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Sjögren's syndrome （SS）， a disorder of immune system， is one of the dominant diseases treated by traditional Chinese medicine （TCM）. China Association of Chinese Medicine organized experts in the field of TCM and western medicine rheumatology and pharmacology to discuss the advantages and optimal regimens of TCM for the treatment of SS. The experts generally agreed on the low early diagnosis rate of SS and the lack of targeted therapeutic drugs. In addition， autoimmune abnormality is the key factor in the occurrence of SS and deficiency of both Qi and Yin is the core pathogenesis. SS has unique tongue manifestations， which is expected to allow for the early diagnosis and treatment with integrated traditional Chinese and western medicine. TCM has advantages in treating SS in terms of alleviating clinical symptoms and systemic involvement， individualized treatment， relieving sleep and mood disorders， preventing the occurrence in the early stage， and enhancing the effectiveness and reducing toxicity in the treatment by integrated TCM and western medicine. In general， TCM has advantages in different stages of SS. Internal and external use of TCM， acupuncture， and acupotome are all available options. The optimal regimens should be determined on the basis of pattern identification， stage of disease， and the advantages of TCM. Clinical characteristics and biomarkers of SS should be studied to classify patients， so as to design precision evidence-based TCM regimens for SS. On the basis of unique tongue manifestations of SS， models for early diagnosis and poor prognosis identification of SS should also be established to achieve early prevention and treatment and to improve the prognosis. In the future， we should vigorously carry out high-quality evidence-based medical research on the treatment of SS by TCM and integrated traditional Chinese and western medicine and develop relevant guidelines to optimize and standardize current diagnosis and treatment， thereby laying a basis for clarifying and explaining the advantages of TCM in treating SS.
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Objective To investigate the clinical features of 4 cases with systemic lupus erythematosus (SLE) complicated by chylothorax and chylous ascites.Methods Clinical manifestations,laboratory examinations,treatment and prognosis of 4 patients with SLE complicated by chylothorax and chylous ascites,who were admitted to our center in recent 13 years,were retrospectively analyzed.Results Four patients were female.The average age of SLE at presentation was 38 years (ranging from 31 to 47 years of age).The average disease duration of chylothorax and chylous ascites was 6.5 months (ranging from 3 to 12 months).Of the 4 patients,3 were complicated with chylothorax and chylous ascites,and 1 with chylothorax.Three patients were treated with corticosteroid,and 2 patients were treated combined with immuno-suppressive agents (cyclophosphamide or ciclosporin A).Chylothorax and chylous ascites improved in 1 patient.Conclusion The clinical manifesta-tions of chylothorax and chylous ascites are relatively rare in patients with systemic lupus erythematosus,and more attention should be given to improve the quality of life of these patients.
RESUMO
Objective To study the role of transforming growth factor-?1(TGF-?1) and bone morphogenetic protein 2 (BMP2) in the ankylosing spondylitis, and to evaluate whether synovial levels of TGF-?1/ BMP2 mRNA and TGF-?1/BMP2 protein expression correlate with disease activity and macroscopic observation during arthroscopy. Metheds TGF-?1/BMP2 mRNA and protein were detected by in situ hybridization and immunohistochemistry.The vascular morphology of synovial membrane was assessed for vascular morphology, tortuous vessels, straight vessels, vascular density, synovial hypertrophy, by 2 blinded observers and Reece's method using a validated VAS methods. They were significantly higher in AS than that in RA in different synovial regions. Results TGF-?1 mRNA and TGF-?1 expression were significantly higher in early AS than that in early RA in perivascular region and sublining interstitial tissue. BMP2 mRNA and BMP2 expression were significantly higher in AS than that in RA in different synovial regions.No significant relation was found between TGF-?1/BMP2 expression and CRP/ESR/platelet count in early AS. A positive relation was found between the TGF-?1 and synovial hypertrophy in synovium lining layer region, and between TGF-?1 and straight vessels,vascular density in perivascular region, and between BMP2 and synovial hypertrophy in sublining region in early AS. Conclusion Expression of TGF-?1 mRNA and TGF-?1 protein is higher in AS synovial tissue than that in RA. BMP2 mRNA and BMP2 expression are significantly higher in AS than that in RA.