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Objective To measure serum surfactant protein (SP) A and D levels in patients with interstitial lung disease associated with rheumatoid arthritis (RA).Methods Serum SP-A and SP-D levels of RA,RA-ILD patients and healthy controls were assessed using a sensitive enzyme-linked immunosorbent assay (ELISA).The relationship between SP-A and SP-D and RA-ILD was analyzed.The serum SP-A and SP-Dpositive rate was calculated for the three groups.The correlation between SP-A and SP-D with RF,anti-CCP,antinuclear antibody,antikeratin antibody,anti-perinuclear factor,C-reactive protein,erythrocyte sedimentation rate,were analyzed.Mean value of groups were compared with variance analysis,Spearmam rank correlation test was used for correlation analysis.Results The levels of serum SP-A in RA-ILD patients and RA patients as well as in healthy controls were [ (51.2±9.2),(25.9±2.6),( 15A±0.3 ) μg/L] respectively.The level of serum SP-D of the three groups was [ ( 42.5 ±8.1 ),(20.8 ± 1.5 ),( 16.6±0.8 ) μg/L ] respectively.The levels of serum SP-A and SP-D in patients with RA complicated with ILD were higher than those simple RA patients and healthy controls (P＜0.05).The levels of serum SP-A and SP-D in patients with RA were not significantly higher than those in healthy controls (P＞0.05).The positive rate of serum SP-A and SP-D in RA-ILD patients were significantly higher than those in simple RA patients and healthy controls.The positive rate of serum SP-D of RA-ILD patients was higher than that of SP-A.The levels of serum SP-A and SP-D in patients with RA complicated with ILD were correlated positively with age,C-reactive protein.The level of serum SP-D was correlated positively with RF,anti-CCP,antikeratin antibody.There was no correlation between the level of serum SP-A and SP-D with RA-ILD and antinuclear antibody,antiperinuclear factor,erythrocyte sedimentation rate.Conclusion The levels of serum SP-A and SP-D are correlated with RA-ILD and may be useful markers for ILD in patients with RA.These two paramenters may be helpful to early diagnosis of RA-ILD.The Serum SP-D levels are more sensitive in predicting the development of RA-ILD than other parameters and can help in assessing the severity of lung damage.
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Objective Using single direction dispersion breathless DWI, to analyze the value of DWI for vertebral bone marrow infiltration in patients with acute leukemia (AL). MethodsForty-two patients with AL and 15 healthy volunteers received vertebral sagittal DWI with single shot spin-echo echoplan imaging (SS-SE-EPI) sequence( b value ＝ 0,650 s/mm2) at a GE Signa Excite 1. 5 T scanner with 8 channels body coil. DWI for all patients were performed from three directions, including from superior to inferior (S/I), from anterior to posterior (A/P) and from right to left (R/L). The apparent diffusion coefficient (ADC) value was measured on ADC map from each direction using GE-Function tool DWI software. Forty two patients consisted of 13 onset with untreated patients and 29 treated patients (7 nonremission,8 complete remission and 14 consolidation therapy). The ADC values among the three diffusion directions were compared. Analysis of variance and t test were used to compare the ADC values in different AL stages, Pearson correlation analysis was used to analyze the correlation between ADC values and the percentage of bone marrow progenitor cells. Results The ADC values from S/I, A/P and R/L of 362 vertebras in the 57 subjects are (0. 758 ±0. 009) × 10-3 mm2/s, (0. 732 ±0. 009) × 10 -3 mm2/s and (0. 758 ±0. 009) × 10 -3 mm2/s, respectively. There is no statistical significance( F ＝ 2. 958, P ＞ 0. 05 ).The ADC values from S/I of 94 vertebras in 15 healthy volunteers is (0. 697 ± 0. 122) × 10 -3 mm2/s, of 85 vertebras in 13 untreated AL patients is (0. 592 ±0. 071 ) × 10-3mm2/s. There is statistical significance between them ( t ＝ 2. 568, P ＜ 0. 05 ) ; The ADC value of 183 vertebras in 29 treated AL patients [ ( 0. 796 ±0. 225 ) × 10-3mm2/s]is higher than that in untreated patients with statistical significance (t ＝ -1. 332,P ＜0. 05). One hundred and forty vertebras in patients with complete remission and consolidation therapy were [ (0. 786 ±0. 184) × 10-3 mm2/s],and 43 vertebras in patients with non-remission(NR) [ (0. 804 ±0. 327 ) × 10 - 3 mm2/s], there was not statistical significance between them ( t ＝ - 0. 160, P ＞ 0. 05 ). The ADC values from S/I direction of untreated patients showed significant negative correlation with the proportion of the blast cell in the bone marrow ( median value 26. 4％. Min 7.9％, Max 48. 2％ ) ( r ＝- 0. 524, P ＜ 0. 05 ). ConclusionsDWI of vertebral bone marrow is isotropy. ADC value is a non-invasive and quantitative index for evaluating the pathogenetic condition of AL.
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Objective To study the appearance of magnetic resonance imaging (MRI) in early stages of cartilage degeneration and to detect its values.Methods Intra articular injection of 5 units of papain causing a reversible loss of cartilage proteoglycan in the New Zealand rabbit knees.Rabbits were scanned with magnetic resonance imaging,using a 0 3 T Hitachi magnet with 16 cm coil.Gradient echo sequences and spin echo sequences were performed in the sagittal planes at 0,24,48 and 72 hours after intra injection of papain.Then signal intensity and thickness of cartilage were measured.The proteoglycan content was measured biochemically and histochemically.Results The cartilage thickness and signal intensity decreased significantly in treated knees compared with control knees at 24 and 48 hours ( P 0 05) after injection of papain.These changes on magenetic resonance (MR) images were consistent with the changes of proteoglycan concentration measured by biochemical analysis and histochemical staining of cartilage.Conclusion It is possible for MRI to detect the early stages of cartilage degeneration.
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Objective To assess the diagnostic value of MR imaging of the wrist synovitis in early rheumatoid arthritis.Methods 60 wrists in 30 patients underwent MR imaging examination,including T1WI,T2WI,STIR and contrast-enhanced fat-suppressed 3D fast-gradient-echo sequence.MRI manifestations were analysed in comparison with clinical and laboratory test data.Results All changes including synovial hyperplasia and pannus formation(30 cases),articular cartilage destruction(21 cases),bone erosion(16 cases),joint effusion(25 cases) and tendon lesion of wrists could be showed clearly by MRI.The signal intensity of the pannus before and after administration of contrast agent and the enhanced curve of the pannus could be used to assess the lesions whether or not activation.Conclusion MRI is helpful in diagnosing early rheumatoid arthritis.
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Objective To investigate the value of MSCT in evaluating pulmonary functional changes in silicosis.Methods 56 cases of silicosis and 10 healthy people(as control group) underwent inspiratory and expiratory MSCT scans and pulmonary functional test one week later.The CT findings including silicotic nodules,large opacity,emphysema,reticular opacities,bronchiectasis and air trapping were recorded and graded subjectively on CT images.Air retention and emphysema were quantified using the software of Pulmo.CT scores were correlated with spirometric findings by using spearman rank correlative analysis in comparison with pulmonary functional index.Results The scores of CT features except for reticular shadows were of significant difference between silicotic group and control group,but not between simple silicotic group and complex silicotic group.The scores of air retention and emphysema on CT were significantly negative correlation.The reticular shadows were of positive correlation with FEF 75%,FEF 50% and FEV1,but on correlation with FEV1/FVC.There were no correlation between the scores of silicotic nodules,bronchiectasis,large shadows and pulmonary functional test.There was obvious correlation between air retention,the scores of emphysema on CT and the index of pulmonary function in obstruction of small airway.Conclusion MSCT is of important value in evaluating the damage of pulmonary function in silicosis.