Objective To evaluate the effectiveness of "screen and target population intervention policy" for stroke intervention in Nanhui county of Shanghai city.Methods A cross sectional survey on stroke was carried out in January 1999,and 696558 population in Nanhui county of Shanghai city were investigated in the study. Surveillance data on incidence and mortality rate of stoke from January 1996 to December 1998 in the county were retrospectively checked and reinvestigated.The CVHI of 35 years old and over in this population which have one and more of risk factors were measured,their CVHI total score

1 kHz at least; For the cerebral infarction cases with carotid atheromatous plaque, the frequence plots for f max , f mode and f mean were separated throughout the cardiac cycle, f max in systole

Crisis is an emergent event that threatens the national security, social regulation, civilian property and life, and needs urgent, decisive response in the condition of high instability. Crisis management should be prompt, active, honest, responsible and soluble, and should be carried out according to the model of preparation, reduction, response and recovery. SARS outbreak in China revealed constitutive defects in the immediate response for emergent public health event as well as crisis management. This paper provides some information for establishing the immediate response system for emergent public health event and crisis management.

Objective:To strengthen the research on theory and method of early warning for emergent public health event,so as to obtain timely information,correctly analyze the situation,and apply effective measures when the event happens.Methods: The definition of vulnerability of emergent public health event and the vulnerability factors were discussed.The indicator system and the evaluating method for public health vulnerability were systematically studied.The extenics theory and the theory of vulnerability evaluation were used for warning exercise.Results: We constructed an extenics model for early warning of emergent public health event;the model was used to evaluate the public health of a population.Conclusion: The theory of vulnerability evaluation is introduced in emergent public health event to construct an extenics model for early warning of emergent public health event;the model can be used to evaluate the public health of certain population.

Objective To explore the effect of nursing intervention on the oral hygiene of vagrant patients with mental problems.Methods Toally 80 vagrant patients with mental problems were saved and treated with oral health care intervention for a period of three months.The pre-intervention effects were prepared with the post-intervention ones in terms of tooth brushing,oral health and periodontal disease related symptoms intervention.Results Before intervention,the rate of tooth brushing was significantly higher and the rate of periodontal disease related symptoms significantly lower than that before intervention (P＜0.05).The scores on physical function limitation,pain and discomfort,psychological discomfort,weakened ability in independent living and the total score after intervention were all significantly lowered as compared to the pre-intervention.Conclusion Oral nursing intervention can improve oral hygiene and oral health of vagrant patients with mental diseases.

Objective To clarify the intravenous thrombolysis utilization of acute ischemic stroke patients in Huashan hospital,and to analyze the factors affecting thrombolytic therapy compliance.Methods The data from a prospective cohort were analyzed.Consecutive acute stroke and transient ischemic attack patients from Huashan Hospital emergency room were recruited in 2014.Eligible ischemic stroke patients were divided into two groups according to intravenous thrombolysis or not.Results Totally 220 patients from emergency room were assessed in 2014.Among eligible patients,43 patients refused intravenous thrombolysis,whereas 59 patients chose this therapy.After multiple analysis,age,baseline NIHSS score,limb weakness,hemiplegic paralysis,facial paralysis or speech symptoms were significantly different between the two groups (U =936.000,P =0.024;U =284.500,P ＜ 0.01;x2 =8.824,P =0.003;x2 =7.732,P=0.005;x2 =5.169,P=0.038;x2 =5.040,P=0.025).Patients with NIHSS score ＜7 tended to refuse thrombolysis therapy in the receiver operating characteristic curve analysis (sensitivity 0.93,specificity 0.71).From 2008 to 2014,244 cases were analyzed in the thrombolysis database.Compared with patients with higher baseline NIHSS score,intracranial hemorrhage rate (2.6％ vs 19.4％;x2 =12.466,P ＜0.01),7-day mortality rate (1.3％ vs 16.9％;x2 =12.308,P ＜0.01) and 3-month mortality rate (3.8％ vs 21.1％;x2 =11.993,P ＜0.01) were lower in patients whose baseline NIHSS score ＜ 7 (minor group).A higher rate of excellent outcome (3-month modified Rankin Scale score ≤ 1)was observed in minor group (78.2％ vs 38.0％;x2 =34.403,P ＜ 0.01).Conclusions Intravenous thrombolysis was performed in 54.6％ of eligible ischemic stroke patients.Age,baseline NIHSS score,limb weakness,hemiplegic paralysis,facial paralysis or speech symptoms were associated with patients' decision of thrombolysis.The effectiveness and safety of intravenous thrombolysis were promising for patients with mild stroke.

A comparison of the volatile compounds in Rhizomes Curcumae (Ezhu) and Radix Curcumae (Yujin) was undertaken using gas chromatography-mass spectrometry (GC-MS).Ultrasonic extraction and GC-MS methods were developed for the simultaneous determination of five sesquiterpenes,namely,α-pinene,β-elemene,curcumol,germacrone and curdione,in Ezhu and Yunjin.Good linearity (r＞0.999) and high inter-day precision were observed over the investigated concentration ranges.The validated method was successfully used for the simultaneous determination of five sesquiterpenes in Ezhu and Yujin.The quantitative method can be effectively used to evaluate and monitor the quality of Chinese curcuma in clinical use.

Objective To assess the incidence of thrombocytopenia and abnormal coagulation,door to needle time (DNT),and safety in patients with ischemic stroke who receive intravenous thrombolytic treatment prior to the availability of blood platelet (PLT) and coagulation results.Methods Consecutive acute ischemic stroke (AIS) or transient ischemic attack patients within 12 hours of symptom onset who were admitted from January 2009 to March 2013 were retrospectively recruited.First laboratory reports in their medical charts were collected to assess the incidence of thrombocytopenia and abnormal coagulation.In the mean time,consecutive AIS patients who received intravenous thrombolysis at Huashan Hospital during the same period were retrospectively recruited.The thrombolytic procedures were further optimized since June 10.3760/cma.j.issn.1006-7876.2014.07.00626,2012.With informed consent,intravenous thrombolysis was initiated without PLT and coagulation results after certain previous history and medications were ruled out.Thrombolytic patients were divided into two groups based on the initiation of thrombolysis before or after PLT and coagulation results.Baseline demographic data,symptomatic intracerebral hemorrhage rates,mortality on the 7th day as well as functional outcome at 3 months were collected.DNT as well as efficacy and safety of thrombolysis therapy were compared between the two groups.Results Of 298 AIS patients within 12 hours of onset,8 had thrombocytopenia or abnormal coagulation.One hundred and twenty cases of intravenous thrombolysis patients were recruited.Waiting for PLT and coagulation results prolonged DNT than without waiting for them (90 min vs 59 min; U =870.000,P ＜0.01).There was no statistically significant difference in the rate of symptomatic intracerebral hemorrhage (sICH),early efficacy,7 d mortality and 3-month good outcome between two groups.Conclusions The incidence of thrombocytopenia and abnormal coagulation is low in AIS patients.Initiating intravenous thrombolysis prior to the availability of coagulation results can shorten DNT,while increased risks of sICH and 7 d mortality were not observed.

Objective To determine factors associated with favorable clinical outcome in acute ischemic stroke patients who received intravenous thrombolysis.Methods Patients treated with intravenous recombinant tissue plasminogen activator (rt-PA) between January 1,2008 and May 31,2013 were recruited.Favorable outcome was defined as modified Rankin scale (mRS) score ＜ 2 at 3 months.The baseline characteristics were compared by univariate and multivariate analysis.Results Of all the 148 patients studied,within the 4.5-hour time window,the rate of patients with a favorable outcome was 52.4％ (65/124),significantly better than those beyond the time window(20.8％ (5/24),x2 =8.048,P =0.005).Univariate analysis showed that age (U =2 146.000,P =0.025),TOAST classification (x2 =11.412,P =0.010),Oxfordshire Community Stroke Project (OCSP) classification (x2 =17.409,P =0.001),baseline blood glucose (U =1 446.500,P ＜ 0.01),baseline fibrinogen (U =1 689.000,P =0.038),admission NIHSS score (U =1 140.000,P ＜ 0.01),24-hour NIHSS score (U =458.000,P ＜0.01),and early symptom improvement (24-hour NIHSS score decreased ≥ 4 points,or down to 0 point;x2 =19.576,P ＜ 0.01) were the factors associated with clinical outcomes.Multivariate analysis revealed that age (odds ratio (OR) =0.943,95％ confidence interval (CI) 0.892-0.996,P =0.024),baseline fibrinogen (OR =0.448,95％ CI 0.208-0.963,P =0.040),baseline NIHSS score (OR =0.749,95％ CI 0.663-0.845,P ＜ 0.01),and early symptom improvement (OR =14.970,95％ CI 4.460-50.249,P ＜ 0.01) were independent predictors of clinical outcomes.Conclusions The effect of intravenous thrombolysis on clinical outcomes of acute ischemic stroke patients is time-dependent.Age,baseline NIHSS score,baseline fibrinogen level,and early symptom improvement are independent predictors of clinical outcomes after intravenous thrombolysis.

Objective: To compare the accumulative scores of cerebrovascular hemodynamic parameters (CVHP) in different populations and to analyze the relationship between the change of accumulative scores and the risk of stroke. Methods: A total of 10 565 participants aged 40 years and above were selected from a cluster sampling community-based population. Their risk factors were investigated and CVHP was evaluated. The CVHP scores were accumulated by a unified approach, and the incidence of stroke was followed up. The participants were grouped into health adult, single factor exposure, multiple-factor exposure, and newly developed stroke during the follow-up period. The differences of CVHP accumulative scores and the change law among the 4 groups were compared respectively according to age and sex. Results: The accumu-lative scores of the mean (SD) CVHP in the health adult, single factor exposure, multiple-factor exposure, and newly developed stroke groups were 86.44 (20.69), 72.07 (28.10), 60.82(34.64), and4.01 (29.36) in men respectively, and they were 83.95 (22.19), 67.97 (29.73),59.91 (31.34), and 42.64 (28.00) in women respectively, which had a tendency to gradually decrease. The accumulative scores of CVHP and their distributions at the same age stage in all the 4 groups had significant differences (P ＜ 0.01 ). The accumulative scores of CVHP and their distributions for the same factors between all age groups also had significant differences (P ＜0. 01). Conclusions: The accumulative scores of CVHP had a tendency to gradually decrease from the health adults, risk factor exposure to high risk status before stroke. The decrease of the accumulative scores is closely associated with the increase of stroke risk, which can be used as a predictor of stroke.