Objective To assess the feasibility and application value of wearable electrocardiogram (ECG) devices in the remote dynamic monitoring of ECG abnormalities among patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI), and to explore the dynamic change characteristics and clinical significance of various kinds of arrhythmias. Methods A total of 124 CHD patients after PCI from three primary hospitals separately in Kuche City, Shawan City, and Shache County of Xinjiang Uygur Autonomous Region were enrolled. Village doctors were trained to assist patients in wearing wearable ECG devices, and a 12-lead resting ECG was recorded weekly for these patients one month after discharge. Basic clinical information during hospitalization and ECG data for four consecutive weeks after discharge were collected. Line charts were plotted, and the Cochran-Armitage trend test was used to analyze the changes in the detection rates of various kinds of arrhythmias monitored by the wearable devices over the four weeks. Results During the one-month continuous dynamic monitoring, the wearable ECG devices demonstrated high capabilities in detecting various kinds of arrhythmias, including rhythm abnormalities (41 cases, 33.06%), conduction blocks (29 cases, 23.39%), ST-segment changes (71 cases, 57.26%), electrical axis deviation (18 cases, 14.52%), ventricular hypertrophy (8 cases, 6.54%), and QT interval abnormalities (88 cases, 70.97%). The cumulative detection rate of rhythm abnormalities, ST-segment changes, electrical axis deviation, ventricular hypertrophy, and QT interval abnormalities all showed a weekly increasing trend (Cochran-Armitage trend test P<0.05). Some patients experienced the same type of arrhythmia multiple times during the follow-up, suggesting that electrophysiological abnormalities exhibited dynamic fluctuations or a persistent state. Conclusion Wearable ECG devices could effectively achieve remote dynamic ECG monitoring for post-PCI patients, with good feasibility and clinical utility.

Electrocardiogram (ECG) serves as a crucial tool for diagnosing cardiovascular diseases. With the rapid advancement of artificial intelligence (AI) technology, the application of AI in ECG analysis has gradually become a research hotspot. AI technology not only enables automated and accurate ECG interpretation, but also significantly improves the efficiency and accuracy of largescale cardiovascular disease screening in populations. This review summarizes the latest progress in AIassisted ECG analysis for cardiovascular system diseases, with a focus on its applications in arrhythmias, structural heart diseases, and acute cardiovascular events. Furthermore, it discusses development directions. As explainable AI technology evolves in the future, AIECG models are expected to be more widely adopted in clinical practice.

Objective To explore the application value of wearable electrocardiographic (ECG) monitoring devices in the remote diagnosis and treatment of cardiovascular and cerebrovascular diseases. Methods A total of 16 117 ECG reports collected via wearable ECG devices from community health centers in Kuche City of Xinjiang Uygur Autonomous Region were randomly selected. The analysis focused on the detection rate of abnormal ECGs, the identification of critical values and warning-level ECG findings, as well as the clinical outcomes of cases with critical values. Results The study included 16 117 valid ECG recordings. The average age of the participants was 54.5 years, with 7 256 (45.02%) males and 8 861 (54.98%) females. Among these ECGs, 4 985 cases were abnormal, including 45 (0.28%) with critical values and 548 cases (3.40%) of warning ECGs. Of the 45 cases with critical values, 2 (4.44%) were lost to follow-up, 15 (33.33%) refused medical advice, 5 (11.11%) died despite rescue efforts at local hospitals, and 22 (48.89%) followed the recommendation to seek medical care. Among these 22 cases, the time from receiving the ECG diagnosis to presenting at the hospital ranged from 41 to 436 minutes, with an average duration of 108.95 minutes. After seeking medical attention, 6 cases were discharged after observation and improvement, 9 received pharmacological treatment, and 7 underwent surgical procedures. Among the 7 surgical cases, the time from admission to surgery ranged from 16 to 372 minutes, averaging 101.86 minutes. Of these cases, 5 (71.43%) underwent coronary stent implantation, 1 (14.29%) was transferred to a higher-level hospital for coronary artery bypass grafting, and 1 (14.29%) received pacemaker implantation. One case died despite rescue efforts. Conclusion Wearable ECG monitoring devices enable remote ECG monitoring and early risk warning, facilitating timely medical intervention, reducing the risk of cardiovascular events, and demonstrating significant application value.

Paroxysmal atrial fibrillation (PAF) is a type of arrhythmias with high morbidity and mortality. It is characterized by brief episodes of atrial fibrillation that terminate spontaneously. Particularly in patients with cryptogenic stroke or transient ischemic attack, the detection rate of PAF is even higher. If it is not identified in time, the risk of stroke and heart failure will further increase. Since PAF is often asymptomatic or occurs silently, early screening and management are key to preventing related complications. The application of artificial intelligence technology in the medical field has provided new tools and methods for the diagnosis of PAF. This article reviews recent research and practical value of artificial intelligence technology in assisting PAF screening, prediction, diagnosis and management, and discusses its application prospects and challenges in the field of PAF.

Objective To investigate the relationship between 24-hour ambulatory blood pressure (ABP) changes in hypertension patients with liver-kidney yin deficiency and the risk of cardio-cerebrovascular diseases, as well as the association between blood pressure circadian rhythm and the development of these diseases. Methods Clinical data of 123 hypertension patients with liver-kidney yin deficiency who had undergone 24-hour ABP monitoring were retrospectively analyzed. Based on the presence of coronary heart disease or cerebral infarction, these patients were divided into a cardiovascular disease group (n=29), a cerebrovascular disease group (n=34), a cardio-cerebrovascular disease group (n=28), and a control group (without coronary heart disease or cerebral infarction, n=32). The 24-hour systolic blood pressure (SBP), diastolic blood pressure (DBP), daytime SBP and DBP and their load, as well as nocturnal SBP and DBP and their load were summarized and compared among the groups. Results No significant nocturnal blood pressure decline was observed in hypertension patients with liver-kidney yin deficiency, and their circadian rhythm was disrupted; 74% of the patients exhibited a non-dipper blood pressure pattern. However, no statistically significant difference in circadian rhythm was found among the groups (P>0.05). Analysis of variance or Kruskal-Wallis tests revealed that except for nocturnal DBP, 24-hour SBP and DBP, daytime SBP and DBP, nocturnal SBP, and corresponding blood pressure load all showed statistically significant differences between the disease groups and the control group (all P<0.05). Intergroup comparisons indicated that the cardiovascular disease group had the highest blood pressure level and the greatest blood pressure load. Conclusion Hypertension patients with liver-kidney yin deficiency exhibit severe disruption of blood pressure circadian rhythm, predominantly presenting as a non-dipper pattern. Atherosclerosis may contribute to elevated blood pressure and load in the early stage of cardio-cerebrovascular diseases. However, with the aggravation of vascular sclerosis to the stage of combined cardio-cerebrovascular involvement, blood pressure level and load slightly decrease compared to the early phase. These findings highlight the importance of assessing cardio-cerebrovascular event risks alongside blood pressure management.

Objective To analyze the therapeutic effect of low-flow oxygen inhalation in elderly patients with hypertension complicated by obstructive sleep apnea syndrome (OSAS). Methods A total of 175 elderly patients with hypertension and OSAS were selected as study subjects. All patients received conventional antihypertensive medication as recommended by guidelines. Those receiving continuous positive airway pressure (CPAP) therapy, low-flow oxygen inhalation therapy, and no corresponding intervention were assigned to a CPAP group (55 cases), a low-flow oxygen group (60 cases), and a control group (60 cases), respectively. Clinical data were collected, including body mass index, waist circumference, underlying diseases, laboratory test results and color Doppler echocardiography parameters, as well as systolic/diastolic blood pressure, Epworth sleepiness scale (ESS) scores, nocturnal minimum saturation of peripheral oxygen (SpO2), and apnea hypopnea index (AHI) before and after intervention (3 months of treatment). ResultsBlood pressure control and respiratory parameters in the low-flow oxygen group both improved significantly after oxygen inhalation (both P<0.05). After 3 months of follow-up, the nocturnal minimum SpO2 in both the low-flow oxygen and CPAP groups increased significantly compared with pre-intervention levels (both P<0.01). There was statistically significant difference in nocturnal minimum SpO2 after intervention among the three groups (P<0.01). After pharmacotherapy or intervention, systolic and diastolic blood pressures both decreased significantly in all the three groups compared with pre-intervention levels (all P<0.05), and post-intervention differences in systolic and diastolic blood pressures among the three groups were statistically significant (all P<0.05). Compared with baseline, both the low-flow oxygen group and the CPAP group demonstrated significant reduction in ESS score and AHI after the intervention (both P<0.05). Conclusion Low-flow oxygen inhalation therapy in elderly patients with hypertension and OSAS could partially improve sleep respiratory parameters, increase nocturnal SpO2, and help to increase the compliance rate of blood pressure control, reduce the use of antihypertensive medication and alleviate economic burden.

Objective To investigate whether irisin exerts its protective effect against myocardial hypoxia/reoxygenation (H/R) injury by regulating the MEK1/RanBP2 signaling pathway. Methods An H/R injury model was established by using H9C2 cardiomyocytes. The H9C2 cells were randomly divided into four groups: a control group (untreated H9C2 cells), an H/R group (H9C2 cells subjected to H/R injury), an irisin group (H9C2 cells pretreated with 10 ng/mL irisin for 2 h), and an H/R+ irisin group (H9C2 cells pretreated with 10 ng/mL irisin for 2 h followed by H/R injury). Cell viability was assessed using the MTT assay, and cell death rate was evaluated by lactate dehydrogenase leakage rate. Mitochondrial dysfunction induced by H/R injury was also detected. Changes in the expression of the E3 ubiquitin ligase (RanBP) 2 and MEK1 signaling molecules were analyzed by immunoblotting. Results Irisin significantly inhibited H/R-induced H9C2 cardiomyocyte death. The cell viability rate was only (43.28±2.37)% in the H/R group, however it increased to (76.24±6.28)% after irisin pretreatment (P=0.000 7), and the cell death rate decreased from (57.38±4.38)% to (26.38±3.29)% (P=0.000 4). Additionally, irisin effectively inhibited the opening of the mitochondrial permeability transition pore induced by H/R injury. Mechanistic studies further revealed that the protective effect of irisin was associated with the regulation of RanBP2 cellular localization via the MEK1 signaling pathway. Conclusion Irisin protects against myocardial H/R injury by inhibiting MEK1-mediated sequestration of RanBP2 and altering the cellular localization of RanBP2.

Objective To explore the clinical performance of non-invasive prenatal testing (NIPT) in screening for fetal chromosomal copy number variations (CNVs). Methods In this retrospective cohort study, 196 high-risk NIPT samples were analyzed. The results of chromosomal karyotyping analysis or chromosomal microarray analysis (CMA) were compared. The positive rate and positive predictive value (PPV) of fetal CNVs, and other clinical data were screened by NIPT, so as to assess the detection value of NIPT for fetal CNVs. Results A total of 20 378 NIPT samples were tested. Among the 196 high-risk samples, 54 were CNVs, with a screening positive rate of 0.265%. Forty-six pregnant women underwent interventional prenatal diagnosis, among whom there were 21 cases confirmed with CNVs including 13 cases with pathogenic variations, 3 cases with likely pathogenic variations, and 5 cases with variations of unknown significance. The PPV of NIPT for screening CNVs was 45.65%. Seventeen cases of microdeletion CNVs and 36 cases of microduplication CNVs were screened out by NIPT, and 1 case was microdeletion combined with microduplication CNVs, accounting for 31.48% (17/54), 66.67% (36/54), and 1.85% (1/54), respectively. The corresponding PPVs were 64.29%, 35.48% and 100.00%, respectively. Statistical analysis showed that there were no statistically significant differences in the positive rate and PPV of NIPT for screening microdeletion CNVs and microduplication CNVs (all P>0.05). Conclusion NIPT demonstrates relatively high positive rate and PPV for screening fetal CNVs. Interventional prenatal diagnosis should be recommended for those with high-risk of CNVs by NIPT. NIPT combined with chromosomal karyotyping analysis and CMA could provide precise genetic counseling and guidance for clinical practice.

Objective To investigate the correlation between peripheral serum Semaphorin 3E (Sema3E) protein levels and recent death of acute myocardial infarction (AMI) patients undergoing emergency percutaneous coronary intervention (PCI). Methods A total of 147 patients treated by PCI were selected, including 67 AMI patients and 80 patients with stable coronary artery disease. All participants were followed up for an average of 6 months (ranging from 3 to 12 months), with all-cause death as the endpoint event. Based on the follow-up outcomes, patients were categorized into a survival group (139 cases) and a death group (8 cases) to analyze the correlation between peripheral serum Sema3E protein levels and their recent death. A subgroup analysis of the 67 AMI patients was performed. These patients were further divided into an AMI survival group (61 cases) and an AMI death group (6 cases) based on the follow-up results. The relationship between Sema3E protein levels and recent death of AMI patients after emergency PCI was explored. Results There were statistically significant differences in age, neutrophil count (NE), hemoglobin, NT-proBNP, and Sema3E protein level between the survival and death groups (all P<0.05). Multivariate binary Logistic regression analysis identified age (OR=1.140, 95%CI 1.028-1.264, P=0.013), NE (OR=1.582, 95%CI 1.091-2.296, P=0.016), and serum Sema3E protein level (OR=1.002, 95%CI 1.001-1.003, P=0.001) as risk factors for their recent death. Subgroup analysis showed statistically significant differences in age, hemoglobin, total cholesterol, low-density lipoprotein cholesterol, and Sema3E level between the two subgroups (all P<0.05). Multivariate binary Logistic regression analysis further confirmed serum Sema3E (OR=1.005, 95% CI 1.000-1.009, P=0.037) as an independent risk factor for recent death of AMI patients. Conclusion Peripheral serum Sema3E protein levels are correlated with recent death of AMI patients undergoing emergency PCI.

Objective To explore the expression levels of serum ferritin, nesfatin-1, and cAMP response element-binding protein (CREB) in patients with gestational diabetes mellitus (GDM), and their correlation with insulin resistance. Methods Sixty-three patients with GDM were selected as an observation group. Based on matching principle, 63 healthy pregnant women who had undergone prenatal care during the same period were selected as a control group at a ratio of 1∶1. The levels of fasting plasma glucose (FPG) and fasting insulin (FINS), and homeostasis model assessment of insulin resistance (HOMA-IR) were compared between the two groups at admission. The levels of serum ferritin, nesfatin-1 and CREB were compared between the two groups at admission, and among patients with different severities of disease in the observation group. We analyzed the correlation of these indicators with HOMA-IR, FPG, FINS and disease severity. The value of ferritin, nesfatin-1, and CREB in assessing the severity of GDM was explored. Results The levels of FINS, FPG, HOMA-IR, ferritin, CREB, and nesfatin-1 in the observation group were all higher than those in the control group (all P<0.05). The levels of serum ferritin, CREB, and nesfatin-1 in severe patients of the observation group were higher than those in mild to moderate patients (P<0.05). The levels of serum ferritin, nesfatin-1, and CREB in the observation group were positively correlated with HOMA-IR, FPG and FINS levels, and disease severity (all P<0.01). The AUC value of the combined serum ferritin, CREB, and nesfatin-1 for evaluating the severity of GDM was larger than that of each indicator alone (all P<0.01). Conclusion The levels of serum ferritin, CREB and nesfatin-1 in patients with GDM are significantly elevated, and closely correlated with insulin resistance. Understanding the changes in the levels of these serum biomarkers could assist in the clinical assessment of the disease severity, and guide clinical treatment.

Objective To analyze the predictive value of heart rate deceleration capacity (DC) and QT dispersion (QTd) for major adverse cardiovascular events (MACEs) in patients with acute myocardial infarction (AMI). Methods A retrospective analysis was conducted on 80 AMI patients who had all undergone percutaneous coronary intervention (PCI), designated as an observation group. Based on the occurrence of MACEs during follow-up, they were further divided into an occurrence group (20 cases) and a non-occurrence group (60 cases). Additionally, 80 healthy examinees during the same period were selected as a control group. Heart rate DC and QTd were compared between the observation group and the control group, as well as between the occurrence group and the non-occurrence group from the observation group. The predictive value of heart rate DC and QTd for MACEs in AMI patients was analyzed by using ROC curve analysis. Results Among the 80 AMI patients in the observation group, 20 experienced MACEs during follow-up, accounting for 25.00% (20/80). The heart rate DC in the observation group was significantly lower than that in the control group, while the QTd was significantly higher (both P<0.01). The heart rate DC in the occurrence group was lower than that in the non-occurrence group, and the QTd was higher (both P<0.01). ROC curve analysis showed that the combined assessment of heart rate DC and QTd had a higher predictive value for MACEs in AMI patients (AUC=0.958) compared to either parameter alone (AUC=0.895 and 0.812, respectively). Conclusion Heart rate DC and QTd could predict the risk of MACEs in AMI patients, and their combined use offers higher predictive value.

Objective To investigate the risk factors for all-cause mortality in elderly patients with coronary heart disease (CHD) complicating hypertension, and to establish a prediction model. Methods A total of 240 elderly patients with CHD and hypertension were enrolled as research subjects. Based on different prognoses, the patients were divided into a survival group (195 cases) and a death group (45 cases). Univariate and multivariate Logistic regression analyses were used to screen risk factors for all-cause mortality in elderly patients with CHD and hypertension, and a nomogram prediction model was constructed. Results There were no statistically significant differences between the two groups in terms of sex, smoking history or history of hyperlipidemia (all P>0.05). However, statistically significant differences were observed in age, history of diabetes, duration of CHD, duration of hypertension, systolic blood pressure, diastolic blood pressure, heart rate, left ventricular ejection fraction (LVEF), creatinine levels, and brain natriuretic peptide levels (all P<0.05). Binary Logistic regression analysis showed that age, history of diabetes, LVEF, creatinine levels, and brain natriuretic peptide levels were all independent risk factors for all-cause mortality in patients with CHD complicated by hypertension (all P<0.05). Based on the above five risk factors, a nomogram prediction model was further developed. Validation using the ROC curve demonstrated that the model exhibited good performance in predicting the risk of all-cause mortality among elderly CHD patients complicating hypertension, with an AUC value of 0.823 (95%CI 0.730-0.917). The model showed good discrimination and high clinical application value. Conclusion The nomogram model constructed based on the five risk factors—age, history of diabetes, LVEF, creatinine levels, and brain natriuretic peptide levels, could effectively increase the prediction value for all-cause mortality risk in elderly patients with CHD and hypertension.

Objective To investigate the correlation between serum complement C1q tumor necrosis factor-related protein 1 (CTRP1), pentraxin 3 (PTX3) and matrix metalloproteinase-9 (MMP-9) levels, and the therapeutic effect of trimetazidine in patients with unstable angina pectoris (UAP). Methods A total of 148 UAP patients were selected as research subjects. All patients received trimetazidine treatment. Based on clinical efficacy after 8 weeks, they were divided into an effective group (105 cases) and a non-responders group (43 cases). Serum levels of CTRP1, PTX3, and MMP-9 were compared between the two groups; the correlation between these serum indicators and clinical efficacy was analyzed. Logistic regression analysis was used to identify risk factors for trimetazidine treatment inefficacy, while ROC analysis was utilized to evaluate the predictive value of combined serum indicators for treatment inefficacy. Results After 2 and 4 weeks of treatment, serum levels of CTRP1, PTX3, and MMP-9 were all higher in the non-responders group than those in the effective group, while each serum indicator showed a negative correlation with therapeutic efficacy (all P<0.05). Serum CTRP1, PTX3, and MMP-9 levels at 2 and 4 weeks were identified as risk factors for trimetazidine treatment inefficacy in UAP patients. The AUC values for their combined prediction of treatment inefficacy were 0.870 and 0.920, respectively. Conclusion The expression of serum CTRP1, PTX3 and MMP-9 is all upregulated in UAP patients, which is closely correlated with therapeutic efficacy of trimetazidine. Combined detection of these biomarkers could serve as an effective indicator for early clinical prediction of treatment outcomes.

Objective To explore the application value of Panavia F resin cement (abbreviated as Panavia F cement) and multi-functional glass ionomer cement (abbreviated as multi-functional cement) in the restoration of tooth defects. Methods We selected clinical data of 106 patients with tooth defects who had undergone dental restoration. According to different restorative materials, they were divided into a Panavia F group and a glass ionomer group, with 53 cases in each group. The Panavia F group was restored using Panavia F cement, while the glass ionomer group was restored by using multi-functional cement. The therapeutic efficacy, inflammatory mediators ［high-sensitivity C-reactive protein (hs-CRP), interleukin-1 beta (IL-1β) and matrix metalloproteinase-2 (MMP-2)］, periodontal indicators, gingival health status ［modified United States public health service (USPHS) criteria］, and the occurrence of complications were compared between the two groups. Results The total effective rate of restoration in the Panavia F group showed no statistically significant difference compared to the glass ionomer group (P>0.05). At 3 and 6 months after restoration, the levels of hs-CRP, IL-1β, and MMP-2 in the Panavia F group were all lower than those in the glass ionomer group (all P<0.01). The probing depth, plaque index, and bleeding index in the Panavia F group were all lower than those in the glass ionomer group (all P<0.05). At 6 months after restoration, the modified USPHS rating in the Panavia F group was better than that in the glass ionomer group (P<0.05). There was no statistically significant difference in the overall incidence of complications between the two groups (P>0.05). Conclusion Both Panavia F cement and multi-functional cement are safe and reliable restoration options for tooth defects. The former demonstrates superior effects in reducing inflammatory response, and improving gingival health and periodontal condition compared to the latter.

Objective To investigate the characteristics of ambulatory electrocardiography (AECG) in patients with viral infection. Methods Basic information, conventional electrocardiogram (ECG), and AECG monitoring data of patients with viral infection were retrospectively collected and statistically analyzed. Results A total of 277 patients were enrolled, including 111 males with a mean age of (60.6±20.2) years and 166 females with a mean age of (53.4±16.8) years. The average age of males was significantly higher than that of females (P<0.01). The positive detection rate of conventional ECG was significantly lower than that of AECG monitoring (76.2% vs. 96.8%, P＜0.01). Among the patients, there were 60 cases (21.7%) with atrial arrhythmia, 72 cases (26.0%) with ventricular arrhythmia, and 18 cases (6.5%) with atrioventricular block. The incidence of atrial arrhythmia in males was significantly higher than that in females (30.6% vs. 15.7%, P<0.01). Logistic regression analysis showed that age was an independent risk factor for the occurrence of atrial arrhythmia, ventricular arrhythmia, and intraventricular conduction block. Conclusion Patients with viral infection are prone to various types of arrhythmias, with severe cases even presenting third-degree atrioventricular block.

Objective To investigate the independent and combined predictive value of remnant cholesterol (RC) and heart rate variability (HRV) for major adverse cardiovascular events (MACEs) in patients with coronary heart disease (CHD) during hospitalization, aiming to provide a new assessment tool for clinical risk stratification and precise intervention. Methods A total of 332 patients with CHD were selected as study subjects. Data including age, sex, smoking history, blood pressure, echocardiographic parameters, serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were recorded. Average heart rate, and HRV indexes including SDNN, triangular index, SDNN index, rMSSD and pNN50 were recorded via 24-hour ambulatory electrocardiography monitoring. Based on the occurrence of MACEs during hospitalization, these patients were divided into a MACEs group (44 cases) and a non-MACEs group (288 cases). Multivariate Logistic regression analysis was used to explore influencing factors for MACEs in patients with CHD during hospitalization. ROC curves were plotted to evaluate the predictive efficiency of RC and SDNN for MACEs. Results Neutrophil count, and triglyceride, TC and RC levels were all significantly higher in the MACEs group than those in the non-MACEs group (all P<0.01); HDL-C and SDNN were significantly lower in the MACEs group (both P<0.05). Multivariate Logistic regression analysis showed that RC (OR=1.275, 95%CI 1.145-1.419, P<0.01) and SDNN (OR=0.967, 95%CI 0.951-0.982, P<0.01) were independent influencing factors for MACEs in CHD patients. ROC curve analysis revealed that the AUC values for predicting MACEs in CHD patients using RC and SDNN were 0.755 (95%CI 0.662-0.848, P<0.01) and 0.771 (95%CI 0.703-0.840, P<0.01), respectively. The AUC value of the combined prediction of RC and SDNN for MACEs was 0.845 (95%CI 0.779-0.910, P<0.01). Conclusion Both RC and SDNN could independently predict the risk of MACEs in CHD patients during hospitalization. Their combined assessment model demonstrates higher predictive efficiency and clinical utility.

Using ambulatory electrocardiography (AECG) segment from a patient with vasovagal syncope implanted with a BIOTRONIK Evia DR dual-chamber pacemaker as the point of entry, this paper systematically analyzes the design principles of BIOTRONIK pacemaker's closed-loop stimulation technology and electrocardiographic characteristics. It aims to provide references for electrocardiography technicians in analyzing and diagnosing pacemaker-associated AECGs.

Objective To analyze the efficacy of negative pressure puncture in the initial use of arteriovenous fistula (AVF) among patients with diabetic kidney disease (DKD). Methods A total of 80 DKD patients undergoing initial AVF conventional puncture (first 10 punctures) were enrolled, with 40 patients assigned to the negative pressure puncture group and the other 40 cases to the conventional puncture group. Clinical data of the two groups were analyzed. We compared the first-attempt success rate, puncture duration, puncture pain, complications,and blood flow compliance rate between the two groups. The operator satisfaction, and patient satisfaction were also assessed. Results The negative pressure puncture group demonstrated a significantly higher first-attempt success rate and significantly shorter puncture duration compared to the conventional puncture group (both P<0.01). Face rating scale (FRS) scores during puncture were also significantly lower in the negative pressure puncture group (P<0.01). The incidence of puncture-related injuries, hematomas, and oozing were significantly reduced in the negative pressure puncture group, while blood flow compliance rate, operator satisfaction, and patient satisfaction were all significantly higher (all P<0.05). Conclusion For DKD patients during initial AVF use, negative pressure puncture significantly improves puncture success rates, reduces patient puncture pain, prevents complications such as hematomas and oozing, and enhances the satisfaction of both operators and patients.

Objective To investigate the effect of network-platform-based family cardiac rehabilitation intervention on patients with chronic heart failure (CHF). Methods A total of 88 CHF patients were selected, and randomly divided into a control group and an observation group using the random number table method, with 44 cases in each group. The control group received routine care after discharge, while the observation group received network-platform-based family cardiac rehabilitation intervention. Both groups underwent continuous intervention for 2 months. Exercise tolerance, cardiac function parameters, and quality of life before and after intervention were compared between the two groups. Results After the intervention, the observation group showed significantly longer 6-minute walk test distance, significantly better cardiac function parameters, and significantly higher scores across all the 36-item short form health survey (SF-36) domains (all P<0.01) compared to the control group. Conclusion Network-platform-based family cardiac rehabilitation intervention could effectively improve exercise tolerance and cardiac function in CHF patients, thereby enhancing their quality of life.

Objective To explore the application value of the PDCA cyclic quality control concept in fall risk intervention for heart failure (HF) outpatients, and to provide a practical basis for optimizing outpatient nursing management. Methods Patients visiting the heart failure outpatient clinic from June 2023 to May 2024 were selected as study subjects. Among them, 12 860 patients visited from June to November 2023 (pre-intervention), and 13 240 patients visited from December 2023 to May 2024 (post-intervention). The pre-intervention group received traditional nursing management, while the post-intervention group received fall risk interventions guided by the PDCA cyclic quality control concept. The incidence of falls, severity of fall-related injuries, and patient satisfaction were compared between the two groups. Results The incidence of falls after the intervention was 0.03% (4/13 240), significantly lower than the 0.22% (28/12 860) before the intervention (χ2=21.36, P<0.05). All fall-related injuries after the intervention were mild, showing significant improvement compared to the pre-intervention group (mild and moderate fall-related injuries accounting for 71.4% and 28.6%, respectively; Z=2.03, P<0.05). Patient satisfaction scores after the intervention were significantly higher than those before the intervention ［(96.2±3.5) scores vs. (75.3±5.8) scores; t=42.67, P<0.05］. Conclusion The PDCA cyclic quality control concept effectively reduces fall risk, mitigates fall-related injuries, and improves patient satisfaction among heart failure outpatients, demonstrating its value for clinical promotion.

Objective To investigate the clinical effect of a nursing program based on the chronic disease trajectory framework for patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods A total of 118 CHD patients who had undergone PCI were selected, and randomly divided into an observation group and a control group, with 59 cases in each group. The control group received routine nursing care, while the observation group received chronic disease trajectory framework-based nursing in addition to the routine nursing care. This intervention involved establishing a specialized nursing team, categorizing patients according to the phases of the disease trajectory (critical, acute, and stable phases), and implementing targeted interventions focusing on both disease- and daily life-related behaviors. The intervention lasted for 6 months in both groups. Changes in emotion regulation ability, selfefficacy, healthpromoting behaviors, and quality of life were compared between the two groups before and after the intervention. Results After 6 months of intervention, all scores in both groups improved significantly compared to pre-intervention levels (all P<0.05). The scores of adaptive emotion regulation and self-efficacy, the total and sub-domain scores of healthpromoting behaviors, and quality of life score in the observation group were all significantly higher than those in the control group, while the score of non-adaptive emotion regulation was significantly lower (all P<0.01). Conclusion Implementing chronic disease trajectory framework-based nursing for CHD patients after PCI could effectively enhance their emotion regulation ability and self-efficacy, and improve their health-promoting behaviors and quality of life.

Objective To investigate the impact of nursing intervention based on symptom management strategy on blood glucose levels and psychological status in patients with gestational diabetes mellitus (GDM). Methods Clinical data of 108 patients with GDM were selected, and they were divided into a control group and a management group by random number table method, with 54 cases in each group. The control group was given routine nursing, while the management group was given nursing intervention based on symptom management strategy on the basis of the control group. The blood glucose levels ［fasting blood glucose (FBG) and 2-hour postprandial blood glucose (2hPG)］, psychological status ［Hamilton depression rating scale (HAMD) and Hamilton anxiety rating scale (HAMA)］, health self-management ability ［adult health self-management skill rating scale (AHSMSRS)］, and nursing satisfaction after intervention were compared between the two groups. ResultsAfter intervention, the levels of FBG and 2hPG in the management group were both lower than those in the control group (all P<0.01). The HAMD and HAMA scores of the management group were both lower than those of the control group, while the AHSMSRS score was higher than that of the control group (all P<0.01). The nursing satisfaction of the management group (98.15%) was higher than that of the control group (87.04%), with statistically significant difference (P<0.05). Conclusion Nursing intervention based on symptom management strategy effectively controls blood glucose levels, improves psychological status, enhances health self-management capacity, and increases nursing satisfaction of GDM patients.

The primary objective of standardized residency training in neurology is to cultivate specialists with professional competence, among which clinical professionalism is particularly crucial. Case reports, as an important medium for refining clinical reasoning, could comprehensively enhance residents' clinical comprehensive abilities and serve as an effective pathway to achieve the goals of standardized training. This article systematically elaborates on the value, role, and feasibility of publishing case reports in neurology residency training, with a focus on their positive impact on improving residents' professional competence.

The development of artificial intelligence (AI) has accelerated the transformation of medical education concepts and the interdisciplinary integration. Electrocardiogram (ECG) interpretation, as an essential clinical skill for cardiologists, plays a crucial role in patients' diagnosis, treatment decisions, and prognostic recovery. This paper investigates and analyzes the current situation of ECG learning among postgraduates, their learning needs, and cognition of AI. In response to issues such as the disconnection between theory and practice, lack of clinical data, and insufficient systematic training, suggestions and strategies for improving ECG learning based on AI are proposed to strengthen students' clinical thinking and professional competence.

Takotsubo syndrome is a reversible cardiomyopathy that predominantly affects middleaged and elderly women. It is triggered by psychological or physical stressors, leading to a massive release of catecholamines and resulting in apical ballooning changes. Since its initial documentation over three decades ago, its diagnostic criteria, pathophysiological mechanisms and treatment strategies have been continuously revised and updated, and the latest international expert consensus was released in 2024. The pathophysiology of Takotsubo syndrome involves myocardial stunning, which causes heart failure with reduced ejection fraction. Treatment should be individualized based on its diverse triggers and complications. This article reviews the classic theories and recent research advances in Takotsubo syndrome, focusing on analyzing its typical electrocardiographic characteristics and the electrocardiographic differences used for differential diagnosis.

Complete right bundle branch block (CRBBB) is a common electrocardiographic abnormality observed across all age groups. It is characterized by delayed conduction or anatomical rupture in the right bundle branch, resulting in delayed depolarization of the right ventricle after the left ventricle. This conduction disorder often coexists with various cardiovascular diseases, such as atrial fibrillation, coronary heart disease, heart failure, and cardiomyopathies, with its incidence varying significantly among different populations. Historically, CRBBB was usually considered to have limited clinical significance. However, recent studies indicate that it has important clinical significance not only in patients with structural heart diseases but also in newonset cases, general population, and athletes.