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Objective We reported a case of osteogenesis imperfecta (OI) concurrent with ankylosing spondylitis (AS) and reviewed the literature to investigate the Musculoskeletal manifestations of OI.Methods A 27 years old male patient was admitted to department of rheumatology,Qilu hospital with complaints of left hip and low back pain accompanied with morning stiffness.He had pain and gradual limitation in range of motion of the spine for 2 years and symptomatic exacerbation nearly 8 months.His mother,aunt,daughter and son suffered from OI as well.Clinical examinations revealed blue sclera but hearing and teeth were normal.He had typical AS appearance and severe deformities of left hip joint.His erythrocyte sedimentation rate (ESR) was 32 mm/1 h,C-reactive protein (CRP) was 9.00 mg/L,and human leukocyte antigen (HLA)-B27 was positive.Magnetic resonance imaging (MRI) scanning of sacroiliac joint was consistent with spondyloarthropathies and avascular necrosis of left femoral head.After being treated with daily 99Te methylenediphonate intravenously,oral risedronate 5 mg and diclofenac sodium and sulfasalazine,his condition was improved.Results OI was an autosomal dominant hereditary disease defined by bone frailty due to abnormal synthesis of type Ⅰ collagen in bone matrix.It affects the entire skeleton,predisposing the patient to frequent non-traumatic fractures,causing pain,skeletal deformity,and disability.Conclusion OI patients have many musculoskeletal manifestations,such as arthralgia and deformities and should be considered in the differential diagnosis by rheumatologist.
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Objective Thymoma is associated with autoimmune diseases. We retrospectively analyzed the clinical characteristics of thymoma complicated systemic lupus erythematosus (SLE). Methods Patients were from Qilu Hospital Shandong University between June 2004 and June 2014, and satisfied classification criteria of American College of Rheumatology (ACR) classification criteria 1997 for SLE. Thymoma was diagnosed by chest CT scan. Results Nine cases were of thymoma complicated with SLE, with the male:female ratio of 1∶8. The age of SLE onset was (48±19) years, age of thymoma discovery was (47±19) years. The follow-up period was 3 to 10 years. Three cases (33%) were benign thymoma and underwent thymectomy and verified by histopa-thology test. One case presented thymoma 9 years after SLE, 5 cases (56%) presented SLE and thymoma simultaneously, 3 cases (33%) presented SLE after thymectomy. Clinical manifestations of SLE included 4(44%) skin lesions, 8(89%) polyarthritis, 5(56%) nephritis, 3(33%) leukocytopenia, 3(33%) throm-bocytopenia, 2 (22%) of interstitial pneumonia, 4 (44%) pleural effusion, no neuropsychiatric systemic lupus erythematosus. Nine cases (100%) were ANA positive, 7 (78%) were anti-dsDNA positive. Conclusion SLE complicated thymoma usually occurs in relatively older age, tend to present with multi-systemic presentations, and high percentage of anti-dsDNA positivity.
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Objective To discuss the feasibility of moving average method (X‐B method) in the quality control of coagulation function measurement .Methods Fluctuation average value tendency of prothrombin time (PT ) ,activated partial thromboplastin time (APTT) ,thrombin time (TT) and fibrinogen (FIB) of clinical specimen ,detected by using Stago Compact analyzes ,were ana‐lyzed ,and compared cryochemic plasma method .Results Average value of PT ,APTT ,TT and FIB changed in small ranges .Tend‐ency of quality control chart of X‐B method and cryochemic plasma method were basically consistent .Conclusion X‐B method ,u‐sing plasma of patients ,could be used for the quality control of PT ,APTT ,TT and FIB examination and for the monitoring of the stability of analyzers .
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Peripheral neuropathy induced by human immunodeficiency virus (HIV) infection and antiretroviral therapy is not only difficult to distinguish in clinical practice, but also difficult to relieve the pain symptoms by analgesics because of the severity of the disease at the later stage. Hence, to explore the mechanisms of HIV-related neuropathy and find new therapeutic options are particularly important for relieving neuropathic pain symptoms of the patients. In the present study, primary cultured embryonic rat dorsal root ganglion (DRG) neurons were used to determine the neurotoxic effects of HIV-gp120 protein and/or antiretroviral drug dideoxycytidine (ddC) and the therapeutic actions of insulin-like growth factor-1 (IGF-1) on gp120- or ddC-induced neurotoxicity. DRG neurons were exposed to gp120 (500 pmol/L), ddC (50 micromol/L), gp120 (500 pmol/L) plus ddC (50 micromol/L), gp120 (500 pmol/L) plus IGF-1 (20 nmol/L), ddC (50 micromol/L) plus IGF-1 (20 nmol/L), gp120 (500 pmol/L) plus ddC (50 micromol/L) plus IGF-1 (20 nmol/L), respectively, for 72 hours. The results showed that gp120 and/or ddC caused neurotoxicity of primary cultured DRG neurons. Interestingly, the severity of neurotoxicity induced by gp120 and ddC was different in different subpopulation of DRG neurons. gp120 mainly affected large diameter DRG neurons (>25 microm), whereas ddC mainly affected small diameter DRG neurons (< or =25 microm). IGF-1 could reverse the neurotoxicity induced by gp120 and/or ddC on small, but not large, DRG neurons. These data provide new insights in elucidating the pathogenesis of HIV infection- or antiretroviral therapy-related peripheral neuropathy and facilitating the development of novel treatment strategies.
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Animals , Humans , Rats , Analgesics , Diagnosis-Related Groups , Ganglia, Spinal , HIV , Insulin-Like Growth Factor I , Neuralgia , Neurons , Peripheral Nervous System Diseases , ZalcitabineABSTRACT
Objective To investigate the olfactory function in patients with systemic lupus erythematosus (SLE) and to explore factors that may influence it.Methods The Connecticut Chemosensory Clinical Research Center (CCCRC) test was carried out in SLE patients and healthy controls for olfactory function testing.ELISA method was used to detect anti-ribosomal P protein antibody in the serum.The statistical methods used in this study including t test,ANOVA,LSD-t test,Pearson correlation analysis,multiple linear regression analysis,andx2 test.Results ① The CCCRC scores of the active,inactive group and healthy controls were compared,the difference was statistical significant (F=26.52,P=0.01).CCCRC score in active SLE group (62±16) was lower than that of the inactive group (80±13) the and the normal control group (83±12) (P＜0.01),while there was no statistical significant difference between the inactive group and the normal controls (P=0.226).② CCCRC score was lower in 16 ARPA positive SLE patients (61±17) than 49 negative patients (74±16) (t=2.681,P=0.009).③ In addition,CCCRC score showed a negative correlation with ARPA serum concentration (r=-0.327,P=0.008).There was no significant correlation between CCCRC score and disease course (r=0.141,P＞0.05).④ Multiple linear regression analysis indicated that CCCRC score was associated with age and ARPA.Conclusion SLE patients have olfactory dysfunction and the dys-function is associated with age and ARPA.
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Objective To establish new classification criteria for early rheumatoid arthritis (E-RA) based on large samples of early inflammatory arthritis patients and to evaluate the value of this criteria in China.Methods Patients who had arthritic complaints with disease duration less than one year were enrolled.They were divided into RA group and non-RA group according to the clinical diagnosis by experienced rheumatologists.The clinical and laboratory parameters were analyzed and those with high sensitivity or specificity were selected as the new classification criteria.Statistical analysis was carried out by using t test,x2 test and Logistic regression.Results ① A total of 803 patients with early inflammatory arthritis were included in this study.Five hundreds and fourteen patients were diagnosed as early RA and 251 were diagnosed as other rheumatic diseases,and the diagnosis of 38 patients remained unestablished by the end of follow-up.② New E-RA classification criteria were established based on the parameters with high sensitivity and/or specificity.The sensitivity of the new E-RA criteria was 84.4％,which was higher than 1987 ACR criteria (58.0％),while the corresponding specificities were similar,which were 87.4％ and 93.6％ respectively.③ Compared with the complex scoring system of 2010 ACR/EULAR criteria,the E-RA criteria was more simple and practical.The diagnostic sensitivity and specificity of E-RA criteria were higher than those of 2010 ACR/EULAR criteria reported in the literatures.④ New classification criteria based on scoring system using Logistic regression analysis was established.The sensitivity of this criteria was 86.4％,which was higher than 1987 ACR criteria (58.0％).Conclusion The diagnostic value of the E-RA criteria developed in this study for early RA is better than 1987 ACR criteria,and is more simple than 2010 ACR/EULAR criteria.It may be used as a new classification criteria for early RA diagnosis.
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To investigate the effects of didannsine(ddI)on the morphological alterations of dorsal root ganglion(DRG)neurons,dissoci-ated DRG cells from rat embryo were studied.DRG cells were cultured for 3 days and then treated with ddI for additional 3 claysin differ-ent concentrations(1μg/ml,5 μg/ml,10μg/ml and 20 μg/ml,respectively).Afarthat,DRG cells were processedformicrotubule as-soeiated protein 2(MAP2)labeling and observed under confocal laser scanning microscopy(CLSM).The results showed that both thenumber and length of neurites of the DRG cells after exposed to ddl significantly down-regulated in a dose-dependentmanner compared withcontrol group,thus suggesting that ddI may have inhibitory effects on neufite regeneration and outgrowth in dissociated DRG cultures.
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To investigate whether HIV3B and HIV Ada-M can infect cultured human dorsal root ganglion (DRG) neurons, organotypic and dissociated human fetal DRG cell culture models were established. On the 14th day, organotypic cultured DRG explants were exposed to HIV3B or HIV Ada-M for another 14 days. Outgrowth and morphology of neurites were observed with phase contrast microscope at different time of cultured age. On the 3rd day, dissociated cultured DRG cells were exposed to HIV3B or HIV Ada-M for another 3 days. After that, dissociated DRG cells were processed for microtubule-associated protein 2 (MAP2) labeling and observed with fluorescent microscopy. DRG explants on the 28th day and dissociated DRG cells on the 6th day, the samples were processed for electronic microscopic observation. Both organotypic and dissociated DRG cultures were cultured continuously in culture media as controls. Immature HIV-like particles were found in organotypic cultured DRG neurons. Many HIV-like particles were found in dissociated cultured DRG neurons. HIV infection could not cause morphological and ultrastruc( )l alterations on both organotypic and dissociated cultured DRG neurons. These discoveries will be valuable for studies on pathogenic (mee)hanisms of HIV infection and/or HIV associated peripheral neuropathies.
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To investigate the neurotoxic effect of human immunodeficiency virus (HIV) gp120 on cultured dorsal root ganglion (DRG)neurons in vitro, dissociated and organotypic mouse embryo's DRG cell culture models were established. Both dissociated and organotypic DRG cultures were treated with HIV gp120 in different concentration (250 pmol/L and 1 nmol/L, respectively, 2 times/7 days). For dissociated DRG cultural cells, microtubule-associated protein 2 (MAP2) immunofluorescent labeling was processed for observing the changes of neuronal cell body and neurites. The change of the ultrastructure in the organotypic cultured DRG was observed by electron microscopy.The difference of the number and length of neurites between the control group and HIV gp120 treated groups were significant (P＜0.001),whereas there was no significant difference in the diameter of neurons between them (P＞0.05). The ultrastructural changes included the decrease or loss of cristae in mitochondria and accumulation of many high densed particles between the microtubules and the neurofilaments by using both the concentrations of HIV gp120 treatment. The present results indicate that HIV gp120 had a directly neurotoxic effect on the cultured DRG neurons, especially more sensitive to mitochondria.
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To investigate the neuronal migration and synthesis of peptidic neurotransmitters in vitro, neuromuscular co-cultures of nodose ganglia and cardiac muscle cells of Wistar rats were established. The living cells of co-cultures were observed with an inverted contrast microscope at different culture age. At 72 h and 96 h of culture age, the neuromuscular co-cultures were examined by Holmes' reduced silver staining technique for observing the neuronal migration. Immunohistochemical staining method was used for investigating the synthesis of peptidic neurotransmitters- substance P (SP) and calcitonin gene-related peptide (CGRP). The neuronal morphorlogical maturation in neuromuscular co-cultures seems at 72 h of culture age in terms of the observation of living cells and Holmes' reduced silver staining technique. SP- and CGRP-immunoreactive neurons were observed in neuromuscular co-cultures at 96 h of culture age but not 72 h. The results indicate that the neuronal morphological maturation can not represent the maturation of neurotransmitter synthesis. The synthesis of neurotransmitters is not maturated in the neuromuscular co-cultures until 96 h of the culture age.
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Objective To investigate the association between rheumatoid arthritis (RA) and the presence of the shared epitope (SE) of HLA DRB1 gene in Han nationality of Shandong population.Methods The method of DNA amplification with sequence specific primers (PCR SSP) was used to determine 17 alleles of HLA DRB101,04,10 genotypes in 132 RA patients and 130 healthy controls from the Han nationality population in Shandong.Results The frequencies of SE were significantly increased in RA patients compared with controls (50 0% vs 22 3%, P
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Objective To determine health related quality of life (QOL) of patients with systemic lupus erythematosus (SLE) and to identify the factors affecting QOL. Methods One hundred and fifty-one consecutive patients with SLE were separated into different groups according to the type or stage of disease. Health status were measured by 1 health transition (HT) and 8 composite scales of the medical outcomes study short form-36 (SF-36). The mean scores for each subscale of the SF-36 for patients with SLE in China were compared to those of a health population in China and of foreign SLE patients.The effect of patients′age,sex,education level,disease duration,disease activity (assessed by SLEDAI score),and organ damage(assessed by SLICC/ACR DI) and treatment were analyzed. ANOVA, rank sum test and correlation analysis were applied for statistical analysis. Results Patients with SLE had significantly lower HT and mean scores in each subscale of the SF-36 compared to those of a health population in China,while the scores in such subscales as physical functioning (PF), bodily pain (BP), vitality (VT), role-emotional (RE) and mental health (MH) were higher than those of foreign SLE patients. The mean scores of those patients with lupus nephritis and center neural lupus or in active state were lower than those not or those in steady-going. The SLEDAI score and SLICC/ACR DI were the most important elements that affected the QOL in SLE patients and showed obviously negative correlated with one′s scores in SF-36. The glucocorticoid dose of patients was closely negatively correlated with one′s scores. The latter were also associated with age, education level and disease duration. Conclusion The health status of patients with SLE is mainly associated with disease activity,damage and therapy. The SF-36 is a valid instrument for measuring the health related QOL in SLE.