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Objective:To evaluate the value of shear wave elastography (SWE) in skin assessment of Systemic sclerosis (SSc).Methods:A total of 58 SSc patients admitted to Peking University Third Hospital from May 2021 to October 2022 and 41 healthy volunteers were included in the study. Skin shear wave elastography (SWE) was performed at 17 sites defined in modified Rodnan skin score (mRSS) measurement, and shear wave velocity values were recorded to evaluate skin hardness. SPSS 22.0 software was used to analyze the skin hardness of SSc patients and healthy controls, and the correlation between skin hardness of SSc patients and clinical data was analyzed. A logistic regression model was constructed to evaluate the diagnostic efficacy of skin hardness at different sites of SSc patients, and to further select the most practical measurement site.Results:The SWE value of SSc patients was significantly higher than that of healthy control group ( P<0.05). There was a positive correlation between SWE and mRSS in the measurement of bilateral fingers, bilateral dorsal hands, bilateral forearms, fore-chest, abdomen, bilateral thighs, and bilateral dorsal feet. Skin stiffness measured by SWE was significantly correlated with SSc disease activity score (EScSG-DAI), ( r=0.71, P<0.001), disease injury score (SCTC-DI), (P=0.55, P=0.005) and functional score (HAQ-DI), ( r=0.46, P=0.003). Reducing the number of measurement sites to 12 (bilateral fingers, bilateral hands, bilateral forearms, bilateral upper arms, forehead, fore-chest, bilateral dorsum of feet) performs as well as all 17 measurement sites simultaneously in assessing disease activity. Conclusion:SWE is a good evaluation tool to reflect the skin lesions of SSc, which is of great value for the diagnosis and evaluation of the disease. We can further standardize the measurement sites and select the most appropriate evaluation strategy, so as to achieve better clinical application.
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Haploidentical hematopoietic stem cell transplantation is a recommended alternative therapy for children with severe aplastic anemia who lack a human leukocyte antigen (HLA)-identical sibling donor and do not respond well to immunosuppressive therapy; however, due to non-identical HLA, the patients may have donor-specific anti-HLA antibody, which may lead to a relatively high incidence rate of poor graft function. Compared with HLA-identical transplantation, conditioning regimen for haploidentical transplantation still needs to be explored. This article reviews the detection and treatment of donor-specific anti-HLA antibody, the selection of conditioning regimen, and the mechanism and treatment of poor graft function in haploidentical hematopoietic stem cell transplantation.
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Child , Humans , Anemia, Aplastic/therapy , Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Transplantation Conditioning , Transplantation, HomologousABSTRACT
Hepatic fat content is an important index for the early diagnosis, disease grading, and outcome evaluation of nonalcoholic fatty liver disease (NAFLD). Various magnetic resonance imaging (MRI) methods have been used to determine hepatic fat content in NAFLD, among which proton density fat fraction obtained by magnetic resonance spectroscopy and chemical-shift-encoded MRI can achieve precise quantification of hepatic fat and therefore, it is considered the imaging gold standard for the diagnosis of fatty liver disease and has been applied in clinical research. This article reviews the research advances in the MRI techniques for quantification of hepatic fat content, in order to provide a reference for clinical application and experiment.
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Objective To investigate the causes of misdiagnosis related to rheumatism diseasecases.Methods A search was performed in database WanFang to identify the misdiagnosed clinical cases reports which were published in Chinese Journal and a retrospective analysis was conducted.All data were analyzed by chi-square test and Fisher's exact test.Results We screened 705 citations and identified 215 articles on the rheumatic diseases,finally,187 reports and 195 cases in total with definite diagnosis were included,accounting for 25.5％ of the total number of misdiagnosed cases.Primary vasculitis (72 cases),rheumatoid arthritis (25 cases),spondyloarthropathy (17 cases),polymyositis (14 cases),systemic lupus erythematosus (13 cases) and Sj(o)gren's syndrome (SS) (12 cases) were amongst the top misdiagnosed rheumatic diseases.There was no difference between 1998-2006 and 2007-2015 in the overall misdiagnosis cases.Single disease comparison,polymyositis,spondyloarthropathy and IgG4 related disease were increased (P=0.002;P=0.034;P=0.060;respectively),while polymyositis was delayed (P=0.002).Rheumatism misdiagnosed cases reported mainly came from tertiary hospitals and the department of rheumatology.Conclusion Misdiagnosed rheumatism are common in clinic.Strengthen the physicians' continuous education,the validity of clinical thinking mode and rational use of diagnostic criteria are important to make correct diagnosis.
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<p><b>BACKGROUND</b>Interleukin (IL)-37, also called IL1F7, is a natural inhibitor of inflammatory and immune responses. It is involved in the pathogenesis of rheumatoid arthritis (RA). This study aimed to investigate the role of IL1F7 gene polymorphism in RA susceptibility in a large cohort of patients.</p><p><b>METHODS</b>Five selected single-nucleotide polymorphisms in IL1F7 genes (rs2723186, rs3811046, rs4241122, rs4364030, and rs4392270) were genotyped by TaqMan Allelic Discrimination in Northern Chinese Han population. The allele and the genotype were compared between patients with RA and healthy controls. Association analyses were performed on the entire data set and on different RA subsets based on the status of the anti-cyclic citrullinated peptide antibody and the rheumatoid factor by logistic regression, adjusting for age and gender.</p><p><b>RESULTS</b>Trend associations were detected between rs2723186, rs4241122, rs4392270, and RA in Stage I (160 patients with RA; 252 healthy controls). Further validation in Stage II comprised 730 unrelated patients with RA (mean age: 54.9 ± 12.6 years; 81.6% females) and 778 unrelated healthy individuals (mean age: 53.5 ± 15.7 years; 79.5% females). No significant differences in the distributions of alleles and genotypes were observed between the case and control groups in both the entire set and the different RA subsets. Disease activity and age of RA onset were also not associated with genotype distributions.</p><p><b>CONCLUSION</b>IL1F7 gene polymorphism does not significantly influence RA susceptibility in the Northern Chinese Han population.</p>
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BACKGROUND@#Interleukin (IL)-37, also called IL1F7, is a natural inhibitor of inflammatory and immune responses. It is involved in the pathogenesis of rheumatoid arthritis (RA). This study aimed to investigate the role of IL1F7 gene polymorphism in RA susceptibility in a large cohort of patients.@*METHODS@#Five selected single-nucleotide polymorphisms in IL1F7 genes (rs2723186, rs3811046, rs4241122, rs4364030, and rs4392270) were genotyped by TaqMan Allelic Discrimination in Northern Chinese Han population. The allele and the genotype were compared between patients with RA and healthy controls. Association analyses were performed on the entire data set and on different RA subsets based on the status of the anti-cyclic citrullinated peptide antibody and the rheumatoid factor by logistic regression, adjusting for age and gender.@*RESULTS@#Trend associations were detected between rs2723186, rs4241122, rs4392270, and RA in Stage I (160 patients with RA; 252 healthy controls). Further validation in Stage II comprised 730 unrelated patients with RA (mean age: 54.9 ± 12.6 years; 81.6% females) and 778 unrelated healthy individuals (mean age: 53.5 ± 15.7 years; 79.5% females). No significant differences in the distributions of alleles and genotypes were observed between the case and control groups in both the entire set and the different RA subsets. Disease activity and age of RA onset were also not associated with genotype distributions.@*CONCLUSION@#IL1F7 gene polymorphism does not significantly influence RA susceptibility in the Northern Chinese Han population.
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Adult , Aged , Female , Humans , Male , Middle Aged , Arthritis, Rheumatoid , Genetics , Asian People , Genetics , Case-Control Studies , China , Ethnology , Genetic Predisposition to Disease , Genotype , Interleukin-1 , Genetics , Polymorphism, Single NucleotideABSTRACT
Epigenetic modifications have been proved to be a powerful way to activate silent gene clusters and lead to diverse secondary metabolites in fungi. Previously, inactivation of a histone H3 deacetylase in had led to pleiotropic activation and overexpression of more than 75% of the biosynthetic genes and isolation of ten compounds. Further investigation of the crude extract of strain resulted in the isolation of twelve new diterpenoids including three cassanes (-), one cleistanthane (), six pimaranes (-), and two isopimaranes ( and ) along with two know cleistanthane analogues. Their structures were elucidated by extensive NMR spectroscopic data analysis. Compounds and showed potent inhibitory effects on the expression of MMP1 and MMP2 (matrix metalloproteinases family) in human breast cancer (MCF-7) cells.
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Objective To evaluate the clinical and radiographic characteristics and function of erosive hand osteoarthritis (EOA) patients. Methods Data were obtained from 19 patients with EOA, including their social conditions, clinical conditions, radiographic scores and hand function evaluation. The number of hand osteoarthritis (HOA) patients was 312. The control group consisted of non-EOA patients with hand osteoarthritis with a ratio of 4:1 to EOA patients. A non-parameter test analysis was performed. All data were analyzed by SPSS 23.0 statistical analysis, t test, χ2 test, Fisher exact probility and Spearman's correlations analysis were used for statistical analysis. Results Totally data of 19 patients were collected. Eighteen were female. Onset age was (56±8). Average duration was 56 (12~120) months. FIHOA scores of all the EOA patients were at least 5. All the erosions of 39 joints were characteristically central and erosive changes in 7 joints (18%) showed up as gull-wing. Among 39 erosive joints, including 12 (31%) E and 27 (69%) R, 34 (87%) distal interphalangeal joints were involved. Data analysis found out that EOA patients had longer disease duration (Z=2.610, P=0.009), more severe K-L level (44 ±11 vs 26 ±7, t=7.134, P<0.01), higher AUSCAN total score (28±6 vs 21±7, t=3.781, P<0.01) and higher AUSCAN function score (18±6 vs 12±6, t=4.042, P<0.01). The differences of ESR and CRP were not significant between EOA and non-EOA patients. Conclusion Erosions seen in EOA patients are centrally located gull-wing in the DIP joints. EOA patients have longer duration, more severe radiographic damage and worse joint function.
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BACKGROUND:Epidermal growth factor is an auxiliary growth factor,but its effect on the growth of bone marrow mesenchymal stem cells (BMSCs) is uncertain.OBJECTIVE:To establish a mature method for isolation,extraction and identification of rat BMSCs,to investigate the effects of epidermal growth factor (EGF) on the proliferation and migration ability of BMSCs and to explore its potential mechanisms at the same time.METHODS:Rat BMSCs were isolated and purified using the improved whole bone marrow adherence method.After the cells were subcultured to the third generation,we detected the expression of cells surface antigens CD29,CD45 and CD90 by flow cytometry.BMSCs were further identified by osteogenic and adipogenic differentiation.Meanwhile,the effect of EGF on the proliferation of passage 3 BMSCs was measured by cell counting kit-8 and clonogenic assay.And the migration of P3 cells was verified by Transwell chamber.In addition,we detected the expression of proteins related to PI3K/Akt and nuclear factor-κB signaling pathways by western blot assay.RESULTS AND CONCLUSION:The primary BMSCs were polygonal and spindle-shaped,and then gradually appeared to be spindle-shaped.The results of flow cytometry demonstrated that the passage 3 cells were positive for CD29 and CD90,but negative for CD45.Furthermore,we successfully induced the osteogenic and adipogenic differentiation of BMSCs in vitro.Additionally,our data demonstrated that EGF promoted the proliferation and migration of passage 3 BMSCs.The relative expression levels of p-Akt and Bcl-2 of PI3K/Akt signaling pathway was up-regulated and the expression of Bax was down-regulated.At the same time,the relative expression level of phosphorylated p65 of nuclear factor-κB signaling pathway was up-regulated and the expression of phosphorylated inhibitor κB was down-regulated.Moreover,the downstream protein of matrix metalloproteinase-9 was up-regulated.Those proteins were related to the migaration of BMSCs.In summary,our results suggest that EGF could promote the proliferation and migration of BMSCs.
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Objective To investigate the clinical and laboratory features of male patients with anti-phospholipid syndrome (APS).Methods Thirty-three male APS patients admitted to Peking University People's Hospital from January 2003 to April 2015 were enrolled.One hundred and fourteen female APS patients were selected as controls.Female patients with thrombosis were analyzed.x2 test, Fisher's exact test and t test were used for statistical analysis.Results Among male patients, 39.4％ were primary APS and 60.6％ were secondary APS.Compare with female patients,the prevalence of venous thrombosis was significantly higher than that in male APS (72.7％ vs 29.8％,x2=19.719, P=0.000).The male APS patients experienced more episodes of thrombosis (75.8％ vs 22.8％, x2=31.669, P=0.000) and not less than two locations of thrombosis than female (69.7％ vs 22.8％, x2=25.321, P=0.000), there was still significant difference between male patients and female patients with thrombosis.There was no difference of antiphopholipid antibodies between the two groups.Conclusion Male patients with antiphospholipid syndrome are more prone to have thrombosis.More clinical interventions should be implemented in male patients with APS.
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This study was aimed to investigate the safety and effectiveness of tumor-ablative Chemotherapy combined with low intensity conditioning regiment BUCy/TBICy for patients with hematologic malignancies receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT). The clinical data of 30 patients with hematologic malignancies received above-mentioned therapeutic method from January 2012 to January 2013 was analyzed retrospectively, and the engraftment, GVHD, infection, conditioning-related toxicity, relapse and survival rates were evaluated. All the patients signed the informed consent before transplantation. The median follow-up duration was 20.5 (16.3-27.3) months. The results indicated that all the patients had been engrafted successfully. One year overall survival (OS) and disease-free survival (DFS) rates were 93.3% and 83.3% respectively. No conditioning-related toxicity occurred. The incidences of II-IV grade aGVHD was 37.9%, among which incidence of III-IV grade aGVHD was 3.4%; incidence of extensive cGVHD was 13.8%. So far, 1 case relapsed, 1 case displayed graft rejection, and poor function of graft occurred in 1 case, death occurred in 2 cases(6.7%). It is concluded that tumor-ablative chemotherapy combined with low intensity-modified BUCy/TBICy is safe and effective in allogeneic hematopoietic stem cell transplantation for hematologic malignancies, and it is useful to reduce relapse of hematologic malignancies after transplantation.
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Hematologic Neoplasms , Therapeutics , Hematopoietic Stem Cell Transplantation , Methods , Retrospective Studies , Transplantation Conditioning , Methods , Transplantation, Homologous , Treatment OutcomeABSTRACT
Objective To explore the diagnostic value of anti-cyclic citrullinated peptide (CCP) 3.1 IgG/IgA antibody detected by enzyme-linked immunosorbent assay (ELISA) in patients with rheumatoid arthritis (RA).Methods The ELISA was used to measure the anti-CCP3.1 antibody in the serum of 169 RA patients,100 patients with other rheumatic diseases (including systemic lupus erythematosus,Sjogren's syndrome and osteoarthritis) and 72 healthy controls.The diagnostic value of CCP3.1 was assessed and compared with the second generation of anti-CCP IgG (CCP2) antibody,the correlations between anti-CCP3.1 antibody and the clinical and laboratory parameters were analyzed.Two-independent samples t test,chi-square test and Spearman's correlation were adopted for statistical analysis.Results ① The average cut-off concentration of anti-CCP3.1 antibody was (1122±1429) U/ml in RA,(13±14) U/ml in other rheumatic diseases and (6±5) U/ml in healthy controls.② The area under curve of ROC for anti-CCP3.1 antibody and anti-CCP2 antibody were 0.923 and 0.936 respectively.There was no difference between the sensitivity (82％ vs 79％)and specificity (97％ vs 99％) of anti-CCP3.1 antibody and anti-CCP2 antibody.The Kappa values between anti-CCP3.1 antibody and anti-CCP2 antibody was 0.763.③ We also found that anti-CCP3.1 antibody was positive in 20％(7/35) of anti-CCP2 antibody negative,43％(18/42) of RF negative,62％(47/76) of AKA negative,71％(49/69) of APF negative and 13％ of autoantibodies negative patients,indicated that antiCCP3.1 antibody had a potential value in the diagnosis of serum negative patients with RA.④ The presence of anti-CCP3.1 antibody was correlated with RF,HRF-IgG,APF,AKA,GPI and IgA (P＜0.05),except disease activity.Conclusion The sensitivity of anti-CCP3.1 antibody is slightly higher than anti-CCP2 antibody.The Anti-CCP3.1 antibody is a very valuable parameter for the diagnosis of RA,especially in serum negative patients.
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<p><b>OBJECTIVE</b>To evaluate the efficacy of salvaged allogeneic hematopoietic stem cell transplantation (allo-HSCT) for refractory/recurrent acute myeloid leukemia (AML).</p><p><b>METHODS</b>A total of 45 patients with refractory/recurrent AML were enrolled from September 2006 to April 2010. The median blasts in bone marrow (BM) were 36% (20% to 92%) before conditioning. The donors were identical siblings (6) or unrelated ones (9) or haploidentical family members (30). Conditioning regiments were individualized according to patients' status, the regimen with high-dose cytarabine plus BuCy/CY was mostly used (20). The patients with impaired organ function received above regimen except using fludarabine instead of cyclophosphamide (16). FLAG followed by reduced-intensified BuCy was employed for the recipients with more than 40% blasts in BM (6) to reduce leukemia burden. TBI/CY or TBI/Fludarabine was used for the recipients with extramedullary infiltration of leukemia or multidrug resistant leukemia. G-CSF, MTX, NVT, Vm26, Acla or Thaltipa was added into conditioning regiments according to leukemia character.</p><p><b>RESULTS</b>All but 2 patients attained durable engraftment. The incidence of grade II to IV aGVHD and cGVHD were 34%, 59.1%, respectively. With median follow-up 30 (0.5 - 57) months, the relapse rate was 29.2%. Twenty-nine of 45 (60.2%) patients remained in complete remission since salvaged HSCT. Three-years disease-free survival and overall survival were 60.2% and 62.6%, respectively.</p><p><b>CONCLUSION</b>Our results indicated that the combination of salvaged HSCT with prophylactic immunotherapy might be a promising modality for treatment of refractory/recurrent AML, even with high leukemia burden.</p>
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Middle Aged , Young Adult , Hematopoietic Stem Cell Transplantation , Methods , Leukemia, Myeloid, Acute , Mortality , Therapeutics , Recurrence , Survival Rate , Transplantation Conditioning , Methods , Treatment OutcomeABSTRACT
<p><b>BACKGROUND</b>Toll like receptor (TLR) 9 has been shown to play a crucial role in the pathogenesis of systemic lupus erythematosus (SLE) in animal models. Its pathogenic role in human SLE, however, was poorly elucidated. This study was performed to investigate the role of TLR9 involved in the aberrant signaling pathway and its correlation with disease activity in SLE.</p><p><b>METHODS</b>mRNA level of TLR9 and interferon (IFN) regulatory factor 5 (IRF5) in peripheral blood mononuclear cells (PBMCs) were determined by real-time polymerase chain reaction (PCR). IFN-a expression was measured in the serum of the SLE patients by enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>TLR9 expression was significantly higher in SLE patients than that in health controls (P = 0.011). SLE patients with positive anti-dsDNA antibody had significantly higher expression of TLR9 than that with negative anti-dsDNA antibody (P = 0.001). TLR9 expression was positively correlated with fever (P = 0.017), alopecia (P = 0.046), safety of estrogens in lupus erythematosus national assessment SLE disease activity index (SELENA-SLEDAI) score (r(s) = 0.385, P = 0.003), and the level of IRF5 (r(s) = 0.35, P = 0.027) and IFN-a (r(s) = 0.627, P = 0.001) in SLE patients.</p><p><b>CONCLUSION</b>TLR9 is associated with SLE disease activity and might be involved in the IFN-a pathway of SLE.</p>
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Antibodies, Antinuclear , Blood , Enzyme-Linked Immunosorbent Assay , Interferon Regulatory Factors , Metabolism , Interferon-alpha , Blood , Leukocytes, Mononuclear , Metabolism , Lupus Erythematosus, Systemic , Blood , Genetics , Metabolism , Real-Time Polymerase Chain Reaction , Toll-Like Receptor 9 , Genetics , MetabolismABSTRACT
Objective To evaluate the clinical significance of the level of [gG4 in the bronchoalveolar lavage fluid (BALF) of patients with rheumatic disease related interstitial lung disease (RD-ILD).Methods Eighteen patients with RD-ILD,14 patients with pulmonary infection and 12 patients without ILD or pulmonary infection,were recruited consecutively from the in-patient ward of Peking University People's Hospital.Clinical features and laboratory data were extracted from the medical record database of Peking University People's Hospital.The level of IgG4 was determined by ELISA.The statistical analysis of data using t test,and the correlation between the two variables were analyzed using linear regression analysis.Results The level of IgG4 was significantly higher in BALF of patients with RD-ILD than patients' without ILD or pulmonary infection,whereas there was no difference compared to patients with pulmonary infection.The level of IgG4 in BALF of patients with RD-ILD was positively correlated with the percentage of lymphocytes (r=0.53,P=0.03),and significantly negatively correlated with the percentage of macrophages (r=-0.65,P=0.005).Conclusion The level of IgG4 is significantly elevated in BALF of patients with RD-ILD,which is probably secreted from the lymphocyte of the lung.
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This study was purposed to investigate the clinical features and related factors influencing prognosis of patients with severe intestinal graft-versus-host disease (siGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). 710 patients received allo-HSCT in Beijing Dao-Pei hospital from Jan 2007 to Jan 2011 were enrolled in this study. A total of 34 patients with siGVHD out of 710 patients were analyzed retrospectively, and the univariate analysis for related factors influencing prognosis were carried out by using SPSS 19.0 software. The results showed that the incidence of siGVHD was 4.79%, its medium occurrence time was 29 (18 - 210) days after allo-HSCT. 18 out of 34 patients with siGVHD received colonoscopy, among them 6 patients were complicated with viral enteritis. The deep ulcers could be found under colonoscope. Histopathologic examination revealed the viral inclusion bodies or positive viral antigen. Methylprednisolone (MP), cyclosporine A (CsA) or tacrolimus combined CD25 monoclonal antibody and oral budesonide were used for treatment of siGVHD. 29 out of 34 cases achieved complete response (CR) with CR rate of 85.29%, overall survival rate was 58.82% (20/34). 9 out of 29 cases achieving CR died of other complications. The univariate analysis of the related factor indicated the hyperacute GVHD is the adverse factor influencing overall survival of patients with siGVHD. It is concluded that early colonoscopy is an effective way for definitive diagnosis of siGVHD. The combined treatment including MP, CsA or tacrolimus, CD25 monoclonal antibody and oral budesonide shows a significant curative effects. Intensive treatment of complications in late period of GVHD can enhance the overall survival rate.
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Gastrointestinal Tract , Graft vs Host Disease , Diagnosis , Hematopoietic Stem Cell Transplantation , Methods , Retrospective StudiesABSTRACT
Objective To analyze the correlation between serum interleukin (IL)-33 and early rheumatoid arthritis (RA) by testing the serum IL-33 of patients with RA.Methods One hundred patients with early RA whose disease duration was less than 1 year were selected,40 patients with osteoarthritis (OA) and 70 healthy controis were selected.The serum IL-33 levels of the three groups were detected by enzyme-linked immunosorbent assay (ELISA).The correlation between serum IL-33 levels and clinical features of patients with RA were analyzed.Kruskal-Wallis test,Mann-Whitney U test,X2 test and Spearman correlation analysis were used for statistical analysis. Results The level of serum IL-33 in RA patients [(282±871)pg/ml ] was significantlv higher than that of the healthy controls [(7±38) pg/ml,P<O.01 ] and OA patients [(8±35)pg/ml,P<0.01].The levels of serum IL-33 in RA patients were related with rheumatoid factor (RF),occult rheumatoid factor immunoglobulin G (HRF-IgG),anti-cyclic citrullinated peptide antibodies (anti-CCP),anti-mutated citrullinated vimentin antibodies (anti-MCV).The positive rate of RF,HRF-IgG,anti-CCP and anti-MCV in IL-33 positive group (86%,31%,86%,94%) was significantly higher than that of the IL-33 negative group (54%,11%,42%,72%)(P<0.05).Conclusion The level of serum IL-33 is significantly elevated in RA and it is significanfly associated with some of the auto-antibodies (including RF,anti-CCP antibodies,anti-MCV antibodies and HRF-IgG).Thus,IL-33 may be a factor for unfavorable prognosis to RA patients.
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Objective To investigate the clinical significance of D-dimer in systemic lupus erythematosus (SLE). Methods The study group comprised 261 SLE patients who were admitted in ward from 2005 to 2008 in Peking University People's Hospital Collect the clinical data to investigate the clinical significance of D-dimer. Results ( 1 ) The D-dimer levels of 56 patients were increased due to coexist reduced renal function, infections, disseminated intravascular coagulation ( DIC), liver disorders, pregnancy and injury. With the exception of above patients, 142 ( 69. 3 ) patients were increased in total 205 patients. (2)The level of D-dimer was positively correlated with SLE disease activity index( SLEDAI ) score ( r =0. 598,P =0. 000), and was associated with anti-dsDNA antibody, ESR, C-reactive protein(CRP) and complement C3 and C4. (3)D-dimer level was associated with important organ involvement. (4)All patients with thrombosis had increased D-dimer, but patients without thrombosis had normal or increased D-dimer levels. Conclusion The level of D-dimer elevates in patients with active disease or important organ involvement , it can not identify thrombosis. All patients with thrombosis had increased D-dimer levels.
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<p><b>OBJECTIVE</b>To study the clinical effificacy of electroacupuncture (EA) on treating knee osteoarthritis (KOA) of Shen ()-Sui () insuffificiency (SSI) syndrome type.</p><p><b>METHODS</b>A total of 245 patients (279 knees) of KOA-SSI were randomly assigned to two groups by lottery: 141 knees in the treatment group and 138 knees in the control group. The treatment group was managed with EA at the dominant points of Neixiyan (Ex-LE4) and Waixiyan (Ex-LE5) as well as the conjugate points of Xuanzhong (GB39) and Taixi (KI3) for 30 min, once a day, with 15 days as one course; 2 courses were applied with a 5-day interval in between. The control group was treated with intra-articular injection of 2 mL hyaluronic acid into the affected joint every 7 days for 5 times in total. The clinical effects on the patients in different stages were observed, and their symptom scores of knee and contents of cytokines, including interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), prostaglandin E(2alpha) (PGE(2alpha)) and matrix metalloproteinases-3 (MMP-3), in the knee joint fluid were measured before and after treatment.</p><p><b>RESULTS</b>The study was completed in 235 patients (263 knees); four patients (7 knees) in the treatment group and six patients (9 knees) in the control group dropped out. Comparison of therapeutic effects (excellent and effective rates) between the two groups showed insignificant differences (P>0.05). Symptom scores of knee and contents of cytokines in the knee flfluid after treatment were lowered signifificantly in the patients of stage I-III in both groups (P<0.05 or P<0.01). However, the lowering of the total symptom score of knee in the patients of stage III in the treatment group was more signifificant (P<0.05).</p><p><b>CONCLUSIONS</b>EA could effectively alleviate the clinical symptoms in KOA patients of stage III, showing an effect superior to that of hyaluronic acid. EA also shows action in suppressing the secretion of IL-1, IL-6, TNF-alpha, PGE(2alpha) and MMP-3 in the knee flfluid.</p>
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Aged , Female , Humans , Male , Middle Aged , Cytokines , Metabolism , Electroacupuncture , Methods , Matrix Metalloproteinase 3 , Metabolism , Osteoarthritis, Knee , Diagnostic Imaging , Therapeutics , Radiography , Syndrome , Synovial Fluid , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To explore the efficacy of tumor-ablative individualized allogeneic hematopoietic stem cell transplantation for the treatment of patients with high risk/refractory leukemia.</p><p><b>METHODS</b>Fivety-seven patients with high risk/refractory leukemia were enrolled. Tumor-ablative individualized conditioning regimens included HDAra-C + Bu/Cy, Ara-C + Bu/Fludarabine, G-CSF primed HDAra-C + Bu/Cy, and FLAG followed by reduced-intensified BuCy. Overall survival (OS), disease free survival (DFS), graft versus host disease, infection and relapse post grafting were analyzed.</p><p><b>RESULTS</b>Fifty-six patients attained durable engraftment. The median follow-up duration was 17.5 (2 - 34) months. The 18 months probabilities of OS and DFS were (74.7 ± 6.1)% and (62.4 ± 6.7)%, respectively. In addition, the 18 months probabilities of OS and DFS in patients who attained complete remission (CR) before transplantation were (74.2 ± 7.1)% and (58.8 ± 8.1)%, respectively, while in those not attained CR were (77.0 ± 11.8)% and (72.7 ± 11.7)%, respectively. Twenty nine patients developed acute GVHD (aGVHD) (grade I in 18, grade II in 4, grade III in 2 and grade IV in 5). The probabilities of aGVHD was (50.9 ± 6.6)% by Kaplan-Meier curve analysis. The probabilities of grades 2-4 and grades 3-4 aGVHD were (19.3 ± 5.2)% and (12.3 ± 4.3)% respectively. Extensive chronic GVHD (cGVHD) was observed in 36 patients. The probabilities of cGVHD was (64.3 ± 6.4)% by Kaplan-Meier curve analysis. Cytomegaloviremia (CMV) was observed in 39 (68.42%) patients, hemorrhagic cystitis in 13 (22.8%) patients, fungous infection in 16 (28.07%) patients and bacterial infection in 38 (66.67%) patients. Relapse occurred in 14 patients (hematologic relapse in 11 and extramedullary relapse in 3), probabilities of relapse being (24.6 ± 5.7)%. The 17.5-month probability of relapse in patients who attained CR before transplantation was (28.1 ± 7.7)%, while in those not attained CR was (15.6 ± 10.2)%. Fifteen patients died (6 from hematological relapse, 5 from infection of bacterial and fungous, 4 from cGVHD) after 100 days.</p><p><b>CONCLUSION</b>Tumor-ablative individualized allogeneic hematopoietic stem cell transplantation is a promising and safe choice for treatment of high risk/refractory leukemia, even with high leukemia burden.</p>