Objective:To explore influence of holistic nursing on serum levels of N terminal pro brain natriuretic peptide (NT‐proBNP) , high sensitive cardiac troponin T (hs‐cTnT ) and quality of life in patients with chronic heart failure (CHF) .Methods:A total of 108 CHF patients treated in our hospital from Jan 2015 to May 2016 were randomly and e‐qually divided into routine nursing group and holistic nursing group (received holistic nursing based on routine nursing group) .Serum levels of NT‐proBNP ,hs‐cTnT and score of Chinese questionnaire of quality of life in patients with cardio‐vascular disease (CQQC) were compared between two groups before and after nursing .Results:There were no significant difference in serum levels of NT‐proBNP and hs‐cTnT and CQQC score between two groups before nursing , P>0.05 all . Compared with before nursing ,after nursing ,there were significant reductions in serum levels of NT‐proBNP and hs‐cTnT , and significant rise in CQQC score in holistic nursing group , P<0.01 all .Compared with routine nursing group after nurs‐ing ,there were significant reductions in serum levels of NT‐proBNP [(2.65 ± 0.53)μg/L vs .(2.07 ± 0.52)μg/L] and hs‐cTnT [ (0.42 ± 0.12)μg/L vs .(0.31 ± 0.09)μg/L] ,and significant rise in CQQC score [ (52.87 ± 9.56) scores vs . (57.43 ± 10.20) scores] in holistic nursing group ,P<0.05 or <0.01. Conclusion:Holistic nursing contributes to reducing serum levels of NT‐proBNP and hs‐cTnT , it can improve cardiac function and quality of life in patients with chronic heart failure ,which is worth clinical application and extending .

Objective:To explore influence of dexmedetomidine on Riker sedation -agitation scale (SAS) score and Ramsay sedation score in patients with hypertensive cerebral hemorrhage after borehole drainage . Methods :A total of 96 patients with hypertensive cerebral hemorrhage after borehole drainage treated in our hospital were selected . According to analgesic drugs taken after operation ,they were divided into dexmedetomidine group (n=48) and mid‐azolam group (n= 48) .Riker SAS score ,Ramsay sedation score and adverse reactions after operation were com‐pared between two groups . Results:Compared with midazolam group ,there were significant rise in Ramsay seda‐tion score [6h :(1.59 ± 0.52) scores vs .(2.13 ± 0.15) scores] and significant reduction in Riker SAS score [6h :(4.09 ± 0.82) scores vs .(3.73 ± 0.76) scores] on 6h ,12h and 24h after operation ,P<0.05 or <0.01 ;and signifi‐cant reduction in incidence rate of adverse reactions (37.5% vs .10.4% , P< 0.05 ) in dexmedetomidine group . Conclusion:Dexmedetomidine possesses definite analgesic and sedative effects on patients with hypertensive cerebral hemorrhage after borehole drainage ,it's safe andreliable ,which is worth extending .

Objective:To observe influence of cardiac resynchronization therapy (CRT ) on ventricular remodeling and inflammation in patients with chronic heart failure (CHF) .Methods :A total of 84 CHF patients treated in our hospital from Jun 2012 to Feb 2015 were selected , according to randam number table , they were randomly and e‐qually divided into routine treatment group (received routine medication ) and combined treatment group (received CRT based on routine treatment group) .Left ventricular ejection fraction (LVEF) ,left ventricular end -diastolic dimension (LVEDd) ,6min walking distance (6MWD) ,levels of high sensitive C reactive protein (hsCRP) ,inter‐leukin (IL)‐6 and tumor necrosis factor (TNF)–αwere compared between two groups before and three months after treatment .Results:Compared with before treatment ,three months after treatment ,there were significant rise in LVEF and 6MWD ,and significant reductions in LVEDd ,levels of hsCRP ,IL‐6 and TNF‐α in combined treatment group ( P<0.05 or < 0.01 ) ,while there were no significant improvements in above indexes in routine treatment group .Compared with routine treatment group ,there were significant rise in LVEF ± [(29.42 ± 4.32)%vs .(37.16 ± 4.72)% ] and 6MWD [ (232.66 ± 40.54) m vs .(304.12 ± 51.65) m] ,and significant reductions in LVEDd [ (64.35 ± 7.81) mm vs .(57.64 ± 6.12) mm] ,levels of hsCRP [ (23.21 ± 3.45)μg/ml vs .(16.31 ± 2.02)μg/ml] ,IL‐6 [ (22.08 ± 3.82)μg/ml vs .(15.79 ± 2.09)μg/ml] and TNF‐α[ (32.66 ± 5.66)μg/ml vs .(23.23 ± 3.12)μg/ml] in combined treatment group , P<0.05 or <0.01. Conclusion:CRT can significantly reduce levels of hsCRP ,IL‐6 and TNF‐αin CHF patients ,which may be the main mechanism delaying ventricular remodeling and improving cardiac function .

Objective:To explore the effectiveness and safety of levosimendan treating severe decompensated heart failure (SDHF) .Methods :A total of 80 patients with SDHF caused by various caused were selected ,randomly and equally divided into levosimendan group and dobutamine group .Both groups received intravenous drip of corre‐sponding drug based on routine treatment ,and the course was 24h .After two weeks ,therapeutic effects were com‐pared between two groups .Results:After two weeks ,total effective rate of levosimendan group was significantly higher than that of dobutamine group (95.0% vs .72.5% , P= 0.005) .Compared with dobutamine group ,after two weeks , there were significant reductions in dyspnea status score [ (2.57 ± 0.80 ) scores vs . (1.89 ± 0.70 ) scores] ,general status score [(3.23 ± 0.65) scores vs .(2.95 ± 1.29) scores] ,respiratory frequency [(24.32 ± 0.98) times/min vs .(20.6 ± 1.58) times/min] and level of brain natriuretic peptide [(1584 ± 325.63) mg/ml vs .(1011.92 ± 302.31) mg/ml] ,and significant rise in left ventricular ejection fraction [(40.16 ± 4.85)% vs .(46.53 ± 3.37)% ] in levosimendan group , P<0.05 or <0.01. Conclusion:In short-term therapeutic effect on severe decompensated heart failure ,levosimendan is superior to dobutamine ,it possesses good safety and tolerance ,which can be used as an effective drug for severe decompensated heart failure .

Objective:To explore therapeutic effects of trimetazidine combined atorvastatin calcium on chronic heart failure (CHF) .Methods:According to random number table ,a total of 80 CHF patients were randomly and equally divided into routine treatment group and combined treatment group (received trimetazidine and atorvastatin calcium based on routine treatment group) .NYHA class improvement ,6min walking distance (6MWD) ,left ventricular ejection fraction (LVEF) , left ventricular end‐systolic dimension (LVESd ) , plasma levels of brain natriuretic peptide (BNP ) , C reactive protein (CRP) and adverse drug reactions (ADR) were compared between two groups before and six months after treatment .Re‐sults:Compared with routine treatment group after treatment ,there was significant rise in total effective rate of heart function improvement (77.5% vs .95.0% ) in combined treatment group , P=0.023. Compared with routine treatment group ,there were significant rise in 6MWD [ (346.6 ± 47.3) m vs .(396.4 ± 49.2) m] and LVEF [ (44.5 ± 4.8)% vs . (49.3 ± 5.4)% ] ,and significant reductions in LVESd [ (54.2 ± 4.1) mm vs .(51.1 ± 4.3) mm] ,plasma levels of BNP [ (348.4 ± 61.3) pg/ml vs .(251.4 ± 53.6) pg/ml] and CRP [ (9.1 ± 2.2) mg/L vs .(6.4 ± 1.6) mg/L] in combined treatment group , P<0.05 or <0.01. No severe ADR was found in two groups .Conclusion:Trimetazidine combined ator‐vastatin calcium can significantly improve cardiac function and exercise capacity ,improve quality of life and ventricular re‐modeling in CHF patients ,it's safe and reliable ,which is worth extending .

Objective:To evaluate therapeutic effect and safety of rosuvastatin on patients with hyperlipidemia com‐plicated hyperuricemia .Methods :A total of 88 patients with hyperlipidemia complicated hyperuricemia ,who were hospitalized in our hospital ,were selected ,randomly and equally divided into rosuvastatin group (10 mg/d) and atorvastatin group (20 mg/d) ,both groups were treated for eight weeks .Changes of levels of blood lipids and serum uric acid (SUA) were observed and compared between two groups before and after treatment .Results:Compared with before treatment ,after eight -week treatment ,there were significant reductions in levels of blood lipids (ex‐cept high density lipoprotein cholesterol ) and SUA in both groups , P<0.01 all;compared with atorvastatin group after treatment ,there were significant reductions in levels of total cholesterol [ (4.87 ± 0.47) mmol/L vs .(4.48 ± 0.53) mmol/L] in rosuvastatin group (P=0.04) ,and there was no significant difference in SUA level between two groups , P>0.05. There were all no more serious side effects in both groups .Conclusion:While reducing blood lipid levels ,rosuvastatin can also reduce serum uric acid level in patients with hyperlipidemia ,and it possesses good safety and tolerance .

Objective:To explore diagnostic value of 6min walking test (6MWT) for coronary heart disease (CHD) . Methods :A total of 192 patients suspected of CHD ,including 123 men and 69 women ,who were treated in our hos‐pital ,were selected .After hospitalization ,all patients received 6MWT and coronary angiography (CAG) examina‐tion .With CAG results as the gold standard for diagnosing CHD ,sensitivity ,specificity ,accuracy ,positive predic‐tive value and negative predictive value of 6MWT diagnosing CHD were calculated ,and they were compared be‐tween men and women .Detections of 6WMT among groups of different diseased number of vessels were compared . Results :With CAG results as the standard ,accuracy ,specificity ,sensitivity ,positive predictive value and negative predictive value of 6MWT diagnosing CHD were 71.35% ,80.58% ,60.67% ,72.97% and 70.34% respectively . Compared with female patients ,there were significant rise in accuracy (57.97% vs .77.24% ) ,sensitivity (39.29%vs .70.49% ) ,specificity (70.73% vs .83.87% ) and positive predictive value (47.83% vs .81.13% ) , P<0.05 or<0.01 ,and significant reductions in false positive rate (29.27% vs .16.13% ) and false negative rate (60.71% vs . 29.51% ) in male patients (P<0.05 or <0.01) ,there was no significant difference in negative predictive value be‐tween two groups (P>0.05) .Compared with single - and double -vessel coronary disease ,there was significant rise in true positive rate (43.75% ,54.05% vs .100% ) of triple - or multi -vessel coronary disease diagnosed by 6MWT , P< 0.01 both . Conclusion:The 6min walking test possesses high specificity and sensitivity diagnosing CHD ,and its diagnostic value is higher for male patients and patients with serious condition .Its procedures are sim‐ple with low cost and no damage to patients ,which can be used as adjunctive examination for CHD diagnosis and ex‐tended in clinic .

Objective:To study influence of type 2 diabetes mellitus (T2DM) on ambulatory blood pressure (ABP) levels and blood pressure variability (BPV) in aged patients with essential hypertension (EH) .Methods:A total of 80 aged EH +T2DM patients treated in our hospital from Jun 2014 to Jan 2016 were selected as observation group ,another 80 aged pure EH patients were selected as EH control group .The 24hABP indexes and BPV indexes were compared between two groups . Results:Compared with EH control group , there were significant rise in 24h mean systolic blood pressure [24hSBP , (126.47 ± 9.64) mmHg vs .(134.98 ± 10.63) mmHg] ,nighttime mean SBP [nSBP ,(125.73 ± 10.19) mmHg vs .(133.74 ± 11.29) mmHg] ,daytime mean SBP [dSBP ,(128.29 ± 10.97) mmHg vs .(136.42 ± 12.18) mmHg] ,daytime mean pulse pressure [dPP ,(59.46 ± 10.79) mmHg vs .(65.38 ± 11.69) mmHg] ,nPP [ (58.00 ± 10.11) mmHg vs .(67.14 ± 9.93) mmHg] and 24hPP [ (59.27 ± 10.16) mmHg vs .(64.76 ± 11.62) mmHg] , P<0.01 all;and significant rise in 24hSBP standard deviation [24hSBPSD ,(12.63 ± 2.87) mmHg vs .(18.41 ± 3.09) mmHg] and nSBPSD [ (10.14 ± 3.53) mmHg vs .(14.89 ± 3.54) mmHg] in observation group , P<0.01 both .Conclusion:Diabetes mellitus elevates daytime and nighttime SBP ,increases BPV and risk of cardiovascular diseases in aged EH patients .

Objective:To explore the correlation among plasma levels of fibrinogen (Fg) ,D-dimer (DD) and antithrombin III (ATIII ) and carotid atherosclerosis (CAS) in AMI patients .Methods:A total of 147 AMI patients treated in our de‐partment from Jan 2012 to Dec 2014 were enrolled as AMI group ,another 120 patients without myocardial infarction (MI) were treated as control group .According to ACS severity ,AMI group was further divided into normal group (n=22) ,mild group (n=30) ,moderate group (n=40) and severe group (n=55) .Plasma levels of Fg ,DD and ATIII ,and carotid inti‐ma-media thickness (IMT) were measured and compared among all groups .Results:Compared with control group ,there were significant rise in plasma levels of Fg [ (3.12 ± 0.87) g/L vs .(5.01 ± 1.38) g/L] ,DD [ (317 ± 50)μg/L vs .(1530 ± 218)μg/L] and carotid IMT [(0.86 ± 0.41) mm vs .(1.12 ± 0.29) mm] ,and significant reduction in plasma AT Ⅲ level [ (87 ± 18)% vs .(76 ± 19)% ] in AMI group , P<0.01 all. Compared with normal group ,there were significant rise in plasma levels of Fg and DD ,and significant reduction in plasma ATIII level in moderate group and severe group , P<0.05 or <0.01. Spearman correlation analysis indicated that plasma Fg and DD levels were significant positively correlated with CAS severity (r=0.426 ,0.535 ,P<0.01 both) ,ATIII level was significant inversely correlated with CAS severity in AMI patients ,(r= -0.438 ,P=0.005) .Multi-factor Logistic regression analysis indicated that plasma Fg and DD levels were independent risk factors for MI (OR=2.836 ,2.231 , P<0.01 both) ,and plasma ATIII level was independent protective factor for MI (OR=0.899 , P=0.014 ) .Conclusion:Plasma Fg and DD levels are independent risk factors for MI and plasma ATIII level is independent protective factor for MI .

Objective:To observe changes of serum levels of myeloperoxidase (MPO) and lipoxin A4 (LXA4) in pa‐tients with coronary heart disease (CHD) and explore its clinical significance .Methods :A total of 120 CHD patients treated in our hospital from Jun 2013 to Sep 2014 were selected as CHD group ,another 40 healthy subjects were re‐garded as normal control group .According to CHD type ,patients were divided into stable angina pectoris (SAP) group (n=36) ,unstable angina pectoris (UAP) group (n=46) and myocardial infarction (MI) group (n=38) .Ac‐cording to plaque nature assessed by CT value ,patients were divided into calcified plaque group (n= 27) ,mixed plaque group (n=31) and non-calcified plaque group (n=62) .Levels of MPO and LXA4 and ratio of MPO/LXA4 were compared among all groups .Results:Compared with normal control group ,there were significant rise in MPO level [ (167.2 ± 20.4) U/L vs .(218.3 ± 32.5) U/L] and MPO/LXA4 [ (0.78 ± 0.08) vs .(1.34 ± 0.27)] ,and sig‐nificant reduction in LXA4 level [ (214.6 ± 31.3) nmol/L vs .(162.4 ± 22.4) nmol/L] in CHD group ,P<0.05 or<0.01 .Compared with SAP group ,there were significant rise in MPO level [ (180.4 ± 21.6) U/L vs .(230.3 ± 32.5) U/L vs .(238.6 ± 44.7) U/L] and MPO/LXA4 [ (0.97 ± 0.11) vs .(1.37 ± 0.23) vs .(1.62 ± 0.25)] ,and significant reduction in LXA4 level [ (184.7 ± 23.7) nmol/L vs .(156.3 ± 21.2) nmol/L vs .(148.4 ± 19.6) nmol/L] in UAP group and MI group ,and MPO/LXA4 of MI group was significantly higher than that of UAP group , P<0.05 or < 0.01 . Compared with calcified plaque group and mixed plaque group , there were significant rise in MPO level [(196.3 ± 27.2) U/L vs .(211.2 ± 24.6) U/L vs .(231.6 ± 26.5) U/L] and MPO/LXA4 [(1.13 ± 0.14) vs .(1.26 ± 0.16) vs .(1.51 ± 0.21)] ,and significant reduction in LXA4 level [ (174.3 ± 23.4) nmol/L vs .(167.4 ± 21.2) nmol/L vs .(154.6 ± 19.2) nmol/L] in calcified plaque group ,and MPO/LXA4 of mixed plaque group was significantly higher than that of calcified plaque group , P<0.05 or <0.01 .Conclusion:There exist significant ab‐normal levels of MPO and LXA4 in CHD patients ,ratio of MPO/LXA4 is more helpful for determining disease se‐verity and stability of atherosclerotic plaque .