Xiu-Hai Guo

Chinese PLA General Hospital (301 Hospital), Peping, Beijing, China

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Publications (7)5.02 Total impact

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    ABSTRACT: Objective: To determine the pattern of muscle edema occurring in the lower limb muscles of Asian hypokalaemic periodic paralysis (hypoPP) patients using magnetic resonance imaging (MRI). Specifically, the relationship between muscle edema and muscle activity during daily use was examined by comparing the lower limb muscle MRI of healthy subjects following exercise and hypoPP patients. Methods: Twenty Asian patients (mean age: 29·3±7·53 years) clinically diagnosed with hypoPP were enrolled in the present study. Ten healthy subjects were also enrolled. Direct automated DNA sequencing of the S4 regions of CACNA1S and SCN4A in all hypoPP patients was performed. The upper and lower legs of all hypoPP patients during the time interval between attacks and healthy subjects pre- and post-exercise were examined on a 3 T system with T2-weighted fat saturation sequence. Images were evaluated by means of a region of interest analysis. A scoring from 0 to 3 was used to compare the degree of muscle edema among individual muscles. Results: Three hypoPP patients were identified with mutations in the screened genes: R1239H and R900S of CACNA1S and R672H of SCN4A. The lower leg muscles of both hypoPP patients and healthy subjects after exercise displayed significantly higher MRI signal intensities compared to healthy subjects before exercise (P < 0·0001 and P < 0·0001, respectively). In contrast, there was no significant change in the upper leg muscle signal intensities of hypoPP patients and healthy subjects following exercise compared to pre-exercise healthy subjects (P = 0·7598 and P = 0·9651, respectively). In the hypoPP patient group, high signal intensity in the upper leg muscles was seen only in the patient with the R1239H mutation. In the lower legs, muscle edema was most frequently seen in the gastrocnemius lateralis, soleus, and gastrocnemius medialis in the hypoPP patient group. Furthermore, the degree of muscle edema was the greatest in these muscles. This similar pattern of muscle edema was also seen in healthy subjects after exercise. Conclusions: In Asian hypoPP patients, muscle edema as well as the underlying abnormal ion distributions across the muscle membrane is present even during the time interval between attacks of muscle weakness. The muscles of the lower leg are more likely to be edematous than muscles of the upper leg since these muscles are more actively used in daily life. Thus, muscles subjected to high activity are more likely to be edematous and sodium-overloaded.
    Neurological Research 09/2014; · 1.18 Impact Factor
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    ABSTRACT: This review aims to illustrate the relationship between clinical features and the prognosis of patients with limb-shaking transient ischemic attack (LS-TIA). Relevant articles published in two main Chinese medical periodical databases (China National Knowledge Infrastructure and China Science Periodical Database) from 1986 to June 2013 were identified with keywords "limb shaking" and "transient ischemic attack". Original articles and case reports about LS-TIA were selected. A total of 63 cases collected from 19 articles were included in the pooled analysis. LS-TIA presented in two cerebrovascular diseases, of which atherosclerotic high-grade stenosis or occlusion in carotid artery system and moyamoya disease formed 95.2% and 4.8%, respectively. Of 63 patients, 11 (17.5%) were once misdiagnosed as epileptic and prescribed useless antiepilepsy drugs. The multivariable Logistic regression model showed a significant protective effect of patients with revascularization therapy on prognosis, compared with patients treated with drugs (odds ratio 0.20, 95% CI 0.05-0.74, P = 0.016). Chronic carotid artery system hypoperfusion can induce limb(s) shaking, followed by high possibility of ischemic stroke in the same brain territorial. Revascularization of the responsible artery may work better than conservative drug-based therapy.
    Chinese medical journal 11/2013; 126(22):4354-7. · 0.90 Impact Factor
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    ABSTRACT: To study the correlation of compensation by collateral circulation and clinical locations in ischemic stroke cases. A total of 25 ischemic stroke cases were retrospectively analyzed. MRI (magnetic resonance imaging) and DSA (digital subtraction angiography) were performed in all cases. Each patient was found to have at least one cerebral artery occlusion by DSA. The quantity relationship between collateral circulation and ischemic stroke location was analyzed by SPSS 11.5 statistics software. Among all cases, 46 arterial occlusions were found by chance. DSA demonstrated internal carotid artery occlusion (n = 24) and vertebral & basilar artery occlusion (n = 22). And all cases had at least one collateral circulation. Among 23 cases of single collateral circulation, there were 8 cases of single ischemic stroke locations and 15 cases of multiple ischemic stroke locations; among 23 cases of multiple collateral circulations, there were 18 cases of single ischemic stroke locations and 5 cases of multiple ischemic stroke locations. Effective collateral circulation can be established spontaneously through multiple ways when cerebral artery occlusion takes place if an intact Wills circle is present. Multiple collateral circulations may significantly decrease the quantity of ischemic stroke locations.
    Zhonghua yi xue za zhi 12/2010; 90(47):3365-7.
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    ABSTRACT: A patient with migraine-induced stroke with risk factors involving both anterior cerebral artery and posterior cerebral artery territory was presented. To better explain the symptom, the mechanisms of the migraine-induced stroke with risk factors were assessed and a hypothesis was raised.
    Headache The Journal of Head and Face Pain 07/2010; 50(7):1203-6. · 2.94 Impact Factor
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    ABSTRACT: Mutation screening was performed to a Chinese family with hypokalaemic periodic paraiysis(HOKPP) for locating the corresponding mutations of gene and for specifying the clinical features associated with mutations. The cilnical features of patients from HOKPP family were summurized. Techniques of target exon PCR and direct sequencing were used to screen the mutation in CACNA1S and SCN4A genes in all numbers of the family. Two patients of the family showed the typical features of HOKPP: the age of disease onset is during the childhood, acetazolamide is effective to patients treated. A heterozygous point mutation 3716 (G>A) causing R1239H was found in exon 30 of CACNA1S gene of the patients, but not found in normal members of the family. The mutant R1239H in CACNA1S gene exists in Chinese patients with familial hypokalaemic periodic paralysis.
    Zhonghua yi xue yi chuan xue za zhi = Zhonghua yixue yichuanxue zazhi = Chinese journal of medical genetics 06/2006; 23(3):272-4.
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    ABSTRACT: In this report are reviewed two unrelated patients with typical normokalemic periodic paralysis (normoKPP) features and the results of screening the SCN4A gene for the disease-related mutation. Two sporadic cases with normoKPP were screened for previously known mutations in SCN4A gene (T704M, A1156T, M1360V, I1495F, M1592V) that lead to hyperKPP; denaturing high performance liquid chromatography (DHPLC) was used. Then the rest exons of SCN4A gene were screened by DHPLC, and sequence analysis was performed on those with DHPLC chromatogram variation when compared with unaffected control. Two cases and one patient's father were detected with V781I, which was proved to be a singular missense mutation in SCN4A gene. The mutation V781I exists in Chinese patients with normoKPP and may be responsible for normoKPP.
    Zhonghua yi xue yi chuan xue za zhi = Zhonghua yixue yichuanxue zazhi = Chinese journal of medical genetics 01/2005; 21(6):566-9.
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    ABSTRACT: To study the clinical features of normokalemic periodic paralysis (normoKPP) and to confirm the relation between Met1592Val mutation and normoKPP and clarify its clinical features. The clinical features of 14 patients in a Chinese family of normoKPP were summarized. All 24 exons of SCN4A gene were screened with denaturing high performance liquid chromatography (DHPLC) technology, and then sequence analysis was performed on those with abnormal elution peak. This family showed typical clinical features of normoKPP without myotonia. The progress of most patients was benign. Two missence mutations were found in exon 1 and exon 24 respectively. Linkage analysis and direct sequencing showed the mutation in exon 1 was g189a, a benign polymorphism, and the mutation Met1592Val in exon 24 was responsible for this disease. The mutation Met1592Val does exist in Chinese patients, and lead to normoKPP. NormoKPP is similar to hyperKPP not only in clinical futures but also in genetic level.
    Zhonghua yi xue za zhi 02/2004; 84(2):125-9.