G X Jiang

Shanghai Jiao Tong University, Shanghai, Shanghai Shi, China

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Publications (15)45.1 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the discharge diagnosis of demyelinating diseases in the central nervous system (CNS) and analyze the predictive value of the new diagnostic criteria in Suzhou, China. We collected clinical information and data of laboratory examinations for all cases with a diagnosis of various demyelinating diseases in the CNS. All data were reviewed individually by four senior neurologists, and a diagnosis was finally given to each patient according to the McDonald criteria and the Poser criteria for multiple sclerosis (MS). In the analysis, 176 patients with a diagnosis of demyelinating diseases in the CNS at discharge were included. In 82 patients with a diagnosis of MS at discharge, the MS diagnosis was confirmed for 74 patients according to the McDonald criteria for MS, and the positive predictive value for the discharge diagnosis of MS was 90.2% (74/82). According to the Poser criteria, 61 patients were diagnosed as MS. The consistency of the two diagnostic criteria for MS was 78.4%, based on the results of the evaluation. Under-diagnosis of MS could be one of the explanations for the low prevalence of MS in China. Compared to the Poser criteria, the McDonald criteria had a higher sensitivity for the diagnosis of MS.
    Acta Neurologica Scandinavica 01/2010; 121(1):24-29. · 2.47 Impact Factor
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    ABSTRACT: Using hierarchical cluster analysis, applied to 47 cases of Guillain-Barré Syndrome (GBS) incident in South-West Stockholm (SWS) during the period from January 1973 to June 1992, we identified three major clinicoepidemiological subgroups. The first subgroup, 25.5% of the cases (26.7 +/- 6.7 years), recorded a peak incidence at ages 20-29 years and presented significant differences from other subgroups, a high proportion of cases with onset at low age preceded by respiratory infection (83.3%) and with normal motor conduction velocity (50.0%). Also found, were less affected biological parameters, a rapidly progressive course and independence in gait at one month after onset. A second subgroup, 27.7% of cases, was severely affected, clinically and functionally. It consisted predominantly of young individuals (22.7 +/- 11.1 years), with a high incidence (69.2% of cases) in autumn. A third subgroup, comprising 40.4% of cases, was older (61.1 +/- 11.0 years) and, in general, also severely affected. The incidence of this form appeared to be invariant with time.
    Acta Neurologica Scandinavica 01/2009; 93(2-3):175-83. · 2.47 Impact Factor
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    ABSTRACT: To describe clinical features of patients with multiple sclerosis (MS) in Shanghai, China. Prevalent patients with MS were identified and investigated by a network of physicians in 11 districts of Shanghai during the period from 1 September 2004 to 31 August 2005. Admission registries of each hospital in the study area were checked systematically for patients with a diagnosis of MS, neuromyelitis optica or other demyelinating disorders. All patients with collected information were evaluated by four senior neurologists according to the McDonald criteria. There were 249 (146 female and 103 male) patients with a confirmed MS diagnosis, at a female-to-male ratio of 1.4. The mean age at onset of MS was 37.4 years for the 249 patients with MS and, on the prevalence day, 42.7 years. The most frequent location of clinical MS lesions in the central nervous system was the spinal cord (61%), followed by the cerebrum (55%) and optic nerves (41%). Nearly all (96%) of the patients with MS had been examined by magnetic resonance imaging, and 226 (94%) patients of those examined were suggestive of MS. No family history of MS was found in any of the patients. Most (86%) of the patients had no or mild disability on the prevalence day (31 December 2004). Almost all (96%) patients with MS had been treated with corticosteroids. Clinical features of patients with MS are described based on the information from the largest case series reported among Chinese. Comparisons and discussions are made with findings from the other populations.
    Multiple Sclerosis 07/2008; 14(5):671-8. · 4.47 Impact Factor
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    ABSTRACT: We describe the age- and sex-specific incidence of Guillain-Barré syndrome (GBS) in Harbin, China, based on the information from a prospective survey among a well-defined large population during one year. A network of physicians reported incident patients with a GBS diagnosis from a general population of 5.4 million inhabitants in Harbin, China, during the period from 1 October 1997 to 30 September 1998. Each reported patient was examined by senior neurologists and the GBS diagnosis was validated according to standard diagnostic criteria. All GBS patients were followed-up for six months after onset. Admission registers at all hospitals in Harbin were also checked afterwards for screening patients with a GBS diagnosis who might have been missed. During the study period, 79 patients with a GBS diagnosis were reported. After validation, the GBS diagnosis was confirmed in 70 patients. Another GBS patient was found through the screening of admission registers at hospitals. Among them, 36 GBS patients were residents in Harbin and the other 35 patients were from geographical areas out of Harbin. The GBS incidence, age-adjusted to the European standard population, was 0.66 (95% CI 0.46-0.91) per 100,000 person-years, with a male to female ratio of 1.4. The highest GBS incidence was found in the youngest age-group and the incidence among the elderly was remarkably lower than those reported from other populations in Western countries. Possible explanations for the distinct pattern of age-specific incidence of GBS are discussed. Further studies are needed.
    Journal of the Peripheral Nervous System 10/2002; 7(3):208 - 209. · 2.57 Impact Factor
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    ABSTRACT: Objectives: To set up an epidemiological surveillance system of Guillain–Barré syndrome (GBS) in Sweden and to evaluate the pilot practice of the system for 2 years. Material & methods: A network of neurologists reporting incident patients with a GBS diagnosis among a general population of 4.5 million inhabitants in Sweden during 1996–1967. Historical GBS data from the national hospital in-patient registry were used for predicting incidences and controlling under-reporting. Results: One hundred and seventeen cases were reported. No alarm signals were identified during the study period. A re-analysis of data in 1996 revealed: 1) a higher than expected incidence in the population aged below 40 years in January, and 2) 27% underreporting mainly associated to one hospital and to GBS patients hospitalized outside neurological departments. Threshold values for GBS incidences among the general and selected populations were obtained from corrected data. Conclusion: The Swedish Network for GBS Surveillance can provide immediate support for epidemiological evaluation of suspected outbreaks or increased GBS incidence.
    Acta Neurologica Scandinavica 12/2001; 101(2):104 - 111. · 2.47 Impact Factor
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    ABSTRACT: We described clinical manifestations, outcomes, prognostic indicators and clinico-epidemiological subgroups for 53 adult patients with Guillain-Barré syndrome (GBS) in Sweden during the period 1996-97. These patients were identified from a population of 2.8 million inhabitants and prospectively followed up for one year by a network of neurologists. An additional 10 cases, of whom five were adults who had not been prospectively followed up, were not included in the analyses. At 6 months after onset 80% of the patients could walk without aid, while at 1 year 46% were fully recovered, 42% had mild residual signs or symptoms, 4% had moderate and 6% severe disabilities, and 2% had died. Intravenous human immunoglobulin or plasmapheresis were used in 72% of the patients. The sum of the Medical Research Council (MRC) score at nadir was found as the only significant predictor for residual signs at 1 year in a multivariate model. Three subgroups, with different clinico-epidemiological characteristics, were identified by using cluster analysis. In conclusion, GBS in Sweden is frequently preceded by a respiratory infection, is often treated with immunomodulatory therapies, and exhibits a high recovery rate and a low fatality rate.
    European Journal of Neurology 12/2000; 7(6):685-92. · 4.16 Impact Factor
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    ABSTRACT: To set up an epidemiological surveillance system of Guillain-Barré syndrome (GBS) in Sweden and to evaluate the pilot practice of the system for 2 years. A network of neurologists reported incident patients with a GBS diagnosis among a general population of 4.5 million inhabitants in Sweden during 1996 1997. Historical GBS data from the national hospital in-patient registry were used for predicting incidences and controlling under-reporting. One hundred and seventeen cases were reported. No alarm signals were identified during the study period. A re-analysis of data in 1996 revealed: 1) a higher than expected incidence in the population aged below 40 years in January, and 2) 27% under-reporting mainly associated to one hospital and to GBS patients hospitalized outside neurological departments. Threshold values for GBS incidences among the general and selected populations were obtained from corrected data. - The Swedish Network for GBS Surveillance can provide immediate support for epidemiological evaluation of suspected outbreaks or increased GBS incidence.
    Acta Neurologica Scandinavica 03/2000; 101(2):104-10. · 2.47 Impact Factor
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    ABSTRACT: We describe the incidence of Guillain-Barré syndrome (GBS) in Sweden in 1996. Information of incident GBS patients was mainly collected by a multicentre network of 18 neurologists prospectively monitoring a general population with 4.48 million inhabitants across the country and complemented with data from the national hospital in-patient registry. GBS diagnoses for all patients were validated by neurologists. While 53 patients with GBS were identified by the network neurologists from the study population, the other 20 GBS patients were recognized after carefully reviewing the registered data. There were 44 (60%) male patients and 29 (40%) female patients and the mean age at onset for all patients was 48.6 (SD 24.3) years. The GBS incidence, age-adjusted to the European standard population, was 1.51 (95% CI 1.18-1.90) per 100 000 person-years in 1996, higher in males and increased with age. When compared with selected studies, the GBS incidence in Sweden is moderately high, and the variation of GBS incidence in Europe seems to be small.
    European Journal of Neurology 02/2000; 7(1):11-6. · 4.16 Impact Factor
  • G X Jiang, Q Cheng, S Fredrikson, H Link
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    ABSTRACT: To evaluate the first hospital-admission patients with multiple sclerosis (MS) in the population. By using the data from hospital discharge registry of MS diagnosis in Stockholm during 1984-1993, we calculated rates of first hospital-admission patients with MS in the population and evaluated the temporal trend of the rates during the study period. There were 719 first hospital-admission patients with MS corresponding to 1556 admissions. The mean age at the first admission was nearly the same for male patients (44.3 years, SD: 12.9) and for female patients (44.6 years, SD: 13.7). The mean annual rate of first hospital-admission patients with MS was 4.46 per 100,000 person-years. The sex rate ratio of first hospital-admission patients with MS between females and males was 2.19:1. The first hospital-admission rate of MS could be used as an epidemiological indicator which is useful in planning of hospital service for MS patients.
    Acta Neurologica Scandinavica 08/1999; 100(1):64-8. · 2.47 Impact Factor
  • G.-X. Jiang, Q. Cheng, S. Fredrikson, H. Link
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    ABSTRACT: Objectives - To evaluate the first hospital-admission patients with multiple sclerosis (MS) in the population. Material and methods - By using the data from hospital discharge registry of MS diagnosis in Stockholm during 1984–1993, we calculated rates of first hospital-admission patients with MS in the population and evaluated the temporal trend of the rates during the study period. Results - There were 719 first hospital-admission patients with MS corresponding to 1556 admissions. The mean age at the first admission was nearly the same for male patients (44.3 years, SD: 12.9) and for female patients (44.6 years, SD: 13.7). The mean annual rate of first hospital-admission patients with MS was 4.46 per 100,000 person-years. The sex rate ratio of first hospital-admission patients with MS between females and males was 2.19:l. Conclusion - The first hospital-admission rate of MS could be used as an epidemiological indicator which is useful in planning of hospital service for MS patients
    Acta Neurologica Scandinavica 01/1999; 100(1):64-68. · 2.47 Impact Factor
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    ABSTRACT: To describe the incidence of Guillain-Barré syndrome in Sweden during the period 1978-93 and its temporal and geographical variations. Stratified and Poisson regression analyses and tests for detection of small epidemics were applied to population based hospital discharge data from 2257 incident cases of Guillain-Barré syndrome in Sweden during the study period. The incidence of Guillain-Barré syndrome was (1) 1.77 per 100000 person-years when age adjusted to the European population; (2) higher in males; and (3) stable across time, although occasional increases of annual incidence rates were found-namely, in 1978 (relative risk (RR) 1.30 (95% CI 1.10-1.54)), and in 1983 (RR 1.24 (95% CI 1.06-1.40)). The incidence increased with age and was bimodal, with peaks at 20-24 and 70-74 years. There was a moderate but significant seasonality with a peak in August, particularly among the young age groups. The age adjusted incidence by county varied from 1.11 to 2.57 per 100000 person-years. Neither temporal nor spatial clustering was significant, except during the period July-September in 1983 at ages below 40 years. The incidence of Guillain-Barré syndrome in Sweden during the period 1978-93 had a magnitude similar to those described in other surveys, a bimodal distribution by age, and modest geographical and temporal variations with significantly high rates in 1978 and 1983 and in autumn. Minor outbreaks might have passed unnoticed up to the present. Whereas reported drug induced cases of Guillain-Barré syndrome may in part explain the high incidence in 1983, the cause of the aberrant incidence in 1978 remains unknown. Epidemiological surveillance of Guillain-Barré syndrome in Sweden might have been useful.
    Journal of Neurology Neurosurgery & Psychiatry 06/1997; 62(5):447-53. · 4.92 Impact Factor
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    ABSTRACT: The clinicoepidemiological features of Guillain-Barré syndrome (GBS) were studied using population-based information from medical records of 69 patients in South-West Stockholm, during the period from January 1973 to June 1992. The diagnoses were validated according to the National Institute of Neurological and Communicative Disorders and Stroke criteria. Mean age at onset was 43 +/- 20 years. For 46 patients, events during the 30-day period preceding clinical onset, 74% of them identified as respiratory infections, were recorded. The presence of preceding events was associated with male gender. A more rapid clinical progression was found among women. A CSF/serum albumin ratio > or = 10, denervation potentials and mechanical ventilation required were associated with poor recovery or long duration of hospitalization. Reduced motor conduction velocity was more common and pronounced among older patients and with a high CSF/serum albumin ratio. These results suggest that there is clinical, electrophysiological and epidemiological heterogeneity in GBS, and that clinicoepidemiological subgroups of GBS may exist.
    The Italian Journal of Neurological Sciences 02/1997; 18(1):49-53.
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    ABSTRACT: In order to describe the incidence of Guillain-Barré syndrome (GBS) in Stockholm County (SC) and hospital use by GBS patients, we conducted a retrospective epidemiological study on GBS covering 1973-1991, using the Hospital Inpatient Register in SC. There were 556 patients, bona fide residents in the county during the study period, discharged from hospitals with GBS diagnosis. The mean annual incidence, age-adjusted to the European population, was 1.84 (2.15 for males and 1.57 for females) per 100,000 population. The incidence increased with age and showed a bimodal distribution with peaks in the 10-29 and 70-79 age-groups. Annual incidence rates were highest in 1978 and 1983. Neither heterogeneity of annual or monthly rates nor linear trends during the period were found to be significant, except in 1978 for patients below 40 years of age, RR 1.72 (95% CI 1.08-2.71) and in 1983 for patients at ages 40 years and over, RR 1.48 (95% CI 1.02-2.16), when compared with GBS incidences in the same age-groups during the remaining study period. The mean +/- SD duration of hospital stay, including long-term care or rehabilitation institutions, for GBS patients, was 86 +/- 210 days, with considerably longer duration for the elderly. The rate of hospital use by GBS patients was 162 days per 100,000 inhabitants per year. In accordance with results of prior studies in South-West Stockholm and described GBS epidemics in Sweden, this study supports that an etiologically different subgroup of GBS exists at ages below 40 years, and that relevant but small time-space variations, such as the reported zimeldine epidemic in 1983, resist detection by hospital data analysis of pooled GBS cases. Efficient epidemiological surveillance of GBS may require targeted development of clinico-epidemiological tools.
    European Journal of Epidemiology 02/1997; 13(1):25-32. · 5.12 Impact Factor
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    ABSTRACT: In this study, we determined the relationship between Guillain-Barré syndrome (GBS) and pregnancy. By taking advantage of several nationwide registers and the availability of personal identification numbers, we calculated person-years for Swedish females aged 15-49 years in the following categories: (1) neither pregnant nor postpartum; (2) pregnant; (3) in the first month postpartum, or (4) in the first 3 months postpartum during 1973-1983. For these women, we determined the corresponding exposure status of hospital-registered GBS cases. Medical records were examined for GBS cases hospitalized during the 2-week period postpartum and 1-month period after the last menstruation. Poisson regression analysis yielded age-adjusted relative risks (RRs) of 0.86 (95% CI 0.40-1.84) for pregnant women, and 1.47 (0.54-3.99) and 2.21 (0.55-8.94) for females during the 3-month and the 30-day period after delivery. The risk for GBS seems to be lower during pregnancy and increases after delivery.
    Neuroepidemiology 02/1996; 15(4):192-200. · 2.37 Impact Factor
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    ABSTRACT: We describe the incidence and explore the quality of registered diagnosis for Guillain-Barré syndrome (GBS) in a population-based retrospective study in South-West Stockholm (SWS), Sweden, during the period 1973-1991. We used data on registered hospital discharges and open-care visits, and from medical records. Medical records were available for 83 (80.6%) of 103 patients with registered GBS diagnosis at discharge from hospitals. For 69 (83.1%) of such patients, the information from the hospital record fulfilled the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) clinical criteria for GBS. One out-patient presented with suspected GBS. In contrast, none of 40 patients discharged with diagnosis of unspecific polyneuropathy fulfilled the above mentioned criteria. During the period 1973-1991, the mean annual incidence of GBS per 100,000 was 1.74, 95% CI 1.41-2.12, from register data and 1.49, 95% CI 1.19-1.85, after excluding those not fulfilling criteria for GBS. The age-adjusted incidence after validation was higher for men, 1.64, 95% CI 1.19-2.21, than for women, 1.46, 95% CI 1.05-1.99. An increasing incidence with age was found, presenting the age-specific curve a bimodal shape. The results of this study confirm that hospital discharge diagnostic data in Sweden can be used for purposes of epidemiological research and surveillance for GBS, and show that the incidence of GBS in SWS compares to those described in other populations.
    Acta Neurologica Scandinavica 03/1995; 91(2):109-17. · 2.47 Impact Factor

Publication Stats

169 Citations
45.10 Total Impact Points

Institutions

  • 2008–2010
    • Shanghai Jiao Tong University
      • Department of Neurology
      Shanghai, Shanghai Shi, China
  • 2009
    • Instituto de Salud Carlos III
      • Área de Epidemiología Aplicada
      Madrid, Madrid, Spain
  • 1995–2009
    • Karolinska Institutet
      • • Department of Neurology
      • • Institutionen för klinisk neurovetenskap
      Solna, Stockholm, Sweden