Effect of chemokines CXCL9 and CXCL10 on bone erosion in patients with rheumatoid arthritis / 北京大学学报(医学版)

OBJECTIVE@#To detect the serum level of soluble chemokines CXCL9 and CXCL10 in patients with rheumatoid arthritis (RA), and to analyze their correlation with bone erosion, as well as the clinical significance in RA.@*METHODS@#In the study, 105 cases of RA patients, 90 osteoarthritis (OA) patients and 25 healthy controls in Peking University People's Hospital were included. All the clinical information of the patients was collected, and the serum CXCL9 and CXCL10 levels of both patients and healthy controls were measured by enzyme-linked immune sorbent assay (ELISA). CXCL9 and CXCL10 levels among different groups were compared. The correlation between serum levels with clinical/laboratory parameters and the occurrence of bone erosion in RA were analyzed. Independent sample t test, Chi square test, Mann-Whitney U test, Spearman's rank correlation and Logistic regression were used for statistical analysis.@*RESULTS@#The levels of CXCL9 and CXCL10 were significantly higher in the RA patients [250.02 (126.98, 484.29) ng/L, 108.43 (55.16, 197.17) ng/L] than in the OA patients [165.05 (75.89, 266.37) ng/L, 69.00 (33.25, 104.74) ng/L] and the health controls [79.47 (38.22, 140.63) ng/L, 55.44 (18.76, 95.86) ng/L] (all P < 0.01). Spearman's correlation analysis showed that the level of serum CXCL9 was positively correlated with swollen joints (SJC), rheumatoid factor (RF) and disease activity score 28 (DAS28) (r=0.302, 0.285, 0.289; P=0.009, 0.015, 0.013). The level of serum CXCL10 was positively correlated with tender joints (TJC), SJC, C-reactive protein (CRP), immunoglobulin (Ig) A, IgM, RF, anti-cyclic citrullinated peptide antibody (ACPA), and DAS28 (r=0.339, 0.402, 0.269, 0.266, 0.345, 0.570, 0.540, 0.364; P=0.010, 0.002, 0.043, 0.045, 0.009, < 0.001, < 0.001, 0.006). Serum CXCL9 and CXCL10 levels in the RA patients with bone erosion were extremely higher than those without bone erosion [306.84 (234.02, 460.55) ng/L vs. 149.90 (75.88, 257.72) ng/L, 153.74 (89.50, 209.59) ng/L vs. 54.53 (26.30, 83.69) ng/L, respectively] (all P < 0.01). Logistic regression analysis showed that disease duration, DAS28 and serum level of CXCL9 were correlated with bone erosion in the RA patients (P < 0.05).@*CONCLUSION@#Serum levels of CXCL9 and CXCL10 were remarkably elevated in patients with RA, and correlated with disease activities and occurrence of bone erosion. Chemokines CXCL9 and CXCL10 might be involved in the pathogenesis and bone destruction in RA.

Quality of life of patients with arthritis in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the quality of life of arthritis patients in China.</p><p><b>METHODS</b>Patients (n = 1 344) were selected by stratified random sampling according to the economic conditions and the ranking of hospitals, and asked to complete the arthritic self-reported questionnaire of quality of life.</p><p><b>RESULTS</b>The scores of quality of life were not different between male arthritis and female arthritis in different age groups (P > 0.05). The lower scores of quality of life were reported more often among the women older than 65 years. Those of lower educational level and lower income got fewer scores. Compared to the married and unmarried patients, the divorcees and those who were bereft of their spouses gained low scores (t = 9.310, P = 0.001). Among different occupation groups, the labors and farmers also got lower scores than others (P < 0.05). On the other hand, if the arthritis with better physical conditions, it was more possible that the scores were higher, but to pressed pain index, there were no different scores shown between the second and third grade (mean difference = 4.910, P = 0.765), and to joint swell index, there are no different scores between either the 0 and 1 grade (mean difference = 16.308, P = 0.079) or the 2 and 3 grade (mean difference = 6.643, P = 0.533).</p><p><b>CONCLUSION</b>To improve the quality of life of all arthritis patients, enhancing the quality of medical technology and enriching the medical knowledge are evidently necessary. However, it is also important to prefect social security system, to improve the country education and pay attention to life of elderly in order to improve the quality of life of all arthritis patients.</p>

Follow-up study on the serological reactivity of infants diagnosed with congenital syphilis in Shanghai / 中华传染病杂志

Objective To determine the status of false-positive report of congenital syphilis (CS),to analyze the possible causes of mis-diagnosis.Methods Basic information on CS in Shanghai in the past five years was collected.We identified infants diagnosed with CS and followed up the sero- logical reactivity of those patients and their mothers.The serological reactivity[rapid plasmin reagin (RPR)and treponema palidum hemagglutination assay(TPPA)]of infants was followed-up for up to 24 months,or until both antibodies turned to negative.The medical history of the mothers was col- lected,and their sera were examined for syphilitic antibodies.Results Total 99 infants diagnosed with CS were recruited. The major diagnostic method was treponemal antibody detection.Only 31.3% of the 99 infants exhibited clinical symptoms or syphilis-like symptoms at delivery.The cumu- lative RPR loss rates of the infants were 44.2%,64.0%,72.7%,83.9% and 87.1% at 1-3,3-6,6- 12,12-18 and 18-24 months after birth,respectively.The cumulative TPPA loss rates were 1.1%, 18.6%,44.6%,66.7% and 74.4% for 1-3,3-6,6-12,12-18 and 18-24 months after birth,respec- tively.TPPA remained positive in all mothers with syphilis.Conclusion The diagnosis of congenital syphilis determined solely by the positive tests of RPR and TPPA is unreliable and can be misdiagno- sis.The diagnosis and management of congenital syphilis should be urgently improved,and that the profes- sional health institutions should perform and closely monitor the quality controls in the diagnosis of CS and standardize the intervention strategy of maternal syphilis.