ABSTRACT
Objective :To detect peripheral serum levels of matrix metalloproteinase (MMP)—2 ,MMP—9 and tissue in—hibitor of metalloproteinases (TIMP)—1 in CHF patients ,and analyse their relationship with CHF prognosis .Meth—ods : A total of 200 CHF patients ,who were hospitalized in our hospital from Mar 2015 to Mar 2017 ,were enrolled as CHF group ;according to NYHA classification ,they was further divided into class II group (n＝ 78 ) ,class III group (n＝68) and class IV group (n＝ 54 ) ;according to prognostic condition ,CHF group was divided into good prognosis group (n＝126) and poor prognosis group (n＝74).Another 150 healthy subjects were enrolled as healthy control group .Peripheral serum levels of MMP—2 ,MMP—9 and TIMP—1 were measured and compared among all group .Results : Compared with healthy control group , there were significant rise in peripheral serum levels of MMP—2 and MMP—9 ,and significant reduction in TIMP—1 level in CHF group , P＝ 0.001 all.Along with NYHA class rose , peripheral serum levels of MMP—2 and MMP—9 gradually increased , and TIMP—1 level gradually de—creased ,there existed significant difference between any two subgroups , P＝0.001 all.Compared with good prog—nosis group ,there were significant rise in peripheral serum levels of MMP—2 [ (47.72 ± 9.57) ng／ml vs.(57. 42 ± 8.63) ng／ml] ,MMP—9 [ (50. 63 ± 8. 95) ng／ml vs.(62.83 ± 9. 67) ng／ml] ,and significant reduction in TIMP—1 level [ (29. 68 ± 6. 43) ng／ml vs.(20.74 ± 4.07) ng／ml] , P＝0.001 all.AUCs of MMP—2 ,MMP—9 and TIMP—1 judging poor prognosis was 0.689 ,0.683 and 0. 871 respectively ;sensitivity and specificity of MMP—2≥51. 13ng／ml , MMP—9≥57. 67ng／ml ,TIMP—1＜24. 79ng／ml predicting poor prognosis in CHF patients were 59.12% and 80. 93%, 67. 57% and 73.86%,94.19% and 81.79% respectively ,and their Youden＇s indexes were 0. 616 ,0.623 and 0. 516 respectively .Kaplan—Meier analysis indicated that according to two—year poor prognosis rate ,the high level MMP—2 patients was significantly higher than that of low level patients (78.05% vs.8.47%) ,and that of high level MMP—9 patients was significantly higher than that of low level patients (72.09% vs.10.53%) ,and that of low level TIMP—1 patients was significantly higher than that of high level patients (87.18% vs.4.92%) , P＝0.001 all.Con—clusion : There are significant rise in MMP—2 and MMP—9 levels ,and significant reduction in TIMP—1 level in periph—eral blood of CHF patients .They significantly affect patients＇prognosis ,which may be effective markers predicting prognosis of CHF .
ABSTRACT
Objective:To evaluate the effect of humanistic care for medical care integration on quality of life in elder patients with mild cognitive impairment. Method:Seventy patients with mild cognitive impairment in our hos-pital were randomly divided into experimental group ( n=35 ) and control group ( n=35 ) using random number ta-ble. The patients in the control group were given routine care, while those in the experimental group were given hu-manistic care for medical care integration and home visiting once a month besides routine care. All the patients were evaluated by the Montreal Cognitive Assessment Scale ( MoCA) , Activities of Daily Living ( ADL) , and the MOS Item Short from Health Survey ( SF-36 ) during hospitalization, three months and six months after hospital discharge. Result:Three and six months after hospital discharge, the scores of these three scales of all subjects in two groups were significantly higher than those during hospitalization ( P<0 . 05 ) . The scores of the subjects in the experimental group also significantly higher than those of the control group, and the differences were statistically significant (P<0. 05). Conclusion: For the elder patients with mild cognitive impairment, humanistic care for medical care integration can significantly improve the cognitive function, self -care ability and quality of life. Therefore, it is worthy using in clinical treatment.