Efficacy and Safety of Ultrafiltration in Patients with Heart Failure: A Single-Center Experience.

INTRODUCTION: There is a paucity of literature on the efficacy and safety of ultrafiltration in Chinese patients with heart failure (HF). Therefore, we aimed to compare the efficacy and safety of ultrafiltration with diuretics and provide information and evidence as to the best approach for patients with HF. METHODS: In this single-center, non-randomized interventional study patients with HF either received diuretics or ultrafiltration. The efficacy outcomes included changes in the weight, dyspnea score, and 6-min walk distance from baseline to 48 h after treatment. Safety outcomes were evaluated in both the groups with respect to changes in systolic blood pressure, heart rate, serum creatinine, blood urea nitrogen, blood potassium ion concentration, and blood sodium ion concentration. RESULTS: A total of 149 patients with HF (diuretics, 73; ultrafiltration, 76) were included. At 48 h, patients in the ultrafiltration group showed significantly greater weight loss and better improvement in dyspnea score and 6-min walk distance compared to patients in the control group (P < 0.05). However, the two groups showed no statistically significant difference in terms of safety outcomes such as systolic blood pressure, heart rate, serum creatinine, blood urea nitrogen, blood potassium ion concentration, and blood sodium ion concentration, suggesting similar safety profiles of both the groups. CONCLUSION: Ultrafiltration was associated with greater weight loss and better dyspnea score and 6-min walk distance with similar safety profiles as compared with diuretics. Ultrafiltration can be considered as an optimal option for Chinese patients with HF.

Effect of levosimendan combined with recombinant human brain natriuretic peptide on diuretic resistance.

Levosimendan is a calcium sensitizer used for managing heart failure (HF) because of its inotropic and vasodilatory effects. As many patients do not respond to levosimendan as a monotherapy, it may be necessary to combine it with other diuretic agents such as recombinant human brain natriuretic peptide (rhBNc P). The aim of this study was to investigate efficacy of levosimendan when combined with rhBNP in patients with diuretic resistance and low ejection fraction (EF) rate.The study included HF patients with diuretic resistance and low EF. Before grouping, patients with a 24-hour urine volume of <0.5 mL/kg/h were administered with furosemide injection. Treatment group was administered levosimendan injection based on the original diuretic and rhBNP.One hundred twenty-eight patients were included, with 64 patients each in the control and treatment arms. 24-hour urine volume of the treatment group was significantly higher than that of the control group. Moreover, dyspnea score of the treatment group significantly improved compared with control group. In the treatment group, 12.5% of patients had no significant changes in the urine volume, weight, and dyspnea score before and after the treatment, indicating poor curative effect of the treatment, whereas in the control group, 23.4% of patients had poor curative effect (P < .05). No significant change was observed in the systolic blood pressure, heart rate, and serum creatinine level before and after treatment in both groups.Levosimendan in combination with rhBNP can effectively relieve diuretic resistance, reduce body weight, improve dyspnea, and ensure safety in the treatment process.

Treatment of left accessory cardiac pathway conduction disorders using radiofrequency catheter ablation under the guidance of the Ensite NavX 3D mapping system: a retrospective study.

To investigate the effectiveness and safety of using the Ensite NavX three-dimensional (3D) mapping system during Radiofrequency catheter ablation (RFCA) of left accessory pathway (AP) disorders. A total of 227 patients having their left AP treated by RFCA, were classified into study group (n = 112) and the control group (n = 115). X-ray irradiation time and exposure doses during the course of the operations were recorded. Time taken to place the mapping catheter along with total duration of operations and procedural complications were compared. The X-ray irradiation time and exposure doses in the course of manipulating the ablation catheters were significantly lower in the study group compared to control (5.1 ± 2.3 min vs. 13.1 ± 3.1 min; P < 0.05 and 5.7 ± 2.6 mGy vs. 17.8 ± 4.3 mGy; P < 0.05, respectively). The total duration of operation was also significantly shorter in the study group compared to control (53.1 ± 18.8 min vs. 62.3 ± 20.6 min; P < 0.05). No procedural complications were reported in both groups. The irradiation time and exposure dose along with total operation duration was significantly reduced when the Ensite NavX mapping system was used during RFCA in comparison with traditional X-ray fluoroscopy method.

Effect of arsenic trioxide maintenance therapy on long - term recurrence rate in patients with acute promyelocytic leukemia / 中国基层医药

Objective To explore the effect of arsenic trioxide maintenance therapy on the long-term recur-rence rate in patients with acute promyelocytic leukemia ( APL ) . Methods From December 2011 to December 2013,60 patients with APL in the First People's Hospital of Huzhou were selected and divided into control group and observation group according to random number table, with 30 cases in each group. All patients received the same induction therapy and consolidation therapy. During the maintenance treatment period, all - trans retinoic acid ( ATRA) was given to the control group,and arsenic trioxide was used in the observation group. The serum levels and incidence of adverse reactions in the two groups were detected and compared after two cycles of the maintenance therapy. Three years of follow - up was conducted after treatment to record and compare the recurrence rate and survival rate in the two groups. Results The levels of TC and TG after 1 and 2 cycles of treatment were higher than those before treatment in both two groups(all P<0. 05),but the levels of lipid indicators in the observation group were lower than those in the control group,and the differences were statistically significant (t=2. 044,2. 175,all P<0. 05). The incidence rates of retinoic acid syndrome,elevated intracranial pressure and other adverse reactions in the observation group during the treatment were lower than those in the control group(6. 67％ vs. 26. 67％,6. 67％ vs. 30. 00％,6. 67％ vs. 26. 67％),and the differences were statistically significant(χ2 =0. 043,0. 023,0. 043,all P<0. 05). The survival rates after 2 and 3 years of treatment in the observation group were higher than those in the control group(90. 00％ vs. 66. 67％,83. 33％ vs. 60. 00％),and the differences were statistically significant(χ2 =4. 812,4. 812,all P<0. 05). The recurrence rate after 3 years of treatment in the observation group was lower than that in the control group(10. 00％ vs. 33. 33％),and the difference was statistically significant(χ2 =4. 812,P <0. 05). Conclusion For patients with APL, the application of arsenic trioxide in the maintenance therapy can produce no significant effect on their lipid metabolism, and at a certain extent, can help reduce the incidence of adverse reactions and recurrence rate,and improve the survival rate.

The efficacy and safety of ultrafiltration for patients with heart failure: results from a single-center randomized controlled study / 中华心血管病杂志

Objective@#To evaluate the efficacy and safety of ultrafiltration in patients with heart failure.@*Methods@#One hundred and thirty four cases of patients with heart failure, who hospitalized in our hospital from June 2010 to June 2016 were enrolled in this study. Random serial number was generated using SPSS 22.0 software, patients were then randomly divided into control group and ultrafiltration group with the proportion of 1∶1 (67 cases in each group). Patients in the control group received standard therapy. Patients in the ultrafiltration group received ultrafiltration therapy for 8 hours. Curative effect was evaluated after 8 hours treatment in the control group and after 12 hours in the ultrafiltration group. Following parameters were compared between the two groups: body weight, dyspnea score and 6 minutes walking distance as well as blood pressure, heart rate, Na+ , K+ , Cl-, pH, HCO3-, Hb, PLT, Cr, BUN levels.@*Results@#(1)Two patients died during run-in process and eventually 132 cases were chosen for final analysis (65 cases in control group and 67 cases in the ultrafiltration group). Gender, age, type of heart failure, dyspnea score, body weight at baseline were similar between the two groups. (2)Post therapy, patients′ body weight decreased obviously, while dyspnea score and 6 minutes walking distance increased significantly in the ultrafiltration group compared to baseline(all P<0.05), and the improvement was significantly greater compared to control group(all P<0.05). (3)The safety index comparison of two groups: blood pressure, heart rate, Na+ , K+ , Cl-, pH, HCO3-, Hb, PLT, Cr, and BUN were similar between the two groups at baseline and post therapy.@*Conclusion@#Ultrafiltration therapy is safe and effective to treat patients with heart failure.

Clinical Observafion of Simvastatin Combining Ezetimibe for Treating the Patients of Acute Coronary Syndrome With Impaired Glucose Tolerance / 中国循环杂志

Objective: To observe the inlfuence of simvastatin combining ezetimibe on blood levels of glucose and lipids in patients of acute coronary syndrome (ACS) with impaired glucose tolerance (IGT). Methods: A total of 316 patients with ACS and IGT were randomly divided into 2 groups: Treatment group, the patients received simvastatin 20 mg/day with ezetimibe 10 mg/day,n=160 and Control group, the patients received simvastatin 20 mg/day,n=156. All patients were treated for 24 months. Blood levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were observed at 6, 12 and 24 months of medication; fasting blood glucose (FBG), 2 hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c) and the number of patients with new onset diabetes were examined at 6 days and 12, 24 months of medication. Results:①In Treatment group, at 6 months of medication, blood levels of TC (mmol/L) and LDL-C (mmol/L) were (3.5 ± 0.5) and (2.1 ± 0.4) which were both lower than baseline levels (5.2±1.2) and (3.5±0.5),P0.05; HbA1c at 12 and 24 months were similar to baseline,P>0.05; 2hPG (mmol/L) level at 24 months was higher than 6 days (9.5 ± 1.1) vs (8.7 ± 1.0),P0.05. Conclusion: Ezetimibe combining simvastatin may better reduce blood lipids, while it had no real effect on blood glucose metabolism in patients with ACS and IGT.

Establishment and Improvement of Quality Management System for Drug Dismounting and Subpackage in Our Hospital / 中国药房

OBJECTIVE: To establish and improve the quality management system of drug dismounting and subpackage in hospital.METHODS: The status quo and problem of drug dismounting and subpackage were analyzed,and improvement approaches were put forward.RESULTS: The quality management system of drug dismounting and subpackage was established and improved by enhancing personnel quality,dismounting environment,material management as well as process control.CONCLUSION: The quality management system of drug dismounting and subpackage can effectively guarantee the quality of dismounted drug and is worthy of spreading.