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Objective:To investigate the prognosis and related factors of ischemic cardiomyopathy.Methods:Clinical data of 271 patients with acute decompensated chronic heart failure admitted to the Cardiac Intensive Care Unit of Tianjin Chest Hospital from December 2019 to June 2022 were enrolled, including 135 cases with ischemic cardiomyopathy (ICM group) and 136 cases with non-ischemic cardiomyopathy (NICM group). Patients were followed up for 48 weeks; and the primary endpoint was all-cause death and/or readmission due to heart failure, the secondary end point was cardiogenic death. Kaplan-Meier survival curve was used to compare the difference in prognosis between the two groups. Univariate and multivariate Cox regression models were used to evaluate the factors influencing the primary and secondary end points of ischemic cardiomyopathy.Results:Compared with the NICM group, ICM group had higher proportion of patients with older age, fast pulse rate, high body mass index, comorbidities of hypertension, diabetes, chronic kidney disease, stroke or peripheral vascular disease; and greater left ventricular end-diastolic diameter, right ventricular end-diastolic anteroposterial diameter, pulmonary artery systolic blood pressure, and left ventricular ejection fraction (all P<0.05). Kaplan-Meier survival analysis showed that survival without primary endpoint (Log-rank P=0.009) and survival without secondary endpoint (Log-rank P=0.037) were lower in the ICM group than in the NICM group. Multivariate Cox regression analysis showed that elevated triglyceride (TG)/high density lipoprotein-cholesterol (HDL-C) ratio and elevated neutrophil percentage were independent risk factors for primary and secondary endpoint events in patients with ischemic cardiomyopathy. Conclusions:Patients with ischemic cardiomyopathy have lower survival rates than those with non-ischemic cardiomyopathy. High levels of TG/HDL-C ratio and neutrophil percentage are independent risk factors for poor prognosis in ischemic cardiomyopathy.
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OBJECTIVE:To investigate the effects of low molecular weight heparin calcium and rivaroxaban combined with atorvastatin on related indexes in patients with acute pulmonary embolism(APE). METHODS:The data of 72 APE patients were analyzed retrospectively. According to treatment plan,the patients were divided into group A(21 cases),group B(26 cases)and group C(25 cases). Group A was treated with intramuscular injection of Low molecular heparin calcium injection immediately after admission;2 days later,they were given Warfarin sodium tablets;7 days later,Low molecular heparin calcium injection was stopped while warfarin was still administrated,lasting for 3-6 months. Group B was given Low molecular heparin injection(same usage and dose as group A);2 days later,they were additionally treated with Rivaroxaban tablets;7 days later,Low molecular heparin calcium injection was stopped while rivaroxaban was still administrated,lasting for 3-6 months. Based on the treatment in group B,group C was treated with Atorvastatin calcium tablets 20 mg orally,once a day in the evening,lasting for 3-6 months. The time of dyspnea,chest pain and cyanosis disappearance were observed in 3 groups as well as the levels of HR,pa(O2),pa(CO2), CRP,D-dimer,TNF-α,IL-1,IL-6,ET-1 and NO before and after treatment. The occurrence of clinical outcome events and ADR were also observed. RESULTS:The time of dyspnea,chest pain and cyanosis disappearance in group A were longer than group B, and the group B was longer than the group A,with statistical significance(P0.05). After treatment ,HR of 3 groups were all lower than before ,and they showed group Agroup B>group C,with statistical signif-icance(Pgroup A and group B,with statistical significance (P0.05). ET-1 levels in 3 groups were significantly lower than before,and the levels showed group group group B>group A,with statistical significance (P<0.05). The incidence of clinical outcome events in group A was significantly higher than group C, the incidence of ADR in group B was significantly lower than that group A,with statistical significance(P<0.05). CONCLUSIONS:Low molecular weight heparin calcium and rivaroxaban combined with atorvastatin can significantly im-prove clinical symptoms and blood gas indexes,relieve vascular endothelial damage,reduce the levels of inflammatory cytokines and improve the prognosis of patients with APE,without increasing the incidence of ADR.
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Objective To investigate the level of self-concept on occupation among junior nurses.Methods One hundred and thirty-nine nurses with nursing experience of 1-5 years were involved in the survey by using the Nurses' Self-Concept Questionnaire (NSCQ).Comparisons were done between the groups of nurses with undergraduate education and those with three-year training courses in terms of self-concept and its dimensions.Results The total score of junior nurses on self concept was(5.33±0.77).The score of the nurses with undergraduate education was(5.16±0.88),significantly lower than the score of(5.44±0.71)of the nurses with three-year training courses(P<0.05).Conclusion The nursing administration should attach importance to the self-concept on occupation, instructing specially the nurses with undergraduate education so as to enhance their mental health and their self-identification of nursing as an occupation.
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@#Objective To investigate the effect of leg cycle ergometer on walking ability of stroke patients with hemiplegia at convalescent period.Methods Seventy patients with hemiplegia after stroke for 3 to 6 months with a certain walking capability were randomly divided into the treatment group and control group with 35 cases in each group.The control group was treated with routine rehabilitation training;the treatment group was added with leg cycle ergometer training.All patients in the two groups were assessed with simplified Fugl-Meyer Assessment(FMA),Berg Balance Scale(BBS),ambulation capacity(walking time in 10 meters and walking distance in 6 minutes and Holden's functional ambulance classification),changes of spasticity,and the ability of daily living(ADL)at the time of begin and 6 weeks later.Results The motor function of lower extremity,balance performance,walking capability and ADL of the patients in two groups improved(P<0.05)after 6 weeks' treatment,but the therapeutic effect of the treatment group was better than the control group(P<0.05).Conclusion The application of leg cycle ergometer combined with routine rehabilitation training can distinctly improve the motor function of lower extremity,balance performance,walking ability and ADL for patients after stroke.