Stroke burden in China has increased over the past 30 years, and remains particularly high in rural areas. There is a north-to-south gradient in stroke in China, with the greatest stroke burden observed in the northern and central regions.
Stroke is the leading cause of death in China and confers a huge burden and effort on patients and health professionals. China has the world's largest population and has been experiencing a rapid economic development. In this article, we review the current status of stroke epidemiological features and risk factors, and the recently ongoing stroke epidemiological survey in China. Epidemiological studies suggested that stroke incidence increases with age and that the elderly population is expected to increase over time in China. Stroke mortality increased gradually from 1990 to 2000 but declined since the beginning of the 21st century, probably related to better control of vascular risk factors and the advances in acute stroke care. The Chinese lifestyle has changed rapidly during the past 3 decades. Moreover, China is a big country with substantial geographic disparities. The geographical variation and chronological trend of vascular risk factors may determine changes in the prevalence and subtypes of stroke in China. In this review, the current Chinese researches on the critical management of stroke and the potential direction and support of the Chinese government are discussed.
This study aimed to explore pre-hospital delay and its associated factors in first-ever stroke registered in communities from three cities in China. The rates of delay greater than or equal to 2 hours were calculated and factors associated with delays were determined by non-conditional binary logistic regression, after adjusting for different explanatory factors. Among the 403 cases of stroke with an accurate documented time of prehospital delay, the median time (interquartile range) was 4.00 (1.50–14.00) hours. Among the 544 cases of stroke with an estimated time range of prehospital delay, 24.8% of patients were transferred to the emergency department or hospital within 2 hours, only 16.9% of patients with stroke were aware that the initial symptom represented a stroke, only 18.8% used the emergency medical service and one-third of the stroke cases were not identified by ambulance doctors. In the multivariate analyses, 8 variables or sub-variables were identified. In conclusion, prehospital delay of stroke was common in communities. Thus, intervention measures in communities should focus on education about the early identification of stroke and appropriate emergency medical service (EMS) use, as well as the development of organized stroke care.
This clinical score may help identify acute stroke patients with high risk of DVT. In addition, it also serves as a platform to develop further models of DVT prediction in stroke patients based on clinical factors.
Background: In China, stroke is the leading cause of death and contributes to a heavy disease burden. However, a nationwide population-based survey of the mortality of stroke and its subtypes is lacking for this country. Methods: Data derived from the National Epidemiological Survey of Stroke in China, which was a multistage, stratified clustering sampling-designed, cross-sectional survey, were analyzed. Mortality rate analyses were performed for 476,156 participants ≥20 years old from September 1, 2012 to August 31, 2013. Results: Of the 476,156 participants in the investigated population, 364 died of ischemic stroke, 373 of hemorrhagic stroke, and 21 of stroke of undetermined pathological type. The age-standardized mortality rates per 100,000 person-years among those aged ≥20 years were 114.8 for total stroke, 56.5 for ischemic stroke, and 55.8 for hemorrhagic stroke. The age-standardized mortality rates of total stroke, ischemic stroke, and hemorrhagic stroke were all higher in rural areas than those in urban areas. The stroke mortality rate was higher in the northern regions than in the south. An estimated 1.12 million people aged ≥20 years in China died of stroke during the period from September 1, 2012 to August 31, 2013. Conclusions: The burden of stroke in China is still heavy. Greater attention should be paid to improve strategies for preventing stroke.
IntroductionThere is a downward trend of stroke-related mortality in the USA. By reviewing all published articles on stroke mortality in China, we analysed its trend and possible factors that have influenced the trend.MethodsBoth English and Chinese literatures were searched on the mortality of stroke or cerebrovascular diseases in China. Potential papers related to this topic were identified from PubMed, Medline, Embase, Cochrane Library, Wanfang Database, SINOMED and China National Knowledge Infrastructure databases.ResultsComparing the results from the most recent population-based epidemiological survey and databank from the national Center for Disease Control and Prevention, the age-adjusted stroke mortality rate has shown a downward trend among both urban and rural population in the past 30 years in China. Comparing with 30 years ago, the rate of stroke mortality has decreased by more than 31% in urban/suburban population and 11% in rural population. In men, the age-adjusted stroke mortality rate decreased by 18.9% and in women by 24.9% between 1994 and 2013. Factors that may have contributed to the trend of decreased stroke mortality rate include (1) improved healthcare coverage and healthcare environment; (2) improved treatment options and medical technology; (3) support by government to educate the public on stroke and stroke prevention; and (4) improved public knowledge on stroke.ConclusionsThe age-adjusted stroke mortality rate in China has shown a downward trend among both urban and rural population in the past 30 years. The major influencing factors that helped in reducing stroke mortality in China included improved healthcare coverage, healthcare environment, the updated treatment options and modern medical technology.
Systems containing interfaces between dissimilar materials can exhibit lower thermal conductivity than their pure constituents, with important implications for thermal management and thermoelectric energy conversion. However, the heat transfer processes at such interfaces, in particular those between organic and inorganic materials, remain for the most part uncharacterized. We use vacuum thermal evaporation to grow archetypal multilayer thin films of copper phthalocyanine (CuPc) and Ag or Al, and measure their thermal conductivity as a function of interface density. We observe large thermal boundary resistance values (7.8×10−8 m2 K/W for CuPc/Ag and 2.0×10−8 m2 K/W for CuPc/Al), attributable to acoustic mismatch, heat carrier mismatch, and weak bonding.
The craniopuncture combined with urokinase infusion therapy could reduce the rate of re-bleeding after surgery and the case fatality by 90 days. It also could improve the activities of daily living (Barthel index >or=95) at day 90. Thus, this therapy was a safe and practical technique in treating cerebral hemorrhage (30-80 ml), especially suitable for hospitals in rural areas or developing countries.
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