Anti-SSA/SSB-negative primary Sjögren's syndrome showing different clinical phenotypes: a retrospective study of 934 cases

Abstract Background Currently, only a few studies have described the general characteristics of patients with primary Sjögren's syndrome (pSS) who tested negatives for anti-SSA and anti-SSB antibodies. We aimed to further investigate the clinical characteristics of these patients in a large sample. Methods Data from patients with pSS who were treated at a tertiary hospital in China between 2013 and 2022 were retrospectively analyzed. Clinical characteristics of the patients were compared between those with and without anti-SSA and anti-SSB antibody negativity. Factors associated with anti-SSA and anti-SSB negativity were identified by logistic regression analysis. Results Overall, 934 patients with pSS were included in this study, among whom 299 (32.0%) tested negative for anti-SSA and anti-SSB antibodies. Compared with patients testing positive for anti-SSA or anti-SSB antibodies, that testing negative for the two antibodies had a lower proportion of females (75.3% vs. 90.6%, p < 0.001) and thrombocytopenia (6.7% vs. 13.6%, p = 0.002), but a higher proportion of abnormal Schirmer I tests (96.0% vs. 89.1%, p = 0.001) and interstitial lung disease (ILD) (59.2% vs. 28.8%, p = 0.001). Anti-SSA and anti-SSB negativity was positively associated with male sex (odds ratio [OR] = 1.86, 95% confidence interval [CI]: 1.05, 3.31), abnormal Schirmer I tests (OR = 2.85, 95% CI: 1.24, 6.53), and ILD (OR = 2.54, 95% CI: 1.67, 3.85). However, it was negatively related to thrombocytopenia (OR = 0.47, 95% CI: 0.24, 0.95). Conclusion Approximately one third of pSS patients had anti-SSA and anti-SSB negativity. pSS patients testing negative for anti-SSA and anti-SSB showed a higher risk of abnormal Schirmer I tests and ILD, but a lower risk of thrombocytopenia.

Lateral needling at Lianquan (CV 23) for post-stroke dysphagia: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of lateral needling at Lianquan (CV 23) for post-stroke dysphagia, and explore its mechanism.@*METHODS@#A total of 64 patients with post-stroke dysphagia were randomly divided into an observation group and a control group, 32 cases in each group. Both groups were treated with conventional basic treatment. The observation group was treated with lateral needling at CV 23, without needle retaining, once a day. The control group was treated with swallowing rehabilitation training, once a day. Both groups were treated for 5 days a week, with 2 days interval, 1 week as one course and 4 courses were required. Before and after treatment, the Kubota water swallowing test grade and standardized swallowing assessment (SSA) score were compared in the two groups. Before and after treatment, the video fluoroscopic swallowing study (VFSS) was used to measure the hyoid bone movement displacement and pharyngeal delivery time in the observation group.@*RESULTS@#Compared before treatment, the Kubota water swallowing test grade after treatment was improved in the two groups (P<0.05), and the observation group was superior to the control group (P<0.05); the SSA scores after treatment were decreased in the two groups (P<0.05), and the observation group was lower than the control group (P<0.05). Compared before treatment, the hyoid bone movement displacement was increased and pharyngeal delivery time was shortened after treatment in the observation group (P<0.05).@*CONCLUSION@#Lateral needling at CV 23 could improve dysphagia symptoms in patients with post-stroke dysphagia, its mechanism may be related to the increasing of hyoid bone movement displacement and shortening of pharyngeal delivery time.

Evaluation of cardiac function and systolic dyssynchrony of fetuses exposed to maternal anti-SSA and anti-SSB antibodies using two-dimensional speckle tracking imaging / 中华超声影像学杂志

Objective:To evaluate the cardiac function and systolic dyssynchrony of fetuses exposed to maternal autoimmune antibodies (anti-SSA/Ro60, anti-SSA/Ro52 and anti-SSB/La) by using two-dimensional speckle tracking imaging (2D-STI).Methods:A total of 52 pregnant women with singleton pregnancy in the Affiliated Hospital of Inner Mongolia Medical University from July 2018 to November 2020 were selected. Eighteen fetuses of mothers with autoimmune antibodies were enrolled as autoimmune disease (AD) group and 34 fetuses of healthy mothers without antibodies were included as control group. Maternal baseline characteristics, fetoplacental Doppler parameters, and conventional echocardiographic data of two groups were prospectively collected. The systolic global and regional longitudinal strain of left and right ventricles (LV and RV) and the time to peak strain of regional myocardium were measured using 2D-STI. The differences in time to peak strain between the LV free wall and RV free wall (two-chamber dyssynchrony, 2C-DYS) and between the septum and LV free wall (one-chamber dyssynchrony, 1C-DYS) were also calculated.Results:There were no significant differences between the two groups in conventional systolic and diastolic functional parameters for the LV and RV(all P>0.05). The myocardial deformation parameters and 2C-DYS obtained by 2D-STI showed no statistical differences between two groups(all P>0.05). However, 1C-DYS was significantly more prolonged in the AD group than control group[28.50(13.50, 39.25)ms vs 19.50(8.00, 29.25)ms, P=0.042]. Conclusions:LV systolic mechanical dyssynchrony in fetuses of mothers with autoimmune antibodies suggests in-utero subclinical damage of the cardiac conduction system.

Congenital heart block secondary to neonatal lupus

@#Neonatal lupus is a passively acquired autoimmune disease that occurs in children of mothers with anti-Ro/SSA and/or anti-La/SSB antibodies. [1-4] The most serious complication in the neonate is complete heart block. [3-8] This is a case report of a newborn female presenting with persistent bradycardia detected in utero. The diagnosis was confirmed by maternal anti-Ro/SSA and/or anti-La/SSB antibodies and in utero detection of fetal heart block on echocardiogram. Therapeutic management involved placement of a permanent pacemaker.

Saikosaponin A Changes Drug Resistance of A549/DDP Cells Through Wnt/β-Catenin Pathway / 中国实验方剂学杂志

Objective:To investigate the effect and mechanism of saikosaponin A （SSA） on the reversal of cisplatin （DDP） resistance in human lung cancer cell line A549/DDP. Methods:The resistance of A549 and A549/DDP cells to DDP and the inhibitory effects of SSA against the proliferation of A549 and A549/DDP cells were detected using cell counting kit-8 （CCK-8）. The apoptosis rates of A549/DDP cells treated with SSA or DDP or SSA combined with DDP and the changes in reactive oxygen species （ROS） were determined by flow cytometry. The mRNA expression levels of C-myc， B-cell lymphoma 2 （Bcl-2） and cysteinyl aspartate-specific protease-3 （Caspase-3） were detected by real-time polymerase chain reaction （Real-time PCR）， followed by the determination of <italic>β</italic>-catenin transcriptional activity using the TopFish dual-luciferase reporter assay system and the measurement of <italic>β</italic>-catenin protein expression in A549/DDP cells by Western blot. Results:The results of CCK-8 assay showed that the DDP resistance of A549/DDP cells was 12.82 times that of A549 cells （<italic>P</italic><0.05）. SSA inhibited the viability of A549 cells with the half maximal inhibitory concentration （IC₅₀） being 34.9 μmol·L^-1， and also suppressed the viability of A549/DDP cells in a concentration-dependent manner. Since the inhibition rate of 20 μmol/L SSA against A549/DDP cells was less than 10%， the reversal concentration was set at 20 μmol/L. Flow cytometry revealed that compared with the control， DDP alone increased the apoptosis rate of A549/DDP cells （<italic>P</italic><0.05）， stimulated the accumulation of intracellular ROS （<italic>P</italic><0.05）， down-regulated the mRNA expression levels of C-myc and Bcl-2 in A549/DDP cells， up-regulated Caspase-3 mRNA expression， and reduced the transcriptional activity of <italic>β</italic>-catenin （<italic>P</italic><0.05）. Compared with the DDP group， the SSA+DDP group exhibited obviously increased apoptosis of A549/DDP cells， enhanced accumulation of intracellular ROS， down-regulated C-myc and Bcl-2 mRNA expression， up-regulated Caspase-3 mRNA expression （<italic>P</italic><0.05）， and weakened <italic>β</italic>-catenin transcription （<italic>P</italic><0.05）. DDP combined with SSA better decreased the <italic>β</italic>-catenin protein expression in contrast to that of control or DDP （<italic>P</italic><0.05）. Conclusions:SSA enhances the sensitivity of A549/DDP cells to DDP possibly by inhibiting the activation of Wnt/<italic>β</italic>-catenin pathway.

Permanent pacemaker implantation in complete congenital fetal atrioventricular (AV) block: a case report / Implantación de marcapasos permanente en bloqueo atrioventricular (AV) fetal congénito completo: reporte de caso

Abstract: One of the most common pathologies attributed to lupus neonatal refers to atrioventricular (AV) congenital block, which diagnosis can be made between 16 and 30 weeks of gestation due to persistent fetal bradycardia. The development of this disease is mostly related to maternal anti-Ro/SSA and anti-Smith autoantibodies. Currently, there are a number of alternatives for prenatal and postnatal treatment, with some controversy about their viability. The placement of a permanent pacemaker is presented as one of the most appropriate procedures currently, even with the risks awarded. This case report describes the placement of a permanent pacemaker to a two-month-old newborn with high maternal contents of anti-Ro/SSA and anti-Smith nuclear autoantibodies, with a favorable outcome.(AU)

Resumen: Una de las patologías más comunes atribuidas al lupus neonatal se refiere al bloqueo congénito atrioventricular (AV), diagnóstico que se puede realizar entre 16 y 30 semanas de gestación debido a bradicardia fetal persistente. El desarrollo de esta enfermedad se relaciona principalmente con los anticuerpos anti-Ro/SSA materno y anti-Smith. Actualmente, existen varias alternativas para el tratamiento prenatal y postnatal, con cierta controversia sobre su viabilidad. La colocación de un marcapasos permanente se presenta como uno de los procedimientos más adecuados actualmente, incluso con los riesgos adjudicados. Este relato de caso describe la colocación de un marcapasos permanente en un recién nacido de dos meses con alto contenido materno de autoanticuerpos anti-Ro/SSA y anti-Smith, con un resultado favorable.(AU)

Prevalencia y significado clínico de los anticuerpos anti-SS-A(RO) en pacientes con enfermedades reumáticas autoinmunes sistémicas / Prevalence and clinical significance of anti-SS-A(RO) antibodies in patients with systemic autoimmune rheumatic diseases

Por la importancia diagnóstica que tiene la detección de los distintas especificidades de anticuerpos que permite distinguir síndromes reumáticos que se sobreponen en el plano clínico, se exploró su frecuencia en un grupo de 4 693 pacientes con enfermedades reumáticas autoinmunes sistémicas (SARDs) en el periodo entre el 10 de junio del 2010 al 10 de junio del 2016. Fueron estudiados con ANA screen, ANA combi e IMMUNOBLOTTING. Solo fueron positivos 277 (5,9 %), 250 del sexo femenino y 27 del sexo masculino. Existió una importante prevalencia de reactividad contra los anticuerpos anti-SS-A con 140 pacientes (50 %), seguido de los antinucleosoma con 97 (35 %) y los DNA ds con 72 (25 %), en el resto de los anticuerpos no existieron hallazgos importantes. Este estudio sugiere que para los pacientes con manifestaciones clínicas de enfermedades reumáticas autoinmunes sistémicas es necesario y útil la utilización de estas pruebas que, junto con la información clínica y en algunos casos histológica, puede ayudar a realizar un diagnóstico más preciso.

Due to the diagnostic importance of the detection of different antibody specificities that allows us to distinguish rheumatic syndromes that clinically overlap; we studied its prevalence in a group of 4 693 patients with systemic autoimmune rheumatic diseases In the period between June 10, 2010 and June 10, 2016. For that purpose we used ANA Screen and ANA Combi. 277 (5 %) were female and 250 male. There was a significant prevalence of anti-SS-A antibodies140 (50 %) followed by antinucleosome 97 (35 %) and DNAs of 72 (25 %), no significant results were obtained with the rest of the other antibodies. Our results suggest the usefulness of these tests in patients with clinical manifestations of systemic autoimmune rheumatic diseases together with the clinical and histological information that could help to make an accurate diagnosis.

Analysis on results difference of two methods for detecting 146 cases of anti-nuclear antibody / 国际检验医学杂志

Objective To investigate the results difference of the indirect immunofluorescence (IIF) and immunoblotting (LIA) for detecting ant-inuclear antibodies (ANA) and clinical value .Methods One hundred and forty-six ANA detection specimens of IIF negative and LIA positive were collected and performed the detection of HBV antibodies and anti-HCV antibodies .Results (1) In 146 specimens of IIF (-)LIA (+ ) ,the positive specimen numbers of single anti-Ro52 antibody ,anti-SSA antibody and anti-AMA-M2 antibody were 69 cases ,42 cases and 15 cases respectively ,which of anti-RNP antibody ,anti-PCNA antibody and PM-Scl antibody were 3 cases ,5 cases and 2 cases respectively ,the combined 2-item positive was in 8 cases .(2)Among positive specimens of single anti-Ro52 antibody ,HBsAg(+ ) ,anti-HBe(+ ) ,anti-HBc(+ ) model and HBsAg(+ ) ,HBeAg(+ ) ,HBcAb(+ ) model of hepatitis B ,and hepatitis C were 51 cases ,4 cases and 7 cases respectively ,7 cases were non-hepatitis patients .(3) Among positive specimens of single ant-SSA antibody ,6 cases were hepatitis B patients and 36 cases were the patients with non-hepatitis B .Conclu-sion Anti-Ro52 antibody and anti-SSA antibody are easier to be missed by the IIF detection .Anti-Ro52 antibody positive has a cer-tain relation with small three positive of hepatitis B .

Clinical Observation of Deeply Needling Lianquan (CV23) plus Acupuncture at the Ten Nape Points for Post-stroke Pseudobulbar Palsy / 上海针灸杂志

Objective By observing the effect of deeply needling Lianquan (CV23) plus acupuncture at the ten nape points on the deglutition function in post-stroke pseudobulbar palsy, to objectively evaluate the efficacy of deeply needling Lianquanplus acupuncture at the ten nape points in treating post-stroke pseudobulbar palsy.Method A total of 141 patients diagnosed with post-stroke pseudobulbar palsy were divided into a treatment group (71 cases) and a control group (70 cases) by following asimple-randomized design (random number table). The treatment group was intervened by deeply needling Lianquan plus acupuncture at the ten nape points, while the control group was intervened by conventional acupuncture. A month later, the general therapeutic efficacy, Kubota's water drinking test, Toshima Ichiro's swallowing assessment, and Standardized Swallowing Assessment (SSA) were evaluated, and the therapeutic efficacies of the two groups were compared.Result The general therapeutic efficacy, waterdrinking test result, Toshima Ichiro's swallowing assessment, and SSA score were significantly improved in both groups after the treatment (P<0.05). After the treatment, the general therapeutic efficacy, water drinking test result, Toshima Ichiro's swallowing assessment, and SSA score in the treatment group were significantly different from those in the control group (P<0.05), and the treatmentwas superior to the control group. The total effective rate was 91.5% in the treatment group, versus 70.0% in the control group, and the between-group difference was statistically significant (P<0.05).Conclusion Deeply needling Lianquan plus acupunctureat the ten nape points is effective in treating post-stroke pseudobulbar palsy, superior to the conventional needling method.

The significance of serological markers and European League Against Rheumatism SS Disease Activity Index score in patients with primary Sj(o)gren's syndrome / 中华风湿病学杂志

Objective To explore the relationship between the clinical features,serological markers and European League Against Rheumatism SS Disease Activity Index (ESSDAI) scores of primary Sj(o)gren's syndrome (SS).Methods We enrolled 106 patients,who fulfilled the 2002 classification criteria for primary SS from December 2008 to January 2015,to evaluate the relationship among the clinical characteristics,laboratory features,serological variables and ESSDAI scores.According to serological variables,the prognosis was subdivided into three distinct groups:favourable (no serological markers),intermediate (one serological marker) and poor (two or more serological markers).These data were analyzed by Chi-square test and variance analysis.Results The mean ESSDAI score of 106 pSS patients was (11±7).ESSDAI score was categorized according to the EULAR-SS recommendations as low activity,moderate activity and high activity (scores of 0-4,5-13 and ≥14,respectively),and the positive rate of antinuclear antibody (ANA) 1:100 (6 cases,37.5％;37 cases,66.1％;32 cases,94.1％) in three different ESSDAI levels was statistically different (x2＝18.110,P＜0.01).Those with positive ANA 1:100[positive (13±7) and negative (7±4)],anti-SSA antibody postive (12±7) and negative (9±7),anti-RNP antibody (positive 16±9 and negative 10±6) had higher ESSDAI scores than those with negative ones (F=8.812,P=0.0001;F=3.862,P=0.024;F=5.786,P=0.004).No statistical difference in ESSDAI means were found between patients with positive anti-SSB antibody,rheumatoid factor (RF),FS level,dry mouth,Raynoud's phenomenon and psychosomatic diseases.The ESSDAI scores of favourable group,intermediate group and poor group were significantly different (8±5,10±7,14±7,F=8.715,P=0.000 1).In comparison with the other two groups,the poor pSS patients had a higher frequency of positive ANA 1:100 (15 cases,55.6％;20 cases,57.1％;40 cases,90.9％),anti-SSA antibody(11 cases,0.7％;23 cases,41.1％;36 cases,81.8％),anti-SSB antibody (6 cases,2 2.2％;13 cases,37.1％;23 cases,52.3％),anti-RNP antibody (0 case,0;2 cases,5.7％;9 cases,20.5％) (x2=17.408,P=0.002;x2=14.306,P=0.006;x2=12.330,P=0.015;x2=1 1.482,P=0.022).Conclusion Patients with two or more serological markers may have higher ESSDAI score,and which in turn may associate with poor prognosis.

Gene cloning and expression purification of human autoimmune antigen SSA/60 / 国际检验医学杂志

Objective To clone human autoimmune antigen SSA/Ro60 and to purify its expression to provide the material basis for the assisted diagnosis of human autoimmune diseases .Methods The SSA/Ro60 gene was cloned by RT‐PCR and directionally inserted into expression vector pPICZ .The recombinant plasmid was transformed into Pichia SMD1168 .The obtained recombinant protein was identified by SDS‐PAGE and Western blotting .Results The amplified full‐length sequence was about 1 .5 kb in size . The pPICZ‐SSA positive clone produced a 60 × 103 recombinant protein which had natural immunogenicity of human autoimmune antigen SSA/Ro60 by SDS‐PAGE and Western blot .Conclusion Human autoimmune antigen SSA/Ro60 is successfully cloned and expressed ,which lays a foundation for diagnosing autoimmune diseases .

Probable influencia de las Guías de la ACC/AHA 2013 sobre el tratamiento de la hipercolesterolemia, en la nueva Norma Oficial Mexicana para el manejo de los niveles inadecuados de lípidos / Probable influence of 2013 ACC/AHA Guideline on the Treatment of hypercholesterolemia to reduce atherosclerotic cardiovascular disease in adults, in the Mexican Official Norm for prevention and treatment of dyslipidemia

Revisamos las nuevas Guías de la AHA/ACC para el tratamiento de la hipercolesterolemia. El enfoque general de tratamiento está orientado a iniciar fármacos en fases iniciales, incluso con estatinas en casos de prevención primaria. En fecha próxima se revisará y analizará la NOM-037-SSA2-2012, para la prevención, tratamiento y control de las dislipidemias. En lo general, la propuesta de la NOM coincide con las nuevas Guías Norteamericanas; no obstante, consideramos que cada caso debe individualizarse.

We revised the new 2013 ACC/AHA Guideline on the treatment of hypercholesterolemia to reduce atherosclerotic cardiovascular disease in adults. Treatment is essentially oriented to the early implementation of pharmacological interventions, including the use of statins for primary prevention. In the near future, the Mexican NOM-037-SSA2-2012, for prevention and treatment of dyslipidemia will be analyzed. Substantially, the Mexican NOM-037-SSA2-2012 concords with the new 2013 ACC/AHA Guideline, withal we consider that treatment should always be individually adjusted.

One case report of autoantibody-associated congenital heart block / 临床儿科杂志

ObjectiveTo explore the pathogenesis, clinical manifestations, diagnosis, and treatment of autoanti-body-associated congenital heart block.MethodsThe clinical data of one child with autoantibody-associated congenital heart block was retrospectively analyzed.ResultsIn 24 week gestation, fetal bradycardia had been found by routine fetal echocar-diography. After birth, the anti-SSA/Ro antibodies and anti-SSB/La antibodies were positive in both infant and her mother. The diagnosis of autoantibody-associated congenital heart block was conifrmed. Intravenous immunoglobulin at 1 g/kg was adminis-trated. At 6 months follow-up, the electrocardiogram suggested type I second degree atrioventricular block.ConclusionIn the fetus or neonates found to have bradycardia and excluded the cardiac structural abnormalities, the autoimmune antibody should been tested and early intervention should been promoted.

Advances in fetal immune mediated atrioventricular block / 临床儿科杂志

Fetal atrioventricular block (AVB) is a type of fetal bradyarrhythmias. The reported incidence of fetal complete atrioventricular block (CAVB) and mortality of perinatal fetuses and neonates are signiifcantly higher in pregnancies of anti-SSA/Ro-positive mothers than that of anti-SSA/Ro-negative mothers. The auto-antibodies in maternal serum that can be transported into fetal circulation through placenta may damage fetal cardiac conductive system and eventually result in fetal AVB. There are evidences that early diagnosis and proper treatment can improve the prognosis and survival rate of affected fetuses. In this article, the pathogenesis, risk factors, prenatal diagnosis, treatment and prognosis of fetal immune mediated AVB is reviewed.

Sjogren's syndrome: An underdiagnosed condition in mixed connective tissue disease

OBJECTIVE: To determine the prevalence of sicca symptoms, dry eye, and secondary Sjögren's syndrome and to evaluate the severity of dry eye in patients with mixed connective tissue disease. METHODS: In total, 44 consecutive patients with mixed connective tissue disease (Kasukawa's criteria) and 41 healthy controls underwent Schirmer's test, a tear film breakup time test, and ocular surface staining to investigate dry eye. In addition, the dry eye severity was graded. Ocular and oral symptoms were assessed using a structured questionnaire. Salivary gland scintigraphy was performed in all patients. Classification of secondary Sjögren's syndrome was assessed according to the American-European Consensus Group criteria. RESULTS: The patients and controls had comparable ages (44.7±12.4 vs. 47.2±12.2 years) and frequencies of female gender (93 vs. 95%) and Caucasian ethnicity (71.4 vs. 85%). Ocular symptoms (47.7 vs. 24.4%) and oral symptoms (52.3 vs. 9.7%) were significantly more frequent in patients than in controls. Fourteen (31.8%) patients fulfilled Sjögren's syndrome criteria, seven of whom (50%) did not have this diagnosis prior to study inclusion. A further comparison of patients with mixed connective tissue disease with or without Sjögren's syndrome revealed that the former presented significantly lower frequencies of polyarthritis and cutaneous involvement than did the patients without Sjögren's syndrome. Moderate to severe dry eye was found in 13 of 14 patients with mixed connective tissue disease and Sjögren's syndrome (92.8%). CONCLUSIONS: Sjögren's syndrome, particularly with moderate to severe dry eye, is frequent in patients with mixed connective tissue disease. These findings alert the physician regarding the importance of the appropriate diagnosis of this syndrome in such patients. .

Prevalence and significance of anti-SSA60 antibodies and anti-SSB antibodies in systemic lupus erythematosus patients / 中华风湿病学杂志

Objective To investigate the detection rate of anti-SSA60 and SSB antibodies in sera of patients with systemic lupus erythematosus (SLE).The correlation of anti-SSA and SSB antibodies with SLE clinical outcome was also investigated.Methods This study included 251 cases of SLE diagnosed in our hospital between 2007 and 2010.ELISA and double immunodiffusion method was used to detect the sera antiSSA60 and SSB antibodies.The patients were closely monitored for three years in terms of clinical and laboratory parameters and the presence of associated Sj(o)gren' s syndrome (SS).Statistical analysis were performed using student t test or x2 test.Results ① The detection rate of anti-SSA60 antibody in serum of patients with SLE was 65.3％.The detection rate of anti-SSB antibody in serum of patients with SLE was 28.3％; ② During the three-year follow up,patients with anti-SSA60 (29.3％,48 cases) or SSB antibodies (35.2％,25 cases) were more likely to have dry mouth and eyes and later developed SS (P＜0.05); ③ Patients with anti-SSA60 antibody were more likely to develop serositis (20.7％ vs 8.0％),neuropsychiatric lupus erythematosus (NPLE)(18.9％ vs 8.0％),and hematuria (35.4％ vs 21.8％)(P＜0.05).Patients with negative anti-SSB antibody were more likely to have fever (43.7％ vs 57.8％,x2=4.082,P＜0.05); ④ Patients positive for anti-SSB antibody were also positive for anti-Sm antibody (50.7％ vs 32.8％,x2=6.956,P＜0.05);⑤ Younger patients were more likely to have anti-SSA60 and SSB antibodies in their sera (P＜0.05); ⑥Patients positive for anti-SSA60 antibody had higher SLE disease activity index (SLEDAI) than patients with negative anti-SSA60 antibody [(17±9) vs (15±7),t=2.389,P＜0.05].Patients positive for anti-SSB antibody had higher level of IgG [(18±7) vs (16±6) g/L,t=2.304,P=0.023],and lower level of CRP than patients negative for anti-SSB antibody [(14±20) vs (21±33) mg/L,t=-2.173,P=0.031].Conclusion Patients positive for anti-SSA60 antibody have higher SLEDAI and more severe clinical outcomes.Patients with antiSSA or anti-SSB antibody are more likely to develop dry mouth and eyes which eventually leads to SS.

Rhizomelic Chondrodysplasia Punctata With Maternal Systemic Lupus Erythromatosus.

We report Rhizomelic Chondrodysplasia Punctata (RDCP), a rare, autosomal recessive disorder with rhizomelic shortening of limbs, congenital cataracts and seizures but without any biochemical abnormality. The mother of the baby developed Systemic Lupus Erythromatosus (SLE) with Ro/SSA antibodies 11 months after delivery. Ro/SSA antibodies may generate calreticulin antibodies causing characteristic skeletal changes.

Calidad microbiológica de carne de res comercializada en el mercado municipal de Culiacán, Sinaloa / Microbiological quality of beef sold in the municipal market of Culiacan, Sinaloa

The microbiological quality of raw meat was evaluated in 18 retail units of the municipal market in Culiacan, Sinaloa. The levels of E. coli were measured using methods from the Bacteriological Analytical Manual, and the O157 sero-group and the H7 antigen were also evaluated using chromogenic media and PCR, respectively. The results were confirmed using real time-PCR (PCR-TR) and PCR to detect virulence genes (vt1, vt2, eaeA and hlyA). Of the samples tested, 31.5% were positive for E. coli, with concentrations between 100 and 700 CFU/g of beef. Nine suspected E. coli O157:H7 strains were isolated from 16 samples, which were then discarded by the PCR-TR test. The virulence genes were not detected. The microbial contamination of beef could indicate the presence of pathogens from fecal sources. To guarantee the quality of these products, it is important to incorporate food safety programs.

Se evaluó la calidad microbiológica de carne de res en 18 comercios del mercado municipal de Culiacán, Sinaloa. Para determinar E. coli se usó la metodología del Manual Bacteriológico Analítico, y para evaluar el serogrupo O157 y antígeno H7, se usaron medios cromogénicos y PCR, respectivamente. La confirmación se hizo por PCR tiempo real (PCR-TR) y la detección de genes de virulencia (vt1, vt, eaeA y hlyA), por PCR. El 31.5% de muestras resultaron positivas para E. coli, con concentraciones entre 100 y 700 UFC/g. Se aislaron nueve cepas presuntivas de E. coliO157:H7 de 16 muestras, las cuales fueron descartadas con la técnica PCR-TR. No se detectaron genes de virulencia. La contaminación microbiana de la carne de res podría indicar la presencia de patógenos provenientes de fuentes fecales. Por ello es importante incorporar programas de inocuidad para garantizar la calidad de estos productos.

Afasias e áreas cerebrais: argumentos prós e contras à perspectiva localizacionista / Aphasias and brain areas: positive and negative aspects of the localization argument

O objetivo do presente estudo foi investigar como áreas corticais comprometidas por um acidente vascular encefálico (AVE) estão relacionadas com os diferentes tipos de afasia, visto que há controvérsias com relação à localização da lesão no cérebro e as características dos quadros de alteração da linguagem. Foram avaliados 26 indivíduos destros, portadores de lesão cérebro-vascular esquerda e de sintomas afásicos, através do protocolo de Montreal-Toulose, módulo standard inicial - versão alpha, que inclui provas de nomeação, repetição, compreensão oral, compreensão escrita e leitura, e de uma entrevista, que possibilitou a avaliação da fluência do discurso. Os sujeitos foram divididos em quatro subgrupos, de acordo com o sítio de lesão: frontal, temporal, têmporo-parietal e parietal/ parieto-occipital. Os dados foram submetidos a uma análise multidimensional (Similarity Structure Analysis [SSA]) e o método das variáveis externas como pontos. Os resultados revelaram uma correlação positiva alta entre lesão na área frontal e o acometimento da fluência no discurso, assim como correlações positivas altas entre lesão no lobo temporal e prejuízos em todas as habilidades avaliadas no teste: nomeação, repetição, compreensão oral, compreensão escrita e leitura, o que, até certo ponto, corrobora as idéias de estudos localizacionistas, na medida em que estabelece o papel preponderante do lobo temporal para a linguagem e a importância do lobo frontal para as praxias da fala. No entanto, nos demais subgrupos, têmporo-parietal e parietal/ parieto-occipital, se observou correlações positivas apenas com a compreensão oral e com a repetição, essa última somente no segundo grupo e com índice baixo, e correlações negativas altas com a fluência no discurso, o que sugere que esta habilidade se manteve preservada nestes grupos e fragiliza o argumento localizacionista.

The aim of the present work was to investigate how cortex areas compromised by Cerebral Vascular Accident (CVA) are related to the classification of aphasia, since there are controversies about the location of the lesion in the brain and the characteristics related to variations in speech patterns. Through the Montreal-Toulose protocol, 26 right-handed persons who were affected by left cerebral-vascular lesion and have been showing aphasic symptoms have been evaluated. The Montreal-Toulose protocol, initial standard module - version alpha, includes nomination, repetition, oral comprehension, reading and writing comprehension tests as well as an interview, which allows an evaluation of the discourse fluency. The subjects were allocated into four sub-groups, according to the lesion sites: frontal, temporal, temporo-parietal and parieto-occipital. For the analysis of the data, a Multidimensional Similarity Structure Analysis (SSA) was carried out along with an external variable method. The results show a high positive correlation between the lesion in the brain's frontal lobe and difficulties in the discourse fluency as well as a high positive correlation between the lesion in the brain's temporal lobe and hindrances in all abilities tested: nomination, repetition, oral comprehension, reading and writing comprehension. It is in accordance with localizational studies, since it highlights the fundamental role of the temporal lobe for the language and the importance of the frontal lobe for the speech praxis. However, in the remaining sub-groups (temporo-parietal and parieto-occipital) there have been positive correlations only between oral comprehension and repetition, with the latter showing correlation only with the second group and presenting a low score. High negative correlations with the discourse fluency were observed. It suggests that this ability has remained preserved in those groups, which in turns weakens the localization argument.

Ultraviolet A induces the apoptosis of epidermal cells in mice injected with anti-Ro/SAA-postive sera / 中华皮肤科杂志

Objective To investigate the susceptibility ofepidermal cells to ultraviolet A(UVA)-induced apoptosis in dopachrome tautomerase knockout Dct~(-/-) mice versus wildtype C57BL/6J mice.Methods High titer of anti-Ro/SSA-positive sera collected from three patients with SLE and typical cutaneous phntosensitivity were intraperitoneally injected into both Dct~(-/-) and wildtype mice,which were then chronically exposed to UVA irradiation at a single dose of 10 J/cm~2 three times a week for two weeks.Then,UVA-irradiated tail skin was excised from each mouse,embedded with paraffin,cut into 4 to 5-μm sections followed by hematoxylin/eosin staining and terminal deoxynucleotidyl transferase nick end labeling(TUNEL),respectively,for the counting of sunburn cells(SBC) and apoptotie cells.Results After chronic UVA exposure,the number of SBC and TUNEL-positive cells per 100 epithelial cells was significantly higher in serum-injected Dct~(-/-) mice than in serum-injected wildtype mice(14±1.0 vs 7±-0.6,62±2.7 vs 30 ±1.6,both P<0.05).A significant decrease was also observed in the number of SBC (6 ±0.9 per 1 00 epithelial cells)and TUNEL-positive cells (42±2.5 per 100 epithelial cells)in uninjected Dct~(-/-) mice compared with those of serum-injcoted Dct~(-/-) mice(both P<0.05).Conclusions The deficiency of Dct gene increases the susceptibility of epidermal cells to UVA-induced apoptosis under the presence of anti-Ro/SSA antibody,which potentially contributes to the develop-ment of anti-Ro/SSA antibody-mediated photosensitivity in SLE.