Abstract:Objective:To investigate the early predictive value of the veno-arterial carbon dioxide difference[P(cv-a)CO2]combined with the renal resistive index(RRI)for acute kidney injury(AKI)in patients with septic shock.Method:A total of 48 patients with septic shock admitted to Sanming First Hospital Affiliated to Fujian Medical University from June 2024 to June 2025 were selected as the research subjects.They were divided into the AKI group(18 cases)and the non-AKI group(30 cases)according to whether AKI occurred.P(cv-a)CO2 and RRI were detected at 1 hour and 3 hours after admission to the ICU,respectively.The differences between the two groups were compared,and the predictive efficacy of each index and the combined index for AKI was analyzed through the receiver operating characteristic(ROC)curve.Result:At 3 hours of ICU admission,the P(cv-a)CO2 and RRI in the AKI group were significantly higher than those in the non-AKI group,and the difference was statistically significant(P＜0.05).The area under the curve(AUC)of P(cv-a)CO2 for predicting AKI was 0.860(95％CI:0.757～0.963),the optimal cut-off value was 6.5 mmHg,the sensitivity was 72.2％,and the specificity was 83.3％.The AUC of RRI for predicting AKI was 0.840(95％CI:0.706～0.973),the optimal cut-off value was 0.66,the sensitivity was 77.8％,and the specificity was 83.3％.The AUC of the combined prediction of the two increased to 0.925(95％CI:0.844～1.000),with a sensitivity of 88.9％and a specificity of 90.0％.Conclusion:In patients with septic shock,early combined monitoring of P(cv-a)CO2 and RRI can significantly improve the predictive accuracy of AKI,has a good clinical application prospect,and is conducive to achieving earlier risk assessment and intervention.

Abstract:Objective:This study explores the actual effect of the combined intervention model of case management and rapid rehabilitation care for patients undergoing bariatric metabolic surgery and its impact on self-management ability scores.Method:68 patients who underwent bariatric metabolic surgery at the First Affiliated Hospital of Xiamen University from January 2023 to December 2024 was selected as the study objects.A randomized controlled trial of bariatric metabolic surgery nursing was conducted during this period.The groups were distinguished through the scheme of the digital table of medical record numbers.They were divided into the experimental group and the control group,with 34 cases in each group.Patients in the control group received basic perioperative nursing measures,while those in the experimental group received the case management combined with rapid rehabilitation care model.The nursing effects of the two groups were compared,with indicators including complication rate,hospital stay,difference in Body Mass Index(BMI)change,difference in waist circumference change,difference in hip circumference change,Herth Hope Scale score,self-management ability score,and quality of life score.Result:In the data of hospital stay and complication dimensions,the advantages of the experimental group were more obvious(P＜0.05).After surgery,the differences in BMI,waist circumference,and hip circumference changes of the experimental group were significantly greater than those of the control group(P＜0.05).The assessment of the Herth Hope Scale by patients confirmed that the data of the experimental group was significantly higher than that of the control group(P＜0.05);after receiving nursing intervention,the experimental group had higher self-management ability(P＜0.05).In the quality of life dimension,the advantage of the experimental group was obvious after nursing(P＜0.05).Conclusion:The combined intervention model of case management and rapid rehabilitation care for patients undergoing bariatric metabolic surgery can shorten the recovery time,reduce the complication rate,assist in improving the surgical effect,enhance the hope level and self-management ability,and improve the quality of life.

Abstract:Degenerative lumbar spinal stenosis(DLSS)is a common spinal disease in orthopedics and traumatology.For patients with severe DLSS who have failed to respond to non-surgical treatment,especially those with progressive neurological dysfunction,surgical treatment is the preferred option.For patients with mild to moderate DLSS,conservative treatment with traditional Chinese medicine(TCM)is more preferred.TCM has rich experience in treating DLSS,with multiple treatment methods and precise efficacy.This article provides a review of TCM treatments for DLSS in recent years.

Abstract:Objective:To explore the effect of heart-protecting moxibustion on the cardiac function of patients with chronic heart failure(CHF)of qi deficiency and blood stasis type.Method:A total of 83 patients with Qi-deficiency and blood-stasis type CHF admitted to Suizhou Traditional Chinese Medicine Hospital from January 2022 to September 2024 were selected and randomly assigned using a random number table into a control group(routine care,42 cases)and an observation group(routine care plus Heart-care Moxibustion,41 cases).The TCM syndrome scores,6-minute walking distances,sleep quality and quality of life of the two groups were compared.Result:After the intervention,the 6-minute walking distance of the observation group was higher than that of the control group,while the TCM syndrome score,Pittsburgh Sleep Quality Index(PSQI),and Minnesota Liuing with Heart Failure Questionnaire(MLHFQ)score were lower than those of the control group.The differences were statistically significant(P＜0.05).Conclusion:Heart-protecting moxibustion can alleviate symptoms in CHF patients with qi deficiency and blood stasis,improve heart function,and enhance sleep quality and overall quality of life.

Abstract:Objective:To explore the application value of operating room nursing based on the risk pre-control model in patients undergoing cerebral hemorrhage surgery,and to provide evidence-based basis for optimizing the clinical nursing plan.Method:By using the random number table method,92 patients with cerebral hemorrhage admitted to Union Hospital Affiliated to Fujian Medical University from April 2023 to April 2025 were divided into the control group and the observation group,with 46 cases in each group.The control group received conventional operating room care,while the observation group received operating room care based on the risk pre-control model.The postoperative recovery indicators,the degree of neurological deficits and the prognosis of the two groups were compared.Result:All postoperative recovery indicators in the observation group were better than those in the control group,and the difference was statistically significant(P＜0.05).The score of the National Institutes of Health Stroke Scale(NIHSS)in the observation group after nursing was lower than that in the control group,and the difference was statistically significant(P＜0.05).One month after the operation,the modified Barthel Index(MBI)score of the observation group was higher than that of the control group,and the Glasgow Outcome Scale(GOS)and modified Rankin Scale(mRS)grades were better than those of the control group.The differences were statistically significant(P＜0.05).Conclusion:The implementation of operating room nursing based on the risk pre-control model for patients undergoing cerebral hemorrhage surgery can effectively accelerate the postoperative rehabilitation process of patients,promote the repair and reconstruction of neurological function,and significantly improve the long-term prognosis and self-care ability of patients.

Abstract:Objective:To compare the clinical effects of absorbable screws and metal internal fixation in interphalangeal joint fusion for hammer toe deformity,with a focus on the degree of postoperative pain,foot and ankle function,and complications.Method:60 patients with hammer toe deformity admitted to the First Affiliated Hospital of Anhui Medical University from January 2023 to January 2025 were selected and divided into the control group(metal internal fixation,n=30)and the observation group(small-diameter absorbable screw internal fixation,n=30)by random number table method.The surgical-related indicators(intraoperative blood loss,operation time,postoperative hospital stay,medical expenses),pain degree at different time points after surgery[visual analogue scale(VAS)],foot and ankle function(Maryland score),and bone metabolism indicators[type Ⅰ collagen carboxyl-terminal peptide(CTX),type Ⅰ procollagen amino-terminal propeptide(PINP),bone-specific Alkaline Phosphatase(BALP)]and the incidence of complications were compared between the two groups.Result:There was no statistically significant difference in intraoperative blood loss,operation time and postoperative hospital stay between the two groups of patients(P＞0.05).The medical expenses of the observation group yuan were lower than those of the control group yuan,and the difference was statistically significant(P＜0.05).Three months after the treatment,there was no statistically significant difference in pain level between the two groups(P＞0.05).Four weeks after treatment,the pain degree in the observation group was lower than that in the control group,and the difference was statistically significant(P＜0.05).After treatment,the ankle function scores of both groups increased,but the difference was not statistically significant(P＞0.05).After treatment,the carboxyl-terminal peptide(CTX)of type Ⅰ collagen in both groups decreased compared with that before treatment,while the PINP and BALP of type Ⅰ procollagen increased compared with those before treatment.There was no statistically significant difference between the groups(P＞0.05).Compared with the control group,the incidence of complications in the observation group was lower,and the difference was statistically significant(P＜0.05).Conclusion:The application of absorbable screws in interphalangeal joint fusion for hammer toe deformity,compared with traditional metal internal fixation,can effectively alleviate the pain of patients in the early postoperative period(4 weeks),significantly reduce medical costs and the incidence of complications,and has comparable effects in promoting the recovery of foot and ankle function and early bone healing.

Abstract:Objective:To explore the clinical effect of laparoscopic total hysterectomy with modified vaginal stump and circular ligament suspension,and to evaluate the impact of its clinical application on patients' sexual life,negative emotions,etc.Method:From September 2023 to September 2024,64 patients with benign uterine tumors who met the surgical indications and had no fertility requirements in the Department of Obstetrics and Gynecology of Yangdong District People's Hospital,Yangjiang City,were selected and divided into an experimental group of 32 cases and a control group of 32 cases by the random number table method.The experimental group underwent laparoscopic total hysterectomy with modified vaginal stump and round ligament suspension.The control group underwent laparoscopic total hysterectomy.The surgical indicators and the occurrence of complications of the two groups were compared.The patients were followed up for 6 months,and the negative emotions and quality of sexual life[Female Sexual Function Scale(FSFI)]of the two groups were compared and analyzed.Result:There was no statistically significant difference in the surgical indicators between the two groups(P＞0.05).The incidence of complications in the experimental group was lower than that in the control group,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in the preoperative negative emotions between the two groups(P＞0.05).The level of negative emotions in the experimental group after the operation was lower than that in the control group,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in the preoperative FSFI scores between the two groups(P＞0.05).The follow-up results showed that the FSFI score of the experimental group was higher than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion:The application of the modified vaginal stump-round ligament suspension technique in laparoscopic total hysterectomy not only has high safety,can significantly reduce the incidence of postoperative complications and the level of anxiety and depression,but also can effectively alleviate postoperative pelvic floor dysfunction and improve the quality of sexual life of patients.

Abstract:Objective:To explore the effect and value of coronary intervention in patients with chronic coronary syndrome(CCS)complicated with heart failure(HF).Method:A total of 70 patients with CCS combined with HF admitted to the Second Hospital of Zhaoqing City from September 2023 to January 2025 were selected as the study objects and grouped according to whether they received coronary intervention.They were divided into the CCS combined with HF interventional treatment surgery group(observation group)and the CCS combined with HF non-interventional treatment surgery group(control group),with 35 cases in each group.The laboratory examination indicators,cardiac color Doppler ultrasound indicators,heart rate deceleration capacity(DC)and heart rate variability(HRV)of the two groups were compared.Result:After treatment,the improvements of high-sensitivity troponin(hs-cTnI),N-terminal pro-B-type natriuretic peptide(NT-proBNP),myoglobin(Myo),and creatine kinase isoenzyme MB(CK-MB)in the observation group were all better than those in the control group,and the differences were statistically significant(P＜0.05).After treatment,the improvements in left atrial diameter(LAD),left ventricular end-diastolic diameter(LVDD),and left ventricular ejection fraction(LVEF)in the observation group were all better than those in the control group,and the differences were statistically significant(P＜0.05).After treatment,the improvement of DC and HRV in the observation group was better than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion:Coronary intervention for patients with CCS combined with HF can more significantly improve laboratory test indicators,cardiac color Doppler ultrasound indicators,DC and HRV,and the overall value is more definite.

Abstract:Objective:To explore the application effect of rope and belt therapy in the early rehabilitation after knee arthroplasty.Method:60 cases who underwent total knee arthroplasty(TKA)in the Department of Orthopedics of Dehua County Hospital from June 2023 to January 2025 selected as the observation subjects.They were randomly divided into the control group(30 cases,using the random number table method to implement the standard rehabilitation training program),while the study group(30 cases,received intervention with rope and belt therapy in combination with conventional training).The Harris Knee Function Scale(HSS),knee range of motion,balance function,walking function and 6-minute Walk Test(6MWT)of the two groups were compared.Result:After 2 weeks,6 weeks,and 12 weeks of treatment,the HSS score,Berg Balance Scale(BBS)score,and Holden Ambulation Scale[Functional Ambulation Category(FAC)]score of the study group were higher than those of the control group,and the differences were statistically significant(P＜0.05).After 2 weeks,6 weeks and 12 weeks of treatment,the range of motion and 6MWT of the knee joint in the study group were greater than those in the control group,and the difference was statistically significant(P＜0.05).Conclusion:The application of rope and belt therapy in the early rehabilitation stage after total knee arthroplasty(TKA)can effectively improve knee joint mobility,enhance balance ability,and significantly improve the walking function of patients.

Abstract:Objective:To analyze the improvement effect of balanced psychotherapy combined with escitalopram oxalate on anxiety,depression and social function in patients with depression.Method:A total of 96 patients with depression admitted to Putuo District Mental Health Center from January 2022 to June 2024 were selected as the research subjects for a randomized controlled trial.They were divided into the control group(n=48)and the intervention group(n=48).The control group was intervened with mental health education combined with escitalopram oxalate.The intervention group was carried out with balanced psychotherapy combined with escitalopram oxalate,and the intervention period was 8 weeks.The clinical efficacy of the two groups was compared by using the results of the Hamilton Depression Scale(HAMD-17),Hamilton Anxiety Scale(HAMA),Social Disability Screening Scale(SDSS),Interpersonal Trust Scale(ITS),Self-esteem Scale(SES),and Monterlil Cognitive Assessment Scale(MoCA)before and after the intervention respectively.Result:The final number of people who completed the intervention study:46 cases in the control group and 45 cases in the intervention group.After 8 weeks of treatment,the HAMD-17,HAMA and SDSS scores of both groups decreased,and the scores of the intervention group were lower than those of the control group,with statistically significant differences(P＜0.05).The SES and MoCA scores of both groups increased,and the scores of the intervention group were higher than those of the control group,with statistically significant differences(P＜0.05).Conclusion:Balanced psychotherapy combined with escitalopram oxalate can effectively alleviate anxiety and depression in patients with depression,improve social functions,and has good clinical promotion value.

Abstract:Objective:To explore the application effect of the optimized standardized pre-hospital emergency treatment process in the sudden syncope incident at the terminal building of Baiyun Airport.Method:A retrospective cohort study design was adopted.Based on the continuous quality reconstruction of the department,14 patients with sudden syncope in the terminal building from January to April 2024 were included as the control group.Conventional procedures were used.Starting from May 2024,the department optimized the pre-hospital emergency process,which included the establishment of a rapid response team(RRT),a hierarchical dispatching system,and a standardized transfer plan.Seventeen patients with sudden syncope in the terminal building from May to December 2024 were included as the study group,and an optimized process was adopted.Compare the odd-numbered data of educational background,etiology,gender,rescue failure,first aid satisfaction,age,onset time,first aid response time,etc.between the two groups.Result:The emergency response time of the study group was shorter than that of the control group,and the failure rate of rescue was lower than that of the control group.The difference was statistically significant(P＜0.05).Compared with the control group,the total satisfaction with first aid in the study group was higher,and the difference was statistically significant(P＜0.05).Conclusion:The optimized pre-hospital emergency treatment process significantly shortens the emergency response time for syncope incidents in the terminal building.The quality of on-site first aid and safe transfer of patients has been significantly improved.Avoid rescue failure,improve patient prognosis and enhance patient satisfaction.

Abstract:Objective:To explore the application effect of blended online and offline teaching combined with practical cases in oral care teaching.Method:A total of 84 students majoring in oral nursing who were undergoing internships and studies at Zunyi city Stomatological Hospital Honghuangang District from June 2023 to June 2025 were selected as the study objects and randomly divided into the experimental group and the control group after stratification according to the enrollment grade,with 42 students in each group.The control group adopted the traditional teaching mode,while the experimental group implemented the blended teaching of online and offline on this basis and combined with typical cases.The theoretical scores,skill operation scores,learning investment time and course evaluation situations of the two groups were compared.Result:After teaching,the single-choice questions,multiple-choice questions,short-answer questions and the total score of the experimental group were significantly higher than those of the control group,and the difference was statistically significant(P＜0.05).In terms of periodontal probing,supragingival scaling,pit and fissure sealants,and the total score of skill operations,it was also significantly better than the control group,and the difference was statistically significant(P＜0.05).The learning investment time of the experimental group was significantly less than that of the control group,and the difference was statistically significant(P＜0.05).The course evaluation shows that 92.86％of the students believe that the course has stimulated their interest in learning,91.67％think it helps cultivate their ability to analyze and solve problems,94.05％believe it has enhanced their teamwork skills,and the approval rates for the rest of the items are all around 90％.Conclusion:The blended teaching of online and offline combined with practical cases has shown good results among students of oral care in different grades.It can significantly improve theoretical and operational scores,optimize learning engagement,enhance learning interest and professional identity,and has the value of promotion and application.

Abstract:Objective:To explore the therapeutic effect of diethylstilbestrol combined with hysteroscopic surgery in patients with abnormal uterine bleeding,and to provide a basis for optimizing clinical treatment plans.Method:From January 2023 to March 2025,72 patients with abnormal uterine bleeding admitted to the First Hospital of Zhangzhou China Merchants Economic and Technological Development Zone were randomly divided into two groups,with 36 cases in each group.The control group received hysteroscopic surgery treatment,and the observation group was additionally treated with diethylstilbestrol.The clinical efficacy,endometrial thickness,menstrual conditions,sex hormone levels,and complication occurrence were compared between the two groups.Result:The therapeutic effect of the observation group was better than that of the control group.After treatment,the endometrial thickness and menstrual volume scores of the observation group were lower than those of the control group,the menstrual duration was shorter than that of the control group,the hormone index levels were lower than those of the control group,and the complications were fewer than those of the control group.The differences were statistically significant(P＜0.05).Conclusion:Compared with simple hysteroscopic surgery,adding diethylstilbestrol to the treatment of patients with abnormal uterine bleeding is more effective.The sex hormone levels of patients after treatment were significantly improved,the endometrial thickness decreased,which was beneficial for the recovery of the menstrual cycle and menstrual volume,and it could also reduce the occurrence of complications.

Abstract:Objective:To explore the clinical efficacy of precision moxibustion in patients with cervical spondylosis and neck pain accompanied by negative emotions.Method:A total of 105 patients with cervical spondylosis and neck pain accompanied by negative emotions who were admitted to Liaobu Hospital in Dongguan City from May 2023 to December 2024 were selected as the research subjects and randomly divided into the sham moxibustion group,the precision moxibustion group,and the acupuncture group,with 35 cases in each group.All three groups selected bilateral Fengchi,Jingbailao,Jianzhongshu,Jianjing,Xinshu and Dangshu,and were respectively treated with fake mugwort,fine moxibustion and acupuncture.Observe and compare the tenderness threshold,the score of Northwick Park Neck Pain Scale,the score of McGill Pain Question-naire(NPQ),and the scores of Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS)before and after treatment in each group.Result:After treatment,the tenderness threshold of the left Fengchi point in the precision moxibustion group and the right Fengchi point in the acupuncture group was significantly higher than that in the sham moxibustion group,and the difference was statistically significant(P＜0.01).After treatment,the tenderness threshold of the right Fengchi point in the precision moxibustion group and the left Fengchi point in the acupuncture group was higher than that in the sham moxibustion group,and the difference was statistically significant(P＜0.05).After treatment,the bilateral shoulder mid-shu tenderness thresholds in the precision moxibustion group and the acupuncture group were significantly higher than those in the sham moxibustion group and before treatment,and the difference was statistically significant(P＜0.01).After treatment,the scores of the MPQ and the NPQ in the precision moxibustion group were significantly lower than those in the sham moxibustion group,and the difference was statistically significant(P＜0.01).After treatment,the scores of the MPQ and the NPQ in the acupuncture group were lower than those in the sham moxibustion group,and the difference was statistically significant(P＜0.05).After treatment,the scores of the MPQ and the NPQ in the precision moxibustion group and the acupuncture group were significantly lower than those before treatment,and the difference was statistically significant(P＜0.01).After treatment,the scores of the SDS and the SAS in the precision moxibustion group and the acupuncture group were significantly lower than those in the sham moxibustion group and before treatment,and the difference was statistically significant(P＜0.01).Conclusion:Acupuncture and fine moxibustion have comparable therapeutic effects on patients with cervical spondylosis and negative emotions.Both are beneficial for relieving neck pain,reducing patients'negative emotions,and improving their quality of life.However,in clinical practice,precise moxibustion treatment can be selected based on the advantages of moxibustion and the patient's condition.This not only enhances the therapeutic effect but also promotes the development of moxibustion therapy techniques.

Abstract:Objective:To explore the influence of pain control nursing based on evidence-based support on the pain degree and sleep quality of postoperative patients with lumbar intervertebral disc protrusion.Method:According to the random number table method,76 postoperative patients with lumbar intervertebral disc protrusion admitted to Beijing Jishuitan Hospital Guizhou Branch from June 2024 to February 2025 were divided into 2 groups,with 38 cases in each group.The control group received routine care,while the observation group received pain control care based on evidence-based support.The pain degree,lumbar function,comfort level and sleep quality of the two groups were compared.Result:After the nursing care,compared with the control group,the Visual Analogue Scale(VAS)score of the observation group was lower.In the Japanese Orthopaedic Scale Association Assessment(JOA),the scores for subjective symptoms,clinical symptoms and limited daily activities were higher,while the score for bladder function was lower.The scores of each dimension of the Comfort Status Scale(GCQ)are higher.The Pittsburgh Sleep Quality Index(PSQI)score was lower,and the difference was statistically significant(P＜0.05).Conclusion:The implementation of pain control nursing based on evidence-based support can effectively alleviate the pain of postoperative patients with lumbar intervertebral disc protrusion,improve lumbar function,enhance comfort and sleep quality,and is worthy of clinical reference.

Abstract:Objective:To explore the clinical value of using CT stereotactic guidance for puncture,drainage and clearance in the treatment of patients with hypertensive cerebral hemorrhage.Method:A clinical treatment analysis was conducted on 120 patients with hypertensive cerebral hemorrhage admitted to Shuyang Zhongzhi Hospital from October 2021 to January 2025.The patients were divided into a control group(60 cases)and a study group(60 cases)based on the random number table method.The control group received corresponding treatment using traditional craniotomy surgery;The study group was treated with CT stereotactic guidance for puncture,drainage and clearance.The Glasgow Coma Scale(GCS)score,National Institutes of Health Stroke Scale(NIHSS)score,activities of daily living(ADL)score,and total incidence of postoperative complications were observed and compared between the two groups.Result:The GCS score and ADL score of the study group after surgery showed significant improvement compared with those of the control group,and the NIHSS score also showed significant reduction compared with that of the control group.The clinical statistical results of the total incidence of complications in the study group showed a significant reduction compared with those of the control group(P＜0.05).Conclusion:During the clinical treatment of hypertensive cerebral hemorrhage,the full application of CT stereotactic guidance for puncture,drainage and clearance can reduce the incidence of complications,promote the ability of daily living activities and prognosis.

Abstract:Objective:To explore the clinical effect of acetylcysteine combined with meropenem in the treatment of severe pneumonia.Method:60 patients with severe pneumonia admitted to Suixi County People's Hospital from October 2023 to October 2024 were selected and divided into two groups.The control group(n=30)was treated with meropenem alone,while the experimental group(n=30)was given acetylcysteine on the basis of meropenem.The clinical efficacy,inflammatory indicators,pulmonary function indicators,oxygenation index and adverse reactions were compared between the two groups.Result:The total effective rate of treatment in the experimental group(93.33％)was higher than that in the control group(73.33％)(P＜0.05).After treatment,the levels of C-reactive protein(25.37±8.75 mg/L vs 45.83±12.41 mg/L),white blood cell count[(8.47±1.68 × 109/L vs 11.26±2.35 × 109/L)],interleukin-6(42.32±12.61 pg/mL vs 68.59±18.78 pg/mL),procalcitonin(2.13±0.82 ng/mL vs 4.61±1.59 ng/mL)and tumor necrosis factor-α(28.91±8.39 pg/mL vs 48.28±11.47 pg/mL)in the experimental group were all lower than those in the control group.The peak expiratory flow and oxygenation index of the experimental group after treatment were higher than those of the control group(P＜0.05).There were no significant differences in mortality(3.33％vs 10.00％)and incidence of adverse reactions(10.00％vs 16.67％)between the two groups(P＞0.05).The mechanical ventilation time in the experimental group(5.22±1.15 days)was shorter than that in the control group(7.84±1.09 days)(P＜0.05).Conclusion:The combined application of acetylcysteine and meropenem in the treatment of severe pneumonia can not only effectively improve the clinical therapeutic effect,but also alleviate the inflammatory response,improve pulmonary function,shorten the duration of mechanical ventilation,and has good safety.

Abstract:Objective:A prognostic prediction model for chronic heart failure based on hematological and echocardiographic examination indicators was constructed,and the model was verified to analyze its predictive value.Method:A total of 100 patients with chronic cardiac insufficiency admitted to Shiyan People's Hospital of Bao'an District,Shenzhen City from August 2023 to August 2024 were selected as the research subjects.The patients were randomly divided into the modeling group(n=80)and the validation group(n=20).The modeling group was divided into the good prognosis group(NYHA improved by≥grade 1 after treatment and remained stable for more than 3 months)and the poor prognosis group(NYHA showed no improvement 6 months after treatment)based on the prognosis of the patients.The general information,echocardiographic examination parameters and hematological examination indicators of all patients in the modeling group were collected.The differences between the patients in the good prognosis group and the poor prognosis group were compared.logistic regression equation was used to conduct multivariate analysis of the influencing factors affecting the prognosis of patients with chronic heart failure,and a risk nomogram model was constructed.Result:There was no statistically significant difference between the two groups in terms of gender,age,disease duration,smoking history,drinking history,coronary heart disease history,hypertension history,diabetes history and hyperlipidemia history(P＞0.05).There was no statistically significant difference in cardiac output,stroke volume and cardiac index between the two groups(P＞0.05).The left ventricular end-diastolic and end-systolic diameters in the good prognosis group were both smaller than those in the poor prognosis group,and the left ventricular ejection fraction was higher than that in the poor prognosis group.The differences were statistically significant(P＜0.05).There was no statistically significant difference between the two groups in terms of fasting blood glucose,hemoglobin,total cholesterol,triglycerides,uric acid and serum creatinine(P＞0.05).The levels of troponin and N-terminal pro-B-type natriuretic peptide in the good prognosis group were both lower than those in the poor prognosis group,and the difference was statistically significant(P＜0.05).logistic regression equation calculation revealed that enlarged left ventricular end-diastolic diameter,enlarged left ventricular end-systolic diameter,decreased left ventricular ejection fraction,elevated troponin,and elevated N-terminal pro-B-type natriuretic peptide are all risk factors for poor prognosis in patients with chronic heart failure.After constructing a nomogram prediction model based on the above risk factors and conducting ROC curve analysis,it was found that the AUC,sensitivity and specificity of the model were 0.778,83.26％and 80.41％,respectively.Decision curve analysis(DCA)shows that the benefits are higher when the threshold probability is 16％to 95％.Conclusion:Enlarged left ventricular end-diastolic diameter,enlarged left ventricular end-systolic diameter,decreased left ventricular ejection fraction,elevated troponin,and elevated N-terminal pro-B-type natriuretic peptide are all risk factors affecting the poor prognosis of patients with chronic heart failure.Constructing a predictive model based on the above factors has good predictive efficacy.

Abstract:Objective:This study aims to compare the risk factors and coronary artery lesion characteristics of acute ST-segment elevation myocardial infarction(STEMI)between indigenous Tibetans and immigrant Han people in plateau areas,providing evidence-based medical basis for precise prevention and treatment strategies among different ethnic groups in plateau areas.Method:A retrospective analysis was conducted on 203 STEMI patients admitted to Lhasa People's Hospital from January 2019 to January 2025.By reviewing electronic medical records,baseline data,risk factors,onset conditions,laboratory tests and imaging examination results of the patients were collected and recorded.The risk factors and characteristics of coronary artery lesions of the two groups of patients were compared.Result:A total of 128 indigenous Tibetan STEMI patients(indigenous Tibetan group)and 75 immigrant Han STEMI patients(immigrant Han group)were included.The average age of the indigenous Tibetan group was significantly higher than that of the immigrant Han group.Both groups were mainly male,and the difference was statistically significant(P＜0.05).The prevalence of hypertension among indigenous Tibetans is higher,while the current proportions of alcohol consumption and smoking are lower,and the hemoglobin level is also lower.The differences are statistically significant(P＜0.05).There was no statistically significant difference in the comparison of coronary artery lesion characteristics such as the offender's blood vessels,postoperative blood flow recovery,and the number of implanted revascularization stents(P＞0.05).Conclusion:Compared with the immigrant Han group,STEMI patients in the indigenous Tibetan group were older,and the levels of liver enzymes,myocardial enzymes,D-dimer and C-reactive protein were higher after admission,suggesting a more severe degree of myocardial injury.However,in terms of the characteristics of coronary artery lesions,the two groups showed similar pathological features.

Abstract:Objective:To explore whether there is a connection between glucagon-like peptide-1(GLP-1)in the serum of patients with type 2 diabetes and carotid atherosclerosis,and to construct a nomogram model that can predict the risk of type 2 diabetes complicated with carotid atherosclerosis.Method:A retrospective study was conducted on 120 patients with type 2 diabetes who were hospitalized in the Department of Endocrinology of Dahua Hospital,Xuhui District,Shanghai from December 2023 to January 2025.Based on the results of the color Doppler ultrasound examination of the cervical vessels received during hospitalization,they were divided into two groups:those with carotid atherosclerotic plaques were classified into the carotid atherosclerosis group,while those without obvious plaque formation were included in the simple type 2 diabetes group.The general clinical data and biochemical indicators of the two groups were compared.logistic regression was used to analyze the influencing factors of carotid atherosclerosis,and a risk prediction nomogram model was constructed simultaneously.The discriminative efficacy of the model was evaluated by the receiver operating characteristic(ROC)curve,and its accuracy was quantified by the area under the curve(AUC).And the net benefits of the model under different threshold probabilities were evaluated through decision curve analysis(DCA)to determine its clinical application value.Result:Among the 120 T2DM patients included in the study,69 cases(57.5％)were complicated with carotid atherosclerosis and 51 cases(42.5％)were patients with simple type 2 diabetes.Intergroup comparisons showed that there were statistically significant differences in age,gender,height,glucagon-like peptide-1(GLP-1),systolic blood pressure,fasting plasma glucose(FPG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and glycated hemoglobin(HbA1c)between the two groups(P＜0.05).Multivariate logistic regression analysis showed that decreased GLP-1 level,elevated fasting blood glucose and elevated total cholesterol were all independent risk factors for type 2 diabetes mellitus complicated with carotid atherosclerosis(P＜0.05).Based on the above statistically significant variables,a nomogram prediction model is constructed.The area under the ROC curve of this model was 0.91(95％CI:0.86～0.96),indicating that its discriminative ability was good.The P value of the Hosmer-Lemeshow test was 0.323,suggesting that the model had good calibration and stability.The results of decision curve analysis(DCA)show that the model presents positive net benefits within a wide range of threshold probabilities,indicating that it has potential clinical application value.Conclusion:Decreased GLP-1 level,elevated fasting blood glucose level and elevated total cholesterol level are all independent risk factors for carotid atherosclerosis in patients with type 2 diabetes,and the differences are statistically significant(P＜0.05).The predictive model constructed based on the above variables has good discriminative efficacy and clinical application potential for this disease combination.