[ACC2013]ACC未来发展及中国心血管研究的国际影响——ACC 2013候任主席John. G. Harold博士专访
<International Circulation>: Speaking of China on the international scene, you mentioned that you expect China to have an increasing impact on CV literature. What do you think needs to improve in China to increase that impact further?
《国际循环》:关于中国在国际舞台上的角色,您提到过您期待中国能在心血管领域有越来越大的影响。您认为中国有哪方面需要取得进步以进一步增加其影响力?
Dr. Harold: In the realm of clinical research, it is always about reliability and integrity. Our registries have developed some very specific protocols to data collection and recording. As technologies evolve it is important to have reliable registries that are supported. The wealth of clinical data is almost infinite in China, given the population. The College is looking to support Chinese cardiology in any way we can and we have a great number of resources ot provide his support. We are impressed with the number of submissions as well as the number of attendees. These Scientific Sessions will host one of the largest number of Chinese cardiologists we have ever had. We have a great deal of respect to the China delegation and I will co-chairing the chapters presentations which will be one of the highlights of the meeting. A lot of members are curious to see how some of these problems are going to be dealt with, especially when it comes to the sheer magnitude of the population. How do you introduce systems of care into a nation of 1.3 billion people with significant gaps in development? Saudi Arabia is facing some of the same challenges. My colleagues at the college look forward to collaborating with our brothers in China. Dr. Harlan Krumholz from Yale is already doing a number of collaborations within China. He is working closely with government representatives to look clinical problems of cost, quality, and outcome. These are a lot of the same issues that we deal with in the United States. The issue is providing the right treatment to the right patient at the right time. In those terms, we have a lot in common. We have a lot to learn from each other.
Harold博士:在临床研究方面,最重要的永远是可靠性和完整性。我们的注册研究发展了一些专门的数据收集和记录方案。随着技术的发展,可靠的技术研究对于技术支持来说十分重要。中国人口众多,有着无穷无尽的临床数据财富。ACC希望尽自己所能支持中国心脏病学事业,而且我们也有很多资源来提供支持。中国的投稿数量和参会者数量都令我们印象深刻。本次ACC年会迎来的中国心血管医师也为历届最多。我们对中国代表团充满敬意。我将会作为中国分会议程的联合主席,这个议程将会是本次大会中的亮点之一。许多会员都很有兴趣了解在规模如此大的人口中,心血管问题的解决方法。如何在一个发展不平衡的13亿人口的国家中建立医疗体系?沙特阿拉伯也在面对一些同样的问题。ACC中我的同事希望能和我们在中国的同道合作。耶鲁大学的Harlan Krumholz博士目前正在中国进行一些合作项目。他在和政府代表密切合作,研究关于医疗开支、质量和结果方面的问题。在美国我们也在解决很多同样的问题,即在正确的时间为正确的患者提供正确的治疗。因此,我们有很多共同之处,很多互相学习之处。
<International Circulation>: Smoking cessation is big debate in China. What are your opinions on the economic impact of smoking in China?
《国际循环》:戒烟在中国引起了广泛讨论,您对吸烟在中国的经济影响有何看法?
Dr. Harold: That data is already available. It is clear that the public health implications are so extraordinary, and the impact on the health care system is so dramatic, that it is in the country’s economic interest to look at alternatives to the revenue generated from cigarette sales. On a plane to China back in 1989, the person sitting next to me was a business man. He owned factory that produces cigarette paper and helps produce over a billion cigarettes a year. What an extraordinary statistic. My predication was that within a short period of time, this will have tremendous negative impacts for China. Not only are you dealing with tobacco, but also the ravages of pollution. The combination of air pollution and cigarette smoking is a perfect storm for CV disease. In fact, my colleagues in Britain are publishing on this concept on the effect of particulate matter and risk of coronary disease and MI and how this augments the tobacco risk. This risk is compounded particularly in Beijing. China will lose a valuable part of its population to will be subject to early demise, early coronary disease, and early chronic obstructive lung disease. The number one thing that China could do is to begin to look at smoking cessation. Coronary disease will continue to double and will quickly overwhelm the resources of the country. The contribution to the GNP is already substantial and will only get worse.
Harold博士:我们已经有了相关的数据。很明显吸烟对公共卫生的影响以及医疗系统的影响都很大,国家经济需要寻找对卷烟销售税的替代品。1989年,在一家飞往中国的飞机上,坐在我旁边的人是个商人。他的工厂生产每年为超过10亿支卷烟生产卷烟纸。这个数据真是非常庞大。我当时确定在很短的时间内,吸烟会对中国产生巨大的负面影响。需要解决的问题不仅是烟草,还包括污染破坏的环境。空气污染和吸烟二者的共同作用对于心血管疾病是一场风暴。事实上,我在英国的同事发表的文章显示了悬浮颗粒对冠心病和心肌梗死造成影响,增加了吸烟带来的风险。尤其是在北京,这两个风险同时存在。中国会因为过早死亡、早发冠心病和早发慢性阻塞性肺疾病而损失很多青壮年人口。中国应当做的第一件事就是着眼于戒烟。冠心病会持续增加,并且耗尽国家的资源。心血管疾病对经济的影响已经很大,而且会越来越大。
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