Management of elbow dysfunction associated with giant cell tumor of the distal humerus: achieving oncologic safety and good function by a combined reconstruction.

BACKGROUND: The purpose of our study was to evaluate the functional outcomes and oncologic results of elbow salvage surgery using arthrolysis combined with ligament repair and external fixation for reconstruction of the elbow after tumor excision and autografting. METHODS: We retrospectively reviewed 6 patients with elbow dysfunction associated with giant cell tumor of the distal humerus. All patients were treated with our combined protocol. We assessed the Musculoskeletal Tumor Society system score, range of motion, Mayo Elbow Performance Score, recurrence, and complications for each patient. RESULTS: The mean follow-up period was 48 months (range, 36-60 months). There were no cases of postoperative fracture, infection, elbow dislocation, elbow stiffness, or local recurrence. The average Musculoskeletal Tumor Society score was 28 of 30 points (93%; range, 87%-100%). The Mayo Elbow Performance Score improved from a mean of 61 points to 93 points, with mean flexion of 135° and mean extension of 3°. CONCLUSIONS: Local tumor resection, autografting, and elbow reconstruction by arthrolysis combined with ligament repair and external fixation can be performed with oncologic safety and provide satisfactory functional outcomes with low complication rates.

New Chinese dietary guidelines: healthy eating patterns and food-based dietary recommendations.

BACKGROUND AND OBJECTIVES: The Chinese Dietary Guidelines (CDGs) were first released to the public in 1989 by the Chinese Nutrition Society (CNS). In 2016, the Ministry of Health commissioned the CNS to revise and publish new CDGs. METHODS AND STUDY DESIGN: The CNS convened an expert committee of leaders in the fields of nutrition, epidemiology, public health, preventive medicine, and food science. The CDGs were revised according to the World Health Organization Handbook for Guideline Development procedures. The expert committee recommended key inclusions for the CDGs on the basis of the current status of public health and priority health challenges affecting the Chinese population, as well as the quality of scientific evidence. RESULTS: The CDGs (2016) provide six key dietary recommendations for the general Chinese population aged 2 years and above. In addition to a newly revised Chinese Food Guide Pagoda, both the Chinese Food Guide Plate and Chinese Food Guide Abacus are newly created pictorial models in the CDGs (2016); the Chinese Food Guide Abacus is specifically designed for children. Seven additional dietary guidelines targeting specific populations are included; these guidelines emphasize the different physiological and nutritional requirements of particular populations, including dietary guidelines for vegetarians for the first time. CONCLUSIONS: The CDGs (2016) is an official document published by the National Health Commission of China. Its content highlights the current status of public health and offers advice to address health concerns faced by the Chinese population. The CDGs (2016) have been widely disseminated and accepted in the Chinese population; the National Nutrition Week is a major national event in which the CDG are used as its core to increase public awareness towards a healthy diet and lifestyle.

Management of Heterotopic Pregnancy: Experience From 1 Tertiary Medical Center.

The objective of this study is to summarize the experiences of our department in the management of heterotopic pregnancy (HP) and to analyze the influence of different treatment modality on the viable intrauterine pregnancy.There were 64 patients diagnosed as HP in the Department of Gynecology and Obstetrics in our hospital between January 2003 and June 2014, 52 HP patients with viable intrauterine pregnancy were included and analyzed in our study. Interventions included expectant management, surgical management and transabdominal sonographic guided transvaginal aspiration of ectopic gestational embryo (embryo aspiration) management.Main outcome measures are maternal outcome and pregnancy outcome.In expectant management group, 4 patients suffered rupture of ectopic pregnancy, 6 patients transferred to surgical management, 1 patient suffered a fever of 40.4°C, the abortion rate was 5% (1/20). In surgical management group, emergency surgery was performed in 9 patients with unstable hemodynamics and 3 patients with stable hemodynamics, 1 patient suffered uterine rupture 5 weeks later and dead fetus was demonstrated, 1 patient suffered urinary retention postoperative, the abortion rate was 14.8% (4/27). In embryo aspiration management group, 1 patient needed another embryo aspiration, all patients were eventful and no abortion was observed.In our retrospective study, transabdominal sonographic guided aspiration of ectopic gestational embryo has the best maternal outcome and the lowest abortion rate, surgical management group shows the highest abortion rate, and expectant management presents the worst maternal outcome.

Early cervical cancer impact of peritoneal vaginoplasty combined with laparoscopic radical hysterectomy improved sexual function.

OBJECTIVE: We investigated the impact of laparoscopic radical hysterectomy (LRH) in combination with peritoneal vaginoplasty (PV) in improving sexual function after radical hysterectomy (RH) in patients with early cervical cancer. METHODS: A total of 79 patients with early-stage cervical cancer younger than 45 years were assigned to receive LRH in combination with PV (the LRH-PV group; n = 31) or LRH alone (the LRH group; n = 48). Other 40 healthy females were selected as controls (the control group). The sexual function was assessed with Female Sexual Functioning Index (FSFI). The FSFI scores and sexual function in the postoperative 1 year were compared between the LRH-PV and LRH groups, LRH-PV and control groups, and LRH and control groups, respectively. RESULTS: Patients with LRH-PV showed significantly higher scores in sexual satisfaction, lubrication, pain, and total score than those with LRH alone (P < 0.05) but were not statistically different in scores regarding sexual desire, arousal, and orgasm (P > 0.05). Healthy controls showed the highest in total scores and 6 domains among all subjects. In addition, the FSFI total scores in the LRH-PV group, LRH group, and LRH-PV + LRH group were significantly decreased compared with the control (P < 0.05). CONCLUSIONS: Peritoneal vaginoplasty to lengthen the vagina improves sexual function of patients with early cervical cancer receiving LRH in sexual satisfaction, lubrication, and pain.

Analyzing simultaneous positive expression of EZH2 and P53 protein to improve predictive value in cervical squamous cell carcinoma.

OBJECTIVE: The current study was undertaken to investigate the predictive value of simultaneous enhancer of zeste homolog 2 (EZH2) and P53 expression in lesions of patients with cervical squamous cell carcinoma. METHODS: Quantum dot double fluorescence staining was applied to detect EZH2 and P53 protein in biopsy tissue of 168 patients with cervical squamous cell carcinoma. The expression was classified into double positive (EZH2 and P53 were positively expressed), single positive (either EZH2 or P53 was positively expressed), and double negative (neither was positively expressed). The EZH2 and P53 expression, clinical stages of cervical cancer, lymph node metastasis, progression-free survival, and overall survival were analyzed. RESULTS: A relationship of EZH2 and P53 expression with the clinical stage of cervical cancer and lymph node metastasis was indicated. Simultaneous detection of both proteins could partly predict prognosis, consistent with previous studies' results. The current study demonstrated that the expression levels of EZH2 and P53 in tumor tissue and the proportion of cases with double-positive expression significantly increased with increasing clinical stages of cancer, also confirming up-regulated expression of EZH2 and P53 with increasing stages. These findings may suggest that the 2 proteins were involved in the development of cervical cancer, but the nature of their interaction is undefined. The increase of EZH2 and P53 expression in patients with lymph node metastasis indicated that they may be involved in metastasis of cervical cancer. CONCLUSION: Simultaneous positive EZH2 and P53 expression could improve the predictive value of a poor prognosis in cervical cancer.

Transvaginal surgical management of cesarean scar pregnancy: analysis of 49 cases from one tertiary care center.

OBJECTIVE: To investigate the safety and effectiveness of transvaginal surgical management of cesarean scar pregnancy (CSP). STUDY DESIGN: Retrospective analysis of 49 CSP patients who received transvaginal surgery in our hospital between December 2009 and April 2013. Patients were divided into two groups. Group A (30 patients) was defined as patients who had not received any treatment before transvaginal surgical management. Group B (19 patients) referred to patients who had received any previous treatment. Preoperative, intraoperative and postoperative data of both groups were collected and analyzed retrospectively. RESULTS: Preoperative serum ß-hCG level, preoperative hemoglobin level and average serum ß-hCG resolution time of group A and group B were 53,458.50 (36,382.00-94,100.50) versus 9779.00 (932.50-29623.00)U/l, 123.87±10.95 versus 109.94±16.05 g/l and 3.55±1.81 versus 1.83±1.15 weeks (P<0.05). Vaginal bleeding and gestational age in group A were significantly lower than in group B, 2.5 (0.50-11.00) versus 15.00 (3.50-31.50) days and 52.50 (46.50-56.70) versus 60.00 (48.00-90.00) days, respectively (P<0.05). The operative time, estimated blood loss, postoperative hospital stay, hospitalization expenses and menstruation recovery time of group A and group B were 56.61±24.40 versus 67.56±43.52 min, 45.65±27.83 versus 76.67±50.87 ml, 5.10±2.89 versus 5.33±3.99 days, 9001.94±1848.37 versus 11,032.33±5534.14 RMB and 1.16±0.47 versus 1.26±0.63 month respectively, which were similar between the two groups (P>0.05). The intraoperative complication rate in group A was significantly lower than group B, 0 (0/30) versus 21.05% (4/19) (P<0.05). The postoperative complication rate and total complication rate in group A and group B were 10.00% (3/30) versus 21.05% (4/19) and 10.00% (3/30) versus 31.58% (6/19) (P>0.05), respectively. CONCLUSION: Transvaginal surgery is an effective and relatively safe treatment option for CSP patients.

Outline of the report on cardiovascular disease in China, 2010.

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.

[The current situation of blood pressure control and the influencing factors on hypertensive patients in residential communities of China].

OBJECTIVE: To understand the situation of blood pressure control and the major factors influencing the programs among those hypertensive patients living in the communities from different parts of China. METHODS: A protocol of community-based standardized blood pressure management was developed based on the current Chinese guideline for prevention, treatment of hypertension. Grass-roots caretakers from community health service centers across China were trained under the requirement of this protocol to manage the hypertensive patients. In this study, the hypertensive patients who had been registered in the project centers from Beijing, Hebei, Gansu, Jiangsu, Zhejiang, Guangdong provinces, were selected as the study subjects, and the baseline data for these patients was analyzed. RESULTS: By the end of 2010, a total of 242 182 patients were registered. The mean age was 61.0 ± 10.5, with 48.5% of them being males. The overall control rate of blood pressure was 27.4%. The control rate was significant lower among patients who were in lower age group, being male, with higher BMI, smoking, drinking or with more salt consumption. However, the control rate was significant higher among those patients who had family history of hypertension, always undertook physical exercise or receiving medical treatment. CONCLUSION: The blood pressure control rate for community hypertensive patients in China was still in a relatively low level. Standardization management measures should be strengthened so as to improve the rate of control on high blood pressure.

[Relations between smoking, alcohol intake, physical activity, sleeping hours and the metabolic syndrome in Chinese male aged 18 - 45 years old].

OBJECTIVE: To analyze the relationship between prevalence of metabolic syndrome (MS) and behavior habits such as smoking, alcohol intake, physical activity, sleeping hours. METHODS: A multi-stage stratified cluster sampling was conducted in 31 provinces, autonomous regions, and municipalities in China according to the program of National Nutrition and Health Survey. Questionnaire survey, interview, physical examination, measurement of biochemical indices, and dietary investigation were done. In total, 4937 men aged 18 to 45 years old were selected. RESULTS: The MS prevalence was 6.9% (329/4937). The rate of drinking was 49.4% and smoking rate was 54.4%. The percentage of sleeping was hours from 7 to 8 was 70.5%. The percentage of spending time on physical activity over 420 minutes/week was as high as 41.9%. Data from single logistic regression showed volume of smoking more than 600 packs and alcohol intake were associated with high risk of MS and no significantly associations were found between MS and the duration of physical activity and the sleeping time. Multivariate logistic regression showed that the risk of MS in smokers with the volume more than 600 packs age increased significantly as compared to nonsmokers with the odds ratio as 1.443 (95%CI: 1.044 - 1.993) and 1.765 (95%CI: 1.150 - 2.708) in smokers with volume from 600 to 899 packs age, and more than 900 packs age respectively. Compared to the nondrinkers, the odds ratios were 1.525 (95%CI: 1.135 - 2.048), 2.322 (95%CI: 1.671 - 3.255) and 2.033 (95%CI: 1.478 - 2.796) in subjects volume of alcohol drinking as 1 to 2 times per week, 3 to 4 times per week and more than 5 times per week respectively. CONCLUSION: Tobacco and alcohol were associated with high risks of MS.

[Relationship between duration of low to moderate intensity physical activity and the prevalence of metabolic syndrome].

OBJECTIVE: To analyze the relationship between low to moderate physical activity and the prevalence of metabolic syndrome (MS). METHODS: A multi-stage stratified cluster sampling was conducted in 31 provinces, autonomous regions, and municipalities in the interior of China according to the program of the National Nutrition and Health Survey in 2002. Questionnaire survey, interview, physical examination, measurement of biochemical indices and dietary investigation were done. In total, the physical activity of 26 477 persons aged 18 or above were investigated. The duration of low to moderate physical activity was divided into five grades: 0-min/week, 90-min/week, 151-min/week, 301-min/week, over 420 min/week, and the MS prevalence were investigated respectively. The relationship between MS and age (including four age groups 18-, 35-, 45-, 60 or above) or the duration of physical time were investigated. RESULTS: The MS prevalence among persons aged 18 or above was 9.4% (2490/26 477). And the prevalence was 10.3% (1191/11 516) in man and 8.7%(1299/14 961) in women, respectively (χ(2) = 21.035, P = 0.000). The MS prevalence was 2.1% (127/6070) in 18-years old group and 15.0% (1012/6734) in over 60 years old group. The MS prevalence increased with increasing age (χ(2) = 776.768, P = 0.000). 81.2% (21 499/26 477) of subjects engaged in low to moderate intensity physical activity. The percentage of spending time on physical activity over 420 min/week was dominant and as high as 43.7% (11 561/26 477). The MS prevalence was 13.8% (166/1203) for 0-min grade, 13.2% (64/485) for 90-min grade, 11.8% (153/1298) for 151-min grade, 10.1% (124/1225) for 301-min grade and 12.5% (512/4090) for over 420 min grade (χ(2) = 9.58, P = 0.047). Logistic regression analysis results showed, the MS risk of subjects spending 301-min per week on low to moderate intensity physical activity was significantly low than the MS prevalence among subjects of 90-min grade, OR = 0.844 (95%CI: 0.675 - 0.968), and no statistical difference was found in people spending over 420 min per week OR = 0.936(95%CI: 0.769 - 1.136). CONCLUSION: Most of people aged 18 or above engaged in low to moderate intensity physical activity. MS prevalence may be decreased by low to moderate intensity physical activity for 301-min per week, but the decrease was not significant while the duration of time was longer than 420 min per week.

[Hypertension Control in Communities (HCC): evaluation result of blood pressure management among hypertensive].

OBJECTIVE: To determine the effects related to community-based standardized blood pressure management programs on the control of hypertension. METHODS: A protocol of community-based standardized blood pressure management was developed based on the current Chinese guideline for prevention, treatment of hypertension. Grass-roots caretakers from community health service centers across China were trained using this protocol and required to manage hypertensive patients according to the protocol. Patients were treated on therapeutic life style change or/and medication, and followed up based on the criteria of risk stratification. The control rate of hypertension was evaluated after 1 year. Effect of intervention (EI) was estimated as '1 year rate (mean)' minus the number showed at the baseline. RESULTS: By the end of 2008, a total of 29 411 hypertensive patients (47.2% for male, mean age 61.4 +/- 10.9 years) with full information had been under management for one year according to the protocol. Among all patients, 8.9% were classified as under low risk, 50.8% as moderate risk and 40.3% as high and very high risk showed in baseline data. After standardized management, the EI of smoking, drinking and systolic/diastolic blood pressure were -7.1% (P < 0.05), -7.3% (P < 0.05), and -14.8-8.3 mm Hg (P < 0.05), respectively. However, EI of overweight/obesity was 0.3% (P > 0.05). For all patients, the control rate rose to 74.7%, with EI as 53.1%, and all of the sub-groups, including age, risk stratification, had significant increases. The longer the management was under, the higher the control rate was seen. Results from the multivariate logistic regression showed that older age, male and having higher blood level were adverse factors for the undertaking the control and management programs of hypertension. CONCLUSION: Results from our study showed that standardized management could significantly improve the program on the control of hypertension at the community level, in China.

[The association of stroke with high plasma low-density lipoprotein cholesterol level and metabolic syndrome in Chinese adults].

OBJECTIVE: To investigate the impact of high plasma LDL-C level with or without metabolic syndrome (MS) on the incidence of stroke in Chinese adults. METHODS: Totally 42 626 subjects (25-75 years old) from Chinese National Health and Nutrition Survey in 2002 were stratified four groups based on plasma LDL-C level:<2.00 mmol/L group, 2.00-2.50 mmol/L group, 2.51-3.31 mmol/L group, and >or=3.32 mmol/L group. The prevalence of MS (with 2005 International Diabetes Federation criteria) and stroke and the risk factors of stroke were compared among the four groups. RESULTS: (1) The prevalence of MS and stroke increased with rising of LDL-C level. The prevalence of MS in LDL-C>or=3.32 mmol/L group increased 2.5 times (7.9% vs 20.1%) as compared with that in LDL-C<2.00 mmol/L group and the prevalence of stroke increased 4.2 times (0.5% vs 2.1%), all P<0.01. (2) In subjects with similar LDL-C level, the prevalence of stroke was significantly higher in a subgroup with MS than that without (P<0.01). (3) After adjustment for age, sex and smoking, logistic regression analysis showed that both LDL-C level and MS were positively associated with the development of stroke; the odds ratio (OR) was 2.35 and 3.15 (P<0.0001), respectively. (4) Compared with the subgroup of LDL-C<2.00 mmol/L without MS, OR for stroke in the subgroups of LDL-C 2.00-2.50 mmol/L, 2.51-3.31 mmol/L, and >or=3.32 mmol/L without MS was 1.03, 1.89, and 2.08, whereas the OR for stroke in the subgroups with MS and similar level of LDL-C was 4.38, 5.23 and 6.15; this indicated that the risk of stroke in subjects with MS increased by 3-4 times compared with subjects without (P<0.0001). CONCLUSION: Both high LDL-C level and MS are independent risk factors of stroke, but the risk of stroke will be further increased in the presence of high LDL-C level plus MS. It is suggested that combined intervention therapy of LDL-C and MS will play an important role in the prevention of stroke.

[Impact of metabolic syndrome with hyperglycemia on prevalence of stroke in Chinese].

OBJECTIVE: To investigate the impact of metabolic syndrome (MS) with or without hyperglycemia on stroke prevalence compared to that of diabetes alone. METHODS: 44 100 subjects, 20 570 males and 23 530 females, aged 25 - 75, who had participated in the Chinese Residents Nutrition and Health Examination Survey held in the mainland of China 2002, underwent anthropometry, measurement of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), high density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), and 2 hour plasma glucose (2 h PG) after 75 g oral glucose tolerance test (OGTT). 22 570 subjects, 10 698 males and 11 872 females, were divided into 5 groups: control group without MS risk factors (n = 17 518), Group of diabetes mellitus (DM) without MS (n = 638), group of MS with normoglycemia (n = 2501), Group of MS with mild hyperglycemia (n = 1058), and group MS with DM (n = 855). The relationship between MS and stroke was studied by multiple logistic regression analysis. RESULTS: The prevalence of MS increased along with age. The MS prevalence rates of the subjects with FPG > or = 5.6 mmol/L in the age groups 25 - 34, 35 - 44, 45 - 54, and > or = 55 were 23.5%, 37.2%, 45.7%, and 53.0% respectively, all significantly higher than those of the subjects with the FPG < 5.6 mmol/L (2.2%, 4.7%, 7.8%, and 9.5% respectively, all P < 0.01). The prevalence rates of stroke of the groups of DM, normal blood sugar with MS, mild hyperglycemia with MS, and DM with MS were 2.94%, 2.27%, 2.89%, and 4.11%, respectively, all significantly higher than that of the control group (0.19%, all P < 0.01). After adjustment for age, sex, smoking status, and LDL-C, no significant difference was observed between the neighboring MS groups (all P > 0.05). Compared to the group of MS with normoglycemia, the OR value for stroke of the DM with MS was 1.84 (95% CI 1.20 - 2.83, P < 0.01), which was still significant after adjusting for LDL-C (P < 0.05). CONCLUSION: (1) People with glucose intolerance had very high prevalence of stroke than novmoglgcemic people. (2) Hyperglycemia in MS has an extremely important role in the impact of MS on stroke in Chinese. (3) Diabetes by itself has the same significance as the combination of MS components in the development of stroke.

[The prevalence and onset of age of stroke in Chinese adults].

OBJECTIVE: To analyze the prevalence and onset of age of stroke in Chinese adults aged 35 years old and above. METHODS: Data from the 2002 National Nutrition and Health Survey was used to analyze the prevalence of stroke by age, sex, regions, and the differences of onset of age of stroke among the alive patients. RESULT: Standardized prevalence of stroke in Chinese adults aged 35 years old and above was 1111.5 per 100,000, 1258.9 per 100,000 in male which was higher than female (959.3 per 100,000). The prevalence of stroke in urban (1544.8 per 100.000) was higher than that in rural (758.1 per 100,000). The standardized prevalence of stroke in the north (1479.3 per 100,000) was significantly higher than that in the south (719.6 per 100,000). The standardized prevalence of stroke in eastern, central and western region was 1469.0 per 100,000, 1085.4 per 100,000, 614.9 per 100,000, respectively. It is estimated that there were 5.627 million patients with stroke aged 35 years old and above in China in 2002. The age at onset of stroke in the alive patients was skewed distribution. Median was 60 years old. The first incidence of stroke within 60-age group accounted for 32.4%. The age at onset of stroke was no significantly different between male (60 years old, chi(2) = 0.00, P > 0.05) and female (60 years old). The median of the age at onset of stroke (61 years old) in urban was higher than that in rural (58 years old, chi(2) = 17.34, P < 0.01). The median in eastern region was higher than that in central and western regions (57 years old, chi(2) = 12.92, P < 0.01). CONCLUSION: The prevalence of stroke was significant different by sex and regions. Among the alive patients, more than half of their first incidence of stroke were before the age of sixties.

[Do isolated hypertension and metabolic syndrome have equal risk of stroke in Chinese adults?].

OBJECTIVE: To analyze whether isolated hypertension and metabolic syndrome ( Based on the 2005 IDF criteria) have equal risk on stroke in Chinese adults. METHODS: 25194 subjects (25-75 years old) from Chinese National Health and Nutrition Survey in 2002 were divided into control group, isolated hypertension ( i-HTN) group, metabolic syndrome (MS) without hypertension ( non-HTN/MS) group , MS with hypertension (HTN/MS) group. The clinical features and risk for stroke ( using multiple logistic stepwise regression analysis) were compared among 4 groups. RESULTS: (1) The clinic features in the i-HTN group was non-central obesity, and its plasma glucose, triglyceride 9TG), high density lipoprotein cholesterol ( HDL-C) levels were normal . (2) The prevalence of stroke in control group , i-HTN group, non-HTN/MS group and HTN/MS group was 0.14%, 1.27%, 1.19% and 2.14%, respectively. (3) After adjustment for age, sex, smoking, low density lipoprotein cholesterol level, logistic regression analysis showed that the i-HTN group, non-HTN/MS group and HTN/MS group had higher risk of stroke compared with the controls, the odd ratio (OR) were 4.18, 8.00, 8.69 (P < 0.01), respectively. Compared with i-HTN group, OR in HTN/MS group was 2.05, while no difference was found between i-HTN group and non-HTN/MS group ( P>0.05). (4) Among different components of the MS, hypertension (OR 2.33), central obesity (OR 2.09), low HDL-C (OR 1.69), hyperglycemia (OR 1.66) except hypertriglyceridemia were all significantly related to stroke (P < 0.01). CONCLUSION: (1) MS and hypertension were an independent risk factor for the development of stroke in Chinese adults. (2) Though there was no clinical features of insulin resistance in i-HTN group, it was observed that the i-HTN and non-HTN/MS had equal contribution to stroke. The risk of stroke will be further increased if hypertension included in the MS.

Stroke in China: epidemiology, prevention, and management strategies.

In this review, we examine the current status of stroke epidemiology, prevention, and management strategies in mainland China. The main findings suggested that total age-adjusted incidence of first-ever stroke in China is not very different from that in developed countries. Stroke incidence, mortality, and prevalence varied widely among different regions within China, with a noticeable north-south gradient. The proportion of intracerebral haemorrhage was high and reached 55% in one city. Hypertension is the most important risk factor for stroke. The mass approach combined with a high-risk approach for stroke prevention showed encouraging effects, and various unconventional local therapeutic traditions are commonly used to treat stroke in China. Several national guidelines on stroke prevention and treatment have been developed. Because of methodological limitations in the epidemiology studies, data are unreliable in terms of making any firm conclusions. Up-to-date, well-designed, and well-done epidemiological studies and therapeutic trials in China are urgently needed.