Objective To investigate the clinical efficiency of nasal continuous positive airway pressure (nCPAP) on patients with chronic heart failure(CHF) due to hypertensive heart disease complicated with severe obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Fifty cases with CHF due to hypertensive heart disease complicated with severe OSAHS were divided into treatment group and control group with 25 cases each by the method of random digits table.nCPAP and routine drug treatment were administered in treatment group,while only routine drug treatment was given in control group.Cardiac functional grading,blood pressure,left ventricular end diastolic dimension (LVDd),left ventricular ejection fraction (LVEF),B-type natriuretic peptide (BNP),high-sensitivity C-reactive protein (hs-CRP) were compared before and after 3-month therapy.Results The effective rate in treatment group was significantly higher than that in control group [76.00％(19/25) vs.40.00％(10/25)],and there was significant difference (P ＜0.05).There was significantly decreased in blood pressure in two groups at the end of the therapy [treatment group:(127.52 ± 10.38)/(72.44 ±4.92) mmHg(1 mmHg =0.133 kPa) vs.(176.80 ± 12.90)/ (100.44 ±5.55) mmHg;control group:(150.12 ± 18.96)/ (81.64 ±9.42) mmHg vs.(176.00 ± 11.69)/ (96.08 ± 18.59) mmHg] (P ＜ 0.01),but the blood pressure was significantly lower in treatment group than that in control group (P ＜0.05).LVDd,BNP and hs-CRP in treatment group was declined significantly [(49.12 ± 3.18) mm vs.(57.44 ± 3.62) mm,525.52 ng/L vs.785.25 ng/L,(7.76 ± 1.69) mg/L vs.(18.04 ± 2.58) mg/L](P＜ 0.01);LVEF was significantly increased [(46.12 ± 2.52)％ vs.(38.68 ± 4.65)％](P＜ 0.01).There was no significant difference in LVDd and LVEF in control group before and after therapy (P ＞ 0.05).BNP and hs-CRP also were declined significantly [668.66 ng/L vs.850.96 ng/L,(12.88 ± 2.02) mg/L vs.(19.40 ± 2.30) mg/L] (P ＜ 0.05 or ＜ 0.01),but the above two were significantly lower in treatment group than those in control group(P ＜ 0.05).Conclusion nCPAP therapy can effectively improve the symptoms of heart failure,decrease blood pressure,improve cardiac function,reduce the inflammation response to patients with CHF due to hypertensive heart disease complicated with severe OSAHS.

Objective To investigate the influence of nasal continuous positive airway pressure (nCPAP) therapy on tumor necrosis factor-ot (TNF-α) and interleukin-6 (IL-6) in patients with chronic heart failure (CHF) and severe obstructive sleep apnea syndrome (OSAS).Methods Seventy-two cases with CHF and severe OSAS were divided into treatment group (36 cases) and control group (36 cases) by random digits table.Treatment group was treated by nCPAP and routine drug while control group only by routine drug treatment for 12 weeks.The changes of TNF-α and IL-6 before and after therapy were observed.Results The serum TNF-αt and IL-6 before treatment between two groups was no significant difference (P＞ 0.05).The serum TNF-αt and IL-6 after 12 weeks treatment in both two groups was significantly lower than that before treatment [treatment group:(29.94 ± 8.27) ng/L vs.(13.17 ± 3.61) ng/L,(92.08 ± 11.88) ng/L vs.(46.17 ± 20.01) ng/L;control group:(28.01 ± 7.21) ng/L vs.(22.13 ± 5.43) ng/L,(96.01 ± 12.19) ng/L vs.(68.66 ± 11.10) ng/L] (P ＜ 0.05),the treatment group decreased more significantly (P ＜ 0.05).Conclusion nCPAP therapy could effectively decrease the levels of TNF-α and IL-6 and reduce inflammation response in patients with CHF and severe OSAS.

Objective To investigate the relationship between brachial- ankle pulse wave velocity (baPWV) and heart rate variability (HRV), cardiac function in patients with essential hypertension.Methods One hundred and eighty patients with essential hypertensive from January 2014 to August 2016 were collected.The patients were divided into elevated group(baPWV≥1 400 cm/s,100 cases) and normal group (baPWV < 1 400 cm/s, 80 cases) according to the baPWV value. The general data, heart function and HRV of the 2 groups were compared. Results The standard deviation of all normal-to-normal(SDNN),standard deviation of all 5-min mean NN intervals(SDANN)and proportion of number of pairs of adjacent normal-to-normal intervals by more than 50 ms(PNN50%)in elevated group were significantly lower than those in normal group: (116.3 ± 17.0) ms vs. (135.8 ± 19.4) ms, (96.0 ± 21.4) ms vs. (120.0 ± 25.1) ms and (9.3 ± 3.1)% vs. (12.0 ± 4.1)%,and there were statistical differences (P<0.01); there was no statistical difference in root mean square of successive differences (RMSSD)between 2 groups(P>0.05);the left ventricular ejection fraction(LVEF)in elevated group was significantly lower than that in normal group:(57.2 ± 7.0)% vs.(63.0 ± 8.2)%,and there was statistical difference (P<0.01); there were no statistical differences in left ventricular end-diastolic dimension (LVDd) and left ventricular end systolic dimension (LVSd) between 2 groups (P>0.05); the interventricular septal thickness (IVST) in elevated group was significantly higher than that in normal group:(11.4 ± 2.5)mm vs.(9.5 ± 1.4)mm,and there was statistical difference(P<0.01).In patients with essential hypertension,there was a significant negative correlation between baPWV and SDNN,SDANN, PNN50%,LVEF(P<0.01),and there was a significant positive correlation between baPWV and IVST (P<0.05).Conclusions The baPWV measured in patients with essential hypertension can effectively reflect the HRV and cardiac function of the patients.

Objective: To analyze the characteristics of changes in serum cholesterol level in sepsis patients, and to explore its correlation with prognosis. Methods: A retrospective analysis was conducted. Two hundred and six patients with sepsis admitted in the Third People′s Hospital of Dalian from February 2015 to February 2019 were enrolled (observation group), and 206 patients without sepsis hospitalized in the same period were served as control group. The basic clinical data of the two groups were collected, and the results of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and biochemical parameters were compared. The patients with sepsis were divided into death group and survival group, and risk factors influencing the prognosis of patients with sepsis were analyzed with Logistic regression analysis. Results: Compared with control group, the levels of serum TC [(2.49 ± 1.14) mmol/L vs. (3.40 ± 1.26) mmol/L, t=6.240] and HDL-C [(1.66 ± 0.89) mmol/L vs. (2.49 ± 0.81) mmol/L, t=5.532] in observation group were significantly lower (P<0.05), and that of LDL-C showed no statistically significant difference [(1.96 ± 0.91) mmol/L vs. (2.10 ± 0.72) mmo/L, t=0.940, P>0.05]. In observation group, the patients in death group (85 cases) were older than those of the survival group (121 cases)[(75.6 ± 8.6) years vs. (62.5 ± 6.0) years, t=4.565], serum creatinine (SCr) was higher than that of survival group [(246.2 ± 34.6) μmol/L vs. (165.4 ± 35.6) μmol/L, t=5.420], and the levels of serum TC [(2.15 ± 0.59) mmol/L vs. (2.89 ± 1.02) mmol/L, t= 5.475], HDL-C [(1.40 ± 0.42) mmol/L vs. (1.94 ± 0.52) mmol/L, t=4.856] and LDL-C [(1.73 ± 0.56) mmol/L vs. (1.97 ± 0.72) mmol/L, t=4.261] were significantly lower than those of survival group (P<0.05). Logistic regression analysis showed that age was the risk factor of death in sepsis patients (OR=1.256, 95% CI 1.006 -1.056, P=0.012), and TC was the protective factor for the prognosis of sepsispatients (OR=-0.758, 95%CI 0.579-0.867, P=0.014). Conclusions The levels of TC, HDL-C in sepsis patients are significantly lowered, and the levels of TC, HDL-C, LDL-C in death group are significantly lower than those in survival group. TC may be used as a clinical indicator to assess the outcome of sepsis patients.