The efficacy of tolvaptan for heart failure in chronic kidney disease: A protocol for systematic review and meta-analysis

The impact of palliative care on the physical and mental status and quality of life of patients with chronic heart failure: A randomized controlled trial

BACKGROUND

Chronic heart failure (CHF) is the terminal stage of several diseases. The present study aimed to investigate the impact of palliative care on the physical and mental status and quality of life of patients with CHF.

METHODS

This single-center randomized controlled clinical trial was conducted at Xiangtan Central Hospital. A total of 103 cases were included and divided into a study group (n = 54) and a control group (n = 49). The control group received usual care, whereas the study group received usual care plus palliative care. Statistical analyses were conducted on Simplified Coping Style Questionnaire, negative emotions, Minnesota Living with Heart Failure Questionnaire scores, and nursing satisfaction before and after intervention in the 2 groups.

RESULTS

After the intervention, the positive coping style score in the research group was higher than that in the control group, while the negative coping style score was lower than that of the control group (P < .05). After the intervention, the Beck Anxiety Inventory and Beck Depression Inventory-II scores of the 2 groups decreased compared to before the intervention, and the study group had lower scores than the control group (P < .05). After the intervention, the Minnesota Living with Heart Failure Questionnaire scores of the 2 groups decreased compared to those before the intervention, and the study group had lower scores than the control group (P < .05). Nursing satisfaction of the research group (94.44%) was higher than that of the control group (81.63%) (P < .05).

CONCLUSIONS

Adopting palliative care to intervene in CHF patients can effectively regulate their physical and mental state, alleviate negative emotions, transform coping styles towards the disease, and improve their quality of life, with high patient satisfaction.

In-vitro evaluation of immunomodulatory activity of sulphation-modified total ginsenosides derivative-3

Background

Ginseng has been used in biomedicine to prevent and treat decreased physical and mental capacities. Total ginsenosides (TG) from ginseng root which have antitumor and immune-enhancing properties, are the principal active components of Panax ginseng, while the sulphation-modified TG derivative-3 (SMTG-d3) was expected to enhance the anticancer activity in conventional medicinal treatments.

Methods

The chlorosulphonic acid-pyridine technique, used for the sulfation modification of TG to improve their biological activity, and the infrared spectroscopic characteristics of TG and SMTG-d3 were investigated, and the effects of SMTG-d3 on immunocytes and cytokines relevant to tumor treatment were assessed. The MTT assay was used to assess the effect of TG and SMTG-d3 on the cytotoxicity and T-lymphocytic proliferation against mouse splenocytes. The LDH method was employed to evaluate NK activity induced by TG or SMTG-d3. The production levels of splenocytes-secreted IL-2 and IFN-γ and peritoneal macrophages-secreted TNF-α were determined using mouse ELISA kits.

Results and discussion

It showed that the ideal conditions for the sulfation modification of TG: the volume ratio of chlorosulfonic acid to pyridine lower than 1:2.5; controlled amount of chlorosulfonic acid; and a yield of 51.5% SMTG-d3 (2 h, < 45°C). SMTG-d3 showed two characteristic absorption peaks at 1,230 cm^-1 and 810 cm^-1, indicating the formation of sulfuric acid esters and the presence of sulfuric acid groups. SMTG-d3 exhibited higher antitumor immunological activity than TG by promoting the proliferation of T lymphocytes and the production of IFN-γ and TNF-α, thus enhancing NK cell activity, and reducing cytotoxicity. The findings imply sulfated modification represents an effective method of enhancing the immunomodulatory activities of TG and could be used as the basis for developing new drug target compounds; SMTG-d3 can serve as an antitumor immunomodulator and can be considered an effective and prospective herbal formulation in clinical applications.