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代谢综合征与心血管病预防
代谢综合征(MS)近年来在国内外心血管病防治领域受到越来越多的关注和重视,国家"十一五"科技规划也将此项研究列为心血管病防治的重点项目.其主要原因是MS的研究结果为动脉粥样硬化性疾病的更早期预防提供理论基础.
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应重视心血管疾病的人群防治
目前,心血管病,包括高血压、冠心病和脑卒中,已成为危害人民健康和生命的主要疾病.据世界卫生组织"2001年世界卫生报告"[1],2000年全球因心血管疾病死亡人数高达1 670万,其中一半以上发生在发展中国家,1/3以上为中年人.心血管病是全球被忽略的三大"流行病"之一(其他两种为吸烟和道路交通伤害),越来越严重地威胁着人类的生命和健康.我国的情况也大致相似,据卫生部2003年中国卫生统计年鉴[2],2002年我国大城市居民心脏病死亡率达75.68/10万,仅次于恶性肿瘤、脑血管病(91.37/10万),居死因的第3位;农村居民心脏病死亡率为73.93/10万,仅次于恶性肿瘤、呼吸系统疾病、脑血管病(89.12/10万),居死因的第4位.
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OU Ming, male, was born in Shunde City of Guangdong Province, December 1924. After graduating from Medical College of Lingnan University in 1948, he was served as a physician in Chinese People's Liberation Army, government organization and Zhongshan Medical College. In 1956, he was appointed the post of participating in the founding of a new medical college, Guangzhou College of Traditional Chinese Medicine, and has worked there ever since, acting in the past as department head of internal medicine, deputy director of the affiliated hospital, director of teaching administration office and vice-president of the college successively and now as a full professor. Cardiovascular disease is his speciality and he has devoted to the scientific study of integration of traditional and western medicine in his field since then. He has taken charge of various national research projects, including “Clinical and Experimental Studies of the Effect of Ilexonin A on Congestive Heart Failure”, “The Molecular Biological Basis of Deficiency Syndrome in Traditional Chinese Medicine”, “Clinical and Experimental Studies of the Effect of Kaixin Capsule on Asymptomatic Myocardial Ischemia”, etc., and acted as the head of national collaborating group studying the treatment of cardiovascular diseases by traditional Chinese medicine and the integration of traditional and western medicine, a national key project of medicine in the 7th Five-Year Plan. Many achievements in scientific research have been obtained, which were appraised by experts as the achievements of advanced level in the country. A total of thirteen prizes (science and technology progress prize and commendation prize) has been awarded to him by Ministry of Science and Technology, Ministry of Health, State Administration of Traditional Chinese Medicine and Guangdong Commission of Science and Technology. His writings are abundant. More than ten monographs concerning traditional Chinese medicine have been published for most of which he acted as the chief-editor, including Concised Dictionary of Traditional Chinese Medicine (The People's Health Publishing House, 1979), Chinese-English Dictionary of Traditional Chinese Medicine (Hong Kong Three-Joint Book Company, 1982), New Compilation of Traditional Chinese Medicine (Shanghai Science and Technology Publishing House, 1991), Series of Traditional Chinese Medicine (in English)(Hong Kong Haifeng Publishing House, 1991-1994), Syndrome Differentiation, Treatment and Recent Research of Coronary Heart Disease (Qingdao People's Publishing House, 1994), Big Dictionary of Traditional Chinese Medicine (The People's Health Publishing House, 1995), etc. Furthermore, more than 20 academic papers have been published in the well-known Chinese medical journals, such as Chinese Journal of Integrated Traditional and Western Medicine, Journal of Traditional Chinese Medicine, Chinese Journal of Herbal Medicine, Traditional Chinese Drug Research and Clinical Pharmacology, Journal of Guangzhou University of Traditional Chinese Medicine, etc.
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世界中医药学会联合会心血管病专业委员会成立大会暨首届学术研讨会纪要
世界中医药学会联合会(简称世界中联)心血管病专业委员会于2005年10月16、17日在北京友谊宾馆召开成立大会暨首届学术研讨会.大会由世界中联副秘书长、美国哈佛大学医学院麻省总医院研究员张群豪主持.卫生部副部长兼国家中医药管理局局长、世界中联主席余靖、世界中联副主席兼秘书长李振吉、中国中西医结合学会会长、中国科学院院士陈可冀、世界中联副主席兼司库龙致贤、国家中医药管理局国际合作司司长沈志祥、北京中医药大学校长郑守曾、中日友好医院院长许树强、福建中医学院院长杜建以及世界中联副秘书长姜再增等嘉宾应邀出席大会.来自世界各地以及北京地区的中医、西医及中西医结合专家200余人出席了大会.
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microRNA及其在心血管疾病中的作用研究进展
microRNA 是一类长22 个核苷酸左右的进化保守的内源性非编码单链RNA 小分子.自1993 年Lee 等[1]发现第一个被称为lin-4 的microRNA 以来,研究者对microRNA 的生物合成、功能及作用机制进行了大量研究.目前,人们已经鉴别出500 多个人类microRNA,它与RNA干扰(RNAi)一起被认为是RNA 研究的又一次革命[2].microRNA 可参与细胞的分化、增殖、凋亡以及多种生物组织的发育调节过程[3-6],但在哺乳动物心血管系统中的生物学功能自2005 年才得以阐释[7].目前,已证实microRNA在血管生成和心血管疾病中均具有重要作用[8-9].在心血管疾病发生发展过程中,血管内皮损伤及其功能紊乱对疾病进程具有重要作用,而诸如内皮型一氧化氮合酶(eNOS)等内皮特异性基因的表达将直接影响这些疾病的发生发展过程.因此,探讨microRNA 在心血管疾病中的调节作用及其机制具有理论与临床上的双重价值.
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盘点心血管疾病新的生物标志物
在过去的20年里,生物标志物已成为临床实践中越来越重要的工具,它有助于疾病的诊治和判断预后.而心血管系统又是生物标志物被广泛应用的领域.
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激光在心血管疾病治疗中应用的新进展
激光在心血管疾病中主要用于治疗冠心病、周围血管疾病、心脏瓣膜病、先天性心脏病和肥厚性心肌病等.直接心肌血运重建术(direct myocardial revascularization,DMR),亦称经心肌血运重建术(transmyocardial revascularization,TMR)或激光心肌血运重建术(transmyocardial laser revascularization,TMLR),是近年来应用于外科临床的新技术.经皮直接心肌血运重建术(percutaneous direct myocardial revascularization,PDMR)是在TMR基础上发展起来的用于心内科临床的一种全新型冠心病介入治疗技术,是冠心病治疗史上的又一新进展.这些都为过去常规内外科治疗不能奏效的冠心病病人提供了一种新的有效的治疗方法[1,2].
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他汀类药物治疗心血管疾病的非降脂作用研究进展
心血管疾病如冠心病(CHD)、高脂血症、动脉粥样硬化(AS)等日益威胁着人类健康和生命,其发病与诸多因素(如血脂异常、高血压、糖尿病、吸烟等)有关,而他汀类药物是目前能够较为有效地控制心血管事件发生和发展的药物之一.他汀类药物为胆固醇合成酶系中的限速酶羟甲基-戊二酸单酰辅酸A还原酶抑制剂,可抑制肝脏胆固醇的合成.他汀类药物除具有降低血胆固醇和低密度脂蛋白作用外,还具有中度降低血甘油三酯和升高高密度脂蛋白的作用.随着他汀类药物的临床应用和深入研究,发现他汀类药物除了降脂作用以外,还具有保护内皮细胞、抗炎、稳定易损斑块、抗血栓、改善心肌重构等作用.现就他汀类药物治疗心血管疾病的非降脂作用做一综述.
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褪黑素与心血管疾病相关性研究进展
褪黑素(melatonin, MT) 化学名称N-乙酰-5-甲氧色胺(N-acetyl-5-methoxytrypatmine),是松果体分泌的一种吲哚类神经内分泌素.近年来国内外学者对MT生物学作用的研究已成为生命科学研究的一个热点,动物实验表明MT除具有调节生物的昼夜节律、提高免疫力、改善睡眠、抗炎、抗氧化、抗肿瘤、抗衰老外,还影响心血管系统,具有抗高血压、调节血脂代谢、抗心肌细胞损伤及对血管内皮保护的作用.本文对MT的生物学特点、作用和在心血管疾病中的生理、病理学意义做一综述.
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从循征医学看老年心血管病药物治疗进展(下)
三、老年冠状动脉粥样硬化性心脏病(冠心病)的药物治疗1.他汀类药物:对这类药物的药理研究发现它除了良好的降胆固醇、甘油三酯的作用外,还具有重要的非调脂作用,如抑制炎症、稳定斑块,改善内皮功能,抗血小板聚集、改善血流状态,抑制平滑肌细胞增殖等作用.因而他汀类药物在临床得到广泛的应用.甚至有人认为它所带来的贡献可以与20世纪40年代青霉素所带来的贡献相媲美.因此,他汀类药物成为目前研究的热点和重点.
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循证医学与心血管病临床实践
循证医学(evidenee based medicine,EBM)指遵循科学证据的临床医学[1].1992年由Guyatt领导的加拿大McMaster.大学临床流行病教学组首次在JAMA上提出循证医学概念[2],随后由被称为"循证医学之父"的Sackect等出版专著陈述循证医学含义及方法[3].
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做好心血管疾病预防领跑健康中国
心血管疾病(包括冠心病和卒中)是影响我国居民健康的第一杀手,半数冠心病患者首次发病即是急性心肌梗死或猝死.在我国,心血管疾病造成的直接经济损失1993年为187.4亿元,2003年达到了1300亿元,增加近6倍.
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优化的药物治疗是冠心病二级预防的基石
任何有效治疗应该能够改善症状和(或)延长寿命.自从经皮冠状动脉(冠脉)介入术(PCI)引入心血管疾病治疗后,PCI的适应证在日益拓宽,PCI能够有效减少有症状冠心病患者的心绞痛,并减少ST段抬高心肌梗死(MI)和高危的急性冠脉综合征患者的病死率.但该技术能否减少稳定性冠心病患者死亡和MI的预后终点尚不清楚,也没有证据显示可以减少稳定性心绞痛患者的心脏事件.
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临床试验荟萃分析质疑阿司匹林在血管疾病一级预防的地位
2009年5月30日Lancet发表了对阿司匹林用于血管疾病一、二级预防临床试验荟萃分析的结果[1].研究包括6个一级预防试验(共纳入处于低危险受试者95 000人,随访660 000人年,共出现3554个严重血管事件)和16个二级预防试验(处于高危险受试者17 000人,随访430000人年,共出现3306个严重血管事件).对比长期使用阿司匹林与安慰剂的作用,统计治疗期间意向治疗分析为首次严重血管事件(心肌梗死、卒中或血管死亡)和严重出血.
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心血管疾病合并失眠诊疗中国专家共识
Recent years have seen a large amount of research indicating a high morbidity and mortality of cardiovascular disease (CVD) combined with insomnia,which leads to increasing attentions in studying the association between insomnia and CVD,such as coronary heart diseases,hypertension,heart failure,psycho-cardiology diseases and so on.Sufficient evidence shows that patients suffering from CVD are much more likely to get involved in insomnia than healthy persons.Furthermore,causing great troubles to patients with CVD,insomnia seriously influences the treatment process and prognosis of CVD.However,there is a lack of pragmatic direction for the diagnosis and treatment of this comorbidity.As a result,a specialized consensus statement offering guidance in diagnosing and treating CVD combined with insomnia,is in exigent need.This consensus,which is made by experienced experts from various relevant professional fields including cardiology,psychiatry,neurology,psychology and so forth,has summarized the recommendations for the concepts,epidemiology,pathophysiology mechanisms,diagnosis,management and the special approaches of traditional Chinese medicine in this comorbid conditions.In conclusion,it' s certain that this consensus will contribute to the practitioners in managing CVD accompanied with insomnia.
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血脂康(胶囊)临床应用中国专家共识(2017修订版)
Xuezhikang, a Chinese traditional medicine, contains natural statin and is effective on dyslipidemia by inhibiting cholesterol synthesis. Xuezhikang therapy for 8 weeks in patients with hyperlipidemia reduced total cholesterol (TC) by 23%, low density lipoprotein cholesterol (LDL-C) by 28.5%and triglyceride(TG) by 36.5% , and increased high density lipoprotein cholesterol (HDL-C) by 19.6% , respectively. Data from China Coronary Secondary Prevention Study (CCSPS) showed that treatment with Xuezhikang lowered the risks of major coronary events, death from coronary heart disease, and all cause death in patients with myocardial infarction, indicating that Xuezhikang can be used in the primary and secondary prevention of cardiovascular disease.
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中国心脏康复与二级预防指南2018精要
Since the publication of China expert consensus on rehabilitation and secondary prevention of coronary heart disease in 2012, cardiac rehabilitation therapy has been developed rapidly in China. In 2015, Committee of Cardiac Rehabilitation and Prevention of Chinese Association of Rehabilitation Medicine published guidelines for rehabilitation/secondary prevention of cardiovascular diseases in China (2015 edition). The present guidelines, Guidelines for Cardiovascular Rehabilitation and Secondary Prevention in China 2018 simplified edition, were revised based on the 2015 edition and with referring to the latest updates in the relevant international guidelines published in 2017 and 2018.
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基质交感分子1与心血管疾病
近年来,高血压、冠心病等心血管疾病的发病率逐年增高,由于其发病机制复杂,病理生理过程仍不完全清楚,目前以离子通道研究心血管疾病的发生较多.新近研究发现基质交感分子(stromal interaction molecule,STIM)1作为钙库操纵性钙通道(store-operated channels, SOC)的感受器,通过调控钙离子内流,影响细胞的增殖、迁移、分化等生物学行为,参与心血管系统疾病的发生发展,有可能成为一个新的潜在的治疗靶点.本文结合国内外研究现状,对STIM1在心血管疾病中的研究进展作一综述.
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循环microRNA与心血管疾病临床诊断
心血管疾病作为人类健康的头号"杀手",其发病率与病死率在世界范围内均居高不下.及时准确地诊断该类疾病能够为医疗干预方案的选择提供指导,进而大程度减少对患者造成的危害.
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Endothelial injury and SMC proliferation and migration are the same common pathophysiological processes of many cardiovascular diseases such as artherosclerosis, hypertension, diabete and restenosis. So it is very important to determine their functional interaction under pathology conditions.