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8. Long-Term Trends in Stroke Management and Burden Among Low-Income Women in a Rural Area From China (1992–2019): A Prospective Population-Based Study

Author

Tian, Xiaobing, primary, Liu, Jie, additional, Yu, Changshen, additional, Hou, Yabing, additional, Zhan, Changqing, additional, Lin, Qiuxing, additional, Zhang, Xinyu, additional, Zhang, Xin, additional, Guo, Dandan, additional, Yang, Qiaoxia, additional, Tu, Jun, additional, Wang, Yaogang, additional, Ning, Xianjia, additional, and Wang, Jinghua, additional

Published
2021
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11. Health care reform and stroke prognosis in low-income Chinese populations from 1992 to 2018

Author

Liu, Jie, Lin, Qiuxing, Gao, Ying, Zhang, Xinxin, Qi, Dongwang, Wang, Conglin, Tu, Jun, Wang, Yaogang, Ning, Xianjia, and Wang, Jinghua

Abstract

Background Improving maternal and newborn health remains one of the most critical public health challenges, particularly in low- and lower-middle-income countries. To overcome this challenge, interventions to improve the continuum of care based on real-world settings need to be provided. The Ghana Ensure Mothers and Babies Regular Access to Care (Embrace) Implementation Research Team conducted a unique intervention program involving over 21 000 women to improve the continuum of care, thereby demonstrating an intervention program’s effectiveness in a real-world setting. This study evaluates the implementation process of the Embrace intervention program based on the RE-AIM framework. Methods A cluster-randomized controlled trial was conducted in 32 sub-district-based clusters in Ghana. Interventions comprised of four components, and to evaluate the implementation process, we conducted baseline and endline questionnaire surveys for women who gave birth and lived in the study site. The key informant interviews of health workers and intervention monitoring were conducted at the health facilities in the intervention area. The data were analyzed using 34 components of the RE-AIM framework and classified under five general criteria (Reach, Effectiveness, Adoption, Implementation, and Maintenance). Results In total, 1480 and 1490 women participated in the baseline and endline questionnaire survey, respectively. In the intervention area, 83.8% of women participated (reach). The completion rate of the continuum of care increased from 7.5% to 47.1%. Newborns who had danger signs immediately after birth decreased after the intervention (relative risk = 0.82, 95% confidence interval = 0.68-0.99) (effectiveness). In the intervention area, 94% of all health facilities participated. Mothers willing to use their continuum of care cards in future pregnancies reached 87% (adoption). Supervision and manual use resolved the logistical and human resource challenges identified initially (implementation). The government included the continuum of care measures in their routine program and developed a new Maternal and Child Health Record Book, which was successfully disseminated nationwide (maintenance). Conclusions Following the RE-AIM framework evaluation, the Embrace intervention program was considered effective and as having great potential for scaling across in real-world settings, especially where the continuum of care needs to be improved.

Published
2021

14. Epidemiology of Isolated Impaired Glucose Tolerance Among Adults Aged Above 50 Years in Rural China

Author

Tian,Xiaobing, Li,Yan, Liu,Jie, Lin,Qiuxing, Yang,Qiaoxia, Tu,Jun, Wang,Jinghua, Li,Jidong, Ning,Xianjia, Tian,Xiaobing, Li,Yan, Liu,Jie, Lin,Qiuxing, Yang,Qiaoxia, Tu,Jun, Wang,Jinghua, Li,Jidong, and Ning,Xianjia

Abstract

Xiaobing Tian,1,* Yan Li,2,3,* Jie Liu,1,2,4,5,* Qiuxing Lin,1,2,4,5 Qiaoxia Yang,6 Jun Tu,1,2,4,5 Jinghua Wang,1,2,4,5 Jidong Li,2,7 Xianjia Ning1,2,4,5 1Department of Neurology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 2Center of Clinical Epidemiology & Evidence-Based Medicine, The Jizhou People’s Hospital, Tianjin, People’s Republic of China; 3Department of Anesthesiology, The Jizhou People’s Hospital, Tianjin, People’s Republic of China; 4Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, People’s Republic of China; 5Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, People’s Republic of China; 6Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 7Department of Neurosurgery, The Jizhou People’s Hospital, Tianjin, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xianjia Ning; Jidong Li Email xning@tmu.edu.cn; jd_li_doctor@163.comIntroduction: Isolated impaired glucose tolerance (i–IGT) is a subtype of prediabetes in which an individual demonstrates elevated 2-h post-glucose load glucose levels but normal fasting plasma glucose levels. However, few studies have explored the prevalence and risk factors of i–IGT among adults in rural China. Thus, we aimed to explore the prevalence and risk factors of i–IGT among adults ≥ 50 years old in a low-income, rural population in China.Materials and Methods: Individuals aged ≥ 50 years with normal fasting plasma glucose levels were included in the final analysis. Fasting and 2-h venous blood samples were collected to assess the selected parameter measurements.Results: A total of 2175 individuals were included in this study. The i–IGT prevalence was 22.9% and significantly higher among fe

Published
2021

15. Long-Term Trends in the Stroke Prognosis Among Rural Residents in China: A Population-Based Surveillance Study

Author

Han,Jing, Liu,Jie, Wu,Yakun, Lin,Qiuxing, Guo,Dandan, Zhang,Xin, Tu,Jun, Ning,Xianjia, Wang,Jinghua, Han,Jing, Liu,Jie, Wu,Yakun, Lin,Qiuxing, Guo,Dandan, Zhang,Xin, Tu,Jun, Ning,Xianjia, and Wang,Jinghua

Abstract

Jing Han,1,&ast; Jie Liu,1– 4,&ast; Yakun Wu,1,5,&ast; Qiuxing Lin,1– 3,5 Dandan Guo,1 Xin Zhang,1 Jun Tu,1– 3,5 Xianjia Ning,1– 3,5 Jinghua Wang1– 3,5 1Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 2Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China; 3Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China; 4Center of Clinical Epidemiology & Evidence-Based Medicine, The Jizhou People’s Hospital, Tianjin, 301999, People’s Republic of China; 5Department of Neurology, Tangshan Gongren Hospital, Tangshan, 063000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jinghua Wang; Xianjia Ning Email jwang3@tmu.edu.cn; xning@tmu.edu.cnObjective: Although stroke mortality has remained stable over the past decade, the long-term trends of stroke burden are scarce in China, especially in low-income populations. Thus, we aimed to explore the secular trends in the prognosis of stroke in a low-income population in China.Methods: This was a population-based stroke surveillance study that included all of the participants in the Tianjin Brain Study. Stroke management and outcomes were evaluated for all stroke patients. Trends in the burden of stroke were assessed as annual percentage changes.Results: Overall, 1462 stroke cases occurred from 1992 to 2018, and 58.7% of patients were male. The rates of diagnosis by neuroimaging and of hospitalization increased noticeably across sexes and ages for all stroke types, and the greatest increases were observed among elderly women; diagnosis by neuroimaging increased by 4.7% and the rate of hospitalization increased by 12.4% (all P< 0.001). Stroke fatality decreased by 3.7% annually among

Published
2021

16. Sex -Specific Differences in the Association Between Metabolic Syndrome and Carotid Intima-Media Thickness Among a Low-Income Population in China: A Cross-Sectional Study

Author

Fan,Liming, Yang,Qiaoxia, Zhang,Xin, Lin,Qiuxing, Guo,Dandan, Liu,Jie, Tu,Jun, Wang,Jinghua, Li,Yan, Ning,Xianjia, Fan,Liming, Yang,Qiaoxia, Zhang,Xin, Lin,Qiuxing, Guo,Dandan, Liu,Jie, Tu,Jun, Wang,Jinghua, Li,Yan, and Ning,Xianjia

Abstract

Liming Fan,1,&ast; Qiaoxia Yang,2,&ast; Xin Zhang,3,&ast; Qiuxing Lin,3– 5 Dandan Guo,3 Jie Liu,2– 4 Jun Tu,3– 5 Jinghua Wang,3– 5 Yan Li,6 Xianjia Ning3– 5 1Department of Medical Clinical Laboratory, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 2Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 3Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 4Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China; 5Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China; 6Department of Anesthesiology, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xianjia NingDepartment of Neurology, Tianjin Medical University General Hospital, Laboratory of Epidemiology, Tianjin Neurological Institute & Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, 154 Anshan Road, Heping District, Tianjin, 300052, People’s Republic of ChinaTel +86-22-60817505Fax +86-22-60817448Email xning@tmu.edu.cnYan LiDepartment of Anesthesiology, Tianjin Jizhou People’s Hospital, 18 Nanhuan Road, Jizhou District, Tianjin, 301900, People’s Republic of ChinaTel/Fax +86-22- 60733586Email drliyan@163.comIntroduction: Carotid atherosclerosis is a well-established biomarker associated with future cardiovascular disease and stroke. We explored the influence of sex on the relationship between metabolic syndrome (MetS) and its components with carotid intima-media thickness (CIMT) among a low-income pop

Published
2021

17. Sex Differences in the Prevalence of and Risk Factors for Abnormal Glucose Regulation in Adults Aged 50 Years or Older With Normal Fasting Plasma Glucose Levels

Author

Zhang, Xinxin, primary, Liu, Jie, additional, Shao, Shuang, additional, Yang, Yuan, additional, Qi, Dongwang, additional, Wang, Conglin, additional, Lin, Qiuxing, additional, Liu, Yue, additional, Tu, Jun, additional, Wang, Jinghua, additional, Ning, Xianjia, additional, and Cui, Jingqiu, additional

Published
2021
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29. Incidence and predictors of progression of carotid atherosclerosis in a low-income Chinese population—a prospective cohort study.

Author

Lin, Qiuxing, Liu, Jie, Hu, Peng, Li, Teng, Yang, Qiaoxia, Tu, Jun, Wang, Jinghua, Li, Jidong, and Ning, Xianjia

Abstract

More than 200 million individuals have been diagnosed with carotid atherosclerosis (CAS) in China. We aimed to investigate the incidence and potential predictors of CAS progression in a low-income rural area in China. A population-based cohort study was conducted on individuals aged ≥45 years from 2014 to 2019. Multivariable analyses were used to investigate the predictors of carotid plaque (CP) formation, plaque number, and carotid intima-media thickness (CIMT). A total of 1479 participants were finally enrolled in this study. The incidence rate of CP was 42.9 cases per 1000 person-years, and the progression of median CIMT was 137.50 μm over five years. The risk of CP formation increased 2-fold in participants aged ≥75 years (P = 0.002) compared with those aged 45–54 years. The corresponding risk was 59% higher in participants with hypertension (P = 0.001) and 73% higher in alcohol drinkers (P = 0.006). With each 1- standard deviations (SD) increase in high- and low-density lipoprotein cholesterol levels, the risk of CP occurrence decreased by 16% (P = 0.016) and increased by 29% (P = 0.002), respectively. Participants aged ≥75 years exhibited a 3.3-fold higher risk of having a high number of plaques than those aged 45–54 years (P = 0.014). Moreover, older age and the waist-to-hip ratio were independent predictors of CIMT progression. This is the first longitudinal study to explore the incidence and predictors of CAS progression in a low-income rural population in China with a high prevalence of stroke. More detailed and precise strategies for prevention and intervention of CAS progression are necessary, especially in low-income rural areas in China. [ABSTRACT FROM AUTHOR]

Published
2022
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30. Temporopolar blurring signifies abnormalities of white matter in mesial temporal lobe epilepsy.

Author

Li, Yuming, Liu, Peiwen, Lin, Qiuxing, Li, Wei, Zhang, Yingying, Li, Jinmei, Li, Xiuli, Gong, Qiyong, Zhang, Heng, Li, Luying, Sima, Xiutian, Cao, Danyang, Huang, Xiang, Huang, Kailing, Zhou, Dong, and An, Dongmei

Subjects
*HIPPOCAMPAL sclerosis, *TEMPORAL lobe epilepsy, *TEMPORAL lobectomy, *WHITE matter (Nerve tissue), *EPILEPTIFORM discharges, *FEBRILE seizures, *EPILEPSY
Abstract

Objective Methods Results Interpretation The single‐center retrospective cohort study investigated underlying pathogenic mechanisms and clinical significance of patients with temporal lobe epilepsy and hippocampal sclerosis (TLE‐HS), in the presence/absence of gray–white matter abnormalities (usually called “blurring”; GMB) in ipsilateral temporopolar region (TPR) on MRI.The study involved 105 patients with unilateral TLE‐HS (60 GMB+ and 45 GMB−) who underwent standard anterior temporal lobectomy, along with 61 healthy controls. Resected specimens were examined under light microscope. With combined T1‐weighted and DTI data, we quantitatively compared large‐scale morphometric features and exacted diffusion parameters of ipsilateral TPR‐related superficial and deep white matter (WM) by atlas‐based segmentation. Along‐tract analysis was added to detect heterogeneous microstructural alterations at various points along deep WM tracts, which were categorized into inferior longitudinal fasciculus (ILF), uncinate fasciculus (UF), and temporal cingulum.Comparable seizure semiology and postoperative seizure outcome were found, while the GMB+ group had significantly higher rate of HS Type 1 and history of febrile seizures, contrasting with significantly lower proportion of interictal contralateral epileptiform discharges, HS Type 2, and increased wasteosomes in hippocampal specimens. Similar morphometric features but greater WM atrophy with more diffusion abnormalities of superficial WM was observed adjacent to ipsilateral TPR in the GMB+ group. Moreover, microstructural alterations resulting from temporopolar GMB were more localized in temporal cingulum while evenly and widely distributed along ILF and UF.Temporopolar GMB could signify more severe and widespread microstructural damage of white matter rather than a focal cortical lesion in TLE‐HS, affecting selection of surgical procedures. [ABSTRACT FROM AUTHOR]

Published
2024
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31. Hearing impairment prevalence and risk factors among adults in rural China: a population-based cross-sectional study.

Author

Yang, Dong, Liu, Jie, Yang, Qiaoxia, Lin, Qiuxing, Zhang, Xin, Wang, Mingxin, Li, Xin, Tu, Jun, Wang, Jinghua, and Ning, Xianjia

Subjects
HEARING disorders, AUDIOMETRY, OLDER people, SYSTOLIC blood pressure, QUALITY of life, NOISE-induced deafness
Abstract

Objective: Over the past few decades, the prevalence of hearing impairment (HI) has rapidly increased, making HI one of the most common causes of disability, globally. The burden of HI is particularly heavy in low socioeconomic status populations. Despite extensive research into the range of HI prevalence in low socioeconomic status populations, worldwide, population-based studies have been rare. Thus, we explored HI prevalence and risk factors among low-income, middle-aged and elderly individuals in Tianjin, China. Method: Between September and November 2013, 2351 rural residents in Tianjin, China were recruited into the study. All participants completed questionnaire surveys, physical examinations, laboratory examinations, and hearing tests. HI was measured using pure-tone audiometry, and audiologists determined the final diagnoses.Results: Among the 2351 participants, ≥45 years old, the prevalence of HI was 49.3%, including 54.3% among men and 46.0% among women. Slight HI accounted for the largest proportion of individuals (40.7%). The risk of HI among men was 32.9% higher than among women. Moreover, the risk of HI increased with increasing age. Compared with the 45–54-year-old group, the risk of HI in individuals in the 55–64-year-old, 65–74-year-old, and ≥75-year-old groups were 25.8%, 109.9%, and 373.7% higher, respectively. Moreover, increased with each 1-mmHg SBP, the risk of HI increase 0.7% (95%CI: 1.001–1.013; P = 0.017); while increased with each 1-mmHg DBP, the risk of HI decrease 1.7% (95%CI: 0.973–0.993; P = 0.001) Conclusions: The burden of HI in rural northern China is heavy, especially among elderly men and people with elevated systolic blood pressure (SBP). Addressing HI prevention is critical for reducing the HI burden and improving quality of life. [ABSTRACT FROM AUTHOR]

Published
2021
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