Objective:To understand the current status of financial toxicity in patients with heart failure and the factors affecting it, and to provide ideas for making personalized and informed decisions.Methods:Using a scoping review methodological framework, PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, VIP, Wanfang, and SinoMed Databases were searched and screened for relevant literature on financial toxicity in patients with heart failure, with a timeframe of January 1, 2014-October 31, 2023, respectively. Relevant literature was identified based on inclusion and exclusion criteria, and data were extracted, collected, summarized, and the findings were reported.Results:Ten literatures that met the inclusion and exclusion criteria were identified. The results showed 5 cross-sectional surveys, 2 qualitative studies, and 1 each of reviews, mixed studies and commentaries. Heart failure patients generally faced high levels of financial toxicity, the incidence and severity of patient financial toxicity varied somewhat between study outcomes. Factors influencing financial toxicity in heart failure patients included age, education level, family income level, discussion of medical costs with physicians, type of insurance the patient had, and occupational status.Conclusions:In the future, we can develop and apply a specialized assessment tool for financial toxicity in heart failure patients in China, further explore the factors affecting financial toxicity in heart failure patients, and formulate personalized treatment plans and financial support strategies for patients according to the influencing factors, so as to reduce the impact of financial toxicity on heart failure patients.

Objective:To investigate the effect and necessity of fine operation on the improvement of the preparation outcome of paclitaxel (albumin-binding) intravenous infusion for injection.Methods:The detailed refinement of the preparation method in the specification of paclitaxel (albumin-binding) for injection was developed. The fine operation of paclitaxel (albumin-binding) for injection mainly consists of two parts: The mixing method of solvent and drug: including syringe needle length into drug vial, solvent injection speed, state of drug waiting for dissolution, and the shaking speed of the drug vial. The method of extracting the dissolved liquid in the drug vial and injecting it into a 100 ml sterile empty 0.9% sodium chloride injection bottle: including the speed of refilling the 100 ml sterile empty 0.9% sodium chloride injection bottle, and restoring the pressure balance inside and outside the infusion bottle. The effect of fine operation on the preparation of paclitaxel (albumin-binding) for injection was evaluated by comparing the production of foam and the preparation time before and after the implementation of fine operation.Results:Before and after the implementation of fine operation, the foaming rate of the foam in the drug vial decreased from 28.57% (10/35) to 12.50% (12/96), the difference was statistically significant ( χ2 value was 4.471, P=0.029); and the foaming rate of the mixed liquid from the drug vial into the 100 ml sterile empty 0.9% sodium chloride injection bottle decreased from 46.15% (6/13) to 9.09% (3/33), the difference was statistically significant ( χ2 value was 8.140, P value was 0.004); and the preparation time of single drug was reduced by 3.37 minutes after the implementation of fine operation, the difference was statistically significant ( t value was 79.744, P<0.05). Conclusion:The preparation method of fine operation of paclitaxel (albumin-binding) for injection is operable, safe and reliable. After implementation, it can effectively reduce the production of foam in the drug vial and infusion bottle, improve the stability of drug preparation, shorten the preparation time, and ensure the safe, timely and effective medication for patients.

OBJECTIVE:To investigate the effects of blood concentration monitoring of cylosporin A(CsA) in patients with nephrotic syndrome(NS)on efficacy and safety. METHODS:The medical records of 154 NS patients receiving CsA and blood concentration monitoring in nephrology department of China-Japan Friendship Hospital during Jan. 2014-Aug. 2017 were analyzed retrospectively. The results of blood concentration monitoring in 63 adult inpatients with refractory NS receiving CsA for the first time within 6 months of initial treatment were analyzed statistically. The relationship of blood concentration monitoring with efficacy and safety was analyzed. RESULTS:The blood concentration of CsA in 154 patients were monitored for 512 times with an average of 3.32 times/person,and average blood concentration was(125.98±105.13)ng/mL. The patients with blood concentration of CsA＜100 ng/mL accounted for 44.14%. There was no statistical significance in average monitoring times or average blood concentration between male and female,average blood concentration of CsA among different age groups (P＞0.05). The blood concentration was monitored for 237 times in 63 adult inpatients with refractory NS receiving CsA for the first time within 6 months of initial treatment(induction period). Average blood concentration of effective group were significantly higher than ineffective group;the proportion of effective group with blood concentration＜100 ng/mL was significantly lower than that of ineffective group,with statistical significance (P＜0.05). Among 63 patients,17 patients suffered from ADR (the incidence of ADR was 26.98%). The average blood concentrations of ADR patients were significantly higher than those without ADR;the monitoring times of ADR patients with blood concentration＞150 ng/mL was significantly higher than those without ADR,with statistical significance(P＜0.05). There was no statistical significance in the incidence of ADR between effective group and ineffective group (P＞0.05). Among effective group,there was no statistically significance in average blood concentration between ADR patients and patients without ADR(P＞0.05);the monitoring times of ADR patients with blood concentration＞150 ng/mL was significantly higher than patients without ADR,with statistical significance(P＜0.05). With the increase of monitoring times,the incidence of ADR decreased gradually. There was no statistical significance in the incidence of ADR among patients who were monitored for different times (P＞0.05). CONCLUSIONS:The pharmacokinetics of CsA varies in different patients and many factors affect its blood concentration. The changes of blood concentration affect the efficacy and safety of CsA. It is difficult to determine the dosage of CsA based on experience in the treatment of NS with CsA. Great importance should be attached to blood concentration monitoring of CsA and the implementation of individualized dosage regimen based monitoring results so as to improve therapeutic efficacy and reduce the occurrence of ADR.

Objective: To establish the UPLC typical chromatogram and evaluate the quality of Jinji pills. Methods: The UPLC typi-cal chromatogram was performed on an Agilent proshell 120 C18column (150 mm×4. 6 mm,2. 7 μm) with gradient elution by the mobile phase of acetonitrile-0. 1% phosphoric acid aqueous solution system at a flow rate of 0. 8 ml·min-1. The detection wavelength was 240 nm. Results: The UPLC typical chromatogram included 15 common peaks when taking berberine hydrochloride as the reference peak, and 7 of them were identified by the comparison with the reference substances. Conclusion: The established methods have high specificity and good repeatability, and can be used for the quality control of the product.

Objective: To establish a GC method for the determination of borneol and camphor in Xingkening capsules. Methods:A capillary column using polyethylene glycol 20000 (PEG-20M) as the stationary phase (30 m×0. 53 mm,1 μm) was employed. The flow rate of carries gas (N2) was 3. 0 ml·min-1. The inlet temperature was 200℃, the temperature of flame ionization detector was 210℃, the column temperature was 140℃, and the split ratio was 1 ∶ 1. Results: The linear range of borneol was 13. 25-1 325. 19 μg·ml-1(r=0. 999 9), and the average recovery was 100. 22% with the RSD of 0. 92% (n=6). The linear range of camphor was 1. 029-16. 464 μg·ml-1(r=0. 997 5),and the average recovery was 98. 89% with the RSD of 2. 78% (n=6). Conclusion: The method is simple, accurate and reliable, which can be used for the quality control of borneol and camphor in Xingkening capsules.

Objective: To improve the quality standard of Funing granules. Methods: TLC was used for the qualitative identifica-tion of Angelicae Sinensis Radix, Chuangxiong Rhizoma, Scutellariae radix, Atractylodis macrocephalae rhizoma, Citri reticulatae peri-carpium, Cyathulae radix, Paeoniae radix alba and Glycyrrhizae radix Et rhizoma. The content of paeoniflorin was determined by HPLC. Results: The TLC spots were clear and well-separated without any interference from the negative control. The linear range of paeoniflorin was 19. 23-2525. 18 ng(r=0. 999 9), the average recovery was 101. 88% ,and the RSD was 0. 62% (n=6). Conclu-sion: The method is simple and accurate with good reproducibility, and can be used for the quality control of Funing granules.

Objective: To explore the effect and security of minimally invasive surfactant therapy (MIST) in treatment of preterm infants with neonatal respiratory distress syndrome (NRDS). Methods: A total of 48 pretrm infants with gestational ages between 30-36 weeks diagnosed with NRDS in Guangzhou Women and Children′s Medical Center from January 2017 to January 2018 were randomly divided into MIST group (23 cases) and intubation-surfactant-extubation+ continuous positive airway pressure ventilation (INSURE) group (25 cases) by adopting random number table method.The patients in MIST group were put on nasal continuous positive airway pressure (nCPAP) and a thin vascular catheter was inserted through the vocal cords under direct vision with direct laryngoscope then infused pulmonary surfactant(PS) into the lung; the patients in INSURE group were endotracheally intubated and infused with PS into the lung through endotracheal tube with positive airway pressure, then extubated and put on nCPAP again.The incidences of adverse reactions and various complications related to the 2 groups were observed. Results: There were no significant differences between 2 groups in oxygen saturation decrease(26.1% vs.36.0%), bradycardia (13.0% vs.24.0%) and reuse PS (8.7% vs.4.0%) (all P>0.05). There were no significant differences between 2 groups in noninvasive ventilation time [8 d (5.5-12.5 d) vs.7 d(5.0-14.0 d)], total oxygen intake time [12 d(7.0-26.5 d) vs.10 d(10.0-23.0 d)] and length of hospital stay [(34.22±16.06) d vs.(30.88±14.35) d] (all P>0.05). There was no death or intraventricular hemorrhage in both groups, and there were no significant differences between 2 groups in the incidences of pneumothorax (0 vs.4.0%), bronchopulmonary dysplasia (21.7% vs.16.0%), retinopathy of prematurity (21.7% vs.12.0%) and necrotizing enterocolitis (21.7% vs.12.0%) (all P>0.05). Conclusions MIST technique is a safe and effective method to administrate surfactant in preterm infants with NRDS.In the NRDS patients who do not need intubation and mechanical ventilation, MIST technique can be used to administrate PS.

Objective To investigate effects of different ventilation methods during pulmonary surfactant(PS) administration on cerebral oxygen metabolism in preterm infants with neonatal respiratory distress syndrome.Methods Newborns met the inclusion criteria were enrolled into this study,and they were randomly divided into manual group and mechanical group.During PS administration,the proximal end of the tracheal tube was connected to a bag valve mask device in the manual group or a mechanical ventilator in the mechanical group.Brain near infrared spectroscopy monitoring was carried out to detect the cerebral oxygen saturation(ScO2),and the mean arterial blood pressure (MABP) was simultaneously recorded.Results For all 49 preterm infants,PS was administered to preterm infants with severe respiratory distress syndrome treated with mechanical ventilation,including 24 cases of manual ventilation and 25 cases of mechanical ventilation.The left cerebral ScO2 and correlation coefficient of ScO2 and MABP(rScO2-MABP) showed no difference in both groups before PS administration.During administration,ScO2 dramatically increased in both groups [manual group:(85.88 ± 5.54) ％ vs.(77.31 ± 5.40) ％,t =5.521,P =0.000;mechanical group:(83.88 ± 3.18) ％ vs.(76.53 ±4.38)％,t =6.741,P =0.000],and gradually decreased after administration,the level of ScO2 didn't return to the baseline till the 2nd 5 minutes after PS administration [manual group:(79.25 ± 3.02) ％ vs.(77.31 ± 5.40) ％,t =1.560,P =0.220;mechanical group:(78.59 ± 3.45) ％ vs.(76.53 ± 4.38) ％,t =1.832,P =0.074].The same trend of ScO2 change rate was shown simultaneously in both groups.The rScO2-MABP markedly increased during administration in both groups (manual group:2.34 ±0.16 vs.1.86 ±0.21,t =9.022,P =0.000;mechanical group:2.12 ± 0.15 vs.1.87 ±0.21,t =4.810,P =0.000).The rScO2-MABt,in mechanical group rapidly decreased to baseline during the 1st5 minutes (1.84 ± 0.18 vs.1.87 ± 0.21,t =0.538,P =0.635) but went back to baseline in manual group during the 2nd 5 minutes(1.84 ±0.19 vs.1.86-0.21,t =0.350,P =0.809).Change rates of rScO2-MABP were markedly higher in manual group than those in mechanical group during the 1 st 5 minutes (1.15 ± 0.13 vs.1.00 ± 0.15,t =4.943,P =0.000).Conclusions ScO2 could be affected transiently by PS administration with different methods of ventilation.The effect on cerebral autoregulation in mechanical group is shorter than that in manual group.

Objective:To establish an HPLC method for the determination of ginsenoside Rg1 ,ginsenoside Re and ginsenoside Rb1 in Xueluotong capsules. Methods:A column of Waters Symmetry C18 ( 250 mm × 4. 6 mm,5 μm) at the temperature of 35 ℃ was used to separate the target components, the mobile phase consisted of acetonitrile-water with gradient elution, the flow rate was 1. 0 ml ·min-1 , the detection wavelength was 203 nm and the injection volume was 10 μl. Results:The linear range of ginsenoside Rg1 was 0. 055-2. 732 μg(r=0. 9998), and the average recovery was 107. 23% with RSD of 1. 17%(n=6). The linear range of ginsenoside Re was 0. 341-8. 542 μg(r=0. 9999), and the average recovery was 101. 63% with RSD of 3. 52%(n=6). The linear range of gin-senoside Rb1 was 0. 717-14. 336 μg(r=0. 9997), and the average recovery was 100. 63% with the RSD of 3. 79%(n=6). Conclu-sion:The method is simple, accurate and reliable, which can be used for the quality control of Xueluotong capsules.

Objective:To identify toddalolactone and establish the analysis method for Jinji tablets.Methods: An Hypersil DBS C18column(250 mm×4.6 mm,5 μm) was used. The mobile phase consisted of acetonitrile-0.1% phosphoric acid solution. The flow rate was 0.8 ml·min-1and the detection wavelength was at 330 nm. Toddalolactone was identified by an LC-MS method and the re-sult was compared with that of the reference regent.TLC and HPLC analytical methods were used for analysis of toddalolactone.Re-sults:Totally 58 batches of Jinji tablets were tested,and the suspected samples were confirmed by HPLC-MS/MS.Toddalolactone was detected out from 20 batches of samples. Conclusion:The method is simple,rapid and accurate, which is able to detect toddalolac-tone quickly and effectively.