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| 1 | Efficacy and safety of intravenous recombinant tissue plasminogen activator in mild ischaemic stroke:a meta-analysis显示文摘The benefits and safety of intravenous recombinant tissue plasminogen activator(IV-tPA)for patients with mild ischaemic stroke(MIS)are still unclear.The objective of this meta-analysis was to evaluate the efficacy and safety of IV-tPA as treatment for patients with MIS.We performed a systematic literature search across MEDLINE,Embase,Central,Global Health and Cumulative Index to Nursing and Allied Health Literature(CINAHL),from inception to 10 November 2016,to identify all related studies.Where possible,data were pooled for meta-analysis with odds ratio(OR)and corresponding 95%confidence interval(CI)using the fixed-effects model.MIS was defined as having National Institutes of Health Stroke Scale score of≤6.We included seven studies with a total of 1591 patients based on the prespecified inclusion and exclusion criteria.The meta-analysis indicated a high odds of excellent functional outcome based on the modified Rankin Scale or Oxfordshire Handicap Score 0-1(OR=1.43;95%CI 1.14 to 1.79;P=0.002,I2=35%)in patients treated with IV-tPA compared with those not treated with IV-tPA(74.8%vs 67.6%).There was a high risk of symptomatic intracranial haemorrhage(sICH)with IV-tPA treatment(OR=10.13;95%CI 1.93 to 53.02;P=0.006,I2=0%)(1.9%vs 0.0%)but not mortality(OR=0.78;95%CI 0.43 to 1.43;P=0.43,I2=0%)(2.4%vs 2.9%).Treatment with IV-tPA was associated with better functional outcome but not mortality among patients with MIS,although there was an increased risk of sICH.Randomised trials are warranted to confirm these findings. | Shoujiang You Anubhav Saxena Xia Wang WeeYong Tan Qiao Han Yongjun Cao Chun-Feng Liu | 2018 | Stroke & Vascular Neurology2018，3，1： | 24 |
| 2 | Current status of intravenous tissue plasminogen activator dosage for acute ischaemic stroke:an updated systematic review显示文摘The optimal dose of recombinant tissue plasminogen activator(rtPA)for acute ischaemic stroke(AIS)remains controversial,especially in Asian countries.We aimed to update the evidence regarding the use of low-dose versus standard-dose rtPA.We performed a systematic literature search across MEDLINE,Embase,Cochrane Central Register of Controlled Trials(CENTRAL),PsycINFO and Cumulative Index to Nursing and Allied Health Literature(CINAHL)from inception to 22 August 2016 to identify all related studies.The outcomes were death or disability(defined by modified Rankin Scale 2-6),death,and symptomatic intracerebral haemorrhage(sICH).Where possible,data were pooled for meta-analysis with ORs and corresponding 95% CIs by means of random-effects or fixed-effects meta-analysis.We included 26 observational studies and 1 randomised controlled trial with a total of 23210 patients.Variable doses of rtPA were used for thrombolysis of AIS in Asia.Meta-analysis shows that low-dose rtPA was not associated with increased risk of death or disability(OR 1.13,95% CI 0.95 to 1.33),or death(OR 0.86,95% CI 0.74 to 1.01),or decreased risk of sICH(OR 1.06,95% CI 0.65 to 1.72).The results remained consistent when sensitivity analyses were performed including only low-dose and standard-dose rtPA or only Asian studies.Our review shows small difference between the outcomes or the risk profile in the studies using low-dose and/or standard-dose rtPA for AIS.Low-dose rtPA was not associated with lower risk of death or disability,death alone,or sICH. | Xia Wang Shoujiang You Shoichiro Sato Jie Yang Cheryl Carcel Danni Zheng Sohei Yoshimura Craig S Anderson Else Charlotte Sandset Thompson Robinson John Chalmers Vijay K Sharma | 2018 | Stroke & Vascular Neurology2018，3，1： | 10 |
| 3 | Impact of COVID-2019 on stroke services in China: survey from the Chinese Stroke Association显示文摘Background The COVID-19 pandemic and physical distancing guidelines have compelled stroke practices worldwide to reshape their delivery of care significantly.We aimed to illustrate how the stroke services were interrupted during the pandemic in China.Methods A 61-item questionnaire designed on Wenjuanxing Form was completed by doctors or nurses who were involved in treating patients with stroke from 1 February to 31 March 2020.Results A total of 415 respondents completed the online survey after informed consent was obtained.Of the respondents,37.8%,35.2%and 27.0%were from mild,moderate and severe epidemic areas,respectively.Overall,the proportion of severe impact(reduction>50%)on the admission of transient ischaemic stroke,acute ischaemic stroke(AIS)and intracerebral haemorrhage(ICH)was 45.0%,32.0%and 27.5%,respectively.Those numbers were 36.9%,27.9%and 22.3%;36.5%,22.1%and 22.6%;and 66.4%,47.5%and 41.1%in mild,moderate and severe epidemic areas,respectively(all p<0.0001).For AIS,thrombolysis was moderate(20%-50%reduction)or severely impacted(>50%),as reported by 54.4%of the respondents,while thrombectomy was 39.3%.These were 44.4%,26.3%;44.2%,39.4%;and 78.2%,56.5%,in mild,moderate and severe epidemic areas,respectively(all p<0.0001).For patients with acute ICH,39.8%reported the impact was severe or moderate for those eligible for surgery who had surgery.Those numbers were 27.4%,39.0%and 58.1%in mild,moderate and severe epidemic areas,respectively.For staff resources,about 20%(overall)to 55%(severe epidemic)of the respondents reported moderate or severe impact on the on-duty doctors and nurses.Conclusion We found a significant reduction of admission for all types of patients with stroke during the pandemic.Patients were less likely to receive appropriate care,for example,thrombolysis/thrombectomy,after being admitted to the hospital.Stroke service in severe COVID-19 epidemic areas,for example,Wuhan,was much more severely impacted compared with other regions in China. | Xia Wang Menglu Ouyang Cheryl Carcel Chen Chen Lingli Sun Jie Yang Yao Zhang Guofang Chen Shoujiang You Yongjun Cao Lu Ma Xin Hu Yi Sui Craig Anderson Lili Song Yongjun Wang David Wang | 2020 | Stroke & Vascular Neurology2020，5，4： | 2 |
| 4 | 亚洲人群需要降低重组组织型纤溶酶原激活剂的剂量治疗急性缺血性卒中吗?显示文摘在欧美国家,急性缺血性卒中(acute ischaemic stroke,AIS)患者在4.5 h时间窗内给予静脉应用重组组织型纤溶酶原激活剂(recombinant tissue plasminogen activator,rt-PA)治疗的标准剂量为0.9 mg/kg,然而在亚洲国家由于对患者颅内出血风险的担忧以及患者经济承受能力的差异,部分国家或地区在临床实践中选择应用低剂量rt-PA,日本甚至将0.6 mg/kg的剂量纳入其指南。 | XIA WANG SHOUJIANG YOU SHOICHIRO SATO 李淑娟 | 2018 | 中国卒中杂志2018，13，5： | 2 |
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