Clinical characteristics and prognosis of takotsubo syndrome patients in single center

Takotsubo syndrome(TTS)is a clinical syndr-ome that frequently occurs in postmenopausal women,mostly induced by stress factors.It is characterized by chest pain,ST-segment elevation,and/or T-wave changes in electrocardiogram,along with my-ocardial troponin elevation.[1]TTS can be easily misdia-gnosed as myocardial infarction,and improper treatme-nt may lead to serious consequences.There are few re-ports and research on this disease.[2]

Comparative analysis of breast and lung cancer survival rates and clinical trial enrollments among rural and urban patients in Georgia

Objectives:Rural patients have poor cancer outcomes and clinical trial(CT)enrollment compared to urban patients due to attitudinal,awareness,and healthcare access differential.Knowledge of cancer survival disparities and CT enrollment is important for designing interventions and innovative approaches to address the stated barriers.The study explores the potential disparities in cancer survival rates and clinical trial enrollments in rural and urban breast and lung cancer patients.Our hypotheses are that for both cancer types,urban cancer patients will have longer 5-year survival rates and higher enrollment rates in clinical trials than those in rural counties.Methods:We compared breast and lung cancer patients’survival rates and enrollment ratios in clinical trials between rural(RUCC 4-9)and urban counties in Georgia at a Comprehensive Cancer Center(CCC).To assess these differences,we carried out a series of independent samples t-tests and Chi-Square tests.Results:The outcomes indicate comparable 5-year survival rates across rural and urban counties for breast and lung cancer patients,failing to substantiate our hypothesis.While clinical trial enrollment rates demonstrated a significant difference between breast and lung cancer patients at CCC,no significant variation was observed based on rural or urban classification.Conclusion:These findings underscore the need for further research into the representation of rural patients with diverse cancer types at CCC and other cancer centers.Further,the findings have considerable implications for the initiation of positive social change to improve CT participation and reduce cancer survival disparities.

A cross-sectional study on the nurses’attitude towards rapid response system activation for clinically deteriorated patients

Background:Hospitals have reported that implementing rapid response system activation(RRS)activation has increased patient safety.As a result,there has been growing interest in identifying factors that lead to successful RRS activation.While introducing an automated RRS activation system has prompted nurses to be more vigilant about monitoring vital signs,it has not necessarily encouraged them to conduct thorough patient assessments to identify early signs of deterioration.Purpose:The current study aimed to assess nurses’attitudes towards RRS activation for clinically deteriorated patients in the clinical units of King Abdul-Aziz Hospital.Methods:A descriptive cross-sectional research design was utilised in the study,and 144 nurses working in the medical and surgical units of King Abdul-Aziz Hospital were recruited to participate using a convenient non-probability sampling technique.Results:The study’s findings reported that nurses have a positive attitude towards RRS benefits(Mean=3.70;SD=0.70).Their overall attitude towards RRS activation among clinically deteriorated patients is still low positive(Mean=2.71;SD=0.61).The nurses’attitudes towards RRS benefits significantly differ among nationalities and the clinical area/unit where they were assigned,with a P-value of 0.0194 and 0.000,respectively.Attitudes towards RRS barriers significantly differ among nationality(P-value=0.0037),education level(P-value=0.0032),area of assignment(P-value=0.020),and whether they have a good understanding of abnormal observations(P-value=0.0122).Regarding the nurses’attitude towards management belief,the significant result is only with the clinical area/unit of assignment with a P-value of 0.000.Conclusion:The current study found a low positive attitude towards RRS activation among ward nurses,especially given that monitoring vital signs is critical to their job.Nurses may fear being perceived as clinically inept for redundant activations caused by poor quality,but their attitude towards activating the RRS in clinical deterioration is still largely negative.This is because most RRSs rely on ward nurses to recognise clinical deterioration and manually alert responders through phone calls,hospital communication systems,or face-to-face communication.

Evaluation of Clinical Outcomes of ses Stent in Patients with Coronary Artery Disease After Intracoronary Stenting in Small Vessels

Background:Limited data are available for sirolimus-eluting stent(SES,Cypher)implantation in patients with coronary artery disease in small vessels.The clinical longtermoutcomes of SES in patients with coronary artery disease after intracoronary stenting in small vessels has not been yet evaluated.

Predictive clinical features of cardioembolic infarction in patients aged 85 years and older

Objective To assess predictive clinical factors of cardioembolic infarction in very old patients(85 years of age and older).Methods Prospective hospital-based stroke registry("The Sagrat Cor Hospital of Barcelona Stroke Registry")is an acute-care teaching hospital in Barcelona,Catalonia,Spain.From 956 first-ever cardioembolic stroke patients included in the stroke registry over a 24-year period,639 were younger than 85 years of age and 317 were 85 years or older(mean age:88.9 years).Demographics,clinical characteristics,risk factors and early outcome were compared.Predictors of cardioembolic infarction in the oldest age group were assessed by multivariate analyses.Results In a logistic regression model based on demographics,risk factors,clinical features and complications,female gender(odds ratio[OR]=1.74,95%confidence interval[CI]:1.27–2.39),heart failure(OR=2.27,95%CI:1.46–3.56),altered consciousness(OR=1.76,95%CI:1.28–2.42),and infectious complications(OR=2.01,95%CI:1.39–2.91)were predictors of cardioembolic stroke in the oldest age group.By contrast,heavy smoking,heart valve disease,hypertension,headache,early seizures,sensory deficit,and involvement of the posterior cerebral artery were independently associated with cardioembolic stroke in the younger group.Conclusions Identification of a differential clinical profile of cardioembolic stroke between patients aged 85 years or more and those younger than 85 years helps clinicians to the optimal management of ischemic infarction in the oldest segment of the population.

Clinical features and treatment options for mitral regurgitation in elderly inpatients

Objective To summarize clinical characteristics and treatment strategy of Chinese elderly mitral regurgitation （MR） inpatients under the current guidelines, and to identify factors related to treatment options in them. Methods A single center retrospective study was conducted in which patients hospitalized in Fuwai hospital from May ist of 2014 to April 30 of 2015 with moderate to severe MR assessed by transthoraeic echocardiography were enrolled consecutively （n = 1741）. Patients 〉 60 years old were grouped as elderly group （n = 680） and patients 〈 60 years were grouped as control group （n = 1061）. The elderly group was categorized into two subgroups based on surgical status. Results The mean age of the elderly group was 66.98 i 5.94 years. The most common reason of MR in elderly group was degenerative MR （41.18%）. Atherosclerotic risk factors such as hypertension, diabetes or hyperlipidaemia were more commonly observed in elderly group than the control group （45.44% vs. 25.17%, P 〈 0.001; 19.56% vs. 8.48%, P 〈 0.001; 35.29% vs. 19.51%, P 〈 0.001）. Elderly group had higher Enroscore Ⅱ score （5.54 ± 2.42 vs. 3.15 ± 1.66）, greater left ventricular end diastolic diameter （LVEDD） （57.72±12.3 vs. 57.33 ± 10.19 ram） and a lower surgery rate （54.71% vs. 63.91%）; P 〈 0.05. Age, left ventricular ejection fraction （LVEF）, regurgitation grade, Eu- roScore-Ⅱ high risk stratification and having diabetes were identified as factors associated with therapy decisions in elderly MR patients. Conclusions Valve surgery was denied in 45.29% of elderly MR inpatients. Older age, impaired LVEF, lower regurgitation grade, Euro- Score-Ⅱ high risk stratification, and having diabetes were factors most significantly associated with surgery denial among elderly Chinese inpatients with MR.

Analytical study of care quality and moral distress in clinical situations and patient care

Objective: Nursing profession conventionally meets a high standard of ethical behavior and action. One of the ethical challenges in nursing profession is moral distress. Nurses frequently expose to this phenomenon which leads to different consequences such as being bored by delivering patient care that decline care quality and make it challenging to achieve health purposes. This study was conducted to investigate the association between the aspects of moral distress and care quality.Methods: In this descriptive–analytical study, 545 nurses of intensive and cardiac care units and dialysis and psychiatric wards were recruited by census sampling. Three questionnaires, Sociodemographics, Moral Distress Scale, and Quality Patient Care Scale, were distributed among the participants and collected within 9 months. Data analysis was conducted by descriptive statistics, analysis of variance, and the least significant difference in SPSS 13.Results: Investigating moral distress domains(ignoring patient, decision-making power, and professional competence) and care quality domains(psychosocial, physical, and communicational) demonstrated that in being exposed to moral distress, ignoring patient had no effect on psychosocial domain(P=0.056), but decision-making and professional competence of moral distress had positive effect on psychosocial, physical(bodily), and communication domains of care quality.Conclusions: Because moral distress domains are effective on patient care quality, it is recommended to enhance the knowledge of nurses, especially beginners, about moral distress, increase their strength alongside standardizing nursing services in decisionmaking domains, improve the professional competence, and pay attention to patients.

Clinical Characteristics, Imaging Findings and Surgical Outcomes of Chiari Malformation Type I in Pediatric and Adult Patients

A growing number of children and adolescents are being diagnosed as Chiari malformation type I （CM- I ） for behavioral disorders, developmental delay, seizures, or abnormal orpharyngeal function. The aim of this study was to compare the clinical characteristics, imaging findings and surgical outcomes of CM- I in pediatric and adult patients. Between January 2014 and June 2017, 84 patients with CM- I underwent surgical treatment in our department. We divided the patients into two groups： pediatric group （n=l 1, age 〈18 years） and adult group （n=73, age 〉18 years）. Data on clinical characteristics, imaging findings, surgical outcomes, and prognosis were retrospectively reviewed and compared between these two groups. For clinical presentation, scoliosis （36.4%） and developmental delay （36.4%） were more common in pediatric patients, whereas, sensory disturbance （58.9%） and motor weakness （41. 1%） were more common in adult patients. Imaging findings showed that the incidence of hydrocephalus and craniovertebral junctional abnormalities was significantly higher in pediatric group than in adult group （P〈0.05）. Compared to adult group, pediatric group showed a better improvement or resolution of syrinx and tonsillar herniation after surgical treatments （P〈0.05）. The total Chicago Chiari Outcome Scale （CCOS） score in pediatric patients at the last follow- up was significantly higher than that in adult patients （P=0.002）. In conclusion, the clinical characteristics and imaging findings appeared to be different in pediatric and adult patients with CM- I. The surgical outcomes of pediatric patients were shown to be significantly better than those of adult patients.

Impact of SGLT2 inhibitors on major clinical events and safety outcomes in heart failure patients:a meta-analysis of randomized clinical trials

BACKGROUND Sodium-glucose co-transporter-2 inhibitors(SGLT2i)significantly reduce the risk of cardiovascular(CV)and renal adverse events in patients with diabetes mellitus,heart failure(HF)and/or chronic kidney disease.We performed a meta-analysis to explore the impact of several different SGLT2i on all-cause mortality,CV mortality,HF hospitalizations and the combined outcome CV death/HF hospitalization in HF patients across the spectrum of left ventricular ejection fraction(LVEF)phenotypes.METHODS A systematic search in MEDLINE database and Cochrane library through March 2021 was performed without limitations.Randomized clinical trials that provided data about the impact of SGLT2i on all-cause mortality,CV mortality,HF hospitalizations or the combined outcome of CV death/HF hospitalization in HF patients were included.A random effects model was used for calculating the effect estimates.RESULTS Nine studies(n=16,723 patients,mean age:65.9 years,males:70.7%)were included in the quantitative synthesis.Compared to placebo,SGLT2i use was associated with 14%lower risk of all-cause mortality[hazard ratio(HR)=0.86,95%CI:0.78−0.94,I^(2)=0,P=0.0008],32%lower risk of HF hospitalizations(HR=0.68,95%CI:0.62−0.74,I^(2)=0,P<0.001),14%lower risk of CV mortality(HR=0.86,95%CI:0.77−0.95,I^(2)=0,P=0.003)and 26%lower risk of CV death/HF hospitalization(HR=0.74,95%CI:0.68−0.80,I^(2)=0,P<0.001).Regarding the safety outcomes,our data revealed no significant differences between SGLT2i and placebo groups in drug related discontinuations,amputations,severe hypoglycemia,hypotension,volume depletion,ketoacidosis and genital infections.By contrast,a protective role of SGLT2i against placebo was found for serious adverse events and acute kidney injury.CONCLUSIONS In patients with HF,regardless of LVEF phenotype,all SGLT2i had an excellent safety profile and significantly reduced the risk of all-cause mortality,CV mortality,HF hospitalizations and CV deaths/HF hospitalizations compared to placebo.

Chronic kidney disease and risks of adverse clinical events in patients with atrial fibrillation

BACKGROUND Chronic kidney disease(CKD)is highly prevalent in patients with atrial fibrillation(AF).However,the asso-ciation between CKD and clinical consequences in AF patients is still under debate.METHODS We included 19,079 nonvalvular AF patients with available estimated glomerular filtration rate(eGFR)values in the Chinese Atrial Fibrillation Registry from 2011 to 2018.Patients were classified into no CKD(eGFR≥90 mL/min per 1.73 m2),mild CKD(60≤eGFR<90 mL/min per 1.73 m2),moderate CKD(30≤eGFR<60 mL/min per 1.73 m2),and severe CKD(eGFR<30 mL/min per 1.73 m2)groups.The risks of thromboembolism,major bleeding,and cardiovascular mortality were estimated with Fine-Gray regression analysis according to CKD status.Cox regression was performed to assess the risk of all-cause mortal-ity associated with CKD.RESULTS Over a mean follow-up of 4.1±1.9 years,there were 985 thromboembolic events,414 major bleeding events,956 car-diovascular deaths,and 1,786 all-cause deaths.After multivariate adjustment,CKD was not an independent risk factor of throm-boembolic events.As compared to patients with no CKD,those with mild CKD,moderate CKD,and severe CKD had a 45%,47%,and 133%higher risk of major bleeding,respectively.There was a graded increased risk of cardiovascular mortality associated with CKD status compared with no CKD group:adjusted hazard ratio[HR]was 1.34(95%CI:1.07−1.68,P=0.011)for mild CKD group,2.17(95%CI:1.67−2.81,P<0.0001)for moderate CKD group,and 2.95(95%CI:1.97−4.41,P<0.0001)for severe CKD group,respectively.Risk of all-cause mortality also increased among patients with moderate or severe CKD.CONCLUSIONS CKD status was independently associated with progressively higher risks of major bleeding and mortality,but didn’t seem to be an independent predictor of thromboembolism in AF patients.

Clinical Evaluation of a Vancomycin Dosage Strategy Based on a Serum Trough Concentration Model in Elderly Patients with Severe Pneumonia

Objective This study aimed to evaluate the clinical benefits of a vancomycin dosage strategy based on a serum trough concentration model in elderly patients.Methods This prospective single-center, open-label, randomized controlled trial categorized 66 elderly patients with severe pneumonia into study and control groups. The control group received vancomycin using a regimen decided by the attending physician. Meanwhile, the study group received individualized vancomycin therapy with a dosing strategy based on a serum trough concentration model. The primary endpoint was the proportion of patients with serum trough concentrations reaching the target values.The secondary endpoints were clinical response, vancomycin treatment duration, and vancomycinassociated acute kidney injury(VA-AKI) occurrence.Results All patients were at least 60 years old(median age = 81 years). The proportion of patients with target trough concentration achievement(≥ 15 mg/L) with the initial vancomycin regimen was significantly higher in the study group compared to the control group(75.8% vs. 42.4%, P = 0.006).Forty-five patients(68.2%) achieved clinical success, the median duration of vancomycin therapy was10.0 days, and VA-AKI occurred in eight patients(12.1%). However, there were no significant differences in these parameters between the two groups. The model for predicting vancomycin trough concentrations was upgraded to: serum trough concentration(mg/L) = 17.194-0.104 × creatinine clearance rate(mL/min) + 0.313 × vancomycin daily dose [mg/(kg·d)].Conclusion A vancomycin dosage strategy based on a serum trough concentration model can improve the proportion of patients achieving target trough concentrations in elderly patients with severe pneumonia.

Evaluation Nursing Students’ Views of Improved Competence Development after Clinical Supervision: An Educative Approach to the WHO Patient Safety Model

Bachelor of Science Nursing (BSN) students’ education comprises both theories and practical aspects. Access to resources is required for the development of a professional identity, which includes gaining technical knowledge and receiving feedback, guidance as well as social and emotional support from clinical supervisors. The aim of this study was to evaluate BSN students’ views of professional development after clinical supervision (CS) during their undergraduate education. An additional aim was to illuminate how competence development was related to the WHO Patient Safety Educational Model. A cross-sectional study was conducted, in which CS was measured as part of a survey completed by a sample of nursing students after their clinical placement at two time-points, namely 2012 and 2013. Statistical descriptive and inferential analyses were used and differences in the responses between Time 1 and Time 2 compared. The benefit of CS for nursing students’ competence development revealed a positive significant relationship between students’ Interpersonal skills and the factor Improved care/skills. There were differences in terms of variables related to the Importance value of CS and Professional skills. The results can be used to inform undergraduate nursing education leaders, teachers and practice partners on individual, group and organisational level in order to enhance patient safety and highlight the importance of CS for BSN students’ professional development.

Clinical Observation on Treatment of 78 Patients of B-Thalassemla with Bushen Ylsul (补肾益髓) Method and Study on Its Molecular Mechanism

Objective: To study the treatment of B-Thalas-semia (ThE) with Chinese herbal medicine for Bushen Yisui (BSYS), its theoretical base and molecular mechanism. Methods: Seventy-eight patients with ThE were treated with BSYS recipe (consisted of 11 Chinese herbal drugs as Dogwood fruit, Fleeceflower root, prepared Rehmannia root and turtle shell, etc.) orally taken, 3 times per day, 10 g/time, 3 months as one therapeutic course. Hemoglobin (Hb), red blood cell (RBC), reticulocyte (Ret) and hemoglobin F (HbF) were checked every month. At the same time, PAGE, PVR, PCR-SSCP, RT-PCR, DNA series analysis, mRNA gene expression analysis techniques were used to conduct the systematic gene analysis in patients to study the molecular mechanism of TCM treatment from aspects of gene mutation, gene expression and control-regulation. Results: All the blood criteria in patients after BSYS treatment were improved significantly with clinical symptoms

Clinical Effect of Zishenwan on Elderly Patients with Prediabetes Based on the Method of Sweet-Bitter Therapeutic

[Objectives]To study the clinical effect of Zishenwan on elderly patients with prediabetes based on the method of Sweet-Bitter Therapeutic.[Methods]Total 64 elderly patients with prediabetes in Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine from April,2020 to July,2021 were randomly divided into control group(32 cases)and Zishenwan group(32 cases).The control group received basic treatment(diet control and regular luck exercise),while the Zishenwan group was treated with Zishenwan on the basic treatment.[Results]The results of intragroup comparisons after treatment show that both of the groups improved plasma glucose,insulin,plasma lipid metabolism and other related indexes.The results of inter-group comparisons were as follows.(i)The FPG and 2hPG of the Zishenwan group were significantly lower than the control group(P<0.05).(ii)The FINS and HOMA-IR of the Zishenwan group were significantly lower than the control group(P<0.05).(iii)The LDL-C of the Zishenwan group were significantly lower than the control group(P<0.05).(iv)The ADP,hs-CRP,and GLP-1 of the Zishenwan group were significantly improved compared to those of the control group(P<0.05).Although there was no significant difference in other indicators,the improvement trend is better than that of the control group.[Conclusions]Zishenwan can further improve plasma glucose level of the elderly patients with prediabetes on the basis of basic treatment,and to a certain extent,reduce the plasma glucose to normal,which is beneficial to the benign outcome of the elderly patients with prediabetes.In addition,it can improve insulin secretion and reduce insulin resistance,which provides a basis for the disease control of elderly patients with prediabetes.It can also improve the lipid metabolism of elderly patients with prediabetes,and the effect on LDL-C is significant.It is speculated that its mechanism may be closely related to the changes of ADP,hs-CRP and GLP-1 in the body of elderly patients with prediabetes.

Comparison of Clinical Characteristics and Outcomes of Pediatric and Adult Patients with Coronavirus Disease 2019 in Shenzhen,China

Objective Here we aimed to investigate the difference in clinical characteristics and outcomes between pediatric and adult patients with COVID-19.Methods A total of 333 consecutive patients with laboratory-confirmed SARS-CoV-2 infection treated in the departments of Internal medicine of Shenzhen Third People’s Hospital from January 11 th to February 10 th,2020 were included.The data were obtained from electronic medical records.The epidemiological data,clinical characteristics,length of hospital stays,and outcomes of pediatric and adult patients were compared.Results Compared with adult patients,pediatric patients had a shorter time of symptom onset to hospitalization than adults[median time,1(IQR,1.0-1.0)d vs.3(IQR,2.0-6.0)d,P<0.001],milder or fewer symptoms,less severe chest CT findings.The clinical severity classification of children was less severe than adults.Up to 15 th March,the end of the follow-up,33(100%)children and 292(97.3%)adult patients had been discharged from hospital.Only 2(0.7%)adult patients died,with an overall case mortality of 0.6%.The median length of hospital stay of pediatric patients was shorter than that of adult patients[19(95%CI:16.6-21.4)d vs.21(95%CI:19.9-22.1)d,P=0.024].Conclusion Pediatric patients with COVID-19 had milder or less clinical symptoms,less evident pulmonary imaging changes,better prognosis,and shorter length of hospital stay.

Clinical Observation on Treatment of 50 Patients with Candidal Vaginitis by Chinese Herbal Medicine Combined with Canesten

From January 2001 to January 2002, 50 patients of candidal vaginitis were treated by Kushen powder (KSP,苦参散) combined with Canesten as the treatment group, and controlled by a control group including another 50 patients treated with Canesten alone. The therapeutic results were satisfactory and reported as follows.

Clinical Observation on Influence of Chinese Medicines for Promoting Blood Circulation to Remove Blood Stasis on FIB and DD in Plasma of Patients with Cerebral Thrombosis

to study the influence of Chinese medicines for promoting blood circulation to remove blood stasis on fibrinogen(FIB)and D-dimer(DD)in plasma of patients with cerebral thrombosis. Method:73 inpatients with acute cerebral thrombosis were randomly divided into a control group of 34 cases and a treatment group of 39 cases.The content of FIB and DD in plasma was detected before treatment and on the 7th and 14th days after treatment.Result:FIB content in plasma after treatment was lower than that before treatment in the control group(P<0.01)and more remarkable in the treatment group(P<0.001).There was an obvious difference in DD content before and after treatment in both groups.DD content on the 7th and 14th days after treatment in the treatment group was obviously higher than that in the control group(P<0.01 and P<0.05 respectively). Conclusion:Chinese medicines for promoting blood circulation to remove blood stasis can reduce the FIB content in plasma of patients with cerebral thrombosis,raise the DD content in plasma, cause the peak of DD content appear earlier and obviously improve hypercoagulability of blood in patients with cerebral thrombosis.

Clinical Observation on Quality of Life in Coronary Artery Bypass Grafting Patients Treated According to Syndrome Differentiation of TCM

Objective: To evaluate the clinical effect and quality of life (QOL) in coronary artery bypass grafting (CABG) patients treated according to syndrome differentiation of TCM. Methods: Eighty-two CABG patients were allocated in the control group (n = 39) treated with conventional method of western medicine, and the TCM-treated group (n

Clinical study of recombinant human brain natriuretic peptide in patients with acute myocardial infarction complicating congestive heart failure

Objectives To observe the efficacy and safety of recombinant human brain natriuretic peptide(rh-BNP) on patients with acute myocardial infarction complicating congestive heart failure.Methods 40 patients with acute myocardial infarction complicated by congestive heart failure were randomly divided into control group and treatment group of 20 cases.The control group,15 cases of acute anterior myocardial infarction,5 cases of acute inferior wall myocardial infarction, 15 males and 5 females,aged 55-70 years,mean age 58±12 years;treated 16 cases of acute anterior myocardial infarction,4 cases of acute myocardial infarction,16 males and 4 females,aged 56-70 years,mean age 59±11 years;two groups of age,gender,severity of disease and vascular lesions no significant difference and comparable(P】0.05).Conventional group were given aspirin,clopidogrel, statins,Inotropic,diuretic and vasodilator therapy.In the con- ventional treatment group based on the use of recombinant human brain natriuretic peptide(new bios,Tibet Pharmaceutical Co.,Ltd.Chengdu Nuodikang biopharmaceutical production, usage:1.5μg/Kg intravenous injection(impact), then 0.0075μg-0.01μg/(kg·min)infusion rate).Continuous medication 72 h.The clinical symptoms observed for 3 days in patients before treatment and after treatment,heart rate,blood pressure and left ventricular ejection fraction (LVEF) and tumor necrosis factor(TNF-α),brain natriuretic peptide(BNP) levels were measured.Results In control group,8 cases markedly effect,5 cases effect and 7 cases no effect,the total effective rate was 65%;In treatment group,13 cases markedly effect,6 cases effect and 1 cases no effect,the total effective rate was 95%,compared with two groups P New bios treatment group significantly increased cardiac index(CI) in patients with heart failure and left ventricular ejection fraction(LVEF) than the control group(all P【0.05),further reduce the levels of tumor necrosis (TNF-α) and brain natriuretic peptide(BNP).Conclusions rh-BNP can improve symptoms and heart function,reduced plasma tumor necrosis factor(TNF-α) and BNP levels of acute myocardial infarction patients with congestive heart failure,the treatment safe and reliable.As small sample size observed,larger sample to be accumulated to further evaluate its efficacy and safety.

Are the data on quality of life and patient reported outcomes from clinical trials of metastatic non-small-cell lung cancer important?

Majority of the patients with advanced non-small-cell lung cancer(NSCLC)experience two or more disease related symptoms,which may have a negative impact on their health-related quality of life(HR QOL).These patients prefer a therapy that would improve disease related symptoms,as opposed or treatment that slightly prolongs their survival without improving symptoms.The improvements of the symptoms augment the significance of improved response rates or progression free survivals.The choice of the questionnaires to evaluate patients-reported outcomes(PROs)and HRQOL benefits and methods of collecting the data and their interpretations are very important and are discussed in this manuscript.PROs and HR QOL outcomes are important in patients with advanced NSCLC only when the data are collected and analyzed correctly.Then they can be viewed as components of the total value of a treatment,providing a comprehensive picture of the benefits and risks of anticancer therapies.Enabling the patients to feel during the last months of their lives more comfortable and not be dependent on their loved ones is a very important task in the treatment of advanced NSCLC.