Physical activity for people with cardiovascular disease: recommendations of the National Heart Foundation of Australia

To provide physical activity recommendations for people with cardiovascular disease, an Expert Working Group of the National Heart Foundation of Australia in late 2004 reviewed the evidence since the US Surgeon General's Report: physical activity and health in 1996. The Expert Working Group recommends that: people with established clinically stable cardiovascular disease should aim, over time, to achieve 30 minutes or more of moderate intensity physical activity on most, if not all, days of the week; less intense and even shorter bouts of activity with more rest periods may suffice for those with advanced cardiovascular disease; and regular low-to-moderate level resistance activity, initially under the supervision of an exercise professional, is encouraged. Benefits from regular moderate physical activity for people with cardiovascular disease include augmented physiological functioning, lessening of cardiovascular symptoms, enhanced quality of life, improved coronary risk profile, superior muscle fitness and, for survivors of acute myocardial infarction, lower mortality. The greatest potential for benefit is in those people who were least active before beginning regular physical activity, and this benefit may be achieved even at relatively low levels of physical activity. Medical practitioners should routinely provide brief, appropriate advice on physical activity to people with well-compensated, clinically stable cardiovascular disease.     

临床电子医嘱CPOE对医疗质量的影响与投资效益研究

患者药物不良反心（ADEs）对医院医疗质量有重要影响,绝大部分ADEs事件都能通过信息系统进行预防,由于资金投入以及一作流氍的改变,临床电子陕嘱（CPOE）应用遇到了许多困难。上海交通大学附属第六人民医院通过将CPOE与临床决策支持结合,显著降低了医疗差错．通过减少不必要的临床环节节省了大景医疗成本,并且约26个月就可以完全收回系统的投资成本。CPOE应用为医院电了病历应用水平提升提供了重要契机,也为循证医疗提供了重要的信息化发展基础。     

Non-valvular atrial fibrillation and stroke prevention. National Blood Pressure Advisory Committee of the National Heart Foundation

Atrial fibrillation (AF) affects 5% of people older than 65 years. Among patients with AF, the risk of stroke averages about 5% per year. The risk of stroke increases cumulatively with increasing age, previous transient ischaemic attack or stroke, hypertension, diabetes, impaired left ventricular function and a large left atrium. Management aims to identify and treat the underlying cause, control the ventricular rate, restore and maintain sinus rhythm, and minimise the risk of stroke. Warfarin reduces the risk of stroke by about two-thirds, and aspirin by about one-fifth. The risk of anticoagulant-associated haemorrhage increases with serious concomitant disease, and with poorly controlled hypertension and poorly controlled anticoagulation. All patients with chronic AF should be considered for oral anticoagulant therapy, and the decision based on the balance between the risks of thromboembolism and bleeding. The recommended INR (international normalised ratio) is 2.0-3.0. Treating 1,000 "average" AF patients (ie, those with a 5% per year risk of stroke) with warfarin prevents about 30 strokes and causes at least two episodes of major haemorrhage each year. Treating 1,000     

热应激对心血管系统的影响

在热环境下,过度的热应激会对心血管系统造成一定的影响.但是,适度的预热应激处理可以使机体产生热休克蛋白,从而对心血管系统产生一定的影响.本文就热应激对心血管系统产生的影响,作一概述.     

抗精神病药物诱导性心血管疾病方面的研究进展

精神分裂症是一种复杂的多维度障碍,在药物治疗过程中产生的药物诱导性心血管疾病是导致死亡的最主要原因之一,抗精神病药物对诱导心血管疾病发病的不同风险因素具有促进作用,因此患者发生代谢综合征和心血管疾病的风险很高,另外患者很少能够得到最优化的心血管疾病治疗。某些抗精神病药物尤其是氯氮平和奥氮平,经常导致体重增加,血脂异常和糖尿病等。所以精神分裂症、抗精神病药物和心血管疾病的联系需要做进一步的研究,需要更好的治疗方案,降低患者的心血管疾病的发生率和死亡率。     

基因芯片技术在心血管研究中的应用

心血管系统生理功能和病理改变的分子机制十分复杂,不仅由于该系统多样的组织细胞构成,如心肌细胞、成纤维细胞、血管平滑肌细胞、内皮细胞、神经细胞等,更由于其广泛的信号分子共存,如α、β肾上腺素受体、血管紧张素受体、乙酰胆碱受体等交互作用所影响的各种信号分子,同时也涉及包括血流切变应力在内的各种理化刺激.     

葛根素对心血管作用的研究

目前,葛根素已广泛用于治疗心绞痛、心肌梗死、心律失常等疾病,由于疗效可靠、药源丰富、价格低廉、副作用少等优点得到了临床认可,现就有关葛根素对心血管作用的研究进展作一综述.     

心血管功能诊断仪的研制

目的：通过测量人体的脉搏波，准确获取心血管系统的有关参数。方法：引入修正的Frank弹性腔分室网络理论，得到有关血流动力流变学参数之间的相互关系。采用应变片式压力传感器无创检测脉搏波的不同信息变化，经过放大装置、数据采集分析系统，全方位、多功能地显示各种脉图，从而获到心血管系统的有关参数。结果：系统通过对20例不同年龄层病人进行有创与无创检测对比试验，经分析处理得出与心血管有关的39项参数的测量误差均不大于 1%。结论：该系统实现了有关心血管参数的定性和定量分析，为无创伤检测心血管疾病提供了一种新的手段，为中医诊脉的科学化、客观化提供了一个有力的工具。     

超声生物显微镜在心血管疾病研究中的应用进展

超声生物显微镜(ultrasound biomicroscopy,UBM)作为近年新兴的活体成像技术,已成功用于观察各种小动物模型及人类浅表组织.在心血管疾病研究领域,该技术显现出独特优势,如非侵入性、观察连续性、高分辨率、实时性、价格优势等,使充分利用模型动物进行实时连续心血管形态功能分析成为可能.本文对UBM的特点...     

有氧运动干预对心血管神经症的影响

目的探讨有氧运动干预对心血管神经症(CN)的影响。方法将60例CN患者随机分为二组,即药物治疗组和运动治疗组各30例。药物治疗组给予谷维素和倍他乐克治疗,运动组在药物治疗基础上加用运动治疗,疗程3个月。两组治疗前均进行运动平板心电图检查,运动组根据测试结果的最大运动量的70% ~80%制定运动量进行有氧运动。两组治疗前后采用症状自评量表(SCL 90)进行评分。结果1.CN患者运动能力与正常人比较无统计学意义(最大心率161±10. 1vs160. 9±10. 7,最大代谢当量10. 4±2. 1vs10. 0±1. 7,P均>0. 05); 2.干预后运动组SCL 90各项评分明显低于药物治疗组(总分147. 9±28. 9vs186. 0±43. 7,总均分1. 6±0. 3vs2. 1±0. 5,阳性分91. 8±42. 7vs142. 6±59. 2,阳性均分2. 6±0. 4vs3. 1±0. 3,P均<0. 01),以躯体表现、抑郁、焦虑、恐怖尤为明显(分别为1. 9±0. 6vs2. 2±0. 6, 1. 8±0. 6vs2. 2±0. 8, 1. 7±0. 4vs2. 6±0. 8, 1. 4±0. 3vs1. 7±0. 7,P均<0. 01)。结论运动治疗心血管神经症安全、有效,值得临床推广。