Neurological deterioration in the acute phase of minor ischemic stroke is an independent predictor of poor outcomes at 1 year: results from the China National Stroke Registry (CNSR) / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The risk of clinical deterioration still exists in the acute phase despite the fact that patients with minor stroke may display less severe symptoms. The impact of this clinical deterioration on long-term outcomes is unknown. We characterized the clinical features of neurological deterioration (ND) in the acute phase of minor ischemic stroke (MIS) and investigated its impact on mid- and long-term outcomes.</p><p><b>METHODS</b>This was a multi-centered, prospective clinical study involving patients with MIS (the National Institutes of Health Stroke Scale, NIHSS ≤3) recruited from the China National Stroke Registry. Patients were included who had been hospitalized within 24 hours of stroke onset. Baseline characteristics, complication rates during hospitalization, etiology of stroke, as well as 3-, 6-, and 12-month post-stroke outcomes were compared between patients with and without ND during the acute phase.</p><p><b>RESULTS</b>A number of 368 (15.2%) out of 2424 patients included in the study exhibited ND in the acute phase. Compared to patients without ND, patients with ND had longer hospital stay, increased rate of baseline diabetes, and multiple complications. Multivariate Logistic regression indicated that ND in acute phase was an independent factor predictive of increased dependence (adjusted odds ratio = 5.20, 95% CI, 3.51-7.70, P < 0.001) at 12-month post-stroke.</p><p><b>CONCLUSIONS</b>The risk of ND in the acute phase is high in patients with MIS. ND in the acute phase is an independent predictor for poor outcomes at 12 months post-stroke onset.</p>

Possible association of ACE gene I/D polymorphism with blood pressure--lowering response to hydrochlorothiazide / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To explore the association between polymorphism in the ACE I/D gene and blood pressure-lowering response to hydrochlorothiazide (HCTZ) in 829 patients.</p><p><b>METHODS</b>HCTZ 12.5 mg was taken once a day for six weeks. The blood pressure reduction and ratio reaching target blood pressure were compared in different ACE genotype groups.</p><p><b>RESULTS</b>The reduction in SBP of patients carrying DD was greater than that in other groups carrying II or ID (12.2 mmHg versus 5.4 mmHg, 12.2 mmHg versus 4.4 mmHg, respectively, P<0.05). The reduction in MAP of patients carrying DD was also greater than that in other groups carrying II or ID (6.9 mmHg versus 3.9 mmHg, 6.9 mmHg versus 3.6 mmHg, respectively, P<0.05). The ratio reaching target blood pressure in DD groups was significantly higher than that in II or ID groups (P<0.05). The pre-treatment SBP, DD genotype, aldosterone levels entered the multi-linear regression model significantly and might affect the reduction of SBP. The pre-treatment DBP, aldosterone levels, DD genotype entered the multi-linear regression model significantly and might affect the reduction of DBP. The pre-treatment MAP, DD genotype, aldosterone levels entered the multi-linear regression model significantly and might affect the reduction of MAP.</p><p><b>CONCLUSION</b>ACE genotyping is associated with blood pressure-lowering response to HCTZ. Specific genotypes might be associated with the response to specific antihypertensive treatment.</p>

Severe acute respiratory syndrome--retrospect and lessons of 2004 outbreak in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To summarize lessons learned from an outbreak of severe acute respiratory syndrome (SARS) in China during the spring of 2004.</p><p><b>METHODS</b>Data of SARS cases were officially reported by Beijing Municipal Center for Disease Control and Prevention (BCDC) and Anhui Provincial Center for Disease Control and Prevention (APCDC) and results of epidemiological investigations were collected and analyzed.</p><p><b>RESULTS</b>Three generations of 11 cases of SARS were identified during the outbreak. Initial two cases were most likely to be infected in Diarrhea Virus Laboratory of National Institute of Virology, China Centers for Disease Control and Prevention and main mode of transmission was direct contact with SARS patients. Delay in detecting initial case resulted in spread of the illness at hospitals and communities with two generations of secondary cases.</p><p><b>CONCLUSIONS</b>SARS outbreak in 2004 has yielded following lessons for public health globally. (1) Lab bio-safety programs should be made and should be strictly abided by. Studies in highly pathogenic viruses such as SARS coronavirus should be utmost cautious. (2) Management systems of occupational exposure to virus and disease surveillance need to be strengthened to take all risk factors into account so as to detect potential patients with infectious disease as early as possible.</p>

Study on the effectiveness and cost-benefit of influenza vaccine on elderly population in Beijing city / 中华流行病学杂志

<p><b>OBJECTIVE</b>To estimate the effectiveness of inactivated influenza vaccine in elderly population.</p><p><b>METHODS</b>An quasi-experimental study was used. 590 elderly people who volunteered to receive the influenza vaccine were served as vaccine group, while 602 persons who did not want to receive the inoculation but could match the vaccine group were served as controls. One baseline and three follow-up surveys were carried out.</p><p><b>RESULTS</b>The protective rates of influenza like ill (ILI) as 52.38%, 36.84% and 37.89% with the decreasing rates of visits to ILI clinic as 45.16%, 50.54% and 50.54% were found after 1 month, 3 month and 6 month of inoculation of influenza vaccine; The protective rates of common cold, other respiratory tract or chronic disease were 49.54%, 64.54%, and 38.82%, respectively. The benefit-cost ratio was 4.98:1 in elderly population.</p><p><b>CONCLUSION</b>Influenza vaccination could decrease ILI incidence and recurrence rates of related chronic diseases on elderly population to provide better economic benefits for the elderly.</p>

Case fatality rate of severe acute respiratory syndromes in Beijing / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To describe the case fatality rate of SARS in Beijing.</p><p><b>METHODS</b>Data of SARS cases notified from Beijing Center for Disease Control and Prevention (BCDC) and supplemented by other channels were collected. The data were analyzed by rate calculation.</p><p><b>RESULTS</b>The case fatality rate of SARS in Beijing was 7.66%, and had an ascending trend while the age of cases was getting older, and a descending trend while the epidemic development. The case fatality rate in Beijing was lower than that in other main epidemic countries or regions.</p><p><b>CONCLUSIONS</b>The risk of death increases with the increment of age of SARS patients. Beijing is successful in controlling and treating SARS.</p>

A case-control study on children with Guillain-Barre syndrome in North China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To explore the risk factors for Guillain-Barre syndrome.</p><p><b>METHODS</b>Case-control study design was used in 51 cases of Guillain-Barre syndrome, and 51 matched controls. All of the 51 cases in this study had been examined by electrophysiology. Serum IgG antibodies specific for C. jejuni were determined in all the subjects by ELISA. Each case and control were interviewed using an ad hoc questionnaire, including his/her demographic information, onset of the illness, their personal hygiene and so on.</p><p><b>RESULTS</b>The study showed that Guillain-Barre syndrome was associated with a few factors, such as polio vaccine immunization before onset of illness (OR=7.27), no hand washing after defecation and before meals (OR=6.15). Infection of C. jejuni was strongly associated with the illness (OR=9.5, P<0.001).</p><p><b>CONCLUSION</b>It is suggested that occurrence of Guillain-Barre syndrome may correlate to infection of C. jejuni and poor personal hygiene in children.</p>

Driver sleepiness and risk of car crashes in Shenyang, a Chinese northeastern city: population-based case-control study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To estimate the association of driver sleepiness with the risk of car crashes.</p><p><b>METHODS</b>A population-based case-control study was conducted in Shenyang, a northeastern city in China, between November 2001 and July 2002. The case group comprised 406 car drivers involved in crashes, and 438 car drivers recruited at randomly selected sites, and on the day of week, and the time of day when they were driving on highways in the study region during the study period were used as control groups. Face-to-face interviews with drivers were conducted according to a well-structured questionnaire covering the circumstances of their current trip and their background information. Stanford sleepiness scale and Epworth sleepiness scale were used to quantify acute sleepiness and chronic sleepiness respectively.</p><p><b>RESULTS</b>There was a strong association between chronic sleepiness and the risk of car crash. Significantly increased risk of crash was associated with drivers who identified themselves as sleepy (Epworth sleepiness score > or = 10 vs < 10; adjusted odds ratio 2.07, 95% confidence interval 1.30 to 3.29), but no increased risk was associated with measures of acute sleepiness.</p><p><b>CONCLUSIONS</b>Chronic sleepiness in car drivers significantly increases the risk of car crash. Reductions in road traffic injuries may be achieved if fewer people drive when they are sleepy.</p>

A case-control study on the risk factors for road injury / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the risk factors of road injury.</p><p><b>METHODS</b>Case-control study was used. From November 2001 to August 2002, 406 drivers who had 438 drivers who had not experienced a motor vehicle crash in Huanggu district, Shenyang city were recruited by randomly selection on time of day, day of week and site in the same period at same district. Face to face interviews with drivers were conducted according to a highly structured questionnaire covering the circumstances of the current trip, usual behavior and background characteristics of the drivers and the condition of motor vehicles. Stanford sleepiness scale and Epworth sleepiness scale were used to quantify acute and chronic sleepiness respectively.</p><p><b>RESULTS</b>Increased risk was associated with drivers who identified themselves as having chronic doziness (OR = 1.98, 95% CI: 1.26 - 3.12). Increase in risk was associated with measures of acute tiredness, but without statistical significance (OR = 2.38, 95% CI: 0.89 - 6.31). Comparing to permanent daytime work pattern, rotating shifts or permanent night-work pattern increased the risk of crash (OR = 2.09, 95% CI: 1.48 - 2.94). The risk of motor vehicle crash among the drivers who drank alcohol in the previous 6 hours was 3.59 times (95% CI: 1.13 - 11.39) of those drivers who did not drink. Driving violations also contributed to the increased risk of crash (OR = 1.73, 95% CI: 1.22 - 2.46).</p><p><b>CONCLUSION</b>Factors as chronic doziness, rotating shifts or permanent night-work pattern, driving under alcohol impairment, violation of motor vehicle regulation all significantly increased the risk of road injury. Acute sleepiness might serve as a potential risk factor for road injury.</p>