International Circulation:  Thank you very much for joining International Circulation at TCT 2011.  Dr. Gao， how is PCI currently used in China for complex lesions?
　　国际循环：请问目前国内对于冠脉复杂病变的介入治疗水平如何？
　　Prof. Gao:  That is a very good question.  Last year in China we performed 290，000 cases， with 50-60% being complex lesions.  Including CTO，multivessel disease and left main; left main was performed about 5% of the time.  China’s cardio vascular surgery across the entire country is relatively difficult to get because only the large hospitals have this service.  Many of the smaller hospitals don’t have cardio vascular surgery for coronary heart disease， so many complex lesions are selected for PCI by the interventional cardiologist， much more than CABG.  But in the larger hospitals， like my hospital， there is no problem to have a routine consultation with a cardio surgeon for the complex cases and for the best treatment.
　　高润霖教授：这是一个很好的问题，去年中国共进行了290000例手术。50%～60%为复杂病变。包括：CTO，多支病变和左主干疾病；其中，5%在处理左主干问题。在中国整个国家内进行心血管手术是相对困难的，因为只有大医院能够进行该类手术。许多小型医院不能为冠心病患者进行心血管手术，所以复杂病变就选择由介入心脏病医师进行PCI治疗，其比值远高于冠状动脉搭桥术。但是在大医院里，像我们医院，为了让复杂病例能够得到最佳治疗，与心外科进行例行会诊完全没有问题。
　　International Circulation:  What are your recommendations for reducing PCI related complications?
　　国际循环：您对避免和减少PCI相关并发症有什么意见和建议？
　　Prof. Gao:  First， education is very important.  In all PCI meetings we will emphasize PCI complications: how to prevent them and how to treat them.  So， Education is first.  Second is being sure there are good indications for selecting the technique and perform the procedure accurately according to protocol guidelines.  The third thing—and maybe the most important—complications will decrease along with experience accumulation.  Experienced hospitals and personnel have a lower rate of complications than do new ones.   So most important is increased experience decreases complications.  But for the beginners: training， education， learn the indications and techniques， and gaining experience with other physicians is very important.
　　高润霖教授：首先，教育是非常重要的。在所有的PCI会议上我们都强调PCI并发症：如何对其进行避免和治疗。所以，教育是第一位的。第二就是确保有采用该技术治疗的良好适应症和根据拟定的指南进行手术。第三，可能是最重要的，并发症会随着经验的积累而减少。有经验的医院和人员要比初学者的术后并发症发病率低。因此，最重要的就是增加经验已降低并发症发病率。但是对于初学者：培训，教育，学习适应症和技术，并从其他医师那里获得经验是非常重要的。
　　International Circulation: At the CIT - TCT joint session， there were many TCT dignitaries that joined you with your Chinese dignitaries.  What was your impression of that session?
　　国际循环：在CIT-TCT联合会议上，有许多TCT元老和您和您的中国专家们一起出席。你对该届会议的印象如何？
　　Prof. Gao:  We felt much honored that Dr. Leon， Dr. Stone， Dr. Colombo and many famous experts joined our session; it is really a successful session.  Interesting case presentations， mini-lectures and wonderful comments from distinguished panals attracted quite a lot of participants. The conference room was full of audience， many of them had no seats and standed against the wall.  Dr. Leon gives very strong support to CIT.  Actually from the beginning 6 years ago we started to  have a joint programs， TCT at CIT session， and from last year the CIT name changed to “CIT in partnership with TCT”.  So we have an even closer relationship with TCT.  From the design of scientific program to the types of lectures， TCT has helped a lot， Dr. Leon， Dr.Stone and many experts from CRF have given great help.
　　高润霖教授：Leon医生，Stone医生和Colombo医生以及这么多著名专家能够参与我们的这次会议，让我感到非常的荣幸；这届会议的确非常成功。非常有趣的病例介绍，小型讲座和来自杰出专家的精彩评论吸引了相当多的参与者。整个会议室坐满了听众，许多人没有座位只能靠墙站着。Leon医生非常支持CIT会议。事实上，6年前我们开始TCT和CIT会议的联合方案，从去年开始，CIT的名字改为“CIT与TCT合作”。因此，我们与TCT的关系更近了一步。从系统大纲的设计到演讲的类型，TCT都帮了很多忙，Leon医生，Stone医生和许多来自CRF的专家也都提供了极大的帮助。
　　International Circulation: Looking at the big picture of cardiovascular medicine in China， what do you think are Chinese hot-topics in cardio vascular medicine?
　　国际循环：对于中国现在的心血管医学大局，您认为中国心血管内科的热点是什么？
　　Prof. Gao: I think for the Chinese the hot topic is prevention of heart disease because in China cardiovascular disease， including stroke is the number one killer.   In China there is a large population and to treat all those with cardio vascular disease is impossible.  So prevention is very important.   Major risk factors like hypertension， hyperlipidemia， smoking， diabetes， obesity are still increasing and with the risk factors the incidence and  mortality of coronary heart disease and stroke are also increasing.  Therefore the most important issue for cardiovascular medicine in China is prevention.
　　高润霖教授：我认为中国的热点是心脏病的预防，由于心血管疾病，包括中风是中国的头号杀手。中国的人口众多，让他们都接受心血管病治疗是不可能的，所以预防是非常重要的。许多危险因素像是高血压，高血脂，吸烟，糖尿病，肥胖的发病率仍在上升，随着危险因素的升高冠心病和中风的死亡率也在不断攀升。因此，中国心血管内科最重要的问题是预防。
　　International Circulation: How do you think the medical community in China should go about implementing the prevention strategy you are talking about?
　　国际循环：在您看来，中国的医学界应该如何实施您刚才谈到的预防策略？
　　Prof. Gao:  Prevention will start from the need to control the risk factors.  Hypertension， for example is a most important risk factor: in China -- around 20% of adults has hypertension， which is around 200 million people with hypertension.   Currently the control rate is only 7%.  If we can control hypertension， we can significantly decrease coronary heart disease and stroke.
　　高润霖教授：预防将从控制危险因素开始。比如高血压是非常重要的危险因素，在中国——20%的成年人患有高血压，也就是说大约2亿人是高血压患者。目前的控制率只有7%。如果能够控制高血压，我们能够显著降低冠心病和中风的发病率。
　　International Circulation: Is that a genetic issue or is that a lifestyle issue?
　　国际循环：这是遗传问题还是生活方式的问题呢？
　　Prof. Gao:  Genetics may be of some issue， but I think that lifestyle and lifestyle change is very significant.
　　高润霖教授：遗传可能是部分原因，但是我认为生活方式和生活方式的改变是非常重要的。
　　International Circulation: What needs to be changed?
　　国际循环：都有什么方面需要改变呢？
　　Prof. Gao: We need toi modify unhealthy lifestyle， for example， to fight the caloric intake that is increasing， to decrease salt intake， to encourage people to exercise.  You know， 20-30 years ago Chinese had a low fat calorie intake， bicycle is the mian transportation tool.  But now fat and cholesterol intake has increased very rapidly， car has taken place of bicycle.  With that hypertention， obesity and diabetes all have increased.  And smoking has not significantly decreased.  So those risk factor combinations have made coronary heart disease and stroke increase in China.  The government recognizes this is a serious problem and has implemented many programs to try to control the risk factors.  The Minister of Health recently gave a speech at the United Nation high level meeting on noncommunicable disease prevention and control to announce the projects to control chronic disease in China.
　　高润霖教授：我们需要改变不健康的生活方式，比如，控制高热量饮食的摄入，降低食盐的摄入量，鼓励全民运动。你知道，20-30年前，中国人脂肪的摄入量很低，自行车是主要的代步工具。但是现在，脂肪和胆固醇的摄入迅速升高，汽车代替了自行车。高血压，肥胖和糖尿病的发病率都随之升高。而吸烟数量并没有明显降低。所以这些危险因素综合起来使得冠心病和中风的发病率在中国不断升高。政府也认识到这是一个严重问题并已经实施了许多方案试图控制这些危险因素。卫生部部长最近在联合国高层会议上就非传染性疾病预防和控制发表了讲话并宣布了控制中国慢性疾病的计划。
　　International Circulation: Dr. Gao， thank you very much.
　　国际循环：非常感谢您，高医生。