Evaluation and characteristics of subclinical synovitis in patients with clinical remission of rheumatoid arthritis / 西安交通大学学报(医学版)

【Objective】 To evaluate musculoskeletal ultrasound (MSUS) detected subclinical synovitis of rheumatoid arthritis (RA) with different clinical remission criteria so as to explore the clinical characteristics of subclinical synovitis. 【Methods】 Forty-six consecutive patients with RA in clinical remission [disease activity score-28 (DAS28)≤2.6] underwent clinical and MSUS examinations at baseline and 1 year follow-up. Clinical remission was defined according to the DAS28 using the erythrocyte sedimentation rate (DAS28-ESR) and C-reactive protein level (DAS28-CRP), clinical disease activity index (CDAI), simplified clinical disease activity index (SDAI), and American College of Rheumatology/European League Against Rheumatism criteria Boolean (ACR/EULAR criteria). Subclinical synovitis was assessed by MSUS. Differences between the subclinical synovitis and non-subclinical synovitis groups were analyzed. 【Results】 The percentages of patients who achieved DAS28-ESR, DAS28-CRP, CDAI, SDAI, and ACR/EULAR remission at baseline and 1 year were 97.8%, 95.6%, 67.4%, 54.3%, 52.2% and 91.3%, 93.5%, 54.3%, 50.0%, and 45.6%, respectively. Subclinical synovitis was detected in 55.5%, 54.5%, 45.2%, 40.0%, 41.6% and 45.2%, 46.5%, 40.0%, 39.1%, and 38.1% of these patients, respectively. There were 45.6% and 41.3% patients who fulfilled all the criteria, yet 38.1% and 36.8% still had evidence of subclinical synovitis at baseline and 1 year. Compared with the patients without subclinical synovitis, those with subclinical synovitis had a significantly positive rate of anti-CCP antibody and a higher disease activity score at baseline (P<0.05). 【Conclusion】 MSUS detected subclinical synovitis is common. The positive anti-CCP antibody and higher disease activity score at baseline may be related to subclinical synovitis in patients with RA in clinical remission.

Relationship between clinical phenotype and autoantibodies in systemic sclerosis / 西安交通大学学报(医学版)

【Objective】 To detect autoantibodies in Chinese systemic sclerosis (SSc) patients and analyze the relationship between clinical phenotype and autoantibodies in SSc. 【Methods】 We sequentially included 93 SSc patients. Their general information and clinical data were gathered. The differences in clinical characteristics among autoantibody negative and positive groups were analyzed statistically. 【Results】 Anti-nuclear antibodies were detected in 82 (88.2%) SSc patients. The positive rate of autoantibodies was detected in 26 cases (28.0%) of anti-Scl-70 antibody, 24 cases (25.8%) of anti-SSA/Ro-52 antibody, 19 cases (20.4%) of anti-U1-snRNP antibody, and 16 cases (17.2%) in anti-CENP-B antibody, respectively. The patients with positive anti-SSA/Ro-52 antibody had a significantly higher morbidity rate of pulmonary arterial hypertension (P=0.016). Patients with anti-Scl-70 antibody showed a higher incidence rate of digital tip ulcers or gangrene (P=0.004) and cardiac damage (P=0.014). The patients with anti-U1-snRNP antibody had a higher prevalence of pulmonary arterial hypertension (P=0.047) and Raynaud’s phenomenon (P=0.019), and showed an increased trend in the occurrence of interstitial lung disease (P=0.058). Those with anti-CENP-B antibody had a lower IgG level (P=0.049) and higher ALP (P=0.010) and γ-GT (P=0.003). The incidence of autoimmune liver disease was increased in anti-CENP-B positive patients (P=0.001). 【Conclusion】 Different autoantibodies in SSc are associated with clinical phenotype, and may contribute to the diagnosis, evaluation, and prognostic judgment of the disease.

The relationship between the frequency of dendritic cell subsets in peripheral blood and kidney damage in patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective:To investigate the frequency of myeloid dendritic cells (mDC) and plasmacytoid dendritic cells (pDC) in peripheral blood of patients with systemic lupus erythematosus (SLE) and their relationship with renal injury.Methods:The frequency of peripheral mDC and pDC in 102 SLE patients and 10 healthy controls were detected by flow cytometry. The quantitative data were expressed by [ M( P25, P75)]. The measurement data of the two groups with non-normal distribution was analyzed by Mann Whitney U test. The correlation between the two groups was analyzed by Spearman rank correlation analysis and multiple linear regression. Results:The frequency of pDC [14.00%(7.92%, 19.65%) vs 24.55%(19.68%, 32.90%), Z=-3.163, P<0.01] and mDC [21.25%(13.28%, 32.83%) vs 34.85%(24.58%, 41.93%), Z=-2.607, P<0.01] in the peripheral blood of 102 patients with SLE were significantly lower than those of healthy controls. The frequency of pDC [9.09%(7.31%, 17.38%) vs 24.55%(19.68%, 32.90%), Z=-3.033, P=<0.01] and mDC [9.40%(7.88%, 21.60%) vs 34.85%(24.58%, 41.93%), Z=-3.231, P<0.01] in 12 patients with newly diagnosed SLE were also significantly lower than those in healthy controls. After adjustedfor confounding factors, multivariate analysis showed that SLEDAI level was the main factor influencing the frequency of pDC ( P=0.019) and mDC ( P<0.01). In addition, pDC[8.02%(2.25%, 9.97%) vs 16.70%(11.80%, 24.60%), Z=-2.490, P=0.015] and mDC[8.80%(5.99%, 12.80%) vs 20.20%(11.20%, 42.80%), Z=-2.226, P=0.029] in patients with active LN were also significantly lower than that of patients with stable LN. The mDC frequency was positively correlated with the levels of complement C3 ( r=0.455, P<0.01) and C4 ( r= 0.289, P, P<0.01). Conclusion:The frequency of mDC and pDC in SLE patients is significantly abnormal, which is closely related to disease activity. In addition, pDC and mDC may be involved in the occurrence and development of LN.

Clinical features and outcomes of seronegative rheumatoid arthritis in western China after one-year treatment with traditional disease modifying anti-rheumatoid drugs / 西安交通大学学报(医学版)

ABSTRACT:Objective To investigate the clinical features of seronegative rheumatoid arthritis (RA)in western China and its outcomes after one-year treatment with disease modifying anti-rheumatoid drugs (DMARDs) so as to provide evidence for effective therapy.Methods We made a retrospective analysis of 240 RA patients treated in our department from May 2013 to June 2014.We compared the 47 seropositive and 25 seronegative RA patients in clinical features,laboratory parameters and outcomes after one-year DMARDs medication.Results The percentage of seronegative RA was 10.4% (25/240).The number of swollen small joints was significantly smaller in seronegative RA group (P<0 .0 1 ).Compared with those in seropositive RA,the level of hemoglobin was lower,the level of platelets was higher,and the level of alkaline phosphatase was lower in seronegative RA (P<0 .0 5 ).The remission rate was higher in seronegative RA group than in seropositive RA group after one-year DMARDs administration (P<0.05).Conclusion Seronegative RA is not rare in clinic.Even though seronegative RA patients often present fewer swollen small joints, it is difficult to distinguish between seronegative and seropositve RA just based on the clinical features.Besides,hematological damage is more severe in some patients with seronegative RA.Only after one-year treatment with DMARDs,the remission rate is higher in seronegative RA patients than in seropositve RA ones.

Transfection of double gene co-expressing adenovirus vector into arthritis rats / 中国组织工程研究

BACKGROUND:Abnormal activation of lymphocytes and nuclear factorκB-dependent non-specific inflammation are two major manifestations of joint damage in rheumatoid arthritis. Co-stimulatory signal CD40/CD40L is the dominant co-stimulatory factor in the recognition and activation of T cel s. IκBαeffectively inhibits nuclear factorκB pathway, prevent the inflammation in the central link, and suppress the damage caused by inflammatory factor in the synovial tissue. OBJECTIVE:To investigate the therapeutic effect of double gene co-expressing adenovirus vector on arthritis based on an arthritis model rat transfected by CD40LIg-IRES2-IκBαco-expressing adenovirus vector. METHODS:The pAdCD40LIg-IRES2-IκBαco-expressing adenovirus vector was established. Arthritic model was established through multi-subcutaneous injections of complete Freund's adjuvant of type col agen II (1 g/L) into Wistar rats. Then 20 arthritic rats were divided into two groups:untreated group and transfection group, receiving an injection of saline and pAdCD40LIg-IRES2-IκBαadenovirus vector to distal joint cavity of limbs, respectively. RESULTS AND CONCLUSION:At 14 days post-transfection, compared with the untreated group, the mean arthritis index score, the CD40L expression of lymphocytes in synovial fluid, the nuclear factor-κB p65 expression in synovial tissue, and levels of interleukin-2, interleukin-6, tumor necrosis factor-α, matrix metal oproteinase-3 and matrix metal oproteinase-9 in synovial fluid of rats in transfection group were significantly lower than those in untreated group. Focal transfection of the CD40LIg-IκBαco-expression adenovirus vector can effectively inhibit arthritic symptoms, and reduce the expressions of inflammatory cytokine in synovial fluid and inflammatory molecule in synovial tissue of arthritic rats, which shows good therapeutic effect.

The influence of sometostatin on TNF-α in patients with severe acute pancreatitis / 中国基层医药

Objective To explore the clinical effect of sometostatin in the treatment of severe acute pancreatitis and its influence on the level of TNF-α.Methods 68 cases with severe acute pancreatitis were randomly divided into two groups,34 cases in the control group were received general treatment,34 cases in the observation group were given sometostatin on the basi of general treatment for 5 ～ 7 days.The clinical effects and clinical indexes were observed and compared between the two groups.Results After treatment for 3 days,the level of TNF-α in the observation group was significantly lower than that in the control group( P ＜0.05 ),and the observation group patients recovered rapidly.The recovery time of blood amylase and intestinal function,hospital stay days,incidence of complications and mortality in the observation group were significantly shorter than those in the control group ( P ＜ 0.05 ).Conclusion Sometostatin is effective for treatment of severe acute pancreatitis,can decrease the level of TNF-α significantly,shorten disease course and improve the prognosis,which is good for clinical application.

Study on the relationship between cyclin D1 G870A polymorphism and gastric cancer / 中华消化杂志

Objective To assess whether the G870A polymorphism of cyclin D1 (CCND1)was associated with individual susceptibility to gastric cancer in China. Methods Case-control study of 214 individuals was conducted, including 108 controls (non ulcerative dyspepsia) and 106 cases of gastric cancer. The polymorphism analysis of CCND1 A/G was performed in blood samples by PCR-RFLP method. Results The frequency of GG genotype was 19.8% and 7.4% in patients with gastric cancer and controls, respectively. The risk for gastric cancer in patients homozygous (GG) for CCND1 genotypes was 3.5 times higher in comparison with patients carrying AA genotypes (P＜0.05, OR =0.281). Furthermore, the stratification analyses showed that the male, elderly (≥60 years) or H. pylori infected gastric cancer patients who carrying GG genotype were more susceptible to gastric cancer compared with those carrying AA or GA genotype. Conclusion GG genotype is associated with increased susceptibility to gastric cancer in high risk area of Xi'an.

A Searching System of Parasite Pictures and Relevant Information / 中国寄生虫学与寄生虫病杂志

Over 3 000 pictures on five major parasites(schistosome,filaria,hookworm,leishmania and plas-modium)collected between 1950 and 1990 were edited and a searching system was established. The data can be used with a network-based version through a LAN system in the Institute. The adoption of Digital Computerized Management makes it possible for sharing resources in human parasitology.