Objective:To investigate the prognostic value of serum levels of human cartilage glycoprotein 39 (HC-gp39) and microRNA (miR) -499-5p in elderly patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) .Methods:A total of 175 elderly AMI patients who underwent PCI treated in Qingdao Central Hospital from February 2020 to May 2022 were selected as the observation group, and 54 healthy patients who underwent physical examination in the hospital during the same period were selected as the control group. Serum HC-gp39 and miR-499-5p levels and cardiac function parameters [left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD)] of the observation group and control group were compared, and serum HC-gp39 and miR-499-5p levels of patients in the observation group with different cardiac function grades were compared. The correlation between serum HC-gp39 and miR-499-5p levels and cardiac function parameters was analyzed. After 1-year follow-up, elderly AMI patients were divided into occurrence group and non-occurrence group according to whether major adverse cardiovascular events (MACE) occurred after surgery. Clinical data of occurrence group and non-occurrence group were compared to analyze the influencing factors of postoperative MACE in elderly AMI patients. The predictive value of serum HC-gp39 and miR-499-5p levels and their combination on postoperative MACE in elderly patients with AMI was analyzed.Results:The serum levels of HC-gp39, miR-499-5p and LVEDD in the observation group were higher than those in the control group, and LVEF was lower than that in the control group (all P<0.05). The serum levels of HC-gp39 and miR-499-5p in patients with cardiac function classification Ⅲ were higher than those in patients with cardiac function classification Ⅰ and Ⅱ (all P<0.05), and the serum levels of HC-gp39 and miR-499-5p in patients with cardiac function classification Ⅱ were higher than those in patients with cardiac function classification Ⅰ (all P<0.05). Serum HC-gp39 and miR-499-5p levels were positively correlated with LVEDD ( r=0.417, 0.532, all P<0.05), and negatively correlated with LVEF ( r=-0.567, -0.485, all P<0.05). After 1 year of follow-up, 4 cases were lost to follow-up, the follow-up rate was 97.71%(171/175), and 42 cases had MACE. Gensini score, proportion of unrevascularated blood circulation, troponin T, multi-branch ratio of lesion index, serum HC-gp39 and miR-499-5p levels in the occurrence group were higher than those in the non-occurrence group, and hemoglobin and lymphocyte counts were lower than those in the non-occurrence group, with statistical significance (all P<0.05). The results of multifactor stepwise regression analysis showed that troponin T ( OR=2.818, 95% CI: 1.238-6.404), Gensini score ( OR=3.554, 95% CI: 1.562-8.084), serum HC-gp39 ( OR=3.062, 95% CI: 1.346-6.965) and serum miR-499-5p ( OR=4.003, 95% CI: 1.760-9.160) were the influential factors for postoperative MACE in elderly patients with AMI (all P<0.05). The sensitivity of serum HC-gp39, miR-499-5p and their combined prediction of MACE after PCI in elderly AMI patients were 83.33%, 90.48% and 90.48%, respectively, and the specificity was 80.62%, 75.19% and 93.02%, respectively. The area under the curve (AUC) was 0.825, 0.816, 0.901 (all P<0.05), and the AUC of the combination of the two was higher ( P<0.05). Conclusions:Serum HC-gp39 and miR-499-5p levels can be used to predict the prognosis of elderly AMI patients after PCI, and the combination of the two has higher predictive value.

Objective:To investigate the prognostic value of serum levels of human cartilage glycoprotein 39 (HC-gp39) and microRNA (miR) -499-5p in elderly patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) .Methods:A total of 175 elderly AMI patients who underwent PCI treated in Qingdao Central Hospital from February 2020 to May 2022 were selected as the observation group, and 54 healthy patients who underwent physical examination in the hospital during the same period were selected as the control group. Serum HC-gp39 and miR-499-5p levels and cardiac function parameters [left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD)] of the observation group and control group were compared, and serum HC-gp39 and miR-499-5p levels of patients in the observation group with different cardiac function grades were compared. The correlation between serum HC-gp39 and miR-499-5p levels and cardiac function parameters was analyzed. After 1-year follow-up, elderly AMI patients were divided into occurrence group and non-occurrence group according to whether major adverse cardiovascular events (MACE) occurred after surgery. Clinical data of occurrence group and non-occurrence group were compared to analyze the influencing factors of postoperative MACE in elderly AMI patients. The predictive value of serum HC-gp39 and miR-499-5p levels and their combination on postoperative MACE in elderly patients with AMI was analyzed.Results:The serum levels of HC-gp39, miR-499-5p and LVEDD in the observation group were higher than those in the control group, and LVEF was lower than that in the control group (all P<0.05). The serum levels of HC-gp39 and miR-499-5p in patients with cardiac function classification Ⅲ were higher than those in patients with cardiac function classification Ⅰ and Ⅱ (all P<0.05), and the serum levels of HC-gp39 and miR-499-5p in patients with cardiac function classification Ⅱ were higher than those in patients with cardiac function classification Ⅰ (all P<0.05). Serum HC-gp39 and miR-499-5p levels were positively correlated with LVEDD ( r=0.417, 0.532, all P<0.05), and negatively correlated with LVEF ( r=-0.567, -0.485, all P<0.05). After 1 year of follow-up, 4 cases were lost to follow-up, the follow-up rate was 97.71%(171/175), and 42 cases had MACE. Gensini score, proportion of unrevascularated blood circulation, troponin T, multi-branch ratio of lesion index, serum HC-gp39 and miR-499-5p levels in the occurrence group were higher than those in the non-occurrence group, and hemoglobin and lymphocyte counts were lower than those in the non-occurrence group, with statistical significance (all P<0.05). The results of multifactor stepwise regression analysis showed that troponin T ( OR=2.818, 95% CI: 1.238-6.404), Gensini score ( OR=3.554, 95% CI: 1.562-8.084), serum HC-gp39 ( OR=3.062, 95% CI: 1.346-6.965) and serum miR-499-5p ( OR=4.003, 95% CI: 1.760-9.160) were the influential factors for postoperative MACE in elderly patients with AMI (all P<0.05). The sensitivity of serum HC-gp39, miR-499-5p and their combined prediction of MACE after PCI in elderly AMI patients were 83.33%, 90.48% and 90.48%, respectively, and the specificity was 80.62%, 75.19% and 93.02%, respectively. The area under the curve (AUC) was 0.825, 0.816, 0.901 (all P<0.05), and the AUC of the combination of the two was higher ( P<0.05). Conclusions:Serum HC-gp39 and miR-499-5p levels can be used to predict the prognosis of elderly AMI patients after PCI, and the combination of the two has higher predictive value.

Objective    To assess the efficacy and safety of percutaneous closure of patent ductus arteriosus (PDA) solely under echocardiography guidance. Methods    We retrospectively analyzed the clinical data of 200 patients who received the percutaneous closure of PDA under echocardiography guidance in Fuwai Hospital from August 2013 to April 2016. According the different approach, they were divided into 2 groups: a femoral artery approach group (n=143) and a femoral vein approach group (n=57). In the femoral artery approach group, there were 42 males and 101 females aged 3.20±5.63 years. In the femoral vein group, there were 10 males and 47 females aged 7.30±11.36 years. All Patients were treated by percutaneous PDA closure solely under echocardiography guidance. The follow-up was performed at one month after the operation by echocardiography, chest radiograph and electrocardiogram. Results    All 200 patients were successfully treated with percutaneous closure of PDA. The patients’ gender, in-hospital stay, rates of occluder  detachment were similar between the two groups (P>0.05). Compared with the femoral vein approach group, the femoral artery approach group had a younger age (3.20±5.63 years vs. 7.30±11.36 years, P<0.001), less body weight (14.25±11.54 kg vs. 24.25±19.14 kg, P<0.001) and shorter diameter of PDA (3.06±0.79 mm vs. 5.93±0.68 mm, P<0.001) and PDA occluders (5.43±1.00 mm vs. 12.14±0.54 mm, P<0.001), but had higher hospitalization expenses (32 108.2±3 100.2 yuan vs. 25 120.7±3 534.1 yuan, P<0.001). In the femoral vein approach group, one patient was closed under radiation guidance because guide wires could not pass through PDA. One patient in the femoral artery approach group suffered from occluder detachment at one day after operation and was cured by transthoracic minimally invasive PDA occlusion. There were no complications of occluder detachment, residual shunt, pericardial effusion or left pulmonary stenosis during the follow-up. Conclusion    Echocardiography-guided percutaneous PDA closure is safe and effective, while the proper interventional approach should be chosen by the anatomical features of PDA.

Objective To determine whether there is correlation between intracranial and extracranial arterial stenosis in patients with ischemic stroke,and to understand the difference of the main risk factors between them.Methods One hundred and sixty-eight patients with symptomatic ischemic stroke were selected in order to analyze the correlation and risk factors of intracranial arterial stenosis and extracranial arterial stenosis.Results In the 168 cases,123 patients(73.2%)were with abnormal artery(include intimal thickening)and 100 patients(59.5%)were diagnosed with artery stenosis,including 33 cases of intracranial artery stenosis,48 cases of extracranial artery stenosis and 19 cases of intracranial and extracranial stenosis.The rate of extracranial artery stenosis(39.9%)was higher than that of intracranial artery stenosis(31.0%),but there was no significant difference between them(χ2 =2.93,P=0.11).There was no definite correlation between them(χ2 =0.35,P=0.61)and there were statistically significant differences in age and arterial pressure between patients with intracranial and mean extracranial artery stenosis(t=1.98,P=0.05;t=5.42,P<0.001),but the gender,blood pressure,blood glucose and dyslipidemia rate showed no significant difference (χ2 =1.15,3.41,0.43,0.81,P>0.05).Conclusion Extracranial arterial stenosis may not predict the possibility of intracranial arterial stenosis,and extracranial arterial stenosis may be more likely to cause ischemic stroke.

Objective To investigate the efficacy and safety of percutaneous induced thrombosis closure on small patent ductus arteriosus (PDA) solely under echocardiography guidance.Methods From June 2013 to September 2016,276 PDA patients were treated by femoral artery retrograde approach under echocardiography guidance.Twenty-five patients (14 boys,11 girls) among them with small PDA received percutaneous induced thrombosis closure because the delivery sheath could not pass PDA,with mean age (3.7 ± 1.6) years,mean body weight (16.6 ±5.4) kg and the mean diameter of the most narrow PDA was (1.3 ± 0.4) mm.All patients were assessed by transthoracic echocardiography,chest radiography and electrocardiography preoperatively.The intraoperative and postoperative effects were evaluated by echocardiography.Outpatient assessment was performed at 1,3,6 and 12 months after operation with electrocardiography and echocardiography,and yearly thereafter.Results Twenty-five patients were successfully treated with percutaneous induced thrombosis closure solely under echocardiography guidance.The mean operation time was (35.2 ± 6.1) minutes.The immediate residual shunt rates and 24 hours after operation were 28.0％ (7/25 cases) and 16.0％ (4/25 cases),respectively.All patients recovered and were discharged from hospital.The average hospitalization stay was (3.0 ± 0.6) days.The mean follow-up was (16.8 ± 12.3) months,residual shunt was observed in 2 patients (8.0％),and it decreased from 1.5 mm and 2.0 mm preoperatively to 0.8 mm and 1.0 mm postoperatively,respectively.All patients survived without peripheral vascular injury,cardiac perforation,PDA rupture or thrombembolia.Conclusions Percutaneous induced thrombosis closure of small PDA solely under echocardiography guidance is safe and effective.It can avoid occluder implantation and radiation injury.However,the residual shunt after operation needs following up closely.

Objective: To investigate the safety and efficacy of transthoracic minimally invasive patent ductus arteriosus (PDA) occlusion in infants and young children.
Methods: We retrospectively analyzed 105 infants and young children who received the transthoracic minimally invasive PDA occlusion in our hospital from 2012-10 to 2014-10. According to PDA diameter, patients were divided into 2 groups:Group A, the patients with PDA diameter ≥ 4 mm,n=64 and group B, the patients with 2 mm ≤ PDA diameter < 4 mm,n=41. All patients received the left third parasternal intercostal incision under suprasternal echocardiography guidance. The operative effect was evaluated by transthoracic echocardiography, and the follow-up study was performed at 1 month, 3 months, 6 months period and then annually after the operation by echocardiography.
Results: All 105 patients had successfully implanted PDA occluders. The patients’ gender, age, body weight, tracheal intubation time and the in-hospital time were similar between 2 groups,P>0.05. Compared with Group B, Group A had the larger diameters of PDA (5.7 ± 1.4) mm vs (2.7 ± 0.6) mm, P<0.001, PDA occluders (10.6 ± 1.8) mm vs (7.2 ± 1.3) mm, P<0.001, and the higher rates of moderate and severe post-operative thrombocytopenia 10.9% (7/64) vs 0% (0/41),P=0.028, immediate post-operative residual shunt as 15.6% (10/64) vs 2.4% (1/41),P=0.031. There was 1 patient in Group A suffered from pericardial tamponade due to hemorrhage at 2 days after operation and he was cured by emergent pericardial drainage. The patients were followed-up for (11.6 ± 7.8) months. The 1 month post-operative residual shunt was similar between 2 groups as 1.6% (1/64 ) vs 0% (0/41),P=0.421, and there was no residual shunt at 3 months after the operation. There were no complications of occluder detachment, hemolysis, pericardial effusion, left pulmonary artery or descending aortic stenosis occurred during the follow-up period.
Conclusion: Transthoracic minimally invasive PDA occlusion is a safe and effective method to treat the relevant infants and young children, while the post-operative residual shunt and thrombocytopenia should be closely observed in patients with large PDA.

Objective To study application effect of clinical nursing pathway on health ed-ucation in patients with laparoscopic cholecystectomy.Methods A total of 98 patients with laparo-scopic cholecystectomy were randomly divided into control group and pathway group,with 49 pa-tients in each group.Patients in the pathway group received health education according to clinical nursing pathway table while patients in the control group received traditional health education.Re-sults The command condition of health knowledge,compliance of patients and satisfaction to-wards nursing in the observation group were higher than that in the control group (P <0.05). Conclusion Clinical nursing pathway could effectively improve health education in a standardized and scientific way,enhance patients′compliance and maintain harmonious relationship between nurses and patients.

Objective To study application effect of clinical nursing pathway on health ed-ucation in patients with laparoscopic cholecystectomy.Methods A total of 98 patients with laparo-scopic cholecystectomy were randomly divided into control group and pathway group,with 49 pa-tients in each group.Patients in the pathway group received health education according to clinical nursing pathway table while patients in the control group received traditional health education.Re-sults The command condition of health knowledge,compliance of patients and satisfaction to-wards nursing in the observation group were higher than that in the control group (P <0.05). Conclusion Clinical nursing pathway could effectively improve health education in a standardized and scientific way,enhance patients′compliance and maintain harmonious relationship between nurses and patients.