Suggestions for Domestic Primary Stroke Care Arising from Epidemiological Characteristics，Prevention and Treatment of Stroke in China

doi:10.12114/j.issn.1007-9572.2019.00.445

Abstract

Abstract: Stroke is the leading cause of death among Chinese residents，which is a public health problem that endangers health.Stroke is characterized by high morbidity，mortality and disability，which brings heavy burden to patients，families and society.With the development of economy and the change of lifestyle of residents in China，epidemiological characteristics of stroke in the population have changed markedly.Although some progress has been made in stroke prevention and treatment in China，which is far from enough to meet the needs.Community-based strategies for stroke prevention and treatment mean that priority should be given to efforts to strengthen stroke services at the grass-roots level.This paper reviews the epidemiological characteristics，prevention and treatment of stroke in China recently，with a focus on analyzing the needs and problems of stroke prevention and treatment in primary health care in China，hoping to provide evidence-based recommendations for primary stroke care in China.

Key words: Stroke, Epidemiology, Universal precautions, Prevention, Treatment, General practice, General practitioners

摘要： 脑卒中位居我国居民各种死因的首位，是危害健康的公共卫生问题。脑卒中具有高发病率、高死亡率和高病残率的特点，给患者、家庭和社会带来沉重的负担。随着我国经济发展和居民生活方式的改变，人群脑卒中的流行特征有了新的变化。虽然我国脑卒中防治工作已取得初步成绩，但其防治工作目前仍存在较大提升空间。脑卒中防治的“关口前移”“重心下移”策略就是要强化和重视基层社区卫生服务。本文通过回顾现阶段我国脑卒中的流行病学特征和防治现状，从证据角度去透视我国全科医疗服务中脑卒中防治需求及存在的问题，希望能为我国全科医疗服务提供有益的启示和建议。

关键词: 卒中, 流行病学, 综合预防, 治疗, 全科医学, 全科医生

JIANG Bin. Suggestions for Domestic Primary Stroke Care Arising from Epidemiological Characteristics，Prevention and Treatment of Stroke in China　[J]. Chinese General Practice, 2019, 22(30): 3653-3661. DOI: 10.12114/j.issn.1007-9572.2019.00.445.
江滨. 现阶段我国脑卒中流行特征及防治现状对全科医疗服务的启示和建议[J]. 中国全科医学, 2019, 22(30): 3653-3661. DOI: 10.12114/j.issn.1007-9572.2019.00.445.

References

［1］FEIGIN V L，FOROUZANFAR M H，KRISHNAMURTHI R，et al．Global and regional burden of stroke during 1990-2010：findings from the global burden of disease study 2010［J］．Lancet，2014，383（9913）：245-255．DOI：10.1016/S0140-6736（13）61953-4.
［2］杨辉.初级卫生保健与中国全科医学的发展及挑战［J］．中国全科医学，2018，21（28）：3407-3410．DOI：10.12114/j.issn.1007-9572.2018.28.001.
YANG H.General practice in Chinese primary health care：development and challenges［J］．Chin Gen Pract，2018，21（28）：3407-3410．DOI：10.12114/j.issn.1007-9572.2018.28.001.
［3］WANG W Z，JIANG B，SUN H X，et al．Prevalence，incidence，and mortality of stroke in China：results from a nationwide population-based survey of 480?687 adults［J］．Circulation，2017，135（8）：759-771．DOI：10.1161/CIRCULATIONAHA.116.025250.
［4］WANG J H，BAI L L，SHI M，et al．Trends in age of first-ever stroke following increased incidence and life expectancy in a low-income Chinese population［J］．Stroke，2016，47（4）：929-935．DOI：10.1161/STROKEAHA.115.012466.
［5］CHEN Z H，JIANG B，RU X J，et al．Mortality of stroke and its subtypes in China：results from a nationwide population-based survey［J］．Neuroepidemiology，2017，48（3/4）：95-102．DOI：10.1159/000477494.
［6］WANG J H，NING X J，YANG L，et al．Sex differences in trends of incidence and mortality of first-ever stroke in rural Tianjin，China，from 1992 to 2012［J］．Stroke，2014，45（6）：1626-1631．DOI：10.1161/STROKEAHA.113.003899.
［7］WANG Z K，HU S B，SANG S P，et al．Age-period-cohort analysis of stroke mortality in China：data from the global burden of disease study 2013［J］．Stroke，2017，48（2）：271-275．DOI：10.1161/STROKEAHA.116.015031.
［8］WANG Y L，ZHAO X Q，JIANG Y，et al．Prevalence，knowledge，and treatment of transient ischemic attacks in China［J］．Neurology，2015，84（23）：2354-2361．DOI：10.1212/WNL.0000000000001665.
［9］JIANG B，SUN H X，RU X J，et al．Prevalence，incidence，prognosis，early stroke risk，and stroke-related prognostic factors of definite or probable transient ischemic attacks in China，2013［J］．Front Neurol，2017，8：309．DOI：10.3389/fneur.2017.00309.
［10］10.LI Y C，YANG L，WANG L M，et al．Burden of hypertension in China：a nationally representative survey of 174，621 adults［J］．Int J Cardiol，2017，227：516-523．DOI：10.1016/j.ijcard.2016.10.110.
［11］WANG Z W，CHEN Z，ZHANG L F，et al．Status of hypertension in China：results from the China hypertension survey，2012—2015［J］．Circulation，2018，137（22）：2344-2356．DOI：10.1161/CIRCULATIONAHA.117.032380.
［12］WANG L M，GAO P，ZHANG M，et al．Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013［J］．JAMA，2017，317（24）：2515-2523．DOI：10.1001/jama.2017.7596.
［13］PAN L，YANG Z H，WU Y，et al．The prevalence，awareness，treatment and control of dyslipidemia among adults in China［J］．Atherosclerosis，2016，248：2-9．DOI：10.1016/j.atherosclerosis.2016.02.006.
［14］WANG M H，LUO X，XU S B，et al．Trends in smoking prevalence and implication for chronic diseases in China：serial national cross-sectional surveys from 2003 to 2013［J］．Lancet Respir Med，2019，7（1）：35-45．DOI：10.1016/S2213-2600（18）30432-6.
［15］国务院办公厅．国务院办公厅关于印发中国防治慢性病中长期规划（2017—2025年）的通知［EB/OL］．（2017-02-14）［2019-04-30］．http：//www.gov.cn/zhengce/content/2017-02/14/content_5167886.htm.
［16］国家卫生计生委脑卒中防治工程委员会.高危人群中风筛查和干预方案［EB/OL］．［2019-04-30］．http：//cnstroke.com/WebManage/InterveneProject/Index.
［17］HUANG Y N，WANG J G，WEI J W，et al．Age and gender variations in the management of ischaemic stroke in China［J］．Int J Stroke，2010，5（5）：351-359．DOI：10.1111/j.1747-4949.2010.00460.x.
［18］LI Z X，WANG C J，ZHAO X Q，et al．Substantial progress yet significant opportunity for improvement in stroke care in China［J］．Stroke，2016，47（11）：2843-2849．DOI：10.1161/STROKEAHA.116.014143.
［19］WANG Y L，LI Z X，ZHAO X Q，et al．Effect of a multifaceted quality improvement intervention on hospital personnel adherence to performance measures in patients with acute ischemic stroke in China：a randomized clinical trial［J］．JAMA，2018，320（3）：245-254．DOI：10.1001/jama.2018.8802.
［20］LANGHORNE P，O'DONNELL M J，CHIN S L，et al．Practice patterns and outcomes after stroke across countries at different economic levels （INTERSTROKE）：an international observational study［J］．Lancet，2018，391（10134）：2019-2027．DOI：10.1016/S0140-6736（18）30802-X.
［21］JIANG B，RU X J，SUN H X，et al．Pre-hospital delay and its associated factors in first-ever stroke registered in communities from three cities in China［J］．Sci Rep，2016，6：29795．DOI：10.1038/srep29795.
［22］WEI J W，HUANG Y N，WANG J G，et al．Current management of intracerebral haemorrhage in China：a national，multi-centre，hospital register study［J］．BMC Neurol，2011，11：16．DOI：10.1186/1471-2377-11-16.
［23］MOHAN K M，WOLFE C D，RUDD A G，et al．Risk and cumulative risk of stroke recurrence：a systematic review and meta-analysis［J］．Stroke，2011，42（5）：1489-1494．DOI：10.1161/STROKEAHA.110.602615.
［24］JOHNSTON S C，GRESS D R，BROWNER W S，et al．Short-term prognosis after emergency department diagnosis of TIA［J］．JAMA，2000，284（22）：2901-2906．DOI：10.1001/jama.284.22.2901.
［25］JIANG B，WANG W Z，WU S P，et al．Effects of urban community intervention on 3-year survival and recurrence after first-ever stroke［J］．Stroke，2004，35（6）：1242-1247．DOI：10.1161/01.STR.0000128417.88694.9f.
［26］WANG Z，LI J J，WANG C X，et al．Gender differences in 1-year clinical characteristics and outcomes after stroke：results from the China national stroke registry［J］．PLoS One，2013，8（2）：e56459．DOI：10.1371/journal.pone.0056459.
［27］SHI G M，ZHANG Y D，GENG C，et al．Profile and 1-year outcome of ischemic stroke in East China：Nanjing first hospital stroke registry［J］．J Stroke Cerebrovasc Dis，2016，25（1）：49-56．DOI：10.1016/j.jstrokecerebrovasdis.2015.08.032.
［28］WANG D R，LIU J F，LIU M，et al．Patterns of stroke between university hospitals and nonuniversity hospitals in mainland China：prospective multicenter hospital-based registry study［J］．World Neurosurg，2017，98：258-265．DOI：10.1016/j.wneu.2016.11.006.
［29］郝子龙，刘鸣，李伟，等．成都卒中登记方法及3123例患者基本特征和功能结局［J］．中华神经科杂志，2011，44（12）：826-831．DOI：10.3760/cma.j.issn.1006-7876.2011.12.006.
HAO Z L，LIU M，LI W，et al．Basic characteristics and functional outcomes of 3123 consecutive patients in Chengdu stroke registry［J］．Chin J Neurol，2011，44（12）：826-831．DOI：10.3760/cma.j.issn.1006-7876.2011.12.006.
［30］ZHANG Y H，REILLY K H，TONG W J，et al．Blood pressure and clinical outcome among patients with acute stroke in inner Mongolia，China［J］．J Hypertens，2008，26（7）：1446-1452．DOI：10.1097/HJH.0b013e328300a24a.
［31］WEI J W，HEELEY E L，WANG J G，et al．Comparison of recovery patterns and prognostic indicators for ischemic and hemorrhagic stroke in China：the China QUEST （Quality evaluation of stroke care and treatment） registry study［J］．Stroke，2010，41（9）：1877-1883．DOI：10.1161/STROKEAHA.110.586909.
［32］GU H Q，LI Z X，ZHAO X Q，et al．Insurance status and 1-year outcomes of stroke and transient ischaemic attack：a registry-based cohort study in China［J］．BMJ Open，2018，8（7）：e021334．DOI：10.1136/bmjopen-2017-021334.
［33］ZHOU J S，ZHANG Y D，ARIMA H，et al．Sex differences in clinical characteristics and outcomes after intracerebral haemorrhage：results from a 12-month prospective stroke registry in Nanjing，China［J］．BMC Neurol，2014，14：172．DOI：10.1186/s12883-014-0172-5.
［34］WANG W J，LU J J，WANG Y J，et al．Clinical characteristics，management，and functional outcomes in Chinese patients within the first year after intracerebral hemorrhage：analysis from China national stroke registry［J］．CNS Neurosci Ther，2012，18（9）：773-780．DOI：10.1111/j.1755-5949.2012.00367.x.
［35］LIU J F，WANG D R，YUAN R Z，et al．Prognosis of 908 patients with intracerebral hemorrhage in Chengdu，southwest of China［J］．Int J Neurosci，2017，127（7）：586-591．DOI：10.1080/00207454.2016.1216414.
［36］CHEN Y P，LI L M，ZHANG Q L，et al．Use of drug treatment for secondary prevention of cardiovascular disease in urban and rural communities of China：China kadoorie biobank study of 0.5 million people［J］．Int J Cardiol，2014，172（1）：88-95．DOI：10.1016/j.ijcard.2013.12.065.
［37］YUSUF S，ISLAM S，CHOW C K，et al．Use of secondary prevention drugs for cardiovascular disease in the community in high-income，middle-income，and low-income countries （the PURE Study）：a prospective epidemiological survey［J］．Lancet，2011，378（9798）：1231-1243．DOI：10.1016/S0140-6736（11）61215-4.
［38］WEI J W，WANG J G，HUANG Y N，et al．Secondary prevention of ischemic stroke in urban China［J］．Stroke，2010，41（5）：967-974．DOI：10.1161/STROKEAHA.109.571463.
［39］TAN Y，PAN Y S，LIU L P，et al．One-year outcomes and secondary prevention in patients after acute minor stroke：results from the China National Stroke Registry［J］．Neurol Res，2017，39（6）：484-491．DOI：10.1080/01616412.2017.1322804.
［40］GAO Q C，FU X，WEI J W，et al．Use of oral anticoagulation among stroke patients with atrial fibrillation in China：the ChinaQUEST （Quality evaluation of stroke care and treatment） registry study［J］．Int J Stroke，2013，8（3）：150-154．DOI：10.1111/j.1747-4949.2011.00716.x.
［41］张京芬，黄一宁.中国急性缺血性脑卒中的治疗现状［J］．中华神经科杂志，2009，42（5）：223-228．DOI：10.3760/cma.j.issn.1006-7876.2009.04.003.
ZHANG J F，HUANG Y N.Treatment of acute ischemic stroke in China ［J］．Chin J Neurol，2009，42（5）：223-228．DOI：10.3760/cma.j.issn.1006-7876.2009.04.003.
［42］CHEN Z M，SANDERCOCK P，XIE J X，et al．Hospital management of acute ischemic stroke in China［J］．J Stroke Cerebrovasc Dis，1997，6（5）：361-367．DOI：10.1016/s1052-3057（97）80219-4.
［43］茹小娟，戴红，江滨，等．三城市社区卒中患者康复治疗现状调查［J］．中国卒中杂志，2013，8（4）：255-260．DOI：10.3969/j.issn.1673-5765.2013.04.007.
RU X J，DAI H，JIANG B，et al．Current situation of rehabilitation for stroke survivors living in community in three［J］．Chin J Stroke，2013，8（4）：255-260．DOI：10.3969/j.issn.1673-5765.2013.04.007.
［44］王乔，潘习龙，齐红梅，等．二级综合医院脑卒中患者早期康复治疗现状及影响因素分析［J］．中国康复，2013，28（2）：120-122．DOI：10.3870/zgkf.2013.02.013.
WANG Q，PAN X L，QI H M，et al．An overview study and analysis of influencing factors on early stage rehabilitation for stroke patients in second-grade hospitals［J］．Chin J Rehabilitation，2013，28（2）：120-122．DOI：10.3870/zgkf.2013.02.013.
［45］PUSKA P，TUOMILEHTO J，NISSINEN A，et al．The North Karelia project：15 years of community-based prevention of coronary heart disease［J］．Ann Med，1989，21（3）：169-173.
［46］FORTMANN S P，FLORA J A，WINKLEBY M A，et al．Community intervention trials：reflections on the stanford five-city project experience［J］．Am J Epidemiol，1995，142（6）：576-586．DOI：10.1093/oxfordjournals.aje.a117678.
［47］WANG W Z，JIANG B，WU S P，et al．Change in stroke incidence from a population-based intervention trial in three urban communities in China［J］．Neuroepidemiology，2007，28（3）：155-161．DOI：10.1159/000103268.
［48］王文志，吴升平，杨期东，等．我国三城市社区人群开展干预9年脑卒中死亡率的变化［J］．中国慢性病预防与控制，2002，10（2）：49-51．DOI：10.3969/j.issn.1004-6194.2002.02.001.
WANG W Z，WU S P，YANG Q D，et al．The change of mortality of stroke after community-based intervention trial for nine years in three cities of China［J］．Chin J Prev Control Chronic Non - Commun Dis，2002，10（2）：49-51．DOI：10.3969/j.issn.1004-6194.2002.02.001.
［49］国家卫生健康委员会规划发展与信息化司.2018年我国卫生健康事业发展统计公报［EB/OL］．［2019-05-22］．http：//www.nhc.gov.cn/guihuaxxs/s10748/201905/9b8d52727cf346049de8acce25ffcbd0.shtml.
［50］JIANG B，WANG W Z，CHEN H，et al．Incidence and trends of stroke and its subtypes in China.Results from three large cities ［J］．Stroke，2006，37：63-68．DOI：10.1161/01.STR.0000194955.34820.78.
［51］HE W，LIU Y，FENG J，et al．The epidemiological characteristics of stroke in Hunan Province，China ［J］．Front Neurol，2018，9：583．DOI：10.3389/fneur.2018.00583.
［52］国务院办公厅.国务院办公厅关于推进分级诊疗制度建设的指导意见［EB/OL］．［2019-03-09］.http：//www.gov.cn/zhengce/content/2015-09/11/content_10158.htm.
［53］MESCHIA J F，BUSHNELL C，BODEN-ALBALA B，et al．Guidelines for the primary prevention of stroke：a statement for healthcare professionals from the American heart association/American stroke association［J］．Stroke，2014，45（12）：3754-3832．DOI：10.1161/STR.0000000000000046.
［54］中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组.中国脑血管病一级预防指南2015［J］．中华神经科杂志，2015，48（8）：629-643．DOI：10.3760/cma.j.issn.1006-7876.2015.08.003.
［55］《中华健康管理学杂志》编辑委员会，中华医学会健康管理学分会，全国脑血管病防治研究办公室.脑血管健康管理与脑卒中早期预防专家共识［J］．中华健康管理学杂志，2017，11（5）：397-407．DOI：10.3760/cma.j.issn.1674-0815.2017.05.002.
［56］D'AGOSTINO R B，WOLF P A，BELANGER A J，et al．Stroke risk profile：adjustment for antihypertensive medication.the Framingham study［J］．Stroke，1994，25（1）：40-43.
［57］ANDRUS B，LACAILLE D.2013 ACC/AHA guideline on the assessment of cardiovascular risk［J］．J Am Coll Cardiol，2014，63（25）：2886．DOI：10.1016/j.jacc.2014.02.606．
［58］黄久仪，王桂清，沈凤英，等．脑血管血液动力学积分与脑卒中风险的队列研究［J］．中华流行病学杂志，2003，24（2）：89-93．DOI：10.3760/j.issn：0254-6450.2003.02.003.
HUANG J Y，WANG G Q，SHEN F Y，et al．A cohort study on cerebral vascular hemodynamics accumulative score and risks of stroke［J］．Chin J Epidemiol，2003，24（2）：89-93．DOI：10.3760/j.issn：0254-6450.2003.02.003.
［59］PARMAR P，KRISHNAMURTHI R，IKRAM M A，et al．The Stroke Riskometer（TM） App：validation of a data collection tool and stroke risk predictor［J］．Int J Stroke，2015，10（2）：231-244．DOI：10.1111/ijs.12411.
［60］YANG X L，LI J X，HU D S，et al．Predicting the 10-year risks of atherosclerotic cardiovascular disease in Chinese population：the China-PAR project （prediction for ASCVD risk in China）［J］．Circulation，2016，134（19）：1430-1440．DOI：10.1161/CIRCULATIONAHA.116.022367.
［61］GILES M F，FLOSSMAN E，ROTHWELL P M.Patient behavior immediately after transient ischemic attack according to clinical characteristics，perception of the event，and predicted risk of stroke［J］．Stroke，2006，37（5）：1254-1260．DOI：10.1161/01.STR.0000217388.57851.62.
［62］LASSERSON D S，CHANDRATHEVA A，GILES M F，et al．Influence of general practice opening hours on delay in seeking medical attention after transient ischaemic attack （TIA） and minor stroke：prospective population based study［J］．BMJ，2008，337：a1569．DOI：10.1136/bmj.a1569.
［63］SPRIGG N，MACHILI C，OTTER M E，et al．A systematic review of delays in seeking medical attention after transient ischaemic attack［J］．J Neurol Neurosurg Psychiatry，2009，80（8）：871-875．DOI：10.1136/jnnp.2008.167924.
［64］HARBISON J，HOSSAIN O，JENKINSON D，et al．Diagnostic accuracy of stroke referrals from primary care，emergency room physicians，and ambulance staff using the face arm speech test［J］．Stroke，2003，34（1）：71-76.
［65］KIDWELL C S，SAVER J L，SCHUBERT G B，et al．Design and retrospective analysis of the los angeles prehospital stroke screen （LAPSS）［J］．Prehosp Emerg Care，1998，2（4）：267-273.
［66］ZHAO J，LIU R Y.Stroke 1-2-0：a rapid response programme for stroke in China［J］．Lancet Neurol，2017，16（1）：27-28．DOI：10.1016/S1474-4422（16）30283-6.
［67］National Collaborating Centre for Chronic Conditions（UK）.Stroke：National Clinical Guideline for Diagnosis and Initial Management of Acute Stroke and Transient Ischaemic Attack （TIA）［S］．Royal College of Physicians，2008.
［68］EASTON J D，SAVER J L，ALBERS G W，et al．Definition and evaluation of transient ischemic attack：a scientific statement for healthcare professionals from the American heart association/American stroke association stroke council；council on cardiovascular surgery and anesthesia；council on cardiovascular radiology and intervention；council on cardiovascular nursing；and the interdisciplinary council on peripheral vascular disease.the American academy of neurology affirms the value of this statement as an educational tool for neurologists［J］．Stroke，2009，40（6）：2276-2293．DOI：10.1161/STROKEAHA.108.192218.
［69］KERNAN W N，OVBIAGELE B，BLACK H R，et al．Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack：a guideline for healthcare professionals from the American heart association/American stroke association［J］．Stroke，2014，45（7）：2160-2236．DOI：10.1161/STR.0000000000000024.
［70］PATS COLLABORATING GROUP.Post-stroke antihypertensive treatment study.A preliminary result［J］．Chin Med J，1995，108
（9）：710-717.
［71］RASHID P，LEONARDI-BEE J，BATH P.Blood pressure reduction and secondary prevention of stroke and other vascular events：a systematic review［J］．Stroke，2003，34（11）：2741-2748．DOI：10.1161/01.STR.0000092488.40085.15.
［72］AMARENCO P，BOGOUSSLAVSKY J，CALLAHAN A 3rd，et al．High-dose atorvastatin after stroke or transient ischemic attack［J］．N Engl J Med，2006，355（6）：549-559．DOI：10.1056/NEJMoa061894.
［73］GOLDSTEIN L B，AMARENCO P，ZIVIN J，et al．Statin treatment and stroke outcome in the stroke prevention by aggressive reduction in cholesterol levels （SPARCL） trial［J］．Stroke，2009，40（11）：3526-3531．DOI：10.1161/strokeaha.109.557330．
［74］O'REGAN C，WU P，ARORA P，et al．Statin therapy in stroke prevention：a meta-analysis involving 121，000 patients［J］．Am J Med，2008，121（1）：24-33．DOI：10.1016/j.amjmed.2007.06.033.
［75］中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组.中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2014［J］．中华神经科杂志，2015，48（4）：258-273．DOI：10.3760/cma.j.issn.1006-7876.2015.04.003.
［76］WANG Y J，WANG Y L，ZHAO X Q，et al．Clopidogrel with aspirin in acute minor stroke or transient ischemic attack［J］．N Engl J Med，2013，369（1）：11-19．DOI：10.1056/NEJMoa1215340.
［77］RAHMAN H，KHAN S U，NASIR F，et al．Optimal duration of aspirin plus clopidogrel after ischemic stroke or transient ischemic attack［J］．Stroke，2019，50（4）：947-953．DOI：10.1161/strokeaha.118.023978．
［78］WINSTEIN C J，STEIN J，ARENA R，et al.American Heart Association Stroke Council， Council on Cardiovascular and Stroke Nursing， Council on Clinical Cardiology，Council on Quality of Care and Outcomes Research． Guidelines for adult stroke rehabilitation and recovery：a guideline for healthcare professionals from the American Heart Association/ American Stroke Association［J］．Stroke，2016，47（6）：e98-169．DOI：10.1161/STR.0000000000000098.
［79］RU X，DAI H，JIANG B，et al．Community-Based Rehabilitation to Improve Stroke Survivors' Rehabilitation Participation and Functional Recovery.American Journal of Physical Medicine & Rehabilitation，2017，96（7）：e123-e129．DOI：10.1097/PHM.0000000000000650.
［80］牟晓洋，王飞，吴晓辉，等．基于分级诊疗的急性脑卒中规范化三级康复治疗效果及卫生经济学评价［J］．中国全科医学，2017，20（12）：1422-1427．DOI：10.3969/j.issn.1007-9572.2017.12.004．
MOU X Y，WANG F，WU X H，et al．Evaluation on effect and health economics of standardized three-stage rehabilitation program on acute stroke patients based on hierarchical diagnosis and treatment［J］．China General Practice，2017，20（12）：1422-1427．DOI：10.3969/j.issn.1007-9572.2017.12.004．

[1]	BAI Haiwei, MI Xiaokun, LIU Qingrui, ZHU Lin, WANG Yingnan, LIU Junyan, HAN Ying. Predictive Value of Serum Uric Acid in Perioperative Acute Ischemic Stroke in Patients with Non-small Cell Lung Cancer [J]. Chinese General Practice, 2023, 26(36): 4545-4551.
[2]	Eating Disorders Coordination Group of the Psychosomatic Medicine Society of the Chinese Medical Association, Eating Disorders Research Collaboration Group of the Psychiatric Medicine Society of the Chinese Medical Association, CHEN Yan, CHEN Han, LIU Lanying, KONG Qingmei, QIAO Huifen, ZHANG Lan, LI Xueni, KUANG Guifang, ZHANG Darong, LI Keqing, WANG Zhen, CHEN Jue. Chinese Expert Consensus on the Diagnosis and Treatment of Bulimia Nervosa [J]. Chinese General Practice, 2023, 26(36): 4487-4497.
[3]	LUO Weigang, YIN Yuanyuan, LIU Wanhu, XU Yuzhu, CAO Xiaoyun, BU Wei, ZHANG Lingyan, REN Huiling. Correlation of Triglyceride Glucose Index with Early Neurological Deterioration in Patients with Single Subcortical Infarction [J]. Chinese General Practice, 2023, 26(35): 4419-4424.
[4]	LI Dianjiang, PAN Enchun, SUN Zhongming, WEN Jinbo, WANG Miaomiao, WU Ming, SHEN Chong. The Current Status and Influencing Factors of Clinical Inertia in Type 2 Diabetes Patients in Community [J]. Chinese General Practice, 2023, 26(34): 4296-4301.
[5]	HAO Aihua, ZENG Weilin, LI Guanhai, XIA Yinghua, CHEN Liang. Current Situation of the Construction of Family Doctor Team: an Investigation Based on the Perspective of General Practitioners [J]. Chinese General Practice, 2023, 26(34): 4261-4268.
[6]	LIN Kai, YAO Mi, CHEN Zhang, JI Xinxin, LIN Runqi, CHEN Yongsong, Sim MOIRA. Conceptual Framework and Responding Approach of Treatment Burden of Type 2 Diabetes: a Video Recording-based Analysis [J]. Chinese General Practice, 2023, 26(34): 4302-4307.
[7]	LI Jingjing, YUAN Ding, WANG Xiuling, KANG Hongfei, LAI Chengcheng, WANG Peisong, LU Guangping, GAO Yanxia. Evaluation of the Application Effect of Virtual Reality Technology in Standardized Training of General Practice Residents [J]. Chinese General Practice, 2023, 26(34): 4322-4328.
[8]	WANG Zhe, DONG Zhihao, ZHENG Hao, KONG Wencheng, ZHANG Yukuan, ZHANG Qiuyue, HAN Jing. Construction of Optimized Treatment Plan of Acupuncture for Migraine Based on Entropy Weight-TOPSIS Method [J]. Chinese General Practice, 2023, 26(34): 4336-4342.
[9]	GU Hanxin, LIU Yang, LIU Yuanli. Falls Prevention Intervention for Community-dwelling Older Adults from the Perspective of Policy Tools: an International Comparative Study [J]. Chinese General Practice, 2023, 26(34): 4231-4238.
[10]	ZHANG Hanzhi, GE Xuhua, LU Yuan, JIN Hua, GUO Aizhen, CHEN Yuge, MA Linlin, PAN Ying, YU Dehua. Exploration and Differential Analysis of Continuing Education of General Practitioners' Clinical Thinking Ability Based on Working Competence [J]. Chinese General Practice, 2023, 26(34): 4315-4321.
[11]	YAO Yuzhong, MA Xiaojun, SONG Huan, ZHONG Yu. The Management Effect of Diabetes "1358 model" on Community Diabetes Patients Based on "Precision Management Combining General Care and Specialty Care" [J]. Chinese General Practice, 2023, 26(34): 4308-4314.
[12]	QIN Fengyin, ZHANG Qishan, LAI Jinjia, HUANG Yimin, HAN Guoyin, SUN Xinglan, WANG Fen, TAN Yibing. Current Status and Influencing Factors of the Intention to Screen for High-risk Stroke among Community Residents in Guangdong [J]. Chinese General Practice, 2023, 26(34): 4283-4289.
[13]	SU Kaiqi, LYU Zhuan, WU Mingli, LUO Meng, GAO Jing, NIE Chenchen, LIU Hao, FENG Xiaodong. Effect of Electroacupuncture on BDNF/TrkB/PI3K/Akt Pathway and Hippocampal Neuronal Protection in Rats with Learning and Memory Impairment after Ischemia Reperfusion [J]. Chinese General Practice, 2023, 26(33): 4187-4193.
[14]	YIN Miaomiao, CUI Liling, LI Yaqing, WANG Liqun, ZHANG Yue, WU Jialing. Effect of Dual Task on Walking Ability in Posterior Circulation Ischemic Stroke Patients with Vestibular Symptoms [J]. Chinese General Practice, 2023, 26(33): 4207-4212.
[15]	WANG Jie, LI Shiming, WEI Shifei, WANG Ningli. Importance of the Role of Primary Care in Myopia Prevention and Control Behavioral Intervention among Children [J]. Chinese General Practice, 2023, 26(33): 4213-4217.