3.Risk Factors, Clinical Features and Prognosis for Subtypes of Ischemic Stroke in a Chinese Population
Ya-Fu TAN ; Li-Xuan ZHAN ; Xiao-Hui CHEN ; Jian-Jun GUO ; Chao QIN ; En XU
Journal of Huazhong University of Science and Technology (Medical Sciences) 2018;38(2):296-303
It is unanimously accepted that stroke is a highly heterogeneous disorder.Different subtypes of ischemic stroke may have different risk factors,clinical features,and prognoses.The aim of this study was to evaluate the risk factors,clinical characteristics,and prognoses of different subtypes of ischemic stroke defined by the Trial of ORG10172 in Acute Stroke Treatment (TOAST) criteria.We prospectively analyzed the data from 530 consecutive patients who were admitted to our hospital with acute ischemic stroke within 7 days of stroke onset during the study period.Standardized data assessment was used and the cause of ischemic stroke was classified according to the TOAST criteria.Patients were followed up till 30 and 90 days after stroke onset.It was found that large-artery atherosclerosis was the most frequent etiology of stroke (37.4%),and showed the highest male preponderance,the highest prevalence of previous transient ischemic attack,and the longest hospital stay among all subtypes.Small artery disease (36.4%) was associated with higher body mass index,higher plasma triglycerides,and lower plasma high-density lipoprotein cholesterol than cardioembolism.Cardioembolism (7.7%),which was particularly common in the elderly (i.e.,individuals aged 65 years and older),showed the highest female preponderance,the highest prevalence of atrial fibrillation,the earliest presentation to hospital after stroke onset,the most severe symptoms on admission,the maximum complications associated with an adverse outcome,and the highest rate of stroke recurrence and mortality.Our results suggest that ischemic stroke should be regarded as a highly heterogeneous disorder.Studies involving risk factors,clinical features,and prognoses of ischemic stroke should differentiate between etiologic stroke subtypes.
4.Detection of plague IgM antibody in the serum of herding dogs by capture enzyme-linked immunosorbent assay
Xin-hui, WANG ; En-jie, XU ; Gang, LEI ; Li-fu, LIAO ; Turd, RENA ; Jie, TU ; Mattuhut ABULYMIT ; Bing, LI ; Bing-chen, XU
Chinese Journal of Endemiology 2012;31(6):681-683
Objective To establish a capture enzyme-linked immunosorbent assay (ELISA) for detection of plague IgM antibody in herding dogs.Methods ELISA plates were coated with serum IgM antibody against dogs and F1 antibody to plague in the serum of herding dogs was detected by a sandwich ELISA.Results A total of 216 serum samples of herding dogs were tested,26 were positive for plague F1 antibody and the positive rate was 12.03% (26/216); 14 were positive for plague IgM antibody and the positive rate was 6.48% (14/216); IgM positive accounted for 53.8%(14/26) of all positive samples.Conclusions Serum plague IgM antibody of herding dogs can be used to predict the prevalent time and distribution of recent animal plague in plague foci indirectly,and to provide reference information for timely implementation of control measures.
5.A study on the awareness of influenza and pneumonia and thewillingness of vaccination among chronic disease patients
Yi-Juan CHEN ; En-Fu CHEN ; Ben HE ; Hui-Juan GAO ; Qing LI ; Zi-Ping MIAO
Journal of Preventive Medicine 2017;29(4):334-337
Objective To provide evidence for effective implementation of influenza and pneumonia immune strategies, we investigated the awareness of influenza and pneumonia and the willingness of vaccination among chronic disease patients.Methods A stratified multistage cluster sampling method was used to investigate 720 patients less than 75 years of age.Results Overall, 717 completed responses were received.The awareness rates of influenza and pneumonia diseases were 59.83% and 59.55%, respectively.However, the awareness rates of influenza and pneumonia vaccine were 17.71% and 6.00%, respectively.The vaccination rate of influenza vaccine was 1.26% while no patients received pneumonia vaccination.Among those not vaccinated the most frequent reasons for not receiving the vaccine included "Believed oneself unlikely to be infected with influenza/pneumonia" and "No recommendation has been received for influenza/pneumonia vaccination".The influence on recommendations by doctors at vaccine clinic and by general practitioner had no significant statistical difference (P>0.05).Conclusion The main reasons for such low awareness and willingness may be due to their poorly knowledge on the risk of influenza/pneumonia diseases, and related vaccines.Health education and intervention should be taken to heighten the vaccination rates of influenza/pneumonia vaccines.
6.Acceleration of wound healing by a porous collagen/silk fibroin scaffold carrying zinc oxide nanoparticles
Qing LI ; Ren-Fu QUAN ; Li-Hong CHEN ; Li-Hong HE ; En-Liang CHEN ; Hua-Hui HU ; Xuan ZHENG
Chinese Journal of Tissue Engineering Research 2018;22(14):2157-2161
BACKGROUND:Anti-infective ability determine the success or failure of skin grafting. It is one of the commonly used methods to enhance the anti-infective ability of implants by compounding antibacterial materials with scaffolds. OBJECTIVE:To investigate the effect of porous collagen/silk fibroin scaffolds carrying zinc oxide nanoparticles against infection and inflammation, and to evaluate its effect on wound healing. METHODS:Thirty-two Sprague-Dawley rats with a full-thickness wound on the back skin were randomly divided into two groups. In experimental groiup, porous collagen/silk fibroin scaffolds containing zinc oxide nanoparticles were implanted, while only collagen/silk fibroin scaffolds were implanted in control group. Wound healing was compared between the two groups by measuring residual wound area at 1, 2, 4, 8 weeks post implantation. Hematoxylin-eosin and interleukin 6 immumohistochemical staining were performed at 1, 2, 4 weeks post implantation to observe wound morphology and inflammatory reactions. Meanwhile, expression of interleukin 6 and interleukin 1β was detected by real-time PCR. RESULTS AND CONCLUSION:(1) At 2, 4, 8 weeks post implantation, significantly increased healing rate was observed in the experiment group compared with the control group (P<0.05). (2) Findings from the hematoxylin-eosin staining showed that obvious inflammatory cell infiltration was observed in the control group, but less inflammation with vigorous growth of granulation tissues on the wound surface occurred in the experimental group at 1 week after implantation. Then, the wound repair was basically completed in the experimental group presenting with complete and compact epidermal tissue structure, while scar formation with no skin cover was found in the control group at 4 weeks after implantation. (3) Findings from the interleukin 6 immumohistochemical staining showed that there was interleukin 6 positive expression in both two groups to different extents; at 4 weeks after implantation, the expression of interleukin 6 was remarkably reduced in the control group, but it was still a strong positive expression, while week positive expression of interleukin 6 was observed in the experimental group. (4) Compared with the control group, the mRNA expression of interleukin 6 and interleukin 1β was both lower in the experimental group at 1, 2, 4 weeks after implantation, but there was a significant difference between the two groups at 1 and 2 weeks after implantation (P<0.05). Overall, the porous collagen/silk fibroin scaffold carrying zinc oxide nanoparticles can effectively reduce inflammations following skin injury, and accelerate skin wound healing.
7.Clinicopathologic features of aggressive natural killer cell leukemia.
En-bin LIU ; Hui-shu CHEN ; Pei-hong ZHANG ; Zhan-qi LI ; Qi SUN ; Qing-ying YANG ; Li-huan FANG ; Fu-jun SUN
Chinese Journal of Pathology 2011;40(12):810-814
OBJECTIVETo study the clinicopathologic features of aggressive natural killer cell leukemia (ANKL).
METHODSThe clinical and pathologic features were analyzed in 10 patients with ANKL. The complete blood count, peripheral blood smears, bone marrow aspirates and bone marrow biopsies were studied. Immunophenotypic analysis was carried out by flow cytometry and immunohistochemistry. T-cell receptor (TCR) γ gene rearrangement was studied by PCR method.
RESULTSThe most frequent hematologic abnormalities observed were anemia (7 cases) and thrombocytopenia (9 cases). Large granular lymphocytes were found on peripheral blood smears of 6 patients. In bone marrow aspirates, lymphocytosis (> 20.0%) was demonstrated in 8 cases and large granular lymphocytes in 6 cases. Bone marrow biopsies revealed various degrees of neoplastic infiltration, as follows: mild (5 cases), moderate (3 cases) and severe (2 cases). The neoplastic cells were mainly interstitial in distribution in 8 cases and diffuse in 2 cases. Hemophagocytosis was observed in 4 cases. Flow cytometry showed CD2+ sCD3- CD4- CD56+ CD57- in all cases, CD7+ in 9 cases, CD16+ in 5 cases, CD8+ in 4 cases and CD5+ in 1 case. Immunohistochemistry performed in 8 cases showed the following results: cCD3+ in 4 cases, CD56+ in 6 cases, TIA-1+ in 6 cases, granzyme B+ in 4 cases and perforin+ in 2 cases. PCR study revealed germline TCRγ gene configuration in all cases.
CONCLUSIONSANKL is a highly aggressive NK cell-derived lymphoid neoplasm. Comprehensive morphologic, immunophenotypic and molecular analysis are essential in arriving at a correct diagnosis. ANKL needs to be distinguished from other types of NK-cell and T-cell lymphomas.
Adolescent ; Adult ; Bone Marrow ; pathology ; CD3 Complex ; metabolism ; CD56 Antigen ; metabolism ; Child ; Female ; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor ; Humans ; Immunophenotyping ; Leukemia, Large Granular Lymphocytic ; drug therapy ; genetics ; metabolism ; pathology ; Lymphocytosis ; Male ; Middle Aged ; Poly(A)-Binding Proteins ; metabolism ; Recurrence ; Retrospective Studies ; Survival Rate ; T-Cell Intracellular Antigen-1 ; Young Adult
8.A survey of Japanese encephalitis antibody migrant workers in Shenzhen 2009.
Fu-xiang SHAN ; Jin-quan CHENG ; Jin MOU ; Shi-ying ZHANG ; Ya-qing HE ; Jin-hui XIAO ; Ying-jian CHEN ; Wen-guang HUANG ; Liang-en XIONG
Chinese Journal of Preventive Medicine 2010;44(9):806-809
OBJECTIVETo understand the immunological status of Japanese encephalitis (JE) antibodies amongst migrant workers and to provide epidemiological basis for public health strategies on JE prevention and control in Shenzhen.
METHODSA multi-stage random sampling method was used, and 1003 migrant workers aged 18 to 60 from 44 factories were investigated and their serum specimens were collected. The enzyme-linked immunosorbent assay (ELISA) was used to detect JE antibodies qualitatively.
RESULTSThe gross IgG seroprevalence rate for JE was 20.2% (203/1003). Sex-specified seroprevalence was 21.2% (103/485) for male and 19.3% (100/518) for female, respectively (χ(2) = 579, P > 0.05). Age-specific seropositive rates were 22.6% (12/53) for those below 20 years old, 18.7% (120/642) for those between 20-years old, 26.0% (58/223) for those between 30-years old and 15.3% (13/85) for those on or above 40 years old (χ(2) = 7.96, P > 0.05). Proportions for self-reported positive immunization, non-immunization and unclear immunization history were 22.1% (30/136), 22.1% (51/231) and 19.2% (122/636), respectively (χ(2) = 501, P > 0.05). Seroprevalence by region of origins showed that workers from Guangdong province was the highest (30.5%, 50/164), followed by workers from Guangxi (29.7%, 22/74) whilst workers from Shan(3)xi (5.4%, 2/37) had the lowest rate. Seroprevalence rate for managers (29.0%, 31/107) was higher than that of technicians (7.1%, 1/14) (χ(2) = 21.78, P < 0.05). Serological positive rate of workers with university or above educational background was the highest (32.7%, 16/49), followed by that for individuals with college degree (10.3%, 10/97) (χ(2) = 13.02, P < 0.05).
CONCLUSIONNo associations are detected between JE seroprevalence and age, or sex, or self-reported immunization histories amongst migrant labor workers in Shenzhen. However, correlations between JE serological positive rate and region of origins, occupation and educational attainment are found to be significant. The gross seroprevalence of JE antibodies suggests that the level of JE antibodies amongst Shenzhen migrant workers is low and the population immunity barrier has yet to be established. It is necessary to strengthen prevention and control strategies of JE among labor workers of Shenzhen.
Adolescent ; Adult ; Antibodies, Viral ; blood ; China ; epidemiology ; Encephalitis, Japanese ; epidemiology ; prevention & control ; Female ; Humans ; Japanese Encephalitis Vaccines ; administration & dosage ; Male ; Middle Aged ; Transients and Migrants ; statistics & numerical data ; Young Adult
9.Clinicopathologic study of 15 splenectomy specimens of patients with hairy cell leukemia.
Zhan-qi LI ; Hui-shu CHEN ; En-bin LIU ; Qi SUN ; Li-huan FANG ; Fu-jun SUN ; Pei-hong ZHANG ; Qing-ying YANG ; Lu-gui QIU
Chinese Journal of Pathology 2009;38(11):769-773
OBJECTIVETo investigate the clinicopathologic features, diagnosis, differential diagnosis and the prognosis of hairy cell leukemia (HCL).
METHODSFifteen splenectomy specimens of HCL patients were investigated retrospectively using HE and immunohistochemistry in correlation with the follow-up information.
RESULTS(1) The male to female ratio was 2.75:1, age ranged from 36 to 68 years with a median of 47 years. The most consistent clinical feature at presentation was marked splenomegaly (100%). Other symptoms included anemia (80.0%), thrombocytopenia (60.0%), leucocytosis (53.3%), pancytopenia (20.0%) and the absence of B-symptom. (2) The proportion of hairy cells was (14.6 +/- 7.2)% in periphery blood and (47.3 +/- 23.8)% in bone marrow. The positive rate of TRAP assay was 62.5% in bone marrow; 85.7% for TPA test and the detection rate for RLC was 25% by transmission electric microscopy. The frequency of bone marrow involvement was 100%. (3) The average weight of 15 spleens was (3012 +/- 1974) g. The size of 6 spleens ranged from 16 cm x 10 cm x 5 cm to 32 cm x 20 cm x 14 cm. The white pulp of spleen showed a characteristic atrophy feature or even absent due to leukemic infiltration, predominantly involving the red pulp with some sinusoidal pattern. "Blood pool" change was an infrequent feature (3/15 cases). The nuclei of leukemic cells were round (13 cases) or bean-shaped (2 cases), nucleoli inconspicuous or disappeared. The abundant cytoplasm and prominent cell border resulted in a "fried egg" appearance. By immunohistochemistry, leukemic cells were positive for CD45RA, CD20, PAX-5, CD25, CD11c, Annexin A1 and cyclinD1, but negative for CD3 and CD43. (4) 13 cases (86.7%) have been followed-up and all are alive. Among them, 9 cases are living well more than 5 years and 7 more than 10 years.
CONCLUSIONSSplenomegaly is frequently the first manifestation of patients with HCL and occurred predominantly in the middle to elderly adults. Definite diagnosis of HCL requires a combined histological and immunohistochemical assessment of the splenectomy specimen, bone marrow biopsy and aspirate.
Adult ; Aged ; Annexin A1 ; metabolism ; Antigens, CD20 ; metabolism ; CD11c Antigen ; metabolism ; CD79 Antigens ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Ki-67 Antigen ; metabolism ; Leukemia, Hairy Cell ; metabolism ; pathology ; surgery ; Leukemia, Lymphocytic, Chronic, B-Cell ; metabolism ; pathology ; Leukemia, Prolymphocytic ; metabolism ; pathology ; Leukocyte Common Antigens ; metabolism ; Lymphoma, B-Cell, Marginal Zone ; metabolism ; pathology ; Lymphoma, Follicular ; metabolism ; pathology ; Lymphoma, Mantle-Cell ; metabolism ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Spleen ; pathology ; Splenectomy ; Survival Rate
10.Hematopathologic features of T-cell large granular lymphocytic leukemia.
En-bin LIU ; Hui-shu CHEN ; Pei-hong ZHANG ; Zhan-qi LI ; Qi SUN ; Qing-ying YANG ; Li-huan FANG ; Fu-jun SUN
Chinese Journal of Pathology 2012;41(4):229-233
OBJECTIVETo explore the hematopathologic features of T-cell large granular lymphocytic leukemia (T-LGLL).
METHODSA retrospective analysis of the clinical presentation, bone marrow morphology, immunophenotyping and T-cell receptor gene rearrangement status were performed in 19 patients with T-LGLL.
RESULTSOf 19 patients, the most frequent hematological abnormalities were anemia and neutropenia (16/19 and 17/19 patients, respectively). Large granular lymphocytes (LGLs) were observed in 17 of 19 peripheral blood smears and 15 of 19 bone marrow aspirate specimens. Lymphocytosis (> 0.2) was present in 17 of 19 patients in their bone marrow aspirate specimens. Bone marrow biopsy specimens revealed lymphocytosis in 16 cases, with a mild to moderate increase of lymphocytes observed in 12 cases (12/16). The pattern of lymphoid distribution was interstitial in bone marrow sections. Intravascular distribution was seen in 8 cases. Lymphoid nodules were present in 4 cases. Flow cytometery showed an immunophenotype of CD3(+) CD4(-) CD8(+) CD56(-) CD57(+) of the tumor cells in 13 cases. Of the other 6 cases, the immunophenotypes included CD8(-) (1 case), CD56(+) (2 cases) and CD57(-) (3 cases). Immunohistochemistry showed CD3+ (10/10), CD57+ (3/3), CD8+ (6/7), TIA-1+ (6/7), granzyme B+ (4/7), perforin + (1/7), CD4- (4/4) and CD56- (9/9). Clonal T-cell receptor γ gene rearrangement by PCR was detected in 12 cases (12/17).
CONCLUSIONSHematopathologic features of most T-LGLL are distinct. Morphologic, immunophenotypic and molecular analysis of both peripheral blood and bone marrow specimens are essential and complementary in the diagnosis and differential diagnosis of T-LGLL.
Adult ; Aged ; Anemia ; metabolism ; pathology ; Bone Marrow ; pathology ; CD3 Complex ; metabolism ; CD57 Antigens ; metabolism ; CD8 Antigens ; metabolism ; Diagnosis, Differential ; Female ; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor ; Granzymes ; metabolism ; Humans ; Immunophenotyping ; Leukemia, Large Granular Lymphocytic ; metabolism ; pathology ; Lymphocytosis ; metabolism ; pathology ; Male ; Middle Aged ; Neutropenia ; metabolism ; pathology ; Poly(A)-Binding Proteins ; metabolism ; Retrospective Studies ; T-Cell Intracellular Antigen-1