1.Evaluation of exercise on left ventricular function in patients with slow coronary flow by excercise‐stress echocardiography
Guangyuan LI ; Qiuyu CAI ; Chunyan MA ; Fanxin KONG ; Yonghuai WANG ; Pingping MENG ; Jun YANG
Chinese Journal of Ultrasonography 2019;28(5):387-391
Objective To evaluate the role of treadmill exercise‐stress echocardiography in the assessment of left ventricular ( LV ) function in patients with slow coronary flow ( SCF ) ,and discuss the possible mechanism of SCF . Methods Forty‐six patients with diagnosis of SCF were enrolled as SCF group . Forty age and sex matched adults were included as control group . All subjects had underwent clinical evaluation and exercise stress echocardiography . LV diastolic and systolic functions were assessed by conventional echocardiography , tissue Doppler imaging and two‐dimensional speckle tracking echocardiography at rest and during exercise . Results ①LV function in patients with SCF at rest :LV peak systolic longitudinal strain ( LS) was lower in patients with SCF than that in controls ( P <0 .05) . T here was no difference of LV ejection fraction ( LVEF) between the two group( P>0 .05) . Early diastolic mitral annulus velocity ( M itral e′) and the ratio between the early mitral inflow velocity and Mitral e′( M itral E/e′) were significantly decreased in SCF group( all P<0 .01 ) . ②LV function during exercise :LVEF ,LS and M itral e′were significant increased in two groups ( all P <0 .05 ) than those at rest ,but there was no significant difference of LVEF ,LS ,M itral e′ and M itral E/e′ between the two groups ( all P > 0 .05 ) . Compared with control group ,ΔLS and ΔM itral e′were significantly higher in SCF group ( all P<0 .05 ) . Conclusions LV systolic and diastolic function in patients with SCF are impaired at rest . LV systolic and diastolic function recover in patients with SCF during exercise .
2.Discussion on traditional Chinese medicine treatment models of depression named "three phases, five internal organs and ten syndromes"
Jianjun WANG ; Fanxin KONG ; Songjun LIN ; Xuan LIU ; Jinfang LI ; Hongmin LIU ; Zhouke GUO
International Journal of Traditional Chinese Medicine 2018;40(6):481-485
Based on the inheritance, the research group summarized the transmissive pathogenesis of depression in three typical stages, formulating the stepward treatment units which included Chinese medicine, acupuncture and TCM characterized psychotherapy, and formed a sequential treatment plan that balanced the principle of strengthening healthy Qi to eliminate pathogens, active and passive treatment, physical therapy and psychotherapy. Based on the retrospective analyses, ten typical clinical syndromes have been formed, constituting the pattern differentiation of "Three Phases, Five internal organs and Ten syndromes" for depression, which sysmatically showed the TCM syndrome differentiation. This work promoted the experiences and methods of treating depression by Chinese medicine.
3.Definition,Measurement and Evaluation of Drug Clinical Comprehensive Value from a Perspective of the Public Decision-making
Fanxin KONG ; Aixia MA ; Hongchao LI ; Wenxi TANG
China Pharmacy 2020;31(5):539-544
OBJECTIVE:To provide reference for scientific decision-making of evaluation and application of clinical comprehensive value of drugs from the perspective of the public decision-making in China. METHODS :Based on relevant documents and literatures ,drug clinical comprehensive value in other countries and areas ,the core indicators of drug clinical comprehensive value evaluation in China were confirmed. The concept and evaluation methods of each indicator were evaluated , and relevant suggestions were put forward. RESULTS & CONCLUSIONS :It’s suggested that the core indicators of China ’s drug clinical comprehensive value evaluation are safety and efficacy ,economy and affordability ,accessibility and fairness adherence , suitability. The concepts of safety ,efficacy,economy,affordability and adherence indexes are clearly defined ,evaluation methods are systematic ,data sources are sufficient ,and international consensus exists in research design. There is no uniform definition of accessibility which composed of availability ,deliverability,availability,affordability and timeliness. The concept of equity is clearly defined and the evaluation method is systematic ,but the data source is insufficient. Appropriateness is evaluated by drug suitability index but there is no clear definition. Taking efficacy as an example ,efficacy includes intermediate indicators ,outcome indicators and quality of life indicators ,which are often confirmed by epidemiological research ,systematic evaluation and expert consensus. It ’s suggested that the Real World Study data should be used as much as possible when selecting or formulating the clinical comprehensive value indicators of drugs. With the help of multi-criteria decision-making analysis ,technical support should be provided by professional evaluation institutions ,and with the support of experts and researchers ,the above indicators should be empowered to form the clinical comprehensive value judgment of a drug by different public decision-making departments ,so as to decide whether to purchase ,use clinically ,or incorporate medical insurance reimbursement.