chinese stroke
Stroke is the number one cause of death in China. Millions die of it each year. “And it’s happening to a younger and younger population,” said RenYu Liu, MD, PhD, of Anesthesiology and Critical Care. But the potential for reducing these cases is great, if only the people could easily and quickly recognize the signs.  Now, a Penn Medicine global medicine collaboration is paving the way to making a dent in the deadly toll.

The acronym FAST (Face, Arm, Speech, Time) is an easily remembered way for English-speaking people to recognize the signs of stroke but it clearly wouldn’t work in a population that predominanty speaks Chinese. So Liu, who grew up and practiced medicine in China before coming to this country, collaborated with Jing Zhao, MD, PhD, a neurologist at Minhang hospital, Fudan University, China, to create a new system  without a language barrier.

stroke120They used numbers instead, transforming the the phone number for a medical emergency in China (1-2-0) into three stroke-recognition actions. “First, look for an uneven face. Second, examine for arm weakness.  And zero, absence of clear speech,” he explained. In Chinese, the pronunciation for zero is “ling,” similar to “ting,” which means hearing (ie, cannot hear a clear speech).

Once the word got out about this new and simple way to educate China’s population about stroke – which started with a published paper in Lancet Neurology -- it caught on like wild fire. In fact, the day after it was published, the China Stroke Association officially adopted the easy-to-remember series of numbers and incorporated it in its stroke care guidelines.  Liu and Zhao also appeared on multiple TV shows in China, including the nationwide broadcast to introduce Stroke 1-2-0. They also directed and produced an educational video on Stroke 1-2-0 for its website (

“We are also launching a ‘Stroke 1-2-0 Special Task Force of the Chinese Stroke Association’ aimed at reducing  the pre-hospital delay of stroke victims as well as mortality and disability in China,” he said.

“Even in urban settings, the median time to get a stroke victim to the hospital are as long as 15 hours. In rural settings, it could be days,” he said. “If this will help people recognize the signs and call the number, many lives will be saved and disabilities avoided.”

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