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Comparisons between ticagrelor and clopidogrel for the secondary prevention of stroke inWe conducted a randomized, double-blind, placebo-controlled trial at 202 centers in China involving patients with a minor ischemic stroke or transient ischemic attack (TIA) who carriedA total of 11,255 patients were screened and 6412 patients were enrolled, with 3205 assigned to the ticagrelor group and 3207 to the clopidogrel group. The median age of the patients was 64.8 years, and 33.8% were women; 98.0% belonged to the Han Chinese ethnic group. Stroke occurred within 90 days in 191 patients (6.0%) in the ticagrelor group and 243 patients (7.6%) in the clopidogrel group (hazard ratio, 0.77; 95% confidence interval, 0.64 to 0.94; P = 0.008). Secondary outcomes were generally in the same direction as the primary outcome. Severe or moderate bleeding occurred in 9 patients (0.3%) in the ticagrelor group and in 11 patients (0.3%) in the clopidogrel group; any bleeding occurred in 170 patients (5.3%) and 80 patients (2.5%), respectively.Among Chinese patients with minor ischemic stroke or TIA who were carriers of

Background: Sub-health status (SHS) is an increasingly concerned issue with a high prevalence worldwide. Although some factors of lifestyle and environment has been study, few studies have determined comprehensively the associations of lifestyle and living environmental factors with general, physical, mental and social SHS. Methods: A cross-sectional face-to-face survey (Sep 2017 to Sep 2018) was conducted via questionnaire among 6,750 urban residents aged 14 years and above randomly selected from five Chinese cities. There were 5,881 valid questionnaires with a response rate of 87%. General linear model and structure equation model were developed to quantifying the effects of lifestyle behaviors and living environmental factors on SHS. Results: Detection rates of general SHS, physical SHS, mental SHS and social SHS were 66.7%, 67.0%, 65.5% and 70.0%, respectively. Significant association of general SHS, physical SHS, mental SHS and social SHS had been found in smoking, bad dietary habits, breakfast consumption, physical exercise, sleep duration, air, neighbor harmony and living convenience, instead of noiseless. However, associations of general SHS, physical SHS, mental SHS and social SHS were different for second-hand smoking influence, alcohol consumption, sunshine, Bedtime before 11pm, surfing the internet, greenery, air, pleasant housing, spacious rooms and fitness facility. Good lifestyle behaviors and favorable living environment factors positively affected SHS (Pβ=-0.418), but the least on social SHS (β=-0.274). Living environmental factors had the largest effect on mental SHS (β=0.286), but the least on physical SHS (β=0.225). Conclusions: Lifestyle behaviors and living environmental factors were important influencing factors of SHS. Physical SHS was more associated with lifestyle. Lifestyle and living environment were similarly associated with mental and social SHS.

OBJECTIVE: To explore the direct relationship between personality (PN) and sub-health status (SHS) and their indirect association mediated by frustration quotient (FQ) and stress event (SE). METHODS: A multiple-stage stratified sampling method was used to choose the participants, and a total of 4517 eligible urban residents were selected.ANCOVA was used to analyze the independent association between personality and SHS after adjusting the demographic characteristics and lifestyle.A structural equation model was used to analyze the associations among personality, FQ, SE and SHS.Bootstrap method was used to test the direct and indirect association between personality and SHS. RESULTS: Personality was independently associated with total sub-health (F=75.913, P < 0.001), physical sub-health (F=23.618, P < 0.001), mental sub-health (F=101.993, P < 0.001) and social sub-health (F=48.757, P < 0.001).The urban residents with the personalities characterized by anger suppression, anxiety and irritability, and impatience and competitiveness had significantly lower health scores than those with a mature and steady personality (P < 0.05).Personality was associated with FQ and SE, and the indirect association between personality and physical sub-health was mainly mediated by FQ and SE (β=-0.110).Personality showed more a direct association (β=-0.172) with mental sub-health and a slightly less indirect association (β=-0.126) with mental sub-health.Personality showed a more indirect association (β=-0.113) with social SHS and slightly less direct association (β=-0.082) with social sub-health. CONCLUSION: A mature and steady personality may help to promote the general health level, while the personalities of anger suppression, anxiety and irritability, impatience and competitiveness can be associated with the occurrence of sub-health.Building a mature and steady personality has positive effects on the health in general of an individual.

Background: Sub-health status (SHS), a third state between good health and disease, can easily develop into chronic diseases. It is found to be influenced by lifestyle behaviors and health consciousness. Method: A cross-sectional survey using a four-stage stratified sampling method was conducted from March to September 2018 among Chinese urban residents. Questionnaire included demographic characteristics, lifestyle behaviors, health consciousness, and Sub-Health Measurement Scale V1·0. A total of 3535 qualified adults were included in the analysis. A structural equation model (SEM) was adopted to analyze relationships among lifestyle behaviors, health consciousness, and SHS. A bootstrapping method was applied to estimate the mediation effect of health consciousness. Findings: Lifestyle behaviors had a strong direct association with physical sub-health (β=-0·207), faint direct association with social health (β=-0·075), and no significant direct association with mental sub-health (β=-0·050). Health consciousness had a strong direct association with physical sub-health (β=0·480), mental sub-health (β=0·601), and social sub-health (β=0·559). Health consciousness had a complete mediation effect in the relationship between lifestyle behaviors and mental sub-health, and a partial mediation effect in the relationships between lifestyle behaviors and physical and social sub-health. Interpretation: Negative health consciousness and unhealthy lifestyle behaviors associated with worse SHS, which gives a clue that improving health consciousness and altering lifestyle behaviors maybe good for changing sub-health status to health status, which needed proven of further researches. Funding Statement: This research was supported by the National Natural Science Fund, National Natural Science Foundation of China (No: 71673126), and the Science and Technology Planning Project of Guangzhou City of China (No: 201803010089). Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: Verbal informed consent was obtained from every participant prior to data collection. Verbal consent was deemed sufficient by the Nanfang hospital ethics committee because participants had previously volunteered for the study and could refuse to participate. All data were kept strictly confidential.