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25 August 2018, Volume 17 Issue 04 Previous Issue    Next Issue

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Motor evoked potentials for the differential diagnosis of idiopathic Parkinson's disease and multiple system atrophy ZOU Yang, CUI Hailun, HU Yongbo, GAO Ying, ZHANG Yueqi, CHEN Shengdi, WANG Gang 2018, 17 (04):  409-413.  DOI: 10.16150/j.1671-2870.2018.04.010 Abstract ( 322 )   PDF (581KB) ( 63 )   Objective: To investigate the difference in motor evoked potentials (MEP) between idiopathic Parkinson's disease (PD) and multiple system atrophy (MSA), analyze its value for the differential diagnosis of PD and MSA. Methods: Single-pulse transcranial magnetic stimulation (sTMS)-MEP examination was performed in 12 patients with MSA and 12 sex and age matched idiopathic PD patients. MEP parameters were compared between the two groups of patients. Receiver operating characteristic curve was used to screen the parameters suitable for differential diagnosis. Results: The differences of motor threshold, MEP amplitude and central motor conduction time (CMCT) between idiopathic PD and MSA patients were not statistically significant(P>0.05). The waveform of MEP differed significantly between idiopathic PD and MSA patients (P<0.01). The MEP duration showed a trend of prolonging in MSA patients than in idiopathic PD patients, but was not statistically significant (P>0.05). Conclusions: Both duration and waveform of MEP may help the differential diagnosis of MSA from idiopathic PD. References | Related Articles | Metrics

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Comparative analysis of 2005 and 2017 version of diagnostic criteria for dementia with Lewy bodies MENG Jie, CUI Shishuang, MENG Yunxia, WANG Gang 2018, 17 (04):  414-418.  DOI: 10.16150/j.1671-2870.2018.04.011 Abstract ( 420 )   PDF (589KB) ( 108 )   Objective: To understand and study the diagnostic criteria, treatment and prognosis of 2017 version of guideline for dementia with Lewy bodies (DLB) to elevate the understanding and recognition of DLB for having more patients to be diagnosed at early stage to receive whole-course management and comprehensive treatment. Methods: The clinical characteristics and treatment of 30 patients who met the 2005 version of diagnostic criteria for DLB were retrospectively analyzed and were diagnosed again using the 2017 version of diagnostic criteria for DLB. Results: According to the 2017 version of diagnostic criteria for DLB, 27 cases were diagnosed as probable DLB, 3 cases were diagnosed as possible DLB. There were 29 cases（96.7%） with Parkinson's syndrome, 16 cases（53.3%） with fluctuating cognitive impairment, 25 cases （83.3%） with visual hallucinations, 11 cases（36.7%） with REM sleep behavior disorder. There were 21 cases （70%） initiated with Parkinson's syndrome and 9 cases（30%）initiated with cognitive impairment and visual hallucinations. Conclusions: The 2017 version of diagnostic criteria for DLB increases the weight of REM sleep behavior disorder（polysomnographic abnormality） and abnormal 123iodine-MIBG myocardial scintigraphy, providing objective basis for the early recognition and diagnosis of DLB, and is beneficial for patients to receive early management and comprehensive treatment, thereby improving the prognosis of the disease. References | Related Articles | Metrics

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Correlation between lymphocyte G-protein-coupled receptor kinase-5 level and cognitive impairment in patients with Alzheimer′s disease SUN Jialan, HUANG Shu, LAI Xiaoyin, ZHU Wei, HU Rongguo, LI Longxuan 2018, 17 (04):  419-422.  DOI: 10.16150/j.1671-2870.2018.04.012 Abstract ( 254 )   PDF (506KB) ( 53 )   Objective: To investigate the correlation between G protein-coupled receptor kinase-5 (GRK5) level in peripheral lymphocytes and the degree of cognitive impairment in Alzheimer's disease(AD) patients. Methods: A total of 64 patients with AD during January 2015 to December 2017 were enrolled and divided into two groups, including 27 cases of mild dementia and 37 cases of moderate-to-severe dementia; 30 healthy subjects were served as controls. Enzyme-linked immunosorbent assay(ELISA) was used to detect the GRK5 level in peripheral lymphocytes of AD patients and controls. Results: The GRK5 level in mild and moderate-to-severe AD patients was significantly lower than that in controls (P<0.001). Moreover, the GRK5 level in moderate-to-severe AD patients was significantly lower than that in the mild AD patients (P<0.001). Linear regression analyses revealed a strong positive correlation between the GRK5 level and the Mini Mental State Examination (MMSE) score (P<0.001). Conclusions: Our data suggestes that low level of GRK5 is existed in AD patients and mirrored the impairment of cognitive state. GRK5 level of peripheral blood lymphocytes might be used as a novel biomarker for the early diagnosis of AD patients. References | Related Articles | Metrics

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Validation of mSORE score for predicting poor outcome in acute ischemic stroke JI Haifeng, YANG Xuelian, YAO Yulan, CAI Liying, LAI Xiaoyin, WU Dayu, XU Yumei, JIANG Mei 2018, 17 (04):  423-427.  DOI: 10.16150/j.1671-2870.2018.04.013 Abstract ( 325 )   PDF (521KB) ( 63 )   Objective: To explore the value of mSOAR score for predicting the occurrence of adverse prognostic events at discharge in patients with acute ischemic stroke (AIS). Methods: From October 2014 to December 2017, a total of 1 461 AIS patients hospitalized in Neurology Department and Emergency Department of our hospital were enrolled. Related baseline data including age, gender were recorded and Oxfordshire Community Stroke Project (OCSP) classification, pre-stroke modified Rankin scale (mRS) score, and National Institute of Health Stroke Scale (NIHSS) score as well as the mSOAR score were assessed at admission. The adverse prognostic events were defined as death or poor functional outcome with modified Rankin Scale (≥4) when patients were discharged. Results: Of all the subjects, 382 cases(26.1%) had adverse prognostic events at discharge. Between points 1-6, a one-point increase in mSOAR score resulted in a signi-ficant increase in risk of poor prognosis at discharge (P<0.001), and the risk of poor prognosis at discharge between 0-3 and 4-8 in mSOAR score was significantly different (P<0.001). The risk of poor prognosis at discharge was predicted and the AUC value for the mSOAR score was 0.868 (95% CI 0.844-0.891). Conclusions: mSOAR score has a strong ability for predicting the risk of adverse prognostic events at discharge in patients with acute ischemic stroke. References | Related Articles | Metrics

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Use of combined detection of serum OPN and TPS in diagnosis of gastric cancer ZHANG Hua, LI Yongxing, LE Yan, WANG Wenyu, XIANG Mingjie 2018, 17 (04):  428-432.  DOI: 10.16150/j.1671-2870.2018.04.014 Abstract ( 229 )   PDF (550KB) ( 70 )   Objective: To assess the diagnostic value of combined detection of serum osteopontin (OPN) and tissue polypeptide specific antigen (TPS) in patients with gastric cancer (GC). Methods: Seventy patients with GC, 70 patients with superficial gastritis (SG) and 76 patients with atrophic gastritis (AG) were enrolled, and all these patients were pathologically confirmed; 50 healthy volunteers were served as controls. Serum OPN and TPS were detected by enzyme-linked immunosorbent assay (ELISA). The diagnostic value of OPN, TPS and CEA alone and in combination for GC were evalua-ted via sensitivity and specificity. Results: Serum levels of OPN and TPS were significantly increased (P<0.05) in GC patients than those in AG and SG patients and healthy controls. There was no significant difference (P>0.05) betweenserum levels of OPN and TPSin AG and SG patients and in healthy controls. The serum level of OPN in patients with GC on Ⅲ-Ⅳ stage was higher than that in patients on Ⅰ-Ⅱ stage (P<0.05). The serum level of OPN in GC patients with lymph node metastasis was higher than that in patients without lymph node metastasis (P<0.05). The serum level of TPS in patients with GC on Ⅲ-Ⅳ stage was lower than that in patients on Ⅰ-Ⅱ (P<0.05), and the serum level of TPS in GC patients with lymph node metastasis was lower than that in patients without lymph node metastasis (P<0.05). The area under the ROC (receiver operating characteristic) curve of combined detection of OPN, TPS and CEA was 0.849, the sensitivity was 71.4% and the specificity was 81.9% when the Youden Index was 53.3%. Conclusions: Combined detection of OPN, TPS and CEA may be useful in the differential diagnosis of GC and benign gastric diseases. References | Related Articles | Metrics

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Diagnostic value and clinical significance of anti-GP2 and anti-CUZD1 antibodies in Crohn's disease ZENG Junxiang, LUO Ting, GE Wensong, PAN Xiujun, SHEN Lisong 2018, 17 (04):  433-438.  DOI: 10.16150/j.1671-2870.2018.04.015 Abstract ( 376 )   PDF (692KB) ( 66 )   Objective: To investigate the diagnostic value and clinical significance of anti-zymogen granule membrane glycoprotein 2 antibody（GP2） and anti-CUB and zonapellucida-like domains-containing protein 1 antibody（CUZD1） in patients with Crohn's disease (CD）. Methods: A total of 128 CD patients, 82 ulcerative colitis (UC) patients and 60 healthy controls were enrolled. Serum anti-GP2 and anti-CUZD1 antibodies were detected by indirect immunofluorescence assay (IIF). Receiver operator characteristic curve (ROC) was used to evaluate the diagnostic efficiency of anti-GP2 and anti-CUZD1 antibodies in single and combining form. The correlation between the two antibodies and clinical characteristics were analyzed by Logistic regression. Results: ① The positive rates of serum anti-GP2 antibodies in CD, UC and health control groups were 45.3%, 11.0%, 0%, respectively. There was significant difference between CD and UC groups（ χ2=27.12, P<0.01）and between CD and health control groups （ χ2=39.32, P<0.01）. Positive rates of serum anti-CUZD1 antibodies in CD, UC and health control groups were 19.5%, 14.6%, 0%, respectively. There was significant difference between CD and health control groups（ χ2=13.52, P<0.01）, but no significant differences was found between CD and UC groups （ χ2=0.83, P=0.36）. ② The sensitivity of anti-GP2 antibodies was 45.3%, the specificity was 93.7% and the area under ROC curve (AUC）was 0.695; the sensitivity of anti-CUZD1 antibodies was 19.5%, the specificity was 91.5% and AUC was 0.555. The diagnostic value of combined anti-GP2 and anti-CUZD1 antibodies was significantly higher than one of them only (Z=4.44, 2.57, respectively, all P<0.01）. ③ Multiple linear regression analysis indicated a positive correlation between anti-GP2 antibody and the perianal, penetrated and ileocolon form of CD（P<0.05）; and anti-CUZD1 antibody was associated with stenosis and terminal ileum form of CD（P<0.05）. Conclusions: Anti-GP2 and anti-CUZD1 antibodies are potential biomarker for the diagnosis of CD. The combination of anti-GP2 and anti-CUZD1 antibodies have higher diagnostic value than one of them only, and could be used to stratify CD patients phenotypically for providing references to establish specific therapeutic strategies. References | Related Articles | Metrics

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The abnormal percentage of bone marrow macrophages and its clinical significances in myelodysplastic syndromes SONG Dandan, CHANG Chunkang, GUO Juan, XU Feng, ZHAO Youshan, WU Lingyun 2018, 17 (04):  439-443.  DOI: 10.16150/j.1671-2870.2018.04.016 Abstract ( 513 )   PDF (478KB) ( 75 )   Objective: To investigate the percentage of bone marrow macrophages and its correlations with IPSS (international prognostic scoring system) score and percentage of bone marrow CD34+ cells in patients with myelodysplastic syndromes (MDS). Methods: The percentages of bone marrow macrophages were detected by flow cytometry using CD14 and CD68 labeling and the activation of Th cells was detected by flow cytometry using CD3, CD8, IFN-γ, IL-4 labeling. Results: ① Low-risk MDS demonstrated increased percentage of macrophages (1.56%±0.22%) in bone marrow compared to patients with high-risk MDS (0.20%±0.07%) (P<0.001) and controls (0.62%±0.09%) (P<0.001). ② The percentage of bone marrow macrophages was correlated positively with the proportion of Th1 cells (r=0.434, P<0.01). ③ The percentage of bone marrow macrophages was correlated negatively with IPSS score (r=-0.532, P<0.001), percentage of bone marrow myeloblast cells (r=-0.457, P<0.01), peripheral blood hemoglobin concentration (r=-0.398, P<0.01) and percentage of bone marrow CD34+ cells (r=-0.324, P<0.05). Conclusions: The increased percentage of bone marrow macrophages may contribute to the abnormal activation of Th1 cells in low-risk MDS. Detecting the percentage of macrophage may be helpful in evaluating the prognosis of MDS. References | Related Articles | Metrics

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Correlation of subclinical hypothyroidism with carotid intima media thickness in Chinese population XUAN Liping, HOU Yanan, PENG Kui, ZHAO Zhiyun, LI Mian, CHEN Yuhong, DAI Meng, XU Min, BI Yufang, WANG Weiqing, ZHANG Di, XU Jiji 2018, 17 (04):  444-448.  DOI: 10.16150/j.1671-2870.2018.04.017 Abstract ( 296 )   PDF (496KB) ( 42 )   Objective: Studies showed that subclinical hypothyroidism(SCH) was associated with an elevated risk of atherosclerotic cardiovascular disease.This community-based cross-section study aimed to investigate the correlation of SCH and thyroid stimulating hormone(TSH) with carotid intima media thickness(CIMT). Methods: A total of 6 256 Chinese adults (aged≥40 years) with normal thyroid hormone level were enrolled, and standard questionnaire was performed as well as the measurement of anthropometric data and biochemical evaluation. Serum free triiodothyronine(FT3), free thyroxine (FT4), and TSH were determined by chemiluminescent immunoassay, while CIMT was measured by a high-resolution B-mode tomographic ultrasound system. Subjects with TSH>4.94 μIU/L and normal FT4 level were diagnosed as SCH and the others served as controls. Correlations of SCH and TSH level with CIMT were analyzed. Results: There were 458 cases of SCH, 5 798 cases with normal thyroid function, and 2 082 subjects having elevated CIMT. Compared with subjects with normal thyroid function,those with SCH had thicker CIMT [(0.73±0.007) mm vs(0.71±0.001) mm, P=0.003]. Multiple linear regression analysis showed that Log10-TSH was positively correlated with CIMT (β=0.02, P= 0.01). Adjusted logistic regression analysis revealed that SCH was associated with risk of elevated CIMT [odds ratio (OR)=1.28, 95% confidence interval (CI)=1.03-1.61, P=0.03)]. Conclusions: For middle aged and elderly population with normal thyroid function in Shanghai, prevalence of SCH was 7.3%, and subjects with elevated CIMT account for 34.6%. TSH is positively correlated with CIMT in middle-aged and elderly Chinese subjects, and SCH is the independent risk factor for elevated CIMT. References | Related Articles | Metrics

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The predictive value of IgG anti-A/B titer score on severity of hemolytic disease of newborn TANG Weixian, JIN Sha, ZHENG Jiewei, YE Zhen, LIU Xi, SHEN Wei 2018, 17 (04):  449-452.  DOI: 10.16150/j.1671-2870.2018.04.018 Abstract ( 295 )   PDF (455KB) ( 77 )   Objective: To study the correlation of IgG anti-A/B titer score and the severity of hemolytic disease of newborn. Methods: The red blood cell count, hemoglobin and hematocrit value of 27 newborn with hemolytic disease and the IgG anti-A/B titer and titer score of their mother were measured and their correlations were analyzed. Results: With the increase in IgG anti-A/B titer and titer score of mother, the red blood cell count, hemoglobin and hematocrit values of newborn with hemolytic disease decreased. At the same IgG anti-A/B titer, the higher the titer score, the lower the red blood count, hemoglobin and hematocrit value were. Conclusions: According to the correlation analysis, the titer score is more closely related to the severity of hemolytic disease of newborn. For hemoglobin, the correlation coefficient was -0.966. The IgG anti-A/B titer score was of more clinical significance in predicting the severity of hemolytic disease in newborn. References | Related Articles | Metrics

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Level of programmed cell death factor 5 in patients with active rheumatoid arthritis YUAN Yiwei, GU Juanfang, FEI Zhangli, YANG Mingfeng, WANG Yiwen, WANG Hongzhi 2018, 17 (04):  453-456.  DOI: 10.16150/j.1671-2870.2018.04.019 Abstract ( 391 )   PDF (435KB) ( 43 )   Objective: To investigate the expression of programmed cell death factor 5 ( PDCD5) in patients with rheumatoid arthritis (RA) and to explore its potential role in the pathogenesis of RA. Methods: A total of 36 patients with RA and 35 patients with osteoarthritis (OA) were enrolled, and 33 healthy people were served as controls. PDCD5 and IL-6 levels in serum as well as the levels in synovial fluid were measured by enzyme-linked immunosorbent assay (ELISA). Indices including C reaction protein (CRP), erythrocyte sedimentation rate(ESR), rheumatoid factor(RF）and cyclic citrullinated protein (CCP）were also detected, while count of swollen joints (SJC) and count of tender joints (TJC) served as reference of disease activity were recorded. Results: Compared with OA patients and controls, RA patients had a higher serum level of PDCD5 [（32.47±12.79） ng/mL vs （12.79±9.84） ng/mL in OA and (18.40±18.97） ng/mL in controls]. PDCD5 levels in synovial fluid of RA patients were also higher than those of OA patients. Furthermore, serum level of PDCD5 in RA patients was negatively correlated with IL-6 level in serum, however, no correlation was observed in synovial fluid. Pearson analysis showed that serum PDCD5 level in RA was negatively correlated with CRP, ESR, TJC and SJC (R=-0.523, -0.701, -0.845, -0.943, respectively), but had no correlation with RF and CCP. Conclusions: Serum and synovial levels of PDCD5 could reflect the activity of RA, and its abnormal expression may be associated with level of IL-6. References | Related Articles | Metrics