ABSTRACT
Objective@#To evaluate the outcomes of splenectomy in the treatment of relapsed/refractory autoimmune hemolytic anemia (AIHA).@*Methods@#Retrospective analysis was performed in 30 cases with relapsed/refractory AIHA who were treated with splenectomy in our hospital. The pre- and post-operative blood routine indexes and responses were followed up.@*Results@#Among the 30 relapsed/refractory AIHA patients, 20 were pure AIHA (including 13 patients with warm antibody AIHA, 2 with warm-cold double antibody AIHA and 5 with Coombs negative AIHA) and 10 were Evans syndrome. The short-term response was evaluated 10-14 days after operation, and the overall response rate (ORR) of short-term response was 90% [12 cases in complete response (CR), 6 cases in partial response (PR)] in 20 therapeutic evaluable cases. Among 13 patients with long-term follow-up data, except 3 patients with Evans syndrome died (2 cases were refractory to splenectomy, 1 case relapsed after surgery), the ORR of 10 patients with relapsed/refractory pure AIHA at 6 months and 12 months were 90% (9/10) and 70% (7/10), respectively, with a median follow-up of 14 (4-156) months. At the end of follow-up, 3 cases had maintained CR for more than 3 years.@*Conclusion@#The short-term response of splenectomy as a second-line treatment for relapsed/refractory AIHA is satisfactory, and long-term outcome of splenectomy is up to 70% at 1 year. Approximately one-third of patients could maintain sustained remission.
ABSTRACT
Objective To assess the correlation between tenosynovitis or rupture of the flexor hallucis longus (FHL) and pes planus in patients with rheumatoid arthritis (RA).Methods The data of 47 RA patients (97 feet) with painful feet was retrospectively analyzed which was collected From February 2008 to June 2011.In accordance with the results of the FHL changes got by ultrasonography,the patients were divided into 3 groups.Group A consisted of those with normal FHL (27 feet).Group B consisted of those with FHL tenosynovitis (40 feet),and Group C eonsisted of those with FHL rupture (27 feet).Load bearing lateral radiographs were taken for all the patients.The correlation study was carried out based on the pes planus-related parameters,such as the measurement of heel pitch angle (HPA) and tarsal and 1st metatarsal angle (TM1).Factors like patients' age and course of disease were also taken into the consideration during the study.Results The mean age of those in group A was 49.9±9.2 years vs.56.2±9.2 years in group B and 54.7±8.0 years in group C.The mean duration was 4.7±2.6 years in Group A vs.16.2±7.4 years in Group B 5°±3.6° in Group C.The mean TM1 was 2.5°±2.2° in Group A vs.6.5°±3.2° in Group B and 11.2°±4.9° in Group C.Significant statistics difference were found among the three groups in these parameters.HPA＜ 20° was found among 6/27 feet in group A,31/40 in group B and 27/27 in group C.TM1 ＞4° was found among 5/27 feet in group A,30/40 in group B and 27/27 in group C.Conclusion FHL changes were common in RA patients and its severitv had positive correlation to pes planus.These changes were affected by age and duration,and could be evaluated effectively by ultrasound.
ABSTRACT
Objective To explore the role of transforming growth factor (TFG) -β and matrix metalloproteinases( MMPs) in the development of frozen shoulder. Methods Twenty-four patients who underwent shoulder arthroscopy were included, and were divided into frozen shoulder group (n = 12) and control group ( n = 12; n = 2 for shoulder instability, n = 5 for rotator cuff tear and n = 5 for subacromial impingement) . Joint capsule tissues at the rotator cuff interval were obtained, and the expression of TGF-β, MMP-1, MMP-2, MMP-3, MMP-9 and MMP-12 mRNA and protein was detected by Real-time PCR and Western blotting, respectively. Results The expression of TGF-p mRNA in frozen shoulder group and control group was 3.36 × 10~4 ±2.18 × 10~3 and 1.85 × 10~4 ±3.31×10~3, respectively, the expression of TGF-p protein was 1.55 ± 0.33 and 1.13 ±0.21, respectively, and there were significant differences between these two groups (P < 0.05). The expression of MMP1, MMP2, MMP3, MMP9 and MMP12 mRNA and protein in frozen shoulder group was significantly higher than that in control group(P <0.05) . Conclusion The higher expression of TGF-β and MMPs in joint capsule of frozen shoulder may be associated with the development of frozen shoulder.