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Factors Influencing the Emergency Medical Service Response Time for cardiovascular Disease in Guangzhou, China

Current Medical Science 2019年第3期39卷 463-471页

作者： Xiao-qian CHEN Zi-feng LIU Shi-kun ZHONG Xing-tang NIU Yi-xiang HUANG Ling-ling ZHANG department of Health Policy and Management School of Public Health Sun Yat-sen University Guangzhou 510080China department of Medicine Guanghua School of Stomotology Hospital of Stomatology Sun Yat-sen University Guangzhou 510080 China department of Network Management Guangzhou City Emergency Care Centre Guangzhou 510080 China department of Plastic surgery the First Affiliated Hospital Sun Yat-sen University Guangzhou 510080China department of Nursing College of Nursing and Health Sciences University of Massachusetts Boston Boston 02125-3393 USA

While emergency medical service (EMS) response time (ERT) is a major factor associated with the survival of patients with cardiovascular disease (CVD), relatively few studies have explored the factors associated with ERT. This study aimed to assess the current status of ERT and to identify the factors affecting ERT in patients with CVD in China. Between January 1, 2011 and December 31, 2015, EMS responses to CVD incidents in Guangzhou, China, were examined. The primary outcome was ERT, defined as the time from receipt of an emergency call to the arrival of paramedics on the scene. Factors associated with ERT were evaluated by multivariable logistic regression. A total of 44 383 CVD incidents were analysed. The median ERT was 12.58 min (interquartile range=9.98-15.67). Among the risk factors, distance (OR=13.73, 95% CI=11.76- 16.04), level of hospital (OR=1.57, 95% CI=1.40-1.75), and site of the incident (OR=1.53, 95% CI=1.38-1.69) were the top three significant factors affecting the ERT. Our results suggest that greater attention should be given to factors affecting the ERT. It is essential to make continuous efforts to promote the development of effective interventions to reduce the response time.

关键词： emergency medical service cardiovascular disease response time factors China

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Changes of serum beta-endorphin by programmed exercise training are correlated with improvement of clinical symptoms and quality of life in female mitral valve prolapse syndrome

Changes of serum beta-endorphin by programmed exercise train...

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第六届海峡两岸心血管科学研讨会

作者： Paul Chan Division of cardiovascular Medicine Department of MedicineTaipei Medical University-Wan Fang HospitalTaipei CityTaiwan

＜正＞Background:Mitral valve prolapse （MVP） is a common entity in female *** this is a minor disease,it may cause annoying symptoms that impair quality of life （QOL）,and no established therapy for this *** aim of this study isto examine whether programmed exercise training by treadmill in female MVP syn- drome would improve clinical symptoms and ***:An interventional study of 39 females with MVP syn-

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DIETARY PATTERNS IN 10 GROUPS AND THE RELATIONSHIP WITH BLOOD PRESSURE

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中华医学杂志(英文版) 1989年第4期102卷 261-261页

作者： Zhou Bei-fang Wu Xi-gui Tao Shou-qi Yang Jun Cao Tian-xiu Zheng Run-ping Tian Xiu-zhen Lu Chang-qing Miao Huai-yi Ye Feng-ming Zhu Li-guang Zhu Cun Jiang Jie-ping He Hou-qi Ma Fu Du Fu-chang Wan Bin department of Epidemiology Cardiovascular Institute CHinese Academy of Medica Sciences cardiovascular Institute of Capital Iron and Steel Complex department of Biostatistics Institute of Basic Medicine Chinese Academy of Medical Sciences Institute of cardiovascular Diseases Shijingshan Disctrict Beijing Yu County hospital Shanxi cardiovascular Institute Hanzhong Shaanxi Guangxi Medical College Zhoushan city Bureau of Health Zhejiang Qian-an Mine hospital Harbin University of Medical Sciences Harbin Pingfang District hospital First hospital Nanjing Medical College Jintan County Health Station Jiangsu

An epidemiological comparative study on dietary patterns and poWlation means of blood pressure was undertaken in 10 groups (3 of workers, 6 of farmers, 1 of fishermen) of adult males and females of northeast, north, south, middle and east China. Standardized methods and record forms were used for blood pressure measurements and 24-hr dietary recall interviews. Simple correlation and linear regression, multiple regression (adjusted for age, sex and body mass index) and ridge regression were used to analyze the relationship of dietary electrolytes and animal protein to blood pressure. The results show a significant negative association of mean daily intake of Ca and animal protein with population mean blood pressure. Excluding the fishermen’s group, mean daily intake of Na showed significant positive association with both systolic and diastolic blood pressure. The Chinese diet should probably be improved, increasing Ca and animal protein and cutting salt to a much lower level.

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Prognostic significance of red blood cell distribution width in gastrointestinal disorders

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World Journal of Gastroenterology 2017年第27期23卷 4879-4891页

作者： Hemant Goyal Giuseppe Lippi Altin Gjymishka Bijo John Rajiv Chhabra Elizabeth May department of Internal Medicine Mercer University School of Medicine Section of Clinical Biochemistry University of Verona Texas Digestive Disease Consultants department of Gastroenterology Saint Luke’s HospitalSchool of MedicineUniversity of Missouri Kansas City Gastroenterology Attending Mc Laren Northern Hospital

The red blood cell distribution width(RDW) is a routinely measured and automatically reported blood parameter,which reflects the degree of anisocytosis. Recently,the baseline RDW was found to have clinical significance for assessing clinical outcome and severity of various pathological conditions including cardiovascular diseases,sepsis,cancers,leukemia,renal dysfunction and respiratory diseases. A myriad of factors,most of which ill-defined,have an impact on the red cell population dynamics(i.e.,production,maturation and turnover). A delay in the red blood cell clearance in pathological conditions represents one of the leading determinants of increased anisocytosis. Further study of RDW may reveal new insight into inflammation mechanisms. In this review,we specifically discuss the current literature about the association of RDW in various disease conditions involving the gastrointestinal and hepatobiliary systems. We also present some of the related measurements for their value in predicting clinical outcomes in such conditions. According to our data,RDW was found to be a valuable prognostic index in gastrointestinal disorders along with additional inflammatory biomarkers(i.e.,C reactive protein,erythrocyte sedimentation rate,and platelet count) and current disease severity indices used in clinical practice.

关键词：红血房间分发宽度肝炎胰腺炎煽动性的肠疾病 Crohns 疾病 Ulcerative 大肠炎结肠癌 Hepatocellular 癌尖锐 mesenteric 局部缺血胃肠的疾病

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精神卫生服务中保护性约束的概念分析（英文）

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International Journal of Nursing Sciences 2019年第3期 343-348页

作者：叶君荣王琛肖爱祥夏志春于林林建葵廖尧徐禹张云磊 Nursing Administration department Affiliated Brain Hospital of Guangzhou Medical University Early Intervention department Affiliated Brain Hospital of Guangzhou Medical University Traditional Chinese Medicine department Affiliated Brain Hospital of Guangzhou Medical University cardiovascular surgery department Jingzhou Central Hospital Intensive Care Unit department West China Hospital of Sichuan University

目的保护性约束在精神科病房、重症监护室、疗养中心等卫生服务机构的使用较频繁,但其在各专科领域有不同的概念特征。为明确保护性约束在精神卫生服务中使用的定义,本文通过文献回顾阐述其概念特征。方法通过检索Pubmed、Psycinfo和C... 详细信息

目的保护性约束在精神科病房、重症监护室、疗养中心等卫生服务机构的使用较频繁,但其在各专科领域有不同的概念特征。为明确保护性约束在精神卫生服务中使用的定义,本文通过文献回顾阐述其概念特征。方法通过检索Pubmed、Psycinfo和CINAHL数据库,运用Walker and Avant概念分析模型,剖析应用于精神卫生服务中的保护性约束的概念特征。结果保护性约束指在无替代措施前提下,由专业人员实施、通过限制患者躯体活动保护患者及医务人员安全的强制措施。保护性约束的使用前提为:患者存在风险行为、充分的医疗评估和健全的实施制度。保护性约束的使用结局为:冲突得到控制,减轻对医/患的躯体伤害、对医/患的心理伤害,以及减少对医疗机构的影响。结论本文通过对应用于精神卫生服务中的保护性约束进行定义,补充了保护性约束相关理论研究,为将来相关的研究提供理论支撑。

关键词：概念分析精神卫生服务保护性约束质性研究 Walker and Avant模型

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Chaihu-Shugan-San exerts an antidepressive effect by downregulating miR-124 and releasing inhibition of the MAPK14 and Gria3 signaling pathways

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Neural Regeneration Research 2018年第5期13卷 837-845页

作者： Qiong Liu Ning-Ning Sun Zheng-Zhi Wu Da-Hua Fan Mei-Qun Cao department of cardiovascular Medicine Xiang Ya Hospital of Central South University Changsha Hunan Province China Shenzhen Institute of Geriatrics Shenzhen Second People's Hospital The First Affiliated Hospital of Shenzhen University Shenzhen Guangdong Province China The Eighth Affiliated hospital of Sun Yat-sen University Shenzhen Guangdong Province China Chinese and Wsetern Integrative Medicine Shcool of Medicine Jinan University Guangzhou Guangdong Province China.

Dysregulation of mi R-124 has been reported to be involved in the pathophysiology of depression. Chaihu-Shugan-San, a traditional Chinese medicine, has antidepressive activity; however, the underlying mechanisms remain unclear. In this study, to generate a rodent model of depression, rats were subjected to a combination of solitary confinement and chronic unpredictable mild stress for 28 days. Rats were intragastrically administered Chaihu-Shugan-San（2.835 m L/kg/d） for 4 weeks, once a day. Real-time reverse-transcription quantitative polymerase chain reaction, mi RNA microarray, western blot assay and transmission electron microscopy demonstrated that ChaihuShugan-San downregulated mi R-124 expression and upregulated the m RNA and protein levels of mitogen-activated protein kinase 14（MAPK14） and glutamate receptor subunit 3（Gria3）. Chaihu-Shugan-San also promoted synapse formation in the hippocampus. The open field test, sucrose consumption test and forced swimming test were used to assess depression-like behavior. After intragastric administration of Chaihu-Shugan-San, sucrose consumption increased, while the depressive behaviors were substantially reduced. Together, these findings suggest that Chaihu-Shugan-San exerts an antidepressant-like effect by downregulating mi R-124 expression and by releasing the inhibition of the MAPK14 and Gria3 signaling pathways.

关键词： nerve regeneration traditional Chinese medicine Chaihu-Shugan-San depression open-field test sucrose consumption test forced swimming test miR-124 neural plasticity MAPK14 Gria3 neural regeneration

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Simple hematological predictors of AF recurrence in patients undergoing atrial fibrillation ablation

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Journal of Geriatric Cardiology 2019年第9期16卷 671-675页

作者： George Bazoukis Konstantinos P Letsas Konstantinos Vlachos Athanasios Saplaouras Dimitrios Asvestas Konstantinos Tyrovolas Aikaterini Rokiza Eirini Pagkalidou Gary Tse Stavros Stavrakis Antonios Sideris Michael Efremidis department of Cardiology Electrophysiology Laboratory Evangelismos General Hospital of Athens Athens Greece department of Hygiene and Epidemiology School of Medicine Aristotle University of Thessaloniki Thessaloniki Greece department of Medicine and Therapeutics Faculty of Medicine Chinese University of Hong Kong Hong Kong China Li Ka Shing Institute of Health Sciences Faculty of Medicine Chinese University of Hong Kong Hong Kong SAR China department of Medicine Cardiovascular Section Heart Rhythm Institute University of Oklahoma Health Sciences Center Oklahoma City Oklahoma USA

Backgound Red cell distribution width(RDW) and neutrophil-to-lymphocyte ratio(NLR) are simple hematologic indices that have been used to predict adverse outcomes in different clinical settings. The aim of our study is to determine whether RDW and NLR can predict atrial fibrillation(AF) recurrence in patients undergoing AF ablation. Methods Consecutive patients, without known hematological disorders, who underwent AF catheter ablation between January 2014 and April 2017 were enrolled into this study. Blood samples were taken one day before and five hours after the ablation procedure. Results A total of 346 patients(224 males(65%), mean age: 59 ± 11 years old) were included. After a mean follow up of 26.2 ± 12.1 months, 80(23.1%) patients experienced late AF recurrence(defined as any recurrence after the blanking period of three months), while 97(28%) patients experienced early AF recurrence during the blanking period. Univariate analysis showed that early arrhythmia recurrence, type of AF and NLR after the procedure were significantly associated with late AF recurrence, while early arrhythmia recurrence and NLR remained significant in multivariate analysis. RDW was not associated with late AF recurrence. None of the parameters above predicted early arrhythmia recurrence. Conclusions Simple and inexpensive hematological indices such as NLR should be evaluated for their ability to predict AF recurrence in patients undergoing catheter ablation in larger prospective studies.

关键词： Atrial fibrillation Neutrophils Radiofrequency ablation

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Management of Pulmonary Hydatid Disease: Review of 66 Cases from Iraq

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Case Reports in Clinical Medicine 2015年第3期4卷 77-84页

作者： Nazar B. Elhassani Abdulsalam Y. Taha Iraqi Board of Medical Specializations and Scientific Council of Thoracic and cardiovascular surgery Baghdad Iraq department of Cardiothoracic and Vascular surgery School of Medicine Faculty of Medical Sciences University of Sulaimaniyah and Sulaimaniyah Teaching Hospital Sulaimaniyah Iraq

Background: Hydatid disease is a serious health hazard and a major problem to the community in Iraq. The disease is still endemic as witnessed in everyday surgical practice. The aim of this prospective study was to review the management of pulmonary hydatid disease (PHD) in two major thoracic surgical centers (Ibn-Alnafis and Medical city Teaching hospitals), Baghdad, Iraq over one year period. Materials and Methods: Sixty six patients (38 females and 28 males) with PHD admitted and treated surgically in the departments of Thoracic surgery in the aforementioned hospitals were studied. Demographic and clinical features were obtained by direct patients’ interviews and thorough physical examination. The diagnosis in the vast majority of patients was based on plain chest radiography while few had bronchoscopy. All patients had posterolateral thoracotomy for removal of pulmonary hydatid cysts (PHC). The clinical and radiographic findings as well as operative procedures and postoperative complications were reviewed. Results: The age ranged from two and a half years to 60 years with a mean of 22.3. Sixty percent of patients were in second and third decades. Most patients (n = 51, 77%) lived in rural areas. Housewives and students predominated. A positive family history was obtained in 5. Cough, chest pain, dyspnoea and haemoptysis were the main symptoms whereas 15 were acutely ill. Three patients presented with pathognomonic expectoration of laminated membrane and 2 had intra-pleural cyst rupture. The total number of cysts was 99 (61 intact, 50 solitary, and 55 unilateral). The right lung was more frequently involved (n = 64) and right lower lobe was on the top. Cyst size ranged from 3 to 25 cm with a mean of 8.5. The main radiographic appearance was the “full moon against dark sky” visible in 61.6%. Abdominal ultrasound was carried out in 40 patients who revealed 12 hepatic and one splenic HCs. Lung preserving surgery was done in 76 cysts (91.5%) while lobectomy was neces

关键词： Pulmonary Hydatid Disease Cyst Echinococcosis Iraq

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Quality assurance for cardiovascular catheterization and intervention

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Chinese Medical Journal 2014年第6期127卷 1191-1193页

作者： Faisal Latif Thach Nguyen Aravinda Nanjundappa Bonnie H.Weiner department of Medicine Cardiovascular Section VA Medical Center and University of Oklahoma Health Sciences Center Oklahoma CityOklahoma USA Indiana University School of Medicine Community Healthcare System St Mary Medical Center Hobart Indiana USA West Virginia University Charleston West Virginia USA St.Vincent hospital at WorcesterMedical Center HarvardMassachusetts USA

Challenges There are more than 2 000 cardiac catheterizationlaboratories(CCL)in the *** could be a full serviceCCL or they only perform emergency primary coronaryinterventions(PCI).They could also perform elective PCI

关键词： quality assurance cardiovascular catheterization standard of excellence accreditation

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Secondary Prevention Following Coronary Artery Bypass surgery: A Pilot Study for Improved Patient Education

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International Journal of Clinical Medicine 2012年第4期3卷 286-294页

作者： Jeffrey B. Kramer Patricia A. Howard Brian J. Barnes Bashar Ababneh Purna Mukhopadhyay Mazda Biria Gregory F. Muehlebach Emmanuel Daon George L. Zorn William A. Reed James L. Vacek cardiovascular Division Department of Internal Medicine School of Medicine The University of Kansas Medical Center Kansas City Kansas cardiovascular Division Department of Internal Medicine School of Medicine.The University of Kansas Medical Center Kansas City Kansas department of Biostatistics School of Medicinel The University of Kansas Medical Center Kansas City Kansas department of Pharmacy Practice School of Pharmacy The University of Kansas Medical Center Kansas City Kansas Mid-America Thoracic and cardiovascular Surgeons The University of Kansas Medical Center Kansas City Kansas Mid-America Thoracic and cardiovascular Surgeons The University of Kansas Medical Center Kansas City Kansas.

Background: Sustained positive outcomes after coronary artery bypass grafting (CABG) requires risk factor modification and secondary prevention medications. Much attention has been focused on planning at hospital discharge;however longer-term patient compliance is not well described. Hypothesis: A follow-up multidisciplinary educational program improves disease understanding, motivation to reduce cardiovascular risk, and secondary prevention medication prescribing following hospital discharge. Methods: Using a prospective, randomized, controlled design, patients undergoing CABG completed surveys over a year period, assessing disease understanding and motivation. Four to six weeks after CABG, intervention subjects completed a one-time educational program with a multidisciplinary team. The primary endpoint was a composite score of reduced risk factors, medication use, and awareness of prescribed medications. Secondary endpoints evaluated survey scores and medication use rates. Wilcoxon Rank Sum and Chi Square tests compared data between specific time points. Generalized estimating equations and linear contrasts of the parameter estimates compared data at the three time points. Results: The final analysis included 98 subjects (Intervention = 49, Control = 49). The composite score was not different between groups (I = 12.8 ± 4.5 points, C = 12.7 ± 4.9 points, p = 0.9405). Improvements were noted in understanding and motivation in the entire cohort, but these changes were not influenced by the intervention. Medication prescribing declined at 3 and 12 months after CABG without significant differences between the groups. Conclusions: Disease understanding, motivation to reduce risk, and medication use are robust at hospital discharge but the latter declines with time and was not improved by our intervention. These findings are concerning and warrant further study.

关键词： Secondary Prevention Coronary Artery Disease Coronary Artery Bypass

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