Contribution of Cardiorespiratory Fitness to the Obesity Paradox

Until recently, cardiorespiratory fitness (CRF) has been overlooked as a potential modifier of the inverse association between obesity and mortality (the so-called obesity paradox), observed in patients with known or suspected cardiovascular (CV) disease. Evidence from five observational cohort studies of 30,104 patients (87% male) with CV disease indicates that CRF significantly alters the obesity paradox. There is general agreement across studies that the obesity paradox persists among patients with low CRF, regardless of whether adiposity is assessed by body mass index, waist circumference, or percentage body fat. However, among patients with high CRF, risk of all-cause mortality is lowest for the overweight category in some, but not all, studies, suggesting that higher levels of fitness may modify the relationship between body fatness and survival in patients manifesting an obesity paradox. Further study is needed to better characterize the joint contribution of CRF and obesity on mortality in diverse populations.     

Secondary Prevention of Cardiovascular Disease in Older Adults

Atherosclerotic cardiovascular disease is extremely common in older adults and the potential benefits of secondary prevention are perhaps greater in this population than in younger patients. While there is good evidence that secondary prevention efforts are justified in patients up to 80 years of age, limited data are available on secondary prevention in octogenarians and there is no evidence to guide treatment in patients ≥ 90 years of age. Further, the value of secondary prevention may be confounded by prevalent comorbidities, polypharmacy, and limited life expectancy. It is therefore essential that all management decisions be made in relation to individual preferences and goals of care, with understanding by patients that benefits as well as risks may increase with age. Furthermore, research is needed to refine markers to better delineate which older adults are most likely to benefit from preventive therapies.     

Beverage Specific Drinking Contexts

The contextual differentiation of beverage specific consumption is examined in a metropolitan area household survey of current drinkers. The findings indicate that beverage specific consumption is related to such structural proportions as presence/absence of food, drinking location, type of companion, and duration. Wine, for example, is frequently associated with mealtimes, at home, and with relatives.     

国产X线机高故障率原因及对策探讨

目的:为扩大国产X线机临床应用范围,提高整机制造技术水平,降低设备故障率,减少维修次数,逐步建立国产X线机良好的品牌效应。方法:对某院国产X线机近3 a的故障、诊断及修复情况进行综合分析。结果:对产品的机电控制部分,首先注重防机械抖动,其次是选择适应环境温度变化的高稳定性电子器件;对软件系统要增强服务能力,强调完美服务理念。结论:提高管理水平是降低高故障率的唯一途径。     

阿托伐他汀钙治疗慢性充血性心力衰竭100例

目的评价阿托伐他汀钙治疗慢性充血性心力衰竭的疗效。方法将200例慢性充血性心力衰竭患者随机分为对照组和观察组。对照组给予常规治疗，观察组在对照组的基础上加用阿托伐他汀钙。结果观察组总有效率89．00％高于对照组的71．00％，差异具有高度统计学意义（P〈0．01）。观察组LVEF、步行运动耐量优于对照组，差异具有高度统计学意义（P〈0．01）。两组均未出现严重药物不良反应事件。结论阿托伐他汀钙治疗慢性充血性心力衰竭患者疗效可靠，副作用小。     

慢性心力衰竭用药及护理

慢性心力衰竭是心血管疾病的发展趋势,死亡率极高,心衰病患者的治疗与康复是对医护人员的一大考验。慢性心力衰竭以端坐呼吸、劳力性呼吸困难为主要表现,同时伴有不同程度的咳嗽、咯血、乏力、心慌、气短、少尿等症,使患者不得不承受巨大痛苦。护理工作在心衰的治疗过程中起着十分重要的作用,心衰病的护理包括生活起居的护理,饮食护理,保证用药依从性,亦需要对各类药物的正确使用及可出现的不良反应进行合理护理,以提高预后为最终目标。同时,医护人员应开展心衰病的宣讲教育和完善家庭护理服务系统。