ABSTRACT
Objective:To summarize the clinical features and pathological changes of peripheral tissues from patients with neuronal intranuclear inclusion disease (NIID) diagnosed by genetic tests.Methods:Repeat-primed polymerase chain reaction was used to confirm the GGC repeated expansion in the 5′ untranslated region of the NOTCH2NLC gene in patients with suspected NIID who had visited the Department of Neurology of Peking University First Hospital from January 2018 to February 2020. The clinical data and pathological changes of peripheral tissues from patients with genetically diagnosed NIID were collected retrospectively and analysed. Immunostaining with anti-p62 and anti-ubiquitin antibody was performed on peripheral biopsy specimens.Results:Totally nine patients with NIID who had GGC repeated expansion in the NOTCH2NLC gene were found. Five patients were familial (from three faimilies), and four patients were sporadic. The age of onset was 36-61(51.33±7.12) years. The most common symptoms in this NIID group were episodic emotion and personality change (8/9), paroxysmal disturbance of consciousness (6/9) and intermitant head discomfort (6/9). Other symptoms included cognitive dysfunction, limb weakness, limb sensory disturbance, bladder dysfunction, ataxia, seizures and psychiatric symptoms. Brain magnetic resonance imaging showed high signals along the corticomedullary junction on diffusion-weighted image in eight out of nine patients. Skin biopsied samples from nine patients demonstrated the presence of eosinophilic intranuclear inclusions (IIs), appearing in the nucleus of fibroblasts, fat cells and ductal epithelial cells of sweat glands on hematoxylin-eosin staining. IIs were positive on anti-p62 and anti-ubiquitin immunostaining. Electron microscopy indicated the IIs were composed of a pile of filament materials without membrane. Muscle biopsies from two patients showed no obvious neurogenic or myogenic pathologic changes, except in one patient several rimmed vacuoles fibers were found. In one patient sural nerve biopsy showed severe demyelinating pathological changes. No IIs were found in the muscles and peripheral nerve tissue either by histological examination or by immunohistochemical staining with anti-p62 or anti-ubiquitin, while IIs were found by immunofluorescence staining with both anti-p62 and anti-ubiquitin in three patient′s tissue. Conclusions:The phenotype of this NIID patient group is adult-onset NIID, with episodic encephalopathy as the main clinical manifestation. Skin biopsy has high pathological diagnostic value for NIID. The immunofluorescence staining with anti-p62 and anti-ubiquitin is easier to detect the presence of IIs than histological staining and immumohistochemical staining.
ABSTRACT
Objective To evaluate the effect of levamlodipine intervention in diabetic nephropathy patients which accompanied with hypertension, using the technology of diffusion-weighted imaging (DWI) of functional magnetic resonance (fMRI).Methods A controlled prospective method was taken , and fifty diabetic nephropathy ( phase III) patients which accompanied with hypertension were randomized assigned to two groups of A ( n =26) and B ( n =24).Levamlodipine (2.5 mg qd) was taken by patients of group A and amlodipine (5 mg qd) was taken by patients of group B for 24 weeks, respectively.Two groups both took angiotensinⅡreceptor blockers (ARBs) as the first line antithypertensive agents , their urinary albumin excretion rate (UAER), serum creatinine (sCr), cystatin C (Cys C) , and DWI scanning were detected before and after intervention .The levels of UAER, apparent diffusion coeffi-cient (ADC) value were compared between two groups before and after intervention .During the 24th week, two groups'adverse reac-tion to the medicines and the levels of blood pressure were recorded in each follow-up visit.Results The levels of UAER, systolic blood pressure(SBP), and diastolic blood pressure(DBP) were Significantly lower in group A after 24-week intervention compared to baseline [42.5 (25.3~91.0)μg/min vs 49.2(29.7~96.8)μg/min,(112.6 ±6.4)mmHg vs (135.3 ±7.6)mmHg, (71.4 ± 10.7)mmHg vs (80.3 ±11.6)mmHg, P 0.05).Group A had a better improvement of SBP (ΔSBP) and ADC (ΔADC) after inter-vention compared to group B ( P =0.02,0.01, respectively).The overall adverse reaction incidence was 15.4%(4/26) in group A and 41.7%(10/24)in group B, respectively (χ2 =4.27, P =0.0387).Conclusions For the diabetic nephropathy (phase III) pa-tients accompanied with hypertension , levamlodipine likely showed better effects on reducing comprehensive blood pressure and UAER , improving renal microcirculation , with less overall adverse reaction compared to amlodipine .
ABSTRACT
Objective To study risk factors for high-normal blood pressure (HNBP) in residents of urban Xuzhou, Jiangsu province, China. Methods A cross-sectional survey was conducted among 17 500 residents in urban area of Xuzhou from June to December 2008 by cluster sampling with self-designed questionnaire to collect their demographic information and measurements of body height, weight and blood pressure. Data were approached to univariate and multivariate non-conditional logistic regression analysis. Results In total, 17 306 residents finished the survey, with an overall response rate of 98.9percent. Results of univariate analysis revealed that 13 variables such as living region, sex, age,occupation, annual average family income, history of dyslipidemia, smoking, alcohol drinking, intake of pork, and vegetables, daily length of sleeping, body mass index (BMI), abdominal obesity, all were related to HNBP ( P ＜ 0. 05 ). Results of multivariate logistic regression analysis showed that living region, sex,age, annual average family income, alcohol drinking, intake of vegetable, BMI, abdominal obesity all associated with HNBP (P＜0. 05). Conclusions Older age, history of alcohol drinking, increased BMI,abdominal obesity all are risk factors to prompt occurrence of HNBP, and intake of large amount of vegetables is its protective factor.
ABSTRACT
Objective To explore the hypertensive vulnerability of residents living in Xuzhou City to provide evidence for effective intervention. Methods Based on multi-stage stratified randomized sampling methed,a total of 4980 residents aged 15 to 69 years from 9 counties of Xuzhou City were selected and completed a standard questionnaire. Hypertensive vulnerability was compared by using Chi-square test. Results The prevalence of hypertension was 13.62% among 15 to 69 years old participants. The residents who had no idea of normal level of blood pressure accounted for 45. 26%. The residents who thought it was unnecessary to measure blood pressure every year since 35 year-old accounted for 29. 68%. Those who did not know individual's salt intake per day accounted for 57. 23%. The participants who had no information on hypertension prevention or control accounted for 21.53% and 12. 05%, respectively. The higher hypertensive vulnerability was associated with lower educational level or monthly income per capita; higher hypertensive vulnerability of patients is less than normal crowed. The rates of current smoking, alcohol consumption,salt over-intake and non-blood pressure measurement were 16. 45%, 11.10% ,30. 00%, and 32. 05% respectively. The higher educational level, higher monthly income per capita or older age crowd ,the lower rate of non-blood pressure measurement, the higher rate of alcohol consumption ; salt over-intake was different in different education levels ( χ2 = 23.37, P＜0. 05 ) ; the older age group were in a higher proportion of current smokers;the behavior vulnerabilities were no difference between the patients and normal crowds. Conclusion Hypertensive vulnerability of residents living in Xuzhou City is high. Hypertension education and healthy living style should be improved to effectively prevent the development of hypertension.
ABSTRACT
Objective To investigate the molecular epidemiology of hepatitis B virus(HBV) in child carriers. Methods Blood samples were collected from children under 15 in Jiangsu and Zhejiang provinces. Enzyme immunoassay(EIA) and microparticle enzyme immunoassay(MEIA) were applied to screen hepatitis B surface antigen(HBsAg) positive children. Nested-PCR and real time PCR were used to amplify the HBV S gene and detected HBV DNA loads. S gene sequence and three-dimensional structure were analyzed by the DNASTAR and VMD1.8.6, respectively. SPSS 12.0 software was applied for data processing. Results A total of 64 HBsAg-positive cases were found in the screened children, from which 41 HBV S gene sequences were obtained. The average HBV DNA loads were(4.15±0.79)×10~7 copies/mL in 64 HBV carriers. Among 41 sequences. genotype C, B and B+C accounted for 82.93%(34/41), 12.19%(5/41)and 4.88%(2/41), respectively; and the serotypes were adr(34/39,87.18%), adw(4/39,10.24%) and ayr (1/39, 2.56%) with 2 strains unable to be sub-typed. The most common variants of "a" determinant in HBV S gene were 129 site Q→F(glutamine→phenylalanine), 145 site G→R(glycine→lysine), 131 site S→N(serine→asparagine)and 144 site C→A(cysteine→alanine), and the mutation frequencies were 12.20%(5/41), 4.88%(2/41), 2.27%(1/41)and 2.27%(1/41), respectively . The total mutation frequency was 21.95%(9/41). The S protein spatial structures of 129 site "Q→F" and 145 site "G→R" were entirely different from that of the wild strain. Conclusion Wild strain of HBV(C/adr) is predominant in the children HBV carriers, exhibiting a high replication, and the HBV vaccine should be still effective.
ABSTRACT
Objective To evaluate perception and awareness of disease knowledge in patients with chronic obstructive pulmonary disease (COPD) in rural area of Xuzhou City. Methods Perception and awareness of COPD, including its nature, control, medication use, impact on their quality of life, experience of its acute exacerbation, and so on, in 392 patients with COPD were evaluated with self-designed ad hoc questionnaire. Proportion and percentage were used in statistical analysis. Results According to the GLOD standards, 58 of 392 patients with COPD could be classified as stage Ⅰ (14. 8%), 164 as stage Ⅱ (41.8%), 103 as stage Ⅲ (26.3%) and 67 as stage Ⅳ (17.1%), respectively. Only 14 patients (3.6%) had heard COPD, but all of them did not know the definition of COPD and its acute exacerbation. Lung function tests and health education had never been performed for all these patients. One hundred and twenty-six patients (32. 1%) did not understand that smoking is a risk factor for COPD, 343 patients (87. 5%) had never heard that COPD could be prevented and controlled. Only 95 patients (24. 2%) did regular physical exercises. Seventy-six patients (19. 4%) in stable stage did not take theophylline regularly, and none of them took inhalers or nebulizer drugs regularly or temporally, or oxygen therapy and pulmonary rehabilitation at home. During acute exacerbation, 261 patients (66.6%) could take theophyUine or analogous drugs and antibiotics. One hundred and five patients (26. 8%) were admitted to hospital during the past year due to respiratory symptoms. Physical activities were restrained in 224 patients (57.1%), 91 patients (23. 2%) had a little bit feeling of depression sometimes and social communication was impacted in 232 patients (59. 2%). Conclusions Patients with COPD in rural Xuzhan, Jiangsu province were poor in knowledge of COPD, and their treatment during stable stage and acute exacerbation did not meet the standards. COPD had significant impact on their daily life, and education and management for the patients should be strengthened.
ABSTRACT
Objective To know social and demographic characteristics,behavioral characteristics,as well as knowledge-attitude-belief-practice(KABP) and its influential factors of rural community chronic obstructive pulmonary diseases(COPD) patients. Methods Cluster sampling all COPD patients of fangcun and mape township of tongshan county in 2007. A face-to-face interview was performed to investigate the COPD patients in their home,and t test,one-way analysis of variance and multiple linear regression were used to analyze the behavioral characteristics and K.ABE Results The main Patients were old person aged 60-80,with mean of(63 ± 15)years old. The active and passive smoking rate were 49.5% and 35.9%,respectively,and very significance between male and female Patients (X2 = 101. 365,P＜ 0. 05). 62. 9%abstained from smoking mainly owing to having COPD. About 31.9% of the patients had used the firewood and coal to cook for longer than 30 years. 24. 2% often built their body by exercise; however,only 8. 9%participated in convalescence. The mean KABP score of Patients was (38 ± 8). The Patients have lower knowledge to COPD, but give much more concerns to their own diseases. Univariate and multivariate analysis indicated that the main influential factors of COPD patients KABP were education, family attitude, income,sex and the distance between their homes and health stations. Conclusions Community COPD patients have high smoking rate,long firewood and coal cooking history,so active interventions should be took to those risk factors. KABP level of the COPD patients was not good, more health instructions including prevention,treatment and convalescing of COPD need to be gave to COPD patients.
ABSTRACT
BACKGROUND: Lung cancer keeps the first place in malignant tumor death all along. It is quite necessary to clarify the situation and tendency change of residents' lung cancer death for formulating prevention and cure strategy.OBJECTIVE: To investigate the lung cancer death characteristics, death trend and result out potential life loss of the residents in urban areas of Xuzhou.DESIGN: A retrospective descriptive epidemiology study.SETTING: Center for Disease Prevention and Control of Xuzhou.PARTICIPANTS: Totally 3 890 cases died of lung cancer between 1990 and 2003 in the urban areas of Xuzhou city. METHODS: Residents' lung cancer death characteristics and potential life span loss situation with parameters of crude death rate, standardized death rate, age specific death rate and potential life span loss and other indexes of the residents in the urban areas of Xuzhou city in 1990 and 2003were described.MAIN OUTCOME MEASURES: ①Crude death rate of lung cancer;②Potential life span loss; ③Life lost rate.RESULTS: ①During 14 years period , 3 890 cases of lung cancer death happened ,which accounted for 27.43% of total cases of malignant tumor death; ② year average death rate was 28.31/100 thousand, standardized death rate was 24.88/100 thousand, residents' potential life span loss caused by lung cancer death accounted for 24 230 people per year③ life decreasing rate was 1.19/1 000, standardized life decreasing rate was 1.45/1 000, each case of lung cancer death resulted in potential life loss of 6.23 years; males' death rate was higher than females'(x2=575.70,P ＜ 0.01), the ratio of male to female was 2.31:1. Age specific death rate of male and female after 20 years of age increased in an exponential manner.CONCLUSION: Lung cancer is the most serious malignant tumor that threatens the life health of residents in urban areas of Xuzhou city; the potential life span loss caused by lung cancer is very big. The amount of carcinogenic substances exposed in environments is closely related to the occurrence of lung cancer; therefore, prevention and control of lung cancer should be performed actively.
ABSTRACT
Objective To develop a hyperthermia temperature control system for the treatment of pelvic inflammatory disease. Methods Temperature was controlled by using PWM method based on a single chip computer. The system was heated by using heating wire. In the whole cycle of T, the heating wire's work time was divided into three different stages according to different temperature of system: in the lower temperature, the duty cycle of the heating wire's work time was 100%; when the system temperature entered to a certain stage, a control variable was obtained through the PID algorithm which was used to compare the difference between the current temperature and the temperature requirements. The control variable determined the duty cycle of the heating wire's work time: the more close to the temperature required for the temperature of system, the duty cycle of the heating wire's work time was more close to 0; if the temperature exceeded a predetermined value, then the heating wire would not heat in the whole cycle. Results The accuracy of the temperature control system was ?0.2 ℃, the overshoot of the temperature control system was ?0.3 ℃, and the response time of the temperature control system was 500 seconds. Conclusion The temperature control method has high precision, small overshoot, and the right response time, which can meet the requirements of constant temperature of hyperthermia treatment. Besides, it is simple and cheap.