A call for a gender specific approach to address the worldwide cardiovascular burden

Cardiovascular diseases (CVD) among non-communicable diseases are already a major public health challenge worldwide. A further increase in CVD is projected to occur over the next 25 years as a result of both adverse lifestyle changes and demographic shifts in the population age profile. The adverse impact of these health problems will affect women in particular, given the steady rise in the proportion of the aging population that will be women.The critical issue presently in the management of CVD is that we are not even adequately using the data that are available. Women still remain unaware that they are at risk, and information about women is not easily accessible to their physicians. This is a global issue and the need remains for worldwide initiatives with greater vigilance to identify these factors and make efforts to control them effectively.Currently, in scientific research, it is expected that the results of clinical research be analyzed for sex differences, sex- and gender-appropriateness, and sex- and gender-specific approaches for prevention, diagnosis, treatment, and counseling. To address the care discrepancy, the global community needs to develop a conducive environment within a comprehensive policy and operational framework to achieve favorable lifestyles, and CVD risk factor reduction for both men and women.     

心阻抗容积图的传统理论及其局限性

本文就心阻抗容积图的传统理论及其局限性展开讨论。由于传统理论模型与人体胸部结构差异太大，使这一方法存在很多问题。而实践中关于心输出量（ＣＯ）的计算，误差较大，可靠性差。     

The effect of vitamin D supplementation on cardiorespiratory fitness and muscle strength in male adults undergoing basic military training

BackgroundVitamin D deficiency (VDD) is ubiquitous in the Indian subcontinent. VDD has been shown to impair muscle functions. However, the association of VDD with cardiorespiratory endurance is uncertain. Hence, we enrolled and supplemented vitamin D in military recruits with VDD with an aim to evaluate effect of supplementation on cardiorespiratory endurance and muscle strength.MethodWe enrolled 90 military recruits with VDD and randomly allotted them to two groups equally. The group I received cholecalciferol granules 60,000 IU every fortnight for twelve weeks (cases), and the group II was observed as control. Muscle strength and cardiorespiratory endurance was assessed with a battery of tests (standing broad jump, bent arm hang test, 20 m shuttle run) at baseline and repeated at the end of training (nineteen weeks). Blood samples were collected for measurement of serum 25(OH)D and parathyroid hormone.ResultsIn Group I and Group II, there was significant increase in 25(OH) D levels (25.8 ± 7.1 and 17.3 ± 3.5 ng/ml, respectively), and in VO2 max (9.8 ± 8.8 and 12.7 ± 8.6 ml/kg/min, respectively) compared with the baseline values. However, no significant change was observed in muscle strength after supplementation. There was no difference between the groups in VO2 max and muscle strength at baseline and at the end of training.ConclusionVitamin D supplementation did not improve muscle strength and cardiorespiratory endurance in military recruits with VDD. A significant rise in 25(OH) D was observed even in those not supplemented with vitamin D.     

Efficacy of Carbon Dioxide Insufflation for Cerebral and Cardiac Protection During Open Heart Surgery: A Systematic Review and Meta‐Analysis

In spite of widespread application around the world, there has been controversy on the cerebral and cardiac protection efficacy of carbon dioxide insufflation (CDI) during open heart surgery. To make a comprehensive evaluation, we screened all relevant published randomized controlled trials to perform the first systematic review and meta‐analysis for CDI during open heart surgery. We searched PubMed, EMBASE, the Cochrane Controlled Clinical Trial register, WANFAN, CQVIP, and CNKI database for published articles. Randomized controlled trials were included when the research provided data of neurological complications postoperatively, creatinine kinase, MB isoenzyme (CK‐MB) on the first postoperative day, or all‐cause mortality. We chose a fixed‐effects model when the trials showed low heterogeneity, otherwise a random effects model was used. The quality of studies was assessed by modified Jadad scale. Four studies were included in this meta‐analysis. The overall pooled relative risk (RR) for neurological complications was 1.59, 95% confidence interval (CI) = [0.57, 4.46], and the z‐score for overall effect was 0.89 (P = 0.37). The standardized mean difference of the CK‐MB between groups was 1.15, 95% CI = [?1.27, 3.56], and the z‐score for overall effect was 0.93 (P = 0.35). The overall pooled RR for all‐cause mortality was 0.5, 95% CI = [0.16, 1.64], and the z‐score for overall effect was 1.14 (P = 0.25). There was no significant difference between groups. Because of the insufficiency of powerful evidences, the cerebral and cardiac protection efficacy of CDI during open heart surgery needs to be further verified by more high‐quality trials.     

健康教育和呼吸功能训练在心胸外科患者围术期综合应用的研究

目的探讨规范的呼吸系统健康教育和呼吸功能训练对心胸外科手术病人康复的影响。方法选择2006年6～11月开胸手术患者50例为对照组,2006年12月～2007年9月开胸手术患者为实验组,对照组按临床常规护理进行指导,实验组进行规范的呼吸系统健康教育和深慢呼吸、缩唇呼吸、咳嗽训练、吹气球训练等呼吸功能训练,观察比较两组患者术后并发症、胸管留置时间、住院天数,并进行统计学分折。结果实验组明显优于对照组,P<0.05。结论规范的呼吸系统健康教育和呼吸功能训练可减少开胸手术病人术后并发症、缩短胸管留置和患者住院时间,促进病人早日康复。     

茶色素对高脂血症的疗效观察

目的探讨茶色素调节血脂紊乱的作用。方法治疗组：２４８例血脂紊乱者；对照组：５５例的血总胆固醇、甘油三酯、高密度脂蛋白胆固醇正常，４１例的血清脂蛋白（ａ）＜３０ｍｇ／ｄｌ，二组均每次口服茶色素１２．５ｍｇ，每日３次。结果治疗一个月后，治疗组血清总胆固醇平均下降１２％（Ｐ＜０．０００１），甘油三脂下降２０％Ｐ＜０．０００１），高密度脂蛋白胆固醇上升２２％（Ｐ＜０．０００１）。对照组总胆固醇与甘油三酯亦明显下降（Ｐ值分别＜０．０１与０．０５），高密度脂蛋白胆固醇与脂蛋白（ａ）无变化，未见明显副作用。结论茶色素为调节血脂紊乱的较好药物，在心＊协作单位：北京阜外心血管医院、北京解放军总医院、北京医科大学第三医院、北京医科大学人民医院、上海市高血压病研究所、江西医学院心血管病研究所、江西医学院二附院心内科、江西萍乡市人民医院脑血管病的防治中可能起重要作用。     

腺苷对复苏兔心肌及脑组织变化的干预

目的观察腺苷对窒息兔心脑组织病理及心肌酶学的影响。方法采用窒息法制作兔窒息模型,随机分为对照组(A组)、肾上腺素组(B组)、肾上腺素合并腺苷组(C组)。持续窒息4min后,行心肺复苏,4min后静脉给药。A组(n=6)不用复苏药物;B组(n=12)iv肾上腺素0.09mg·kg-1;C组(n=12)iv肾上腺素0.09mg·kg-1并持续静滴腺苷150μg·kg-1·min-1至复苏结束。取左心室和海马HE染色,光镜下观察心肌和海马组织结构改变;采血查血浆肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)浓度。结果B组和C组心肌细胞和海马神经元无明显破坏,B组仅有轻度缺血改变,两组均明显好于A组。复苏成功兔血浆CK、CK-MB浓度,C组相似文献