Projected burden of stroke in China through 2050 / 中华医学杂志(英文版)

BACKGROUND@#Stroke is the leading cause of death in China, and predicting the stroke burden could provide essential information guiding the setting of medium- and long-term health policies and priorities. The study aimed to project trends associated with stroke burden in China through 2050, not only in terms of incidence and mortality but also for prevalence and disability-adjusted life years (DALYs).@*METHODS@#Data on stroke rates in incidence, prevalence, deaths, and DALYs in China between 1990 and 2019 were obtained from a recent Global Burden of Disease study. Demographic-specific trends in rates over time were estimated using three models: the loglinear model, the Lee-Carter model, and a functional time series model. The mean absolute percentage error and the root mean squared error were used for model selection. Projections up to 2050 were estimated using the best fitting model. United Nations population data were used to project the absolute numbers through 2050.@*RESULTS@#From 2019 to 2050, the crude rates for all measures of the stroke burden are projected to increase continuously among both men and women. We project that compared with those in 2019, the incidence, prevalence, deaths, and DALYs because of stroke in China in 2050 will increase by 55.58%, 119.16%, 72.15%, and 20.04%, respectively; the corresponding increases in number were 2.19, 34.27, 1.58, and 9.21 million. The age-standardized rate is projected to substantially decline for incidence (8.94%), death (40.37%), and DALYs (43.47%), but the age-standardized prevalence rate is predicted to increase by 10.82%. By 2050, the burden of stroke among the population aged ≥65 years will increase significantly: by 104.70% for incidence, by 218.48% for prevalence, by 100.00% for death, and by 58.93% for DALYs.@*CONCLUSIONS@#With the aging population in China increasing over the next three decades, the burden of stroke will be markedly increased. Continuous efforts are needed to improve stroke health care and secondary prevention, especially for older adults.

Application analysis of carotid-subclavian artery blood vessel prosthesis bypass grafting in the reconstruction of cerebral blood supply / 国际外科学杂志

Objective:To study the application effect of carotid-subclavian artery blood vessel prosthesis bypass grafting in the reconstruction of cerebral blood supply.Methods:The clinical data of 14 patients undergoing carotid-subclavian artery blood vessel prosthesis bypass grafting to reconstruct cerebral blood supply in the Department of Vascular Surgery, Beijing Tiantan Hospital, Capital Medical University from March 2019 to March 2022 was retrospective collected. And the surgical indications, clinical effect and complications were analyzed.Results:There were 12 males and 2 females, aged from 47 to 74 years, with an average age of 60.5 years. Of 14 patients, 2 patients suffered from common carotid artery stenosis with posterior dilatation, 12 patients suffered from subclavian artery occlusion with vertebral artery steal. All the procedures were successfully performed without intraoperative cerebral infarction, cardiovascular accident, lymphatic leakage or artificial vascular infection. Phrenic nerve injury occurred in 1 patient after operation. During the follow-up of 3-27 months, average 14 months, there were no artificial vascular stenosis, anastomotic stenosis, vertebral artery steal, new cerebral infarction, upper limb ischemia or cerebral ischemia.Conclusion:Carotid-subclavian artery blood vessel prosthesis bypass grafting can be used in reconstructing the blood supply of both the anterior circulation, and the posterior circulation safely and effectively.

Study on the causes of restenosis after endovascular treatment of long segment superficial femoral artery occlusion / 中国医师进修杂志

Objective To study the causes of restenosis after endovascular treatment of long segment superficial femoral artery occlusion.Methods The clinical data of 38 patients with long segment superficial femoral artery occlusion were retrospectively analyzed,and the patients were treated with balloon dilatation and stent implantation.The patients were followed up 6 and 12 months after operation.The changes of claudication distance were observed,and the patients underwent color Doppler vascular ultrasound examination.The patients were divided into patency group and restenosis group according to the results of follow up, and the clinical data were compared between 2 groups.Results The follow-up result showed that patency was in 24 cases(patency group),and restenosis or occlusion was in 14 cases(restenosis group).The ankle brachial index(ABI)in restenosis group was significantly lower than that in patency group: 0.47 ± 0.41 vs.0.50 ± 0.48, and there was statistical difference (P<0.05).The data were classified according to the actual situation.Results showed that the lengths of occlusion segment >30cm, lengths of stent >30cm and age>70 years were the risk factors of restenosis after endovascular treatment in patients with long segment superficial femoral artery occlusion (P<0.05).Conclusions The endovascular treatment of long segment superficial femoral artery occlusion is safe and effective.The lower ABI,lengths of occlusion segment>30cm,lengths of stent>30cm and age>70 years are the risk factors of restenosis after endovascular treatment in patients with long segment superficial femoral artery occlusion.

Evaluation of anticoagulant therapy after cerebral hemorrhage combined with deep vein thrombosis of lower extremity / 国际外科学杂志

Objective To evaluate the efficacy and safety of anticoagulant therapy with low-molecularweight heparin after cerebral hemorrhage combined with deep vein thrombosis of lower extremity.Methods One hundred and fifty-three cases of deep vein thrombosis of lower extremity after intracerebral hemorrhage were collected of Beijing Tiantan Hospital,Capital Medical University from June 2014 to June 2016.According to whether accepted anticoagulant therapy with low-molecular-weight heparin,the patients were divided into treatment group (n =79) and control group(n =74).Compared the head CT images and the ultrasound of lower extremity venous in the day when admissed to hospital and in the 7th day after treatment.The measurement data was adopted by t test,Chi-square test was adopted in the count data.Results Before the low-molecular-weight heparin therapy,the average bleeding volume in intracerebral was (1.38 ± 0.45) ml for the anticoagulant therapy group.After 7 days of low-molecular-weight heparin therapy,the average bleeding volune in intracerebral was (1.01 ± 0.54) ml,there was no increasing cerebral hemorrhage,with a statistically significant difference (P =0.000).The bleeding volume in intracerebral was(1.47 ± 0.47) ml of control group cases,and after 7 days it became (1.17 ± 0.52) ml,with a statistically significant difference (P =0.000),all these showed that cerebral hemorrhage had significantly absorbed.There was no statistically significant difference between the treatment group and the control group (P =0.123).It explained that anticoagulation was not increased intracranial hemorrhage with low-molecular-weight heparin.ultrasound showed that the lower extremity venous thrombosis was stable or decreased before and after anticoagulant therapy,and the difference was statistically significant (P =0.000),indicating that the anticoagulant therapy was effective.Conclusions It is safe and effective in low-molecular-weight heparin anticoagulant therapy for deep vein thrombosis of lower extremity after intracerebral hemorrhage.But patients need strict screening,and follow the individualized treatment.

Application of Herniamesh in the treatment of adult umbilical hernia with 12 cases analysis / 中国医师进修杂志

Objective To evaluate the application of Herniamesh in repairing adult umbilical hernia.Methods The data of 12 aduh patients with umbilical hernia were treated with Hemiamesh from January 2007 to March 2009 was analyzed retrospectively,included characteristics,methods and effects of Hemiamesh Oval Patch 0812 on the repair of hernia.Results All cases were cured.The average stay in hospital was (5±2)d.No postoperative complication,no recurrence follow-up visited 1 to 25 months.Conclusion Repairing umbilical hernia in adult with Hemiamesh Oval Patch 0812 is a kind of simple,safe,effective operation and the ring of hernia no more than 4cm.

Clinical application of VenaTech LP permanent inferior vena cava filter for preventing pulmonary embolism with 107 cases report / 中国医师进修杂志

Objective To assess the clinical value and safety of VenaTech LP permanent inferior vena cava filter (IVCF) for preventing pulmonary embolism (PE) in patients with deep vein thrombosis (DVT). Methods One hundred and seven DVT patients receiving VenaTech LP permanent IVCF implantation from October 2005 to November 2009 were selected. In hospital and following up data were analyzed. Results All the filters were successfully implanted. No symptomatic PE took place during acute stage of thrombosis after filter implantation. No complication took place during following up 1 to 36 months.Conclusion Implantation of VenaTech LP permanent IVCF is safe and effective in the prevention of PE.