Huang M.,Shanghai JiaoTong University |
Zhang X.,Shanghai JiaoTong University |
Chen S.,Shanghai JiaoTong University |
Sun Y.,Qingdao Childrens Hospital |
And 4 more authors.
Pediatric Cardiology | Year: 2013
This study aimed to evaluate the clinical efficacy and safety of carvedilol for pediatric patients with chronic heart failure caused by dilated cardiomyopathy. Seven pediatric medical centers participated in this prospective study. Pediatric patients (n = 89) were randomly divided into an experimental group (carvedilol treatment) and a control group (conventional treatment). The analysis excluded 12 patients lost during the follow-up period. Carvedilol was added to the therapy of the experimental group after at least 1 month of basic treatment with digoxin, an angiotensin-converting-enzyme inhibitor, and diuretics. The control patients received the same basic treatment but did not receive carvedilol. The initial dose of carvedilol was 0.1 (mg/kg day), and the dose was doubled every 2 weeks until the maximum tolerated dose or 0.8 (mg/kg day) was achieved. The tolerated dose was maintained for 6 months. The Ross scales and echocardiographic parameters including left ventricular diastolic diameter, left ventricular systolic diameter, left ventricular ejection fraction, left ventricular fractional shortening, and serous brain natriuretic peptide (BNP) concentration, as well as clinical progress were compared between the two groups. The Ross scales decreased by 11.94 % in the experimental group, which was more than in the control group (2.81 %). In addition, changes to other echocardiographic parameters in the experimental group also were superior to those in the control group. The serous BNP concentration in the experimental group decreased by 30.1 %, which also was more than the decrease (22.2 %) observed in the control group. Clinical improvement was demonstrated by 40 %, no change by 35 %, and clinical deterioration by 25 % of the patients in the experimental group, and by respectively 37.8, 27, and 35.2 % of the patients in the control group. These differences were not statistically significant. Only one patient demonstrated a severe adverse event, severe pulmonary infection, and complete atrioventricular block. None of the other carvedilol-treated patients experienced drug-related side effects. Carvedilol can be safely used for treatment of chronic heart dysfunction in pediatric patients with dilated cardiomyopathy. The results in this study showed an apparent improvement in the cardiac function of these patients. Additional clinical studies are required to determine the most favorable dosing levels and regimens of carvedilol before its safety and efficacy for the pediatric population can be determined conclusively. © 2012 Springer Science+Business Media New York.
Zhuang H.Y.,Beijing Anzhen Hospital
Zhonghua yi xue za zhi | Year: 2010
To evaluate the impact of neoadjuvant hormonal therapy on the permanent transperineal (125)I-seed brachytherapy for localized high-risk prostate cancer. Ten patients with T(1)-T(2a) localized high-risk prostate cancer were reviewed. The mean level of PSA was (29.4 ± 12.6) μg/L (20 - 50 μg/L) and the mean prostate volume (54 ± 33) ml. All cases were sequentially treated on a neoadjuvant hormonal therapy with 1 week of Casodex (50 mg/d) and 3 - 10 months (median: 6 months) of Casodex (50 mg/d) with Zoladex (3.6 mg per 4 weeks, SC). Then all patients received the transperineal permanent interstitial (125)I-seed implantation brachytherapy by template method. The matched peripheral dose of seed implantation was 145 Gy (median number of (125)I seeds: 46), urethral peripheral dose ≤ 80 Gy and rectal peripheral dose ≤ 60 Gy. The mean operative duration was 1.75 hours (range: 1 - 2.5 hours). After neoadjuvant hormonal therapy for 3 - 10 months, the PSA level decreased to (1.4 ± 0.7) μg/L in all patients. The mean prostate volume significantly decreased to (25 ± 10) ml (t-test, P < 0.01). The Foley tube extracted at Days 3 - 5 post-brachytherapy. Side effects of mild dysuria (n = 1) and urethral irritation (n = 1) were effectively managed by symptomatic treatment. After a median follow-up of 13 months (range: 3 - 24), the PSA level was (0.9 ± 0.7) μg/L. A combination of neoadjuvant hormonal therapy with brachytherapy may lower the PSA level and shrink the prostate volume so as to ensure an effective dose in the target tumor and improve the therapeutic efficacy for localized high-risk prostate cancer.
Hu S.S.,National Center for Cardiovascular Diseases |
Kong L.Z.,Ministry of Health of the People Republic of China |
Gao R.L.,National Center for Cardiovascular Diseases |
Zhu M.L.,National Center for Cardiovascular Diseases |
And 5 more authors.
Biomedical and Environmental Sciences | Year: 2012
Major and profound changes have taken place in China over the past 30 years. Rapid socioeconomic progress has exerted a great impact on lifestyle, ranging from food, clothing, working and living conditions, and means of transportation to leisure activities and entertainment. At the same time, new health problems have emerged, and health services are facing new challenges. Presently, cardiovascular diseases (CVD) are among the top health problems of the Chinese people, and pose a serious challenge to all engaged in the prevention and control of these diseases. An epidemic of CVD in China is emerging as a result of lifestyle changes, urbanization and longevity. Both national policy decision-making and medical practice urgently need an authoritative report which comprehensively reflects the trends in the epidemic of CVD and current preventive measures. Since 2005, guided by the Bureau of Disease Prevention of the Ministry of Health of the People's Republic of China and the National Center for Cardiovascular Diseases of China, nationwide experts in the fields of epidemiology, clinical medicine and health economics in the realms of CVD, cerebrovascular disease, diabetes and chronic kidney disease, completed the Report on Cardiovascular Diseases in China every year. The report aims to provide a timely review of the trend of the epidemic and to assess the progress of prevention and control of CVD. In addition, as the report is authoritative, representative and readable, it will become an information platform in the CVD field and an important reference book for government, academic institutes, medical organizations and clinical physicians. This publication is expected to play a positive role in the prevention and control of CVD in China. We present an abstract from the Report on Cardiovascular Diseases in China (2010), including trends in CVD, morbidity and mortality of major CVDs, up-to-date assessment of risk factors, as well as health resources for CVD, and a profile of medical expenditure, with the aim of providing evidence for decision-making in CVD prevention and control programs in China, and of delivering the most authoritative information on CVD prevention and control for all citizens. © 2012 The Editorial Board of Biomedical and Environmental Sciences.
Wang M.,Beijing Shijingshan Hospital |
Guo J.,Beijing Luhe Hospital |
Li J.,Beijing Anzhen Hospital |
Li C.,Peking University |
Qian M.,Peking University
International Journal for Quality in Health Care | Year: 2011
Objective: Cardiovascular risk factors increase risk for stroke recurrence. Secondary prevention of stroke may be affected not only by established risk factors, but also socioeconomic status. This study evaluates relationships between socioeconomic status and cardiovascular and behavioral factors. Design: Cross-section study. Setting: Public Health and Education Institute, Peking University. Participants: Outpatients (n = 2354) with a past diagnosis of stroke or transient ischemic attack. Intervention(s): The investigation consisted of a questionnaire regarding patients' socioeconomic and living status, and a clinical examination at the research center. Main outcome measure(s): Control rates of risk factors for cardiovascular disease. Results: With regard to hypertension patients, 67.0% were aware of having hypertension, 63.6% were treated and 53.9% had controlled hypertension; for patients with hypercholesterolemia, 46.7% were aware of having hypercholesterolemia, 38.6% were treated and 3.8% had controlled hypercholesterolemia; for patients with diabetes mellitus, 28.0% were aware of having diabetes mellitus, 25.7% were treated and 3.5% had controlled diabetes mellitus. After multivariate analysis, education was the strongest associated factor for controls of hypertension and diabetes mellitus. After adjustment for sex and age, strong and graduated relationships were noted between the level of education and control of risk factors, with the odds ratios increasing at every increment. Conclusion: Education exerts the most important effect on the control of established cardiovascular risk factors; Successful intervention to reduce these risk factors will have to be addressed, not just with regard to specific risk factors, but also with the societal conditions that lead to the adoption and maintenance of high-risk behaviors. © The Author 2011. Published by Oxford University Press in association with the International Society for Quality in Health Care; All rights reserved.
Gan H.,Beijing Anzhen Hospital
Pulmonary Embolism and Pulmonary Thromboendarterectomy | Year: 2011
Pulmonary embolism and chronic thromboembolic pulmonary hypertension are health devastating diseases with considerable morbidity and mortality. Pulmonary thrombectomy and pulmonary thromboendarterectomy are the procedures designed to treat pulmonary embolism and chronic thromboembolic pulmonary hypertension with very good early and long term effects. This book presents the latest research in this growing field. As a subsidiary and supporting knowledge to the pulmonary thromboendarterectomy, this book also provides knowledge relevant to the anatomy and physiology of respiratory system; pulmonary circulation and bronchial circulation; the physiology and pathophysiology of coagulation and fibrinolysis; the recent progress in thrombosis, anticoagulant and thrombolysis, deep vein thrombosis, acute pulmonary embolism and chronic thromboembolic pulmonary hypertension. © 2011 by Nova Science Publishers, Inc. All rights reserved.