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中国学术期刊综合评价数据库统计源期刊
中国学术期刊影响因子统计源期刊
中国生物医学文献数据库(CBM)收录期刊
    • 2025 Volume 34 Issue 3
      Published: 28 June 2025
        


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    • WANG Huixin, WU Yicheng, SU Yan'gang
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      Objective  To investigate the correlation between ambulatory arterial stiffness index (AASI) and pulse pressure or blood pressure variability (BPV) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods  A total of 205 patients specifically diagnosed with OSAHS were enrolled as research objects. They completed general data collection, and polysomnography and ambulatory blood pressure monitoring. Based on the classification of circadian blood pressure rhythm, the study population was divided into a dipper blood pressure group (n=92) and a nondipper blood pressure group (n=113). We compared the general clinical characteristics between the two groups as well as the correlation between AASI and ambulatory blood pressure parameters by using Pearson correlation analysis. Multiple linear regression analysis was applied to explore the relationship between AASI and pulse pressure or BPV. Results   The AASI of the non-dipper blood pressure group was significantly higher than that of the dipper blood pressure group (P<0.01). AASI was positively correlated with age, 24-hour mean systolic blood pressure and pulse pressure, while it was negatively correlated with 24-hour mean diastolic blood pressure, and the decline ratio of nocturnal systolic and diastolic blood pressure (all P<0.05). Pulse pressure was associated with AASI if BPV remained constant (P<0.05). Conclusion  The AASI of OSAHS patients demonstrates an association with pulse pressure and age. AASI may serve as a promising indicator reflecting arterial stiffness.
    • FAN Minghui1, XIE Jincheng1, WANG Lianghong1, ZHANG Xiling2, WANG Xinkang2
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      Objective  To develop a transfer learning-based classification model for sleep apnea syndrome using electrocardiogram (ECG) data, increasing its classification accuracy and clinical applicability. Methods  Based on the Apnea-ECG and MIT-BIH polysomnographic databases, with respiratory signals as input, we applied a Butterworth low-pass filter for denoising, and constructed an original data set. To address the problem of insufficient respiratory signal data, a model training method based on a transfer learning approach was proposed: first, ECG signals with a large sample size were used for model pre-training, and then they were fine-tuning for respiratory signals, finally fulfilling binary classification or multi-class classification tasks. A cascade model combining residual network and bidirectional long short-term memory network was proposed, which performed better in capturing the timing features of signals and improving classification performance. Additionally, the performance of this model was made comparative analysis with those of various classic convolutional neural networks. Results  Through comparative experiments, it was found that employing transfer learning approach could accelerate model convergence and improve the model's overall performance. Validated on the test set, the proposed cascade model demonstrated a favorable performance in both binary classification and multi-class classification tasks, achieving an accuracy of 95.43% on the binary classification task and 91.26% on the multi-class classification task. Conclusion  This study offers novel insights into the design of disease classification models under small-sample conditions, and validates the effectiveness of transfer learning in sleep apnea syndrome classification, thereby demonstrating its potential clinical utility.
    • SU Guizhu, ZHUO Liqing
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      Objective  To explore the association between obstructive sleep apnea syndrome (OSAS) and heart rate variability (HRV) or circadian rhythm of blood pressure in hypertensives. Methods  A total of 102 inpatients and outpatients with hypertension were selected in our study, and they were divided into hypertension with OSAS group (55 cases) and primary hypertension group (47 cases). This study enrolled 50 concurrent healthy subjects (all with organic diseases excluded, and without comorbidities of hypertension or OSAS) as a control group. We compared and analyzed the HRV time-domain indexes of SDANN and rMSSD, and HRV frequency-domain indexes of LF and HF, as well as apnea hypopnea index (AHI), nocturnal mean oxygen saturation level, daytime and nocturnal blood pressure levels, and changes of circadian blood pressure rhythm. Results  The nocturnal minimum saturation of arterial oxygen (SaO2) and nocturnal mean SaO2 of patients in the hypertension with OSAS group were both lower than those of patients in the primary hypertension group, while AHI was higher (all P<0.05). There were no statistically significant differences in the above sleep respiratory parameters between the primary hypertension group and the control group (all P>0.05). There were no statistically significant differences in the daytime and nocturnal blood pressure levels, and the incidence of non-dipper pattern between the primary hypertension group and the control group (all P>0.05). Comparisons of the aforementioned parameters between the hypertension with OSAS group and the control group all demonstrated statistically significant differences (all P<0.01). The hypertension with OSAS group exhibited a significantly higher prevalence of non-dipper circadian blood pressure rhythm compared to the other two groups (all P<0.05). Compared to the other two groups, the values of SDANN and LF of patients in the hypertension with OSAS group were higher, while the values of rMSSD and HF were lower (all P<0.05). There were no statistically significant differences in the LF, HF, SDANN and rMSSD values between the primary hypertension group and the control group (all P>0.05). Conclusion  Patients with OSAS demonstrate increased nocturnal blood pressure level, enhanced sympathetic nerve tension and decreased vagus nerve tension, as well as increased risk of cardiovascular and cerebrovascular diseases.
    • CHEN Shangli1, 2, CHEN Xuan3, CHEN Ruojin4, QIN Tao5, WANG Zhenyan1, TANG Zhi6
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      Objective  To investigate the association between homocysteine (Hcy) and the C677T gene polymorphism in its key metabolic enzyme, methylenetetrahydrofolate reductase (MTHFR), and the complications of hypertension, type 2 diabetes mellitus and atherosclerosis in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods  A total of 85 OSAHS patients and 77 non-OSAHS patients were enrolled. The genotypes, and levels of serum Hcy, fasting blood glucose and hemoglobin Alc of all subjects were detected, while cervical vascular ultrasound was performed simultaneously. Hcy≥10 μmol/L was defined as hyperhomocysteinemia (HHcy). The serum Hcy levels were compared among patients with different genotypes. The Hcy levels, MTHFR C677T gene polymorphism, and C/T allele frequencies were compared among an OSAHS with complications group, a pure OSAHS group, and a control group (without OSAHS or complications). Then, multivariate binary Logistic regression analysis was performed to identify independent risk factors for complications in OSAHS patients with confounding factors adjusted. Results  The Hcy levels in the patients with CC, CT and TT genotypes were 10.11 (9.15, 11.07), 10.86 (9.58, 11.10) and 15.81 (11.43, 50.76) μmol/L, respectively. Hcy level in the patients with TT genotype was significantly higher than that in the cases with CT or CC genotypes (both P<0.05). The Hcy levels of the OSAHS with complications group, the pure OSAHS group, and the control group were 11.16 (10.05, 13.80), 9.88 (9.31, 11.41), and 10.38 (9.29, 11.34) μmol/L, respectively. The Hcy level of the OSAHS with complications group was significantly higher than that of the pure OSAHS group (P<0.05). There were no statistically significant differences in gene polymorphism or C/T allele frequency among the three groups. After adjusting for confounding factors, it revealed that HHcy was an independent risk factor for concurrent complications in OSAHS patients, and the odds ratio (95% confidence interval) was 4.682 (1.261-17.380). Conclusion  The MTHFR C677T gene polymorphism affects serum Hcy level. HHcy is an independent risk factor for concurrent complications in OSAHS patients, however, neither the MTHFR C677T gene polymorphism nor the C/T allele frequency were associated with complications in OSAHS patients.
    • WU Jianmin1, XIA Yu2, HU Zhicheng2, WU Lingmin2, DING Ligang2, YAO Yan2
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      Objective  To study the clinical efficacy and safety of radiofrequency catheter ablation for atrial fibrillation (AF) by domestic minimally invasive Columbus  system. Methods  A total of 26 patients with AF who had undergone radiofrequency catheter ablation with Columbus  system and its supporting catheter were successively selected. The immediate success rate of surgery, intraoperative related parameters and surgery-related complications were recorded, while the recurrence of AF and the occurrence of adverse events were observed during follow-up. Results  The enrolled 26 patients were all paroxysmal AF. Pulmonary vein isolation was successfully achieved during operation, and there were no complications related to radiofrequency catheter ablation during perioperative period. During a mean follow-up of (5.92±1.94) months, AF recurred in 5 of 26 patients (19.23%). No serious adverse events such as embolism, bleeding, atrial esophageal fistula, or death occurred during the follow-up. Conclusion  Radiofrequency catheter ablation for AF by using domestic minimally invasive Columbus system is clinically feasible, with satisfactory short-term efficacy and safety.
    • ZHAO Bo1, ZHANG Mengyao1, FENG Zhenqin1, YANG Xinyu1, YU Zongliang1, TANG Fengyan2
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      Objective  By comparing the characteristics of chest lead electrocardiogram (ECG) indicators related to premature ventricular contraction (PVC), to explore the ECG indicators that can identify the origin point of outflow tract PVC more accurately. Methods  Seventy-eight patients with outflow tract PVC who had received successful radiofrequency catheter ablation were retrospectively analyzed. Among them, 52 cases of PVC were originated from the right ventricular outflow tract (RVOT), while 26 cases were originated from the left ventricular outflow tract (LVOT). The V2 transition index, SV2/RV3 index, RV1 wave duration index (RdV1/QRSdV1) and RV1/SV1 amplitude index were measured respectively. Each parameter and its diagnostic efficacy in differentiating outflow tract PVC were compared, and analyzed between the two groups. Results  There were no statistically significant differences in clinical features including age, sex, body mass index, smoking history, drinking history, complicated hypertension, complicated diabetes, cardiac structural and functional parameters, preoperative ventricular arrhythmia burden by 24-hour ambulatory electrocardiography (AECG), and preoperative anti-arrhythmic drug types between the two groups (all P>0.05). V2 transition index, SV2/RV3 index, RdV1/QRSdV1 and RV1/SV1 amplitude index were all significantly different between the two groups (all P<0.01). ROC analysis and decision curve analysis (DCA) were used to explore the diagnostic performance of each parameter in distinguishing the origin of outflow tract PVC. The AUC value of V2 transition index was 0.837, its optimal cut-off value was 0.76, and the sensitivity, specificity and accuracy rate were separately 0.718, 1.000 and 0.780. The AUC value of SV2/RV3 index was 0.859, its optimal cut-off value was 3.48, and the sensitivity, specificity and optimal accuracy rate were separately 0.718, 1.000 and 0.780. The AUC value of RdV1/QRSdV1 was 0.741, its optimal cut-off value was 0.35, and the sensitivity, specificity and accuracy rate were separately 0.487, 1.000 and 0.600. The AUC value of RV1/SV1 amplitude index was 0.836, its optimal cut-off value was 0.34, and the sensitivity, specificity and accuracy rate were separately 0.692, 0.909 and 0.740. V2 transitional index and SV2/RV3 index had higher diagnostic predictive value. DCA results showed that SV2/RV3 index demonstrated the highest net benefit. Based on age, sex, body mass index, smoking and drinking history, hypertension, diabetes, cardiac structural and functional parameters, preoperative ventricular arrhythmia burden, and the use of preoperative anti-arrhythmic drugs, we constructed a basic model. After adding V2 transition index to it, the differentiation performance of the model was significantly improved (C-index was 0.924, 95% confidence interval: 0.851-0.996, P=0.003); after adding SV2/RV3 index, its differentiation performance was further improved (C-index was 0.953, 95% confidence interval: 0.905-1.000, P<0.001). Conclusion  V2 transition index and SV2/RV3 index have relatively high differentiation value in locating the origin of outflow tract PVC, especially SV2/RV3 index demonstrating very high clinical utility value for PVC migrating in lead V2-V3.
    • TAO Lisheng, ZHU Xin, ZHOU Yongqing, DENG Zhaoqun, YAO Jun
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      Objective  To explore the influence of colonization factor (CF) on the adhesion of Jiulian probiotics to intestinal mucosal epithelial cells, and the efficacy of Jiulian probiotics combined with CF in treating intestinal dysfunction. Methods  Twenty patients with intestinal dysfunction were selected. Based on whether the Jiulian probiotics were co-cultured with intestinal mucosal epithelial cells in combination with CF, they were divided into an experimental group (the Jiulian probiotic suspension was co-cultured with intestinal mucosal epithelial cells in combination with CF) and a control group (only the Jiulian probiotic suspension was co-cultured with intestinal mucosal epithelial cells). Observation was conducted using a self-controlled approach. The Jiulian probiotics that adhered to the intestinal mucosal epithelial cells were extracted separately 4 and 12 hours after co-cultivation; the number of formed colonies was counted, and the effect of CF on promoting the adhesion of the probiotics to the intestinal mucosal epithelial cells was analyzed. According to the gastrointestinal symptom rating scale (GSRS) scores, the curative effect was assessed between the two groups. Results  The Jiulian probiotics adherent to cells, harvested from the experimental group after 4 hours of co-cultivation, formed significantly more colonies than those harvested from the control group after 24-hour of cultivation (P<0.05), while the formed colonies after 12 hours of cocultivation were significantly more than those harvested from the control group (P<0.01). After the combination treatment, the GSRS score of the patients was significantly lower than that before the treatment (P<0.01), while symptoms such as abdominal pain and diarrhea were significantly improved. Conclusion  CF could promote the adhesion of Jiulian probiotics to intestinal mucosal epithelial cells. Probiotics combined with CF may become one of effective methods for treating intestinal dysfunction.
    • OU Changyuan, LI Qusheng
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      Objective  To explore the risk factors for poor prognosis in patients with type 2 diabetes mellitus (T2DM) complicated by coronary heart disease (CHD). Methods  A retrospective analysis was conducted on the clinical data of 117 patients with T2DM complicating CHD. The patients were divided into a poor prognosis group (67 cases) and a good prognosis group (50 cases) based on their clinical outcomes. Baseline data, number of diseased coronary arteries, laboratory test indicators and other data were collected, and compared between the two groups. Binary Logistic regression analysis was used to identify the risk factors for poor prognosis. ResultsThe levels of glycated hemoglobin (HbA1c), the proportion of patients with multi-vessel coronary artery disease, as well as the prevalence of hypertension and hyperlipidemia were all significantly higher in the poor prognosis group than those in the good prognosis group (all P<0.01). Logistic regression analysis showed that HbA1c, multi-vessel disease, hypertension, and hyperlipidemia were independent risk factors for poor prognosis in patients with T2DM and CHD (all P<0.05). Conclusion  Actively controlling blood glucose, blood pressure and lipid levels, as well as optimizing coronary artery revascularization strategies are of significant importance for improving the prognosis of patients with T2DM and CHD.
    • LI Jingxiu, GAO Min
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      Objective  To investigate autonomic function changes in patients with neurally mediated syncope. Methods  We collected the clinical data of patients presenting with syncope or presyncope. According to the results of head-up tilt test (HUTT), they were divided into an HUTT positive (mixed type) group and an HUTT negative group, each with 53 cases. Each heart rate variability (HRV) index of the two groups were comparatively analyzed before HUTT and during the testing. Results  Before the testing, there were no statistically significant differences in the HRV time-domain indexes of SDNN, SDANN, SDNN index, rMSSD, pNN50, and TINN between the two groups (all P>005); there were also no statistically significant differences in the HRV frequency-domain indexes of LF, HF and LF/HF between the two groups (all P>0.05). During the process of HUTT, if the during-HUTT indexes were compared between the two groups, it revealed that rMSSD value of the HUTT positive (mixed type) group was significantly higher than that of the HUTT negative group (P<0.05). Conclusion  Compared to pre-HUTT HRV indexes, during-HUTT HRV indexes demonstrate greater clinical significance. The presence of vagal overactivity immediately at the onset of syncope in patients with neurally mediated syncope.
    • GAO Xubo
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      Objective  To investigate the efficacy of sugemalimab combined with cisplatin plus paclitaxel regimen in patients with advanced nonsmall cell lung cancer (NSCLC). Methods  Seventy patients with advanced NSCLC were selected as study objects; by using a randomized single-blind method, they were assigned into a control group and a sugemalimab group, with 35 cases in each group. The control group received cisplatin plus paclitaxel therapy, while the sugemalimab group adopted sugemalimab in addition to the control group's regimen. The short-term efficacy, occurrence of adverse reactions, prognosis, levels of cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), carcinoembryonic antigen, squamous cell carcinoma antigen (SCC-Ag), carbohydrate antigen 125 (CA125) and carbohydrate antigen 50 (CA50), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTCQLQ-C30) scores were compared between the two groups before and after treatment. Results   After three treatment cycles, the sugemalimab group showed a significantly higher disease control rate compared to the control group [80.00% (28/35) vs. 57.14% (20/35), P<0.05]; the levels of CYFRA21-1, carcinoembryonic antigen, SCC-Ag, CA125, and CA50 were all significantly lower in the sugemalimab group than those in the control group (all P<0.01). The sugemalimab group also exhibited significantly lower EORTCQLQ-C30 symptom scores compared to the control group, with significantly higher functional and overall quality of life scores (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). After one year of follow-up, the survival rate was significantly higher in the sugemalimab group than that in the control group [73.53% (25/34) vs. 51.52% (17/33), P<0.05]. Conclusion  Combining sugemalimab with the cisplatin plus paclitaxel regimen improves treatment efficacy in patients with advanced NSCLC, further reduces tumor marker levels, increases quality of life and survival rates, and demonstrates a favorable safety.
    • CAI Xu, ZHANG Guoqing, ZHAO Yonghui, WANG Zhen
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      ObjectiveTo investigate the anesthesia effect of dexmedetomidine combined with esketamine in elderly patients with orthopedic lower extremity surgery. MethodsEighty elderly patients undergoing orthopedic lower extremity surgery were randomly divided into two groups, with 40 cases in each group. The control group was given esketamine for anesthesia, while the drug combination group was given dexmedetomidine combined with esketamine for anesthesia. The anesthesia indexes between the two groups of patients were compared, as well as the vital signs, sedation degree, pain degree, and cognitive status before operation (T0), 6 hours after operation (T1), 12 hours after operation (T2) and 48 hours after operation (T3). The occurrence of adverse reactions was also compared between the two groups. ResultsThe recovery time of spontaneous respiration, anesthesia recovery time, orientation recovery time and extubation time in the drug combination group were all significantly shorter than those in the control group (P<0.05). There were statistically significant differences in heart rate and mean arterial pressure (MAP) at different times in the control group (P<0.01), but there was no statistically significant difference in blood oxygen saturation (SpO2) at different times in the control group (P>0.05). There were no statistically significant differences in heart rate, MAP and SpO2 at different times in the drug combination group (P>0.05). At T1, T2 and T3, heart rate and MAP of the drug combination group were both lower than those of the control group (all P<0.01). There were statistically significant differences in sedation scores at different times in the control group (P<0.01), while there were no statistically significant differences in sedation scores at different times in the drug combination group (all P>0.05). At different times, the sedation scores of the drug combination group were all significantly higher than those of the control group (all P<0.01). There were statistically significant differences in pain scores at different times between the two groups (P<0.01). At T1, T2 and T3, the pain scores of the drug combination group were all significantly lower than those of the control group (all P<0.01). There were statistically significant differences in mini-mental state examination (MMSE) scores between the two groups at different times (all P<0.01). At 24 hours after the operation, MMSE score of the drug combination group was significantly higher than that of the control group (P<0.01); there was no statistically significant difference in MMSE score between the two groups at 72 h, 1 week and 1 month after the operation (all P>0.05). The total incidence of adverse reactions in the drug combination group was 5.00%, significantly lower than 22.50% in the control group (P<0.05). Conclusion  Compared to anesthesia using esketamine alone, dexmedetomidine combined with esketamine is safe and effective for elderly patients with orthopedic lower extremity surgery. It could significantly shorten the recovery time of anesthesia, stabilize perioperative hemodynamics, improve the effect of sedation and analgesia, and reduce the risk of cognitive dysfunction 24 hours after surgery with lower incidence rates of adverse reactions.
    • ZHANG Yujuan
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      Objective  To investigate the clinical significance of electrocardiogram (ECG) ST-T changes in patients with heat stroke. Methods  A retrospective analysis was conducted on the clinical data of 59 patients with heat stroke. These patients were divided into an abnormal ST-T group (n=40) and a normal ST-T group (n=19) based on whether ST-T was abnormal. Statistical analysis was performed on the clinical data and laboratory indicators of the two groups. Results  The patients in the abnormal ST-T group demonstrated significantly advanced age, higher blood glucose, lactate dehydrogenase, cardiac troponin I (cTn I), prothrombin time (PT), international normalized ratio (INR), proportion of multiple organ dysfunction syndrome and body temperature, as well as aspartate aminotransferase, creatine kinase and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels compared to the normal ST-T group (all P<0.01). The levels of Ca2+ and antithrombin Ⅲ (ATⅢ) in the abnormal ST-T group were both significantly lower than those in the normal ST-T group (both P<0.05). Logistic regression analysis showed that age, PT, and INR were independent influencing factors for ST-T abnormalities in patients with heat stroke. Conclusion  Abnormal ST-T changes in ECGs of patients with heat stroke could serve as an important early warning indicator of severe illness and poor prognosis. Early identification of such ECG abnormalities helps to guide clinical intervention, and reduce the risk of multiple organ failure of patients.
    • DONG Shishi
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      Objective  To analyze the predictive value of the changes in serum N-terminal brain natriuretic peptide precursor (NT-proBNP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) levels for poor prognosis among patients with mitral regurgitation (MR). Methods  A total of 102 MR patients were selected as study objects (prospective study). They were divided into two groups based on their prognosis 1 year after mitral valve plasty: a poor prognosis group (37 cases) and a good prognosis group (65 cases). The clinical data as well as serum NT-proBNP and Lp-PLA2 levels before surgery, and 1 month and 3 months after surgery were compared between the two groups. Multivariate Logistic regression analysis was used to identify the influencing factors for poor prognosis. ROC curve analysis was employed to assess the predictive value of serum NT-proBNP and Lp-PLA2 levels 1 month and 3 months after surgery for poor prognosis 1 year after surgery. Results  One month and 3 months after surgery, the levels of serum NT-proBNP and Lp-PLA2 in the poor prognosis group were both significantly higher than those in the good prognosis group (both P<0.01); the levels of serum NT-proBNP and Lp-PLA2 were both associated with poor prognosis (both P<0.01). The AUC values for predicting poor prognosis separately by using NT-proBNP, Lp-PLA2, and their combination 1 month after surgery were 0.738, 0.741, and 0.879, respectively. Three months after surgery, the AUC values for predicting poor prognosis separately by using NT-proBNP, Lp-PLA2, and their combination were 0.762, 0.777, and 0.925, respectively. The AUC value of the combined prediction was greater than that of any single indicator, while the AUC value for predicting poor prognosis by using each serum indicator 3 months after surgery was greater than that 1 month after surgery (all P<0.01). ConclusionThe levels of serum NT-proBNP and Lp-PLA2 elevate in MR patients with poor prognosis after mitral valve plasty. A combined detection of the changes in their levels demonstrates some predictive value for poor prognosis. Combined detection helps to screen highrisk patients, thereby optimizing early-stage clinical treatment strategies.
    • GUO Donghai1, LIU Xiaomei1, PAN Jianjun2
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      Objective  To explore the influence of tirofiban combined with atorvastatin via different administration routes on the efficacy and vascular endothelial function of patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods  The clinical data of 130 patients with CHD were retrospectively analyzed, and they were divided into an intravenous administration group (62 cases) and an intracoronary administration group (68 cases) according to the tirofiban administration route. Cardiac function indexes such as LVEF, LVEDD and LVESD, postoperative TIMI blood flow grading, vascular endothelial function indexes including ET-1 and NO, as well as the occurrence of adverse reactions such as intracranial hemorrhage, exudative hemorrhage and thrombocytopenia were compared between the two groups. Results  After operation, LVEF, LVEDD and LVESD in the intracoronary administration group were significantly better than those in the intravenous administration group (all P<0.01). TIMI blood flow grading, and vascular endothelial function indexes such as ET-1 and NO were also significantly better than those in the intravenous administration group (all P<0.01). There was no statistically significant difference in the occurrence of adverse reactions between the two groups (P>0.05). Conclusion  Intracoronary administration of tirofiban combined with atorvastatin therapy demonstrates superior efficacy in improving antiplatelet effects and vascular endothelial function in CHD patients after PCI.
    • WU Fengjuan, LIU Na, ZHAO Yanan, CHEN Pei
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      Objective  To analyze the survival status of patients with gastrointestinal stromal tumor (GIST) complicated by gastrointestinal bleeding. MethodsThe medical record and postoperative follow-up data of 112 patients with GIST were collected. All patients were treated with either endoscopic submucosal excavation or laparoscopic surgical intervention. They were divided into a bleeding group (n=43) and a non-bleeding group (n=69) according to whether the patients were complicated by gastrointestinal bleeding. The pathological characteristics of the tumor, the prognosis of surgical treatment, and the survival status of the patients were observed in the two groups. ResultsThere were no statistically significant differences in sex or age between the two groups (both P>0.05). In the bleeding group, the proportion of patients with tumors locating outside the stomach was higher, the tumors were larger, the risk grade was higher, and the mitotic figures were more compared to those in the nonbleeding group (all P<0.01). Postoperative immunohistochemical examination results showed that the positive rates of postoperative tissue CD34, CD117, smooth muscle actin, and DOG-1 in the bleeding group were all significantly higher than those in the nonbleeding group (all P<0.05). The recurrence or metastatic rate, and mortality of the patients in the bleeding group during follow-up were also both significantly higher than those in the nonbleeding group (the recurrence or metastatic rate: 37.21% vs. 15.94%, the mortality: 18.60% vs. 4.35%; both P<0.05). Conclusion  Patients with GIST complicated by gastrointestinal bleeding tend to have tumors predominantly distributed in extragastric tissues, which demonstrate accelerated growth speed, higher malignant potential, and are also associated with significantly increased postoperative recurrence or metastasis rate, and mortality.
    • JIANG Junshi1, ZHAO Xiaopeng1, JIA Chengwen1, JI Zhaojuan1, SONG Yujun1, CUI Huandi2
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      Objective  To explore the efficacy and safety of cardiac electronic device implantation via the axillary vein access by meta-analysis. Methods  We searched related literature from CNKI, Embase, CBM, PubMed, WanFang and Cochrane Library database, setting the searching time from the establishment of each database until December 2024. A total of 604 randomized controlled studies on the implantation of cardiac electronic devices through the axillary vein access were retrieved. We evaluated the quality of the enrolled literature by means of the bias risk assessment instrument provided by the Cochrane Collaboration, and then extracted the data and completed heterogeneity test using I2 and CochranQ tests. Data were statistically analyzed using RevMan 5.4 software. ResultsA total of 13 studies involving 2 341 patients were ultimately included. The results of metaanalysis showed that compared with the control group, the success rate of puncture in the axillary vein group was relatively higher {RR=1.07, 95%CI [1.01, 1.13], P=0.020}, with significantly shorter puncture time {MD=-2.13, 95%CI [-3.01, -1.24], P<0.01}. The operation time of the axillary vein approach was shorter {MD=-9.86, 95%CI [-11.70, -8.02], P<0.01}, and the complications were fewer [RR=0.66, 95%CI (0.50, 0.87), P=0.003]. Conclusion  The cardiac electronic device implantation via axillary vein access demonstrates a high success rate,short operation time and low incidence of adverse events, which enables it as a preferred puncture approach. However, more scientifically reasonable prospective randomized controlled studies with larger sample sizes are still needed to make it verified.
    • LI Aizhen
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      Objective  To investigate the efficacy of ambulatory electrocardiographic monitoring in evaluating the prognosis of patients with acute myocardial infarction (AMI) treated by percutaneous coronary intervention (PCI). Methods  Clinical data of 80 AMI patients treated by PCI were retrospectively analyzed. The incidence of adverse cardiovascular and cerebrovascular events was observed during a 1-year follow-up period. Based on the follow-up outcomes, patients were divided into a good prognosis group (n=57) and a poor prognosis group (n=23). Electrocardiogram (ECG) parameters of both groups were recorded, while their prognosis predictive value was assessed. Results  In the good prognosis group, adverse cardiovascular and cerebrovascular events occurred in 5 cases including 3 cases with repeated revascularizations, 1 case with malignant arrhythmia, and 1 case with hypertension. In the poor prognosis group, adverse events included 8 cases of recurrent myocardial infarction, 5 cases of repeated revascularization, 7 cases of heart failure, and 3 cases of cardiogenic shock. No statistically significant difference in QT dispersion was observed between the two groups (P>0.05). However, statistically significant differences were noted in the following parameters: standard deviation of all normal-to-normal (NN) intervals (SDNN), ratio of low-frequency to high-frequency power (LF/HF), turbulence slope, and turbulence onset (all P<0.01). ROC curve analysis revealed that the combined detection of these parameters yielded an AUC value of 0.969, surpassing the prognosis predictive value of any single parameter. Conclusion  Ambulatory electrocardiographic monitoring demonstrates significant predictive value for the prognosis of AMI patients treated by PCI. It makes accurate assessment of their risk for adverse events.
    • LUO Weimin, LEI Lei
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      Critical electrocardiogram (ECG) value reporting system plays a crucial role in the timely recognition and treatment of critical cardiovascular conditions in clinical settings. However, this system still faces several challenges, for example, the diagnostic bias stemming from ECG diagnosticians-lack of clinical context; inconsistent standards set by local professional societies; significant variations in diagnostic efficiency of ECG manifestations related to certain diseases; and failure to make dynamic adjustments and timely incorporation of new critical values. To address these issues, this paper proposes modifications to the critical ECG value reporting system  by including more specific content and clearer standards, and establishing an additional subcategory of “important positive finding” and a graded reporting system, which could support clinical diagnosis and treatment more effectively.
    • WANG Jingjing1, JING Yongming1, SHEN Jihong1, LIU Shichao1, GENG Yiming2, LI Shifeng1
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      Objective  To explore the clinical value of electrocardiographic waterfall plots in the diagnosis of intermittent QRS complex widening. Methods  The typical cases with intermittent QRS complex widening in ambulatory electrocardiography were retrospectively analyzed. The characteristics of their electrocardiographic waterfall plots were observed and summarized. Results  During intermittent QRS complex widening, the electrocardiographic waterfall plot demonstrated widening and discoloration of the R-peak band with concomitant T-peak band discoloration. The electrocardiographic pattern showing normal P-peak band progression with a PR interval within a normal range was observed in conditions such as intermittent left or right bundle branch block and VAT ventricular pacing. Abnormal P-peak band progression (manifesting as shift, fragmentation, or absence) was observed in idioventricular rhythms and VVI pacing rhythms; whereas normal P-peak band progression with shortened PR intervals occurred in intermittent ventricular preexcitation. Conclusion  Electrocardiographic waterfall plot is suitable for rapid diagnosis and differential diagnosis of intermittent QRS complex widening, which could effectively make up for the defects of scatter plot technology in ignoring morphological information.
    • DING Xiaoli, CHEN Xinwei, ZHANG Lin
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      Objective  To explore the value of Lorenz-RR scatter plot on the assessment of disease conditions in patients with acute myocardial infarction (AMI). MethodsWe selected 200 patients with AMI as study objects. Patients were divided into two groups based on the Killip classification: a mild severity group (n=120, Killip class Ⅰ or Ⅱ) and a severe group (n=80, Killip class Ⅲ or Ⅳ). We compared the Lorenz-RR scatter plot indicators [the proportion of low-density area (L), proportion of medium-density area (M), proportion of high-density area (H), total area of scatter plot (S), head area of scatter plot (S1) and short-axis area of scatter plot (S2)] between the two groups. Spearman correlation analysis was adopted to explore the correlation between Lorenz-RR scatter plot indicators and Killip classification. ROC curve analysis was performed to investigate the value of Lorenz-RR scatter plot in assessing the disease conditions of myocardial infarction. ResultsThe L and S1 values in the severe group were significantly higher than those in the mild severity group, while the M, H, S, and S2 values were significantly lower than those in the mild severity group (all P<0.05). The indicators of L and S1 were positively correlated with Killip classification (r=0.610, 0.616, respectively, both P<0.01), while the M, H, S and S2 indicators were negatively correlated with Killip classification (r=-0.620, -0.603, -0.613, -0.481, respectively, all P<0.01). ROC curve analysis showed that the AUC values of L, M, H, S1, S2 and S for evaluating the progression of myocardial infarction were separately 0.784, 0.865, 0.881, 0.787, 0.764 and 0.793, the sensitivities were separately 71.25%, 96.25%, 97.50%, 73.75%, 76.25% and 77.50%, and the specificities were 75.83%, 70.00%, 81.67%, 75.00%, 74.17% and 70.83%, respectively, all with high predictive efficiency (all P<0.01). Conclusion  The progression of AMI is related to the density and area indicators of Lorenz-RR scatter plot. Monitoring the distribution of area and density in Lorenz-RR scatter plot helps to guide clinical evaluation of disease progression.
    • HUANG Juxiang, ZHANG Fangfang, JING Yan, NIE Liantao, JING Yongming, LI Zhongjian, LI Shifeng
      2025, 34(3): 423-428.
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      Objective  To explore the application value of electrocardiographic scatter plot in the diagnosis and differential diagnosis of insertive premature ventricular contraction (PVC). Methods  We selected cases of similar ambulatory electrocardiography such as insertive PVC, ventricular repetitive beats, as well as consecutive ventricular and atrial premature beats. Combined with the reverse techniques of electrocardiographic scatter plots, we analyzed the constant or variable nature of RR interval and its electrophysiological mechanism. The characteristics of electrocardiographic scatter plots and differential diagnosis key points of common arrhythmias similar to insertive PVC were summarized. Results  The compensatory interval (VN′) of insertive PVC was a variable with a variability approximately equal to that of NN cycle. The VN′ and VS cycles of ventricular repetitive beats, and consecutive ventricular and atrial premature beats were constants, indicating a reentrant mechanism. The characteristic of the electrocardiographic scatter plot of insertive PVC was that the VN′ layer was distributed below the NN layer, and fluctuated up and down accordingly; the VN′N point set was obliquely distributed in the short-long interval sector; the NVN′N point set was distributed obliquely along the positive side of y-axis, extending towards the lower right, while the VN′NN point set was distributed along the positive side of x-axis, extending towards the upper left. Common scatter plot features were shared by ventricular repetitive beats, as well as consecutive ventricular and atrial premature beats: the VN′/VS layer was horizontally distributed below the NN layer; VN′N/VSN was vertically distributed in the short-long interval sector; NVN′N/NVSN was distributed obliquely below the positive side of x-axis. Conclusion  The constant or variable nature of RR interval determines the morphological characteristics of electrocardiographic scatter plot; conversely, the electrocardiographic scatter plot can clearly reflect the constant or variable nature of RR interval. Therefore, electrocardiographic scatter plot technology could be used to make quick diagnosis and differential diagnosis of insertive PVC.
    • BAI Shuya1, SHI Rongwei2
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      Insomnia, characterized by frequent difficulty in falling asleep due to the failure of yang to enter yin, is a common clinical syndrome. Western medicine usually treats insomnia with sedative-hypnotic drugs. Professor Li Qiyi's clinical approach primarily focuses on addressing the deficiency of qi and blood, as well as the stagnation of the heart and liver in treatment. Based on presenting symptoms, his therapeutic regimen is supplemented by heat-clearing and fire-purging methods combined with heavy sedation for mind tranquility. Additionally, Professor Li advises patients to develop healthy lifestyles. This article provides novel insights into insomnia treatment by discussing Professor Li's understandings of the etiology and pathogenesis of insomnia, as well as his empirical prescriptions and commonly used drugs in traditional Chinese medicine, focusing on nourishing qi and blood, soothing the liver and resolving depression, and treating the heart and liver together.
    • LI Ning, WEI Xiaohua, YANG Jiewei
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      Objective  To analyze the influence of hospital-community-family trinity linkage management model combined with encouragement-education-exercise-work-assessment (5E) rehabilitation on the compliance behavior and self-management ability of patients with coronary heart disease (CHD) treated by coronary artery bypass grafting (CABG). Methods  We selected 80 CHD patients treated by CABG. They were divided into two groups according to the random number table method, with 40 cases in each group. The control group received routine intervention, while the observation group received the trinity linkage management model combined with 5E rehabilitation. Both groups received continuous interventions for 6 months. The compliance behavior scores were statistically analyzed and compared between both groups after 1 month and 6 months of intervention. The self-management ability [coronary heart disease selfmanagement scale (CSMS)] and quality of life [Seattle angina questionaire (SAQ)] between the two groups were compared before intervention and after 6 months of intervention. Results  After 6 months of intervention, the compliance behavior scores of the two groups decreased compared to that after 1 month of intervention, while the compliance behavior scores of the observation group was higher than that of the control group (P<0.01). After 6 months of intervention, the CSMS and SAQ scores of both groups were higher than those before intervention, while the above scores of the observation group were higher than those of the control group (all P<0.05). Conclusion  The combination of the trinity linkage management model and 5E rehabilitation can effectively improve the compliance behavior, self-management ability, and quality of life of CHD patients treated by CABG.
    • XIE Yuli
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      ObjectiveTo explore the influence of respiratory muscle training combined with task-oriented training on the balance and gait functions in elderly patients with post-stroke hemiplegia. MethodsA total of 252 elderly patients with post-stroke hemiplegia meeting the inclusion criteria were prospectively enrolled in our study. They were randomly divided into a combination group (receiving respiratory muscle training combined with task-oriented training), and a control group (receiving task-oriented training), with 126 cases in each group. Both groups of patients were trained for 8 weeks. The Berg balance scale, six-minute walk test (6MWT), National Institutes of Health stroke scale (NIHSS), and stroke-specific quality of life scale (SS-QOL) were separately used to assess the balance and gait functions, and quality of life of these patients before and after treatment. ResultsBefore treatment, there were no statistically significant differences in Berg score, 6MWT distance, and NIHSS and SS-QOL scores of the elderly patients with post-stroke hemiplegia between the combination group and the control group (all P>0.05). After treatment, the Berg score, 6MWT distance, and SS-QOL score in the combination group were significantly higher than those of the control group, while the NIHSS score was significantly lower than that of the control group (all P<0.01). ConclusionRespiratory muscle training combined with task-oriented training could effectively enhance the balance and gait functions of elderly patients with post-stroke hemiplegia,effectively improve patients- quality of life, and is beneficial for the prognosis improvement.
    • JIANG Yan
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      Objective  To explore the practical application significance of ABC emotional nursing combined with individualized nutritional intervention in hemodialysis patients with chronic renal failure (CRF). Methods  Eighty-four CRF patients undergoing hemodialysis were selected, and divided into two groups according to the method of random number table, with 42 cases in each group. The control group adopted routine nursing, while the observation group adopted ABC emotional nursing combined with individualized nutritional intervention on the basis of the above. The emotional status, nutritional status and quality of life after 3 months of continuous nursing were compared between the two groups. Results  After nursing, the self-rating depression and anxiety scales in the observation group were both significantly lower than those in the control group (both P<0.01). After nursing, the prealbumin and serum albumin levels of the observation group were both higher than those of the control group; the triceps skinfold thickness and mid-arm muscle circumference of the observation group were both significantly greater than those of the control group (both P<0.05); the health questionnaire score of the observation group was significantly higher than that of the control group (P<0.01). Conclusion  ABC emotional nursing combined with individualized nutritional intervention could improve the negative mood and nutritional status in hemodialysis patients with CRF, and improve their quality of life.
    • SUN Liping
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      This article provides a brief introduction to cardiac resynchronization therapy (CRT), and discusses recent advances in its clinical application for treating heart failure. It outlines potential new indications for CRT, and summarizes progress in CRT implantation and pacing techniques. This paper also envisions the broad application prospects of computer modeling and digital twin solutions in CRT. With continuous development of technology, CRT will play an increasingly important role in the treatment of heart failure.