Stroke in China: advances and challenges in epidemiology, prevention, and management
Simiao Wu,Bo Wu,Ming Liu,Zhengming Chen,Wenzhi Wang,Craig S. Anderson,Peter Sandercock,Yongjun Wang,Yining Huang,L Cui,C Pu,Jianping Jia,T Zhang,Xinfeng Liu,S Zhang,Peng Xie,Dongsheng Fan,Xunming Ji,Wong K-Sl.,L Wang +19 more
TLDR
Future efforts should focus on providing more balanced availability of specialised stroke services across the country, enhancing evidence-based practice, and encouraging greater translational research to improve outcome of patients with stroke.Abstract:
With over 2 million new cases annually, stroke is associated with the highest disability-adjusted life-years lost of any disease in China. The burden is expected to increase further as a result of population ageing, an ongoing high prevalence of risk factors (eg, hypertension), and inadequate management. Despite improved access to overall health services, the availability of specialist stroke care is variable across the country, and especially uneven in rural areas. In-hospital outcomes have improved because of a greater availability of reperfusion therapies and supportive care, but adherence to secondary prevention strategies and long-term care are inadequate. Thrombolysis and stroke units are accepted as standards of care across the world, including in China, but bleeding-risk concerns and organisational challenges hamper widespread adoption of this care in China. Despite little supporting evidence, Chinese herbal products and neuroprotective drugs are widely used, and the increased availability of neuroimaging techniques also results in overdiagnosis and overtreatment of so-called silent stroke. Future efforts should focus on providing more balanced availability of specialised stroke services across the country, enhancing evidence-based practice, and encouraging greater translational research to improve outcome of patients with stroke.read more
Citations
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Mortality and recurrent vascular events after first incident stroke: a 9-year community-based study of 0·5 million Chinese adults
Yiping Chen,Neil Wright,Yu Guo,Iain Turnbull,Christiana Kartsonaki,Christiana Kartsonaki,Ling Yang,Ling Yang,Zheng Bian,Pei Pei,D Pan,Y Zhang,Haiqiang Qin,Yongjun Wang,Jun Lv,Ming Liu,Z Hao,Canqing Yu,Richard Peto,Rory Collins,Liming Li,Robert Clarke,Zhengming Chen,Zhengming Chen +23 more
TL;DR: After a first stroke, the risk of recurrence or death within 5 years was high among this population of Chinese adults, and urgent improvements to secondary prevention of stroke in China are needed to reduce these risks.
Journal ArticleDOI
Stroke prevention and control system in China: CSPPC-Stroke Program
Bao-Hua Chao,Feng Yan,Yang Hua,Jian-Min Liu,Yi Yang,Xunming Ji,Bin Peng,Guo-Guang Zhao,Yongjun Wang,De-Zhi Kang,Yilong Wang,Jinsheng Zeng,Lan Chu,Tianxiao Li,Yuming Xu,Ming Liu,Li He,Yun Xu,Jian Wu,Min Lou,Wei Yue,Lei Cao,Wen-Jun Tu,Wen-Jun Tu,Longde Wang +24 more
TL;DR: The CSPPC Stroke program has led to a significant improvement in stroke care, and this program needs to be further promoted nationwide.
Journal ArticleDOI
Bone marrow mesenchymal stem cell-derived exosomes attenuate cerebral ischemia-reperfusion injury-induced neuroinflammation and pyroptosis by modulating microglia M1/M2 phenotypes.
Xiaoli Liu,Meimei Zhang,Haining Liu,Rui Zhu,He He,Yuqing Zhou,Yilei Zhang,Chen Li,Donghui Liang,Qing Zeng,Guozhi Huang +10 more
TL;DR: In this article, the neuroprotective effects of bone marrow mesenchymal stem cell-derived exosomes (BMSC-Exos) are associated with the attenuation of NLPR3-mediated neuron pyroptosis by modulating microglial polarization.
Journal ArticleDOI
Prevalence of stroke in China, 2013–2019: A population-based study
Wen Jun Tu,Yang Hua,Feng Yan,Hetao Bian,Yi Yang,Mingfang Lou,Dezhi Kang,Li He,Lan Chu,Jingsheng Zeng,Jian Wu,Huisheng Chen,Jianfeng Han,Lin Ma,Lei Cao,Longde Wang +15 more
TL;DR: Wang et al. as discussed by the authors determined the recent trends in the prevalence of stroke from 2013 to 2019 stratified by sociodemographic characteristics, including sex, age, residence, ethnicity, and province within a population-based screening project in China.
Journal ArticleDOI
Current Status of Endovascular Treatment for Acute Large Vessel Occlusion in China: A Real-World Nationwide Registry.
Baixue Jia,Zeguang Ren,Maxim Mokin,W. Scott Burgin,Clayton T. Bauer,Jens Fiehler,Dapeng Mo,Ning Ma,Feng Gao,Xiaochuan Huo,Gang Luo,Anxin Wang,Yuesong Pan,Ligang Song,Xuan Sun,Xuelei Zhang,Liqiang Gui,Cunfeng Song,Ya Peng,Jin Wu,Shijun Zhao,Junfeng Zhao,Zhiming Zhou,Yongli Li,Ping Jing,Lei Yang,Yajie Liu,Qingshi Zhao,Yan Liu,Xiaoxiang Peng,Qingchun Gao,Zaiyu Guo,Wenhuo Chen,Weirong Li,Xiaojiang Cheng,Yun Xu,Yongqiang Zhang,Guilian Zhang,Yijiu Lu,Xinyu Lu,Dengxiang Wang,Yan Wang,Hao Li,Li Ling,Guangge Peng,Jingyu Zhang,Kai Zhang,Shuo Li,Zhongqi Qi,Haifeng Xu,Xu Tong,Gaoting Ma,Raynald Liu,Xu Guo,Yiming Deng,Xinyi Leng,Thomas W. Leung,David S Liebeskind,Yilong Wang,Yongjun Wang,Zhongrong Miao,Yang Hua,Deqin Geng,Haicheng Yuan,Hongwei Wang,Haihua Yang,Zengwu Wang,Liping Wei,Xuancong Liufu,Xiangqun Shi,Juntao Li,Wenwu Yang,Wenji Jing,Xiang Yong,Leyuan Wang,Chunlei Li,Yibin Cao,Qingfeng Zhu,Peng Zhang,Xiang Luo,Shengli Chen,Wenwu Peng,Lixin Wang,Xue Wen,Shugui Shi,Wanming Wang,Wang Bo,Pu Yuan,Dong Wang,Haitao Guan,Wenbao Liang,Daliang Ma,Long Chen,Yan Xiao,Xiangdong Xie,Zhonghua Shi,Xiangjun Zeng,Fanfan Su,Mingze Chang,Jijun Yin,Hongxia Sun,Chong Li,Yong Bi,Gang Xie,Yuwu Zhao,Chao Wang,Xianjun Wang,Dongqun Li,Hui Liang,Zhonglun Chen,Yu Xin Wang,Lin Yin,Hongkai Qiu,Jun Wei,Yaxuan Sun,Xiaoya Feng,Weihua Wu,Lianbo Gao,Zhibing Ai,Tan Lan,Li Ding,Qilong Liang,Zhimin Wang,Jianwen Yang,Ping Xu,Wei Dong,Quanle Zheng,Zhenyun Zhu,Liyue Zhao,Qingbo Meng,Yuqing Wei,Xianglin Chen,Wei Wang,Dong Sun,Yongxing Yan,Guangxiong Yuan,Yadong Yang,Jianfeng Zhou,Zhi Yang,Zhenzhong Zhang,Ning Guan,Huihong Wang +141 more
TL;DR: In this article, the benefit of endovascular treatment (EVT) for large vessel occlusion in clinical practice in developing countries like China needs to be confirmed, and the aim of the study was to evaluate the effect of EVT on the performance of patients.
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