Xue-ming Cheng

Epidemiology of Epilepsy in Urban Areas of the People's Republic of China

Summary: To determine the prevalence of major neurologic disorders, a door‐to‐door survey was conducted in six cities of the Peoples Republic of China during 1983 in a well‐defined population of 63,195. The survey included a complete census and a screening interview together with an examination having high sensitivity for detecting individuals with frequently occurring neurologic disorders, including epilepsy. All individuals with responses or findings suggesting neurologic disease were examined by senior neurologists using standardized diagnostic criteria. There was 100% cooperation among the study subjects. Two hundred eighty‐nine individuals alive on prevalence day (Jaunary 1, 1983) were identified as having epilepsy, yielding a lifetime age‐adjusted (to the 1960 U.S. population) point prevalence ratio of 4.4/1,000. There were 16 people who developed epilepsy in the sample population during 1982, providing an age‐adjusted incidence rate of 35/100,000 per year. The most frequent type identified was generalized convulsive seizures. Brain injury, intracranial infection, and cerebrovascular disease, in that order, were the leading putative causes of epilepsy.

Cerebrovascular disease in the People's Republic of China: epidemiologic and clinical features.

A door-to-door survey was carried out in six cities of the Peoples Republic of China (PRC). There was 100% cooperation with the survey. Among 63,195 screened individuals, there were 392 prevalent cases of completed stroke and 115 incidence cases. Prevalence ratios and incidence rates for completed stroke showed a south-to-north gradient. The highest point prevalence ratio and incidence rate (age-adjusted to the 1960 US population) were documented in Harbin in northeast PRC (1,249/100,000; 441/100,00O/yr). The majority of new completed strokes were cerebral infarction, but the percentage of intracerebral hemorrhage (44%) was much greater than that reported among Caucasian populations.

Stroke In China, 1986 Through 1990

BACKGROUND AND PURPOSE Incidence of stroke varies markedly in different world populations. In seven Chinese cities, the effect of a program of risk factor modification on the incidence and mortality of stroke was studied and compared with a control population. This article describes the incidence of stroke in the control populations for the years 1986 through 1990. METHODS Incidence (first-ever strokes only) for 1986 was obtained by door-to-door interview with heads of households with subsequent verification on examination by a neurologist and review of medical and/or hospital records. In subsequent years, cases were ascertained with a three-tier monitoring system: by community health workers, local medical centers, and the Beijing Neurosurgical Institute. RESULTS Average annual age-adjusted incidence per 100,000 was 215.6 (261.5 for males, 174.5 for females; P < .001). There was a significant drop in the total number of cases from 137 in 1986 to 106 in 1990, but the age-adjusted rate showed a significant drop for males only (322.3 to 182.5, P < .001). Marked differences in average annual age-adjusted rates existed among the seven cities, from 486.4 for Harbin to 80.9 for Shanghai. This difference in rate among cities was found for both sexes but was more pronounced in males. CONCLUSIONS The stroke incidence rates in China, like those in Japan, are among the higher ones in the world. In recent years, there has been an apparent decline in stroke incidence. Marked differences in rates were found between males and females with decline in incidence occurring almost exclusively in males. There were also marked differences in stroke incidence among the cities studied. These differences may result in part from differences in diet, alcohol and cigarette consumption, or prevalence of hypertension.

Prevalence of Alzheimer’s Disease and Other Dementing Disorders in an Urban Community of Beijing, China

A door-to-door two-phase study was used to investigate the prevalence of senile dementia in an urban community of Beijing. In the study population, 5,003 individuals aged 60 years and older (≥65 years, n = 3,728) were screened at home with the Chinese version of the MMSE. Persons who screened positive for dementia, using different cutoff scores based on degree of literacy, were further evaluated using the criteria of DSM-III-R and ICD-10. Among subjects who screened positive in phase I, 134 were diagnosed as having dementia in phase II. The prevalence ratios of dementia were 2.68% in the population aged 60 years and older, and 3.49% in the population aged 65 years and older. The prevalence rates among those aged 65 years and older were 1.85% for Alzheimer’s disease, 1.37% for vascular dementia and 0.27% for other dementia (including mixed dementia). The prevalence of all dementia and AD increased steeply with advancing age and was consistently higher in women, but it was not obviously higher for VaD in women. Alzheimer’s disease was the commonest type of dementia. Our prevalence figures for dementia and AD are similar to those previously reported for China.

Epidemiology of Migraine: A Survey in 21 Provinces of the People's Republic of China, 1985

SYNOPSIS

A prevalence survey of incapacitating headache in the People's Republic of China

Two Chinese populations over age 15 were surveyed as to the point prevalence of “incapacitating” headaches in an urban population of 1, 525 persons and a rural one of 1,203. Personal interviews were carried out by a team of instructed interviewers; there was 100% cooperation. In both populations, prevalence in women was twice that in men except in the urban population in the youngest age group. Prevalence in the urban was almost exactly twice that of the rural population, with the highest figure occurring in traders.

Epidemiology of Cerebrovascular Disease in an Urban Community of Beijing, People's Republic of China

A door-to-door survey was carried out in a well-defined population of Beijing to determine the prevalence and incidence of cerebrovascular disease (CVD) among 10,941 individuals. The survey included a

Risk Factors for Febrile Seizures in the People's Republic of China: A Case Control Study

Summary: A case control study was conducted to investigate the association of family history of febrile seizures (FS) and history of maternal, pregnancy and delivery, and postnatal factors with FS. Information was gathered by door‐to‐door survey in six major cities in the Peoples Republic of China. Factors present before the date of onset of FS were assessed in 182 subjects and in an equal number of controls matched for age, sex, and geographic area. The odds ratio for risk of FS in children with a family history of FS in a first‐degree relative was 10.0 (confidence interval 2.7–58.6), confirming other observations that familial factors are an important predisposing characteristic for FS. Maternal acute respiratory infection during the first trimester of pregnancy was slightly more frequent in children with FS (odds ratio 1.9, confidence interval 1.0–3.9). None of the other examined pregnancy or delivery factors was associated with an increased risk, suggesting that birth history is not an important factor predisposing to FS.

Serum cholesterol, its lipoprotein fractions among survivors of cerebrovascular disease. A case-control study.

A case-control study was conducted in 1983 on 210 cerebrovascular disease (CVD) patients identified from a retrospective cross-sectional door-to-door survey of four cities in the Peoples Republic of China. One hundred and eleven male (mean age 63.8 +/- 8.9 years) and 99 female (mean age 63.5 +/- 11.1 years) CVD survivors and controls matched for sex, age, race and area were selected. Total serum cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol were measured to see if there were differences between lipids in survivors of CVD and their matched controls. There was a higher level of total cholesterol in cerebral thrombotic patients (n = 114) and a lower level of total cholesterol and high-density lipoprotein cholesterol in cerebral hemorrhagic patients (n = 35) than in controls, although the results were not statistically significant. The only higher level of total serum cholesterol that might be important was in the group of male thrombotic patients of age greater than 70 years (n = 22; nominal p value less than 0.05). The implication of this finding needs further clarification.