have comparable effect on ovarian reserve function and complication rate. TCRM outperforms LM in optimizing perioperative indicators, improving short-term postoperative endometrial receptivity, and alleviating early postoperative micro-inflammatory status.

Objective  To investigate and analyze the prevalence of vision status and myopia among Grade 12 students, and to provide evidence for myopia prevention and control. Methods  A total of 8 914 Grade 12 students in a district of Chengdu in 2022 underwent visual acuity and refractive status examinations. The recorded data were statistically analyzed to determine the detection rate of poor vision and myopia rate. Results  A total of 8 914 students (17 828 eyes) were surveyed. The detection rate of poor vision was 72.7%, the myopia rate was 59.2%, and the high myopia rate was 3.1%. The detection rate of poor vision was higher in girls than that in boys (χ2=90.027, P<0.001), and the myopia rate was also higher in girls than that in boys (χ2=76.682, P<0.001). The detection rate of poor vision was higher in the right eye than that in the left eye (χ2=27.667, P<0.001), and the myopia rate was also higher in the right eye (χ2=38.859, P<0.001). Conclusion  Poor vision and myopia are prominent problems among Grade 12 students in this district of Chengdu, with girls and the right eye being highrisk subgroups. It is recommended that myopia prevention and control strategies focus on sex differences, and the asymmetric impact of reading and writing postures on both eyes. Meanwhile, regular refractive monitoring and individualized interventions (such as increasing the duration of outdoor activities, improving lighting and correcting poor postures) should be strengthened at the senior high school stage to delay myopia progression and reduce the risk of high myopia.

Objective  To analyze the effect of personalized speech therapy combined with sensory integration (SI) training on preschool children with functional dysarthria (FD). Methods  Ninety-six preschool children with FD were enrolled, and divided into three groups according to different treatment methods: the speech group (n=31) received personalized speech therapy; the training group (n=32) received SI training; and the combined group (n=33) received personalized speech therapy combined with SI training. The therapeutic efficacy among the three groups was compared, along with dysarthria and speech intelligibility scores, oral (tongue, lips and mandible) motor function, and treatment satisfaction of their parents before and after treatment. Results  The overall effective rate in the combined group (93.94%) was higher than that in the speech group (70.97%) and the training group (68.75%) (P<0.05). After treatment, speech intelligibility improved in all the three groups, and the scores for articulation disorder and speech intelligibility in the combined group were higher than those in the speech and training groups (all P<0.05). Oral motor function improved in all the three groups after treatment; and the oral motor function scores for tongue, lips and mandible in the combined group were all significantly higher than those in the other two groups (all P<0.05). Parental treatment satisfaction in the combined group was higher than that in the speech and training groups (P<0.05). Conclusion  For preschool children with FD, personalized speech therapy combined with SI training can improve oral motor function, and enhance speech intelligibility, with significant therapeutic efficacy and high parental treatment satisfaction.

Objective  To investigate the associations between different electrocardiogram (ECG) indicators and the echocardiographic parameter left ventricular mass index (LVMI) in general hospitalized patients primarily from the cardiology department, and to analyze factors affecting the diagnostic accuracy of left ventricular hypertrophy (LVH). Methods  A retrospective study was conducted on 256 general hospitalized patients mainly from the cardiology department. Using LVMI as the gold standard for diagnosing LVH, these 256 patients were divided into an LVH group (n=126) and a non-LVH group (n=130). General data, echocardiographic parameters ［left atrial end-diastolic diameter (LADd), end-diastolic interventricular septal thickness (IVST), end-diastolic left ventricular posterior wall thickness (LVPWT), left ventricular end-diastolic diameter (LVDd), LVMI and LVEF］, and ECG parameters ［Sokolow-Lyon voltage (SV1+RV5/RV6), Cornell voltage (RaVL+SV3), Peguero Lo-Presti voltage (SD+SV4), QRS duration (QRSd), ST-T changes in left precordial leads and QRS frontal electrical axis］ were collected and compared between the two groups. Multiple linear regression analysis was used to identify factors influencing LVH in general hospitalized patients. Multivariate Logistic regression analysis was performed to evaluate factors affecting the diagnostic accuracy of LVH based on the SD+SV4 criterion. Results  Statistically significant differences were observed between the LVH and non-LVH groups in terms of sex, age, smoking history, valvular heart disease history, cardiomyopathy history from general data; and in ECG parameters including atrial fibrillation (AF), composite variable of AF/P-wave duration, ST-T changes, and frontal plane electrical axis (all P<0.05). In the LVH group, RⅠ+SⅢ, SaVR, SV1+RV5/RV6 voltage, RaVL+SV3 voltage, SD+SV4 voltage, QRSd, LADd, IVST, LVPWT, LVDd, and LVMI were all significantly higher than those in the non-LVH group, while LVEF was significantly lower (all P<0.05). Systolic blood pressure, SV1+RV5/RV6 voltage, SD+SV4 voltage, ST-T changes, and frontal plane electrical axis were correlated with LVMI in general hospitalized patients (all P<0.05). After adjusting for other factors, SV1+RV5/RV6 voltage (OR=0.769, 95%CI 0.613-0.965, P<0.05) and QRSd (OR=1.024, 95%CI 1.001-1.047, P<0.05) were identified as influencing factors on the consistency between the SD+SV4 criterion and the gold standard for diagnosing LVH. Conclusion  Systolic blood pressure, SV1+RV5/RV6 voltage, SD+SV4 voltage, ST-T changes, and frontal plane electrical axis are correlated with LVMI in general hospitalized patients. Among these indicators, SD+SV4 voltage has the greatest weight, followed by ST-T changes. SV1+RV5/RV6 voltage and QRSd are factors that influence the accuracy of the SD+SV4 voltage criterion for diagnosing LVH.

Objective  To investigate the characteristics of ischemic J wave and its relationship with culprit vessel localization in patients with non-ST-segment elevation myocardial infarction (NSTEMI) complicated by acute complete occlusion of a single culprit vessel. Methods  A total of 150 NSTEMI patients who had undergone emergency percutaneous coronary intervention (PCI) were retrospectively enrolled. All patients were confirmed by coronary angiography to have acute complete occlusion of a single culprit vessel and underwent resting 18-lead electrocardiogram examination before the procedure. According to the type of culprit vessel, patients were divided into left anterior descending artery (LAD) group, left circumflex artery (LCX) group, and right coronary artery (RCA) group, with 50 cases in each group. The incidence and lead distribution characteristics of ischemic J wave were compared among the three groups. Differences in peak cardiac troponin T (cTnT) level, left ventricular ejection fraction (LVEF), ST-T improvement after PCI, and short-term outcomes during hospitalization were also analyzed between patients with positive and negative ischemic J wave. Results  Among the 150 NSTEMI patients, the positive rate of ischemic J wave was 35.33% (53/150), with the highest rate in the LCX group ［50.00% (25/50)］, followed by the RCA group ［34.00% (17/50)］, and the lowest in the LAD group ［22.00% (11/50)］; the difference among the three groups was statistically significant (χ2=8.636, P=0.013). The lead distribution of ischemic J wave showed good consistency with the perfusion territory of the culprit vessel: LAD-related occlusion was mainly observed in anterior leads, LCX-related occlusion mainly in lateral leads, and RCA-related occlusion mainly in inferior leads. Compared with ischemic J-wave-negative patients, patients with positive ischemic J wave had higher peak cTnT levels (P=0.002), but there were no statistically significant differences in LVEF, proportion of patients with ST-T improvement after PCI, or short-term clinical outcomes during hospitalization between the two groups (all P>0.05). Conclusion  In NSTEMI patients with acute complete occlusion of a single culprit vessel, ischemic J wave is not uncommon, with the highest incidence observed in LCX-related occlusion. This wave highly coincides with the culprit vessel's perfusion territory, suggesting that it may reflect local repolarization abnormalities. For NSTEMI patients with suspected LCX lesions or atypical ST-segment elevation, attention to J-wave elevation may assist in identifying acute complete occlusion.

Objective  To investigate the correlation of peripheral blood γ-glutamyl transferase to platelet ratio (GPR), angiopoietin-like protein 2 (ANGPTL2) level, and lipid metabolism with coronary artery lesions in patients with essential hypertension (EH) complicated by unstable angina pectoris (UAP). Methods  A total of 80 patients with EH complicated by UAP (EH+UAP group) were enrolled. Additionally, 80 patients with EH alone (EH group), 80 patients with UAP alone (UAP group), and 80 healthy controls (healthy group) were included for comparison. The levels of peripheral blood GPR and ANGPTL2, and lipid metabolism parameters ［total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)］ were compared among groups. Subgroup analyses were performed within the EH+UAP group based on the severity of coronary artery lesions. ResultsPeripheral blood GPR and ANGPTL2 level in the EH+UAP group were significantly higher than those in the UAP group, EH group, and healthy group (all P＜0.05). LDL-C level in the EH+UAP group was also significantly higher than that in the other three groups (all P＜0.05). Subgroup analysis showed that in patients with severe lesions (within the EH+UAP group), peripheral blood GPR and ANGPTL2 level were significantly higher than those in patients with mild or moderate lesions (all P＜0.05). Levels of TC, TG, and LDL-C were significantly higher, while HDL-C was significantly lower in patients with severe lesions compared with mild or moderate lesions (all P＜0.05). Spearman correlation analysis revealed that peripheral blood GPR, ANGPTL2, and LDL-C levels were positively correlated with the severity of coronary artery lesions (rs=0.514, 0.577 and 0.489, respectively; all P＜0.001). Conclusion  Changes in peripheral blood GPR, ANGPTL2, and LDL-C level can reflect, to some extent, the coronary artery lesion burden in patients with EH complicated by UAP. Combined monitoring of these indicators may assist in evaluating the severity of coronary artery lesions and providing reference for clinical risk stratification.

Objective  To analyze the efficacy and safety of the use of scoring balloon during percutaneous coronary intervention (PCI) for elderly patients with coronary bifurcation lesions. Methods  Clinical data of 83 elderly patients with coronary bifurcation lesions who had undergone PCI were retrospectively analyzed. Patients were grouped according to different PCI methods: scoring balloons were used in 42 cases during PCI (scoring balloon group), while conventional balloons were used in 41 cases (control group). Perioperative PCI indicators, treatment status of the main branch and side branch (reference vessel diameter, minimum lumen diameter and diameter stenosis rate), vascular late lumen loss, incidence of in-stent restenosis, and major adverse cardiovascular events were compared between the two groups. ResultsThere was no statistically significant difference in operation time between the two groups (P＞0.05). The contrast agent volume in the scoring balloon group was significantly lower, the fluoroscopy time was significantly shorter, and the incidence of coronary dissection (7.14%) was also significantly lower than that in the control group (24.39%, all P＜0.05). Regarding treatments of the main and side branches: there were no statistically significant differences in reference vessel diameter before surgery, immediately after surgery, or at 6 months postoperatively between the two groups (all P＞0.05). No significant differences were found in minimum lumen diameter or diameter stenosis rate before surgery or immediately after surgery (all P＞0.05). At 6 months postoperatively, the scoring balloon group had a significantly greater minimum lumen diameter and significantly lower diameter stenosis rate compared with the control group (both P＜0.05). At 6 months postoperatively, the scoring balloon group showed significantly lower vascular late lumen loss in both main and side branches, and significantly lower incidences of in-stent restenosis in the main branch (2.38%) and side branch (4.76%) compared with the control group (14.63% and 19.51%, respectively; P＜0.05). The total incidence of major adverse cardiovascular events was significantly lower in the scoring balloon group than that in the control group (4.76% vs. 19.51%, P＜0.05). Conclusion  The application of a scoring balloon in PCI yields good outcomes, with reduced vascular late lumen loss, lower incidences of in-stent restenosis and adverse events, and decreased need for stent implantation, thereby alleviating the procedural burden on patients.

Objective  To investigate the abnormal characteristics of chronotropic response index at stage 2 (CRI2) in treadmill exercise test (TET), and its clinical diagnostic value in non-elderly patients with coronary heart disease (CHD). Methods  A retrospective analysis was performed on 100 non-elderly patients (aged 16-59 years) with positive TET results who had undergone coronary angiography within 3 months after TET. Based on coronary angiography results, they were divided into a control group (30 cases, stenosis degree <50%) and a CHD group (70 cases, stenosis degree ≥50%). The CHD group was further divided into mild stenosis (10 cases, stenosis degree 50%-69%), moderate stenosis (10 cases, stenosis degree 70%-89%), and severe stenosis (50 cases, stenosis degree ≥90%) subgroups. CRI2, peak exercise level, heart rate difference before and after exercise, and other chronotropic function indexes were compared among groups. Correlations of CRI2 with these indexes, severity of coronary lesions, and CHD risk factors were analyzed. Results  The proportion of patients with CRI2<0.8 was significantly higher in the CHD group (48.57%, 34/70) than that in the control group (33.33%, 10/30; P＝0.007). Among subgroups, the severe stenosis group had the highest proportion of cases with significantly reduced CRI2 (60.00%, 30/50). The proportion of patients with CRI2<0.8 in the CHD group was significantly higher than that of patients with heart rate decrease <18 beats within the first minute of post-exercise recovery (5.71%, 4/70) or that of cases with peak heart rate minus resting heart rate ≤30 beats (0, both P＜0.05). Correlation analysis of chronotropic function indexes showed that CRI2 was strongly negatively correlated with failure to reach 85% of maximal predicted heart rate, and strongly positively correlated with the difference between peak heart rate and resting heart rate (heart rate reserve, both P＜0.001). There was a statistically significant difference in CRI2 between the control group and the CHD group (H＝15.23, P＜0.01); CRI2 in the severe stenosis group was significantly lower than that in the control group (α′=0.008 3, P＝0.006). Conclusion  Reduced CRI2 is a prominent feature in non-elderly patients with CHD, especially those with severe coronary stenosis, and its abnormality detection rate is higher than that of traditional indexes of heart rate recovery and heart rate reserve. As a sensitive indicator for evaluating chronotropic function of the heart, CRI2 can independently reflect the severity of coronary lesions, and exhibit a “cliff-like” decrease when lesions progress to severe stages, thereby helping to improve early diagnostic efficacy for silent or atypical CHD.

Objective  To investigate the predictive value of posterior circulation collateral score (PC-CS) combined with D-dimer for the prognosis of patients with posterior circulation acute ischemic stroke (AIS) undergoing endovascular treatment. Methods  A retrospective analysis was conducted on 139 patients with posterior circulation AIS who had received endovascular treatment. Based on the 90-day modified Rankin scale score, these patients were divided into a good prognosis group (n=71) and a poor prognosis group (n=68). Differences in baseline characteristics between the two groups were compared. Logistic regression analysis was used to identify risk factors affecting the prognosis. ROC curves were plotted to evaluate the predictive performance of PC-CS combined with D-dimer for the prognosis in patients with posterior circulation AIS. Results  The poor prognosis group had significantly older age, higher baseline National Institutes of Health stroke scale (NIHSS) score and D-dimer level, and significantly lower PC-CS compared with the good prognosis group (all P<0.001). Logistic regression analysis showed that older age, higher baseline NIHSS score, lower PC-CS, and higher D-dimer level were risk factors for poor prognosis in patients with posterior circulation AIS undergoing endovascular treatment (all P<0.001). ROC curve analysis showed that the AUC value for PC-CS, D-dimer, and their combination in predicting poor prognosis of patients with posterior circulation AIS undergoing endovascular treatment was 0.812, 0.938 and 0.975, respectively. The combined prediction model had a significantly higher AUC value than either single indicator, indicating better discriminant efficacy. Internal validation was performed using Bootstrap resampling for 500 times, yielding a C-index of 0.870, indicating good discrimination. The calibration curve showed good agreement between model-predicted probabilities and actual observed probabilities, suggesting ideal calibration consistency. Conclusion  The combination of PC-CS and D-dimer has high predictive value for the prognosis of patients with posterior circulation AIS undergoing endovascular treatment.

Objective  To investigate the correlation between the severity of pulmonary dysfunction and electrocardiographic abnormalities in patients with chronic obstructive pulmonary disease (COPD), so as to provide reference for clinical disease evaluation, and the prevention and treatment of complications. Methods  A retrospective analysis was conducted on data from 900 patients who had undergone routine electrocardiogram (ECG) and pulmonary function testing. Among these, 395 patients with abnormal pulmonary function were screened, including 198 patients with COPD. These 395 patients were divided into four groups according to age, and the detection rate of COPD in each group was calculated. According to the pulmonary function grading criteria in the “Guidelines for the diagnosis and treatment of chronic obstructive pulmonary disease (2021 revised edition)”, 198 COPD patients were further classified into four groups based on the severity of pulmonary dysfunction: mild (72 cases), moderate-moderately severe (52 cases), severe (32 cases), and extremely severe (42 cases) groups. ECG findings were compared among the groups to analyze the incidence of complicated ST-T abnormalities, premature beats, tachycardia, atrial abnormalities, ventricular high voltage or hypertrophy, bundle branch block, and abnormal QRS axis. ResultsThe detection rate of COPD was higher in males than that in females ［139 cases (60.7%) vs. 59 cases (35.5%)］. The detection rate of COPD was the highest in the >80 years group across age groups. The proportion of patients with concomitant electrocardiographic abnormalities increased with the deterioration of pulmonary function impairment. Conclusion  The incidence of electrocardiographic abnormalities in patients with COPD is closely related to disease severity. With the increase of age and progression of the disease, the incidence of concomitant ECG abnormalities rises. Routine ECG examination can serve as an adjunctive tool for disease assessment and prognostic evaluation in COPD patients.

Poor r wave growth (PrWG) in precordial leads is closely associated with left-sided heart failure. Nearly 70% of inpatients with heart failure in the cardiovascular department exhibit electrocardiographic features of PrWG. Through quantitative analysis of electrocardiographic index of PrWG, PrWG is defined as the combination of a “U-turn” phenomenon and bidirectional waves. The “U-turn” phenomenon restricts the R/S ratio of the QRS complex in adjacent leads following PrWG to ≥2, while bidirectional waves restrict the ratio to the interval (0.5, 2). ROC curve analysis has confirmed the feasibility of using the “U-turn” phenomenon to assess heart failure (R/S ratio of the QRS complex ≥2 in adjacent leads following PrWG in precordial leads). This article introduces a classification of electrocardiogram(ECG) PrWG and, based on multicenter study results, reports the parameter characteristics of each type of PrWG ECG pattern and their relationship with heart failure, aiming to further explore the classification features and clinical significance of PrWG.

Based on the automaticity of atrial parasystole and its degree of resetting on sinus rhythm, three types were introduced. ⅰ) Classic type. Sinus automaticity was greater than atrial automaticity (NN<SS); the atrial rhythm reset the sinus rhythm with a delay (NS+SN<2NN). The NN layer essentially ran throughout the entire recording, with a wide and scattered NS layer below and a relatively narrow SN layer above. The Lorenz scatter plot exhibited a nonstandard, obliquely inverted “Y” shape. The difference scatter plot was asymmetric about the line y=x. ⅱ) Special type. Sinus automaticity was greater than atrial automaticity (NN<SS); the atrial rhythm reset the sinus rhythm immediately (SN≈NN). The NN layer ran throughout the entire recording, with a wide and scattered NS layer below, while the SN layer was completely merged into the NN layer and was difficult to identify. The Lorenz scatter plot showed a structure resembling a horizontalthenvertical folded ruler. The difference scatter plot exhibited an obliquely inverted “Y” shape. ⅲ) “Upsidedown world” type. Sinus automaticity was less than atrial automaticity (NN>SS); the sinus rhythm cannot reset the atrial rhythm (SN+NS=2SS). The NN layer receded, while the SS layer emerged. The three layers (SN, SS and NS) were evenly spaced at different heights. The NNN point set gave way to the SSS point set, while the preescape and postescape point sets were located above and in front of the SSS point set, respectively. The difference scatter plot resembled a 180° inversion of the typical pattern seen in premature ventricular contraction. The electrocardiographic scatter plot characteristics of atrial parasystole were distinctive and highly regular. They not only enabled rapid identification of various types of atrial parasystole, but also profoundly revealed the electrophysiological mechanisms underlying each type.

Using a stereoelectrocardiograph, electrocardiogram (ECG) and vectorcardiogram (VCG) were synchronously recorded via the Wilson and Frank dual-lead systems to timely detect and diagnose left anterior fascicular block-type left bundle branch block (LAFB-type LBBB). Cases with clinical manifestations and clearly diagnosed LAFB-type LBBB based on VCG were selected for analysis. In four cases of LAFB-type LBBB, the VCG manifestations showed features of LAFB in the frontal plane and complete LBBB in the horizontal plane. VCG was significantly superior to ECG in diagnosing LAFB-type LBBB. Regardless of the version of ECG diagnostic criteria for LAFB-type LBBB, the diagnostic reliability of ECG remains limited without the verification of VCG. Therefore, clinicians should be cautious in diagnosing LAFB-type LBBB using ECG alone. In practical work, ECG and VCG should complement each other by leveraging their respective strengths to jointly serve clinical practice. Combining the two methods can improve diagnostic accuracy.

Objective  To systematically investigate the pattern of progressive imaging changes of non-neoplastic pulmonary ground-glass nodules (GGNs) during computed tomography (CT) follow-up, clarify their characteristic manifestations and key differentiating points from neoplastic GGNs. Methods  A retrospective analysis was performed on 72 patients with pathologically confirmed non-neoplastic GGNs. Based on the nodule change characteristics during follow-up, patients were divided into a progression group (n=37) and a non-progressive group (n=35). Standardized thin-slice spiral CT scanning and reconstruction protocols were adopted for multi-dimensional analysis of the initial and follow-up CT images of the two groups, including nodule size, density, volume, morphology, margin, distribution, and solid components. Clinical data were also reviewed to identify factors associated with progressive changes. Results  Progressive changes in non-neoplastic GGNs could be classified into five types, among which type Ⅱ (wth increased volume) was the most common (40.5%). Furthermore, 59.5% of progressive changes occurred within the first six months of follow-up. The incidence of underlying diseases in the progression group was significantly higher than that in the non-progressive group (45.9% vs. 11.4%, P<0.05). Compared with neoplastic GGNs, progressive non-neoplastic GGNs mostly had persistently ill-defined margins (83.8%) and 29.7% showed rapid changes in the short term (within 3 months). Nodules with a volume doubling time (VDT) <344 days accounted for 72.4% of progressive nodules, which were significantly different from the typical features of neoplastic GGNs described in the literature (with mostly well-defined margins, slow progression and longer VDT). Conclusion  Progressive changes of non-neoplastic GGNs have unique temporal pattern and imaging characteristics. Short-term rapid changes, persistently ill-defined margins, and a specific VDT range can serve as key indicators for differentiating non-neoplastic GGNs from neoplastic ones. Combining these features with a history of underlying diseases can further improve diagnostic accuracy, thereby effectively reducing unnecessary surgical intervention.

ObjectiveTo analyze the application effect of a personalized humanistic nursing model based on multi-disciplinary team (MDT) in discharge preparation services for neurology patients. MethodsA retrospective analysis was performed on the clinical data of inpatients in Department of Neurology. A total of 5 019 patients who had received routine nursing from January 2022 to December 2023 were assigned to the control group, while 4 378 patients who had received MDT-based personalized humanistic nursing from January 2024 to August 2025 were assigned to the experimental group. The differences in unplanned readmission rate, the average length of stay, discharge processing time and patient satisfaction rate were compared between the two groups. ResultsAfter the implementation of the MDT-based personalized humanistic nursing discharge preparation service program, the unplanned readmission rate of patients decreased from 0.36% (18/5 019) to 0.14% (6/4 378), the average length of stay was shortened from 7.61 days to 6.79 days, and the average discharge processing time was shortened from 25.32 minutes to 8.43 minutes, all with statistically significant differences (P＜0.05). The patient satisfaction rate increased from 90.0% to 96.8%. ConclusionThis case, by introducing the MDT model, provides personalized and humanized whole-process nursing for neurology patients. The discharge preparation services achieve a transformation from a “disease-centered” model to a “patient-needs-centered” model, offering an example for chronic disease management and humanistic nursing practice.

Objective  To explore the intervention effect of hospital-community-family informationized extended nursing service on patients with traumatic brain injury. Methods  A total of 96 patients with traumatic brain injury were selected, and equally divided into two groups by random number table method: the routine nursing group adopted conventional nursing, while the extended service group adopted hospital-community-family informationized extended nursing service. The intervention started on the day of discharge, and both groups received continuous nursing observation for 3 months. The postoperative rehabilitation status, limb motor function, incidence of complications and patients satisfaction with nursing were compared between the two groups. Results  After 3 months of continuous intervention, the China stroke scale score of the extended service group was significantly lower than that of the routine nursing group, while the modified Barthel index score and Fugl-Meyer asessment scale score were both significantly higher than those of the routine nursing group (all P<0.05). The total incidence of complications in the extended service group was significantly lower than that in the routine nursing group (4.17% vs. 18.75%; χ2=5.031, P<0.05), while patients satisfaction with nursing service was significantly higher compared with the routine nursing group (95.83% vs. 79.17%; χ2=6.095, P<0.05). Conclusion  The hospital-community-family informationized extended nursing service, by establishing an “Internet+nursing” three-level linkage system, provides strong support for the postoperative rehabilitation of patients with traumatic brain injury, meets their needs for continuous care after discharge, systematically improves the patients ability of upper and lower limb coordination, reduces the incidence of complications, and enhances overall patient satisfaction.

Objective  To investigate the application effect of key node nursing under the concept of circular quality control in patients with acute myocardial infarction (AMI). Methods  The clinical data of 136 AMI patients were retrospectively analyzed; they were divided into a control group and a circular quality control group according to different nursing methods and matching principles, with 68 cases in each group. The control group received conventional nursing, while the circular quality control group received key node nursing under the concept of circular quality control on the basis of the control group. Both groups were intervened by the same nursing team. The time of critical nodes, improvement of cardiac function, complications, and nursing satisfaction were compared between the two groups. ResultsAfter intervention, the circular quality control group had significantly shorter emergency department stay, first electrocardiogram time, rescue initiation time, and hospital stay compared with the control group (all P<0.001). After intervention, the circular quality control group had smaller left ventricular end-systolic and end-diastolic diameter, as well as higher LVEF compared with the control group (all P<0.001). After intervention, the 30-day readmission rate was lower in the circular quality control group than that in the control group (4.41% vs. 16.18%, P=0.013), the total complication rate was lower (7.35% vs. 20.59%, P=0.021), and patient or family nursing satisfaction was higher (98.53% vs. 88.24%, P=0.016). Conclusion  Application of key node nursing under the concept of circular quality control in AMI patients can shorten treatment time, improve cardiac function, reduce the incidence of complications, and achieve high satisfaction among patients or their families.

The development of the new generation of artificial intelligence (AI) and the construction of “New Medicine” urgently require the cultivation of interdisciplinary talents in “AI+healthcare”. The development of an interdisciplinary integrated curriculum serves as the pedagogical foundation for deepening disciplinary integration and fostering cross-disciplinary composite talents. This paper proposes a curriculum framework for integrating medicine and AI at three levels: a basic curriculum system, a core knowledge curriculum system, and an application module curriculum system. However, the implementation of such an integrated curriculum faces challenges, including a shortage of qualified faculty, the lack of corresponding teaching administration organization, and an underdeveloped ecosystem for cultivating composite talents. Therefore, this paper suggests a “bidirectional integration” approach to align talent cultivation with faculty development. Depending on their institutional structures and disciplinary characteristics, universities can adopt a “decentralized” management model (with the curriculum offered through a medical school or college), a “centralized” management model (with the curriculum offered through an AI school), or a “joint training” model across schools or colleges. In addition, improving an integrated “medical-industry-education-research” training system will help facilitate the successful implementation of the integrated curriculum. By investigating the design of an integrated curriculum of medicine and AI, this paper seeks to promote the cultivation of “AI+healthcare” composite talents, and contribute to the advancement of the new generation of AI and the “New Medicine” initiative.

This paper briefly describes the current situation and shortcomings of the cultivation of critical electrocardiogram (ECG) identification ability in the standardized training of traditional Chinese medicine (TCM) residents, and analyzes the importance of teaching critical ECG identification in this training system. In response to the shortcomings, it actively explores teaching strengthening strategies more suitable for the TCM context, such as innovating classroom teaching paradigms, strengthening the integration of TCM and Western medicine while incorporating ideological and political education to reconstruct the classroom teaching ecology, offering specialized theoretical courses on critical ECGs, enhancing faculty development, and improving the assessment and evaluation system, so as to enhance learning efficiency and clinical practice ability. Emphasizing critical ECG teaching is of great significance for improving the standardized training system for TCM residents and cultivating interdisciplinary TCM talents who possess both TCM and Western medicine knowledge structures, and abilities to integrate and synthesize knowledge.

Objective  To explore the application effect of scenario-based simulation teaching based on the 5R principle (result, recommendation, risk, rights and responsibility) in doctor-patient communication training for patients with severe pneumonia. Methods  A total of 52 resident physicians undergoing standardized training in Department of Respiratory and Critical Care Medicine were selected, and divided into an experimental group (n=32, receiving scenario-based simulation teaching based on the 5R principle) and a control group (n=20, receiving traditional theoretical teaching). After the teaching intervention, evaluations were conducted using a learning effect evaluation form (covering five dimensions: knowledge comprehension, communication skills, clinical response, reflective improvement and humanistic literacy), and a learning satisfaction evaluation form (covering five dimensions: course content, teaching methods, learning environment, learning gains and teacher performance). SPSS 27.0 software was used for statistical analysis. Results  The experimental group scored significantly higher than the control group in knowledge comprehension, communication skills, clinical response and overall learning effect (all P<0.001). No significant differences were found between the two groups in reflective improvement and humanistic literacy scores (P>0.05). The experimental group also showed significantly higher scores in all dimensions of learning satisfaction and overall satisfaction compared with the control group (all P<0.001). Conclusion  Scenario-based simulation teaching based on the 5R principle can effectively improve resident physicians' knowledge comprehension, communication skills and clinical response abilities in doctor-patient communication for patients with severe pneumonia, and significantly enhance learning satisfaction. It can be promoted and applied as an effective teaching method in medical education and training.

Synchronized electrocardiogram (ECG) and phonocardiogram (PCG) detection technology is a novel multimodal cardiac monitoring technique that shifts the analysis of cardiac electrical and mechanical signals from independent monitoring to integrated analysis. By synchronously acquiring ECG and PCG, it enables a more comprehensive assessment of the heart, thereby facilitating early identification and precise treatment of cardiovascular diseases. In recent years, with advances in artificial intelligence and sensor technology, deep learning-based joint analysis of ECG and PCG signals has further improved diagnostic accuracy and efficiency. The development of remote cardiac monitoring systems also provides a new pathway for long-term management of cardiovascular diseases. This article systematically reviews the development, clinical applications, trends, and challenges of synchronized ECG-PCG detection technology, aiming to promote its widespread adoption and innovative development in medical practice.

Myocardial fatty infiltration can increase the risk of arrhythmias through multiple pathways, including disruption of myocardial fiber structure, interference with electrical signal conduction, and induction of local inflammatory responses. This article systematically reviews the pathological mechanisms of fatty infiltration and its effects on cardiac electrophysiological properties, with a focus on its potential associations with atrial arrhythmias (such as atrial fibrillation) and ventricular arrhythmias (such as arrhythmogenic right ventricular cardiomyopathy). On this basis, future research directions for intervention strategies targeting fatty infiltration are further discussed, and its potential clinical significance in the prevention and treatment of arrhythmias is emphasized.

The deep interdisciplinary integration of nursing science and artificial intelligence (AI) represents an important trend in the development of the nursing discipline. This paper reviews the application scenarios, existing problems, and future development directions of AI in clinical nursing, with a focus on its role in assisting nursing staff with real-time patient monitoring, supporting home care, reducing the workload of clinical nursing staff, and enhancing nursing education and skill training, thereby providing technical support for improving nursing quality and efficiency. This paper also highlights some current limitations in the application of AI in the nursing field.

Acute myocardial infarction (AMI) is an important cause of heart failure (HF). With the increasing global incidence of cardiovascular diseases, the incidence of HF after AMI is also rising, seriously affecting patients quality of life and survival rate. In recent years, non-coding RNA (ncRNA) as a key molecule regulating gene expression, has become a hotspot in cardiovascular disease research. ncRNA is involved in pathological processes such as myocardial injury, inflammatory response, and cardiac remodeling. This article reviews the classification of ncRNAs and their mechanisms in the pathogenesis of HF after AMI, and discusses their potential as biomarkers and therapeutic targets.

Echocardiography, with its advantages of noninvasiveness and reproducibility, has become the preferred imaging technique for diagnosing cardiovascular diseases. Echocardiographically measured ejection fraction is one of the most commonly used methods for assessing cardiac systolic function. However, with the continuous development of technology, speckle tracking imaging (STI) has been verified to detect cardiac dysfunction earlier than ejection fraction. Meanwhile, emerging parameters such as global longitudinal strain and peak strain dispersion have also been gradually applied to the evaluation of cardiac function, and their diagnostic performance are also superior to ejection fraction. This article reviews the research progress of STI in the diagnosis of heart failure with preserved ejection fraction and coronary heart disease.