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Psoriatic arthritis is a chronic systemic autoimmune disease, characterized by psoriasis skin lesions and inflammation of the spine and joint. It has complicated clinical manifestations and individual variations. Nearly half of the patients will have joints erosion in two years, which is crippling. The severity of the skin and joint disease frequently do not correlate with each other. Currently, the understanding of the disease is insufficient in China with the lack of standardized diagnosis and treatment. Therefore, researchers from the Chinese Rheumatology Association formulated this specification based on the diagnosis and management experience together with guidelines at home and abroad. The specification summarizes the present situation of domestic diagnosis and treatment, aiming to standardize the diagnosis process and treatment protocols of psoriatic arthritis. Furthermore, it can reduce misdiagnosis and missed diagnosis, as well as improve the prognosis.
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Objective To investigate the expression of CXCR4 and CXCL12 in the labial gland of patients with primary Sj?gren's syndrome (pSS), and to explore their role in the pathogenesis of pSS. Methods The expression of CXCR4 and CXCL12 in labial gland tissues was detected by immunohistochemistry in 32 cases of newly diagnosed pSS and 30 cases of oral mucosa cysts or trauma patients. The expression level, intensity and location were analyzed and compared statistically. χ2 test and Spearman correlation analysis were used for statistical analysis. Results The positive rate of CXCR4 in the test group was 91%(n=29), which was significantly higher than that in the control group (33%, n=10, χ2=21.77, P=0.001). The positive rate of CXCL12 in the test group was 97%(n=31), which was significantly higher than that in the control group 40%(n=12), and the difference was statistically significant ( χ2=23.57, P=0.001). Conclusion CXCR4 and CXCL12 are highly expressed in labial gland of pSS patients, this suggests that they participate in the pathological process of pSS local inflammatory response and play an important role in pSS pathogenesis.
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Objective To observe the therapeutic efficacy of Ganshuang granules in the treatment of hepatic fibrosis.Methods Sixty-eight patients with cirrhosis due to chronic hepatitis B (CHB)were divided into experimental group (n=34)and control group (n=34).Both groups received adefovir dipivoxil for 6 months,and the experimental group received Ganshuang granules additionally for 24 weeks.After treat-ment,the changes in hepatic fibrosis indices including hyaluronic acid (HA),laminin (LN),collagenⅣ(CⅣ),and precollagenⅢ(PCⅢ),as well as liver stiffness value were evaluated by paired t test.Results In the experimental group,the serum levels of HA,LN,CⅣ, and PCⅢwere significantly decreased by 37.5%,34.2%,35.4%,and 39.9%,respectively (t=2.238,2.151,2.148,and 2.198,P<0.05 for all),and the liver stiffness value was significantly cut by 40.6%(t=2.189,P<0.05).However,the control group showed no sig-nificant changes in these indices.Conclusion For patients with cirrhosis due to CHB,Ganshuang granules can effectively reduce serum mark-ers of hepatic fibrosis and liver stiffness value and have a good therapeutic efficacy in the treatment of hepatic fibrosis.
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ObjectiveTo examine the clinical features of fractures and related risk factors in patients with rheumatoid arthritis(RA) in China.MethodsSix hundred and eighty-one RA patients were randomly selected from department of rheumatology of 18 hospitals of China.Data were obtained from the questionnaire,including age,sex,disease duration,the involvement of joints,treatment regimen,features of fractures etc.The possible risk factors of fracture in patients with RA were analyzed with a multi-variate Logistic regression analysis.Results① In 681 RA patients of the survey,48 patients had 54 fractures,and the incidence of fractures was about 8％.② Fractures occurred at various sites.Foot/ankle,femur,spine and wrist were the mostfrequent sites.③ The Logistic regression analysis showed that several factors increased the risk of fracture in RA patients,including long disease duration (OR:1.245,95％CI:0.987-1.570,P=0.065),male gender(OR:0.433,95％CI:0.199-0.942,P=0.035),more deformed joints(OR:1.042,95％CI:1.006-1.079,P=0.023),family history of RA (OR:2.201,95％CI:0.984-4.923,P=0.055),and high scores of SF-36(OR:1.017,95％CI:1.002-1.033,P=0.028).④ According to the degree of correlation from strong to weak,the risk factors of fracture were disease duration,SF-36,sex,number of deformed joints and family history of rheumatoid arthritis.ConclusionThe incidence of fracture is high in patients with rheumatoid arthritis.Several factors could increase the risk of fractures in RA patients,including long disease duration,male gender,more deformed joints,and family history of RA.In order to prevent the occurrence of fractures,cautions should be taken to prevent the development of fractures and treat the disease aggressively to suppress the disease activity of RA.
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Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.
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OBJECTIVE: To study the curative effect of Sodium Ferulate( SF) on rheumatoid arthritis( RA) and its effects on the levels of serum vascular endothelial growth factor( VEGF) and tumor necrosis factor- ? ( TNF- ? ) . METHODS: A total of 43 patients with RA were randomly divided into trial group and the control group: conventional treatment was adopted in both groups, but the trial group was treated additionally with SF injection for 4 consecutive weeks. Serum levels of VEGF and TNF- ? before and after treatment were determined by the enzyme linked immunosorbent assay( ELISA) . RESULTS: The total effective rate in the trial group the control group were 91. 30% vs. 75. 00% ( P
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OBJECTIVE:To observe the curative effects of compound glycyrrhizin injection in treatment of primary sjogren syndrome(PSS).METHODS:68 patients with PSS were randomized into the treatment group and control group,and treated for 4wk with hydroxypiperaquine,bromhexine and carmellose.The treatment group also received compound glycyrrhizin injection in addition to the three agents for the control group.RESULTS:After treatment for 4wk,both groups saw some declines in IgG,IgM,IgA,ESR and RF,and improvement in indicators such as schemer test and saliva flow rate,with the treatment group showing more significant improvement than the control group(P