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Objective: To investigate the misdiagnosis of area postrema syndrome (APS) manifesting as intractable nausea, vomiting and hiccups in neuromyelitis optic spectrum disease (NMOSD) and reduce the risk of misdiagnosis. Methods: We retrospectively analyzed data from NMOSD patients attending the Department of Neurology at the First Medical Center of PLA General Hospital between January 2019 and July 2021. SPSS25.0 was then used to analyze the manifestations, misdiagnosis, and mistreatment of APS. Results: A total of 207 patients with NMOSD were included, including 21 males and 186 females. The mean age of onset was 39±15 years (range: 5-72 years). The proportion of patients who were positive for serum aquaporin 4 antibody was 82.6% (171/207). In total, 35.7% (74/207) of the NMOSD patients experienced APS during the disease course; of these patients, 70.3% (52/74) had APS as the first symptom and 29.7% (22/74) had APS as a secondary symptom. The misdiagnosis rates for these conditions were 90.4% (47/52) and 50.0% (11/22), respectively. As the first symptom, 19.2% (10/52) of patients during APS presented only with intractable nausea, vomiting and hiccups; 80.8% (42/52) of patients experienced other neurological symptoms. The Departments of Gastroenterology and General Medicine were the departments that most frequently made the first diagnosis of APS, accounting for 54.1% and 17.6% of patients, respectively. The most common misdiagnoses related to diseases of the digestive system and the median duration of misdiagnosis was 37 days. Conclusions: APS is a common symptom of NMOSD and is associated with a high rate of misdiagnosis. Other concomitant symptoms often occur with APS. Gaining an increased awareness of this disease/syndrome, obtaining a detailed patient history, and performing physical examinations are essential if we are to reduce and avoid misdiagnosis.
Subject(s)
Male , Female , Humans , Child, Preschool , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Neuromyelitis Optica/diagnosis , Area Postrema , Retrospective Studies , Hiccup/complications , Vomiting/etiology , Nausea/etiology , Inflammation , Syndrome , Autoantibodies , Diagnostic Errors , Aquaporin 4ABSTRACT
Echinococcosis is a serious zoonotic parasitic disease caused by infections with larval Echinococcus. The life cycle of Echinococcus involves a variety of animal hosts, including hoofed animals and rodents as intermediate hosts and carnivores as definitive hosts. The transmission of human echinococcosis is closely associated with the life cycle of E. granulosus and E. multilocularis among animal hosts in nature. This review summarizes the recent advances in the prevalence and influencing factors of E. granulosus and E. multilocularis infections in animal hosts, so as to provide insights into precision control of echinococcosis.
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Objective To investigate the effectiveness of a new health education pathway for echinococcosis control among primary school students in regions highly prevalent for echinococcosis in China. Methods Six primary schools were randomly selected from echinococcosis hyper-endemic regions, with 13 classes assigned to the intervention group and 9 to the control group, and all students in these 21 classes were recruited as the study subjects. Echinococcosis health education was performed through the pathway of assessing the current status-strengthening the building of teaching resources-focusing on practices in the intervention group, while routine health education was given in the control group. A questionnaire survey was performed to assess the score of echinococcosis control knowledge (including theoretical knowledge score and mean daily practical capability score) before and after the health education interventions to evaluate the effectiveness of this new health education pathway for echinococcosis control. Results The mean score of echinococcosis control knowledge was 68.86 ± 18.70 points at baseline, with the mean theoretical knowledge score of 40.97 ± 10.75 points, and the mean daily practical capability score of 27.89 ± 12.50 points. Clustering analysis showed three types of populations, including “unsatisfactory”, “learn and apply creatively”, and “rote learning”, which accounted for 24.62% (240/975), 45.74% (446/975) and 29.64% (289/975), respectively. The mean score of echinococcosis control knowledge was 81.08 ± 18.15 points in the intervention group during the final assessment, with the mean theoretical knowledge score of 43.65 ± 9.40 points, and the mean daily practical capability score of 37.43 ± 12.22 points, and both were significantly higher relative to baseline (t = −4.201 and −15.202, both P values < 0.01). The mean score of echinococcosis control knowledge was comparable between at baseline (70.55 ± 19.46 points) and final assessment (71.74 ± 19.37 points) in the control group (t = −0.87, P > 0.05). Conclusions The awareness of echinococcosis control knowledge is fair among primary school students in echinococcosis hyper-endemic regions; however, the capability of combining theoretical learning and practices requires to be improved. The health education mode based on the pathway of assessing the current status-strengthening the building of teaching resources-focusing on practices seems to remarkably improve the understanding of echinococcosis control knowledge among primary school students in echinococcosis hyper-endemic regions.
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OBJECTIVE: To understand the epidemiological characteristics of death cases of echinococcosis in China from 2008 to 2016, so as to provide an important reference for the prevention and control of echinococcosis. METHODS: The death information registration and management system data were selected to analyze the epidemiological characteristics of the death cases of echinococcosis. The data were analyzed by SPSS 21.0 and the map was drawn by ArcGIS 10.1 software. RESULTS: From 2008 to 2016, a total of 367 death cases of echinococcosis were reported in China, and the number of deaths in turn was 33, 30, 21, 32, 35, 54, 55, and 81 in each year, with an annual average crude mortality of 129.29 /105. The average age of death was (56 ± 18) years; the sex ratio of male to female was 100â¶94. There was no statistical difference between the male and female death cases (χ2 = 0.33, P > 0.05).The death cases of echinococcosis were mainly distributed in endemic areas of Qinghai, Sichuan, Ningxia, Xinjiang, Gansu, Inner Mongolia, Yunnan and non-endemic areas of Heilongjiang, Jiangsu, Henan and Shandong. The death cases in the first eleven provinces accounted for 87.5% (321/367) of the total death cases, among which the highest proportions of the nationality, occupation, educational level, highest diagnostic units, and the place of death were Han (52.0%, 191/367), farmer (46.6%, 171/367), junior high school or below (57.2%, 210/367), provincial or three-level hospitals (46.6%, 171/367), and at home (59.9%, 220/367). CONCLUSIONS: Since 2014, the death cases of echinococcosis in China have been increasing year by year, indicating that the prevention and treatment of echinococcosis is still very serious. The causes for the rise of the fatality rate remain to be further studied.
Subject(s)
Echinococcosis , Adult , Aged , China/epidemiology , Echinococcosis/epidemiology , Echinococcosis/mortality , Echinococcosis/prevention & control , Female , Humans , Incidence , Male , Middle Aged , Risk FactorsABSTRACT
OBJECTIVE: To understand the risk factors of cystic echinococcosis in Tibetan population, so as to provide the reference for development of prevention and control strategies. METHODS: Four cystic echinococcosis highly-prevalent townships were selected from Naqu County of Tibet and Shiqu County of Sichuan Province, which had similar environmental and altitude conditions, from August to September, 2017. Applying the 1â¶1 case-control study, a household survey was conducted to investigate the risk factors of echinococcosis in humans. RESULTS: A total of 378 residents were investigated, of which the numbers of cases and non-cases were both 189. The univariate analysis showed that the years of keeping dogs (OR = 1.032, P < 0.05), the number of keeping dogs (OR = 1.260, P < 0.05), the way of raising dogs (OR = 1.434, P < 0.05), feeding with raw viscera (OR = 1.531, P < 0.05), and there being stray dogs around (OR = 1.946, P < 0.05) were the risk factors of echinococcosis. As a result of the multivariate logistic regression analysis, only three risk factors, feeding with raw viscera, there being stray dogs around, and drinking water resource, were included in the regression model. CONCLUSIONS: Feeding with raw viscera, there being stray dogs around, and drinking water resource are the risk factors of echinococcosis in humans.
Subject(s)
Echinococcosis/epidemiology , Animals , Case-Control Studies , Dogs , Drinking Water , Humans , Prevalence , Risk Factors , Tibet/epidemiologyABSTRACT
Background@#Disease-modifying therapy is the standard treatment for patients with multiple sclerosis (MS) in remission. The primary objective of the current analysis was to assess the efficacy and safety of two teriflunomide doses (7 mg and 14 mg) in the subgroup of Chinese patients with relapsing MS included in the TOWER study.@*Methods@#TOWER was a multicenter, multinational, randomized, double-blind, parallel-group (three groups), placebo-controlled study. This subgroup analysis includes 148 Chinese patients randomized to receive either teriflunomide 7 mg (n = 51), teriflunomide 14 mg (n = 43), or placebo (n = 54).@*Results@#Of the 148 patients in the intent-to-treat population, adjusted annualized relapse rates were 0.63 (95% confidence interval [CI]: 0.44, 0.92) in the placebo group, 0.48 (95% CI: 0.33, 0.70) in the teriflunomide 7 mg group, and 0.18 (95% CI: 0.09, 0.36) in the teriflunomide 14 mg group; this corresponded to a significant relative risk reduction in the teriflunomide 14 mg group versus placebo (-71.2%, P = 0.0012). Teriflunomide 14 mg also tended to reduce 12-week confirmed disability worsening by 68.1% compared with placebo (hazard ratio: 0.319, P = 0.1194). There were no differences across all treatment groups in the proportion of patients with treatment-emergent adverse events (TEAEs; 72.2% in the placebo group, 74.5% in the teriflunomide 7 mg group, and 69.8% in the teriflunomide 14 mg group); corresponding proportions for serious adverse events were 11.1%, 3.9%, and 11.6%, respectively. The most frequently reported TEAEs with teriflunomide versus placebo were neutropenia, increased alanine aminotransferase, and hair thinning.@*Conclusions@#Teriflunomide was as effective and safe in the Chinese subpopulation as it was in the overall population of patients in the TOWER trial. Teriflunomide has the potential to meet unmet medical needs for MS patients in China.@*Trial Registration@#ClinicalTrials.gov, NCT00751881; https://clinicaltrials.gov/ct2/show/NCT00751881?term=NCT00751881&rank=1.
Subject(s)
Humans , China , Crotonates , Therapeutic Uses , Double-Blind Method , Drug Administration Schedule , Immunosuppressive Agents , Therapeutic Uses , Multicenter Studies as Topic , Multiple Sclerosis , Drug Therapy , Metabolism , Proportional Hazards Models , Toluidines , Therapeutic UsesABSTRACT
Objectives To understand the risk factors of cystic echinococcosis in Tibetan population,so as to provide the reference for development of prevention and control strategies.Methods Four cystic echinococcosis highly-prevalent townships were selected from Naqu County of Tibet and Shiqu County of Sichuan Province,which had similar environmental and altitude conditions,from August to September,2017.Applying the 1:1 case-control study,a household survey was conducted to investi-gate the risk factors of echinococcosis in humans. Results A total of 378 residents were investigated,of which the numbers of cases and non-cases were both 189.The univariate analysis showed that the years of keeping dogs(OR=1.032,P<0.05),the number of keeping dogs(OR=1.260,P<0.05),the way of raising dogs(OR=1.434,P<0.05),feeding with raw viscera (OR=1.531,P<0.05),and there being stray dogs around(OR=1.946,P<0.05)were the risk factors of echinococcosis.As a result of the multivariate logistic regression analysis,only three risk factors,feeding with raw viscera,there being stray dogs around,and drinking water resource,were included in the regression model.Conclusion Feeding with raw viscera,there be-ing stray dogs around,and drinking water resource are the risk factors of echinococcosis in humans.
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Objective To understand the epidemiological characteristics of death cases of echinococcosis in China from 2008 to 2016,so as to provide an important reference for the prevention and control of echinococcosis.Methods The death in-formation registration and management system data were selected to analyze the epidemiological characteristics of the death cas-es of echinococcosis.The data were analyzed by SPSS 21.0 and the map was drawn by ArcGIS 10.1 software.Results From 2008 to 2016,a total of 367 death cases of echinococcosis were reported in China,and the number of deaths in turn was 33,30,21,32,35,54,55,and 81 in each year,with an annual average crude mortality of 129.29/105.The average age of death was(56 ± 18)years;the sex ratio of male to female was 100:94.There was no statistical difference between the male and fe-male death cases(Χ2=0.33,P>0.05).The death cases of echinococcosis were mainly distributed in endemic areas of Qinghai,Sichuan,Ningxia,Xinjiang,Gansu,Inner Mongolia,Yunnan and non-endemic areas of Heilongjiang,Jiangsu,Henan and Shandong.The death cases in the first eleven provinces accounted for 87.5%(321/367)of the total death cases,among which the highest proportions of the nationality,occupation,educational level,highest diagnostic units,and the place of death were Han(52.0%,191/367),farmer(46.6%,171/367),junior high school or below(57.2%,210/367),provincial or three-level hospitals(46.6%,171/367),and at home(59.9%,220/367).Conclusions Since 2014,the death cases of echinococcosis in China have been increasing year by year,indicating that the prevention and treatment of echinococcosis is still very serious.The causes for the rise of the fatality rate remain to be further studied.
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OBJECTIVE: To evaluate the application status of China Disease Prevention and Control Information System of Hydatid Disease, in which questions existed are summarized in order to promote the system update. METHODS: A questionnaire was designed and distributed to Inner Mongolia, Sichuan, Tibet, Gansu, Qinghai, Ningxia, Xinjiang and Xinjiang Production and Construction Corps to evaluate the application status of China Disease Prevention and Control Information System of Hydatid Disease assistant with telephone. RESULTS: The recovery rate of questionnaires was 87.5%. The statistics of closed questions showed that national application rate of the China Disease Prevention and Control Information System of Hydatid Disease was 100%, of which 15.3% were low frequency users, 57.1% believed the system was necessary, 28.6% considered it was dispensable, and 14.3% believed that it was totally unnecessary. The statistics of open-ended questions indicated that 6 endemic regions suggested to increase the guidance and training, while 4 endemic regions had opinions on sharing the information of the national infectious disease reporting systems and hydatid disease prevention and control information system, and the opinions on turning monthly report to quarterly report, and increasing statistics and analysis module, and 3 endemic regions deemed that the system had logic errors and defects. CONCLUSIONS: The problems of the system are mainly focused on the existence of systemic deficiencies and logic errors, lacking of statistical parameters and corresponding analysis function module, and lacking of the guidance and training, which limits the use of the system. Therefore, these problems should be resolved.
Subject(s)
Echinococcosis/prevention & control , Health Information Systems , China/epidemiology , Clinical Audit , Echinococcosis/epidemiology , Humans , Surveys and QuestionnairesABSTRACT
In Garze Tibetan autonomous prefecture in Sichuan province, China, 41 echinococciasis patients who had received surgical treatment were recruited in the study, and 82 health persons who had lived in Garze for at least 10 years were selected as controls. The serum levels of Zn, Se and Cu of the cases and controls were detected. The results showed that most echinococciasis cases were distributed in Shiqu county (17.1%, 7/41), and only 1 case was distributed in Yajiang county (2.4%). The male to female ratio of the cases was 1:1.56. The echinococciasis patients were mainly aged 30-39 years (36.59%, 15/41). And, the cases aged 20-49 years accounted for 68.29% (28/41). Compared with health controls, the serum levels of Zn and Se of the cases significantly declined. However, the serum level of Cu of the cases had no significantly change. It was confirmed that the serum levels of Zn and Se were interrelated with the prevalence of echinococciasis.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Age Distribution , Case-Control Studies , Copper , Blood , Echinococcosis, Hepatic , Blood , Epidemiology , Prevalence , Selenium , Blood , Sex Distribution , Tibet , Trace Elements , Blood , Zinc , BloodABSTRACT
<p><b>BACKGROUND</b>Inflammation plays a pivotal role in the formation and progression of ischemic stroke. Recently, more and more epidemiological studies have focused on the association between C-reactive protein (CRP) -717A > G and -286C > T > A genetic polymorphisms and ischemic stroke. However, the findings of these researches are not conclusive.</p><p><b>METHODS</b>We performed a meta-analysis to determine whether these two polymorphisms are associated with the risk of ischemic stroke. Eligible studies were identified from the database of PubMed, Medline, Embase, Web of Science, CNKI, Weipu, and Wanfang. We calculated odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of the association.</p><p><b>RESULTS</b>Four articles were included in our study, including 1926 cases and 2678 controls for -717A > G polymorphism, 652 cases and 1103 controls for -286C > T > A polymorphism. The results of meta-analysis showed that single nucleotide polymorphism (SNP) -717A > G was not significantly associated with the risk of ischemic stroke (GG vs. AA, OR = 1.12, 95% CI = 0.83-1.50, P = 0.207; GG + GA vs. AA, OR = 1.04, 95% CI = 0.93-1.17, P = 0.533; GG vs. GA + AA, OR = 1.10, 95% CI = 0.82-1.47, P = 0.220). Meta-analysis of SNP - 286C > T > A also demonstrated no statistical evidence of a significant association with the risk of ischemic stroke (AA vs. CC, OR = 0.86, 95% CI = 0.59-1.25, P = 0.348; AA vs. CC, OR = 0.92, 95% CI = 0.80-1.06, P = 0.609; AA vs. CC, OR = 0.89, 95% CI = 0.62-1.30, P = 0.374).</p><p><b>CONCLUSIONS</b>This meta-analysis demonstrated little evidence to support a role of CRP gene -717A > G, -286C > T > A polymorphisms in ischemic stroke predisposition. However, to draw comprehensive and more reliable conclusions, further larger studies are needed to validate the association between CRP gene polymorphisms and ischemic stroke in various ethnic groups.</p>
Subject(s)
Humans , Alleles , Brain Ischemia , Genetics , C-Reactive Protein , Genetics , Genetic Predisposition to Disease , Genetics , Genotype , Polymorphism, Single Nucleotide , Genetics , Stroke , Epidemiology , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To study the correlation between lacunar cerebral infarction and level of serum uric acid in elderly male hypertension patients.</p><p><b>METHODS</b>Ninety-eight elderly male hypertension patients were enrolled in this study. They all underwent cerebral magnetic resonance imaging (MRI) scan, and their clinical and laboratory data were collected. The patients were divided into the 1st group (n = 32), the 2nd group (n = 32) and the 3rd group (n = 34) according to the level of serum uric acid.</p><p><b>RESULTS</b>The numbers of lacuner infarction, serum creatinine, urea and high density lipoprotein(HDL) were significantly diferrent from the other groups. The numbers of lacuner infarction were positively related with serum uric acid and urea. Multiple variant analysis showed that serum uric acid was the independent factor of the numbers of lacuner infarction.</p><p><b>CONCLUSION</b>The elevated level of serum uric acid may contribute to the risk factors of lacuner infarction.</p>
Subject(s)
Aged, 80 and over , Humans , Male , Cerebral Infarction , Hypertension , Blood , Regression Analysis , Risk Factors , Uric Acid , BloodABSTRACT
In the title compoud, [Cd(C(12)H(8)N(2))(3)](C(16)H(8)N(2)O(8))·0.5C(16)H(10)N(2)O(8)·CH(3)OH, the Cd(II) atom has a distorted octa-hedral coordination formed by six N atoms from three separate phenanthroline ligands. One of the 4,4'-diazenediyldiphthalic acid mol-ecules is arranged around an inversion center and possesses two -COOH groups, while the other is partially deprotonated and is a dianion for charge balance. It can be noted that, in the undeprotonated acid, the -COOH groups are disordered over two positions by rotation around the C-C bond linking the -COOH group to the phenyl ring. Surprisingly, the H atom is not involved in the disorder. In the dianion, the remaining H atom is located between the two COO groups. These deprotonated and undeprotonated mol-ecules are linked by O-Hâ¯O hydrogen bonds, forming a chain developing parallel to the [111] direction. The methanol solvent molecule is highly disordered; it was not considered in the final model by elimination of its contribution from the intensity data.
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<p><b>BACKGROUND</b>The rodentia and lagomorpha animals are the intermediate hosts of Echinococcus multilocularis, their distribution and infection of this parasite may facilitate the infection of definitive hosts such as dogs. The aim of this study was to determine the distribution of the intermediate hosts of Echinococcus multilocularis in Shiqu County, Sichuan, China.</p><p><b>METHODS</b>A systematic sampling method was used to investigate the density of burrows of rodents and lagomorphs at 97 pasture sites in winter and summer pastureland and remote sensing (RS) technology was used to correlate their densities to the distribution of these animals in different landscape types.</p><p><b>RESULTS</b>Based on the densities of Ochotona curzoniae, Microtus fuscus (dependent variable) and their burrow densities (independent variable) in survey points, regression equations were fitted respectively (Ochotona curzoniae, P < 0.0001, R(2) = 0.8705; Microtus fuscus, P < 0.0001, R(2) = 0.9736). Their burrow density in summer pastureland was higher than in winter pastureland (F = 36.65, P < 0.0001). The burrow densities of Ochotona curzoniae and Microtus fuscus in bareland and half-bareland are higher than in grassland (F = 7.73, P < 0.001).</p><p><b>CONCLUSIONS</b>The regression relationship between the densities of Ochotona curzoniae and Microtus fuscus and their burrow densities indicate that the burrow densities could reflect the animal densities and that the burrow density was greater in summer pastureland than in winter pastureland. The main distribution areas of the intermediate hosts were in bareland and half-bareland.</p>
Subject(s)
Animals , Arvicolinae , Parasitology , China , Echinococcosis , Epidemiology , Echinococcus multilocularis , Virulence , Lagomorpha , ParasitologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the expression of RUNX3 mRNA and protein in hepatic cell carcinoma (HCC) and surrounding normal tissue, to analyze the relationship between RUNX3 expression and clinical pathological parameters.</p><p><b>METHODS</b>Reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry (IHC) were performed to detect the expression of RUNX3 mRNA and protein in HCC and surrounding normal tissue respectively, and their relationship with clinical pathological parameters were analyzed.</p><p><b>RESULTS</b>The relative expression value of RUNX3 mRNA found in 51 cases HCC was 0.4509 +/- 0.0963, and that did in 51 cases surrounding normal tissue was 0.9147 +/- 0.0222. The difference of RUNX3 mRNA expression between two kinds of samples was statistically significant (t = 33.6087, P < 0.001). The positives rate of RUNX3 protein expression found in 51 cases HCC tissue was 49.02% (25/51) and that did in 51 cases surrounding normal tissue was 82.35% (42/51). The difference of RUNX3 protein expression between two kinds of samples was statistically significant (chi2 = 12.5706, P < 0.005). The difference of RUNX3 mRNA and protein expression in some clinical pathological parameters involving differentiation degree, invasion, cancer thrombus and diversion in liver were statistically significant (P < 0.05). However that were not in another clinical pathological parameters involving gender, cancer diameter, cancer location as well as hemorrhage and necrosis of cancer, histotype (P > 0.05).</p><p><b>CONCLUSION</b>The expression of RUNX3 mRNA and protein in HCC were significantly lower than that in surrounding normal tissue. The lower expression of runx3 protein in the HCC probably plays an important role in the tumorigenesis and development of HCC. The RUNX3 gene may be an anti-oncogene of HCC.</p>
Subject(s)
Female , Humans , Male , Carcinoma, Hepatocellular , Chemistry , Pathology , Core Binding Factor Alpha 3 Subunit , Genetics , Physiology , Gene Expression Regulation, Neoplastic , Liver Neoplasms , Chemistry , Pathology , RNA, MessengerABSTRACT
<p><b>OBJECTIVE</b>To assess the seroprevalence and diagnostic value of aquaporin-4 antibody (AQP4-Ab) in patients with inflammatory central nervous system demyelinating diseases.</p><p><b>METHODS</b>Seventy-two patients with neuromyelitis optica (NMO), 68 with multiple sclerosis (MS), 4 with optic neuritis (ON), and 41 with transverse myelitis (TM) were included in this study. The TM group comprised 19 patients with non-longitudinally extensive transverse myelitis (nLETM), 14 with monophasic longitudinally extensive transverse myelitis (mLETM), and 8 with recurrent longitudinally extensive transverse myelitis (rLETM). The serum levels of AQP4-Ab was detected by indirect immunofluorence assay in these patients.</p><p><b>RESULTS</b>AQP4-Ab was detected in 72.2% (52/72) patients with NMO, 5.9% (4/68) patients with MS, 25.0% (1/4) patients with ON, and 17.1% (7/41) patients with TM, showing a significant difference in the positivity between NMO and MS groups (P<0.01). AQP4-Ab seropositivity rate was 5.3% (1/19) in nLETM patients, 62.5% (5/8) in rLETM patients and 7.1% (1/14) in mLETM patients, significantly higher in rLETM than in nLETM (P<0.01) and mLETM groups (P<0.05), but no statistical difference was found between rLETM and NMO groups.</p><p><b>CONCLUSIONS</b>A high seroprevalence of AQP4-Ab is observed in patients with NMO and rLETM, which support the hypothesis that NMO and rLETM belong to NMO spectrum disorders. AQP4-Ab can serve as a useful index for diagnosing NMO and differential diagnosis from MS. More attention and effective immunosuppressive treatments should be given to patients positive for AQP4-Ab.</p>
Subject(s)
Female , Humans , Male , Aquaporin 4 , Allergy and Immunology , Autoantibodies , Blood , Demyelinating Autoimmune Diseases, CNS , Diagnosis , Allergy and Immunology , Multiple Sclerosis , Diagnosis , Allergy and Immunology , Neuromyelitis Optica , Diagnosis , Allergy and Immunology , Seroepidemiologic StudiesABSTRACT
Objective To discuss the different clinical features and prognosis of single cerebral venous thrombosis (CVT) and multiple CVT. Methods The site and the number of vein and thrombosed sinuses of 136 patients with CVT were summarized. The patients were divided into 2 groups according to the numbers of thrombosed sinuses. The clinical features and outcome of the patients with single CVT were analyzed in comparison with those with multiple CVT by univariate analysis. Results In 44 patients (32.4%), only 1 cerebral sinus was involved. In 92 patients (67.6%), 2 or more cerebral veins and sinuses were involved (2 sinuses in 45, 3 sinuses in 35, 4 sinuses in 9, 5 sinuses in 3). The lateral sinus and the sigmoid sinus were the most frequent thrombosed sinuses which were found in 86.8% of patients; the followings were superior sagittal sinus (58.1%), straight sinus (18.4%) , deep venous system (7.4%), and cortical veins (2.9%). Mean ages were significantly older but the short-term prognosis was better in the group of patients with single CVT in comparison with those in the group of patients with multiple CVT. The patients with multiple CVT also presented more serious intracranial hypertension, more frequent parenchymal lesions and systematic thrombotic events than those with single CVT (P<0.05). Conclusion In most CVT patients, 2 or more veins and sinuses are involved and thromboses most commonly implicate the lateral sinus and the superior sagittal sinus. Patients with multiple CVT usually present higher intracranial pressure, more serious clinical course, worse outcome and higher incidence of systematic venous thrombotic events in comparison with patients with single CVT. And the multiple sinus thrombosis is more likely to cause venous infarctions and intracranial hemorrhage than the single one.
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<p><b>OBJECTIVE</b>To assess the diagnostic value of tumor markers in the cerebrospinal fluid (CSF) for meningeal carcinomatosis (MC).</p><p><b>METHODS</b>Twenty-one MC patients (including 13 adenocarcinoma and 8 non-adenocarcinoma patients), 72 patients with tuberculous meningitis (TBM) and 23 with primary intracerebral tumors (PIT) were enrolled in this study. Blood and CSF tumor markers including CEA, CA125, CA15-3, CA19-9, CA72-4, CYFRA21-1, AFP and NSE were measured by Roche E170 electrochemiluminescence analyzer and sandwich assay.</p><p><b>RESULTS</b>CSF tumor markers CEA, CA125, CA199 and CYFRA21-1 and the serum tumor markers CEA, CA125, CA153, CA199 and AFP were significantly higher in MC group than in the other two groups. CSF CEA and CA15-3 were significantly higher in adenocarcinoma MC than in non-adenocarcinoma MC patients, but no significant differences were found in the serum tumor markers between the two groups (P>0.05). CSF tumor markers including CEA, CA125, CA15-3, CA72-4 and CYFRA21-1 were positively correlated to the serum tumor markers (P<0.05). CA199 was positively correlated to the disease course (P<0.05), and age was not correlated to any of the indexes (P>0.05).</p><p><b>CONCLUSION</b>Detection of the tumor markers in the CSF, especially CEA, CA125, CA19-9 and CYFRA21-1, may help in the early diagnosis of MC. CEA and CA15-3 can serve as indicators for differential diagnosis of adenocarcinoma and non-adenocarcinoma.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Adenocarcinoma , Cerebrospinal Fluid , Diagnosis , Antigens, Neoplasm , Cerebrospinal Fluid , Biomarkers, Tumor , Cerebrospinal Fluid , CA-125 Antigen , Cerebrospinal Fluid , CA-19-9 Antigen , Cerebrospinal Fluid , Carcinoembryonic Antigen , Cerebrospinal Fluid , Keratin-19 , Cerebrospinal Fluid , Membrane Proteins , Cerebrospinal Fluid , Meningeal Neoplasms , Cerebrospinal Fluid , DiagnosisABSTRACT
<p><b>OBJECTIVE</b>To investigate the expression of hypoxia-inducible factor-1alpha (HIF-1alpha) and matrix metalloproteinase-2 (MMP-2) in degenerative human intervertebral disc.</p><p><b>METHODS</b>Specimens of the nucleus pulposus of the degenerative discs were obtained from patients with lumbar disc herniation (experimental group), and those from young patients suffering thoracolumbal vertebral bursting fracture served as the control. The experimental group was divided into three subgroups according to the magnetic resonance imaging (MRI) results. The tissue specimens from all the groups were examined for HIF-1alpha and MMP-2 expressions using immunohistochemistry.</p><p><b>RESULTS</b>The tissues in the experimental group showed significantly higher expressions of HIF-1alpha and MMP-2 than those in the control group (P<0.05), and the expressions increased significantly with the severity of the degenerative changes of the intervertebral discs (P<0.05). A positive correlation was found between the expressions of the HIF-1alpha and MMP-2 in degenerative intervertebral discs.</p><p><b>CONCLUSION</b>HIF-1alpha and MMP-2 may participate in the degeneration of human intervertebral discs, in which process their expressions show a common pattern of enhancement with the progression of the condition.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Hypoxia-Inducible Factor 1, alpha Subunit , Metabolism , Intervertebral Disc Degeneration , Metabolism , Lumbar Vertebrae , Matrix Metalloproteinase 2 , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To analyze the magnetic resonance imaging (MRI) characteristics of neuromyelitis optica (NMO) in Chinese patients.</p><p><b>METHODS</b>We retrospectively reviewed the MRI films of 61 patients with NMO (including 57 female and 4 male patients) admitted in our department.</p><p><b>RESULTS</b>Of these patients, 39 (79.6%) showed positivity for serum aquaporin-4 (AQP4) antibody. On MRI, 18 patients showed involvement of the cervical cord alone, 27 had both cervical and thoracic segment involvement, and 16 displayed thoracic segment involvement. The lesions appeared linear (9 cases), diffuse (23 cases), or both (29 cases), mostly located axially with occasional lateral distribution. Thirty-nine of the 61 patients (63.9%) had brain abnormalities, 31 presented with supratentorial lesions (mostly in the juxtacortical, subcortical, deep white matter and lateral ventricle-adjacent regions, n=27), 15 showed infratentorial lesions (mostly in the preiaqueduct-fourth ventricular-central canal, n=13), and 7 had supra- and infratentorial lesions simultaneously.</p><p><b>CONCLUSION</b>NMO has complex MRI presentation, and linear lesions in the spinal cord and preiaqueduct-fourth ventricular-central canal lesions, where AQP4 is high expressed, can be characteristic for NMO. MRI and AQP4 antibody detection are suggested for suspected cases for early diagnosis.</p>