A survey on chronic heart failure management in community physicians in Chengdu / 中华全科医师杂志

A questionnaire survey on chronic heart failure management was conducted in 110 physicians from Xindu,Supo,Jiajiang and Xinhua community hospital in Chengdu from January 2007 to June 2010.Results showed that 77.3％ (85/110) of community physicians lacked knowledge about prevention,diagnosis and treatment of chronic heart failure,and the diagnostic accuracy rate was only 51.3％ (40/78) in these community hospitals.There was lack of awareness of the guideline of chronic heart failure:the rate of β blockers use was 15.0％ (6/40) and only 5.0％ (2/40) used the target dose; the rate of angiotensin converting enzyme inhibitor use was 17.5％ (7/40) and only 7.50％ (3/40) used the target dose.In addition,90％ (99/110) of community doctors lacked the education and management for patients with heart failure.The survey suggests that the current situation of chronic heart failure management in community physicians in Chengdu is unsatisfactory.It is necessary to strengthen the training of community physicians.

Community-based management for chronic heart failure patients under the professional guidance of upper first-class hospital staff / 中华心血管病杂志

<p><b>OBJECTIVE</b>To establish a community-based management model for heart failure patients under the professional guidance of upper first-class hospital staff.</p><p><b>METHODS</b>Two hundreds heart failure (New York Heart Function II-IV) patients aged from 35 to 85 in two communities of Chengdu city were divided into two groups by cluster randomization: the management group and the control group. The community hospital doctors were trained for the evaluation and management of heart failure according standardized guidelines by upper first-class hospital doctors, and responsible for the management of patients in the management group. Meanwhile, the management group patients also received self-care education. Patients in control group were treated by community doctors without special training. Data including the community hospital doctors' knowledge rate of heart failure, positive diagnosis rate, and the rate for standardized medication for heart failure; the patients' knowledge rate of heart failure, the rate of drug compliance, the rate of standardized drug taken for heart failure, the rate of self-care in daily-life, the quality of life, the incidence of cardiovascular events, hospitalization time and cost were compared between the two groups.</p><p><b>RESULTS</b>The community hospital doctors' knowledge rate of heart failure, the related knowledge for prevention and treatment on the causes of heart failure, the positive diagnosis rate, and the rate for standardized medication for heart failure [β receptor blocker 77.3% (17/22); angiotensin-converting enzyme inhibitors 63.6% (14/22)] were significantly higher than doctors in the control group (all P < 0.05). There were 96 in the management group and 97 in the control group. Data were similar between the two groups at baseline. After (18.5 ± 0.5) months, the patient's knowledge rate of heart failure [100% (96/96) vs. 71.1% (69/97)], the rate of drug compliance [78.1% (75/96) vs. 13.4% (13/97)], the rate of standardized drug taken for heart failure[β receptor blocker: 75.0% (72/96) vs. 8.2% (8/97); angiotensin-converting enzyme inhibitors: 60.4% (58/96)vs. 10.3% (10/97)], and the rate of self-care in daily-life [salt and food restriction:88.5% (85/96) vs. 29.9% (23/97); blood pressure monitoring: 83.3% (80/96) vs. 56.7% (55/97); weight monitoring:78.1% (75/96) vs. 13.4% (13/97)] were all significantly higher in the management group than in control group. For patients with New York Heart Function III-IV, the score of the LiHFe questionnaire (43.7 ± 9.2 vs. 49.5 ± 11.3), the incidence of cardiovascular events [63.3% (19/30) vs. 90.3% (28/31)], the days of hospitalization [(8.2 ± 3.2)days vs. (13.9 ± 10.9) days], and the cost for hospitalization [(2873.3 ± 401.6) Yuan vs. (4525.8 ± 6417.8) Yuan] were all significantly lower in the management group (n = 30) than in the control group (n = 31) (all P < 0.05).</p><p><b>CONCLUSIONS</b>The community-based management model for heart failure patients in the community level is effective to improve the management and outcome in this cohort.</p>

Safety and efficiency of pacing at right ventricular outflow versus at ventricular cardiac apex / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the safety and efficiency of pacing at right ventricular outflow versus right ventricular apex.</p><p><b>METHOD</b>Patients were divided into two groups: pacing at ventricular cardiac apex (common pacing group, n = 22) and pacing at right ventricular outflow tract (uncommon pacing group, n = 18).</p><p><b>RESULTS</b>Impedance and amplitude of R-wave were similar during implantation between the two groups (all P > 0.05). The pacing threshold and electric current were significant higher in uncommon group than those in common pacing group (all P < 0.05), however, these differences disappeared at 1 month post pacemaker implantation (all P > 0.05). The mean QRS duration tended to be shorter in uncommon pacing group compared to that in common pacing group (P > 0.05). There was no pacemaker associated adverse effect in both groups.</p><p><b>CONCLUSION</b>The safety and efficiency of pacing at right ventricular outflow was similar as those of pacing at right ventricular apex.</p>

Studies on variation of danshensu content in accelerated stability tests / 中国中药杂志

<p><b>OBJECTIVE</b>To study the variation Laws of content of danshensu accelerated in control and in danshen injection in order to provide reference for stability investigation of danshensu.</p><p><b>METHOD</b>The tests was carried out by classic isothermal method and the content of danshensu was determined by HPLC.</p><p><b>RESULT</b>The contents of danshensu in accelerated tests increase in control and decrease in danshen injection respectively.</p><p><b>CONCLUSION</b>The component of phenic acidity would be hydrolyzed to become danshensu in the accelerated tests. Much attention should be paid to the unusual increase when studies of danshen preparations are carried out.</p>