Objective To explore the relationship between the levels of serum high-sensitivity C-reactive protein(hs-CRP) and soluble carcinogenic inhibitor 2(sST2) and the occurrence of ventricular arrhythmia in patients with chronic heart failure after cardiac resynchronization therapy(CRT). Methods One hundred and seventy-nine patients with chronic heart failure admitted to the Department of Cardiology of the Second Affiliated Hospital of the Military Medical University of the Army from January 2018 to July 2021 were selected as the study subjects. According to whether ventricular arrhythmia occurred one year after CRT, the patients were divided into 141 patients in the non-occurrence group and 38 patients in the occurrence group. The clinical data of two groups of patients were collected, and the indexes of ventricular arrhythmias [corrected QT interval(QTc) and corrected Tp-Te interval(TP-Tec)] were recorded one year after CRT; Spearman method was used to analyze the correlation between serum hs-CRP, sST2 and NYHA cardiac function classification and ventricular arrhythmia. Pearson method was used to analyze the correlation between serum hs-CRP, sST2 and left ventricular ejection fraction(LVEF), hemoglobin(Hb), cardiac troponin I(cTnI), QTc, TP-Tec, respectively; To evaluate the predictive value of serum hs-CRP and sST2 levels on the occurrence of ventricular arrhythmias in patients with chronic heart failure after CRT by using the subject working characteristic curve(ROC); Multivariate logistic regression was used to analyze the risk factors of ventricular arrhythmia in patients with chronic heart failure after CRT.Results The proportion of people with NYHA cardiac function grade ≥ grade II and the levels of cTnI, QTc, TP-Tec, hs-CRP and sST2 in the occurrence group were higher than those in the non-occurrence group(χ2/t=12.604, 11.417, 9.135, 9.513, 12.967, 23.484, P<0.001), LVEF and Hb levels were lower than those in the non-occurrence group(t/P=4.312/<0.001, 2.531/0.012). In patients with chronic heart failure, serum hs-CRP and sST2 levels were positively correlated(r/P=0.716/<0.001), and serum hs-CRP and sST2 levels were positively correlated with NYHA cardiac function grading, cTn Ⅰ, QTc, TP-Tec, and ventricular arrhythmia(hs-CRP: r=0.629, 0.558, 0.672, 0.704, 0.764, P<0.001; sST2: r=0.657, 0.542, 0.618, 0.693, 0.782, P<0.001), and LVEF The Hb level was negatively correlated(hs-CRP: r=-0.583,-0.605, P<0.001; sST2: r=-0.551,-0.629, P<0.001). The area under the curve(AUC) of serum hs-CRP, sST2 and their combination in predicting ventricular arrhythmia after CRT in patients with chronic heart failure were 0.862, 0.887 and 0.964, respectively. The AUC predicted by the combination of the two was higher than that predicted by the single prediction(Z/P=2.882/0.004, 2.250/0.025). NYHA cardiac function grade ≥ grade II, high cTnI, high QTc, high TP-Tec, high hs-CRP, and high sST2 are independent risk factors for the occurrence of ventricular arrhythmia after CRT in patients with chronic heart failure [OR(95% CI)=1.772(1.158-2.711), 2.066(1.243-3.431), 1.488(1.120-1.977), 1.596(1.095-2.325), 2.307(1.343-3.963), 1.819(1.210-2.735)], High LVEF is an independent protective factor [OR(95% CI)=0.853(0.738-0.986)].Conclusion The serum levels of hs-CRP and sST2 were highly expressed in patients with ventricular arrhythmia after CRT in chronic heart failure. The combination of the two had certain predictive value for the occurrence of ventricular arrhythmia, and the increase of both was a risk factor for the occurrence of ventricular arrhythmia.

Objective To observe the clinical effect of Shexiangtongxin Dropping Pill combined with nicorandil Tablets on myocardial ischemia reperfusion injury after PCI.Methods Eighty-six patients with myocardial ischemia-reperfusion injury after PCI were selected from the Cardiovascular Disease Department of Shandong University of Traditional Chinese Medicine Affiliated Hospital from April 2020 to April 2022. They were randomly divided into a control group and an observation group, with 43 patients in each group. The patients in the control group were treated with nicorandil Tablets on the basis of conventional treatment, and the patients in the observation group were treated with Shexiangtongxin Dropping Pill on the basis of the control group. The clinical efficacy of the two groups was observed, and the TCM syndrome scores(chest pain, chest distress, palpitations and sweating, shortness of breath and fatigue, loss of appetite), vascular endothelial function(serum reactive oxygen species(ROS), endothelin 1(ET-1), nitric oxide(NO)), Cardiac ultrasound indicators [left ventricular ejection fraction(LVEF), left ventricular end systolic diameter(LVESD), left ventricular end diastolic diameter(LVEDD)], myocardial ischemia-reperfusion indicators [TIMI grade 3, TIMI frame count(CTFC), myocardial contrast density grade(MBG) grade 3], and major cardiovascular adverse events(MACE). Results After one month of treatment, the total effective rate of the observation group was significantly higher than that of the control group(93.02% vs. 74.42%,χ2/P=7.196/0.027); The TCM syndrome scores of both groups decreased compared to before treatment, and the observation group was lower than the control group(t/P=2.612/0.011, 2.906/0.005, 2.522/0.014, 7.425/<0.001). The levels of ROS and ET-1 in both groups decreased compared to before treatment, while the levels of NO increased compared to before treatment. The decrease/increase amplitude in the observation group was greater than that in the control group(t/P=3.811/0.002, 2.936/0.004, 2.356/0.021). The LVEF values of both groups increased compared to before treatment, while LVESD and LVEDD values decreased compared to before treatment. The increase/decrease amplitude of the observation group was greater than that of the control group(t/P=5.023/<0.001, 2.738/0.008, 5.879/<0.001). After one month of treatment, the number of TIMI grade 3 and MBG3 grades increased compared to before PCI treatment, and the observation group was higher than the control group(χ2/P=3.957/0.047、4.497/0.034). The number of CTFC frames in both groups decreased compared to before PCI treatment, and the observation group was lower than the control group(t/P=3.386/<0.001). The incidence of MACE adverse events(all-cause mortality, acute fatal myocardial infarction, and acute heart failure) in the observation group was lower than that in the control group(χ2/P=4.074/0.044, 4.195/0.041, 4.914/0.027).Conclusion Shexiangtongxin Dropping Pill combined with nicorandil tablets has a significant clinical effect on myocardial ischemia reperfusion injury after PCI, which can improve vascular endothelial function, improve cardiac function, improve myocardial ischemia reperfusion indicators, and reduce the occurrence of MACE events.

Objective To explore the relationship between the levels of serum N-terminal proBNP(NT-proBNP), myocardial injury markers, and cardiac function parameters in children with Kawasaki disease(KD) and concurrent coronary artery disease. Methods One hundred and twelve pediatric patients with KD admitted to the Department of Pediatrics at Tangshan Maternal and Child Health Hospital from September 2019 to April 2022 were selected as the observation group. Based on the ultrasound electrocardiogram diagnosis results, they were divided into coronary artery abnormality subgroup(CAA subgroup, 47 cases) and non coronary artery abnormality subgroup(NCAA subgroup, 65 cases). 102 healthy children undergoing physical examination were selected as the healthy control group. Serum NT-proBNP levels were measured using chemiluminescence immunoassay, and serum cardiac troponin I(cTnI), myoglobin(Mb), and creatine kinase isoenzyme MB(CK-MB) levels were measured using enzyme-linked immunosorbent assay; Left ventricular ejection fraction(LVEF), left ventricular short axis shortening rate(LVFS), cardiac index(CI), and diastole mitral flow spectral velocity(E/A) were measured. Logistic regression analysis of the influencing factors of coronary artery disease in children with KD; The predictive efficacy of serum NT-proBNP, cTnI, Mb, and CK-MB in predicting coronary artery disease in children with KD was analyzed using the receiver operating characteristic curve(ROC) analysis. Results The serum levels of NT-proBNP, cTnI, Mb, and CK-MB in the acute phase of the observation group were higher than those in the recovery phase and the healthy control group(F=725.260, 651.547, 573.800, 292.951, P<0.001). The serum levels of NT-proBNP, cTnI, Mb, and CK-MB in the CAA subgroup were higher than those in the NCAA subgroup(t=4.495, 13.120, 11.234, 12.609, P<0.001). The levels of LVEF, LVFS, and CI in the acute phase of the observation group were significantly lower than those in the recovery phase(t=3.885, 6.081, 5.019, P<0.001). High serum NT-proBNP, high cTnI, high Mb, high CK-MB levels, low LVEF, low LVFS, and low CI are all risk factors for coronary artery disease in children with KD [OR(95%CI)=1.440(1.069-1.940), 1.366(1.090-1.712), 1.514(1.171-1.958), 1.412(1.110-1.797), 1.534(1.203-1.956), 1.666(1.074-2.583), 1.386(1.083-1.775)].The area under the curve(AUC) of serum NT-proBNP, cTnI, Mb, CK-MB, and their combination in predicting the occurrence of coronary artery disease in children with KD were 0.742, 0.948, 0.949, 0.923, and 0.973, respectively(Z/P=4.980/0.000, 1.024/0.306, 0.920/0.357, 1.553/0.121).Conclusion Elevated levels of serum NT-proBNP, cTnI, Mb, and CK-MB expression, as well as decreased levels of LVEF, LVFS, and CI, are risk factors for coronary artery disease in children with KD. Serum levels of NT-proBNP, cTnI, Mb, and CK-MB have high predictive value for predicting coronary artery disease in children with KD.

Objective To analyze the relationship between serum glycogen synthase kinase-3β(GSK-3β) and β-catenin messenger RNA(mRNA) expression levels and disease severity and prognosis in patients with chronic pulmonary heart disease(CPHD).Methods One hundred and eight patients with CPHD admitted to the 321 Hospital of Hanzhong City from January 2020 to October 2021 were selected as the CPHD group. They were divided into a decompensated subgroup of 40 cases and a compensated subgroup of 68 cases based on pulmonary and cardiac function. They were divided into a survival subgroup of 85 cases and a death subgroup of 23 cases based on their one-year survival. A healthy control group consisted of 108 healthy individuals who underwent physical examinations during the same period. Collect basic data of CPHD patients and detect serum GSK-3β in subjects using fluorescence quantitative PCR method. Compare the expression level of β-catenin mRNA, serum GSK-3β levels in each group, Differences in expression levels of β-catenin mRNA; Pearson method for analyzing correlation of β-catenin mRNA expression levels and serum GSK-3β in patients with CPHD, multivariate Cox regression analysis of risk factors for death in CPHD patients, and analysis of serum GSK-3β using receiver operating characteristic curve(ROC), The predictive value of β-catenin mRNA expression levels for mortality in patients with CPHD.Results Compared with the healthy control group, the serum mRNA expression level of GSK-3β in the CPHD group was significantly reduced, the expression level of β-catenin mRNA was significantly increased(t/P=28.208/<0.001, 25.981/<0.001). Compared with the compensatory subgroup, the serum mRNA expression level of GSK-3β in the decompensated subgroup was significantly reduced, The expression level of β-catenin mRNA was significantly increased(t/P=12.572/<0.001, 12.156/<0.001). Compared with the survival subgroup, the proportion of smoking history, PaCO2 and the expression level of β-catenin mRNA significantly increased, with PaO2 and GSK-3 β Significantly reduced mRNA expression levels [χ2(t)/P=5.941/0.015, 3.690/<0.001, 7.353/<0.001, 2.723/0.008, 5.730/<0.001]. Serum GSK-3β from patients with CPHD MRNA and the expression level of β-catenin mRNA was negatively correlated(r/P=-0.502/<0.001). GSK-3 β High mRNA expression is a protective factor for death in patients with CPHD [HR(95%CI)=0.843(0.728-0.976)],High expression of β-catenin mRNA is a risk factor [HR(95%CI)=1.391(1.041-1.859)]. Serum GSK-3 β, the area under the curve of β-catenin mRNA and their combination in predicting death in CPHD patients is 0.838, 0.884, and 0.913, respectively, both of which have good predictive value.Conclusion Serum GSK-3β from patients with CPHD MRNA expression is low, β-catenin mRNA is highly expressed, which is related to the severity of the condition and prognosis, and has a high predictive power for patient prognosis.

Objective To explore the relationship between platelet volume related index(PVIs), Sestrin2, Pannexin-1, and the National Institutes of Health Stroke Scale(NIHSS) scores in patients with acute cerebral infarction, as well as their predictive efficacy for thrombolytic prognosis.Methods Eighty-two patients with acute cerebral infarction admitted to Putian 95 Hospital from January 2020 to October 2022 were selected, all of whom received intravenous thrombolysis treatment. According to the prognosis of thrombolysis, they were divided into a good group of 49 cases and a poor group of 33 cases. Compare the PVIs, Sestrin2, Pannexin1, and NIHSS scores of two groups before and at the 5th and 7th day after treatment. Pearson analysis of the relationship between PVIs, Sestrin2, Pannexin1, and NIHSS scores at the 5th and 7th day after treatment. Multivariate logistic regression analysis of the relevant influencing factors of thrombolysis prognosis in patients with acute cerebral infarction. Receiver Operating Characteristic Curve(ROC) analysis of the predictive efficacy of PVIs, Sestrin2, Pannexin1, and different combination regimens at the 5th and 7th day after treatment on thrombolysis prognosis.Results After 5 and 7 days of treatment, the PVIs, Sestrin2, Pannexin1, and NIHSS scores of the poor group were higher than those of the good group(after 5 days of treatment, t/P=5.171/<0.001, 6.043/<0.001, 8.291/<0.001, 6.215/<0.001; after 7 days of treatment, t/P=10.877/<0.001, 6.496/<0.001, 7.253/<0.001, 11.834/<0.001). PVIs, Sestrin2, and Pannexin1 were positively correlated with NIHSS scores at 5 and 7 days after treatment(5 days after treatment, r/P=0.818/<0.001, 0.762/<0.001, 0.806/<0.001; 7 days after treatment, r/P=0.832/<0.001, 0.796/<0.001, 0.810/<0.001). The results of logistic regression analysis showed that high PVIs, high Sestrin2, and high Pannexin1 were all related risk factors for thrombolysis prognosis [OR(95%CI)=13.672(2.954-63.282), 8.742(1.628-46.944), 9.857(1.021-95.168),P<0.05]. The AUC of PVIs, Sestrin2, Pannexin1, and their combination predicting thrombolysis prognosis in patients with acute cerebral infarction 7 days after treatment was greater than the corresponding prediction plan 5 days after treatment(Z/P=2.115/0.031, 2.102/0.036, 4.207/0.030, 2.056/0.040), and the combined AUC of the three indicators was greater than their respective individual predictions(Z/P=3.115/0.005, 2.896/0.018, 3.402/0.001).Conclusion PVIs, Sestrin2, and Pannexin1 are related to the degree of neurological deficit and thrombolysis prognosis in patients with acute cerebral infarction. Combined detection of the levels of PVIs, Sestrin2, and Pannexin1 at 7 days after treatment is expected to provide an effective plan for early clinical prediction of thrombolysis prognosis.