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Residual recurrence and high disability are major problems of ischemic cerebrovascular disease
.
The 7th Annual Conference of the Chinese Stroke Society and the Tiantan International Cerebrovascular Disease Conference (CSA & TISC 2021) will be held on July 9-11, 2021 at the Beijing National Convention Center
.
In the TISC-II branch of this conference, Professor Wang Yongjun from Beijing Tiantan Hospital, Capital Medical University, gave a special report.
The article is organized as follows
.
With the development of new diagnosis and treatment technologies, the rate of death and disability of cerebrovascular diseases in the hospital is getting lower and lower, but residual recurrence and high disability are still major problems faced by ischemic cerebrovascular diseases
.
At present, the main methods used to reduce disability are reperfusion therapy, neuroprotective therapy and rehabilitation treatment; the main methods of reducing death are anti-cerebral edema, control of complications, and comprehensive management of ICU
.
With the development of empirical medicine to evidence-based medicine, the hospital mortality rate of ischemic cerebrovascular disease in China has dropped from 4.
10% to 0.
60% in 10 years, and the recurrence rate in 1 year has dropped from 17.
70% to 6.
70%
.
However, death and recurrence are still not completely resolved, so residual risks arise
.
Classification of residual risk Residual risk can be divided into quality residual risk, evidence residual risk and unknown residual risk
.
The principle of quality residual risk is that there are methods but not rational use, and the measure is medical quality improvement; the principle of evidence residual risk is that the reason is known but there is no evidence-based medicine method, and its measures provide evidence for the development of evidence-based medicine research; the measure of unknown residual risk The principle is that the reason is unknown and there is no intervention method.
The measures are to clarify the mechanism to find new drug targets
.
Multi-omics and big data bring opportunities to conquer unexplained residual risks.
Change in thinking about problem solving: change from a traditional knowledge-driven approach to a data-driven approach, and then form a new model-driven approach
.
Three key points to complete the new model: high-quality clinical cohort, omics-based big data platform, data and biological information processing team
.
The establishment of big data China's cerebrovascular disease big data platform (Sino-data for Stroke Survivors, SSS) currently has 4.
5 million national medical record homepage data (HQMS) and 1.
6 million data reported by the China Stroke Center Alliance (CSCA) each year There are 470,000 people and community cohorts, 15,000 in precision medicine cohorts, and 20,000 in clinical trials
.
➤Reverse drug development based on clinical big data and multi-omics National Stroke Registry of China III (CNSR-3): Study type: Multicenter, prospective cohort study; Enrolled population: Acute ischemic stroke or transient cerebral ischemia Attack patients; enrollment time: 2015.
8-2018.
3; sample size: 15166 cases; case distribution: 26 provinces, municipalities or autonomous regions; source of cases: 201 hospitals across the country
.
➤Mendelian Randomized Study Based on Whole Genes Based on 50 plasma biomarkers and genome-wide data of 10241 patients with ischemic stroke, using Mendelian randomized study, it was found that there is a causal relationship with stroke outcome (recurrence, disability, death) Four biomarkers can be used as potential drug treatment targets, and new drugs are being further developed
.
➤CNSR Ⅲ cohort DNA methylation group through differential methylation analysis, confirmed the important markers randomly discovered by Mendel, and revealed the molecular mechanism of its correlation with phenotype
.
Apparent genome-wide association analysis (EWAS) finds new and phenotype-related differentially methylated regions
.
Exploring the multi-omics technology route of potential intervention targets, fusing epigenetics, proteomics, protein modification omics, metabolomics and intestinal microbiome, and continuing to improve multi-omics joint analysis
.
Lock to the medlive-neurology channel (medlive-neurology) to view the latest information of CSA & TISC 2021! Long press the QR code to follow the CSA & TISC 2021 special report ☟☟☟ You can also click "Read the original text" to view More CSA & TISC 2021 topics related content!
.
The 7th Annual Conference of the Chinese Stroke Society and the Tiantan International Cerebrovascular Disease Conference (CSA & TISC 2021) will be held on July 9-11, 2021 at the Beijing National Convention Center
.
In the TISC-II branch of this conference, Professor Wang Yongjun from Beijing Tiantan Hospital, Capital Medical University, gave a special report.
The article is organized as follows
.
With the development of new diagnosis and treatment technologies, the rate of death and disability of cerebrovascular diseases in the hospital is getting lower and lower, but residual recurrence and high disability are still major problems faced by ischemic cerebrovascular diseases
.
At present, the main methods used to reduce disability are reperfusion therapy, neuroprotective therapy and rehabilitation treatment; the main methods of reducing death are anti-cerebral edema, control of complications, and comprehensive management of ICU
.
With the development of empirical medicine to evidence-based medicine, the hospital mortality rate of ischemic cerebrovascular disease in China has dropped from 4.
10% to 0.
60% in 10 years, and the recurrence rate in 1 year has dropped from 17.
70% to 6.
70%
.
However, death and recurrence are still not completely resolved, so residual risks arise
.
Classification of residual risk Residual risk can be divided into quality residual risk, evidence residual risk and unknown residual risk
.
The principle of quality residual risk is that there are methods but not rational use, and the measure is medical quality improvement; the principle of evidence residual risk is that the reason is known but there is no evidence-based medicine method, and its measures provide evidence for the development of evidence-based medicine research; the measure of unknown residual risk The principle is that the reason is unknown and there is no intervention method.
The measures are to clarify the mechanism to find new drug targets
.
Multi-omics and big data bring opportunities to conquer unexplained residual risks.
Change in thinking about problem solving: change from a traditional knowledge-driven approach to a data-driven approach, and then form a new model-driven approach
.
Three key points to complete the new model: high-quality clinical cohort, omics-based big data platform, data and biological information processing team
.
The establishment of big data China's cerebrovascular disease big data platform (Sino-data for Stroke Survivors, SSS) currently has 4.
5 million national medical record homepage data (HQMS) and 1.
6 million data reported by the China Stroke Center Alliance (CSCA) each year There are 470,000 people and community cohorts, 15,000 in precision medicine cohorts, and 20,000 in clinical trials
.
➤Reverse drug development based on clinical big data and multi-omics National Stroke Registry of China III (CNSR-3): Study type: Multicenter, prospective cohort study; Enrolled population: Acute ischemic stroke or transient cerebral ischemia Attack patients; enrollment time: 2015.
8-2018.
3; sample size: 15166 cases; case distribution: 26 provinces, municipalities or autonomous regions; source of cases: 201 hospitals across the country
.
➤Mendelian Randomized Study Based on Whole Genes Based on 50 plasma biomarkers and genome-wide data of 10241 patients with ischemic stroke, using Mendelian randomized study, it was found that there is a causal relationship with stroke outcome (recurrence, disability, death) Four biomarkers can be used as potential drug treatment targets, and new drugs are being further developed
.
➤CNSR Ⅲ cohort DNA methylation group through differential methylation analysis, confirmed the important markers randomly discovered by Mendel, and revealed the molecular mechanism of its correlation with phenotype
.
Apparent genome-wide association analysis (EWAS) finds new and phenotype-related differentially methylated regions
.
Exploring the multi-omics technology route of potential intervention targets, fusing epigenetics, proteomics, protein modification omics, metabolomics and intestinal microbiome, and continuing to improve multi-omics joint analysis
.
Lock to the medlive-neurology channel (medlive-neurology) to view the latest information of CSA & TISC 2021! Long press the QR code to follow the CSA & TISC 2021 special report ☟☟☟ You can also click "Read the original text" to view More CSA & TISC 2021 topics related content!
