Objective:To investigate the diagnostic value of CT myocardial perfusion combined with serum cystatin C (CysC) and galectin-3 (Gal-3) for coronary heart disease (CHD) and its correlation with coronary artery disease.Methods:The clinical data of 126 patients with CHD (CHD group) and 126 patients with suspected CHD but excluded CHD by coronary angiography (control group) in Shanxi Provincial General Hospital of Armed Police Force from May 2018 to May 2020 were retrospectively analyzed. CT myocardial perfusion myocardial imaging was performed in both groups, and blood perfusion (BF) and mean transit time (MTT) were calculated. The serum Gal-3 was detected by enzyme-linked immunosorbent method, and the serum CysC was detected by immunoturbidimetric method. The changes of indexes in 2 groups and in CHD patients with different degrees of coronary artery stenosis and number of diseased branches were compared. Logistic regression was used to analyze the influencing factors of CHD; Pearson correlation was used to analyze the relationship between BF, MTT, CysC, Gal-3 and the degree of coronary artery stenosis and the number of diseased branches in patients with CHD; the receiver operating characteristic (ROC) curve was drawn, and the effectiveness of each index in diagnosing CHD was analyzed. The area under curve (AUC) was compared by DeLong test, and the combined diagnosis was performed by Logistic binary regression fitting.Results:The BF in CHD group was significantly lower than that in control group: (102.30 ± 9.25) ml/(100 g·min) vs. (119.97 ± 12.08) ml/(100 g·min), the MTT, CysC and Gal-3 were significantly higher than those in control group: (17.23 ± 3.04) s vs. (5.38 ± 1.29) s, (0.98 ± 0.24) mg/L vs. (0.73 ± 0.18) mg/L and (55.27 ± 16.42) ng/L vs. (16.93 ± 5.75) ng/L, and there were statistical differences ( P<0.01). Logistic regression analysis result showed that BF, MTT, CysC and Gal-3 were the influencing factors of CHD ( P<0.01). ROC curve analysis result showed that the AUC of BF, MTT, CysC combined with Gal-3 in the diagnosis of CHD was the largest (0.879), with a specificity of 84.92% and a sensitivity of 80.95%. In patients with CHD, with the aggravation of coronary artery stenosis and the increase of the number of diseased branches, the BF decreased gradually, the MTT, CysC and Gal-3 increased gradually, and there were statistical differences ( P<0.05). Pearson correlation analysis result showed that the BF had negative correlation with the degree of coronary artery stenosis and the number of diseased branches in patients with CHD ( r=-0.592 and -0.573, P<0.01), and the MTT, CysC and Gal-3 had positive correlation with the degree of coronary artery stenosis and the number of diseased branches (MTT: r = 0.695 and 0.674, P<0.01; CysC: r = 0.546 and 0.519, P<0.01; Gal-3: r = 0.628 and 0.609, P<0.01). Conclusions:CT myocardial perfusion imaging indexes (BF and MTT), serum CysC and Gal-3 levels are related to the degree of coronary artery stenosis and the number of diseased branches in patients with CHD. The combined detection of various indicators can improve the diagnostic value and provide a certain basis for clinical diagnosis and treatment and disease monitoring.

Objective To explore the clinical value of the monitoring of electronic cardiac index (CI) in the evaluation of neonatal congenital heart disease complicated with heart failure. Methods Sixty neonates with congenital heart disease treated in neonatal department from March 1, 2016 to December 30, 2016 were selected, and divided into severe group (n=11), moderate group (n=15), mild group (n=34), and no heart failure group (n=10) according to the modified Ross heart failure score. CI was measured by electronic force measurement. Left ventricular ejection fraction (LVEF) and pulmonary arterial pressure (PAP) were measured by echocardiography. Venous blood sampling was collected to detect the N-terminal type B brain natriuretic peptide (NT-proBNP). Results The neonates in the severe group were mainly under 2-week-old, while those in the mild group and the moderate group were more than 2-week-old. The differences of CI, LVEF, NT-proBNP, and PAP among the groups were statistically different. The CI and LVEF values were lowest in the severe group, followed by moderate group and mild group, and the highest in no heart failure group. The NT-proBNP and PAP values were the highest in the severe group, followed by moderate group and mild group, and the lowest in no heart failure group. Correlation analysis showed that CI was positively correlated with LVEF (r=0.845, P<0.001), and negatively correlated with NT-proBNP (r=-0.886, P<0.001); CI and PAP were weakly negatively correlated (r=-0.595, P<0.001). Conclusions CI reflects the degree of heart failure to some extent and has some clinical value.

OBJECTIVETo evaluate the differences in the therapeutic effects on relapsing-remitting multiple sclerosis (RRMS) at remission stage between acupuncture at acupoints and shallow needling therapy at the nearby points.

METHODSForty-two patients of RRMS were randomized into an observation group and a control group, 21 cases in each one. In the observation group, besides the basic treatment, acupuncture was applied according to's empirical prescriptions as "the empirical ten needles" "thirteen needles of the governor vessel" "twelve needles of hand and foot" as well as the symptomatic points. In the control group, the basic treatment was given. Additionally, the shallow needling therapy was given at the sites 0.2 to 0.3lateral to the acupoints, and the arrival ofwas not required. In the two groups, acupuncture was given once a day for 5 days a week, continuously for 2 weeks. At the intervals of 2 weeks, totally the treatment of 3 months was required. The follow-up visit was conducted for 2 years. Separately, the scores of the expanded disability status scale (EDSS) before and in follow-up after treatment, the annual recurrent rate before and after treatment and recurrent interval after treatment were observed in the patients of the two groups.

RESULTSIn the observation group, EDSS scores in 3-month and 6-month follow-up were reduced as compared with those before treatment (both<0.05) and those in the 12-month and 24-month follow-up were increased (both<0.05). In the control group, EDSS scores were increased in tendency continuously in 3-month, 6-month, 12-month and 24-month follow-up (all<0.05). In each time point of follow-up, the different value of EDSS scores in the observation group was lower than that in the control group (<0.05,<0.01). The annual recurrent rates after treatment were reduced as compared with those before treatment in the two groups (both<0.01) and the value in the observation group was lower than that in the control group (<0.01). The recurrent interval in the observation group was longer than that in the control group[(441.56±65.37) d vs (382.78±59.33) d,<0.01].

CONCLUSIONSAcupuncture achieves the significant therapeutic effects on RRMS at the remission stage. This therapy relieves the symptoms of neural functional deficits, delays the time of occurrence and reduces the annual recurrent rate.