Objective: To investigate the safety and efficacy of ultrafiltration on diuretic sensitivity in heart failure patients with reduced ejection fraction and diuretic resistance. Methods: This was a single-center randomized controlled trial. A total of 148 heart failure patients with reduced ejection fraction admitted to the Hospital of Traditional Chinese Medicine of Xinjiang Uygur Autonomous Region from June 2010 to June 2020 were enrolled in this study, and these patients were randomly divided (ratio 1:1) into the ultrafiltration group (n=74) and the control group (n=74). All patients were treated with diuretics, cardiotonic, vasodilator and other comprehensive drugs according to relevant guidelines. After grouping, the patients in the control group were treated with standard treatment plan, while patients in the ultrafiltration group were treated with ultrafiltration on top of standard therapy. Diuretic drugs were discontinued during ultrafiltration, and intravenously furosemide (40 mg) was given immediately and 24 hours after the end of ultrafiltration. Clinical data including gender, age, complicated diseases, New York Heart Association (NYHA) function classification, etc. were collected. Effectiveness indicators include urine volume (the first 12-hour and 24-hour urine volume and the second 24-hour urine volume after using diuretic), body weight and dyspnea severity score. Safety indicators include systolic blood pressure, serum creatinine, serum Na⁺ concentration, blood K⁺ concentration and the number of deaths before and after intervention. Results: Two patients in the control group died due to worsening heart failure after randomization and were excluded in this study, 146 patients were finally analyzed (72 patients in the control group and 74 patients in the ultrafiltration group). There were 93 males, and the age was (68.3±11.2) years. There was no significant difference between patients in the ultrafiltration group and the control group in gender, age, body weight, course of disease, dyspnea severity score, NYHA function classification Ⅲ/Ⅳ, the proportion of patients with severe edema of both lower limbs, the proportion of patients with complicated diseases, and basic medication (all P>0.05). After using diuretics, the urine volume of the first 12-hour and 24-hour and the second 24-hour were significantly higher in the ultrafiltration group than in the control group (all P<0.05). Body weight decreased significantly after ultrafiltration treatment as compared with that before intervention in the ultrafiltration group (P<0.05). Compared with the control group, the dyspnea severity score was significantly improved in the ultrafiltration group (P<0.05). There was no significant difference in systolic blood pressure, serum creatinine, serum Na⁺ concentration, blood K⁺ concentration of patients between ultrafiltration group and control group before and after intervention (all P>0.05). During the clinical diagnosis and treatment, 2 male patients in the control group died, and the cause of death was aggravation of basic diseases complicated with acute heart failure and cardiogenic shock. There was no death in the ultrafiltration group, and there were no obvious clinical adverse events during and after ultrafiltration. Conclusion: Ultrafiltration therapy is safe and can improve diuretic sensitivity in heart failure patients with reduced ejection fraction and diuretic resistance.
Aged ; Diuretics/therapeutic use* ; Furosemide/therapeutic use* ; Heart Failure/drug therapy* ; Humans ; Male ; Middle Aged ; Stroke Volume ; Ultrafiltration

Shenqi Pills, first recorded in Essentials from the Golden Cabinet(Jin Kui Yao Lue) from ZHANG Zhong-jing in Han dynasty, have the effect of warming and tonifying the kidney Qi and are mainly used for the treatment of insufficiency of kidney Qi and kidney Yang. According to modern medicine, kidney Qi involves heart function, kidney function, immune function, and so on. The clinical indications of Shenqi Pills include kidney deficiency, abnormal fluid, and abnormal urination, and the last one is classified into little urine, much urine, and dysuria. In clinical settings, Shenqi Pills can be applied for the treatment of heart failure, renal failure, cardiorenal syndrome, and diuretic resistance, as well as endocrine, urological, orthopedic, and other chronic degenerative diseases. Shenqi Pills are ideal prescriptions for the weak constitution and emergency treatment. It is of great value and significance to carry out in-depth research on the connotation of the classic articles by integrating TCM and western medicine based on "pathogenesis combined with pathology and drug properties combined with pharmacology".
Humans ; Cardio-Renal Syndrome/drug therapy* ; Diuretics/therapeutic use* ; Drugs, Chinese Herbal/therapeutic use* ; Heart Failure/drug therapy* ; Critical Care

Ascites ; etiology ; therapy ; Diuretics ; therapeutic use ; Humans ; Hypertension, Portal ; complications ; Peritoneovenous Shunt ; Portasystemic Shunt, Transjugular Intrahepatic

Child ; Child, Preschool ; Diuretics ; therapeutic use ; Edema ; drug therapy ; Female ; Furosemide ; therapeutic use ; Humans ; Male ; Nephrotic Syndrome ; complications ; Sulfonamides ; therapeutic use

The knowledge on the pathogenetic mechanisms of bronchopulmonary dysplasia (BPD) has increased considerably over recent years. However, the incidence of the disease has not substantially been changed by our therapeutic approaches. This review summarizes the existing evidence for a number of respiratory and medical strategies to prevent or ameliorate the disease and gives recommendations for clinical practice. Oxygen plays an important pathogenetic and therapeutic role for BPD. Targeting infants at lower oxygen saturation levels than traditionally used seems to confer major advantages. There is no sufficient evidence for a routine use of respiratory strategies like permissive hypercapnia or inhaled nitric oxide to prevent BPD. Diuretics can ameliorate lung function transiently. High intramuscular doses of vitamin A can reduce the risk of BPD. Early or prophylactic surfactant might also be advantageous. Postnatal corticosteroids are effective but, due to their severe side effects, should be restricted to the severest cases. Alpha1-proteinase inhibitor and superoxide dismutase have no proven benefits for BPD. The role of erythromycin has not been completely elucidated yet. Innovative strategies like Clara Cell 10 kD protein still have to be assessed in future trials.
Antioxidants ; therapeutic use ; Bronchopulmonary Dysplasia ; prevention & control ; therapy ; Caffeine ; therapeutic use ; Diuretics ; therapeutic use ; Erythromycin ; therapeutic use ; Humans ; Incidence ; Infant, Newborn ; Nitric Oxide ; administration & dosage ; Oxygen ; therapeutic use ; Ureaplasma urealyticum ; drug effects

OBJECTIVE: To determine the therapeutic status and rate of reaching target blood pressure in elderly isolated systolic hypertension (EISH) patients who were hospitalized and to discuss the rationality of the drug therapy. METHODS: Three hundred and fifty-seven EISH inpatients were investigated retrospectively. The frequencies of using antihypertensive drugs and the strategy of drug therapy programs were calculated. The drug efficacies were assessed among various drug therapy groups. RESULTS: The frequencies of using antihypertensive medicine categories were calcium channel blocker (CCB) 64. 15%, angiotensin-converting enzyme inhibitor (ACEI) 32.77%, diuretics 26.33%, beta-blocker (BB) 25.77%, angiotensin receptor blocker (ARB) 23.81%, and alpha-blocker 4.20%, respectively. Among the 357 cases 42.86% were treated with monotherapy while 57.14% with combined therapy. Among the combination therapy groups, the diuretic-based multiple therapy occupied 16.53%, and the non-diuretic-based multiple therapy held 40.62%. The systolic blood pressure control rate was 67.79%. The rate of diastolic blood pressure < or = 70 mmHg was 26.89%, 8 cases of them occurred myocardial ischemia. CONCLUSION How to select the optimal antihypertensive drug therapy for EISH patients is important in achieving the blood pressure goal. While thinking over intervention at lower blood pressure levels to achieve target goals, physicians should prevent from excessively lowering the diastolic blood pressure.
Adrenergic beta-Antagonists ; therapeutic use ; Aged ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Antihypertensive Agents ; therapeutic use ; Calcium Channel Blockers ; therapeutic use ; Diuretics ; therapeutic use ; Drug Therapy, Combination ; Female ; Humans ; Hypertension ; drug therapy ; Male ; Retrospective Studies ; Systole

We used near-infrared spectroscopy technology to monitor and assess the treatment effect of dehydrating agent in injured rat brain in real time style. We employed the brain edema model in rats resulting from Feeney' s freefall damage, then treated with different doses of mannitol, and collected reduced scattering coefficient (p',) and intracranial pressure (ICP) values after the injury and during the treatment. The results showed that brain edema happened 1 h after the injury in rats' brain tissue, peaked around 72 h after injury, and then began to decrease gradually. The reduced scattering coefficient and ICP values of the treatment group injected with mannitol all decreased after administration. Compared with the effect of low-dose mannitol treatment, that of high-dose mannitol treatment was much better. The duration of the plateau was longer and most experiments results declined significantly. From this we conclude that the reduced scattering coefficient and ICP are consistent with the trend changes, and the reduced scattering coefficient could be used as an indicator for monitoring cerebral edema.
Animals ; Brain Edema ; diagnosis ; Brain Injuries ; therapy ; Dehydration ; Diuretics, Osmotic ; therapeutic use ; Intracranial Pressure ; Male ; Mannitol ; therapeutic use ; Monitoring, Physiologic ; Rats ; Spectroscopy, Near-Infrared

OBJECTIVETo observe the clinical efficacy of combined use of Compound Nanxing Pain Paste with blood-promoting and diuretic Chinese herbal medicines in treatment of chronic knee synovitis.

METHODSFrom October 2008 to March 2011, 120 patients with chronic knee synovitis were equally divided into three groups: oral treatment group, external treatment group and combined treatment group. Patients in oral treatment group had a mean age of (56.58 +/- 5.47) years and a course of disease about (7.35 +/- 2.59) months,involving the left knee in 18 cases,the right knee in 17 cases and both knees in 5 cases, who were administered orally with blood-promoting and diuretic Chinese herbal medicines composed of Wu Ling San and Tao Hong Si Wu Decoction. Patients in external treatment group had a mean age of (56.25 +/- 6.35) years and a course of disease about (7.68 +/- 2.76) months,involving the left knee in 16 cases, the right knee in 20 and both knees in 4 cases, who were treated externally with Compound Nanxing Pain Paste. Patients in combined treatment group had a mean age of (55.65 +/- 4.49) years and a course of disease about (7.50 +/- 3.36) months, involving the left knee in 16 cases, the right knee in 18 and both knees in 6 cases, who were given both oral and external treatments. The clinical effects and knee function of the three groups were assessed and compared.

RESULTSFinally, a total of 118 patients were included in the result analysis, including 40 patients in oral treatment group, 39 patients in external treatment group and 39 patients in combined treatment group. In combined treatment group, 27 patients were clinically cured, 9 were improved, and 3 patients were ineffective vs. 15, 16 and 8 patients in external treatment group, and 13, 16 and 11 in oral treatment group. The overall effective rate of combined treatment group was better than that of oral group and external treatment groups (P < 0.05). The function comprehensive score of knee joints in combined treatment group was better than that of oral treatment group,while the function comprehensive score of knee joints in oral treatment group was better than that in external treatment group in terms of demand for assistance, stair-climbing ability, lameness, and swelling pain.

CONCLUSIONCombined use of oral blood-promoting and diuretic Chinese herbal medicines with Nanxing offers a good therapeutic effect on chronic knee synovitis in relieving pain, reducing swelling and improving joint function,while Nanxing could also reduce pain and improve joint function to a certain extent.

Aged ; Chronic Disease ; Diuretics ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Knee Joint ; Medicine, Chinese Traditional ; Middle Aged ; Synovitis ; therapy

Three small breed dogs were referred for the evaluation of neurologic deficits. Upon physical and neurologic examination, all dogs displayed hyperesthesia, pain, and neck stiffness. Magnetic resonance imaging was performed on the brain and spinal cord, and all three dogs presented Chiari-like malformations and syringomyelia. These dogs were treated with prednisolone and furosemide, and showed rapid improvement of clinical signs. Chiari malformations and syringomyelia were not improved because of congenital disorders. This case report demonstrates the clinical and diagnostic features of Chiari-like malformations and syringomyelia in three small breed dogs.
Animals ; Anti-Inflammatory Agents/therapeutic use ; Arnold-Chiari Malformation/pathology/*veterinary ; Body Size ; Diuretics/therapeutic use ; Dog Diseases/drug therapy/*pathology ; Dogs ; Female ; Furosemide/therapeutic use ; Male ; Prednisolone/therapeutic use ; Syringomyelia/drug therapy/pathology/*veterinary

A 5 year-old spayed female Cavalier King Charles Spaniel was presented after a 3- to 5-day onset of severe respiratory distress. The dog also had a history of several episodes of syncope prior to presentation. A comprehensive diagnostic investigation revealed a midsystolic click sound on cardiac auscultation, signs of left sided cardiac enlargement in ECG and thoracic radiography, mitral valvular leaflet protrusion into left the atrium, decreased E-point-to septal separation (EPSS) and mitral regurgitated flow in echocardiography, all of which are characteristic signs of mitral valvular prolapse. After intensive care with antidiuretics and a vasodilator with oxygen supplement, the condition of the dog was stabilized. The dog was then released and is being medicated with angiotensin converting enzyme (ACE) inhibitor with regular follow-up.
Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Animals ; Diuretics/therapeutic use ; Dog Diseases/*diagnosis/drug therapy ; Dogs ; Enalapril/therapeutic use ; Female ; Furosemide/therapeutic use ; Mitral Valve Prolapse/diagnosis/drug therapy/*veterinary