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Objective: To evaluate both the efficacy, safety, length of stay in hospital and expenses of aggressive diuretic therapy in patients with acute decompensation of chronic heart failure (CHF)., Methods: The retrospective analysis was conducted in the patients with acute decompensation CHF New York Heart Association (NYHA) class III or IV in department of cardiology of Fujian Medical University Union Hospital from January 1st 2006 to September 1st 2007. The 24-hour urine volume on the 2nd day was equivalent or over 2 400 ml was defined as aggressive diuretic therapy group, and those with less than 2 400 ml of urine as non-aggressive diuretic therapy group. The biochemical parameters and vital signs were compared before and after aggressive diuretic therapy, and the mortality, the length of stay and expenses were also compared between the two groups., Results: One hundred and ninety-five patients were enrolled in the study, there were 73 and 122 patients in aggressive diuretic therapy group and in non-aggressive diuretic therapy group respectively. The mortality in aggressive diuretic therapy group was lower than that in non-aggressive diuretic therapy group (1.4% vs. 9.8%, P<0.05). The length of stay, total expenses and average cost in aggressive diuretic therapy group were lower than those in non-aggressive diuretic therapy group respectively [the length of stay: 11 days vs. 16 days; total expenses: 8 483 yuan vs. 12 182 yuan; average expenseI: 721.1 yuan/d vs. 854.4 yuan/d; average expenseII (except for examination expenses): 580.0 yuan/d vs. 698.2 yuan/d, P<0.05 or P<0.01]. There were no significant changes in biochemical parameters and heart rate before and after aggressive diuretic therapy. The systolic pressure (SBP) and diastolic pressure (DBP) were reduced significantly after aggressive diuretic therapy [SBP: (118.2±16.9) mm Hg vs. (127.0±24.9) mm Hg; DBP: (67.2±4.5) mm Hg vs. (75.2±4.9) mm Hg, 1 mm Hg=0.133 kPa, P<0.05 and P<0.01]. No hypotension symptoms such as dizziness and chest distress were found in all patients., Conclusion: Aggressive diuretic therapy in patients with acute decompensation CHF is a safe, effective mode of therapy. It can reduce the length of stay in hospital, expenses and the mortality during hospitalization.

Objective: To investigate the effects and mechanisms of Shexiang Baoxin Pill (SBP) on myocardial fibrosis in spontaneous hypertensive rats (SHR)., Methods: SHR of 12 weeks old were divided into the SBP group, the control group (treated with benazepril) and the model control group. The effects on such indexes as systolic blood pressure (SBP), left ventricular mass (LVM), left ventricular mass index (LVMI), content of myocardial collagen (MC) in left ventricle, extracellular matrix fibronectin (FN), laminin (LN), cardiac fibroblast (cFb) and transforming growth factor-beta1 (TGF-beta1) were determined after 12 weeks of treatment., Results: SBP had no marked pressure depressive effect, but had the effect similar to that of benazepril in reducing the level of LVM, LVMI and content of MC (P < 0.05), as well as the content of LN, FN in myocardium, cFb count and TGF-beta1 expression (P < 0.05)., Conclusion: SBP can prevent and treat myocardial fibrosis, whose action is independent of its hypotensive effect. The mechanism may be associated with such factors as the decrease of MC synthesis in left ventricle and the deposition of extracellular matrix.