Wenzhi Wang - Academia.edu (original) (raw)

Papers by Wenzhi Wang

Epilepsy & Behavior, Nov 1, 2017

Objective: Sudden unexpected death in epilepsy (SUDEP) is associated to the high premature mortal... more Objective: Sudden unexpected death in epilepsy (SUDEP) is associated to the high premature mortality observed amongst people with epilepsy. It is, however, considered a rare event in China, probably due to lack of awareness and limitation of studies in the country. We aimed to provide some initial estimation of the burden of SUDEP in China. Methods: We established a large Chinese community-based cohort of people with epilepsy between January 2010 and December 2011. For any participant who died during follow up, detailed information on cause of death was obtained using a specifically designed Verbal Autopsy Questionnaire. All cases were reviewed by a multidisciplinary expert panel and re-investigated if necessary. SUDEP incidence rates were estimated and case details provided. Results: The cohort consisted of 1,562 people with epilepsy and during a median 5 years follow-up, 72 deaths were reported. The all-causes death incidence was 11.23(95%CI 8.86-14.07) per 1,000 person-years. Fifteen of the deceased died suddenly and unexpectedly in a reasonable state of health in the week preceding death. We recorded detailed information of these 15 deaths. Thirteen were considered to be probable SUDEP and two possible SUDEP. The incidence of probable SUDEP was 2.03(95%CI 1.13-3.38) per 1,000 person-years and the incidence of all suspected (probable and possible) SUDEP was 2.34(95%CI 1.36-3.77) per 1,000 person-years. Significance: The incidence of SUDEP was relatively high among Chinese people with epilepsy when compared with previous community-based studies from high-income countries. The burden of SUDEP in China requires assessments.

CNS Neuroscience & Therapeutics, Feb 1, 2012

(above sort by family name); on behalf of the guidelines writing group of secondary prevention fo... more (above sort by family name); on behalf of the guidelines writing group of secondary prevention for ischemic stroke of cerebrovascular disease group of neurologic branch of Chinese medical association.

Stroke and vascular neurology, Aug 13, 2020

Aim Cerebrovascular disease is the leading cause of death and disability in China, causing a huge... more Aim Cerebrovascular disease is the leading cause of death and disability in China, causing a huge burden among patients and their families. Hence, stroke prevention is critical, especially in the high-risk population. Here, we present the evidence-based guideline suitable for the Chinese population. Methods Literature search of PubMed and Cochrane library (from January 1964 to June 2019) was done. After thorough discussion among the writing group members, recommendations were listed and summarised. This guideline was reviewed and discussed by the fellow writing committees of the Chinese Stroke Association's Stroke. Results This evidence-based guideline was written in three parts: controlling the risk factors of stroke, utilisation of antiplatelet agents and assessing the risks of first-ever stroke. All recommendations were listed along with the recommending classes and levels of evidence. Conclusions This guideline provides recommendations for primary prevention of cerebrovascular disease among high-risk population in China. Controlling related risk factors, appropriately using antiplatelet agents, assessing the risk of developing first-ever stroke should help reduce the rate of cerebrovascular disease in China.

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques, 1987

ABSTRACT:Parkinson's disease (PD) has been proposed to result from the interaction of aging a... more ABSTRACT:Parkinson's disease (PD) has been proposed to result from the interaction of aging and environment in susceptible individuals. Defective metabolism of debrisoquine, inherited as an autosomal recessive, has been associated with this susceptibility. In 35 PD patients and 19 age-matched controls, no significant differences in debrisoquine metabolism were found, although a trend to impaired metabolism was noted in patients with disease onset ≤40. Foci of PD patients were associated with rural living and well water drinking, or rural living coupled with market gardening or wood pulp mills. In a questionnaire survey, patients with PD onset ≤age 47 were significantly more likely to have lived in rural areas and to have drunk well water than those with onset ≥age 54 (p≤0.01). Because of population mobility in North America, a case-control study designed to test environmental, occupational, dietary and other proposed risk factors for PD was conducted in China, where the populati...

Neurological Research, 2015

The growing burden of stroke in China, along with the increasing cost of health care calls for ne... more The growing burden of stroke in China, along with the increasing cost of health care calls for new, more effective strategies for stroke prevention. These strategies should include increasing awareness of stroke symptoms, awareness of risk factors, and provision of easily available information on means of modifying risk factors. The Stroke Riskometer App is exactly such a tool, available in Mandarin, for adult individuals to calculate their risk of stroke over the next 5 and 10 years, and to identify their individual stroke risk factors and linking them to possible means of modifying these risk factors. The use of this App could reduce the risk of stroke for individuals in the Chinese population and contribute to significant reduction in stroke burden in China.

Epilepsy & Behavior, 2011

To identify the possible sources of stigma of epilepsy in key informant groups, "miniethnographic... more To identify the possible sources of stigma of epilepsy in key informant groups, "miniethnographic" studies were conducted in rural and urban locations in China. Data from 45 semistructured interviews and 8 focus group discussions (6 persons each) were analysed to investigate the world experienced by people with epilepsy. Underpinned by a social constructionist approach to data analysis, emerging themes were identified with the use of computer-assisted data analysis (NVivo 8). A hierarchical model was then constructed, to include: Practical Level issues: attitudes to risk, attitudes towards costs of epilepsy; and Cultural Level issues: the contrast between rurality and tradition and urbanization and modernity in the Chinese context. The analysis enriches current research on factors and sources of stigma of epilepsy and highlights issues for future practice.

Epilepsy & Behavior, 2009

To evaluate the effectiveness of a combined intervention on knowledge, attitude, and practice (KA... more To evaluate the effectiveness of a combined intervention on knowledge, attitude, and practice (KAP) of people with epilepsy and their families in rural areas of China, random samples of people with epilepsy and their family members from the intervention populations completed questionnaires prior to the intervention (2002, N = 975) and 2 years later (N = 950). There was no significant difference in important demographic variables between the two samples. KAP levels of patients and their family members improved over the study period. Worry about seizures, discrimination, and medical costs are the principal factors in patients' psychological burden. Psychological burden and inability to concentrate at work are the main influences of the disease on family members. Reduction of the psychological burden of patients and their family members is a significant aspect of treatment to which more attention should be paid in similar future interventions.

Epilepsy & Behavior, 2010

In the Chinese language there is no equivalent for the English word stigma; nevertheless, for man... more In the Chinese language there is no equivalent for the English word stigma; nevertheless, for many years, people with epilepsy in China have suffered from stigma. We suggest that the best Chinese word to use is (meaning ''feeling of disgrace because of the condition-epilepsy or other disease"). Since the 1980s, studies on stigma associated with epilepsy have been conducted in China. These studies found that stigma is felt by about 89% of people with epilepsy and by about 76% of their family members. Here we report the results of a survey conducted in 2008 in a population who were treated with phenobarbital in 2002-2004 during the Demonstration Project of the Global Campaign Against Epilepsy (GCAE). The causes and manifestations of stigma in people with epilepsy and recommendations on overcoming the stigma associated with epilepsy are discussed.

Frontiers in Neurology, 2018

Background: The leading cause of death in China is stroke, a condition that also contributes heav... more Background: The leading cause of death in China is stroke, a condition that also contributes heavily to the disease burden. Nontraumatic intracerebral hemorrhage (ICH) is the second most common cause of stroke. Compared to Western countries, in China the proportion of ICH is significantly higher. Standardized treatment based on evidence-based medicine can help reduce ICH's burden. In the present study we aimed to explore the agreement between the management strategies during ICH's acute phase and Class I recommendations in current international practice guidelines in Beijing (China), and to elucidate the reasons underlying any inconsistencies found. Method: We retrospectively collected in-hospital data from 1,355 ICH patients from 15 hospitals in Beijing between January and December 2012. Furthermore, a total of 75 standardized questionnaires focusing on ICH's clinical management were distributed to 15 cooperative hospitals. Each hospital randomly selected five doctors responsible for treating ICH patients to complete the questionnaires. Results: Numerous approaches were in line with Class I recommendations, as follows: upon admission, all patients underwent radiographic examination, about 93% of the survivors received health education and 84.5% of those diagnosed with hypertension were prescribed antihypertensive treatment at discharge, in-hospital antiepileptic drugs were administered to 91.8% of the patients presenting with seizures, and continuous monitoring was performed for 88% of the patients with hyperglycemia on admission. However, several aspects were inconsistent with the guidelines, as follows: only 14.2% of the patients were initially managed in the neurological intensive care unit and 22.3% of the bedridden patients received preventive treatment for deep vein thrombosis (DVT) within 48 h after onset. The questionnaire results showed that imaging examination, blood glucose monitoring, and secondary prevention of ICH were useful to more clinicians. However, the opposite occurred for the neurological intensive care unit requirement. Regarding the guidelines' recognition, no significant differences among the 3 education subgroups were observed (p > 0.05). Li et al. ICH Management and Practice in Beijing Conclusions: Doctors have recognized most of ICH's evidence-based practice guidelines. However, there are still large gaps between the management of ICH and the evidence-based practice guidelines in Beijing (China). Retraining doctors is required, including focusing on preventing DVT providing a value from the National Institutes of Health Stroke Scale and Glasgow Coma Scalescores at the time of admission.

International Journal of Stroke, 2009

Background and purposes To evaluate the effects of minimally invasive craniopuncture therapy comp... more Background and purposes To evaluate the effects of minimally invasive craniopuncture therapy compared with conservative treatment in treating intracerebral hemorrhage (25-40 ml) in the basal ganglion. Methods A multicenter, randomized control clinical trial comprised 465 cases of hemorrhage in the basal ganglion from 42 hospitals in China. Three hundred and seventy-seven patients with hemorrhage were randomly assigned to receive minimally invasive craniopuncture therapy ( n = 195) or conservative control treatment ( n = 182). The main indices of evaluation were the degree of neurological impairment at the 14th day after treatment, activities of daily living at the end of the 3rd month and the case fatality within 3 months. Results Improvement of neurological function in the minimally invasive craniopuncture group was significantly better than that in the control group at the 14th day ( χ2 = 7 93, P = 0 02). At the end of the 3rd month, there was a significant difference between the ...

Background To design a simplified NIH Stroke Scale (sNIHSS) that requires minimal training but ca... more Background To design a simplified NIH Stroke Scale (sNIHSS) that requires minimal training but can reflect acute basilar artery occlusion (BAO) severity and is predictive for the 90-day outcome after endovascular therapy (EVT). Methods We analyzed the prospectively gathered data of acute BAO treated with EVT in a tertiary stroke center during a 6-year period. The sNIHSS (range: 0 to 20 points) consisted of 4 NIHSS items: level of consciousness - (1) questions and (2) commands; motor function - (3) arms and (4) legs. The 90-day outcomes included functional independence (mRS ≤ 2), favorable outcome (mRS ≤ 3) and death. Results Of 173 patients, 62, 83 and 36 achieved functional independence, favorable outcome and death, respectively. Interobserver reliability of sNIHSS was high (ICC = 0.95), and compared with NIHSS, sNIHSS had a significant reduction of assessment time (median: 1.5 min vs. 5 min, P < 0.01). A multivariable logistic model demonstrated that sNIHSS was independently as...

Journal of Neurology, Neurosurgery & Psychiatry

ObjectiveSudden unexpected death in epilepsy (SUDEP) is a leading cause of epilepsy-related morta... more ObjectiveSudden unexpected death in epilepsy (SUDEP) is a leading cause of epilepsy-related mortality in young adults. It has been suggested that SUDEP may kill over 20 000 people with epilepsy in China yearly. The aetiology of SUDEP is unclear. Little is known about candidate genes for SUDEP in people of Chinese origin as most studies have ascertained this in Caucasians. No candidate genes for SUDEP in Chinese people have been identified.MethodsWe performed whole exome sequencing (WES) in DNA samples collected from five incident cases of SUDEP identified in a large epilepsy cohort in rural China. We filtered rare variants identified from these cases as well as screened for SUDEP, epilepsy, heart disease or respiratory disease-related genes from previous published reports and compared them with publicly available data, living epilepsy controls and ethnicity-match non-epilepsy controls, to identify potential candidate genes for SUDEP.ResultsAfter the filtering process, the five cases...

Scientific Reports

Accurate and up-to-date provincial and regional-level stroke prevalence estimates are important f... more Accurate and up-to-date provincial and regional-level stroke prevalence estimates are important for research planning and targeted strategies for stroke prevention and management. However, recent and comprehensive evaluation is lacking over the past 30 years in China. This study aimed to examine the geographical variations in stroke prevalence based on data from the National Epidemiological Survey of Stroke in China (NESS-China) and demonstrate urban-rural transition and trend over three decades. The stroke prevalence (prevalence day, August 31, 2013) was estimated using the world standard population. The stroke prevalence was 873.4 per 100,000 population, and varied from 218.0 in Sichuan to 1768.9 in Heilongjiang. Stroke prevalence exhibited a noticeable north-south gradient (1097.1, 917.7, and 619.4 in the north, middle, and the south, respectively; P < 0.001) and showed a 2.0-fold, 1.5-fold, and 1.2-fold increase in rural areas in the north, the middle, and the south, respectively, from 1985 to 2013. Overall, stroke prevalence was higher in the rural regions than in the urban (945.4 versus 797.5, P < 0.001) regions. However, the converse was depicted in 12 provinces. A noticeable geographical variation in stroke prevalence was observed and was evolving overtime in China. It is imperative that effective public health policies and interventions be implemented, especially in those regions with higher prevalence. Stroke is the second leading cause of death and the third leading cause of disability-standardized life-years lost globally 1. It is estimated that over two-thirds of stroke deaths worldwide occur in developing countries 2. In China, stroke burden has increased over the past 30 years, in both the rural and urban population, with 2.4 million new strokes and 1.1million stroke-related deaths each year; presently, there are over 11.1 million stroke survivors 3. Some studies 1,2,4,5 have reported substantial geographic variations in the distribution of stroke globally. The differences exist not only between countries but also between regions within a country. High-stroke incidence, mortality, and morbidity were identified in Eastern Europe, Eastern and Southeastern Asia, Central Africa, and Oceania 1. In the1960s, high stroke mortality in the Southeastern United States(the so-called Stroke Belt), especially along the coasts of Georgia and the Carolinas (so-called Stroke Buckle), was reported 6. As Mehndiratta et al. 4 reportedthat Asia is home toa very diverse population both in terms of ethnic variability and socioeconomic difference, with regions in various stages of development and epidemiological transition. The same is true in China. The prevalence of stroke, therefore, is also expected to exhibit geographical differences. At present, the available data on geographical differences of stroke prevalence in China are from two surveys (the 6-city stroke study and the 22 rural population study) conducted 30 years ago. The study reported a north-south gradient with a significantly higher incidence, prevalence, and mortality of stroke in the north compared to that in the south 7,8 .

European Journal of Neurology

Stroke and Vascular Neurology

Introduction There is a downward trend of stroke-related mortality in the USA. By reviewing all p... more Introduction There is a downward trend of stroke-related mortality in the USA. By reviewing all published articles on stroke mortality in China, we analysed its trend and possible factors that have influenced the trend. Methods Both English and Chinese literatures were searched on the mortality of stroke or cerebrovascular diseases in China. Potential papers related to this topic were identified from PubMed, Medline, Embase, Cochrane Library, Wanfang Database, SINOMED and China National Knowledge Infrastructure databases. Results Comparing the results from the most recent population-based epidemiological survey and databank from the national Center for Disease Control and Prevention, the age-adjusted stroke mortality rate has shown a downward trend among both urban and rural population in the past 30 years in China. Comparing with 30 years ago, the rate of stroke mortality has decreased by more than 31% in urban/suburban population and 11% in rural population. In men, the age-adjusted stroke mortality rate decreased by 18.9% and in women by 24.9% between 1994 and 2013. Factors that may have contributed to the trend of decreased stroke mortality rate include (1) improved healthcare coverage and healthcare environment; (2) improved treatment options and medical technology; (3) support by government to educate the public on stroke and stroke prevention; and (4) improved public knowledge on stroke. Conclusions The age-adjusted stroke mortality rate in China has shown a downward trend among both urban and rural population in the past 30 years. The major influencing factors that helped in reducing stroke mortality in China included improved healthcare coverage, healthcare environment, the updated treatment options and modern medical technology.

Frontiers in neurology, 2017

The epidemiological characteristics of transient ischemic attacks (TIAs) in China are unclear. In... more The epidemiological characteristics of transient ischemic attacks (TIAs) in China are unclear. In 2013, we conducted a nationally representative, door-to-door epidemiological survey on TIA in China using a complex, multistage, probability sampling design. Results showed that the weighted prevalence of TIA in China was 103.3 [95% confidence interval (CI): 83.9-127.2] per 100,000 in the population, 92.4 (75.0-113.8) per 100,000 among men, and 114.7 (87.2-151.0) per 100,000 among women. The weighted incidence of TIA was 23.9 (17.8-32.0) per 100,000 in the population, 21.3 (14.3-31.5) per 100,000 among men, and 26.6 (17.0-41.7) per 100,000 among women. No difference in average prognosis was found between TIA and stroke in the population. Weighted risk of stroke among TIA patients was 9.7% (6.5-14.3%), 11.1% (7.5-16.1%), and 12.3% (8.4-17.7%) at 2, 30, and 90 days, respectively. The risk of stroke was higher among male patients with a history of TIA than among female patients with a hist...

The International journal of neuroscience, Jan 4, 2016

The present study analyzed the hospital charges for stroke patients in China and determined the f... more The present study analyzed the hospital charges for stroke patients in China and determined the factors associated with hospital costs. Medical records of hospitalized patients with a primary diagnosis of acute stroke were collected from 121 hospitals in Beijing (2012). Distribution characteristics of hospital charges for different stroke types, hospital levels and types were studied. Factors influencing total hospital charges were analyzed. 60.8% of the 94 906 stroke patients were male and the mean age of these patients was 66.5 ± 13.2 years. The median length of hospital stay (LOHS) for these patients was 14 d (interquartile range, IQR 9-19). The mean hospital charge per patient was 19 270 Chinese Yuan. Forty-five percent of these charges were for medicine, 18% for laboratory and examination, 16% for material, 15% for therapy, 5% for service and 1% for blood product. The mean hospital charge for patients suffering from hemorrhagic stroke was significantly more than ischemic stroke...

Circulation, 2017

Background: China bears the biggest stroke burden in the world. However, little is known about th... more Background: China bears the biggest stroke burden in the world. However, little is known about the current prevalence, incidence, and mortality of stroke at the national level, and the trend in the past 30 years. Methods: In 2013, a nationally representative door-to-door survey was conducted in 155 urban and rural centers in 31 provinces in China, totaling 480 687 adults aged ≥20 years. All stroke survivors were considered as prevalent stroke cases at the prevalent time (August 31, 2013). First-ever strokes that occurred during 1 year preceding the survey point-prevalent time were considered as incident cases. According to computed tomography/MRI/autopsy findings, strokes were categorized into ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and stroke of undetermined type. Results: Of 480 687 participants, 7672 were diagnosed with a prevalent stroke (1596.0/100 000 people) and 1643 with incident strokes (345.1/100 000 person-years). The age-standardized prevalenc...

Scientific reports, Jul 14, 2016

This study aimed to explore pre-hospital delay and its associated factors in first-ever stroke re... more This study aimed to explore pre-hospital delay and its associated factors in first-ever stroke registered in communities from three cities in China. The rates of delay greater than or equal to 2 hours were calculated and factors associated with delays were determined by non-conditional binary logistic regression, after adjusting for different explanatory factors. Among the 403 cases of stroke with an accurate documented time of prehospital delay, the median time (interquartile range) was 4.00 (1.50-14.00) hours. Among the 544 cases of stroke with an estimated time range of prehospital delay, 24.8% of patients were transferred to the emergency department or hospital within 2 hours, only 16.9% of patients with stroke were aware that the initial symptom represented a stroke, only 18.8% used the emergency medical service and one-third of the stroke cases were not identified by ambulance doctors. In the multivariate analyses, 8 variables or sub-variables were identified. In conclusion, p...