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Objective To study the demographic and clinical characteristics, correlation of genotype and phenotype and treatment of Blau syndrome to facilitate early diagnosis and timely treatment of Blau syndrome. Methods Seventy-two patients with Blau syndrome from 11 centers from May 2006 to April 2022 were retrospectively analyzed, and their general information, clinical data, laboratory examination and treatment medication were collected. Results The distribution of patients with Blau syndrome was uniform in geographical north and south of China, and there was no obvious gender bias. The mean age of onset was (14.30±12.81) months, and the age of diagnosis was (55.18±36.22) months. 35% of patients with Blau syndrome happened before 1 year old, and all patients developed before 5 years old. 87.50% (63/72) had granulomatous arthritis, 65.28% (47/72) had rash, 36.11% (26/72) had ocular involvement, 27.78% (20/72) had fever, and 15.28% (11/72) had pulmonary involvement. Arthritic manifestations of Blau syndrome were most at risk, followed by rash, ocular involvement, and fever.The first 25 months of the disease, the risk of developing a rash was the greatest. The risk of developing arthritis was the greatest between 25 months and 84 months. The main mutations were p.R334Q and p.R334W, and patients with p.R334Q mutation had relatively high incidence of fever (35.71%[5/14] vs. 14.29%[1/7], P=0.43) and ocular involvement (42.86%[6/14]vs. 28.57%[2/7], P=0.51). There was a relatively high incidence of rash (85.71%[6/7] vs. 64.29%[9/14], P=0.59) in patients with the p.R334W mutation. Forty-five patients(62.50%)were treated with a combina-tion of glucocorticoid and methotrexate. Twenty-two patients were treated with tumor necrosis factor antagonist in addition to glucocorticoid and methotrexate. Conclusions The risk of different clinical manifestations of Blau syndrome from high to low was arthritis, followed by rash, ocular involvement and fever. The main treatment was glucocorticoid combined with methotrexate, to which biological agents could be added.
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Objective:To evaluate the role of reactive oxygen species (ROS) /nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway in desflurane preconditioning-induced reduction of lipopolysaccharide (LPS)-induced acute cerebral inflammation in rats.Methods:One hundred and twenty clean-grade healthy male Sprague-Dawley rats, aged 8-10 weeks, weighing 200-250 g, were divided into 4 groups ( n=30 each) using a random number table method: control group (group C), LPS-induced acute cerebral inflammation group (group L), desflurane preconditioning group (group D), and N-acetylcysteine plus desflurane preconditioning group (group ND). LPS 1 mg/kg was injected via the tail vein to establish the model of acute cerebral inflammation in L, D and ND groups.In group D, rats inhaled 8.2% desflurane for 1 h once a day for 5 consecutive days, and LPS was intravenously injected at 24 h after the end of the 5th inhalation.In group ND, ROS scavenger N-acetylcysteine 150 mg/kg was intraperitonealy injected at 30 min before each inhalation of desflurane, and the other treatments were similar to those previously described in group D. The expression of Nrf2 and kelch-like ECH-associated protein 1 (Keap1) in microglia and astrocytes in the hippocampal CA1 region was determined by immunofluorescence double staining before LPS injection (at 24 h after the last desflurane preconditioning). Morris water maze test was used to measure the escape latency, space exploration time spent in the original platform quadrant, and frequency of crossing the original platform at 6, 12 and 24 h after injecting LPS.The expression of NOD-like receptor family pyrin domain containing 3 (NLRP3), apoptosis-associated speck-like protein containing CARD (ASC), caspase-1, interleukin-18 (IL-18) and interleukin-1beta (IL-1β) in microglia and astrocytes in the hippocampal CA1 region was determined by immunofluorescence double staining at 6, 12 and 24 h after injecting LPS.Nissl staining and immunofluorescence were used to count normal neurons and activated microglia and astrocytes in the hippocampus at 24 h after LPS injection. Results:Compared with group C, no significant change was found in the expression of Nrf2 and Keap1 in microglia and astrocytes before LPS injection ( P>0.05), and the escape latency was significantly prolonged, the space exploration time spent in the original platform quadrant was shortened, the frequency of crossing the original platform was decreased, the number of normal neurons was decreased, the number of activated microglia and astrocytes was increased, and the expression of NLRP3, ASC, caspase-1, IL-18 and IL-1β was up-regulated after injecting LPS in group L ( P<0.05). Compared with group L, the expression of Nrf2 was significantly up-regulated, and the expression of Keap1 was down-regulated before injecting LPS ( P<0.05), and the escape latency was shortened, the space exploration time spent in the original platform quadrant was prolonged, the frequency of crossing the original platform was increased, the number of normal neurons was increased, the number of activated microglia and astrocytes was reduced, and the expression of NLRP3, ASC, caspase-1, IL-18 and IL-1β was down-regulated after injecting LPS in group D( P<0.05). Compared with group D, the expression of Nrf2 was significantly down-regulated, the expression of Keap1 was up-regulated before injecting LPS ( P<0.05), and the escape latency was significantly prolonged, the space exploration time spent in the original platform quadrant was shortened, the frequency of crossing the original platform was decreased, the expression of NLRP3, ASC, caspase-1, IL-18 and IL-1β was up-regulated, the number of normal neurons was reduced, and the number of activated microglia and astrocytes was increased after LPS injection in group ND ( P<0.05). Conclusion:ROS/Nrf2 signaling pathway is involved in desflurane preconditioning-induced reduction of LPS-induced acute cerebral inflammation in rats.
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Objective:To evaluate the role of O-linked-β-N-acetylglucosamine (O-GlcNAc) transferase (OGT) in methane-induced alleviation of oxygen-glucose deprivation and restoration (OGD/R) injury to rat spinal cord neurons and the relationship with Nrf2 expression.Methods:The primarily cultured spinal cord neurons of rats were seeded in 6-well plates at a density of 1×10 5 cells/ml and divided into 6 groups ( n=60 each) using a random number table method: control group (group C), group OGD/R, methane group (group M), and methane plus OGT inhibitor alloxan group (group MA). The medium was replaced with glucose- and serum-free Earle′s salt solution, and the neurons were exposed to 37 ℃ and 5%CO 2-95%N 2 in an incubator for 2 h followed by routine culture to establish the model of OGD/R.In group M, 200 μl methane-saturated saline (final concentration of methane 1.8 mmol/L) was added at oxygen-glucose restoration.Alloxan 8 mmol/L was added at 10 min after oxygen-glucose restoration to inhibit OGT in MA group.At 12 h of oxygen-glucose restoration, the neuronal survival rate, leakage rate of lactic dehydrogenase (LDH) and apoptotic rate of neurons were measured.The expression of OGT and H3K4me3 in Nrf2 promoter was measured by chromatin immunoprecipitation and fluorescent quantitative real-time polymerase chain reaction.Nucleoprotein was extracted for determination of O-GlcNAc glycosylation of RBBP5 (a H3K4 methyltransferase subunit) by immunoprecipitation and Western blot.The spatial proximity of MLL1 subunit of MLL complex to histone H3 was detected by proximity ligation assay.The expression of Nrf2 protein and mRNA was detected by Western blot and quantitative real-time polymerase chain reaction, respectively.The activities of superoxide dismutase (SOD) and catalase (CAT) and malonaldehyde (MDA) concentration were measured by enzyme-linked immunosorbent assay. Results:Compared with group C, the survival rate of neurons was significantly decreased, and the leakage rate of LDH, apoptotic rate and MDA content in supernatant were increased in OGD/R and M groups ( P<0.01). Compared with OGD/R, the survival rate of neurons was significantly increased, the leakage rate of LDH, apoptotic rate and MDA content in supernatant were decreased, the expression of OGT and H3K4me3 in Nrf2 promoter was up-regulated, O-GlcNAc glycosylation and spatial proximity level of MLL1 to histone H3 were increased, the expression of Nrf2 protein and mRNA was up-regulated, and the activities of SOD and CAT were increased in group M ( P<0.01). Compared with group M, the survival rate of neurons was significantly decreased, the leakage rate of LDH, apoptotic rate and MDA concentration were increased, the expression of OGT and H3K4me3 in Nrf2 promoter was down-regulated, O-GlcNAc glycosylation and spatial proximity level of MLL1 to histone H3 were decreased, the expression of Nrf2 protein and mRNA was down-regulated, and activities of SOD and CAT were decreased in group MA ( P<0.05 or 0.01). Conclusion:OGT is involved in methane-induced alleviation of OGD/R injury to rat spinal cord neurons, which is related to up-regulating Nrf2 expression.
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Objective:To evaluate the effect of methane on purinergic ion channel type 7 receptor (P2X 7R)/nod-like receptor protein 3 (NLRP3) signaling pathway during inflammatory responses in a rat model of spinal cord ischemia-reperfusion (I/R). Methods:Fifty-four clean-grade healthy male Sprague-Dawley rats, aged 3 months, weighing 350-380 g, were divided into 3 groups ( n=18 each) using a random number table method: sham operation group (group S), spinal cord I/R group (group I/R) and methane group (group M). Rats underwent sham operation in group S. Spinal cord ischemia was induced by occlusion of the thoracic aorta combined with controlled hypotension for 9 min, followed by reperfusion in anesthetized animals in group I/R.Methane-rich saline 10 mg/kg was intraperitoneally administered immediately after onset of reperfusion in group M. Motor sensory deficit index (MSDI) in hind limbs was measured at 12, 24 and 48 h of reperfusion.The L 3-5 segment of spinal cord was removed at 48 h of reperfusion for determination of the number of normal neurons (by Nissl staining), the number of activated microglia and expression of P2X 7R, NLRP3, apoptosis-associated speck-like protein containing CARD (ASC), cysteine-requiring aspartate protease (caspase-1), interleukin-1beta (IL-1β) and IL-18 (by immunofluorescence staining) in anterior and posterior horns of spinal cord. Results:Compared with group S, the MSDI was significantly increased at 12, 24 and 48 h of reperfusion, and the number of normal neurons in anterior and posterior horns of spinal cord was decreased, the number of activated microglia was increased, and the expression of P2X 7R, NLRP3, ASC, caspase-1, IL-1β and IL-18 was up-regulated at 48 h of reperfusion in group I/R ( P<0.01). Compared with group I/R, the MSDI was significantly decreased at each time point of reperfusion, and the number of normal neurons in anterior and posterior horns of spinal cord was increased, the number of activated microglia was decreased, and the expression of P2X 7R, NLRP3, ASC, caspase-1, IL-1β and IL-18 was down-regulated at 48 h of reperfusion in group M ( P<0.05). Conclusion:The mechanism by which methane reduces inflammatory responses is related to inhibiting P2X7R/NLRP3 signaling pathway in a rat model of spinal cord I/R.
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Objectives:To analyze the effect of cytokine-like protein 1 (CYTL1) on the pro-inflammatory functions of neutrophils in septic mice.Methods:C57BL/6 mice were randomly (random number)divided into the sepsis group and control group, with 6-12 mice in each group. A septic mouse model was established by the procedure of cecal ligation and puncture (CLP). Neutrophils were isolated from peripheral venous blood 8 h after the procedures according to the density gradient centrifugation method, and the neutrophils were treated with CYTL1 recombinant protein. The Boyden chemotaxis assays were used to detect the activity of CYTL1. fMLF and interleukin-8 were used as positive controls. Phagocytosis was determined by confocal microscopy or on a FACSVerse. Reactive oxygen species generation in neutrophils were monitored with the commercial CellROX Green fluorescent probe.Results:Compared with the control group, CYTL1 showed strong chemotactic activity on neutrophils of septic mice [(10.0 ± 2) vs (66.3 ± 4), t=-21.6, P <0.0001]. CYTL1 has stronger chemotactic activity than IL-8 [(66.3 ± 4.0) vs (21.7 ± 6.5), t = 10.1, P = 0.001]. But the chemotactic activity of fMLF and CYTL1 changed little on neutrophils of septic mice [(66.3 ± 4.0) vs (86.0 ± 13.5), t=-2.4, P = 0.073]. CYTL1 could augment the uptake of E.coli by neutrophils compared with the sepsis group [(7.35 ± 1.66) vs (2.84 ± 0.62), t = 4.4, P = 0.012]. The number of E.coli particles swallowed intracellular by a single cell significantly increased upon the stimulation of CYTL1. CYTL1 could also enhance the intracellular reactive oxygen species production of neutrophils of septic mice [(84340.1 ± 5353.5) vs (351018.7 ± 72291.7), t = 6.4, P = 0.003]. Conclusions:CYTL1 can prompt the pro-inflammatory functions of neutrophils in septic mice. In the early phase of bacterial infection, this protein may play an important role in regulating the inflammation.
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Objective@#To analyze the risk factors related to the myocardial injury after non-cardiac surgery (MINS) in patients who underwent major abdominal surgery.@*Methods@#The clinical data of all patients admitted in the surgical ICU of Peking University People′s Hospital from Jan 2016 to Dec 2018 were analyzed. Logistic multivariate analysis was performed to analyze the association of clinical characteristics with the incidence of MINS.@*Results@#A total of 322 patients were included, 48.4% (156/322) were diagnosed as with MINS. 97.4% (152/156) of MINS occurred during the first 72 h of admission. Multivariate analysis showed that independent predictive factors of MINS were age >65y (OR=1.747, P=0.021), body mass index (OR=1.085, P=0.008), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ, OR=1.066; P=0.047), hypertension (OR=1.747, P=0.027), blood lactate (OR=1.393, P=0.001) and acute kidney injury (OR=2.065, P=0.047).@*Conclusions@#The incidence of MINS in patients who underwent major abdominal surgery was high. Age, body mass index, APACHE Ⅱ score, hypertension, blood lactate level and acute kidney injury after surgery were independent risk factors of MINS.
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Objective To analyze the risk factors related to the myocardial injury after non-cardiac surgery (MINS) in patients who underwent major abdominal surgery.Methods The clinical data of all patients admitted in the surgical ICU of Peking University People's Hospital from Jan 2016 to Dec 2018 were analyzed.Logistic multivariate analysis was performed to analyze the association of clinical characteristics with the incidence of MINS.Results A total of 322 patients were included,48.4％ (156/322) were diagnosed as with MINS.97.4％ (152/156) of MINS occurred during the first 72 h of admission.Multivariate analysis showed that independent predictive factors of MINS were age ＞ 65y (OR =1.747,P =0.021),body mass index (OR =1.085,P =0.008),acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ,OR =1.066;P =0.047),hypertension (OR =1.747,P =0.027),blood lactate (OR =1.393,P=0.001) and acute kidney injury (OR=2.065,P=0.047).Conclusions The incidence ofMINS in patients who underwent major abdominal surgery was high.Age,body mass index,APACHE Ⅱ score,hypertension,blood lactate level and acute kidney injury after surgery were independent risk factors of MINS.
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We retrospectively analyzed 126 children with juvenile idiopathic arthritis (JIA)admitted from January to December 2017,including 65 cases of systemic-onset JIA (SoJIA) and 61 cases of other types of JIA.The value of serum amyloid A protein (SAA) in the identification of the disease activity and infection in children with SoJIA was assessed.The area under the ROC curve of SAA in identification of disease activation of SoJIA patients was 0.934,which was not significantly different with other types of JIA.With the cut-off value of 68.32 mg/L the sensitivity and specificity for diagnosis of SoJIA activity were 0.913 and 0.892 respectively.In SoJIA patients the SAA was closely correlated with ESR and CRP (r=0.721 and 0.699,P＜0.001).The SAA level was significantly higher in the disease active stage than that in stable stage,in the stable stage with infection than that in the stable stage without infection of SoJIA patients.There were also significant differences in platelet and CRP between active disease with infection and active disease without infection.SAA is expected to be used for assessing disease activity of SoJIA,if combined with platelet and CRP,it may be of value in the identification of the complicating infection.
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Objective To investigate the effect of Sirt1 gene knockout on chronic kidney disease induced by 5/6 nephrectomy in mice and vascular endothelial growth factor (VEGF)/fetal liver kinase-1 (Flk-1) signaling pathway.Methods Twenty four male Sirt1 +/+ and Sirt1 +/-mice wererandomly divided into four groups:Sirt1+/+ mice with sham-operation (WT-Sham,n=6),Sirt1+/-mice with sham-operation (KO-Sham,n=6),Sirt1 +/+ mice with 5/6 nephrectomy (WT-Nx,n=6) and Sirt1 +/-mice with 5/6 nephrectomy (KO-Nx,n=6).Proteinuria was determined by urine collection from 8:00 to 8:00 the next day at 20 weeks.Serum creatinine (Scr),urea nitrogen (BUN) and the renal pathological changes were measured after 20 weeks.Expressions of Sirt1,collagen Ⅰ and transforming growth factor β(TGF-β) were used to analyze the changes of renal fibrosis by immunohistochemistry staining.Real-time PCR and Western blotting were used to measure the mRNA and protein expressions of Sirt1,fibronectin,collagen Ⅰ,VEGF and Flk-1 in kidney.Results Sirt1 expressed in glomernlar endothelial cells,podocytes,mesangial cells and renal tubular epithelial cells in Sirt1 +/+ mice,while Sirt1 expression intensity was significantly reduced in Sirt1 +/-mice.Compared with the WT-Sham group,WT-Nx group had increased proteinuria,BUN,Scr,glomernlar sclerosis index and tubulointerstitial fibrosis index at 12 weeks after operation (all P ＜ 0.01),and KO-Nx group had exacerbated the above up-regulations (all P ＜ 0.01).Compared with those in WT-Sham group,the expressions of fibronectin,collagen Ⅰ and TGF-β were up-regulated in WT-Nx group (all P ＜ 0.01),and were significantly augmented in KO-Nx group (all P ＜ 0.01).Compared with those in WT-Sham group,renal mRNA and protein expressions of VEGF and Flk-1 were decreased in WT-Nx group,and KO-Nx group aggravated their down-regulation (all P ＜ 0.01).Conclusions Sirt1 gene knockout can increase proteinuria and Scr,and aggravate renal pathology and renal fibrosis in 5/6 nephrectomized mice,which is associated with the inhibition of VEGF/Flk-1 signaling pathway.It is suggested that Sirt1 may be a potential therapeutic target of chronic kidney disease.
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Juvenile idiopathic arthritis is a disease characterized by autoimmune disorders and immune imbalance. In recent years,immune tolerance has become a hot issue in the pathogenesis of juvenile idiopathic ar-thritis. In this article,cytotoxic T lymphocyte associated-antigen 4,programmed death-1,Treg cells and apoptotic cells in the pathogenesis of juvenile idiopathic arthritis are summarized.
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Objectives To explore the changes of T helper (Th) lymphocyte and its related factors in children with syste-mic-onset juvenile idiopathic arthritis (SoJIA). Methods A total of 36 SoJIA inpatients, hospitalized from January 2012 to June 2013, were divided into active phase group and remission group. In addition, 20 healthy children were selected as normal con-trols. Th1, Th2 and Th17 cell ratios in peripheral blood mononuclear cells were detected and compared between each group by flow cytometry. Serum interferon-γ(INF-γ), interleukin-4 (IL-4), interleukin-17 (IL-17) levels were measured by enzyme-linked immunosorbent assay. Results The proportions of Th17 cells over CD3+CD8-cell were (3.30±2.15)%, (1.78±1.14)%and (1.22± 1.14)%in active phase group, remission group and control group. The difference among three groups was significant (H=14.437, P=0.001), and the active phase group had higher proportion of Th17 than the other two groups (P0.05). The serum IL-17 levels were (125.82 ± 45.87) pg/ml, (57.79±25.84)pg/ml and(50.02±18.37)pg/ml in active phase group, remission group and control group with signifi-cant difference among three groups (F=31.82, P=0.000), and the active phase group had higher level of IL-17 than the other two groups (P0.05). Conclusions Acquired cellular immunity is involved in pathogenesis of SoJIA, the increased proportion of Th1 and Th17 cell and the changes of related cytokines seem to correlate with active phage of SoJIA.
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Objective To explore the influence of allergic rhinitis (AR) on patients with systemic onset juvenile idiopathic arthritis (SoJIA).Methods The study involved 44 cases with SoJIA from Department of Pediatrics,Renji Hospital affiliated to School of Medicine of Shanghai Jiaotong University from July 2008 to November 2013.The Clinical and laboratory data of all patients were recorded respectively.This was a retrospective cohort study.According to the diagnosis of allergic rhinitis (AR),children were subdivided into AR group (16 cases) and Non-AR group (28 cases).ACR Pediatric criteria (ACR Pedi) 30/ 50/70 and related indicators of SoJIA between the two groups were compared.In the AR group,the correlation between AR scores and DAS28 was analyzed.When SoJIA of the two groups relapsed,the AR group (the treatment group) received anti-rheumatism for arthritis as well as nasal spray and oral antihistamines for AR.The non-AR group (control group) only received the anti-rheumatism for arthritis.The improvement of SoJIA between the two groups was analyzed.The continuous variables were analyzed by Student's t-test or the MannWhitney U-test as appropriate.Categorical data were compared between different groups by the Chi-square test.Correlations were determined by Pearson or Spearman's ranking.Results ① In the retrospective analysis:the physician's and patients'/parents' general assessment on a 10 cm visual-analogue scale (VAS),number of joints with res-triction of movement,number of swollen joints,ESR,serum ferritin(SF) and childhood health assessment questionnaire (CHAQ) score were significantly elevated in the AR group compared with Non-AR group at the disease onset [(6.7±1.0) cm vs (4.8±1.9) cm; (6.5±1.4) cm vs (3.2±1.5) cm; 4.1±2.7 vs 2.7± 1.7; 3.4±2.4 vs 1.4±1.5; (87±35) mm/1 h vs (61±40) mm/1 h; (888±1 043) μg/L vs (311±324) μg/L; 1.6±0.5 vs 0.7±0.3,respectively; all P＜0.05].At the 3 and 6 months follow-up after disease onset,the proportion of patients who reached ACR pedi 50,70 in AR group were lower than the Non-AR group,while the cumulative glucocorticoid dose was higher in the AR group than that of those without AR [at 3 months 38％ vs 71％; 13％ vs 46％; (76±35) mg/kg vs (43±36) mg/kg,respectively; at 6 months 25％ vs 71％; 19％ vs 64％; 127±57 vs 67±58,respectively,all P＜0.05]; In the AR group,at the disease onset,3 and 6 months follow-up after disease onset,the scores of AR was positively correlated with DAS28(r=0.741,0.703,0.680,respectively; all P＜0.05).② In the prospective study:when SoJIA was relapsed,systemic feature score,the physician's and patients' /parents' general assessment on a l0 cm VAS,number of joints with restriction of movement,number of swollen joints,ESR,SF and CHAQ score were significantly elevated in the treatment group compared with the control group [3.8±1.5 vs 2.1±1.1; (5.6±1.5) cm vs (4.5±1.6) cm; (4.6±1.9) cm vs (3.1±1.5)cm; 3.9±1.9 vs 2.5±1.4; 2.4±0.9 vs 1.5±1.2; 92±27 vs 53±37; 565(339,1 192) μg/L vs 171(85,284) μg/L; 13(0.8,1.6) vs 0.7(0.5,1); respectively; P＜0.05].The improvement rate of the physician's and patients'/parents' general assessment on a 10 cm VAS,number of swollen joints,number of joints with restriction of movement,ESR and CHAQ score at the follow-up 3 months were higher in treatment group than the control group [71(55,86)％ vs 46(0,75)％; 67(45,81)％ vs 28(-4,62)％; 92(77,96)％ vs 70(27,88)％; 65(48,81)％ vs 0(-17,67)％; 100(46,100)％ vs 42(0,100)％; 67(49,85)％ vs 37(0,75)％; P＜0.05].At the follow-up 6 months,the improvement rate of ESR,patients'/ parents' general assessment on a 10 cm VAS,number of joints with restriction of movement and CHAQ score were higher than control group [94(85,96)％ vs 73(33,85)％; 89(65,99)％ vs 63(5,85)％; 100(100,100)％ vs 100(0,100)％; 91(69,100)％ vs 72(11,91)％; respectively,P＜0.05].Conclusion AR may exert an adverse influence on SoJIA.SoJIA patients who are treated with combined with AR may have better outcome than those who are only treated for arthritis.
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Objective To evaluate the inlluence of atopy on juvenile idiopathic arthritis (JIA).Methods The study involved 117 cases with JIA from Department of Pediatrics,Renji Hospital Affiliated to School of Medicine of Shanghai Jiaotong University from Jul.2008 to Jul.2013.These patients were enrolled for retrospective cohort study,and subdivided into JIA and atopic group or JIA and non-atopic group.There were 34 cases combined with atopy,83 cases without atopy.Based on the diagnosis of allergic rhinitis (AR),those JIA children in the atopic group were organized into AR group (19 cases) and non-AR group (15 cases).The clinical and laboratory data were recorded and analyzed to compare the differences of the remission of American College of Rheumatology Pediatric (ACR Pedi) 30/50/70 between atopic group and non-atopic group,AR group and non-AR group.In AR group,the correlation between AR scores and disease activity score (DAS28) was analyzed.Results 1.The physician's and patients'/parents' general assessment on a 100 mm visual-analogue scale (VAS),number of joints with restriction of movement and childhood health assessment questionnaire (CHAQ) were significantly elevated in atopic group compared with controls at the beginning (all P ＜ 0.05).In the follow-up 3 months after disease onset,the proportion of reaching ACR Pedi 30,50 and the proportion of reaching ACR Pedi 50,70 in 6 months later in JIA with atopy were lower than JIA children without atopy (all P ＜ 0.05) ; In the follow-up 3 and 6 months,the cumulative glucocorticoid dose was higher in atopy group compared with Non-atopy,which showed a statistical significance (all P ＜ 0.05).2.Among the AR group,at the disease onset,the physician's and patients'/parents' VAS,number of joints with restriction of movement and CHAQ were elevated in AR group compared with controls with statistical significance (all P ＜ 0.05).In the follow-up 3 months,the proportion of reaching ACR Pedi 30 and 50 was lower in AR group compared with non-AR group.In the follow-up 6 months,the cumulative glucocorticoid dose was higher in AR group compared with non-AR,which showed a statistical significance.But the ratio of ACR Pedi 30,50 and 70 were lower in AR group compared with non-AR group (all P ＜ 0.05).Among JIA combined with AR,at the beginning,follow-up 3 and 6 months after disease onset,the scores of AR positively correlated with DAS28 (r =0.671,0.518,0.496,all P ＜ 0.05).Conclusion Atopy or AR may exert an adverse influence on JIA.
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With acute lymphoblastic leukemia in skeletal muscle symptom,part of these patients may be misdiagnosed as juvenile idiopathic arthritis. How to distinguish these children has significance for the timely and proper treatment and good prognosis. This article from the history and routine laboratory examination and ima-ging examination put forward early in the disease through the analysis of joint symptoms from juvenile joint pain,blood and imaging characteristics and preliminary identification of childhood leukemia from juvenile idio-pathic arthritis in order to decrease the rate of misdiagnosis.
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Objective To discuss the expression of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) in adenomyosis and its clinical significance. Methods The expression of COX-2 and VEGF was examined by immunohistochemistry SP method, in ectopic endometrium and eutopic endometrium, compared with normal endometrium. Results (1) COX-2 expression in ectopic, eutopic endometrium with adenomyosis was significantly higher than that in control group (P<0.05). No statistically significant difference was found between ectopic endometrium and eutopic endometrium group with adenomyosis (P0.05).(2) VEGF expressions in ectopic, eutopic endometrium with adenomyosis were both significantly higher than that of control group (P<0.05); no statistically significant difference was found between ectopic endometrium and eutopic endometrium group (P0.05).(3) COX-2 and VEGF had the positive relativity in the ectopic endometriumal expression of adenomyosis patient (P<0.05). Conclusion COX-2 and VEGF may play a key role in adenomyosis. Both may have close relation in angiogenesis and may provide new targets for therapy of adenomyosis.