Objective To investigate the gene polymorphisms of clopidogrel-related cytochrome P450 family member 2C19 (CYP2C19) in patients with cardiovascular and cerebrovascular diseases in the Chaozhou region, China. Methods The patients with cardiovascular and cerebrovascular diseases who attended our hospital from October 2017 to October 2022 and were given oral administration of clopidogrel were enrolled as subjects in this study. RT-PCR was used to detect CYP2C19 gene polymorphisms, and DNA sequencing was used for validation. The distribution of genotype and allele frequencies was analyzed for patients categorized as extensive, moderate, and poor metabolizers, and the differences in genotype frequencies were compared between male and female patients. Results Among the 621 patients, there were 260 cases (41.87%) categorized as CYP2C19 extensive metabolizers (*1/*1), 267 cases (43.00%) categorized as moderate metabolizers (*1/*2, *1/*3), and 94 cases (15.13%) categorized as poor metabolizers (*2/*2, *2/*3, *3/*3), and the allele frequencies of CYP2C19*1, CYP2C19*2, and CYP2C19*3 were 63.37%, 30.68%, and 5.96%, respectively. There was no significant difference in the frequency of CYP2C19 genotypes between the male and female patients (P >0.05). Conclusion The prevalence rates of the extensive metabolism genotype of the clopidogrel-related CYP2C19 gene and CYP2C19*1 allele among patients with cardiovascular and cerebrovascular diseases in Chaozhou is slightly lower than those in other regions across China. The distribution of CYP2C19 genotype frequencies is not associated with sex. CYP2C19 genotype should be determined for patients with cardiovascular and cerebrovascular diseases before clopidogrel treatment, which can help to formulate reasonable and safe individualized treatment strategies in clinical practice.

Objective To investigate the effect of graded nursing guided by Modified Early Warning Score (MEWS) in preventing complications in elderly patients with severe heart failure. Methods A total of 76 elderly patients with severe heart failure who were admitted to our hospital from January 2020 to May 2022 were enrolled as subjects and were divided into control group and observation group by drawing lots, with 38 patients in each group. The patients in the control group were given routine graded nursing intervention, and those in the observation group were given MEWS-guided nursing intervention in addition to the intervention in the control group. The two groups were compared in terms of MEWS, critically ill conditions, hospitalization-related indices, cardiac function, complications, and adverse events. Results After nursing, the observation group had significantly lower MEWS and critically ill score than the control group (P<0.05). The observation group had significantly shorter length of hospital stay and duration of mechanical ventilation than the control group (P<0.05). After nursing, compared with the control group, the observation group had a significantly higher left ventricular ejection fraction and significantly lower left ventricular end-diastolic diameter and left ventricular end-systolic diameter (P<0.05). Compared with the control group, the observation group had significantly lower overall incidence rates of complications (7.89% vs 26.30%, P<0.05) and adverse events (2.63% vs 21.04%, P<0.05). Conclusion For patients with severe heart failure, MEWS-guided nursing intervention can reduce the critical degree of conditions, improve cardiac function, reduce complications and adverse events, and shorten the length of hospital stay.