Objective:To systematically summarize the current status and effects of home-based palliative care for patients with advanced chronic heart failure, providing reference for the implementation and development of palliative care in China..Methods:A systematic search was conducted in multiple databases, including China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, VIP, PubMed, Web of Science, EMBASE, CINAHL, and Cochrane Library, for relevant literature on home-based palliative care for patients with advanced chronic heart failure. Reference lists of included studies were also traced, and grey literature was supplemented by searching Baidu Scholar and Google Scholar. The search period was from the inception of each database to December 19, 2024. Two researchers independently evaluated the quality of the literature and extracted data.Results:A total of 11 studies were included. The interventions in home-based palliative care included symptom control, advance care planning, psychological and mental assessments and interventions, disease education, and self-management education. Most studies found that the experimental group had higher quality of life scores, lower healthcare resource usage, and reduced anxiety and depression compared to the control group.Conclusions:Home-based palliative care can improve symptom burden, enhance quality of life, alleviate anxiety and depression, and promote the implementation and discussion of advance care planning for patients with advanced chronic heart failure. It can also reduce healthcare costs and caregiver burden to some extent.

Objective:To systematically summarize the current status and effects of home-based palliative care for patients with advanced chronic heart failure, providing reference for the implementation and development of palliative care in China..Methods:A systematic search was conducted in multiple databases, including China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, VIP, PubMed, Web of Science, EMBASE, CINAHL, and Cochrane Library, for relevant literature on home-based palliative care for patients with advanced chronic heart failure. Reference lists of included studies were also traced, and grey literature was supplemented by searching Baidu Scholar and Google Scholar. The search period was from the inception of each database to December 19, 2024. Two researchers independently evaluated the quality of the literature and extracted data.Results:A total of 11 studies were included. The interventions in home-based palliative care included symptom control, advance care planning, psychological and mental assessments and interventions, disease education, and self-management education. Most studies found that the experimental group had higher quality of life scores, lower healthcare resource usage, and reduced anxiety and depression compared to the control group.Conclusions:Home-based palliative care can improve symptom burden, enhance quality of life, alleviate anxiety and depression, and promote the implementation and discussion of advance care planning for patients with advanced chronic heart failure. It can also reduce healthcare costs and caregiver burden to some extent.

Objective To explore the mechanism by which tumor necrosis factor alpha(TNF-α) induces RIP1 kinase-dependented apoptosis in L929-A fibroblastoma cells.Methods The sub-mitochondrial localization of receptor-interacting protein 1(RIP1),caspase-8 and Bid proteins was detected by dose-gradient trypsin digestion and Western blotting.The levels of reactive oxygen species (ROS),intracellular calcium concentration,mitochondrial membrane potential (MMP),and cellular adenosine triphosphate(ATP) content were determined by fluorescent probe labeling and flow cytometry assay.The mitochondrial respiratory chain complex Ⅰ and Ⅲ activities were detected by commercial kits.Nec-1,A RIP1 kinase specific inhibitor,and RIP1-/-or Bid-/-L929-A cells were used to detect the roles of RIP1 kinase and Bid protein in cell death.Results RIP1,caspase-8 and Bid proteins were co-located in the outer membrane of mitochondrial.TNF-α exposure for 3 h could induce Bid cleavage,inhibit mitochondrial respiratory chain complex Ⅲ activity and reduce MMP.Following these changes and after TNF-α exposure for 6-12 h,the intracellular calcium concentration and ROS were increased,whereas the ATP concentration was decreased,and the cells were killed.Inhibiting RIP1 kinase or knockdown RIP1 or Bid protein could suppress all the cytotoxic effects of TNF-α.Conclusion TNF-α treatment can result in RIP1 kinase-mediated Bid cleavage and inhibit mitochondrial respiratory chains and cell energy metabolism,which ultimately leads to the death of L929-A cells.