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Hepatitis E (Hepatitis E, HE) is an acute and chronic infectious hepatitis caused by hepatitis E virus (Hepatitis E Virus, HEV) infection, which is responsible for most acute hepatitis in the world and is a significant public health problem. The pathogen, HEV, has three Open Reading Frames (ORFs) ORF1, ORF2, and ORF3, each of which has a different function. Most of the current research is focused on ORF1 and ORF2, while the research on ORF3 is still relatively small. To provide more ideas for the study of HEV pathogenesis and the prevention and treatment of HE, this paper reviews the effects of ORF3 on the ERK pathway, growth factors, immune response, and virus release.
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BACKGROUND: The research aims to explore the characteristics of intestinal flora, nutritional status and immune function in patients with different types of obese colon cancer. METHODS: A retrospective analysis is conducted on 64 cases of obese colon cancer diagnosed from June 2018 to January 2020. According to the histological staging of the cancer, they are classified into adenocarcinoma, adenosquamous carcinoma and undifferentiated carcinoma, with corresponding cases of 24, 22 and 18, respectively. The intestinal flora (Bifidobacterium, Lactobacillus, Enterococcus faecalis, Escherichia coli, and yeast), nutritional status (Hb, Alb, PA, TFN, and PNI), immune function (IgG, IgM, IgA, CD4+, CD8+, and CD4+/CD8+) are analyzed in the different groups of patients. Survival curves are evaluated by Kaplan-Meier method and log-rank test for tumour death, local recurrence, and distant metastasis. RESULTS: There were no statistically significant differences in intestinal flora (Bifidobacterium, Lactobacillus, Enterococcus faecalis, Escherichia coli, and yeast), nutritional status (Hb, Alb, PA, TFN, and PNI) and immune function (IgG, IgM, IgA, CD4+, CD8+, and CD4+/CD8+) between different groups. There was a significant correlation between intestinal flora, nutritional status and immune function for all three. The survival curves of tumour death, local recurrence and distant metastasis in different groups of obese colon cancer patients were statistically significant. The tumor mortality rate, local recurrence, and distant metastasis rate in adenocarcinoma were 78.65%, 54.25% and 48.26% respectively. CONCLUSION: There are differences in intestinal flora, nutritional status and immune function among different types of obese colon cancer patients, but adenocarcinoma has the least benefit in intestinal flora, poor nutritional status, and weakest immune function.
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Neoplasias do Colo , Microbioma Gastrointestinal , Estado Nutricional , Obesidade , Humanos , Microbioma Gastrointestinal/imunologia , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias do Colo/imunologia , Neoplasias do Colo/microbiologia , Neoplasias do Colo/patologia , Obesidade/complicações , Obesidade/imunologia , Idoso , Adenocarcinoma/imunologia , Adenocarcinoma/microbiologia , Adenocarcinoma/patologia , AdultoRESUMO
JOURNAL/nrgr/04.03/01300535-202412000-00032/figure1/v/2024-04-08T165401Z/r/image-tiff For patients with chronic spinal cord injury, the conventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection, pressure sores, osteoporosis, and deep vein thrombosis. Surgery is rarely performed on spinal cord injury in the chronic phase, and few treatments have been proven effective in chronic spinal cord injury patients. Development of effective therapies for chronic spinal cord injury patients is needed. We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal cord injury to compare intensive rehabilitation (weight-bearing walking training) alone with surgical intervention plus intensive rehabilitation. This clinical trial was registered at ClinicalTrials.gov (NCT02663310). The goal of surgical intervention was spinal cord detethering, restoration of cerebrospinal fluid flow, and elimination of residual spinal cord compression. We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement, reduced spasticity, and more rapid bowel and bladder functional recovery than weight-bearing walking training alone. Overall, the surgical procedures and intensive rehabilitation were safe. American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries. Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.
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Conventional water immersion ultrasonic testing faces limitations due to factors such as environmental conditions, workpiece dimensions, corrosion, and resource wastage. Contact-based coupling methods, which employ coupling media or specific coupling structures, offer a convenient approach to coupling acoustic waves and reduce signal attenuation. However, these methods are time-sensitive and lack adaptability to uneven surfaces, particularly when dealing with workpieces featuring subtle undulations, resulting in significant signal decay. This paper presents an ultrasonic coupling method based on a flexible capillary water column array. By employing a stable and flexible water column array within the micro-channels as the coupling medium, stable contact-based transmission of ultrasonic signals is achieved. The influence of water column array unit dimensions and array structures is explored through theoretical analysis and experimentation, demonstrating lower energy attenuation compared to reductions in water column area. Notably, the tests revealed the method's adaptability at oblique angles below 20°, which surpasses the performance of submerged detection at similar angles. This research presents an innovative and stable approach for contact-based ultrasonic coupling testing, particularly in scenarios involving dynamic contact scanning between ultrasonic waves and workpieces.
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BACKGROUND: Traumatic brain injury (TBI) is one of the leading causes of death and disability annually worldwide. However, the epidemiology of TBI had not been established in China. We conducted a nationally representative door-to-door survey in the general population across all age groups in 31 provinces in mainland China in 2013. METHODS: All participants were reviewed for a history of physician-diagnosed TBI by trained investigators using a structured questionnaire. TBI survivors were considered as prevalent cases at the prevalent time. The present study also examined the odds of TBI as a function of sex, age, and other demographical variables using logistic regression model. RESULTS: Of 583,870 participants, 2,673 individuals had suffered from a TBI during their past life, yielding a weighted prevalence of being 442.4 (95% CI 342.2-542.6) per 100,000 person. The TBI prevalence increased with increasing age. The present study observed the multiadjusted ORs of TBI were 1.9 (95% CI 1.8-2.1) for the male, 1.9 (95% CI 1.2-3.1) for the farmers, 1.9 (95% CI 1.2-3.3) for the retiree or homemakers, 3.4 (95% CI 1.5-7.7), and 2.8 (95% CI 1.1-6.6) for those whose education were primary school and high school, respectively. The most common external cause was road traffic accidents among those who were aged 18-34 years old and those whose educational levels were middle school in both genders. CONCLUSIONS: Our results indicate TBI was substantially prevalent among Chinese population and underscore the need to develop national strategies to improve the safe education on road and traffic of TBI in rural residents and some subgroup population.
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Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Lesões Encefálicas Traumáticas/epidemiologia , Lesões Encefálicas Traumáticas/etiologia , População Rural/estatística & dados numéricos , Adolescente , Adulto , Idoso , China/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco , Adulto JovemRESUMO
A new type of inhibitor is studied in this paper. Inhibition efficiency and adsorption behavior of an inhibitor film on the steel surface is tested via the electrochemical method and theoretical calculation to establish the adsorption model. Test results confirm that inhibition efficiency is improved with the addition of an inhibitor, and the inhibitor film is formed firmly by comparing the characteristic peaks of S and N. Moreover, the micro-zone corrosion progress of Fe in 3.5% invasive NaCl-simulated seawater environment is studied. The results further show that corrosion is initiated under the zone without the inhibitor film, while it is prevented under the protection of the film. By the experiments, it is shown that inhibitor can be adsorbed on the surface of steel stably and has excellent protection performance for reinforced rebar, which can be widely used in concrete structure.
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Carbonation plays an indispensable role in engineering construction, embracing mineralization, CO2 sequestration and low pH induced corrosion, but the essential mechanism of carbonation occurring in calcium silicate hydrate or portlandite can hardly be interpreted. Observation on how carbonation proceeds at the nano scale is thus critical for a better understanding of its dynamics. Here, using electron microscopy combined with first-principles calculation, a new view on carbonation in the cement system is revealed, considering morphological diversity, growth mechanism and shape evolution. Two types of crystalline forms of calcium carbonate (i.e. cubic and spindle) under room conditions were observed and determined to be calcite, both experimentally and theoretically. The mechanism of morphological evolution of calcite in a cement system was demonstrated based on the theory of aqueous chemistry. The [Ca2+] to [CO3] ratio was the principle cause for the diversity in crystal morphology instead of the types of reactants (i.e. portlandite or calcium silicate hydrates). Excess calcium species in the solution could selectively adsorb on surfaces, resulting in an inhibitive effect on the growth of specific crystal faces, (1 0 4)calcite and (2 1 1[combining macron])calcite in this case. Furthermore, a relationship between relative ionic concentration and the length to diameter ratio was established to predict the shape transformation. This work makes it possible to explore the chemical nature of carbonation from a nano scope rather than being confined to the macroscopic carbonation of concrete.
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BACKGROUND AND AIM: Studies have shown an increasing number of type 2 diabetes (T2D) patients with concomitant obesity and hyperlipidemia syndromes, resulting from relevant metabolic disorders. However, there are few medications and therapies, which can thoroughly address these issues. Therefore, the current study evaluated the efficacy and safety of using JTTZ, a Chinese herbal formula, to treat T2D with obesity and hyperlipidemia. METHODS: A total of 450 participants with T2D (HbA1c ≥ 7.0%; waist circumference ≥ 90 cm and 80 cm in males and females, resp.; and triglycerides (TG) ≥ 1.7 mmol/L) were randomly assigned, in equal proportions, to two groups in this multicenter randomized, positive-controlled, open-label trial. One group received JTTZ formula, and the other received metformin (MET) for 12 consecutive weeks. The primary efficacy outcomes were changes in HbA1c, TG, weight, and waist circumference. Adverse reactions and hypoglycemia were monitored. RESULTS: HbA1c decreased by 0.75 ± 1.32% and 0.71 ± 1.2% in the JTTZ and MET groups, respectively, after 12 weeks of treatment. TG levels in the JTTZ and MET groups were reduced by 0.64 ± 2.37 mmol/L and 0.37 ± 2.18 mmol/L, respectively. Weight was decreased by 2.47 ± 2.71 kg in the JTTZ group and by 2.03 ± 2.36 kg in the MET group. JTTZ also appeared to alleviate insulin resistance and increase HOMA-ß. In addition, symptoms were significantly relieved in participants in the JTTZ group compared to those in the MET group. One case of hypoglycemia was reported in the MET group. No severe adverse events were reported in either group. CONCLUSIONS: The JTTZ formula led to safe and significant improvements in the blood glucose, blood lipids, and weight levels; relieved symptoms; and enhanced ß cell function for T2D patients with obesity and hyperlipidemia. The JTTZ formula has shown that it could potentially be developed as an alternative medicine for patients with T2D, particularly those who cannot tolerate metformin or other hypoglycemic drugs. This trial was registered with Clinicaltrials.gov NCT01471275.
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Accumulating evidence implicates gut microbiota as promising targets for the treatment of type 2 diabetes mellitus (T2DM). With a randomized clinical trial, we tested the hypothesis that alteration of gut microbiota may be involved in the alleviation of T2DM with hyperlipidemia by metformin and a specifically designed herbal formula (AMC). Four hundred fifty patients with T2DM and hyperlipidemia were randomly assigned to either the metformin- or AMC-treated group. After 12 weeks of treatment, 100 patients were randomly selected from each group and assessed for clinical improvement. The effects of the two drugs on the intestinal microbiota were evaluated by analyzing the V3 and V4 regions of the 16S rRNA gene by Illumina sequencing and multivariate statistical methods. Both metformin and AMC significantly alleviated hyperglycemia and hyperlipidemia and shifted gut microbiota structure in diabetic patients. They significantly increased a coabundant group represented by Blautia spp., which significantly correlated with the improvements in glucose and lipid homeostasis. However, AMC showed better efficacies in improving homeostasis model assessment of insulin resistance (HOMA-IR) and plasma triglyceride and also exerted a larger effect on gut microbiota. Furthermore, only AMC increased the coabundant group represented by Faecalibacterium spp., which was previously reported to be associated with the alleviation of T2DM in a randomized clinical trial. Metformin and the Chinese herbal formula may ameliorate type 2 diabetes with hyperlipidemia via enriching beneficial bacteria, such as Blautia and Faecalibacterium spp.IMPORTANCE Metabolic diseases such as T2DM and obesity have become a worldwide public health threat. Accumulating evidence indicates that gut microbiota can causatively arouse metabolic diseases, and thus the gut microbiota serves as a promising target for disease control. In this study, we evaluated the role of gut microbiota during improvements in hyperglycemia and hyperlipidemia by two drugs: metformin and a specifically designed Chinese herbal formula (AMC) for diabetic patients with hyperlipidemia. Both drugs significantly ameliorated blood glucose and lipid levels and shifted the gut microbiota. Blautia spp. were identified as being associated with improvements in glucose and lipid homeostasis for both drugs. AMC exerted larger effects on the gut microbiota together with better efficacies in improving HOMA-IR and plasma triglyceride levels, which were associated with the enrichment of Faecalibacterium spp. In brief, these data suggest that gut microbiota might be involved in the alleviation of diabetes with hyperlipidemia by metformin and the AMC herbal formula.
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Fármacos Antiobesidade/administração & dosagem , Bactérias/isolamento & purificação , Diabetes Mellitus Tipo 2/tratamento farmacológico , Medicamentos de Ervas Chinesas/administração & dosagem , Microbioma Gastrointestinal/efeitos dos fármacos , Hiperlipidemias/tratamento farmacológico , Metformina/administração & dosagem , Adolescente , Adulto , Idoso , Bactérias/classificação , Bactérias/genética , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/microbiologia , Medicamentos de Ervas Chinesas/química , Feminino , Humanos , Hiperlipidemias/metabolismo , Hiperlipidemias/microbiologia , Masculino , Pessoa de Meia-Idade , Triglicerídeos/sangue , Adulto JovemRESUMO
Herein, the protective performance of a new triazole inhibitor for carbon steel was studied by electrochemical methods. Potentiodynamic polarization curves showed that the anti-corrosion efficiency improved with increasing concentrations of the inhibitor and the results show that it is 22 times corrosion resistance efficiency for inhibitor compared to bare aggressive solution. X-ray photoelectron spectroscopy showed that the film adsorbed well on the carbon steel surface. The scanning vibrating electrode technique demonstrated the corrosion process of carbon steel with and without the protection of inhibitor. Thus, a mechanism for the corrosion process was proposed and the behavior of carbon steel under the protection of the inhibitor was discussed.
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The epidemiological characteristics of transient ischemic attacks (TIAs) in China are unclear. In 2013, we conducted a nationally representative, door-to-door epidemiological survey on TIA in China using a complex, multistage, probability sampling design. Results showed that the weighted prevalence of TIA in China was 103.3 [95% confidence interval (CI): 83.9-127.2] per 100,000 in the population, 92.4 (75.0-113.8) per 100,000 among men, and 114.7 (87.2-151.0) per 100,000 among women. The weighted incidence of TIA was 23.9 (17.8-32.0) per 100,000 in the population, 21.3 (14.3-31.5) per 100,000 among men, and 26.6 (17.0-41.7) per 100,000 among women. No difference in average prognosis was found between TIA and stroke in the population. Weighted risk of stroke among TIA patients was 9.7% (6.5-14.3%), 11.1% (7.5-16.1%), and 12.3% (8.4-17.7%) at 2, 30, and 90 days, respectively. The risk of stroke was higher among male patients with a history of TIA than among female patients with a history of TIA (OR: 2.469; 95% CI: 1.172-5.201; P = 0.018), and higher among TIA patients with hypertension than among TIA patients without hypertension (OR: 2.671; 1.547-4.613; P < 0.001). It can be concluded that there are an estimated 1.35 million TIA patients nationwide, with 0.31 million new cases of TIA annually in China. TIA patients were not better managed prior to a stroke event. Early risk of stroke among TIA patients is high. Sex and hypertension may be stroke-associated prognostic factors among TIA patients. TIA clinics and surveillance should be integrated into the national health-care system.
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BACKGROUND: China bears the biggest stroke burden in the world. However, little is known about the current prevalence, incidence, and mortality of stroke at the national level, and the trend in the past 30 years. METHODS: In 2013, a nationally representative door-to-door survey was conducted in 155 urban and rural centers in 31 provinces in China, totaling 480 687 adults aged ≥20 years. All stroke survivors were considered as prevalent stroke cases at the prevalent time (August 31, 2013). First-ever strokes that occurred during 1 year preceding the survey point-prevalent time were considered as incident cases. According to computed tomography/MRI/autopsy findings, strokes were categorized into ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and stroke of undetermined type. RESULTS: Of 480 687 participants, 7672 were diagnosed with a prevalent stroke (1596.0/100 000 people) and 1643 with incident strokes (345.1/100 000 person-years). The age-standardized prevalence, incidence, and mortality rates were 1114.8/100 000 people, 246.8 and 114.8/100 000 person-years, respectively. Pathological type of stroke was documented by computed tomography/MRI brain scanning in 90% of prevalent and 83% of incident stroke cases. Among incident and prevalent strokes, ischemic stroke constituted 69.6% and 77.8%, intracerebral hemorrhage 23.8% and 15.8%, subarachnoid hemorrhage 4.4% and 4.4%, and undetermined type 2.1% and 2.0%, respectively. Age-specific stroke prevalence in men aged ≥40 years was significantly greater than the prevalence in women (P<0.001). The most prevalent risk factors among stroke survivors were hypertension (88%), smoking (48%), and alcohol use (44%). Stroke prevalence estimates in 2013 were statistically greater than those reported in China 3 decades ago, especially among rural residents (P=0.017). The highest annual incidence and mortality of stroke was in Northeast (365 and 159/100 000 person-years), then Central areas (326 and 154/100 000 person-years), and the lowest incidence was in Southwest China (154/100 000 person-years), and the lowest mortality was in South China (65/100 000 person-years) (P<0.002). CONCLUSIONS: 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.
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Acidente Vascular Cerebral/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Encéfalo/diagnóstico por imagem , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural , Fatores Sexuais , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/patologia , Inquéritos e Questionários , Taxa de Sobrevida , Tomografia Computadorizada por Raios X , População Urbana , Adulto JovemRESUMO
To analyze and discuss placebo-related information in clinical research literatures in the past 30 years, including placebo's dosage form, ingredients, preparation process and quality control. Effort were made to research the CNKI. full-text database to preliminary find 700 placebo-related clinical research literature, screen out 301 eligible articles by hand, read the literatures to extract placebo-related information and make statistics and discussions. According to the results, Chinese randomized placebo-controlled clinical studies were characterized by diverse dosage forms of placebo with lack of reports for components, as evidenced by the only 17 literatures describing placebo's preparation or specific composition among the 301 literatures. Placebo-controlled clinical trials covered a wide range of disease spectra, but with a specific tropism of diseases in terms of system classification. Although placebo plays a key role in blinded clinical studies, researchers made less records of placebo, perhaps because they paid less attention to placebo or more attention to the research process or restricted by other objective conditions. Moreover, placebo production, quality control and quality evaluation also need to be further standardized.
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Pesquisa Biomédica/história , Efeito Placebo , Ensaios Clínicos Controlados Aleatórios como Assunto/história , Pesquisa Biomédica/normas , China , História do Século XX , História do Século XXI , Humanos , Controle de Qualidade , Ensaios Clínicos Controlados Aleatórios como Assunto/normasRESUMO
The aim of this study was to analyse high blood pressure detection, management, control and associated factors among residents accessing community health services (CHSs) in Beijing. We screened for HBP in 9524 individuals aged 50 years or older who accessed care in four Beijing CHSs. Among the 9397 residents with questionnaire responses that qualified them for inclusion in the study, 5029 patients with HBP were identified, 1510 (i.e., 30% of the HBP patient group) of whom were newly identified cases. The rate of hypertension detection was 53.5%. Among the 5029 HBP patients, the rates of awareness, treatment and control of hypertension were 70.0%, 62.1% and 29.6%, respectively. In general, the rate of hypertension control was higher when the rates of hypertension awareness and treatment were higher in subgroups stratified by different sociodemographic and risk factors, except for the overweight and obesity subgroups. In conclusion, suboptimal HBP awareness, treatment, and control are still major problems confronting CHSs in Beijing. Control of hypertension in the population may be improved by increasing awareness and improving the treatment of hypertension in CHSs.
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Serviços de Saúde Comunitária , Acessibilidade aos Serviços de Saúde , Hipertensão/epidemiologia , Idoso , Pressão Sanguínea , China/epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Hipertensão/prevenção & controle , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Vigilância da População , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The prevalence rate of overweight and obese has been escalating over the past two decades in China. Even so, the association between obesity and stroke still remains unclear to some extent. AIMS: The aim of this study was to elucidate the association between body mass index and stroke in a large Chinese population cohort. METHODS: A cohort of 26 607 Chinese people, aged over 35 years, was investigated in 1987. Baseline information of body weight and height was used to calculate BMI (weight in kilograms divided by height in meters squared, kg/m(2) ). Cox proportional hazards model was fitted to estimate hazard ratios of stroke adjusted for age, educational level, smoking and alcohol consumption. RESULTS: The 11-year follow-up revealed (241 149 person-years) a total of 1108 stroke events (614 ischemic, 451 hemorrhagic, and 44 undefined stroke). Body mass index ≥ 30·0 was an independent risk factor for stroke both in men and women. Compared with normal weight, hazard ratios for total stroke were 0·74 in men underweight (95% confidence interval: 0·53â¼1·03), 1·63 overweight (95% confidence interval: 1·35â¼1·96), and 2·20 with obesity (95% confidence interval: 1·47â¼3·30); and with ischemic stroke, hazard ratios were 0·52 in those underweight (95% confidence interval: 0·30â¼0·89), 2·08 overweight (95% confidence interval: 1·65â¼2·62), and 3·80 with obesity (95% confidence interval: 2·47â¼5·86). In women, the corresponding hazard ratios for total stroke were 0·79 underweight (95% confidence interval: 0·58â¼1·07), 1·42 overweight (95% confidence interval: 1·16â¼1·73), and 1·57 with obesity (95% confidence interval: 1·06â¼2·31); and for those with ischemic stroke, 0·92 underweight (95% confidence interval: 0·59â¼1·43), 1·90 overweight (95% confidence interval: 1·44â¼2·50), and 2·42 with obesity (95% confidence interval: 1·50â¼3·93). There appeared an evident dose-response relationship between body mass index and the risk of developing stroke, which still appeared, however, adjusted low for hypertension, diabetes, and heart disease. Decreased risk for stroke in the leanest group was confined to men only. No association was found between body mass index and hemorrhagic stroke in both genders. CONCLUSIONS: Our data suggest that body mass index was an independent risk factor for total and ischemic stroke but not for hemorrhagic stroke in both genders. Association between body mass index and stroke was extremely mediated by hypertension, diabetes, and heart disease. Decreased risk for the leanest group was confined to men.
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Índice de Massa Corporal , Obesidade/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , China , Estudos de Coortes , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Acidente Vascular Cerebral/classificaçãoAssuntos
Ataque Isquêmico Transitório/prevenção & controle , Prevenção Secundária/normas , Acidente Vascular Cerebral/prevenção & controle , China/epidemiologia , Humanos , Ataque Isquêmico Transitório/diagnóstico , Ataque Isquêmico Transitório/epidemiologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologiaRESUMO
BACKGROUND AND PURPOSE: Intensive control of the risk factors of stroke and the pre-hospital delay after stroke onset both depend on the level of knowledge of stroke in the general population. Our primary objective was to assess the public knowledge about stroke among urban residents in four cities in China. METHODS: A semi-structured interview and questionnaire was delivered in a survey. Standardized risk factor and symptom statements were used to measure knowledge. The setting of two communities from four different cities of China was used to target a mix of social class and geography. Using systematic sampling and the household as a unit, at least 300 households were chosen in one community. Each household selected one person to fill in the self-designed questionnaire. Uniform training of community physicians was conducted before the survey, and the community physicians completed the survey by face to face indoor-investigation. RESULTS: Total integral questionnaires numbered 2519. The investigation showed that (1) hypertension was identified as a risk factor by nearly 90% of residents. Dyslipidemia, smoking, diabetes, and non-modifiable risk factors were identified by less than 65%; (2) medical therapy of hypertension and diabetes was known by nearly 80% of residents, and the awareness of lifestyle modification was less; (3) weakness or numbness were the most common symptoms identified by community residents (80.2%), and the awareness of other symptoms of stroke ranged from 58.2 to 71.2%; (4) the stroke knowledge score and education level were positively correlated (r(s) = 0.088, P<0.001), and age was negatively correlated (r(s) = -0.142, P<0.001); (5) 53.0% of residents would call an emergency medical system once stroke symptoms began; (6) the main sources of information about stroke were television (74.4%), doctors (63.2%) and newspapers (61.8%). CONCLUSION: At present, the urban community residents in China are lacking in knowledge about stroke. Going forward, we should strengthen health education through television, medical staff, newspapers, magazines. Targeted educational populations should be directed at those who are elderly, lower education, male and high risk.
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Povo Asiático/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Acidente Vascular Cerebral/etnologia , Acidente Vascular Cerebral/psicologia , Inquéritos e Questionários , Adulto , Idoso , Povo Asiático/educação , China/epidemiologia , Diabetes Mellitus/etnologia , Diabetes Mellitus/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertensão/etnologia , Hipertensão/psicologia , Incidência , Masculino , Pessoa de Meia-Idade , Características de Residência , Fatores de Risco , Inquéritos e Questionários/normas , População Urbana , Adulto JovemRESUMO
OBJECTIVE: To explore associations between levels of total cholesterol (TC), triglyceride (TG) and incidence of ischemic and hemorrhagic strokes in populations. METHODS: Baseline investigations on stroke-related risk factors and physical examinations were performed in 10 093 (> 35 years) stroke-free urban community residents from 5 cities in China during May to July in 1987, follow-up investigations on stroke events were made during 1998 to 2000. The hazard ratios and 95% confidence intervals (CI) of ischemic and hemorrhagic strokes in middle, high tertiles of baseline TC or TG levels were compared with low baseline tertile residents using the Cox regression model. RESULTS: There were 491 first strokes during the 8-years cohort follow-up. Compared with the low tertile, risk of ischemic stroke in the middle and high tertiles of TC level was increased by 61% (HR: 1.61, 95%CI: 1.14-2.27) and 58% (HR: 1.58, 95%CI: 1.12-2.22) after adjustments for DBP, age, sex and other variables in the Cox proportional hazards model. Compared with the low tertile, risk of ischemic stroke in the high tertile of TG level was increased by 43% (HR: 1.43, 95%CI: 1.02-2.00). However, risk of hemorrhagic stroke in the middle and high tertiles of TC level decreased by 12% (HR: 0.88, 95%CI: 0.64-1.22) and 33% (HR: 0.67, 95%CI: 0.48-0.95) compared with the low tertile. CONCLUSIONS: Elevated serum TC and TG are independent risk factors for risk of ischemic stroke. However, low TC was related with increased risk of hemorrhagic stroke.
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Colesterol/sangue , Acidente Vascular Cerebral/etiologia , Triglicerídeos/sangue , Idoso , China/epidemiologia , HDL-Colesterol/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/epidemiologiaRESUMO
OBJECTIVES: To retrospectively evaluate the prognostic performance of a dynamic susceptibility contrast (DSC) MRI metric for permeability (relative recirculation or rR) for the prediction of hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS). To compare rR with dynamic contrast-enhanced (DCE) MRI estimates of blood-brain barrier permeability (KPS). MATERIALS AND METHODS: Data obtained from 26 patients (age: 27-89 years) with a working diagnosis of AIS were examined retrospectively. Patients were examined within a mean of 3.5 hours of symptom onset. Eleven patients received intravenous recombinant tissue-plasminogen activator (rt-PA). HT was determined by follow-up computed tomography and/or magnetic resonance imaging 24 to 72 hours after initial imaging. Permeability (DCE) always preceded DSC imaging and consisted of a 3D gradient-recalled echo scan acquired in 4 minutes 48 s. DSC imaging consisted of a T2*-weighted single shot EPI scan acquired in 43 to 86 seconds. Gadodiamide (0.1 mmol/kg) was injected as a bolus for each scan. Permeability (KPS) and rR were calculated offline for regions of interest (ROI) defined within the core of the infarct, as well as within the homologous location in the contralateral hemisphere. The relationship between KPS and rR was investigated using linear regression and receiver operating characteristic (ROC) curves were computed for predicting HT from either rR or KPS. RESULTS: Eleven patients proceeded to HT (including 5 treated with rt-PA). Mean KPS values were significantly elevated in infarct relative to contralateral areas (0.84 +/- 0.57 vs. 0.42 +/- 0.34 mL/100 g/min; P = 0.0003). For infarct ROIs, KPS values were significantly greater in patients with HT compared with non-HT patients (1.25 +/- 0.63 vs. 0.53 +/- 0.23 mL/100 g/min; P = 0.0015). KPS values were higher in patients who received rt-PA than in untreated patients (1.09 +/- 0.61 vs. 0.65 +/- 0.47 mL/100 g/min; P = 0.0497). ROC analysis indicated a KPS threshold value of 0.67 mL/100 g/min for providing an optimal sensitivity and specificity for predicting HT of 91% and 80%, respectively. Mean rR values for infarct ROIs were significantly higher than those determined for contralateral regions (0.17 +/- 0.06 vs. 0.09 +/- 0.03; P < 0.0001). The mean rR for the HT group was significantly greater than for the non-HT group (0.22 +/- 0.05 vs. 0.14 +/- 0.05; P = 0.0002). As with KPS, the mean rR for patients who were treated with rt-PA was significantly greater than for untreated patients (0.21 +/- 0.07 vs. 0.15 +/- 0.05; P = 0.0112). ROC analysis indicated a threshold value of 0.17 for providing optimal sensitivity and specificity for predicting HT of 91% and 87%, respectively. There was a significant correlation between rR and KPS for infarct ROIs (r = 0.67; P < 0.001). CONCLUSIONS: Both KPS and rR are significantly elevated in infarcted, relative to uninfarcted tissue in the same AIS patient. Both parameters were also significantly elevated in HT, relative to non-HT infarcts. The strong correlation between rR and KPS, coupled with the high sensitivity and specificity of rR for the prediction of HT suggest that rR is related to blood-brain barrier integrity in AIS and may prove valuable in the prediction of HT.
Assuntos
Barreira Hematoencefálica/patologia , Isquemia Encefálica/diagnóstico , Hemorragia Cerebral/diagnóstico , Acidente Vascular Cerebral/diagnóstico , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/complicações , Hemorragia Cerebral/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Permeabilidade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Acidente Vascular Cerebral/complicaçõesRESUMO
Regional pulmonary blood flow can be assessed using both dynamic contrast-enhanced (DCE) MR and phase-contrast (PC) MR. These methods provide somewhat complementary information: DCE MR can assess flow over the entire lung while PC MR can detect rapid changes in flow to a targeted region. Although both methods are considered accurate, one may be more feasible than the other depending on pathology, patient condition, and availability of an intravenous route. The objective of this study was to establish a consensus between the two methods by comparing paired DCE MR and PC MR measurements of relative blood flow in Yorkshire piglets (N = 5, age = 7 days, weight = 3.3 +/- 0.6 kg) under various physiological states including regional lung collapse. A strong correlation (R(2) = 0.71, P < 0.01) was observed between the methods. In conclusion, DCE MR and PC MR provide a consistent measure of changes in regional pulmonary blood flow.