Objective To investigate the clinical value of dynamic thromboelastogram monitoring results in thrombolytic therapy for acute ischemic stroke. Methods A total of 70 patients with acute ischemic stroke who attended Emergency Department of Gaoming People’s Hospital from January 2023 to July 2024 were enrolled as subjects and were randomly divided into control group (empirical thrombolytic therapy) and study group (the dose of thrombolytic drug was adjusted based on thromboelastogram results). The two groups were compared in terms of the changes in thromboelastogram (reaction time of coagulation [R], coagulation formation time [K], blood clot formation rate [Angle], maximum amplitude [MA], the percentage decrease in amplitude 30 minutes post maximum amplitude [LY30], and coagulation comprehensive index [CI]) and prognosis after thrombolytic therapy, and the association of thromboelastogram with the middle-and long-term recurrence of stroke was analyzed. Results There were no significant differences in thromboelastogram results between the two groups before thrombolytic therapy (P >0.05), and both groups had significant changes in thromboelastogram results at 1, 6, and 12 hours after treatment (all P <0.05). The patients with a higher R, Angle or CI value tended to have a relatively poor prognosis and a higher middle-or long-term recurrence rate of vascular thrombosis (all P <0.05), and the patients with higher LY30 and MA values tended to have a good prognosis and a lower middle-or long-term recurrence rate of vascular thrombosis (all P <0.05). The Poisson correlation analysis showed that the values of R, K, Angle, and CI were positively correlated with middle-and long-term recurrence in patients with stroke (all P <0.05). Conclusion Dynamic thromboelastogram monitoring has a certain guiding value in thrombolytic therapy for patients with stroke, and thromboelastogram results have a certain value in predicting middle-and long-term recurrence in patients with stroke and can thus be used as routine monitoring indicators for such patients.

Objective To investigate the value of ductus venosus (DV) parameters measured by antenatal color Doppler ultrasound combined with Down’s syndrome screening in the diagnosis of fetal congenital heart disease (CHD).Methods A total of 1689 pregnant women who underwent CHD screening in our hospital from January 2020 to May 2024 were enrolled as subjects. Measurement of DV parameters and Down’s syndrome screening were performed for all subjects, and the detection rate of fetal CHD and diagnostic efficacy were analyzed based on the gold standard of examination results after termination of pregnancy. The fetuses with CHD and those without CHD were compared in terms of DV parameters, alpha-fetoprotein (AFP), unconjugated estriol (uE3), and free β-human chorionic gonadotropin (β-hCG). Results Among the 1689 pregnant women, 60 were diagnosed with fetal CHD based on the gold standard, among whom 55 were detected by DV parameters, with a positive rate of 91.67%, and 52 were detected by Down’s syndrome screening, with a positive rate of 86.67%, while 59 were detected by the combination of DV parameters and Down’s syndrome screening, with a positive rate of 98.33%. The combination of DV parameters and Down’s syndrome screening had significantly higher sensitivity, accuracy, and negative predictive value than each examination alone (P <0.05). The fetuses with CHD had significantly higher values of S/D, PI, PVIV, and PLI than those without CHD (S/D: 5.86±0.85 vs 3.97±0.47, P <0.05; PI: 1.68±0.23 vs 1.05±0.19, P <0.05; PVIV: 1.18±0.22 vs 0.89±0.15, P <0.05; PLI: 1.06±0.19 vs 0.76±0.13, P <0.05). Compared with the fetuses without CHD, the fetuses with CHD had significantly higher levels of AFP (55.65±5.28 ng/mL vs 48.63±4.35 ng/mL, P <0.05) and β-hCG (5.87±1.12 U/L vs 4.23±0.58 U/L, P <0.05) and a significantly lower level of uE3 (1.22±0.23 ng/mL vs 1.61±0.25 ng/mL, P <0.05). Conclusion Antenatal measurement of DV parameters combined with Down’s syndrome screening can improve the accuracy of CHD detection in fetuses, which can help with early intervention and guarantee good prenatal and postnatal care.

Objective To investigate the effect of anesthesia with remifentanil combined with sevoflurane versus propofol in patients with coronary heart disease undergoing non-cardiac surgery. Method A total of 80 patients with coronary heart disease who were admitted to our hospital from June 2022 to June 2024 and underwent non-cardiac surgery were enrolled and divided into observation group and control group using a random number table, with 40 patients in each group. The patients in the control group received anesthesia with propofol and remifentanil, and those in the observation group received anesthesia with sevoflurane and remifentanil. The two groups were compared in terms of surgical conditions, vital signs, myocardial injury markers, cardiovascular events, and adverse events. Results Compared with the control group, the observation group had a significantly shorter time to awakening (15.33±1.79 min vs 17.89±2.35 min), a significantly shorter extubation time (13.20±1.54 min vs 16.46±2.48 min), and a significantly lower incidence rate of cardiovascular events [5.00% (2/40) vs 20.00% (8/40)]. The observation group had a significantly higher heart rate than the control group at 30 minutes after anesthesia (T1) (76.78±4.49 beats/min vs 65.43±4.15 beats/min) and at the end of surgery (T2) (78.72±5.05 beats/min vs 72.95±4.83 beats/min), and the observation group also had a significantly higher mean arterial pressure than the control group at T1 (88.76±6.42 mmHg vs 78.33±5.26 mmHg) and T2 (89.83±6.78 mmHg vs 85.22±5.97 mmHg). Compared with the control group, the observation group had significantly lower levels of creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) immediately after surgery (CK-MB: 13.22±1.89 U/L vs 16.98±2.45 U/L, P <0.05; cTnI: 0.06±0.02 ng/mL vs 0.10±0.03 ng/mL, P <0.05) and at 12 hours after surgery (CK-MB: 16.45±2.46 U/L vs 19.77±3.52 U/L, P <0.05; cTnI: 0.21±0.03 ng/mL vs 0.32±0.05 ng/mL, P <0.05). There were no significant differences in adverse events between the two groups (P >0.05). Conclusion Sevoflurane combined with remifentanil can effectively maintain the vital signs of patients with coronary heart disease undergoing non-cardiac surgery, protect their cardiomyocytes, reduce the incidence rate of cardiovascular events, and help the patients with regain consciousness quickly, without serious adverse events. Therefore, it has a certain application value and holds promise for clinical application.

Objective To investigate the efficacy of Qili Qiangxin capsules in the treatment of elderly patients with moderate or severe pulmonary heart disease (PHD) caused by acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 88 elderly patients with moderate or severe PHD caused by AECOPD who were admitted to our hospital from March 2021 to February 2024 were enrolled as subjects, and they were divided into control group and observation group using a random number table, with 44 patients in each group. The patients in the control group received conventional treatment, and those in the observation group received conventional treatment combined with Qili Qiangxin capsules. The course of treatment was 2 weeks. The two groups were compared in terms of clinical outcome, cardiac function (left ventricular ejection fraction [LVEF], cardiac index [CI], and N-terminal pro-brain natriuretic peptide [NT-proBNP]), quality of life (COPD assessment test [CAT] and Minnesota Living With Heart Failure Questionnaire [MLHFQ]), and treatment safety. Results The observation group had a significantly higher overall response rate than the control group (95.45% vs 81.82%, P<0.05). Compared with the control group after treatment, the observation group had significantly higher levels of LVEF (50.66%±6.59% vs 45.43%±6.17%, P<0.05) and CI (3.19±0.65 L/(min·m²) vs 2.91±0.63 L/(min·m²), P<0.05) and a significantly lower level of NT-proBNP (566.67±97.94 ng/L vs 744.43±102.93 ng/L, P<0.05). The observation group had significantly lower CAT and MLHFQ scores than the control group (CAT: 11.65±2.71 vs 15.52±3.20, P<0.05; MLHFQ: 47.43±7.15 vs 54.56±8.21, P<0.05). No adverse event was observed in either group during treatment.Conclusion Qili Qiangxin capsules have a marked clinical effect in elderly patients with moderate or severe PHD caused by AECOPD and can effectively improve cardiac function and quality of life, with a favorable safety profile.

Objective To investigate the clinical effect of modified Qiju Dihuang decoction combined with nifedipine controlled-release tablets in the treatment of patients with pregnancy-induced hypertension (PIH) and liver-kidney Yin deficiency syndrome. Methods A total of 88 PIH patients who were admitted to our hospital were divided into control group and observation group using a random number table, with 44 patients in each group. The patients in the control group were given nifedipine controlled-release tablets, and those in the observation group were given modified Qiju Dihuang decoction in addition to the treatment in the control group, with a treatment cycle of 1 month for both groups. The two groups were compared in terms of related data and adverse events after treatment. Results The observation group had a better treatment outcome than the control group, and compared with the control group, the observation group had a significantly lower blood pressure (P<0.05), significantly longer prothrombin time (12.56±0.71 s vs 11.48±0.63 s, P<0.05) and activated partial thromboplastin time (27.68±1.39 s vs 25.41±1.33 s, P<0.05), and a significantly lower level of fibrinogen (3.08±0.28 g/L vs 3.65±0.32 g/L, P<0.05). After treatment, the observation group had significantly lower traditional Chinese medicine syndrome scores than the control group (0.82±0.14, 0.78±0.12, 0.74±0.11, and 0.62±0.12 points vs 1.01±0.18, 0.96±0.15, 0.89±0.13, and 0.75±0.15 points, P<0.05), as well as a significantly lower number of patients with adverse pregnancy outcomes (P<0.05). There was no significant difference in adverse events between the two groups (P>0.05). Conclusion Modified Qiju Dihuang decoction combined with nifedipine controlled-release tablets can better control the blood pressure of PIH patients, avoid coagulation abnormalities, and reduce the risk of adverse pregnancy outcomes, with good safety and feasibility.