目的：分析冠状动脉CT血管成像（CTA）联合动态心电图（DCG）与冠心病患者冠脉狭窄程度及预后情况的关联。方法：研究对象选择我院2024年1月~2025年3月收治的210例冠心病患者及同期接受检查的210例非冠心病患者，分别列为病例组和对照组，比较两组CTA参数、DCG参数间差异。依据入院测得（Gensini）评分不同，将入组患者分别列为轻度组（60例，Gensini评分≤30分）、中度组（75例，Gensini评分＞30分、≤60分）和重度组（75例，Gensini评分＞60分），比较三组CTA参数、DCG参数间差异，分析CTA参数、DCG参数与Gensini评分的相关性。统计入组患者不良预后发生情况，比较不同预后患者CTA参数、DCG参数间差异，归纳冠心病患者预后影响因素，检验CTA参数、DCG参数对患者不良预后的预测效能。结果：病例组的最小管腔直径（MLD）、最小管腔面积（MLA）、血流储备分数（FFR）、正常窦性间期的标准差（SDNN）、每5min平均RR间期的标准差（SDANN）、相邻RR间期差值的均方根（RMSSD）均低于对照组，斑块总体积（TPV）、低频/高频比值（LF/HF）均高于对照组（t=24.128，25.811，15.613，37.636，26.858，9.195，59.862，29.389；P＜0.05）。重度组的MLD、MLA、FFR、SDNN、SDANN、RMSSD均低于中度组，轻度组，TPV、LF-HF均高于中度组，轻度组（F=190.291，51.562，186.482，42.084，44.413，22.541，56.503，109.983；P＜0.05）。MLD、MLA、FFR、SDNN、SDANN、RMSSD均与Gensini评分负相关，TPV、LF-HF均与Gensini评分正相关（r=-0.352，-0.377，-0.445，-0.472，-0.332，-0.356，0.401，0.355；P＜0.05）。经统计，210例冠心病患者的不良预后发生率为38.10%（80/210）。预后不良组的MLD、MLA、FFR、SDNN、SDANN、RMSSD均低于预后良好组，TPV、LF-HF均高于预后良好组（t=6.827，12.219，19.313，6.097，7.097，5.027，7.088，12.465；P＜0.05）。MLA、FFR、SDNN升高为冠心病不良预后的保护因素，LF/HF升高为冠心病不良预后的危险因素。FFR、SDNN联合检测预测不良预后的 AUC 值优于两项指标单独检测（Delong检验，P＜0.05）。结论：CTA、DCG能客观评估冠心病患者冠脉狭窄程度，联合检测FFR、SDNN可作为预测冠心病不良预后的重要辅助手段。

Objective:To analyze the correlation between CTA combined with DCG and the degree of coronary stenosis and prognosis in patients with coronary heart disease.Methods:The research subjects selected were 210 patients with coronary heart disease admitted to our hospital from January 2024 to March 2025, as well as 210 non coronary heart disease patients who underwent examinations during the same period. They were divided into a case group and a control group. The differences in CTA parameters and DCG parameters between the two groups were compared. According to the different Gensini scores obtained upon admission, the enrolled patients were divided into mild group (60 cases, Gensini score ≤ 30 points), moderate group (75 cases, Gensini score>30 points, ≤ 60 points), and severe group (75 cases, Gensini score>60 points). The differences in CTA parameters and DCG parameters among the three groups were compared, and the correlation between CTA parameters, DCG parameters, and Gensini score was analyzed. Statistically analyze the occurrence of poor prognosis in enrolled patients, compare the differences in CTA and DCG parameters among patients with different prognoses, summarize the factors affecting the prognosis of coronary heart disease patients, and test the predictive power of CTA and DCG parameters for poor prognosis in patients.Results:The MLD, MLA, FFR, SDNN, SDANN, and RMSSD in the case group were all lower than the control group, while the TPV and LF/HF were higher than the control group (t=24.128，25.811，15.613，37.636，26.858，9.195，59.862，29.389; P<0.05). The MLD, MLA, FFR, SDNN, SDANN, and RMSSD of the severe group were lower than the moderate group, mild group, while the TPV and LF-HF of the mild group were higher than the moderate group, mild group (F=190.291，51.562，186.482，42.084，44.413，22.541，56.503，109.983; P<0.05). MLD, MLA, FFR, SDNN, SDANN, and RMSSD are all negatively correlated with Gensini score, while TPV and LF-HF are positively correlated with Gensini score (r=-0.352，-0.377，-0.445，-0.472，-0.332，-0.356，0.401，0.355; P<0.05). According to statistics, the incidence of poor prognosis in 210 patients with coronary heart disease was 38.10% (80/210). The MLD, MLA, FFR, SDNN, SDANN, and RMSSD of the poor prognosis group were lower than the good prognosis group, while TPV and LF-HF were higher than the good prognosis group (t=6.827，12.219，19.313，6.097，7.097，5.027，7.088，12.465; P<0.05). High MLA, FFR, and SDNN are protective factors for poor prognosis of coronary heart disease, while higher values than LF/HF are risk factors for poor prognosis of coronary heart disease. The combined detection of FFR and SDNN has a better AUC value for predicting poor prognosis of coronary heart disease than the detection of FFR and SDNN alone (Delong test, P<0.05）.Conclusion:CTA and DCG can objectively evaluate the degree of coronary stenosis in patients with coronary heart disease, and combined detection of FFR and SDNN can be an important auxiliary tool for predicting poor prognosis of coronary heart disease.

目的 探讨冠心病（CHD）患者经皮冠状动脉介入（PCI）术后冠脉微循环损伤（CMI）发生的影响因素及构建的Logistic风险预测模型对CMI发生的预测效能，以指导临床制定针对性的干预措施。方法 选取2023年4月至2025年4月于本院接受PCI治疗的143例CHD患者为研究对象，依据PCI术后1 d是否发生CMI，将其分为发生CMI组（86例）和未发生CMI组（57例）。比较两组临床资料；分析CHD患者PCI术后发生CMI的影响因素，构建Logistic风险预测模型，分析其对PCI术后CMI发生的预测效能。结果 发生CMI组心肌梗死病史、糖尿病史、吸烟史、NYHA心功能分级为Ⅲ级、多支冠脉病变、伴有冠脉中重度钙化、症状出现至PCI时间＞6 h占比及冠脉狭窄率、预扩张次数、预扩张时间高于未发生CMI组，最大扩张压力、术后即刻TIMI血流分级为3级占比低于未发生CMI组，PCI术前血清ANGPTL3、EMMPRIN水平及hs-CRP/PA高于未发生CMI组（P＜0.05）；Logistic多因素分析结果显示，糖尿病史、冠脉狭窄率、预扩张次数、NYHA心功能分级、冠脉中重度钙化、症状出现至PCI时间及ANGPTL3、EMMPRIN、hs-CRP/PA为CHD患者PCI术后发生CMI的独立危险因素，最大扩张压力为其独立保护因素（P＜0.05）；构建的Logistic风险预测模型预测PCI术后CMI发生风险的AUC值为0.901（95%CI：0.840～0.945），敏感度、特异度分别为82.56%、80.70%，且该模型与观测值拟合度良好，具有良好的区分度、校准度和临床适用性。结论 依据CHD患者PCI术后发生CMI的影响因素构建的Logistic风险预测模型对CMI发生具有较高的预测效能，可指导临床制定针对性干预措施，以减少PCI术后CMI发生，改善CHD患者预后。

目的 探讨数字减影血管造影（DSA）在冠状动脉病变诊断中的应用价值，并评估血清学参数相对于DSA金标准的诊断效能。方法 本研究纳入100名确诊为冠心病的患者。病例组为100例DSA确诊的冠心病患者，对照组按1:1比例匹配100例同期接受DSA检查排除冠心病的患者。应用DSA技术分别评估冠心病的狭窄程度及部位等指征。回顾性收集并对比分析两组患者的各项血清学参数（cTnI、CK-MB、hs-CRP、LDL-C、TC），计算血清学指标诊断冠心病的效能，并进一步探究以上评估于入组患者性别亚组间的统计学差异。结果 病例组与对照组在性别、年龄、BMI等基线资料上均衡可比（P > 0.05）。以DSA为金标准，cTnI诊断冠心病的灵敏度为82.0%，特异度为85.0%；hs-CRP的灵敏度为85.0%，特异度为75.0%。 cTnI、hs-CRP水平随冠状动脉狭窄程度加重而显著升高（P < 0.05）。且以上冠心病评价指征于患者性别亚组间均无统计学差异（ P <0.05）。结论 DSA技术可用于冠状动脉病变发生的部位、形态、数目等指征的明确评估，且于不同性别亚组间无统计学差异。血清学参数，尤其是cTnI和hs-CRP，对冠心病具有良好的辅助诊断价值，其水平与病变严重程度相关，可作为DSA检查前的有效筛查工具，为后续的治疗提供重要的参考依据。

Objective: To investigate the clinical value of digital subtraction angiography (DSA) in the diagnosis of coronary artery disease (CAD) and to evaluate the diagnostic performance of serological parameters relative to the DSA gold standard. Methods: A total of 100 patients with confirmed CAD were included in this study. The case group comprised 100 patients with CAD confirmed by DSA, while the control group consisted of 100 age- and sex-matched individuals who underwent DSA during the same period and were excluded from CAD. DSA was employed to assess the degree and location of coronary artery stenosis. Retrospective collection and comparative analysis of serological parameters (cTnI, CK-MB, hs-CRP, LDL-C, TC) were performed between the two groups. The diagnostic efficacy of these serological indicators for CAD was calculated, and subgroup analyses were conducted to explore potential sex-related differences. Results: The case and control groups were comparable in baseline characteristics such as sex, age, and BMI (P > 0.05). Using DSA as the gold standard, the sensitivity and specificity of cTnI for diagnosing CAD were 82.0% and 85.0%, respectively; hs-CRP demonstrated a sensitivity of 85.0% and specificity of 75.0%. Levels of cTnI and hs-CRP increased significantly with the severity of coronary stenosis (P < 0.05). No statistically significant differences were observed between male and female subgroups (P > 0.05). Conclusion: DSA provides definitive assessment of lesion location, morphology, and number in coronary artery disease, with no significant sex-related differences. Serological markers, particularly cTnI and hs-CRP, demonstrate good auxiliary diagnostic value for CAD. Their levels correlate with disease severity and may serve as effective screening tools prior to DSA, offering important reference value for subsequent clinical management.

目的：探究阻塞性冠心病患者中舌象纹理特征与冠周脂肪影像组学的相关性。 方法：收集辽宁中医药大学附属医院131例就诊的疑似冠心病患者，其中阻塞性冠心病63例、非阻塞性冠心病68例，提取临床常规指标、舌象纹理特征及右冠状动脉影像组学参数。独立样本t检验、曼-惠特尼U检验、卡方检验、错误发现率校正用于比较组间差异。使用斯皮尔曼相关性分析舌象纹理特征与冠周脂肪影像组学的相关性。采用弹性网络进行特征筛选,按照7：3的比例随机抽样划分为训练集和测试集，使用BP神经网络模型构建冠周脂肪及冠周脂肪与舌象纹理特征联合模型，使用ROC曲线、准确性、精度、召回率、特异度、F1分数、Kappa系数评估模型。 结果：在疑似冠心病患者中，舌象纹理与冠周脂肪影像组学共检出22组弱负相关、1组中等正相关及23组弱正相关；阻塞性冠心病患者中检出4组中等负相关、4组弱负相关、2组中等正相关及6组弱正相关；非阻塞性冠心病患者中检出1组中等负相关、6组弱负相关、1组中等正相关及10组弱正相关。基于BP神经网络构建诊断模型，联合舌象纹理特征后较单一冠周脂肪影像组学模型测试集AUC有所提升。 结论：舌象纹理特征与冠周脂肪影像组学参数在阻塞性冠心病中存在一定的相关性；舌象纹理信息对冠周脂肪诊断阻塞性冠心病具有增量价值。

Abstract:Objective: To investigate the correlation between tongue image texture features and pericoronary adipose tissue (PCAT) radiomics in patients with obstructive coronary heart disease. Methods: A total of 131 patients with suspected coronary heart disease admitted to the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were enrolled, including 63 cases of obstructive coronary heart disease and 68 cases of non-obstructive coronary heart disease. Clinical routine indicators, tongue image texture features, and right coronary artery radiomics parameters were extracted. Independent sample t-test, Mann-Whitney U test, Chi-square test, and false discovery rate correction were used to compare intergroup differences. Spearman correlation analysis was employed to examine the correlation between tongue image texture features and PCAT radiomics. Elastic net was applied for feature selection. The dataset was randomly split into training and test sets at a 7:3 ratio. BP neural network models were constructed using PCAT features alone and in combination with tongue image texture features. Model performance was evaluated using receiver operating characteristic (ROC) curves, accuracy, precision, recall, specificity, F1 score, and Kappa coefficient. Results: In patients with suspected coronary heart disease, 22 weak negative correlations, 1 moderate positive correlation, and 23 weak positive correlations were identified between tongue image texture features and PCAT radiomics. In patients with obstructive coronary heart disease, 4 moderate negative correlations, 4 weak negative correlations, 2 moderate positive correlations, and 6 weak positive correlations were detected. In patients with non-obstructive coronary heart disease, 1 moderate negative correlation, 6 weak negative correlations, 1 moderate positive correlation, and 10 weak positive correlations were observed. The BP neural network diagnostic model combining tongue image texture features with PCAT radiomics demonstrated improved performance on the test set compared with the PCAT radiomics model alone. Conclusion: Tongue image texture features exhibit certain correlations with PCAT radiomics parameters in obstructive coronary heart disease, and tongue texture information provides incremental value for the diagnosis of obstructive coronary heart disease when combined with PCAT radiomics.

冠心病是临床高发的心血管疾病，其病理核心为动脉粥样硬化，而炎症反应异常激活是推动病变进展的关键驱动力。PI3K/Akt通路通过调控炎症反应等，在CHD进程中发挥双向调节作用。现代研究表明，该通路保护性激活不足可加剧血管内皮损伤与斑块不稳定性，而炎症反应的持续又可进一步抑制PI3K/Akt通路活性，形成恶性循环。当动脉粥样斑块破裂，AMI发生后炎症级联反应放大，该通路异常激活，诱发MIRI。“荣泣卫除”出自《黄帝内经》，指营气耗损（荣泣）、卫气失守（卫除），荣卫失和则气血运行不畅、脉络瘀阻。本团队结合该理论与现代研究，认为CHD中PI3K/Akt通路介导的异常炎症反应的病理机制，与“荣泣卫除”理论内涵存在对应关系。研究发现，通过调控PI3K/Akt通路活性，抑制炎症因子激活与炎症蛋白表达，可抑制CHD发生发展进程。故本文基于“荣泣卫除”理论，系统梳理了PI3K/Akt通路介导的炎症反应在CHD中的作用及与中医病机的内在关联，总结中医药防治的研究进展，为中西医结合防治CHD提供参考依据。

Coronary heart disease is a clinically prevalent cardiovascular disease, with atherosclerosis as its core pathology. Abnormal activation of the inflammatory response is a key driving force for disease progression. The PI3K/Akt pathway exerts bidirectional regulatory effects on the progression of CHD by modulating inflammatory responses, among other functions. Modern studies indicate that insufficient protective activation of this pathway can exacerbate vascular endothelial injury and plaque instability, while persistent inflammation further suppresses PI3K/Akt pathway activity, forming a vicious cycle. Following atherosclerotic plaque rupture and the onset of AMI, the inflammatory cascade is amplified, leading to aberrant activation of this pathway and triggering MIRI. The theory of "depletion of nutritive level and exhaustion of defensive level" originates from the?Yellow Emperor's Inner Classic, referring to the depletion of nutritive level (Rong Qi) and the exhaustion of defensive level (Wei Qi), resulting in disharmony between nutritive and defensive levels, which impedes the smooth flow of Qi and blood and causes stasis in the collaterals. By integrating this theory with modern research, our team proposes a correspondence between the pathological mechanism of abnormal PI3K/Akt pathway-mediated inflammatory response in CHD and the theoretical connotation of "depletion of nutritive level and exhaustion of defensive level". Studies have found that modulating PI3K/Akt pathway activity to inhibit the activation of inflammatory factors and expression of inflammatory proteins can suppress the occurrence and progression of CHD. Therefore, based on the theory of "depletion of nutritive level and exhaustion of defensive level", this paper systematically reviews the role of the PI3K/Akt pathway-mediated inflammatory response in CHD and its intrinsic relationship with traditional Chinese medicine pathogenesis, summarizes research progress in TCM prevention and treatment, and provides a reference for the integrated traditional Chinese and Western medicine management of CHD.

目的：探讨年轻冠心病经皮冠状动脉介入治疗（PCI）术后患者康复管理行为的发展轨迹及其异质性亚组，并分析基线心理社会因素及临床特征对轨迹归属的影响，为制定精准化心脏康复管理策略提供依据。方法：采用回顾性研究设计，选取2022年1月至2025年3月在郑州大学第五附属医院心血管内科行首次PCI治疗的265例年轻冠心病患者（年龄22～45岁）为研究对象。于术后1个月（基线）、3个月、6个月、12个月采用冠心病PCI术后康复管理行为问卷进行纵向随访评估；基线时同时完成一般自我效能感量表、社会支持评定量表及医院焦虑抑郁量表测评。应用潜类别增长模型识别康复管理行为的发展轨迹，采用多元Logistic回归分析影响轨迹归属的因素。结果：年轻冠心病PCI术后患者术后1个月康复管理行为总分为（68.5±14.2）分，3个月升至（70.3±13.8）分，之后持续下降，12个月降至（63.2±18.1）分，各时间点差异有统计学意义（P＜0.001）。潜类别增长模型识别出3种行为发展轨迹：持续高行为组（75例，28.3%），行为始终维持高水平且无显著下降；中度下降组（120例，45.3%），行为早期尚可但逐渐下降；持续低行为组（70例，26.4%），行为起点低且下降速度最快。Pearson相关分析显示，基线康复管理行为总分与自我效能、社会支持呈正相关（r=0.523，0.452，均P＜0.01），与焦虑、抑郁呈负相关（r=-0.381，-0.346，均P＜0.01）。多因素Logistic回归分析表明，文化程度高中及以下（OR=2.15，95%CI 1.12～4.13）、合并糖尿病（OR=2.33，95%CI 1.10～4.95）、左心室射血分数＜50%（OR=2.80，95%CI 1.15～6.82）及焦虑得分升高（OR=1.12，95%CI 1.01～1.24）是未维持高水平康复行为的独立危险因素（均P＜0.05）；自我效能得分高（OR=0.92，95%CI 0.88～0.96）及社会支持得分高（OR=0.95，95%CI 0.91～0.99）为独立保护因素（均P＜0.05）。结论：年轻冠心病PCI术后患者康复管理行为整体呈先升后降趋势，且存在3种异质性发展轨迹，仅不足三成患者可长期维持高水平依从。低文化程度、合并糖尿病、心功能不全及高焦虑水平者更易归属行为低下或下降轨迹，而高自我效能、高社会支持则有助于行为维持。临床应建立基于轨迹分层的随访管理体系，对持续低行为组及中度下降组早期识别并实施针对性强化干预。

      目的   残余胆固醇（RC）是反映动脉粥样硬化性血脂异常的重要指标，其在糖尿病合并冠心病患者中的临床意义尚不明确。本研究旨在探讨RC水平对糖尿病合并冠心病患者心力衰竭风险的预测价值，并分析其相关性。方法   本研究为回顾性横断面研究，纳入2021年1月—2024年1月期间在鹤壁市人民医院接受诊治的292例糖尿病合并冠心病患者。根据是否存在心力衰竭分为心力衰竭组（128例）和无心力衰竭组（164例）。对基线特征进行比较，采用单因素和多因素Logistic回归分析RC与心力衰竭的相关性。同时，通过限制性立方样条（RCS）分析探讨RC与心力衰竭风险的线性关系，并通过受试者操作特征（ROC）曲线和曲线下面积（AUC）评估RC的预测价值。结果   心力衰竭组患者的男性比例、高血压患病率、RC水平等高于无心力衰竭组，而估算肾小球滤过率水平显著降低（P＜0.05）。单因素分析显示，RC＞0.7 mmol/L显著增加心力衰竭风险（OR=1.854，95%CI：1.161~2.960，P=0.010）。多因素Logistic回归分析中，全调整模型结果显示，RC作为分类变量时，RC＞0.7 mmol/L的患者心力衰竭风险显著增加1.891倍（OR=1.891，95%CI：1.047~3.415，P=0.035）；作为连续变量时，RC每增加1单位，心力衰竭风险增加2.464倍（OR=2.464，95%CI：1.495~4.064，P＜0.001）；Log₁₀RC的风险比为6.411（95%CI：2.246~18.302，P=0.001）；标化RC的风险比为1.687（95%CI：1.262~2.255，P＜0.001）。限制性立方样条分析表明RC与心力衰竭风险呈线性正相关，ROC分析显示RC预测心力衰竭的AUC为0.621（95%CI：0.555~0.687，P＜0.001）。结论  RC水平与糖尿病合并冠心病患者心力衰竭风险显著相关，且呈线性正相关。RC具有一定的预测价值，可作为该人群心力衰竭风险评估的潜在指标。

       Objective  Residual cholesterol（RC）is  an important marker  reflecting  dyslipidemia  associated with atherosclerosis．Its clinical significance in patients with diabetes and coronary heart disease（CHD）remains unclear．To explore the predictive value of RC level for the risk of heart failure（HF）in patients with diabetes and CHD and analyze their association．Methods  This retrospective cross-sectional study included 292 patients with diabetes and CHD who were treated at Hebi People’s Hospital between January 2021 and January 2024．Patients were divided into the HF group（128 cases）and the non-HF group（164 cases）based on the presence of HF．Baseline characteristics were compared，and univariate and multivariate Logistic  regression analyses were performed to assess the association between RC and HF．Additionally，restricted cubic spline（RCS）analysis was used to explore the linear relationship between RC and HF risk，and the predictive value of RC was evaluated using receiveroperating characteristic（ROC）curves and the area under the curve（AUC）．Results  The HF group had significantly higher proportions of males，hypertension prevalence and RC levels，while estimated glomerular filtration rate were significantly lower compared to the non-HF group（P＜0.05）．Univariate analysis showed that RC＞0.7 mmol/L significantly increased the risk of HF（OR=1.854，95%CI：1.161–2.960，P=0.010）．In the fully adjusted multivariate Logistic regression model，RC（RC＞0.7 mmol/L）was associated with a 1.891-fold increased risk of HF as a categorical variable（OR=1.891，95%CI：1.047–3.415，P=0.035）．As a continuous variable，each increased unit in RC was associated with a 2.464-fold increased risk of HF（OR=2.464，95%CI：1.495–4.064，P＜0.001）．The odds ratios for Log₁₀RC and standardized RC were 6.411（95%CI：2.246–18.302，P=0.001）and 1.687（95%CI：1.262–2.255，P＜0.001），respectively．ROC analysis indicated a linear positive association between RC and HF risk（P=0.002）．ROC analysis showed that RC had predictive value for HF，with an AUC of 0.621（95%CI：0.555–0.687，P＜0.001）．Conclusions  RC levels are significantly associated with the risk of HF in patients with diabetes and CHD，demonstrating a linear positive correlation．RC has potential predictive value and may serve as a useful indicator for assessing HFrisk in this population．

目的 探讨非编码长链 RNA ANRIL（lncRNA-ANRIL）通过调控miR‐181b 介导磷酸酶及张力蛋白同源物基因（PTEN）对冠状动脉粥样硬化性心脏病（冠心病）心肌损伤影响的机制。方法 纳入2023年10月—2024年6月广州市第一人民医院30例确诊为冠心病的患者为观察组, 另选择同期本院体检中心30名健康者为对照组,检测两组研究者血压指标、血脂指标以及血清 lncRNA-ANRIL、miR-181b、PTEN水平, 并比较检测结果。结果 两组的性别、年龄、BMI、吸烟、高血压一般资料对比差异无统计学意义（P>0.05）; 观察组收缩压、舒张压水平以及总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平均高于对照组,而高密度脂蛋白胆固醇则低于对照组（P<0.05）; 观察组血清 lncRNA ANRIL Exon 1-2、lncRNA ANRIL Exon 17-18相对表达水平以及PTEN水平低于对照组（t=12.623、7.741、8.231, P=0.001）, 而miR-181b水平则高于对照组（t=37.250, P=0.001）。结论 相较于正常人群, 冠心病患者血清lncRNA-ANRIL和PTEN水平明显降低,而miR-181b水平升高,提示lncRNA-ANRIL可通过调控miR-181b来调节PTEN的表达, 从而影响冠心病心肌损伤的过程。

Objective To explore the mechanism of competitive binding of non coding long stranded RNA ANRIL（lncRNA-ANRIL）to miR-181b to mediate phosphatase and tensin homolog gene（PTEN）on myocardial injury in coronary heart disease．Methods Thirty patients diagnosed with coronary heart disease in our hospital from October 2023 to June 2024 were included as the observation group,and another 30 individuals from physical examination center during the same period were selected as the control group．Blood pressure indicators,blood lipid indicators, and serum levels of lncRNA-ANRIL, miR-181b, and PTEN were measured in the two groups of patients, and the test results were compared．Results There was no significant difference between the two groups in terms of gender, age, BMI, smoking and hypertension（P>0.05）．The levels of systolic blood pressure（SBP）, diastolic blood pressure（DBP）, total cholesterol（TC）, triglycerides（TG）, and low-density lipoprotein cholesterol（LDL-C） in the observation group were higher than those in the control group,while high-density lipoprotein cholesterol（HDL-C） was lower than that in the control group（P<0.05）．The relative expression levels of lncRNA-ANRIL Exon 1-2, Exon 17-18, and PTEN levels in the observation group were lower than those in the control group（t=12.623, 7.741, 8.231, P=0.001）, while the level of miR-181b was higher than that in the control group（t=37.250, P=0.001）．Conclusions Compared with healthy individuals, serum levels of lncRNA-ANRIL and PTEN are significantly reduced in patients with coronary heart disease, while miR-181b levels are elevated, indicating that lncRNA ANRIL can regulate PTEN expression by miR-181b, thereby affecting the process of myocardial injury in coronary heart disease．

目的 探讨行动研究法的倾向、强化及促成因素（PRECEDE）护理模式在冠心病患者中的应用效果。方法 选取2022年3月—2023年3月新乡市中心医院心内科收治的120例冠心病患者为研究对象,根据其住院ID号,以1：1比例分为对照组与观察组各60例,前者实施PRECEDE护理模式,后者实施基于行动研究法的PRECEDE护理模式,对比两组心功能指标干预前后检测情况、遵医行为及疾病相关知识掌握情况。结果 干预后3个月,观察组左室射血分数（LVEF）高于对照组及干预前,左心室收缩末期容积指数（LVESVⅠ）及左心室舒张末期容积指数（LVEDVⅠ）低于对照组及干预前（P<0.05）。观察组遵医行为比例和相关知识总掌握率均高于对照组（P<0.05）。结论 冠心病患者实施基于行动研究法的PRECEDE护理模式,不仅有助于改善其心功能指标,还能改善其遵医行为,提高其疾病知识掌握率。

目的 探讨以整合照护理念为基础的综合干预体系对稳定性冠心病患者衰弱的影响。方法 选择2021年8月—2022年6月在驻马店市中医院诊治的老年稳定性冠心病患者78例,根据1∶1随机数字表法分为两组,每组各39例。常规组给予常规护理,整合组在常规组护理的基础上给予以整合照护理念为基础的综合干预体系,记录两组患者的预后情况。结果 两组患者在护理3个月后的平衡测试评分、座椅站立测试评分均低于护理前,整合组护理3个月后的平衡测试评分、座椅站立测试评分与常规组相比也降低（P<0.05）。整合组护理3个月后的躯体、心理、社会、精神等维度的生活质量评分均高于常规组（P<0.05）。整合组随访1年的靶血管重建、心肌梗死、心源性死亡、冠状动脉再狭窄等主要心血管事件不良事件发生率为5.13%,常规组为25.64%,整合组低于常规组（P<0.05）。结论 以整合照护理念为基础的综合干预体系能缓解老年稳定性冠心病患者的衰弱状况,改善患者的生活质量,降低主要心血管事件不良事件发生率。

Objective To explore and analyze the effects of a comprehensive intervention based on integrated care on the frailty of elderly stable coronary heart disease（CHD）patients．Methods From August 2021 to June 2022,78 cases of elderly stable CHD patients who were diagnosed and treated in Zhumadian City Hospital of Traditional Chinese Medicine were selected．According to a 1：1 random number table method,78 patients were divided into the integrated group and the traditional group,with 39 cases of each group．The traditional group was given routine care,while the integrated group was given a comprehensive intervention based on integrated care concepts on the basis of the traditional group's care,and the patients' prognosis was recorded．Results The balance test scores and chair stand test scores of both groups after 3 months of nursing care were lower than those before nursing care．The balance test scores and chair stand test scores of the integrated group after 3 months of nursing care were also significantly lower than those of the traditional group（P<0.05）．After 3 months of nursing care,the quality of life scores in physical,psychological,social,and spiritual dimensions in the integrated group were significantly higher than those in the traditional group（P<0.05）．The incidence of major cardiovascular adverse events such as cardiac death,myocardial infarction,target vessel reconstruction,and coronary artery restenosis during a one-year follow-up in the integrated group was 5.13%,compared to 25.64% in the traditional group．The integrated group was significantly lower than the traditional group（P<0.05）．Conclusions The application of a comprehensive intervention based on integrated care concept in elderly stable CHD patients can alleviate frailty,improve quality of life,and reduce the incidence of major cardiovascular adverse events．