ABSTRACT
Chronic heart failure (CHF) is a common chronic disease that requires much care. This study aimed to explore the effects of collaborative care model (CCM) on patients with CHF. A total of 114 CHF patients were enrolled in this study, and were randomly and equally divided into two groups: control and experimental. Patients in the two groups received either usual care or CCM for 3 continuous months. The impacts of CCM on the self-care ability and quality of life were assessed using self-care of heart failure index and short form health survey 12, respectively. Further, cardiac function was assessed by measuring left ventricular ejection fraction (LVEF) and the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP), and by the 6-min walking test. Clinical and demographic characteristics of patients in the control and CCM groups were statistically equivalent. Compared with usual care, CCM significantly enhanced self-care abilities of patients with CHF, including self-care maintenance, self-care management and self-care confidence (all P<0.05). The physical and mental quality of life was also significantly improved by CCM (P<0.01 or P<0.05). Compared with usual care, CCM significantly increased the LVEF (P<0.01), decreased the NT-proBNP level (P<0.01), and enhanced exercise capacity (P<0.001). In conclusion, CCM improved the self-care, quality of life and cardiac function of patients with CHF compared with usual care.
Subject(s)
Heart Failure/physiopathology , Heart Failure/therapy , Patient Compliance , Quality of Life , Self Care/methods , Aged , Female , Heart Failure/blood , Humans , Male , Middle Aged , Natriuretic Peptide, Brain/blood , Peptide Fragments/blood , Reproducibility of Results , Stroke Volume/physiology , Time Factors , Treatment Outcome , Ventricular Dysfunction, Left/blood , Ventricular Dysfunction, Left/physiopathology , Ventricular Dysfunction, Left/therapy , Walk TestABSTRACT
Microvesicles (MVs) are submicrometric membrane fragments that can "engulf" cytoplasmic contents such as microRNAs (miRNAs) from their cellular origin. The study of miRNAs carried within MVs might provide insights into the roles that miRNAs play in the underlying pathophysiologic processes of acute lymphoblastic leu-kemia (ALL). We identified numerous dysregulated MV miRNAs in patients with B- and T-cell ALL by using Agilent microarray analysis. Selected miRNAs obtained by microarray profiling were validated us-ing quantitative reverse transcription-polymerase chain reaction. Us-ing bioinformatic tools, we found that 118 and 116 miRNAs from B- and T-ALL MVs, respectively, regulated the expression of zinc finger protein (ZFP) genes. For example, zinc finger protein 238 (ZNF238), known as a tumor suppressor, was regulated by miR-20b over-expres-sion. Conversely, ZNF267, a cancer-promoting factor, was mediated by downregulated miR-23a and miR-23b. Considering that miRNAs are generally believed to repress gene expression, antineoplastic ZNF238 was likely inhibited while the level of oncogenic ZNF267 was likely increased by miRNA dysregulation, leading to modifica-tion of the ALL microenvironment. In addition, gene ontology and sig-naling pathway analysis demonstrated that a subset of the ZFP genes targeted by altered MV miRNAs are involved in cellular biological processes including proliferation, differentiation, apoptosis, and cell cycle regulation. These findings indicated that cancer-associated MV miRNAs and their target ZFP genes might be novel pathogenic factors in ALL. However, the specific roles exerted by MV miRNAs and their target ZFP genes on the pathological mechanisms of ALL remain to be further understood.