Chinese-style breakout for stroke treatment.

Stroke, also known as stroke, is an acute cerebrovascular disease, the world's second largest and China's largest fatal disease, not only high mortality, but also high morbidity, recurrence rate, disability rate.
the heavy burden of stroke disease in China, how to speed up the pace to bring better treatment for our patients, is it to copy foreign experience, or the road to China? It's worth thinking about.
the burden of stroke disease in China has been "overwhelmed" in recent years, the damage caused by stroke to our country is self-evident.
according to the China Stroke Prevention and Control Report, one person has a stroke every 12 seconds, one person dies of stroke every 21 seconds, and more than 1.9 million people die from stroke every year in China! Unfortunately, however, our level of disease control is not optimistic.
with the good trend of developed countries (morbidity, mortality, disability adjustment life expectancy DALY and other indicators show a downward trend), the incidence of stroke, mortality, DALY in China are showing an upward trend.
china has one of the highest rates of stroke, with a rapid growth rate of 8.7% per year, well above the global average.
among the two major categories of stroke, the incidence of ischemic stroke in China is 1.36 times the world average, and the incidence and mortality rate of hemorrhagic stroke is twice that of the world average.
in terms of mortality, China's annual rate of increase of 10%, and has become the first cause of death of our residents.
, China's stroke mortality rate is 4-5 times that of Europe and the United States, 3.5 times that of Japan, and even higher than that of developing countries such as India.
116.4 million years of global stroke, China accounted for one-third (38.62 million years).
that China is one of the countries with the heaviest burden of stroke in the world, which has brought great distress to society and families.
The Global Burden of Disease Study points out that without access to rational means of prevention and treatment for more effective disease management, the number of stroke deaths and disabilities will double by 2030, mainly in developing countries, when our country will undoubtedly be under greater burden of disease.
The differences at home and abroad doomed us to "copy operations" Whenever we lag behind foreign developed countries in some areas, our first reaction is always to see if there is relevant experience to learn from, but in the field of stroke, I am afraid it is not so easy, although domestic and foreign patients seem to be the same disease, in fact, but there are large differences.
First, from the age of onset, the age of onset of stroke in China is smaller, the average age of onset is 10 years earlier than in Europe and the United States, about 63 years old, some young patients with the first age of onset is even less than 45 years old;
less than 5% of the disease caused by the cervical artery in China, the incidence of intracranial disease alone reached 37.5%, the combined incidence of intracranial intracranial disease was 9.1%, which together reached more than 48%.
In addition, there are differences in disease types, the proportion of cerebral hemorrhage in stroke patients in China is higher than in Europe and the United States, at the same time, the proportion of heart-based cerebral infarction in China is low, acute cerebrovascular disease (including primary cerebral hemorrhage and infarction) is higher, and the proportion of patients with intracranial artery stenosis with cerebral infarction is higher.
brain is a very complex organ, thousands of miles behind, not to mention these zero total differences add up.
if you copy treatment plans abroad, there is no doubt that there is a great risk.
, there are also huge differences in medical capacity at home and abroad.
ischemic stroke as an example, foreign emphasis should be placed on venous thrombosis treatment (6h) and intravascular treatment (thrombosis) within the time window of treatment.
, however, this "time is the brain" treatment for the level of medical requirements is very high, the first time to find the patient's illness and non-stop directly sent to the hospital to complete the treatment in prime time.
And not to say that the current public awareness of stroke disease is not high, even if the first time to identify stroke, considering that more than half of our population lives in rural areas, in the transportation is not convenient, medical resources are insufficient areas how to quickly and effectively transfer patients to hospitals capable of treatment is also a difficult problem.
At this stage, the time between onset and arrival at the hospital in China (22h) is longer than in Europe and the United States (11h), the time from patients to venous thrombosis (95min) is longer than in Europe and the United States (62min), and overall, it is more difficult to provide patients with treatment in prime first aid time, receiving rtPA (a thrombolytic drug) of acute ischemic stroke patients less than 1%.
the differences in medical standards at home and abroad can not be changed in a short period of time, may be in the future for a long time, China will still face such differences in the status quo.
under such circumstances, it is clear that the model of "copying operations" abroad will not meet our growing and pressing medical needs, and we must invest more in research and catch up only if we go faster and better than abroad.
, actively exploring treatment options with "Chinese characteristics" may be the better way out.
neuroscientists or "Chinese characteristics" are known to be highly time-dependent for stroke treatment, with 190 million neurons and 13.8 billion synapses lost for every delay of 1min.
Foreign profits can be timely diagnosis and rehabilitation of stroke patients, so that patients get effective treatment, reduce mortality, taking into account that foreign neuro-protective agents related to large-scale research is less, therefore, the recommendation of neuro-protective agents is relatively low.
However, as mentioned above, stroke patients in China, especially in the vast rural areas, the level of medical care is insufficient, residents' health awareness is weak, road traffic is not smooth, often miss the best treatment time, high mortality rate.
we must consider more options to protect neurons in stroke patients in order to reduce stroke death and disability losses and reduce the socio-economic burden.
is a promising treatment strategy that complements treatments such as thrombosis.
nerve protectors block cellular, biochemical, and metabolic processes that mediate ischemic or ischemic/refill brain tissue damage.
In layman's terms, the acute phase of stroke may produce some harmful substances to the human brain, such as free agents, peroxides, inflammatory factors, etc., when stroke occurs, the earlier the use of nerve protection agents, the more effective to prevent harmful substances damage to the brain, for the brain to win more time.
the guidelines for stroke in China have always been recognized as neuromedulants.
For example, the 2018 edition of China's guidelines for the diagnosis and treatment of acute ischemic stroke mentions that for patients with ischemic stroke, in addition to general treatment, there is also a need for active specific treatment, including nerve protection.
But we must also recognize that since the end of the 20th century, the study of neuro-protective agents has taken decades, and thousands of neuro-protective agents have been recommended for clinical trials in animal experiments, but have proved ineffective in clinical studies.
Nevertheless, we firmly believe that the large number of stroke patients in China, which is the embodiment of our major disease burden, but also the advantages of our clinical research, in large samples of clinical research and pharmaceutical enterprises continue to invest a lot of research and development efforts, will be able to find and confirm that the effective stroke nerve protection agent for the vast number of patients to bring good news.
, we also look forward to china's large-sample clinical research confirmed by the new nerve protection agent to "China's independent innovation" on the world stage.
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