Objective:This study aims to investigate the association of blood pressure,electrocardiogram(ECG)pa-rameters with body mass index(BMI)changes among adolescents of different genders.Methods:A cohort of 1,352 ad-olescents,aged 15 to 25,who underwent physical examinations at the Shanxi international travel health care center between January and December 2021,were enrolled.According to BMI,they were divided into underweight group(n=186),nor-mal weight group(n=742),overweight group(n=268)and obese group(n=156).Each group was further stratificd by sex.ECG parameters,including PR interval,QRS duration,Tp-e/QT and Tp-e/QTc,along with blood pressure and other relevant data,were collected to facilitate comparisons across different BMI categories and between male and female participants within each group.Results:Compared to participants in normal weight group,those in overweight group and obese group had significantly higher diastolic blood pressure(DBP),systolic blood pressure(SBP),QRS duration,Tp-e/QT and Tp-e/QTc,and those in obese group had significantly higher PR interval(P＜0.05 or＜0.01).Within the nor-mal weight group,compared to male participants,the females had significantly lower SBP,DBP,Tp-e/QTc,PR interval and QRS duration,and significantly higher heart rate(HR)and Tp-e/QT(P＜0.01 all).In the overweight group,fe-male participants had significantly lower SBP,DBP,Tp-e/QTc,Tp-e/QT,PR interval and QRS duration compared to males(P＜0.05 or＜0.01);in the obese group,females had significantly lower SBP,PR interval and QRS duration com-pared to males(P＜0.01 all).In male adolescents,compared to those in normal weight group,participants in overweight group and obese group had significantly higher SBP,DBP,Tp-e/QT and Tp-e/QTc(P＜0.01 all).In female adoles-cents,those in overweight group and obese group had significantly higher SBP,Tp-e/QT and Tp-e/QTc compared to those in normal weight group(P＜0.05 or＜0.01).Conclusion:With the increase in BMI,the risk of cardiovascular disea-ses in adolescents elevates.Meanwhile,the impact of BMI changes on blood pressure and ECG parameters varies across ad-olescents of different genders.

Objective:To explore the predictive value of serum levels of annexin A1(AnxA1),clusterin(CLU)and γ-glutamyltransferase/albumin ratio(GAR)for atherosclerotic cardiovascular disease(ASCVD).Methods:A total of 300 patients treated in Xi'an No.9 Hospital between October 2020 and March 2024 were selected.According to ASCVD diagnosis,patients were divided into ASCVD group(n=149)and no ASCVD group(n=151).The base-line data,serum levels of AnxA1,CLU and GAR were compared between two groups.The factors associated with ASCVD were analyzed by multivariate Logistic regression.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum AnxA1,CLU,GAR and combined detection for ASCVD.Results:Com-pared to patients in the no ASCVD group,those in the ASCVD group had significantly higher proportions of family history of early onset coronary heart disease(CHD)(37.76％vs.5.48％),smoking(44.76％vs.23.97％),AnxA1[(1.98±0.39)μg/L vs.(1.05±0.27)μg/L],CLU[(71.61±9.88)mg/L vs.(30.53±6.52)mg/L]and GAR[(1.42±0.32)vs.(0.70±0.19)](P＜0.001 all).Multivariate Logistic regression analysis showed that family history of early onset CHD(OR=3.665,95％CI 1.456～6.072),smoking(OR=2.023,95％CI 1.016～4.073),AnxA1(OR=3.378,95％CI 1.293～5.846),CLU(OR=4.382,95％CI 1.179～7.534)and GAR(OR=3.153,95％CI 2.032～4.787)were independent risk factors for ASCVD(P＜0.001 all).ROC curve analysis in-dicated that the AUC of AnxA1,CLU,GAR alone and combined detection diagnosing ASCVD was 0.821(95％CI 0.766～0.871),0.859(95％CI 0.813～0.902),0.802(95％CI 0.751～0.862)and 0.945(95％CI 0.900～0.970)respectively,and the AUC of combined detection was significantly higher than those of single detection(Z=3.678,2.035,4.139,P＜0.05 or＜0.01).Conclusion:Serum levels of AnxA1,CLU and GAR significantly increase in ASCVD patients,and combined detection of above-mentioned indexes has good predictive efficacy for the occur-rence of ASCVD.

Objective:To analyze the effect of health education model based on the transtheoretical model and stages of change(TTM)on fatigue and daily quality of life in patients with chronic heart failure(CHF).Methods:This randomized controlled study enrolled 84 CHF patients admitted in Jiangsu Province Hospital between November 2022 and December 2023.Patients were randomly divided into control group(n=42,routine health education program)and intervention group(n=42,health education program based on TTM).Scores of Flinders fatigue scale(FFS)and Minnesota living with heart failure questionnaire(MLHFQ)were compared between two groups on 1,3 and 6 months after intervention.Results:Compared to those in the control group,patients in the intervention group had significantly lower scores of FFS[1 month:(16.13±2.70)points vs.(17.88±3.23)points,3 months:(14.20±2.29)points vs.(16.80±2.48)points,6 months:(10.90±2.11)points vs.(15.56±2.65)points]and MLHFQ[3 months:(33.73±9.64)points vs.(43.12±9.60)points,6 months:(27.35±8.81)points vs.(39.54±9.41)points](P＜0.05 or＜0.01).Conclusion:The health education model based on TTM may alleviate fatigue symp-toms and improve quality of life in patients with chronic heart failure.

Objective:To investigate the effect of risk forewarning hierarchical management on mental state,major adverse cardiovascular events(MACE)and quality of life in patients with acute coronary syndrome after percutane-ous coronary intervention(PCI).Methods:This randomized controlled study enrolled 152 patients with acute coro-nary syndrome who underwent PCI in the First Hospital of Qinhuangdao between July 2021 and June 2023.Patients were randomly divided into control group(n=76,conventional intervention program)and intervention group(n=76,additional risk forewarning hierarchical management).After 3-month intervention,mental state[Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)scores],health literacy[perceived knowledge scale for coronary heart diseases(PKS-CHD)score],quality of life[Seattle angina questionnaire(SAQ)score]and in-cidence of MACE were compared between the two groups.Results:Compared to those in the control group,patients in the intervention group had significantly higher total score of PKS-CHD[(35.08±3.59)points vs.(30.53±3.85)points],SAQ dimensional scores of physical limitation[(15.24±1.73)points vs.(13.26±1.45)points],an-ginal stability[(16.84±1.39)points vs.(15.18±1.48)points],disease perception[(17.00±1.46)points vs.(14.34±1.93)points],anginal frequency[(18.55±1.18)points vs.(16.11±1.39)points]and treatment satis-faction[(17.12±1.45)points vs.(14.04±1.93)points](P＜0.001 all),and significantly lower HAMA score[(11.89±1.64)points vs.(13.55±1.56)points],HAMD score[(12.61±1.76)points vs.(16.42±1.92)points]and the incidence of MACE(8.00％vs.28.38％)(P＜0.001 all).Conclusion:Risk forewarning hierarchical man-agement may effectively relieve patients'negative emotions,improve their health literacy and quality of life,and significantly reduce the risk of MACE in patients with acute coronary syndrome after PCI.

Cardiovascular disease is one of the most common causes of death in the world,and related western drugs usually have obvious side effects.Traditional Chinese medicine,characterized by its multi-component and multi-target,has unique advantage in the prevention and treatment of cardiovascular diseases.Cornus Officinal is a histor-ically used plants with medicinal and edible properties.Ancient books and modern literatures have shown that Cor-nus Officinal has the potential to prevent and treat cardiovascular diseases.With the in-depth study of the chemical composition and pharmacological effect of Cornus Officinal,its pharmacodynamic substances and mechanism in the prevention and treatment of cardiovascular diseases are gradually clear.This article reviews the pathways and targets of Cornus Officinal in the prevention and treatment of cardiovascular diseases in recent years,and summarizes its potential effective components,in order to provide theoretical support for the clinical application and traditional Chinese medicine development.

Objective:To investigate the association of systemic immune-inflammation index(SII)and serum cysta-tin C(CysC)with the severity of acute pulmonary embolism(APE),and their predictive value for prognosis.Meth-ods:A total of 181 patients who were first diagnosed with APE in Cangzhou People's Hospital between January 2018 and January 2023 were retrospectively selected.The severity of APE was determined according to risk stratification criteria for pulmonary embolism,and the patients were divided into low-risk group(n=67),middle-risk group(n=81)and high-risk group(n=33).General clinical data and venous blood neutrophils,platelet and lymphocyte counts,CysC and other indicators were collected,and SII was calculated according to the formula.The relevant in-dicators were compared among three groups,and their correlation with the severity of APE was analyzed by Spearman correlation analysis.According to the prognosis,all APE patients were divided into favorable outcome group(n=129)and unfavorable outcome group(n=52).The general clinical data were compared and multivariate Cox regression analysis was used to study the influencing factors of unfavorable outcome in APE patients.The re-ceiver operating characteristic curve(ROC)was drawn to evaluate the predictive value of SII,CysC and their com-bination for the prognosis of APE patients.Nomogram model for prognosis was constructed.Results:Compared with patients in low-risk group,those in the middle-risk group and the high-risk group had significantly higher levels of serum creatinine,CysC and uric acid(P＜0.05 or＜0.01).The SII in the high-risk group was significant-ly higher than those of middle-risk group and low-risk group(P＜0.001 all).Spearman correlation analysis showed that serum creatinine,CysC,uric acid and SII were significant positively correlated with the severity of APE(r=0.356,0.358,0.233,0.353,P＜0.01 all).Compared with patients in the favorable outcome group,those in the unfavorable outcome group had significantly higher levels of D-dimer,serum creatinine,CysC,uric acid and SII(P＜0.01 all).There was a statistically significant difference in the severity of APE between the two groups(P=0.001).Multivariate Cox regression analysis showed that CysC,SII,and middle or high risk of disease severity were independent risk factors for unfavorable outcome in APE patients(HR=1.001～14.453,P＜0.05 or＜0.01).ROC curve indicated that the AUC of SII,CysC and their combination in predicting unfavorable outcome of APE patients were 0.815(95％CI 0.749～0.881),0.747(95％CI 0.661～0.832)and 0.878(95％CI,0.821～0.936),respectively.The combined AUC of the two was significantly higher than those of SII and CysC alone(Z=-2.234,-3.500,P＜0.05 or＜0.01).Based on the above independent risk factors,the AUC values of the 1-year and 3-year unfavorable outcome nomogram models were 92.9 and 88.2,respectively.The calibration prediction curve and the ideal curve fitted well.The decision curve showed that the model had a good net benefit.Conclusion:SII and CysC are significant positively correlated with the severity of APE and they are independent risk factors for unfavor-able outcome of APE,and the combination of the two indicators has a good predictive value for the prognosis of APE.The nomogram constructed has good accuracy and practicability.

Objective:To explore the effect of recombinant human brain natriuretic peptide(rhBNP)on the efficacy,inflammatory factors and cardiac function in patients with dilated cardiomyopathy(DCM)and chronic heart failure(CHF).Methods:This randomized controlled study enrolled 130 patients with DCM and CHF admitted to Dongy-ing District People's Hospital of Dongying City between February 2017 and December 2018.Patients were divided into intervention group(n=65)and control group(n=65).Patients in control group received conventional treat-ment,while those in the intervention group was given additional rhBNP treatment,both groups were treated for 4 weeks.The total effective rate,cardiac function indicators,levels of inflammatory factors and blood lipids,as well as incidence of adverse reactions,were compared between the two groups.Results:The total effective rate(95.38％vs.76.92％,P＜0.001)of the intervention group was significantly higher than that of the control group.After treatment,compared to patients in the control group,those in the intervention group had significant higher left ventricular ejection fraction(LVEF)[(53.21±3.57)％vs.(45.39±2.56)％]and interleukin(IL)-10[(79.55±13.98)pg/ml vs.(69.32±13.86)pg/ml],and significant lower left ventricular end-systolic diameter(LVESd)[(35.25±3.19)mm vs.(40.34±3.09)mm],left ventricular end-diastolic diameter(LVEDd)[(43.29±4.87)mm vs.(50.18±4.21)mm],IL-18[(212.19±24.28)pg/ml vs.(257.98±39.72)pg/ml],and high sensitive C reactive protein(hsCRP)[(11.39±2.29)mg/L vs.(16.59±2.83)mg/L](P＜0.001 all).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.753).Conclusion:The use of the rhBNP based on routine therapy for the treatment of dilated cardiomyopathy and chronic heart failure could effectively improve cardiac function and reduce levels of inflammatory factors.Additionally,it has a high safety profile.

Objective:To explore the application effect of emergency risk management in emergency treatment of pa-tients with acute myocardial infarction(AMI)and its safety.Methods:This randomized controlled study enrolled 103 AMI patients admitted in Haian People's Hospital between April 2020 and January 2023.Patients were divided into intervention group(n=51)and control group(n=52).Patients in intervention group received emergency risk management measures,while those in control group received routine management measures.Rescue quality,heart function,scores of Connor-Davidson resilience scale(CD-RISC),coronary self-management scale(CSMS)and incidence of adverse events were compared between two groups.Results:Compared to patients in the control group,those in intervention group had significant higher rescue success rate(96.0％vs.46.0％),and significant lower emergency stop time[(23.01±2.77)h vs.(36.61±3.00)h]and length of stay[(8.74±2.68)d vs.(15.52±2.91)d](P＜0.001 all).Compared with patients in the control group,those in the intervention group had significant lower cardiac troponin I(cTnI)[(0.48±0.28)ng/L vs.(1.05±0.57)ng/L],heart rate(HR)[(68.13±1.88)beats/min vs.(84.87±1.59)beats/min],left ventricular end-diastolic diameter(LVEDd)[(40.98±0.58)mm vs.(52.09±0.55)mm]and left atrial volume index(LAVI)[(27.07±0.58)ml/m2 vs.(36.86±0.65)ml/m2],and significant higher left ventricular ejection fraction(LVEF)[(67.93±0.56)％vs.(56.91±0.59)％](P＜0.001all).Compared with patients in the control group,those in the intervention group had significant higher scores of CD-RISC[(98.10±1.61)points vs.(71.33±1.87)points]and CSMS[(131.58±1.76)points vs.(111.82±1.75)points](P＜0.001 all),and significant lower incidence of adverse events(4.0％vs.16.0％,P=0.046).Conclusion:Emergency risk management may improve the rescue quality and en-hance cardiac function,and help to improve the psychological resilience and self-management ability in patients with acute myocardial infarction.

Objective:To investigate the predictive value of color Doppler ultrasound combined with electrocardio-gram for right heart dys function in patients with pulmonary heart disease(PHD).Methods:A total of 100 PHD patients admitted in Dongcheng Branch of First Affiliated Hospital of Anhui Medical University between January 2020 and December 2023 were retrospectively analyzed.According to results of 6min walking test(6MWT),pa-tients were divided into good right heart function group(n=64,≥350m)and right heart dysfunction group(n=36,＜350m).The indexes of cardiac color ultrasound[isovolumic relaxation time(IVRT),isovolumetric contraction time(IVCT)and right ventricular Tei index],ECG[24h mean R-R interval standard deviation(SDNN),normal R-R interval standard deviation per 5min(SDANN)and the ratio of low frequency components to high frequency components(LF/HF)]were compared between two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of color Doppler ultrasound,ECG and their combination for right heart dys-function in PHD patients.Spearman correlation coefficient was used to analyze the association of color Doppler ul-trasound,ECG and their combination with right heart dysfunction in PHD patients.Results:Compared with those in good right heart function group,patients in right heart dysfunction group had significant higher IVRT[(120.64±14.08)ms vs.(97.87±10.93)ms],IVCT[(84.28±12.33)ms vs.(71.92±10.61)ms]and Tei index[(0.85±0.11)vs.(0.63±0.07)](P＜0.001 all),and significant lower SDNN[(75.52±12.58)ms vs.(85.58±11.75)ms],SDANN[(63.86±10.92)ms vs.(76.75±11.71)ms]and LF/HF[(1.33±0.19)vs.(1.84±0.27)](P＜0.001 all).ROC curve indicated that the AUC of color Doppler ultrasound combined ECG in diagnosing right heart dysfunction in PHD patients was 0.911(95％CI 0.838～0.959),which was significantly higher than those of color Doppler ultrasound[0.775(95％CI 0.681～0.853),Z=2.404,P=0.016]and ECG[0.688(95％CI 0.588～0.777),Z=3.968,P=0.001]alone.Spearman correlation analysis indicated that there was a significant positive correlation of color Doppler ultrasound(r=0.547),ECG(r=0.375)and their combination(r=0.810)with right heart dysfunction in PHD patients(P＜0.001 all),and the correlation between combined detection and right heart dysfunction in PHD patients was significantly higher.Conclusion:Color Doppler ultrasound combined with ECG possesses high diagnostic performance for right heart dysfunction in PHD patients.

Objective:To explore the value of dynamic changes in serum creatinine(SCr)and cardiac troponin I(cT-nI)levels in predicting the occurrence of heart failure in emcrgency patients with ST segment elevation myocardial in-farction(STEMI)after interventional treatment.Methods:A total of 186 patients with emergency STEMI admitted to Suzhou Ninth People's Hospital between January 2021 and January 2023 were enrolled and followed up for 1 year to record the incidence of heart failure.Receiver operating characteristic(ROC)curves were plotted to determine the optimal cut-off points of Scr,△SCr(absolute value of SCr on 7d after operation-baseline SCr),cTnI,and △cTnI(absolute value of cTnI on 7d after operation-baseline cTnI),and the value of each indicator in predicting heart failure.Results:After 1-year follow-up,the incidence of heart failure after percutaneous coronary intervention(PCI)was 27.78％(50/180).Compared with patients in no occurrence group,those in occurrence group had significant highcr △SCr[18.45(9.01,34.17)μmol/L vs.2.15(0.76,6.45)μmol/L],△cTnI[1.52(0.72,2.71)μg/L vs.0.56(0.15,1.43)μg/L](P＜0.001 all).ROC curve indicated that the optimal cut-off points of SCr,△SCr,cTnI and △cTnI were 113.235 μmol/L,8.595μmol/L,8.475 μg/L and 0.695μg/L,respectively.Multivariate Logistic regression analysis showed that baseline SCr≥113.235μmol/L,△SCr ≥8.595μmol/L,baseline cTnI ≥8.475 μg/L and △cTnI ≥0.695μg/L were independent risk factors for heart failure after PCI in emergency STEMI patients(OR=3.480～21.035,P＜0.01 all).Pearson correlation analysis indicated that baseline SCr was significantly positive associated with baseline cTnI(r=0.232,P=0.002).Conclu-sion:The dynamic changes of serum SCr and cTnI levels may predict the occurrence of heart failure in STEMI patients af-ter interventional treatment.