Objective:To conduct a scoping review of research on home-based palliative care for heart failure patients, explore its current development status, and provide a theoretical basis for future advancements in this field.Methods:A systematic search was performed in databases including CNKI, VIP, CBMdisc, Wanfang Data, PubMed, Web of Science, Embase, and Cochrane Library for literature related to home-based palliative care for heart failure patients. The search covered publications from the inception of each database until December 31, 2023. Literature was screened, and data were extracted, analyzed, and discussed.Results:A total of 19 studies were included, including randomized controlled trials, cohort studies, and qualitative research. The conceptual frameworks for home-based palliative care services for heart failure patients in these studies included the 6S model of palliative care, the 4C model of transitional care, the Omaha System, and chronic disease care models. The structure of these services was primarily nurse-led multidisciplinary team collaboration. Service forms included home visits and telephone follow-ups, with varying service frequencies. The content of the services included physical, psychological, social, and spiritual support. Outcome indicators mainly included patient readmission rates, quality of life, symptom burden, cost-effectiveness, and caregiver burden. Cohort study outcomes primarily focused on patient treatment preferences and place of death. Qualitative research explored the experiences of heart failure patients, caregivers, and healthcare providers with home-based palliative care.Conclusions:Home-based palliative care for heart failure patients has demonstrated positive effects in practice. It is recommended to standardize home-based palliative care models, clarify the needs of patients and their families, and identify barriers and facilitators to the development of home-based palliative care, thereby promoting its advancement for heart failure patients.

This article reported a male neonate with lethal mitochondrial trifunctional protein deficiency (MTPD) caused by compound heterozygous variations in the HADHB gene. The patient presented with poor milk intake complicated by abnormal myocardial enzymes within 24 h after birth and was transferred to the Children's Hospital of Nanjing Medical University on day 4. Physical examination revealed no obvious abnormalities on admission. Laboratory examination showed increased creatine kinase isoenzyme and cardiac troponin levels, and electrocardiogram suggested sinus tachycardia and low QRS voltage in limb leads. Blood screening for metabolic abnormalities showed high levels of tetradecenyl carnitine and various 3-hydroxycarnitines. Heterozygous mutations of c.739C>T(p.Arg247Cys) and c.607C>T(p.Arg203Ter,272) were detected in the HADHB gene in the boy, which were pathogenic variants included in the Human Gene Mutation Database. Followed up to three months of age, the boy was readmitted to hospital due to poor milk intake for one week and poor response for 2 d after catching a cold. After admission, he quickly developed multiple organs dysfunction such as heart failure and respiratory failure, and then died. Lethal MTPD is rare with no effective treatment and poor prognosis. Lethal MTPD should be highly suspected when unexplained cardiomyopathy, hypoglycemia, acidosis and other metabolic abnormalities appear in the neonatal period, and an early diagnosis could be confirmed with genetic testing in the neonatal period.

Objective To investigate the effect of bronchodilators on dyspnea and pulmonary function in patients with chronic obstruction pulmonary disease (COPD) at different degrees.Methods 50 patients with COPD from January 2014 to January 2015 in pneumology department of Tongchuan City People's Hospital were selected.According to the standard of Global initiative for chronic obstructive lung disease (GOLD), the patients were divided into mild degree of 14 cases, moderate degree of 18 cases and severe degree of 18 case.The changes of Borg score of dyspnea, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and inspiratory capacity (IC) after received tiotropium bromide inhalation in each group.Results FEV1, FVC, PEF and IC values significant improved in mild, moderate and severe degree groups after received tiotropium bromide inhalation and the values of improvement rate changed significantly with degrees of disease ( P <0.05 ).The improvement rates of FEV1, FVC and IC were highest in patients at severe degree, improvement rate of PEF was highest in patients at mild degree (P<0.05).After received tiotropium bromide inhalation, the Borg score improved significantly compared with that of pre-treatment in mild, moderate and severe degree groups (P<0.05), the improvement rate of Borg score was highest in severe degree group(P<0.05).There were significantly positive correlations between Borg score and FEV1(r=0.372),FVC(r=0.296),PEF(r=0.284),IC(r=0.704)(all P<0.05).Conclusion Bronchodilator could significantly improve dyspnea and lung function in patients with COPD, and the improvement rate of FEV1, FVC and IC is highest in patients with COPD at server degree, PEF is highest at mild degree and Borg score is highest at server degree, which need the comprehensive analysis of each indicators for reversibility of airflow obstruction.