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Objective To study whether rheumatoid arthritis (RA) increased the risk of stroke by systematically reviewing the literature. Methods Databases including PubMed, Web of Science, CNKI, Wan Fang database, The Cochrane Library (Issue 12, 2017), Embase and Sinomed database were searched to collect case-control studies and cohort studies up to February 1, 2018. The association between RA and stroke was analyzed. Meta-analysis and sub-group meta-analysis were conducted using Revman 5.3 software, and sensitive analysis and publication bias analysis were performed using Stata12.0 software. Results Finally 19 studies involving 248784 RA patients and 5970133 controls were included. Heterogeneity test was carried out and heterogeneity of each study was found to be statistically significant ( χ2=442.77, P<0.01, I2=96％), thus, the random effect model was used for meta-analysis. The risk of RA patients with stroke was 1.40 (1.21, 1.61) compared to the general population or patients without RA. Further subgroup analysis was performed by stratifing for race than indicating that the risk of RA combined with stroke was 1.21 (1.03, 1.56) versus one of non-RA patients among Caucasian. When stratified by whether control group matched on age and sex, the data had shown that the risk of RA with stroke was higher than that of the non-RA patients, whether control group was matched or not, and the risk ratio was 1.36(1.16, 1.60), 1.47(1.00, 2.15) respectively (P=0.001, P=0.05). When stratified by whether arthrophlogosis and/or immune related diseases were excluded in the control group, the risk of RA patients with stroke was 1.45(1.23, 1.72) compared to the non-RA patients when related diseases were not excluded (P<0.01). Conclusion RA patients may have a higher risk of stroke than the general population or patients without RA, especially in Caucasians.
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Objective To study the teaching effect of prevention in clinical epidemiology teaching.Methods 187 clinical medical students of Grade 2010 from China Medical University were selected as the research objectives.2 teaching hours of prevention content was increased in the clinical epidemiology teaching,and the anonymous questionnaire survey was used to assess the teaching effectiveness.A total of 187 questionnaires were issued and 187 valid questionnaires were collected.All the data were analyzed by SPSS 16.0.Results 82.9％ (155 people) of the students believed that the addition of preventive content was necessary,40.1％ (75 people) of the students believed that there was a significant increase in the content of the prevention.For the understanding of the content,only 11.2％ (21 people) of the students said they had a complete understanding of the class,but after teaching 51.3％ (96 people) of the students expressed a clear understanding of the content.82.4％ (154 people) of the students thought that the teaching contents of prevention was tightly combined with the clinical,and 74.9％ (140 people) of the students thought that 2 hours setting was appropriate.Students' demands for prevent content also included:1) how to strengthen prevention in daily life;2) tumor disease prevention,including current international popular tumor vaccine;3) of emergent public health event instance;4) occupational disease prevention measures,etc.Conclusion Increasing the contents of prevention in the clinical epidemiology teaching has made students of clinical medicine change their clinical concept and realize the key role of prevention in clinical treatment.At the same time,this study understands students' needs for the content of prevention,and provides a basis for the setting and op-timization of clinical epidemiology course in the future.
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0.05),the odds ratio(OR)being 0.873,[95% confidential interval(CI):0.428～1.782].(3)The relationship between ischemic stroke and the risk factors was illuminated by the Logistic Regression analysis.The results showed that there was no significant difference of the positive rate of IgA antibody between the case group and control group.Conclusion There may be not relationship between CP IgA antibody and ischemic stroke.There is no relationship between IgA CP antibody and the other risk factors of ischemic stroke.