Development of insomnia in patients with stroke: A systematic review and meta-analysis.

BACKGROUND AND AIM: Stroke is a serious threat to human life and health, and post-stroke insomnia is one of the common complications severely impairing patients' quality of life and delaying recovery. Early understanding of the relationship between stroke and post-stroke insomnia can provide clinical evidence for preventing and treating post-stroke insomnia. This study was to investigate the prevalence of insomnia in patients with stroke. METHODS: The Web of Science, PubMed, Embase, and Cochrane Library databases were used to obtain the eligible studies until June 2023. The quality assessment was performed to extract valid data for meta-analysis. The prevalence rates were used a random-efect. I2 statistics were used to assess the heterogeneity of the studies. RESULTS: Twenty-six studies met the inclusion criteria for meta-analysis, with 1,193,659 participants, of which 497,124 were patients with stroke.The meta-analysis indicated that 150,181 patients with stroke developed insomnia during follow-up [46.98%, 95% confidence interval (CI): 36.91-57.18] and 1806 patients with ischemic stroke (IS) or transient ischemic attack (TIA) developed insomnia (47.21%, 95% CI: 34.26-60.36). Notably, 41.51% of patients with the prevalence of nonclassified stroke developed insomnia (95% CI: 28.86-54.75). The incidence of insomnia was significantly higher in patients with acute strokes than in patients with nonacute strokes (59.16% vs 44.07%, P < 0.0001).Similarly, the incidence of insomnia was significantly higher in the patients with stroke at a mean age of ≥65 than patients with stroke at a mean age of <65 years (47.18% vs 40.50%, P < 0.05). Fifteen studies reported the follow-up time. The incidence of insomnia was significantly higher in the follow-up for ≥3 years than follow-up for <3 years (58.06% vs 43.83%, P < 0.05). Twenty-one studies used the Insomnia Assessment Diagnostic Tool, and the rate of insomnia in patients with stroke was 49.31% (95% CI: 38.59-60.06). Five studies used self-reporting, that the rate of insomnia in patients with stroke was 37.58% (95% CI: 13.44-65.63). CONCLUSIONS: Stroke may be a predisposing factor for insomnia. Insomnia is more likely to occur in acute-phase stroke, and the prevalence of insomnia increases with patient age and follow-up time. Further, the rate of insomnia is higher in patients with stroke who use the Insomnia Assessment Diagnostic Tool.

Prevalence of epilepsy in the People's Republic of China: a systematic review.

To date there has not been a nationwide systematic analysis of the prevalence of epilepsy in China. The aim of this study was to estimate the prevalence of epilepsy in mainland China from the published studies and analyze the prevalence of epilepsy by survey method, gender, location, age, seizure type and prevalence of date. We searched the PubMed, Embase, Chinese Biological Medical Literature (CBM), Chinese National Knowledge Infrastructure (CNKI), Chinese Wanfang and Chongqing VIP databases for epidemiological studies on the prevalence of epilepsy. Thirty-eight studies were included that comprised a total sample size of 7,695,961, among whom 13,224 had epilepsy. The overall prevalence of epilepsy was 2.89‰. The prevalence of males and females were 3.83‰ and 3.45‰, respectively. The location-specific prevalence in urban and rural areas was 2.34‰ and 3.17‰, respectively. Prevalence by age groups, 0-9, 10-19, 20-29, 30-39, 40-49, 50-59, 60-69 and ≥70 were 2.21‰, 3.23‰, 3.14‰, 2.83‰, 2.96‰, 2.61‰, 2.76‰ and 2.22‰, respectively. In the subgroup analysis by prevalence date, prevalence rate of epilepsy ranged from 1.19‰ to 6.70‰. As for the seizure types, the overall prevalence of generalized seizures, partial seizures and unclassifiable seizures were 3.12‰, 0.57‰ and 0.23‰, respectively. Overall, the prevalence rate of epilepsy is different for each area in mainland China. A higher prevalence of epilepsy is found in the subgroup analysis by male, rural, age group of 10-19 and generalized seizures. However, more epidemiological studies are needed from other provinces to estimate the overall prevalence of epilepsy in mainland China.

Association between the apolipoprotein E gene polymorphism and ischemic stroke in Chinese populations: New data and meta-analysis.

Ischemic stroke (IS) is a complex multifactorial inherited disease. Many studies have focused on the potential genetic effects of apolipoprotein E (ApoE) gene polymorphism on IS. However, inconsistencies still exist in the association of ApoE gene polymorphism with IS. The aim of this study was to investigate the ApoE gene polymorphism in relation to IS in the Guangxi Han populations and assess the risk of various ApoE genotypes associated with IS in Chinese populations. We conducted a case-control study involving a total of 166 IS cases and 192 healthy controls to investigate the association of ApoE gene polymorphism with IS in the Guangxi Han populations. Furthermore, we performed a meta-analysis to investigate whether the ApoE gene polymorphism is associated with IS in Chinese populations. There was no evidence for a significant association between ApoE gene polymorphism and IS in the Guangxi Han populations (ɛ2/ɛ2 vs. ɛ3/ɛ3: OR=1.25, 95% CI=0.08-20.17; ɛ2/ɛ3 vs. ɛ3/ɛ3: OR=1.49, 95% CI=0.79-2.79; ɛ2/ɛ4 vs. ɛ3/ɛ3: OR=1.25, 95% CI=0.17-9.00; ɛ3/ɛ4 vs. ɛ3/ɛ3: OR=1.10, 95% CI=0.60-2.04; ɛ4/ɛ4 vs. ɛ3/ɛ3: OR=2.50, 95% CI=0.22-27.87; allele ɛ2 vs. allele ɛ3: OR=1.39, 95% CI=0.80-2.44; allele ɛ4 vs. allele ɛ3: OR=1.16, 95% CI=0.68-1.98). In our meta-analysis, a significant association of ApoE gene polymorphism with IS was found in the genetic model of ɛ2/ɛ4 vs. ɛ3/ɛ3 (OR=2.04, 95% CI=1.45-2.85), ɛ3/ɛ4 vs. ɛ3/ɛ3 (OR=1.93, 95% CI=1.42-2.62), ɛ4/ɛ4 vs. ɛ3/ɛ3 (OR=3.41, 95% CI=2.17-5.34) and allele ɛ4 vs. allele ɛ3 (OR=2.34, 95% CI=1.91-2.86). However, no clear associations were found in the model of ɛ2/ɛ2 vs. ɛ3/ɛ3 (OR=1.56, 95% CI=0.90-2.71), ɛ2/ɛ3 vs. ɛ3/ɛ3 (OR=0.93, 95% CI=0.79-1.09) and allele ɛ2 vs. allele ɛ3 (OR=1.10, 95% CI=0.97-1.25). In conclusion, no association was found between ApoE gene polymorphism and IS in the Guangxi Han populations, while the results of the meta-analysis indicate that the ApoE mutation allele ɛ4 increases the risk of IS in Chinese populations.

Association between the single-nucleotide polymorphism rs12425791 and ischemic stroke in Chinese populations: new data and meta-analysis.

BACKGROUND: Two single-nucleotide polymorphisms rs11833579 and rs12425791 located on chromosome 12p13 were reported to be associated with ischemic stroke in Caucasians. In the present study, we investigated whether the single-nucleotide polymorphism rs12425791 was associated with ischemic stroke in Chinese populations. METHODS: We carried out a case-control study examining a total of 166 Guangxi Han patients with ischemic stroke and 192 healthy controls. We also performed a meta-analysis of the data from our study and those from published studies to investigate whether an association between rs12425791 and ischemic stroke could be detected in Chinese populations. RESULTS: There was no statistically significant association between the single-nucleotide polymorphism rs12425791 and ischemic stroke in the Guangxi Han population. Our meta-analysis also found no significant association between rs12425791 and ischemic stroke in Chinese populations [allelic model odds ratio (OR) = 1.01, 95% confidence interval (CI), 0.96-1.07; dominant model OR = 1.01, 95%CI, 0.94-1.10; recessive model OR = 1.00, 95%CI, 0.86-1.17]. CONCLUSIONS: The single-nucleotide polymorphism rs12425791 does not confer a substantial risk for ischemic stroke in Chinese populations.

[Optimum selection of acupuncture treatment programs of cerebral infarction and its effects on insulin resistance].

OBJECTIVE: To study the optimum acupuncture treatment program and the mechanism for treatment of cerebral infarction. METHODS: Sixty-three cases were randomly divided into 9 groups. The four factors, times of manipulation, the retaining time of the needle, acupuncture instrument and acupoints,and their corresponding three levels were adopted respectively in treatment of each group. Then nerve function defect score and insulin resistance were observed before and after treatment. RESULTS: The acupoints, the times of manipulation and the retaining time of the needle have significant effects on nerve function defect and insulin resistance (P < 0.01 or P < 0.05), and the acupuncture instrument has a significant effect on insulin resistance (P < 0.01). The choice of acupoints was the most important factor for acupuncture treatment of cerebral infarction. CONCLUSION: Acupuncture for regulating The Governor Vessel with twice manipulations and retaining the needle for 60 min is optimum treatment program for cerebral infarction. The good regulating effect of acupuncture on insulin resistance is one of the mechanisms of achieving the therapeutic results.