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Fibroblast growth factors (FGF) are a group of structurally related polypeptides which constitute an elaborate signaling system with their receptors. Evidence accumulated in the years suggests that the FGF family plays a key role in the repair of central nervous system injury. The main protective mechanisms include activating the expression of PI3K-Akt, peroxisome proliferator-activated receptor (PPARγ) and other signals; inhibiting NF-κB-mediated inflammatory response, oxidative stress and apoptosis; regulating neuronal differentiation and neuronal excitability as well as participating in protection of neurovascular units and nerve function repair. This paper comprehensively summarizes the latest research progress in FGF signaling related to diseases of the central nervous system such as cerebral infarction, cerebral hemorrhage, traumatic brain injury, Alzheimer's disease, Parkinson's disease, epilepsy and depression, aiming to provide scientific basis and reference for the development of innovative FGF drugs for the prevention and treatment of neurological diseases.
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Humans , Fibroblast Growth Factors , Phosphatidylinositol 3-Kinases/metabolism , Central Nervous System/metabolism , Signal Transduction/physiology , Alzheimer DiseaseABSTRACT
OBJECTIV E To provide ideas for diagnosis and treatment of fungal endocarditis. METHODS The diagnosis and treatment of 1 case of aspergillus endocarditis participated by clinical pharmacists were analyzed. Clinical pharmacists suggested that blood macrogenomic next-generation sequencing （mNGS）detection and blood microbial culture should be performed to assist in the diagnosis of fungal endocarditis ；considering the mechanism ，target and safety of the drug ，it was suggested to use voriconazole combined with micafungin for antifungal treatment ；through combining with the patient ’s condition and weighing up the pros and cons ，the dose of micafungin was adjusted to 300 mg per day ；clinical pharmacists prevented ，evaluated and dealt with adverse drug reactions during treatment ，and also provided medication guidance and long-term follow-up for the patient after discharge. RESULTS The clinician adopted the advice of the clinical pharmacists. Aspergillus fumigatus was detected in blood mNGS，which bought time for early diagnosis and individualized treatment of the patient. After 1 month treatment of voriconazole combined with micafungin ，the patient ’s condition was well controlled. The alkaline phosphatase and γ-glutamyl transferase of the patient returned to normal after treatment with adenosylmethionine succinate. With the help of medication guidance ，education and discharge follow-up of clinical pharmacists ，the medication compliance of the patient was good and the condition was stable. CONCLUSIONS The clinical pharmacists participate in the diagnosis and treatment process of the patient ，formulate an individualized anti-infective treatment plan for the patient and achieve good results ，which reflect the professional ability and service level of the clinical pharmacist ，and provide ideas for the clinical treatment of fungal endocarditis.
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Objective:To analyze the clinical characteristics of pertussis cases diagnosed by two pathological detection methods: bacterial culture and real-time polymerase chain reaction (RT-PCR), and to explore the applicable value of two pathological detection methods in the diagnosis of pertussis.Methods:Bilateral nasopharyngeal swabs and clinical information of 165 children suspected of pertussis were collected by Hebei Children′s Hospital from April 2019 to January 2020. The bacterial culture and RT-PCR for nasopharyngeal swab specimens were performed in all cases. Chi-square test was used to analyze the cases of pertussis diagnosed by the above two methods.Results:Based on clinical diagnosis, the sensitivity of bacterial culture and RT-PCR for the diagnosis of pertussis was 61.70% (58/94) and 86.17% (81/94), and the specificity was 92.96% (66/71) and 71.83% (51/71), respectively. The positive rate of RT-PCR in children of all ages, seasons and cough courses is higher than that of bacterial culture. Children with pertussis diagnosed by bacterial culture and RT-PCR were basically similar in age, season, and cough course distribution, with the most common cases ≤3 months old, a high incidence trend in summer and autumn, and the course of coughing in children was mostly within 15-21days. The positive rate of bacterial culture in the diagnosis of pertussis in children is affected by the age of the children, and there are statistical differences between children in different age groups (χ2= 11.929, P=0.036). The positive rate of bacterial culture was the highest in children with >3 years old (51.85% [14/27]), followed by children with ≤3 months old (48.72% [19/39]), and the lowest in children with >6-12 months old (15.00% [3/20]). Moreover, the positive rate of bacterial culture in the diagnosis of pertussis in children is also affected by the cough course of the children, and there are statistical differences between children in different cough course groups (χ2=9.841, P=0.020). The positive rate of bacterial culture was the highest in children with cough course 15-21 days (49.23% [32/65]), followed by 43.59% (17/39) in children with cough course 8-14 days, and the lowest in children with cough course of less than 7 days (22.86% [8/35]). Conclusions:Compared with RT-PCR, bacterial culture has lower sensitivity and higher specificity in the detection of pertussis. These two detection methods have their own advantages and limitations. Medical institutions at all levels should comprehensively analyze different laboratory detection methods. Only by combining the two methods can the diagnostic value and level be effectively improved.
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A 72-year-old female patient was admitted to our hospital due to chronic cough, expectoration and dyspnea for 10 years,aggravated with intermittent fever for 1 month. She was diagnosed as acute exacerbation of chronic bronchitis,chronic pulmonary heart disease,cardiac function class IV,bilateral lower extremity venous thrombosis and thrombocytopenia. The application of antico-agulant drugs and coagulant drugs in the patient needed to be well weighed with the methods of the bleeding score system combined with clinical assessment of actual risk of bleeding. The interactions of drugs harmful to the patient should be considered and the prognosis of the patient should also be evaluated with careful clinical thought to reduce the patient's risk.
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Objective To observe the effects of salidroside regulating glucose metabolism in type 2 diabetic mice,then to explore the molecular mechanism. Methods Type 2 diabetes model was induced by feeding high-fat diet and intraperitoneal injecting STZ to male C56BL/6J mice,then the glucose related indexes,micro RNA-370 levels in the serum and liver tissue and the expression of gluconeogenesis key protein(G6Pase and PEPCK) in the liver tissue to observe the treatment effects of salidro-side on type 2 diabetic-caused gluose metabolic disorder.In cell test,we isolated primary hepatocytes,then silenced or over-ex-pressed micro RNA-370 in mouse primary hepatocytes to observe the molecular mechanism of glucose metabolic regulation of the micro RNA-370 and salidroside. Results Treated with salidroside 40,80 and 160 mg·kg-1,the results showed that compared with the model control group,the glucose related indexes were all improved significantly.The relative expression levels of micro RNA-370 in serum and liver,and that of PEPCK and G6Pase all reduced in different degrees,dose-dependently.The changes of middle and high dose group decreased significantly(P<0.05),that of low dose group had a decreasing trend but no statistically significant.In the cell test,compared with the normal control group,salidroside alone group and micro RNA-370 inhibitor group were able to reduce the protein expression level of PEPCK and G6Pase(P<0.05),micro RNA-370mimic alone group can signifi-cantly increase the protein expression level of PEPCK and G6Pase(P<0.05),compared with the micro RNA-370mimic alone group,combining micro RNA-370 mimic and salidroside can significantly reverse the increasing caused by micro RNA-370 mimic alone(P<0.05). Conclusion Our research found that salidroside can improve glucose metabolism disorder in type 2 diabetic mice,and at least in part,through the suppression of micro RNA-370 expression for the first time.
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Objective: To compare the application of Sofren injection in respiratory department before and after the intervention to provide reference for clinical application and pharmacy management.Methods: A retrospective study was conducted on the medical records of inpatients treated with Sofren injection, and then intervene the found problems.Comparative study of Sofren injection in respiratory department before and after the intervention was performed.Results: Among the 584 cases in the retrospective study, those with off-indications were 438 ones (75%), those with inappropriate solvents were 555 ones (95.03%), and those with improper course were 196 ones (33.56%).After the intervention in the clinical practice, the improvement rate of improper solvents was 98.70%, that of off-indications was 29.85%, and that of unsuitable course was 77.71%.Conclusion: Through comparative study on the main problems before the intervention and the effective performance of specific solutions, the application of Sofren injection in respiratory department is greatly improved, which provides reference for the special management of other drugs.
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Objective To evaluate the association between hypersensitive C reactive protein (hs-CRP) and the incidence of acute kidney injury in subarachnoid hemorrhage(SAH) patients.Methods It retrospectively recruited 213 cases of computerized tomography validated SAH patients from the neurology ICU from Beijing Tiantan Hospital between January 2012 and January 2015.The average age was (56.29±11.95) years old,and the patients were divided into AKI and non-AKI groups according to Kidney Disease: Improving Global Outcomes (KDIGO) diagnosis standards, Clinical features of AKI and Non-AKI patients including serum levels of hs-CRP were compared and multi-logistic regression was applied to find the risk factors concerning with the incidence of AKI.Receiver operating characteristics (ROC) curve was also plotted to evaluate the diagnostic value of hs-CRP towards the incidence of AKI.Results A total of 25 (11.74%) patients developed AKI.Average age of the SAH patients in both AKI and non-AKI groups were (63.60±12.21) years old vs.(55.31±11.60) years old(t=-3.33, P<0.05).The ratios of diabetics were were 28.00% vs.11.17% (χ2=5.47,P<0.05) and the ratio of proteinuria were 80.00% vs.34.57%, respectively (χ2=3.83, P<0.05).The median of serum creatinie were 63.72(51.45, 79.72)μmol/L vs.53.21(45.27, 65.62)μmol/L (P<0.05), and serum hs-CRP were (14.12±5.03)mg/L vs.(10.23±6.76)mg/L (P<0.05), and the ratios of antibiotics application were 84.00% vs.43.08% (P<0.05 for all).Multi-logistic regression analysis showed that serum hs-CRP was an independent risk factors for AKI after age, serum creatinine at admission were adjusted.[OR (95% CI) was 3.33(1.13, 9.85),P<0.05 for all].The area under curve of ROC was 0.69 (P<0.05), and the cut-off point of serum hs-CRP under the maximum Youden index was 13.85 mg/L.Conclusion Serum hs-CRP is an independent risk factor of theincidence of AKI in SAH patients, the significantly increase of serum hs-CRP might be an important predictor of the incidence of AKI in SAH patients.
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Objective To explore the risk factors and clinical outcomes of acute kidney injury(AKI) among subarachnoid hemorrhagic(SAH)patients. Methods We retrospectively reviewed and analyzed the clini-cal data of 269 SAH patients from the neurology ICU between Jan. 2012 and Oct. 2013. Clinical features of AKI and non-AKI patients were compared.Multi-logistic regression was done to find the risk factors concerning with the incidence of AKI. Results A total of 39(14.5%)patients developed AKI.The patients with AKI appeared to be older at age,higher at NIHSS score,lower at GCS score than the non-AKI patients(P<0.05 for all).Moreover, the percentage of proteinuria,infectious complications and diuretics administration were significantly higher in the AKI patients(P<0.05 for all).Multi-logistic regression analysis showed that independent risk factors of AKI were age,GCS score and infectious complication[OR(95% CI)were 1.037(1.006,1.068),0.873(0.802,0.951), 3.624(1.543,8.514),respectively;P < 0.05 for all]. The AKI patients also had a higher hospital mortality rate (28.2%)vs.that in non-AKI(0.8%,P<0.01). Conclusions AKI has a higher incidence among SAH patients and AKI patients tend to have higher hospital mortality rate. Prevention of AKI seems to be very important among these patients.
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Objective To observe the effects of salidroside on regulating glucose and lipid metabolism in high sugar high fat induced primary mouse hepatocytes,and to explore the molecular mechanism. Methods Primary hepatocytes were extracted from mice and cultured, then divided into normal control group, model control group ( high sugar high fat induced) ,and salidroside group(high sugar high fat induced and salidroside treated).Model control group and salidroside group were cultured in a high sugar and fatty medium with the optimal concentration of salidroside for 24 h. The glucose consumption, glycogen, and triglyceride concentration were detected, and key proteins of glucose and lipid metabolism were detected by RT-PCR in all three groups. Results Compared with model control group, the glucose consumption and glycogen concentration were both increased ( P<0. 05 ) in salidroside group ( P<0. 05 ) , triglyceride concentration were decreased ( P<0. 05 ) , the mRNA level of gluconeogenesis key protein ( G6Pase and PEPCK) and lipid synthesis key protein ( SREBP-1c, FAS-1, DGAT-2) mRNA expression level were increased (P<0.05),and the level of lipid oxidation key protein (CPT-1α) was decreased (P<0.05). Conclusion Salidroside can reduce insulin resistance and correct glucose and lipid metabolic disorder in high sugar high fat induced primary mouse hepatocytes.
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Objective To observe the effects of salidroside on regulating glucose and lipid metabolism in high sugar high fat induced primary mouse hepatocytes,and to explore the molecular mechanism. Methods Primary hepatocytes were extracted from mice and cultured, then divided into normal control group, model control group ( high sugar high fat induced) ,and salidroside group(high sugar high fat induced and salidroside treated).Model control group and salidroside group were cultured in a high sugar and fatty medium with the optimal concentration of salidroside for 24 h. The glucose consumption, glycogen, and triglyceride concentration were detected, and key proteins of glucose and lipid metabolism were detected by RT-PCR in all three groups. Results Compared with model control group, the glucose consumption and glycogen concentration were both increased ( P<0. 05 ) in salidroside group ( P<0. 05 ) , triglyceride concentration were decreased ( P<0. 05 ) , the mRNA level of gluconeogenesis key protein ( G6Pase and PEPCK) and lipid synthesis key protein ( SREBP-1c, FAS-1, DGAT-2) mRNA expression level were increased (P<0.05),and the level of lipid oxidation key protein (CPT-1α) was decreased (P<0.05). Conclusion Salidroside can reduce insulin resistance and correct glucose and lipid metabolic disorder in high sugar high fat induced primary mouse hepatocytes.
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OBJCETIVE:To investigate the role of clinical pharmacists in medication reconciliation. METHODS:Totally 200 inpatients admitted or transferred to nephrology department of our hospital during Aug.-Oct. 2015 were selected. Within 48 h after admission,1-year medication history were collected by reviewing electronic medical records,consultation,querying self-prepared drugs and medical history;and then medication reconciliation was conducted by clinical pharmacists. RESULTS:Among drug lists collected by clinical pharmacists,there were 987 kinds of drugs,but only 9.63%(95 kinds) drugs were recorded in the medical records. There were 5 cases of ADR in total,and only 40.00% of them (2 cases) were recorded in the medical records. Among 200 patients,medication reconciliation was needed in 45 cases with reconciliation rate of 22.50%. Among 492 medical orders of 200 patients,medication errors were found in 103 medical orders;the number of medication errors per case was (2.3 ± 1.8), mainly including wrong dose,repeated medication,wrong solvent,drug interactions;the potential risk degree was mainly degree 1 (53 orders,51.46%). Among 103 medication reconciliation orders,main plans were drug withdrawal (78 cases,75.73%), followed by drug change(17 cases,16.50%)and drug supplement(8 cases,7.77%). A total of 90 reconciled medical orders were adopted by physicians,with success rate of 87.38%. CONCLUSIONS:Compared with physicians,clinical pharmacists can obtain more detailed and accurate drug list. It can reduce medication error and guarantee the safety of drug use to maximum extent that clinical pharmacists conduct medication reconciliation.
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Objective To evaluate the relationship between placental expression of Gab1 and neonatal birth weight in mothers with gestational diabetes mellitus (GDM).Methods From the singleton and full-term cesarean delivered women in Shengjing Hospital Affiliated to China Medical University between October 2014 and May 2015,30 macrosomia babies with maternal GDM were selected as GDM macrosomia group,30 cases of GDM with normal neonatal birth weight as GDM normal group,30 cases without GDM but with macrosomia as normal macrosomia group,and 30 cases without GDM and with normal neonatal birth weight as the normal control group.Gab1 protein and mRNA expression in placentas were detected using immunohistochemistry,Western blot and real-time quantitative-polymerase chain reaction.Analysis of variance,LSD,Dunnett's T3,Chi-square test and Pearson's correlation analysis were used for statistical analysis.Results (1) Gab 1 protein location and positive expression rate:Gab 1 protein expression in human placenta tissue was located in the nucleus.The positive epression rate of Gab 1 protein in the GDM macrosomia group was higher than in the GDM normal group and normal macrosomia group [93％(28/30),73％(22/30) vs 73％(22/30)] and those in the normal macrosomia group and GDM normal group were higher than in the normal control group[47％(14/30)](x2=4.320,4.320,4.444 and 4.444,all P＜0.05).(2) The expression levels of Gabl protein and mRNA:The expression level of Gab1 protein in the GDM macrosomia group was higher than in the GDM normal group and normal macrosomia group (1.43 ± 0.58 vs 1.05 ± 0.67 and 0.95± 0.59),and that in the normal macrosomia group and GDM normal group were higher than in the normal control group (0.64±0.38) (LSD test,all P＜0.05).The expression levels of Gab1 mRNA showed the same trend as the expression levels of Gab1 protein in the four groups.(3) Gab 1 protein expression level was positively associated with neonatal birth weight (r=0.320,P=0.320).Conclusions The expression of Gab1 in placenta is involved in the regulation of birth weight in GDM mothers.
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Objective To explore the the expression of Klotho mRNA and protein in placenta of macrosomia and its relationship with the birth weight of neonates. Methods The cases were from November 2014 to March 2015 in Shengjing Hospital of China Medical University, divided into 4 groups:the gestational diabetes with macrosomia group (GM), the gestational diabetes with normal birth weight group (GN), the normal pregnancy with macrosomia group (NM) and the normal pregnancy with normal birth weight group (NN). Klotho mRNA and protein expression in the placenta were detected by immunohistochemistry SP method, real-time fluorescent quantitative PCR and western blot, respectively, and were compared among the 4 groups. Results (1) Immunohistochemical detection showed the positive rate of Klotho protein was significantly higher in the placenta of GM (93%,28/30) than in the GN (73%,22/30;P0.05). Conclusions The up-regulation of Klotho gene may be associated with macrosomia. The relationship is not affected by the complication of gestational diabetes.
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Objective:To investigate the rationality of off-label use of tacrolimus combined with Wuzhi capsules in a membranous nephropathy patient. Methods:Based on the related literatures, the application rationality of tacrolimus combined with Wuzhi capsules in a membranous nephropathy patient was analyzed. Results:The combination of tacrolimus and Wuzhi capsules against membranous nephropathy was an off -label drug use, however, it showed certain clinical rationality and economic efficiency. Conclusion:Off-label drug use commonly exists in clinics. Clinical pharmacists should provide evidence support for off-label drug use through searching and analyzing clinical evidences and closely monitoring therapeutic outcome.
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Objective:To investigate the content and mode of pharmaceutical care for the patients with severe burn and promote the rational use of drugs. Methods:Taking the treatment for one patient with severe burn as example,pharmacists provided pharmaceu-tical care in respects of anti-infection therapy,organ preservation,nutritional support, drug interactions, drug precautions, drug incom-patibility, adverse drug reactions and the effect evaluation . Results:The program of rational drug use was provided for clinics through the implementation of pharmaceutical care. The vital signs of the patient were stable, and then the patient left on pass and continued to be treated with rehabilitation therapy. Conclusion:It is necessary for clinical pharmacists to perform pharmaceutical care for the pa-tients with severe burn,reduce the abuse of drugs and improve the medication safety and effectiveness. Meanwhile, the collaborative service of doctors,pharmacists,nurses and inspectors to patients reflects the value of clinical pharmacists.
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<p><b>BACKGROUND</b>Whether two clopidogrel pretreatment strategies prior to elective percutaneous coronary intervention (PCI): a 300 mg loading dose (LD) in clopidogrel naїve patients and a 75 mg maintenance dose (MD) once daily in patients on chronic clopidogrel therapy play the same role in the platelet inhibition in Chinese with different CYP2C19 genotypes remains unknown. We aim to evaluate the impact on platelet inhibition by clopidogrel pretreatment strategy and its interaction effect with CYP2C19 genotype.</p><p><b>METHODS</b>Chinese patients undergoing PCI (n = 840) were assigned to 2×2 groups in the trial according to different clopidogrel pretreatment strategies (470 patients in LD, 370 patients in MD) and CYP2C19 genotypes (494 carriers of any CYP2C19 *2 or *3 loss-of-function allele, 346 non-carriers). The primary outcome was platelet aggregation (PA) as measured by the 10 µmol/L adenosine diphosphate induced light transmission aggregation.</p><p><b>RESULTS</b>Compared with MD group, LD strategy showed a significantly higher PA-((59.22 ± 11.67)% vs. (52.83 ± 12.17)%, P < 0.01), similar PA difference was observed in CYP2C19 loss-of-function carriers compared with non-carriers ((59.41 ± 10.91)% vs. (52.10 ± 12.90)%, P < 0.01). LD patients in either the CYP2C19 loss-of-function allele carrier or non-carrier group showed a significantly higher PA compared with MD group ((61.50 ± 10.61)% vs. (56.84 ± 10.74)%, P < 0.01; (56.06 ± 12.34)% vs. (46.88 ± 11.78)%, P < 0.01, respectively). A quantitative interaction effect was observed between clopidogrel pretreatment strategy and CYP2C19 genotype (P = 0.001).</p><p><b>CONCLUSION</b>The 300 mg LD strategy results in a decreased effect on platelet inhibition compared with the 75 mg MD in Chinese patients receiving clopidogrel prior to PCI, especially in the CYP2C19 2 or 3 loss-of-function allele non-carriers. (ClinicalTrials.gov number NCT01710436)</p>
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Aged , Female , Humans , Male , Middle Aged , Blood Platelets , Coronary Artery Disease , General Surgery , Cytochrome P-450 CYP2C19 , Genetics , Genotype , Percutaneous Coronary Intervention , Methods , Platelet Aggregation , Prospective Studies , Ticlopidine , Therapeutic UsesABSTRACT
ObjectiveTo determine the serum MDA5 levels and their clinical associations in patients with polymyositis/dermatomyositis (PM/DM).MethodsSerum anti-MDA5 antibody was detected by ELISA in 119 adult PM/DM patients,30 patients with systemic lupus erythematosus(SLE),30 patients with rheumatoid arthritis (RA),15 patients with primary Sj(O)gren's syndrome (SS),21 patients with pulmonary infection and 50 healthy controls.t-test,Mann-Whitney U test or chi-square test or Fisher exact test as well as Logistic multivariate regression analysis were carried out to compare the results of this study.ResultsSerum antiMDA5 antibody positive rate in DM patients(22.6％) were significantly higher compared with that of patients with PM (0,P＜0.01),patients with SLE (3.3％,X2=5.68,P＜0.05),RA (3.3％,X2=5.68,P＜0.05),pSS (0,P＜0.05) and pulmonary infection(0,P＜0.05) and healthy controls (0,P＜0.01).In the DM subgroup,CADM patients presented a higher positive anti-MDA5 antibody rate than classic DM patients.The incidence of arthritis,fever,vrash raised CEA and CA153 level,and serum concentration of GGT and ferritin were significantly higher in the anti-MDA5 positive DM group than anti-MDA5 negative DM group (X2=4.08,8.06,6.357,32.4,4.867; Z=-2.86,-2.44; P value of all these tests were less than 0.05 ),while the rate of serum positive ANA,serum level of CK and T,NK cell counts in the peripheral blood were much lower than those in anti-MDA5 negative DM group(X2=4.08; Z=-2.072,-2.013,-2.907; all P＜0.05).Moreover,the incidence of acute/subacute interstitial pneumonia(A/SIP) was significantly higher in anti-MDA5 positive DM patients than anti-MDA5 negative DM patients.The sensitivity and specificity of anti-MDA5 antibody for diagnosing A/SIP in DM patients were 88.2％ and 94％ respectively.Additionally,logistic multivariate analysis showed that anti-MDA5 was an independent risk factor for death of interstitial lung diseases (ILD) in DM (OR=8.46,95％CI 1.77～40.36,P＜0.01).ConclusionIn Chinese PM/DM patients,serum anti-MDA5 antibody is mainly present in DM patients and is a strong predictor for poor prognosis diagnosis of DM with A/SIP and is an independent risk factor for death of ILD in DM.
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ObjectiveTo investigate the clinical significance of peripheral blood lymphocyte subsets in patients with idiopathic inflammatory myopathy (ⅡM).MethodsPeripheral blood lymphocyte subsets was determined by flow cytometry in 89 patients with polymyositis(PM ) or dermatomyositis ( DM ).The association between clinical features and peripheral blood lymphocyte subsets was analyzed by F test,t test and x2 test.ResultsPatients with active DM showed significant decreases in counts of CD3+ cell,CD3+CD4+ cell and CD3+CD8+ cell[(8±4),(5.4±2.8) and (2.6±1.6) ×108/L respectively],compared with those in inactive DM [(16±6), (10.4±5.6) and (5.6±3.8) ×108/L respectively] and healthy controls [(14±4), (8.3±2.8) and (4.6±1.7) ×108/Lrespectively](F=12.901,8.257,7.084; P＜0.05).Logistic regression analysis indicated that myositis disease activity could influence the counts of peripheral blood CD3+ cell,CD3+CD4+ cell and CD3+ CD8+ cell (b=0.211,0.344,0.289; P＜0.05 ).ILD in ⅡM could influence the counts of CD3+ cell and the ratio of CD3+CD4+cell (b=0.928,1.974; P＜0.05 ).Logistic regression analysis indicated that the count of CD3+CD8+ cell was risk factor for death,and the relative risk was 0.989(b=-0.011 ; P＜0.05).ConclusionPeripheral blood lymphocyte subsets may be regarded as useful laboratory parameters for monitoring RA disease activity.Decreased CD8+ T cell may predict a poor outcome of patients with IIM.
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ObjectiveTo determine the serum level of anti-aminoacyl-tRNA synthetase (ARS)antibody in patients with polymyositis (PM) and dermatomyositis (DM) and to investigate the value of anti-ARS antibody for diagnosing interstitial lung diseases(ILD) in patients with PM/DM compared with anti-Jo-1 antibody.MethodsSerum anti-ARS antibody concentrations were measured by ELISA in 109 adult PM/DM patients,20 patients with SLE,20 patients with RA and 50 healthy controls.T test,Mann-Whitney U test,chi-square test or Fisher exact test were used to compare the sensitivity and specificity for diagnosing ILD in PM/DM patients between anti-ARS antibody and anti-Jo-1 antibody.Moreover,McNemar test was employed to analyze the correlation between the clinical features and anti-MDA5 antibody in PM/DM patients.Results The serum positive rate of anti-ARS antibody was 37.9％,7.8％,10％,0 and 0 in PM/DM patients with ILD and without ILD,patients with SLE and RA and healthy controls,respectively.Serum anti-ARS antibody levels and positive rate in the PM/DM patients with ILD were significantly higher when compared with PM/DM patients without ILD,patients with SLE and RA and healthy controls (X2=-13.5,5.45,10.57,15.17; P＜0.01 ).Anti-ARS antibody presented a significantly higher sensitivity for diagnosing ILD in patients with PM/DM compared to anti-Jo-1 antibody (P＜0.01).The rate of fever and ILD were significantly higher in anti-ARS positive group than anti-ARS negative group(X2=12.55,13.53; P＜0.05),while heliotrope rash and shawl sign occurred more often in anti-ARS negative group(X2=5.7,5.8; P＜0.05).Additionally,follow-up study showed that the serum anti-ARS antibody were all negative in nine patients who died of PM/DM with ILD (P＜0.05).ConclusionSerum anti-ARS antibody is a stronger predictor for early diagnosis of PM/DM with ILD compared to anti-Jo-1 antibody.The detection of anti-ARS antibody can be widely applied to clinical practice.
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Objective To investigate the prevalence and clinical features of tuberculosis (TB) in patients with systemic lupus erythematosus (SLE). Methods All articles published in Chinese between 1998-2008 were searched by using "systemic lupus erythematosus (SLE)" and "tuberculosis infection" as the keywords.Data were extracted and then Meta-analysis was done. Results Four hundred and twenty-four patients with the age(32±9) years from 30 studies were available for analysis, in which 45 were males and 379 were females. The duration of SLE when TB infection was diagnosed was (26±19) months.TB was found in 2.3%～19.6% of patients and 15.6% of them died. 73.0% of patients of SLE were in stable phase when infected with TB.7.50% of patients had a history of TB infection years ago. The common manifestations observed were fever (95.2%), weight loss (63.1%), cough and expectoration (60.2%), night-sweat (47.8%), chest pain (44.7%), chest distress and dyspnea (41.1%). 35.0% of patients had hematogenous disseminated pulmonary tuberculosis and 15.1% of patients had tuberculous meningitis. 45.3% of patients had extra-pulmonary TB. The focus of infection could not be identified in 2.8% of patients. Both ESR and CRP were elevated in patients(93.9%, 77.1%), but the positive rate of tuberculin test, anti-TB antibody and sputum smear posivity was low (19.3%, 41.8%, 14.3%). Conclusion TB incidence in patients with SLE is evidently high and the clinical mani-festation is not typical. Extra-pulmonary TB and serious infection are more frequently. Severe TB infection and extra-pulmonary TB are frequent. More patients with SLE are in stable phase when infected with TB. Early diagnosis of TB infection is important.