Objective:To explore the application effect of modified early cardiac rehabilitation in patients with acute myocardial infarction after percutaneous coronary intervention (PCI) .Methods:Using the convenient sampling method, a total of 193 patients who were diagnosed with acute ST-segment elevation myocardial infarction and underwent PCI in Huabei Petroleum Administration Bureau General Hospital were selected as research objects from January 2018 to January 2020. They were randomly divided into the observation group (97 cases) and the control group (96 cases) . Patients in the control group received routine nursing, while the observation group received modified early cardiac rehabilitation nursing. The Barthel Index, 6-Minute Walk Test (6MWT) and the MOS Item Short from Health Survey (SF-36) were used to compare the effects of interventions.Results:After intervention, the distance of 6MWT in the observation group was longer than that in the control group, and the score of Barthel Index in the observation group was higher than that in the control group, and the differences were statistically significant ( P<0.05) . After 6 months of follow-up, scores of general health, social function, emotional function, physiological function and mental health in SF-36 of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Modified early cardiac rehabilitation is beneficial to improve the activity of daily living, increase exercise tolerance and improve quality of life of patients with acute myocardial infarction after PCI.

Objective The study was to investigate the activation of tumor necrosis factor α (TNF-α) mRNA transcription and protein expression in peripheral blood and activation of signal path PI3K/AKT in patients with chronic heart failure. Methods From February 2015 to April 2018, 244 patients with heart failure in the cardiovascular department of our hospital were selected as heart failure group, while 244 healthy cases were enrolled as the control group at the same time. The peripheral blood samples of two groups were collected. We detected the transcription and protein expression of TNF-α mRNA and the activation of PI3K, AKT in peripheral blood. The left ventricular ejection fraction (LVEF) were measured in two groups. The correlations between influencing factors and LVEF were analyzed. Results The levels of PI3K, AKT in the heart failure group were higher than those in the control group. The differences were statistically significant respectively (P < 0.05). The mRNA relative content and protein content of TNF-α in peripheral blood mononuclear cells of heart failure group were higher compared with those of control group (P < 0.05). The LVEF of heart failure group was significantly lower than that of the control group (34.50 ± 6.33) ％ versus (55.60 ± 2.49) ％, P < 0.001). Among 244 patients with heart failure, Spearman correlation analysis showed that there were significant positive correlations between TNF-a mRNA and protein expression levels and the levels of PI3K, AKT respectively (P < 0.05). Multiple factors unconditional Logistic regression analysis showed that the TNF-α mRNA, protein expression and PI3K, AKT levels in peripheral blood were independent risk factors for LVEF (P < 0.05). Conclusion The expression levels of PI3K, AKT and TNF-α are all significantly increased in chronic heart failure patients, which could participate in the occurrence and development of heart failure.