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This case report described the diagnosis and treatment of an ethnic Tibetan case with severe neurocysticercosis residing in agricultural areas of Sichuan province.
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Objective:To investigate the causes of secondary glaucoma after vitrectomy for familial vitreous amyloidosis associated with transthyretin (TTR) gene Gly83Arg mutation.Methods:A retrospective case study. From January 2008 to January 2020, 13 cases (23 eyes) with hereditary vitreous amyloidosis and treated by vitrectomy in the Affiliated Hospital of Zunyi Medical University were collected. Among them, there were 7 males with 12 eyes and 6 females with 11 eyes. The average age was 43.0±4.8 years. All the affected eyes underwent standard three-channel vitrectomy through the flat part of the ciliary body. According to whether complete vitreous detachment (PVD) was formed during the operation, it was divided into complete PVD group and incomplete PVD group; according to the occurrence time of secondary glaucoma and vitreous amyloidosis after surgery, it was divided into 1-12 months group and 13-36 months group, >37 months group. The average follow-up time after surgery was 36.7±6.0 months. The incidence of secondary glaucoma and the recurrence rate of vitreous amyloidosis between groups were compared by χ2 test; the correlation between recurrence of vitreous amyloidosis and secondary glaucoma after surgery was analyzed by Spearman rank correlation analysis. Results:Among the 23 eyes, there were 8 eyes in the complete PVD group and 15 eyes in the incomplete PVD group, respectively. Vitreous amyloidosis recurred in 15 eyes (65.22%, 15/23) after surgery. There were 14 (93.30%, 14/15) and 1 (6.70%, 1/15) eyes in the incomplete PVD group and the complete PVD group, respectively; the comparison of the recurrence rate of vitreous amyloidosis between the two groups was statistically significant ( χ2=11.676, P<0.01). 1-12 months group, 13-36 months group, >37 months group included 1 (4.35%, 1/23), 12 (52.17%, 12/23), 2 (8.70%, 2/23) Only eye. The recurrence rate in the 13-36 months group was significantly higher than that in the 1-12 months group and >37 month group. Secondary glaucoma occurred in 11 eyes (47.80%, 11/23) after surgery. 1-12 months group, 13-36 months group, above 37 months group were 1 (4.35%, 1/23), 8 (34.78%, 8/23), 2 (8.70%, 2/23) eyes. The incidence of secondary glaucoma in the 13-36 months group was higher than that in the 1-12 months group and >37 months group. Among 11 eyes with secondary glaucoma, 10 eyes had recurrence of vitreous amyloidosis after surgery, and 1 eye had no recurrence. The results of Spearman rank correlation analysis showed that there was a positive correlation between the recurrence of vitreous amyloidosis and the occurrence of secondary glaucoma ( rs=0.516, P=0.012). Conclusion:The incidence of secondary glaucoma after vitrectomy in a family with vitreous amyloidosis caused by the Gly83Arg mutation of TTR gene is higher, and its occurrence is significantly positively correlated with the recurrence of vitreous amyloidosis.
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To determine the impact of Cysticercus cellulose (C. cellulose) infection on mental health among school-aged children in Tibetan agricultural areas of Sichuan Province. Methods: In October 2015, all primary schools located in Tibetan agricultural areas in Yajiang, Ruoergai, and Muli county of Sichuan Province were selected as the research sites. All school-aged children at five- and six-grade were enrolled for the study by a multistage stratified cluster sampling method. Antibodies against C. cellulose were detected. Mental Health Test and questionnaire survey were conducted for school-aged children to collect data. The impact of C. cellulose infection on mental health among school-aged children was analyzed with the multilevel linear regression. Results: A total of 2 453 school-aged children were investigated. The C. cellulose seropositive rate was 6.03% (148/2 453). There were 0.16% (4/2 453) patients with seropositive accompanied by seizure, 2.28% (56/2 453) with seropositive accompanied by headache, 2.08% (51/2 453) with seropositive accompanied by frequent weak, and 0.41% (10/2 453) were seropositive accompanied by frequent nausea. The rate of C. cellulose infection was 4.53% (111/2 453). The mean score of the mental health test was 6.59±2.61. There were significant difference in score of mental health test in children whose demographic characteristics were different. The mental health scores of school-aged children were clustered at the school level. After controlling the factors of demographic characteristics, the result of multilevel model demonstrated that the factor of school-aged children with C. cellulose seropositive accompanied by headache was statistically significant (β=1.14, P=0.017). Conclusion: The status of C. cellulose infection among school-aged children in Tibetan agricultural areas is not optimistic. C. cellulose infection has impacted on mental health of local school-aged children. It is necessary to strengthen the prevention and control of C. cellulose infection in epidemic area.
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Animals , Child , Humans , Cysticercosis , Diagnosis , Epidemiology , Cysticercus , Mental Health , Neurodevelopmental Disorders , Epidemiology , Seroepidemiologic Studies , Tibet , EpidemiologyABSTRACT
Objective To evaluate the ELISA kit for detection of IgG antibodies against Taenia solium cysticercus in hu-mans,so as to provide a reference for its application in clinical practice. Methods The sera collected from the patients with neurocysticercosis,echinococcosis,taeniasis and healthy people,respectively,were checked by ELISA for specific IgG anti-bodies against T. solium cysticercus,as described in the instruction of the kit. Results Of the 30 patients with neurocysticerco-sis at active stage,28 showed seropositive reaction,indicating a sensitivity of 93.33%. There were no positive reactions in the 100 healthy people. Two of the 42 persons with taeniasis were seropositive with an infection rate of 4.76%. Forty-one of the 60 persons with echinococcosis showed positive reactions,suggesting that the cross reaction rate of the kit with echinococcosis was 68.33%. Conclusions The assessed ELISA kit has a reasonably high sensitivity but a poor specificity,and the cross reaction rate with echinococcosis is very high. It is urgent to improve the sensitivity and specificity of the diagnostic kit for detection of T. solium cysticercosis in China.
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Objective To evaluate the value of serum kaliuretic peptide (KP) in predicting atrial fibrillation (AF) and its prognosis,by detecting serum KP levels in patients with severe sepsis.Methods Fifty-six patients with severe sepsis in Integrated Intensive Care Unit of Shajing Hospital of Shenzhen Affiliated to Guangzhou Medical University from January 2014 to August 2015 were collected as the case group.In addition 20 cases health checkup for the same period were collected as the control group.Serum KP were determined in all patients in the case group every day for 1 week after admission,meanwhile the APACHE-Ⅱ score was undertook,then according to heart guardianship and electrocardiogram whether occurrence of AF the case group were divided into AF group and non AF group.According to survival after 28 days again divided into survival group and death group,the relationship of serum KP with AF and the prognosis were analyzed.Serum KP was detected on the day of physical examination in the control group.Results (1) The incidence of AF was 32.1％(18/56) in 56 patients with severe sepsis.(2)Serum KP in admission to hospital in case group was significantly higher than that in the control group((234.2±73.5) pmol/L vs.(169.6±65.4) pmol/L;t =3.47,P =0.001).Serum KP in admission to hospital in AF group was significandy higher than that in the non AF group((306.0±35.6) pmol/L vs.(200.2±61.2) pmol/L;t =6.79,P =0.001).Serum KP in AF group before 1 day of the occurrence AF was significantly higher than of the admission to hospital ((339.2± 30.5) pmol/L vs.(306.0±35.6) pmol/L;P=0.007),serum KP on the day of occurrence AF was significantly higher than before 1 days of the occurrence AF((390.6±47.8) pmol/L vs.(339.2±30.5) pmol/L;P=0.006),there was no difference between the serum KP after 1 days of occurrence AF and on the day of occurrence AF(P=0.246),but began to gradually declining.Serum KP and APACHE-Ⅱ score in death group on admission to hospital were significantly higher than survival group((301.1±42.0) pmol/L vs.(199.8±61.5) pmol/L,(26.1±2.8) points vs.(19.9±4.3) points;t =6.44,5.67;P＜0.001).(3) Linear correlation analysis showed that serum KP on admission to hospital was positively correlated with the occurrence of AF(r=0.679,P=0.010).According to AF grouping,serum levels of KP on admission to hospital draw ROC curve,the serum KP of AUC was 0.908(95％ CI:0.831-0.984),when the KP value was 351.5 pmol/L,the sensitivity of the occurrence AF was 89.9％,specificity of 97.4％.(4)Linear correlation analysis showed that serum KP on admission to hospital was positively correlated with death(r=0.659,P =0.010),according to prognostic grouping,serum KP on admission to hospital and APACHE-Ⅱ score ROC curve was drew,the serum KP of AUC was 0.893 (95％ CI:0.811-0.974),when the KP value was 338.5 pmol/L,the sensitivity of death was 78.9％,specificity of 97.3％.Conclusion Early serum KP level can be used as an indicator to predict AF and prognosis in the patients with severe sepsis.