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Oral anti-coagulants use in Chinese hospitalized patients with atrial fibrillation

Chinese Medical Journal 2024年第2期137卷 172-180页

作者： Jing Lin Deyong Long Chenxi Jiang Caihua Sang Ribo Tang Songnan Li Wei Wang Xueyuan Guo Man Ning Zhaoqing Sun Na Yang Yongchen Hao Jun Liu Jing Liu Xin Du Louise Morgan Gregg C.Fonarow Sidney C.Smith Jr Gregory Y.H.Lip Dong Zhao Jianzeng Dong Changsheng Ma On behalf of CCC-AF investigators Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China National Clinical Research Center for Cardiovascular Diseases Beijing 100029 China Department of Epidemiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vessel DiseasesBeijing 100029China International Quality Improvement Department American Heart AssociationDallasTX 07076USA Division of Cardiology Geffen School of Medicine at University of CaliforniaLos Angeles CA 90024USA Division of Cardiology University of North CarolinaChapel HillNC 27599USA Department of Cardiology Liverpool Centre for Cardiovascular ScienceUniversity of Liverpool and Liverpool Heart&Chest HospitalLiverpool L143PEUK Department of Clinical Medicine Aalborg UniversityAalborg 9000Denmark 不详

Background:Oral anti-coagulants(OAC)are the intervention for the prevention of stroke,which consistently improve clinical outcomes and survival among patients with atrial fibrillation(AF).The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in China.Methods:Using data from the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation(CCC-AF)registry,guideline-recommended OAC use in eligible patients was assessed.Results:A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019,of whom 38,203 were at a high risk of stroke,9717 were at a moderate risk,and 4610 were at a low risk.On admission,only 20.0%(6075/30,420)of patients with a diagnosed AF and a high risk of stroke were taking OAC.The use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population(adjusted odds ratio:0.54,95%confidence interval:0.43-0.68;P70%of AF patients were at a high risk of stroke.Although poor performance on guideline-recommended OAC use was found in this study,over time the CCC-AF project has made progress in stroke prevention in the Chinese AF population.Registration:ClinicalTrials.gov,NCT02309398.

关键词： Atrial fibrillation Oral anti-coagulants OAC Stroke prevention contraindication

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Phytopharmacological Review on Vitex agnus‐castus: A Potential Medicinal Plant

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Chinese Herbal Medicines 2016年第1期8卷 24-29页

作者： hina zahid ghazala h.rizwani sumaira ishaqe Department of Pharmacognosy Faculty of Pharmacy University of Karachi University Road Karachi-75270 Pakistan

Vitex agnus-castus is a small tree or shrub, belonging to the family Verbenaceae. It is a deciduous shrub native to European, Mediterranean, and Central Asian countries. V. agnus castus has a long tradition as a herbal remedy and was used in ancient times not only as an anaphrodisiac but also against diverse disturbances of the female genital system. The major constituents in V. agnus-castus are flavonoids, essential oils, diterpenes, and glycosides. The flavonoids （casticin, quercetagetin, and isovitexin） have been shown in vitro to affect estrogen receptors. V. agnus-castus could be used to treat acne, digestive complaints, menstrual irregularities, premen- strual syndrome （PMS）, mastalgia, and infertility, and also for lactation support. Although V. agnus-castus has been used for centuries and enjoys wide support from practitioners and the general public for many gynecological complaints, few clinical studies support its documented uses. The presence of phytochemical and pharmacological activities has proved that the plant has a leading capacity for the development of new good efficacy drug in future.

关键词： clinical pharmacology contraindication Vitex agnus-castus

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Colonoscopy a Real Diagnostic Paragon

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Surgical Science 2017年第6期8卷 256-268页

作者： A. Z. Kaleem N. Naheed S. M. Ahmad Scunthorpe General Hospital North Lincolnshire & Goole NHS Foundation Trust Scunthorpe UK

Diagnostic colonoscopy acquires the status of gold standard investigation for evaluation of colonic problems. Formally, colonoscopy was first initiated in June 1969 in America. Colonoscopic history can be traced back to 1958. Matsunaga from Japan was the pioneer as he used a gastrocamera which was the start of colonoscopic era. Flexible sigmoidoscopy was later introduced in 1963. Existing colonic perforation and refusal of a fully compos mentis patient, remain absolute contraindications to diagnostic colonoscopy. Bowel Perforation, although less common, is a disastrous complication of colonoscopy. It is a basic right of any patient who has been offered a colonoscopic procedure to have appropriate, clear and concise information about colonoscopy. Consent literally means permission or an agreement which is granted by a patient to a health care individual to receive examination, test, treatment or intervention. Colonoscopic consent process should be valid and has voluntary, fully informed and capacity aspects as its integral components. There were a lot of oppositions against colonoscopy at that time. It was believed to be dangerous and unnecessary exercise by many surgeons. Time has proved that to be a wrong perception. It is now believed to be an extremely useful diagnostic modality. It is safe procedure in experienced hands and provides valuable clinical information. Colonoscopy is not a pleasant investigation as it is usually related with pain and discomfort by patients;fortunately, good analgesia and safe conscious sedation make this hostile but worthwhile procedure tolerable to patients.Today colonoscopy has kept its status of the gold standard investigation in diagnosing bowel cancer and has prime role in the assessment of majority of large bowel symptoms. Colonoscopy also retains the status of being an investigation with highest sensitivity and specificity, out of all available diagnostic modalities, for identifying adenomatous polyps and now it has acquired a unique status of being a diagnostic paragon.

关键词： Diagnostic Colonoscopy Indication contraindication Complications Colorectal cancer Consent Communication

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Colonoscopy a True Therapeutic Icon

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Surgical Science 2017年第7期8卷 287-298页

作者： Ahmed. Z. Kaleem Nabish Naheed Syed M. Ahmad Colorectal Department Northern Lincolnshire and Goole NHS Foundation Trust Scunthorpe UK

Colonic polypectomy remained the first colonoscopic therapeutic intervention which was successfully accomplished with the help of an early snare. This therapeutic procedure was executed by Dehyle in Europe and Shinya in USA in 1971 [1]. Thus, these two colonoscopists acquired the pioneer’s position of therapeutic colonoscopy. Now the colonoscopy has achieved a special status in treating colorectal diseases because of its unique therapeutic aspect. The common uses of therapeutic colonoscopy are broadly classified in to the four major categories because of its unique therapeutic properties. These uses include resection and ablation, hemostasis, decompression with or without recanalization and foreign body extraction. Colonic perforation remained an absolute contraindication to therapeutic colonoscopy which is analogous to diagnostic colonoscopy. Good Communication plays a vital role in accomplishment of successful therapy with the help of colonoscopy. Consent process remained a complex process which should be well organized and tailored as per patient’s needs. There are lot of advancements in colonoscopy in recent years and many new procedures and treatment modalities have become available to treat colorectal diseases with the help of colonoscope. The recent advancement in colonoscopy has led to having many novel techniques. This therapeutic colonoscopy has made a significant change in current colorectal cancer management as polyps can be treated in the early stage, thus reducing the incidence of colorectal cancer. This is the basis of the United Kingdom existing bowel screening program, which is only feasible because of colonoscopy-induced interventions. The successful uses of these techniques obviate the need for a major surgical operation and colorectal disease can be treated with minimally invasive colonoscopic methods. These attributes make colonoscopy a true therapeutic icon.

关键词： Therapeutic Colonoscopy Indication contraindication Complications Colorectal Cancer Diverticular Disease Consent Communication

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Obesity Management-Bariatric Surgery vs Lifestyle Modification

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Open Journal of Endocrine and Metabolic Diseases 2013年第1期3卷 69-74页

作者： Poondy G. R. Raman Subodh Banzal MGM Medical College Indore India Shri Aurobindo Institute of Medical Sciences Indore India

Role of Bariatric surgery for obesity is briefly outlined. Selection criteria, contraindications, evaluations of patients before surgery, types of bariatric surgery with their merits and demerits are discussed. Result... 详细信息

关键词： Types of Bariatric Surgery Selection Criteria contraindication Merits and Demerits Lifestyle Modification

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Try Analyzing the Usage of Monkshood in Gynecology

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海外英语 2012年第1X期 284-285页

作者：戴曦成都中医药大学四川成都6210000

This paper centers on the usage of monkshood in gynecology and tries to analyze why monkshood is rarely mentioned in nowa days' teaching

关键词： monkshood gynecology usage contraindication

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