A serological mass survey was carried out in Wuzhou City in 1980, 1,136 IgA/VCA-positive persons being followed up for 4 years. Altogether 35 NPC cases were detected, of which 15 (43%) were in stage I and 17 (48.5%) in stage II, early cases (I + II) thus amounting to 91.5%. The detection rate of early cases was 2.9 times higher than in our outpatient clinic. IgA/VCA antibody could be detected 16-41 months prior to clinical diagnosis of NPC. We conclude that, if IgA/VCA-positive individuals are examined routinely once a year, NPC can be detected in the early stages of evolution. The annual detection rate of NPC in IgA/VCA antibody-positive individuals was 31.7 times higher than that of the annual incidence of NPC in the general population in the same age group, while during the 4-year follow-up period the incidence was 7.5 times higher than in the general population for the same age group. These results further indicate that EB virus plays an important role in the development of NPC, and that serological screening and follow-up studies are valuable for the early detection of NPC.
Background: The diagnostic value of serum specific Immunoglobulin E (sIgE) and nasal allergen provocation test (NAPT) has been well investigated in local allergic rhinitis (LAR). We hypothesized that nasal local sIgE could be used for the diagnosis of LAR instead of NAPT. Methods: This was a prospective single center study. Overall, 212 chronic rhinitis patients were screened, of whom 73 were recruited based on negative findings for serum IgE and positive findings for local eosinophils. Ten healthy subjects were also recruited as controls. All participants completed questionnaires at recruitment to record their demographic data, nasal symptom severity, and physician-diagnosed comorbid asthma. Symptom severity was recorded using a visual analogue scale (VAS) of 10 cm and allergic status was assessed by serum sIgE. Nasal secretions were collected for analysis of local sIgE and eosinophils, and NAPT was performed for confirmation of LAR. Results: Overall, 14 patients demonstrated positive local sIgE results. Twelve of these patients had significantly higher local sIgE levels compared to controls, and also demonstrated positive NAPT results. The VAS scores, nasal airway resistance measured by active rhinomanometry, and the levels of local sIgE, ECP, histamine and leukotriene C4 were significantly increased from baseline values following NAPT. Sensitivity, specificity, and diagnostic accuracy of local sIgE for diagnosis of LAR were 91.7% respectively. Conclusions: The measurement of local sIgE levels in nasal secretion is a reliable and effective diagnostic method for LAR.
To investigate proton magnetic resonance spectroscopy (HMRS) as a diagnostic biomarker to identify mild cognitive impairment (MCI) following stroke in the acute phase. A total of 72 stroke patients were recruited in the acute phase of stroke from the Department of Neurology, including 36 stroke patients with MCI and 36 stroke patients without MCI. All patients underwent brain MRI/MRS examination on a 3.0 T scanner and a neuropsychological test in the acute phase of stroke. Single-voxel HMRS was performed to obtain hippocampal metabolism intensities and brain infarcts were assessed on MRI. Group difference in metabolite ratios was analyzed using a T-test. Spearman rank correlation was used to study the correlation between metabolite ratios and Montreal Cognitive Assessment scores. The hippocampal n-acetylaspartate/creatine (NAA/Cr) ratio was found to be significantly lower in stroke patients with MCI compared with stroke patients without MCI (P<0.02). However, we found no differences in the metabolite ratios between hippocampus ipsilateral to infarctions and the contralateral side (P>0.05) in stroke patients with MCI. Furthermore, a correlation was found between hippocampal NAA/Cr ratios and Montreal Cognitive Assessment scores in stroke patients with MCI (P<0.01). HMRS could be a biomarker to identify MCI following stroke in the acute phase by capturing neurodegenerative changes.
Objective We examined whether antiplatelet therapy is safe for ischemic stroke patients with cerebral microbleed. Methods We retrospectively analyzed ischemic stroke patients admitted to our hospital from 2015 to 2018. Baseline information was extracted from the computerized database. Adverse events, including symptomatic cerebral hemorrhage, recurrent cerebral infarction, and death, were collected by phone. Results A total of 184 ischemic stroke patients were examined, including 106 with and 78 without cerebral microbleed. No patient experienced symptomatic cerebral hemorrhage after discharge. Patients with cerebral microbleed had a higher prevalence of hypertension (92% vs 74%) and suffered from more serious leukoaraiosis (3.0 ± 1.7 vs 1.3 ± 1.4 points on the Fazekas scale). Leukoaraiosis scores were correlated with the number of cerebral microbleeds (r = 0.42). Conclusions Antiplatelet therapy may be safe for ischemic stroke patients with cerebral microbleed. The risk-benefit ratio should be carefully evaluated before withholding antiplatelet therapy.
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