Background and Purpose: Intracranial hemorrhage (ICH) constitutes an important subtype of stroke. In a prior study, we found that the city of Changsha, People’s Republic of China, not only had a high incidence of stroke, but also had almost the highest incidence of cerebral hemorrhage. To provide information for preventing and managing ICH, we undertook this study supervising and determining the annual first-ever average incidence of cerebral hemorrhage from 1986 to 2000 in Changsha. Methods: In January 1986, people from 6 well-defined communes in the Kai-fu district in Changsha were selected as the study population. Since 1991, we added another 18 well-defined communes of the same district. Data on these residents were obtained from the census register of the local administrative office. Persons who had a history of stroke were excluded from our study at the beginning. Every year, we checked up on the population and carried out door-to-door inquiries to verify the new cases of ICH and stroke. If the patients were diagnosed in hospital, as many as possible were examined with CT and/or MRI. The incidence rate adjusted to the World population in 1985 for age and sex, as well as the prevalence of risk factors were calculated. Results: An accumulative total of 551,163 people were supervised in 15 years (from 1986 to 2000); the annual average incidences of stroke and ICH were 236.6/100,000 (adjusted rate: 154.7) and 131.0/100,000 (adjusted rate: 73.1), respectively. From 1986 to 2000, the total annual average rate of stroke confirmed by CT and/or MRI in Changsha was 70.8%, and for ICH it was 64.7%. The incidences of stroke and ICH confirmed by image analysis were 167.5 (adjusted rate: 110.8) and 84.7 (adjusted rate: 55.1), respectively. The mean annual mortality rate of ICH was 78.3/100,000 (adjusted rate: 49.3) and that of stroke was 124.5/100,000 (adjusted rate: 97.0). The percentage of ICH among stroke cases was 55.4%. Among patients with ICH, 79.8% had hypertension, 30.6% had cardiovascular disease, 7.6% had diabetes mellitus, and 12.5% had an abnormal high level of lipid. Among patients with other subtypes of stroke apart from ICH, the percentages were 76.6, 40.6, 15.5, and 22.5%. Conclusions: The incidence of ICH in Changsha is very high, so is the proportion of ICH among all stroke cases. Changsha is an area with a high incidence of ICH in the world. Hypertension is the prominent risk factor. The study demonstrated the importance of ICH as a significant subtype of stroke.

No abstract

Toll-like receptors (TLRs), the innate immunity components, have been demonstrated to participate in multiple autoimmune diseases. However, our knowledge of the roles of TLRs in myasthenia gravis (MG) is still scarce. In this study, we detected the mRNA expression of TLR1 to TLR10 in peripheral blood mononuclear cells (PBMCs) of MG patients and the healthy controls by quantitative real-time polymerase transcription chain reaction. Our data demonstrate that aberrant expressions of TLRs exist in the PBMCs of MG patients and of the total, expression level of TLR9 mRNA has significantly positive relation with the clinical severity of MG, which suggests that TLRs may be involved in the pathogenesis of MG.

Objective: A myriad of transcription factors and inflammatory cytokines have been described to participate in the pathogenesis of Guillain-Barré syndrome (GBS). However, the innate immunity components – Toll-like receptors (TLRs) – have never been explored in this disease. We therefore investigated the expression of TLR2, 4 and 9 in the peripheral circulation of GBS patients as well as healthy controls. Methods: Twenty-one GBS patients and 21 healthy donors participated in this study. Peripheral blood mononuclear cells were used for mRNA and protein analysis of TLR-related molecules. Also, peripheral blood mononuclear cells from different subjects were incubated with different TLR agonists and the subsequent IFN-γ secretion was determined. Results: Expression of TLR2, 4 and 9 as well as their related signaling molecules were higher in GBS patients compared to healthy controls. Disability scores of GBS patients had a strong positive correlation with the high levels of expression of TLR2, 4 and 9. Conclusions: The TLR signaling pathway may be involved in the pathogenesis of GBS.

No abstract