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Recent advances in promising drugs for primary prevention of gastroesophageal variceal bleeding with cirrhotic portal hypertension

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 4-13页

作者： Ji-Yao Sheng Zi-Fan Meng Qiao Li Yong-Sheng Yang Department of Hepatobiliary and Pancreatic Surgery the Second Hospital of Jilin UniversityChangchun 130041China Jilin Engineering Laboratory for Translational Medicine of Hepatobiliary and Pancreatic Diseases the Second Hospital of Jilin UniversityChangchun 130041China

Background:Gastroesophageal variceal bleeding is one of the most severe complications of patients with *** primary prevention drugs,including non-selectiveβ-blockers,have effectively reduced the incidence of bleeding,their efficacy is limited due to side effects and related *** recent advances in precision medicine,precise drug treatment provides better treatment *** sources:Literature search was conducted in PubMed,MEDLINE and Web of Science for relevant articles published up to May *** on clinical trials was obtained from https://***/and http://***/.Results:The in-depth understanding of the pathogenesis and advances of portal hypertension has enabled the discovery of multiple molecular targets for promising *** to the site of action,these drugs could be classified into four classes:intrahepatic,extrahepatic,both intrahepatic and extrahepatic targets and *** these classes of drugs offer advantages over traditional treatments in prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal ***:This review classified and summarized the promising drugs,which prevent gastroesophageal variceal bleeding by targeting specific markers of pathogenesis of portal hypertension,demonstrating the significance of using the precision medicine strategy to discover and develop promising drugs for the primary prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension.

关键词： Cirrhotic portal hypertension Target drug primary prevention Bleeding

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Biological mechanisms and possible primary prevention of depression

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World Journal of Psychiatry 2022年第5期12卷 770-772页

作者： Chih-Yun Kuo Ivo Stachiv Department of Neurology and Centre of Clinical Neuroscience First Faculty of MedicineCharles UniversityPrague 12108Czech Republic Department of Functional Materials Institute of PhysicsCzech Academy of SciencesPraha 18021Czech Republic

Individuals with unipolar depressive disorder(UDD)are having an increased risk of death and development of dementia in later *** is widely expected that in a near future UDD would be the leading cause of death;therefore,a primary inexpensive prevention of UDD will be of a great importance to the *** studies provide evidences supporting the positive effect of Mediterranean diet on a reduced risk for development of depression.

关键词： Unipolar depressive disorder Mediterranean diet Depression primary prevention Dementia

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Chinese expert consensus on primary prevention for pelvic floor dysfunction during pregnancy

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Gynecology and Obstetrics Clinical Medicine 2023年第3期3卷 133-139页

作者： Xiuli Sun Lei Gao Hongmei Zhu Wei Jiao Jianjun Guo Jianliu Wang Lihui Wei Sports Exercise and Health Branch of Chinese Preventive Medicine Association Department of Obstetrics and Gynecology Peking University People's HospitalBeijingChina School of Sports Medicine and Physical Therapy Beijing Sports UniversityBeijingChina Sports and Medicine Integration Innovation Center Capital University of Physical Education and SportsBeijingChina 不详

Objective Pregnancy has been identified as a risk factor for pelvic floor dysfunction(PFD).The aim of this study was to establish primary prevention measures for PFD during pregnancy and reduce the overall incidence of *** We assembled a panel of 36 experts,including gynecologists,obstetricians,and *** surveys and expert meetings,the panel reviewed and assessed the safety and effectiveness of various clinical *** on expert comments from Round 1,a revised list of 8 clinical interventions was developed and submitted for a second round of expert *** A consensus was reached on the importance of implementing prevention measures to protect pelvic floor function during *** particularly emphasized the significance of health education,weight management,pelvic floor muscle training,respiratory training,overall exercise,physical activity,and perineal *** The expert consensus provides comprehensive clinical measures to safeguard pelvic floor function during *** paper represents the initial step toward developing scientific recommendations for pregnant women regarding the primary prevention of *** research should focus on the implementation of these recommendations in clinical practice.

关键词： Pelvic floor muscle training Pelvic floor dysfunction Pregnancy primary prevention Respiratory training Overall training Physical activity

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primary prevention of sudden cardiac death by implantable cardioverter-defibrillator therapy in Chinese patients with heart failure： a single-center experience

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Chinese Medical Journal 2010年第7期123卷 848-851页

作者： CHEN Tai-bo CHENG Kang-an GAO Peng CHENG Zhong-wei FAN Jing-bo JIANG Xiu-chun FANG Quan Department of Cardiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing 100730China

Background An implantable cardioverter-defibrillator （ICD） has been suggested for heart failure patients for primary prevention of sudden cardiac death. However, few data have been reported on the application of ICD as primary prevention of sudden cardiac death in China. We evaluated the value of primary prevention ICD therapy in Chinese patients with heart *** Thirty-four patients at an average age of （60.2±13.7） years seen in Peking Union Medical College Hospital were treated with ICD implantation for primary prevention of sudden cardiac death from November 2005 to July 2009. Single-chamber ICDs were implanted in 16 （47.0%） cases, and dual-chamber or cardiac resynchronization therapy defibrillators in 18 （53.0%） cases. The patients had an average left ventricular ejection fraction of （26.9±5.5）% （11% to 35%）, of which 18 （53.0%） patients had ischemic cardiomyopathy and 16 （47.0%） patients had non-ischemic cardiomyopathy. All patients were followed up at three months after the implantation and every six months thereafter or when prompted by an ICD *** There were five （14.7%） deaths, including two of heart failure and three with a non-cardiac course, during an average follow-up of （15.0±11.9） months. Forty-one ICD therapy events were recorded, including 19 （46.3%） appropriate ICD therapies in six patients and 22 （53.7%） inappropriate ICD therapies in four patients with single chamber leads. Inappropriate ICD therapies were mainly due to supraventricular tachyarrhythmias, especially atrial fibrillation. Patients with ischemic cardiomyopathy and non-ischemic cardiomyopathy did not differ in the incidence of either appropriate or inappropriate *** ICD for primary prevention of sudden cardiac death in China prevents patients from arrhythmia death. Relatively high incidence of inappropriate therapies highlights the importance of an atrial lead.

关键词： implantable cardioverter-defibrillator primary prevention heart failure Chinese

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Plasma big endothelin-1 is an effective predictor for ventricular arrythmias and end-stage events in primary prevention implantable cardioverter-defibrillator indication patients

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Journal of Geriatric Cardiology 2020年第7期17卷 427-433页

作者： Xiao-Yao LI Shuang ZHAO Xiao-Han FAN Ke-Ping CHEN Wei HUA Zhi-Min LIU Xiao-Di XUE Bin ZHOU Shu ZHANG Arrhythmia Center State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Objective To investigate whether plasma big endothelin-1(ET-1) predicts ventricular arrythmias(VAs) and end-stage events in primary prevention implantable cardioverter-defibrillator(ICD) indication patigents. Methods In total, 207 patients fulfilling the inclusion criteria from Fuwai Hospital between January 2013 and December 2015 were retrospectively analyzed. The cohort was divided into three groups according to baseline plasma big ET-1 tertiles: tertile 1( 0.7 pmol/L, n = 70). The primary endpoints were VAs. The secondary endpoints were end-stage events comprising all-cause mortality and heart transplantation. Results During a mean follow-up period of 25.6 ± 13.9 months, 38(18.4%) VAs and 78(37.7%) end-stage events occurred. Big ET-1 was positively correlated with NYHA class(r = 0.165, P = 0.018), serum creatinine concentration(Scr;r = 0.147, P = 0.034), high-sensitivity C-reactive protein(hs-CRP;r = 0.217, P = 0.002), Lg NT-pro BNP(r = 0.463, P primary prevention ICD indication patients, plasma big ET-1 levels can predict VAs and end-stage events and may facilitate ICD-implantation risk stratification.

关键词： Big endothelin-1 End-stage events Implantable cardioverter-defibrillator implantation primary prevention Ventricular arrythmias

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Meta-Analysis of Aspirin for primary prevention of Stroke

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Yangtze Medicine 2022年第2期6卷 41-55页

作者： Panpan Zheng Yanjun Mao Xiaoxia Yan Junrong Ding Yongsheng Ou Shanghai Pulmonary Hospital Affiliated to Tongji University Shanghai China Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine Shanghai China

Objective: This paper aims to evaluate the safety and efficacy of aspirin in primary stroke prevention by meta-analysis. Methods: By searching PubMed, Cochrane Library, Embase, MEDLINE, Web of Science, CNKI, China Biomedical Literature Database, VIP Database and Wanfang Database, we collected randomized controlled trials on aspirin for primary prevention of stroke. The retrieval time limit is from the establishment of the database to December 2021. Two researchers independently conducted literature search, screening, data extraction and quality evaluation, and Meta-analysis was performed using RevMan 5.3. Results: A total of 19 articles were included, including 220,636 subjects. Meta-analysis results show that long-term preventive use of aspirin can reduce the incidence of stroke [RR = 0.91, 95% CI (0.85, 0.98), P = 0.009], and reduce the incidence of ischemic stroke [RR = 0.84, 95% CI] (0.77, 0.91), P RR = 0.80, 95% CI (0.72, 0.88), P RR = 0.85, 95% CI (0.75, 0.97), P RR = 1.23, 95% CI (1.04, 1.46), P = 0.01] and gastrointestinal bleeding [RR = 1.62, 95% CI (1.35, 1.93), P RR = 0.97, 95% CI (0.93, 1.02), P = 0.20]. Conclusion: Long-term prophylactic use of aspirin can reduce the overall incidence of stroke, but there is also a risk of bleeding. The advantages and disadvantages of aspirin should be fully evaluated and strict screening should be carried out before medication, which can minimize adverse reactions and improve the safety and effectiveness of aspirin in the primary prevention of stroke.

关键词： Aspirin Stroke primary prevention Meta-Analysis

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Evidence in primary prevention of Type 2 Diabetes Mellitus—What It Means for primary prevention of Type 2 Diabetes Mellitus Epidemic in Papua New Guinea

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Journal of Diabetes Mellitus 2022年第2期12卷 87-97页

作者： Leslie Bahn Kawa Department of General Internal Medicine Port Moresby General Hospital Port Moresby Papua New Guinea

Type 2 diabetes is in epidemic proportion in Papua New Guinea. Although many people are at high-risk of developing diabetes, there is no diabetes prevention policy and services in Papua New Guinea to address this problem. A literature search was carried out to assess the available evidence in the primary prevention of type 2 diabetes mellitus among the population with pre-diabetes. The result shows that the primary preventative studies conducted on lifestyle modification and the use of metformin in prediabetes patients reduced overt type 2 diabetes mellitus. The application of the evidence in the prevention of the type 2 diabetes epidemic in Papua New Guinea, driven by a policy is feasible to address the diabetes epidemic.

关键词： primary prevention prevention Trials Type 2 Diabetes Mellitus Prediabetes

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Healthy diet,depression and quality of life:A narrative review of biological mechanisms and primary prevention opportunities

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World Journal of Psychiatry 2021年第11期11卷 997-1016页

作者： Octavio Pano Elena H Martínez-Lapiscina Carmen Sayón-Orea Miguel Angel Martinez-Gonzalez Jose Alfredo Martinez Almudena Sanchez-Villegas Preventive Medicine and Public Health University of NavarrePamplona 31008Spain Department of Neurology Center of Neuroimmunology Hospital Clinic of BarcelonaInstitut d’Investigacions Biomèdiques August Pi SunyerBarcelona 08036Spain Department of Preventive Medicine and Public Health University of NavarraPamplona 31008Spain IdiSNA Navarra Institute for Health ResearchPamplona 31008Spain Department of Public Health Navarra Institute of Public Health and EpidemiologyPamplona 31003Spain CIBER Pathophysiology of Obesity and Nutrition Institute of Health Carlos IIIMadrid 28049Spain Department of Nutrition Harvard T.H.Chan School of Public HealthBostonMA 02115United States Department of Food Sciences and Physiology University of NavarrePamplona 31008Spain Precision Nutrition and Cardiometabolic Health Program IMDEA Food InstituteMadrid 28049Spain Department of Clinical Sciences University of Las Palmas Gran CanariaLas Palmas Gran Canaria 35080Spain

Unipolar depressive disorder(UDD)affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted life years lost in *** is imperative for leading economies to implement preventive strategies targeted towards UDD,given consistent policies are currently *** established similarities between the aetiological hypotheses of depression and cardiometabolic diseases are shifting paradigms within this *** is believed that dietary practices could potentially reduce the incidence of depression;similar to their effects on ***,the aim of this review was to compile current evidence on healthy dietary patterns as suitable contributors towards primary prevention strategies against *** of the well-known biological mechanisms behind depression have been positively associated with healthful diets and dietary patterns to varying ***,a common factor of UDD is the production and overall effects of inflammatory cytokines,such as interleukin-6,tumor necrosis factor-α,and Creactive *** compounds have been associated with depressive symptoms,disturbances in neuroendocrine function,leaky gut,monoamine activity and brain function,while also being key factors in the development of cardiometabolic *** Mediterranean diet(MD)in particular,is well supported by first-level evidence regarding its preventive qualities against metabolic and cardiovascular diseases and thus considered a model for healthy eating by various *** one of the few clinical trials investigating these associations,the PREDIMED trial,individuals with diabetes assigned to a MD supplemented with mixed tree nuts experienced a 41%relative risk reduction for developing ***,there is a need to include health related quality of life as an indicator of physical and mental well-being,considering its putative associations

关键词： Depression Nutrition Mediterranean Quality of life primary prevention Epidemiology

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Chinese Guideline on the primary prevention of Cardiovascular Diseases

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Cardiology Discovery 2021年第2期1卷 70-104页

作者： Chinese Society of Cardiology of Chinese Medical Association Cardiovascular Disease prevention and Rehabilitation Committee of Chinese Association of Rehabilitation Medicine Cardiovascular Disease Committee of Chinese Association of Gerontology and Geriatrics Thrombosis prevention and Treatment Committee of Chinese Medical Doctor Association Dayi Hu Yaling Han Guang Ning Changsheng Ma 不详 Peking University People’s Hospital General Hospital of Northern Theater Command Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine Beijing Anzhen Hospital Capital Medical University

Cardiovascular disease is the leading cause of mortality in *** prevention of cardiovascular disease with a focus on lifestyle intervention and risk factor control has been shown to effectively delay or prevent the occurrence of cardiovascular *** promote a healthy lifestyle and enhance the detection,diagnosis,and treatment of cardiovascular risk factors such as hypertension,dyslipidemia,and diabetes,and to improve the overall capacity of primary prevention of cardiovascular disease,the Chinese Society of Cardiology of Chinese Medical Association has collaborated with multiple societies to summarize and evaluate the latest evidence with reference to relevant guidelines and subsequently to develop recommendations for primary cardiovascular disease prevention in Chinese *** guideline consists of 10 sections:introduction,methodology for developing the guideline,epidemiology of cardiovascular disease in China and challenges in primary prevention,general recommendations for primary prevention,assessment of cardiovascular risk,lifestyle intervention,blood pressure control,lipid management,management of type 2 diabetes,and use of *** promulgation and implementation of this guideline will play a key role in promoting the practice of primary prevention for cardiovascular disease in China.

关键词： Cardiovascular disease primary prevention Guideline

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A Critical Evaluation of the Role of Routine Uses of Statin as a Tool for primary prevention of Cardiovascular Diseases

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Open Journal of Preventive Medicine 2016年第4期6卷 133-142页

作者： Irtiza Hasan Tasnuva Rashid Md. Harun Ur Rashid Bhuiyan Cardiology Canterbury Christ Church University Kent UK Internal Medicine The University of Edinburgh Edinburgh UK Department of Epidemiology School of Public Health The University of Texas HSC Houston TX USA Clinical & Interventional Cardiology Z. H. Sikder Cardiac Care & Research Centre Dhaka Bangladesh

Use of Statin is a cornerstone in modern day medical practice and an essential component for primary prevention of cardiovascular diseases (CVD). Various evidences exemplify and resonate the importance of Statins in reducing CVD mortality and improvement of survivability. However, there is a continental variation in recent guidelines directing lipid-lowering therapy in regards to aim, dose, timing as well as the protocol for initiation of therapy. Similar uncertainties exist with regards to the generalizability of the finding from available evidence, a variation of benefits of Statin with respect to age and gender, the validity of the research conducted and actual gain in survivability and mortality benefits. Thus, there is a need for looking at the actual indications, risk-benefit ratios and cost effectiveness before tediously prescribing Statin for the primary prevention of CVDs. This paper will attempt to critically review the evidence behind the uses of Statins in the primary prevention of CVDs.

关键词： Statin Cholesterol Cardiovascular Diseases primary prevention

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