Study on the associated factors of early-stage hip involvement in patients with ankylosing spondylitis based on magnetic resonance imaging / 中华风湿病学杂志

Objective:To evaluate the clinical characteristics and identify potential factors of the early-stage hip involvement in patients with ankylosing spondylitis (AS) based on the magnetic resonance imaging (MRI).Methods:A retrospective group control study was carried out in 570 AS patients who were consecutively admitted to our hospital from 2014 to 2018. Patients with hip pain or hip function limitation but lacking definitive evidence of hip involvement on radiography were underwent hip MRI. Patients were divided into three groups: no hip involvement, early-stage hip involvement (hip involvement detected by MRI but with negative radiographs) and advanced-stage hip involvement (Bath Ankylosing Spondylitis Radiology Index-hip score ≥2). The study factors included demographic, laboratory, clinical and radiographic data. Simple and multiple ordinal logistic regression analysis were used to identify factors associated with the early-stage hip involvement and advanced-stage hip involvement.Results:A total of 236 patients (41.4%) presented with hip involvement, in which 146 cases (25.6%) were diagnosed with early-stage hip involvement, while 90 cases (15.8%) were diagnosed with advanced-stage hip involvement. Multivariate logistic regression analysis demonstrated that older age at onset [ OR=0.80, 95% CI (0.72, 0.90), P<0.01], more active inflammation in the sacroiliac joints [ OR=1.13, 95% CI(1.07, 1.18), P<0.01] and worse BASMI score [ OR=3.06, 95% CI(2.14, 4.13), P<0.01] were associated with the occurrence of early-stage hip involvement. Conclusion:MRI is superior to radiography in detecting early-stage hip involvement. MRI is more suitable for hip involvement assessment in AS patients with suspected symptoms or risk factors of hip involvement.

Risk factors of disease progression and adverse pregnancy outcome in patients with systemic lupus erythematosus during pregnancy / 中华全科医师杂志

Objective To investigate the risk factors of disease progression and adverse pregnancy outcome in patients with systemic lupus erythematosus (SLE) during pregnancy.Methods Clinical data of 118 pregnant women with SLE admitted from June 2004 to October 2015 were retrospectively analyzed.The patients were divided into selective pregnant group (group A,n =72 cases) and non-selective pregnant group (group B,n =46) according to the disease activity of SLE.The disease progression and pregnancy outcomes were compared between two groups.Results The various system damages occurred in group B,including hematological damage in 16 cases,kidney damage in 19 cases,erythra in 10 cases,arthritis in 10 and serositis in 12 cases;while the corresponding cases in group A were 10,14,6,4 and 4(x2 =7.133,P=0.008;x2 =6.658,P =0.010;x2 =4.304,P =0.038;x2 =7.030,P =0.008;x2 =10.095,P =0.001).SLE exacerbation occurred in 28 cases (74％) of group B and 12 cases (17％) of group A (x2 =34.944,P =0.000).The logistic regression analysis showed that hypocomplementemia,proteinuria,SLEDAI score before pregnancy and positive anti-dsDNA antibody were the risk factors of SLE disease exacerbation during pregnancy.The maternal complications occurred in group B,including pregnancyinduced hypertension in 7 cases,preeclampsia in 10 cases and infections in 11 cases/times;while the corresponding cases (case/time) in group A were 2,6 and 4 (x2 =4.526,P =0.033;x2 =4.304,P =0.038;x2 =8.525,P =0.004).There were 14 cases of therapeutic induced labor,7 case of stillbirth and 27 cases of total fetal loss in group B,while the corresponding cases in group A were 2,0 and 4 (x2=18.317,P =0.000;x2 =9.080,P =0.003;x2 =40.920,P =0.0300).The logistic regression analysis showed that positive anticardiolipin antibody,proteinuria,SLEDAI score before pregnancy and renal dysfunction during pregnancy were risk factors of fetal loss.There were 87 cases of successful delivery (73.7％),the successful delivery rates were 41.3％ (19/46) in group B and 94.4％ (68/72) from group A,respectively.The infant complications occurred in group B,including premature birth in 15 cases,low birth weight in 13 cases,neonatal jaundice in 5 cases and mild asphyxia in 5 cases;while the corresponding cases in group A were 24,18,4 and 2 (x2 =11.442,P =0.001;x2 =11.395,P =0.001;x2 =4.664,P =0.031;x2 =8.035,P =0.005).Conclusion SLE patients whose disease conditions are not well controlled would lead to higher percentage of disease deterioration during pregnancy and worse pregnancy outcomes.

Serum vitamin D levels in patients with systemic lupus erythematosus and their relationship with disease activity / 实用医学杂志

Objective To detect the serum 25- OH-D levels in patients with systemic lupus erythematosus (SLE) and investigate the function of vitamin D in the pathogenesis of SLE. Methods Eighty SLE patients including 40 healthy donors and 40 RA (rheumatoid arthritis) patients were enrolled in this study. Serum 25-OH-D levels were detected with ECL method. Results (1)Serum 25-OH-D levels in patients with active SLE were lower than those with inactive SLE patients and healthy controls. (2)Serum 25-OH-D levels were negatively correlated with SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) scores (r = -0.45,P < 0.01) and 24-hours urinary protein excretion (r = -0.32,P < 0.05). Conclusion Serum 25-OH-D levels in SLE patients decrease and have close relationship with disease activity and renal lesions.

Expression and significance of Th17 cells in peripheral blood of patients with rheumatoid arthritis / 中国综合临床

ObjectiveTo investigate the expression and significance of Thl7 cells in peripheral blood of patients with Rheumatoid Arthritis (RA).MethodsThirty-three active RA and 27 stable RA patients and 30 healthy individuals were enrolled in the study.Intracellular flow cytometry detection of TH17 cells in peripheral blood was established.The correlations between Th17 cells and RA disease activity (DAS28 scale) as well as bone erosion were analyzed.ResultsThe expressions of Th17 cells in the patients with RA were significantly higher than those of healthy controls [ ( 1.60 ± 0.51 ) ％ vs (0.81 ± 0.21 ) ％,t =10.30,P ＜ 0.001 ].The Th17 levels in active RA patients were also higher than that of stable RA patients and healthy subjects [ ( 1.94 ±0.38 ) ％ vs ( 1.19 ± 0.27) ％,t =8.85,14.60,P ＜ 0.01 ].And the Th1 7 levels in stable RA patients were also higher than that of healthy subjects (t =5.88,P ＜0.01 ).Active RA patients with bone erosion ( 19 cases) also had higher levels of Th17 cells than those without bone erosion ( 14 cases) [ ( 2.09 ± 0.39 ) ％ vs.( 1.74 ±0.29 ) ％,t =2.83,P ＜ 0.01 ].The expression of Th17 cells was positively correlated with the DAS28 score ( r =0.86,P ＜ 0.01 ).ConclusionThere is a high expression of Th17 cells in peripheral blood of RA patients,which is related to disease activity and bone erosion.Th17 cells might play an important role in the pathogenesis of RA.