心血管病学

建国５０年来,我国老年心血管病学在赶超世界先进水平方面取得了举世瞩目的成就,现简介如下。　　一、高血压　　１．流行病学：我国曾进行过３次大规模高血压调查,１９５８～１９５９年患病率为５１１％,１９７９～１９８９年为７７３％,１９９１年为１１２６％。３０年来患病率不断升高,近１０年升高２５％,高血压已成为我国的一个重大社会问题。１９９１年抽样普查,以收缩压（ＳＢＰ）≥１６０ｍｍＨｇ（１ｍｍＨｇ＝０１３３ｋＰａ）、舒张压（ＤＢＰ）＜９０ｍｍＨｇ为单纯收缩期高血压（ＩＳＨ）,其患病率为１２５…     

利用Internet医学信息资源制作心血管病学多媒体教学课件

Internet是当今世界最大的计算机互联网络，它利用计算机技术、网络通讯技术和多媒体信息技术传递和共享人类优秀的信息资源。若能充分利用Internet的医学信息资源，制作心血管多媒体教学课件，将对提高心血管病学的医、教、研水平具有重要的意义。     

老年心血管病学教学改革的探讨

在老年人中,心血管疾病是发病与死亡率最高的疾病之一。全国目前60岁以上老年人已达1.34亿,占总人口的11.7%,我国已进入老龄化社会。预计到21世纪30年代左右,老年人口将占总人口的四分之一。人口老龄化问题已成为人们关注的重要社会问题。近20年来,率先进入老龄化社会的一些发达国     

第四届海峡两岸心血管病学学术研讨会纪要

由复旦大学附属中山医院、上海第二医科大学附属瑞金医院、台湾长庚大学医学院、台湾长庚纪念医院和台湾亚东纪念医院联合主办的第四届海峡两岸心血管病学学术研讨会于 2 0 0 2年 3月 30～ 31日在上海华亭宾馆举行。本次大会出席代表 30 0余人 ,其中台湾长庚大学医学院、林口长庚纪念医院的李英雄教授和台湾亚东医院的朱树教授带领的台湾心血管医学界人士有 4 1人。大会共收到论文 4 0 0余篇 ,其中 82篇论文在大会上做学术交流 ,还进行了分会场的学术交流和讨论。在大会学术交流中 ,进行了心血管各领域的交流和研讨 :(1)高血脂和冠心病方…     

心血管专业文献检索的常用途径和方法

本文根据多年从事文献检索工作的实践 ,探讨心血管文献检索的常用途径和方法 ,以期对国内心血管专业工作者进行文献检索、信息查询提供帮助     

心血管病学百年进展

在现代医学中，心血管病学是内科学的一个重要组成部分，在20世纪20年代逐渐形成独立的学科，1628年，Harvey发现血液循环。1733年，Hales测量动脉血压，奠定了心血管生理学基础。1768年Heberden和1772年Jenner对心绞痛的描述和病因的确定开创了临床诊断心血管病的先河。1819年，Laennec发明听诊器，提供了最早用于诊断心血管病的仪器。1785年，Withering用洋地黄治疗心力衰竭，提供了最早治疗心血管病的手段。近百年来，心血管病学取得了长足进步，近50年的发展尤其迅速。     

第五届海峡心血管病学论坛

尊敬的各位同道：第四届（2013）海峡两岸医药卫生交流协会、心血管病委员会年会、第五届海峡心血管病学论坛暨第五届GAP—CCBC心血管临床危重疑难病例研讨会将于2013年11月30日-12月1日在福建省福州举办。     

互联网上心血管系统主要国外信息资源

介绍互联网上国外心血管疾病专业的信息资源．以便广大临床医务人员有效地利用互联网络查询有关信息。     

我国康复心脏病学的发展及现状（08版）

目的：报告中国现代康复心脏病学的发展和现状。方法：回顾性分析主要发表在1998年～2008年8月《心血管康复医学杂志》的有代表性的298篇论文。结果：1991年中国康复医学会心血管病专业委员会（Cardiovascular Committee of Chinese Association Medicine，CCCARM）成立。该会1992年创办了《中国心血管康复医学》杂志，1998年公开出版．定名为《心血管康复医学杂志》，先后制定了《中国心肌梗塞康复程序参考方案》一～四版，《心脏分级运动试验结果判定标准》，《冠心病人康复危险分层法》，《中国经皮冠状动脉介入治疗的康复程序》，《中国心血管病人生活质量评定问卷》，出版了《康复心脏病学》等专著。开展急性心肌梗死康复医疗的单位由中国康复医学会心血管病专业委员会成立前的3所医院发展至20个省、市的许多医院（无并发症者多为二周程序），成功进行了合并心力衰竭等合并症的急性心肌梗塞的康复医疗。近年心脏康复对防治冠脉介入治疗后的再狭窄做出了宝贵贡献，研究证明运动，控制冠心病危险因素可减少再狭窄；心衰康复取得了重大进展。在冠心病等的危险因素及衡量病情严重程度、判断预后的指标研究方面也有丰硕的成果。我会我刊编委会制定的“中国心血管病人生活质量评定问卷”今年获得了认证，统计分析证明该问卷与广泛使用的健康调查简表在所有患者，高血压、冠心病、心衰患者均有较好的信度和效度，为进一步广泛协作，测定其大样本常模打下基础。《心血管康复医学杂志》被评为中国科技核心期刊，中国科技论文统计源期刊；影响因子位于同类刊物前列；国际订户分布在16个国家和地区。结论：中国康复心脏病学发展甚快．但仍需继续努力。     

我国康复心脏病学的发展及现状

目的：报告中国现代康复心脏病学的发展和现状。方法：回顾性分析主要发表在1998年-2005年6月《心血管康复医学杂志》的有关292篇论文。结果：1991年中国康复医学会心血管病专业委员会0（Cardiovascular Committee of Chinese Association Medicine，CCCARM）成立。该会1992年创办了《心血管康复医学杂志》，先后制定了《中国心肌梗塞康复程序参考方案》一～三版，《心脏分级运动试验结果判定标准》，《冠心病人康复危险分层法》，出版了《康复心脏病学》等专著。开展急性心肌梗死康复医疗的单位已由2所医院发展至19个省、市的许多医院（无并发症者多为二周程序），成功进行了合并心力衰竭等合并症的急性心肌梗塞的康复医疗。近年心脏康复对防治冠脉介入治疗后的再狭窄做出了宝贵贡献，研究证明运动，控制冠心病危险因素可减少再狭窄。在冠心病等的危险因素及衡量病情严重程度、判断预后的指标方面也有丰硕的成果。《心血管康复医学杂志》被评为中国科技核心期刊，中国科技论文统计源期刊。结论：中国康复心脏病学发展是很快的，但需要继续努力。     

Evolutionary cardiology and experimental research

Evolutionary medicine studies the role of evolution in health problems. Diseases are considered as phenotypes generated by the expression of sets of genes and a complex interplay with the environment. The main mechanisms involved in evolutionary medicine are antagonistic pleiotropy, ecological antagonistic pleiotropy, atavisms and heterochrony. Antagonistic pleiotropism refers to genes that are beneficial during certain stages of development but become detrimental in others. Ecological antagonistic pleiotropy refers to the misadaptation to current lifestyle conditions which are different from those in which humans evolved. These mechanisms participate in the development of congestive heart failure, hypertension and atherosclerosis. Atavistic conditions or genes are expressed in our ancestors but have remained silent during evolution being suddenly expressed without an apparent cause during the appearance of a disease is another mechanism in evolutionary cardiology. The change in the heart metabolism from fatty acid to glucose dependent can be considered as an atavistic condition that appears in the heart after a stroke and may underlie impaired cardiomyocyte regeneration. Heterochrony is the expression of genes that cause the appearance of traits at a different timing during development and is therefore related to atavisms. Evolutionary medicine explains the interactions of pathogens and the host in infectious diseases where the cardiac tissue becomes a target. Mechanisms involved in evolutionary medicine participate in the generation of diseases and may be approached experimentally. Therefore, to better understand health problems and therapeutical approaches, an evolutionary medicine approach in experimental medicine may prove useful.     

Palliative care in cardiology

Palliative care is an approach aimed at improving the quality of life of patients (and their families) faced with a life-threatening condition. Chronic heart failure (CHF) is a progressive disease with increasing incidence and prevalence. Despite (or perhaps, because of) all the advances in medicine, CHF remains one of the leading causes of death. Even with the availability of numerous prognostic tools, an estimate of the course and outcome of a CHF patient continues to pose a challenge. As a result, palliative care should be initiated early and provided in parallel with curative treatment. The cornerstone of palliative care is communication based, mainly, on listening to the patient, telling the patient their unfavorable diagnosis, and therapeutic dialog. Drug therapy is provided in an effort to alleviate the symptoms. Non-pharmacological options of improving the quality of life of the patient include nutritional care, rehabilitation and, possibly, treatment of sleep apnea. Deactivation of the implantable cardioverter/defibrillator should also be considered as an option. Last but not least, the attending physician should focus on the psychological and spiritual needs of the patient. Palliative care in cardiology poses a major challenge to all members of teams caring for the CHF patient not only over the last weeks of their lives, but during their entire course of treatment.     

Internet Addiction or Excessive Internet Use

Background: Problematic Internet addiction or excessive Internet use is characterized by excessive or poorly controlled preoccupations, urges, or behaviors regarding computer use and Internet access that lead to impairment or distress. Currently, there is no recognition of internet addiction within the spectrum of addictive disorders and, therefore, no corresponding diagnosis. It has, however, been proposed for inclusion in the next version of the Diagnostic and Statistical Manual of Mental Disorder (DSM). Objective: To review the literature on Internet addiction over the topics of diagnosis, phenomenology, epidemiology, and treatment. Methods: Review of published literature between 2000–2009 in Medline and PubMed using the term “internet addiction. Results: Surveys in the United States and Europe have indicated prevalence rate between 1.5% and 8.2%, although the diagnostic criteria and assessment questionnaires used for diagnosis vary between countries. Cross-sectional studies on samples of patients report high comorbidity of Internet addiction with psychiatric disorders, especially affective disorders (including depression), anxiety disorders (generalized anxiety disorder, social anxiety disorder), and attention deficit hyperactivity disorder (ADHD). Several factors are predictive of problematic Internet use, including personality traits, parenting and familial factors, alcohol use, and social anxiety. Conclusions and Scientific Significance: Although Internet-addicted individuals have difficulty suppressing their excessive online behaviors in real life, little is known about the patho-physiological and cognitive mechanisms responsible for Internet addiction. Due to the lack of methodologically adequate research, it is currently impossible to recommend any evidence-based treatment of Internet addiction.     

Collaboration by Use of the Internet Yields Data of High Quality and Detects Non-uniform Management of Patients with Helicobacter pylori Infection

Background: The benefits of new technology steadily being introduced in medicine should be documented. In this study, remote entry of a set of data from the daily routine was submitted via the Internet to a common database. The usefulness and quality of the information are evaluated. Methods: Fourteen hospitals reported a common data set on consecutive Hp+ve patients handled in accordance with daily practice. Participants submitted their data via the Internet to a database. There was no monitoring or other surveillance. No audit was planned or expected, but was nevertheless possible. Doctor compliance with the common agreement was checked, differences in medical practice were noted and quality was assessed comparing the most important source data with the data in the final database. Results: Four-hundred-and-forty patients were included. The quality of the reported data was high, only 1.3% showing a discrepancy between source data and the database. Overall treatment success was 89%, with no significant differences between hospitals. There were significant differences in clinical practice between the centres, the proportion of patients treated for ulcer disease varying from 36% to 96% ( P < 0.001). Doctor compliance with the agreed collaboration varied significantly ( P < 0.001). Conclusion: Internet collaboration through remote data entry in a common database yields data of high quality without monitoring, and is a powerful and resource economic tool for clinical multicentre trials and quality assurance.     

Current applications of big data and machine learning in cardiology

Machine learning (ML) is a software solution with the ability of making predictions without prior explicit programming, aiding in the analysis of large amounts of data. These algorithms can be trained through supervised or unsupervised learning. Cardiology is one of the fields of medicine with the highest interest in its applications. They can facilitate every step of patient care, reducing the margin of error and contributing to precision medicine. In particular, ML has been proposed for cardiac imaging applications such as automated computation of scores, differentiation of prognostic phenotypes, quantification of heart function and segmentation of the heart. These tools have also demonstrated the capability of performing early and accurate detection of anomalies in electrocardiographic exams. ML algorithms can also contribute to cardiovascular risk assessment in different settings and perform predictions of cardiovascular events. Another interesting re-search avenue in this field is represented by genomic assessment of cardiovascular diseases. Therefore, ML could aid in making earlier diagnosis of disease, develop patient-tailored therapies and identify predictive characteristics in different pathologic conditions, leading to precision cardiology.     

Post-truth era and cardiology: After ORBITA,before CABANA

The evidence-based medicine is rooted in the scientific truth. Oxford Dictionaries has released its 2016 word of the year: “Post-truth,” which they define as “relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief”. In everything from climate change denial to the anti-vaccine movement, we’re seeing the consequences of a failure to engage with scientific evidence. Fake news and post-truth pronouncements are increasingly common in social media and political era and are unfortunately also progressively being applied to the medical science. We also see some evidence of post-truth signals in daily cardiology procedures and guidelines including both interventional cardiology and cardiac electrophysiology. Guideline recommendations made before the randomized-controlled trials (RCT) are published might result in a scenario that the interventions or procedures have been performed on millions of people, costing billions of dollars, leading to unnecessary use of health care resources and often, ending up being even accepted as routine procedures in certain clinical situations. “Justice delayed is justice denied” is a legal cliché meaning that if timely justice is not provided to the sufferer, it loses it importance and violates human rights. In medicine, “The RCT delayed is justice denied”, as highlighted by ORBITA (Objective Randomised Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina) trial and as may happen with CABANA (Catheter Ablation versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation Trial) in the post-truth era.     

New challenges of geriatric cardiology: from clinical to preclinical research

The field of geriatric cardiology reflects the evolving medical approaches tailored to address the needs of the growing population of oldest old with cardiovascular diseases (CVD). The burden of CVD is expected to increase particularly for the most common types of chronic heart disease of the elderly including coronary artery disease, heart failure and atrial fibrillation. In this context of dramatic demographic changes, geriatric cardiologists are facing important challenges. In this review, we outline the basic concepts of geriatric cardiology and describe these challenges as well as the unmet needs around this discipline with also a focus on the translation from basic research.