Objective To evaluate the clinical and image characteristics of rheumatoid arthritis (RA) patients accompanied with bronchiectasis (BR).Methods By retrospectively analyzing 67 patients admitted to our department,we divided RA patients into RA-BR group and non-BR group,according to the presence of BR or not.For those with interstitial lung disease (ILD),the ILD lesions were classified by inflammatory,fibrosis and mixed pattern.The clinical and image characteristics,as well as the correlation between BR patients with clinical/other lung changes were analyzed.Independent sample t test was used to compare the difference between the two groups if the data was normally distributed and those data that were not distributed normally were analyzed by Mann-Whitney U-test.Spearman correlation analysis was used for variables related analysis.Logistic regression analysis was used to identify independent risk factors for the presence of respiratory symptoms.Results Twenty-nine patients (43％) showed BR in CT scan.There was no statistically significant difference between BR and uon-BR group in age,gender,disease course of RA,smoking history and rheumatoid serology;respiratory symptom was presented in 6 pts in both groups;bronchiectasis involved unilaterallung in 10 patients (34％) and bilaterally in 19 (66％),26 patients (90％) were found to have bronchiectasis in their lower lobe.ILD was presented in 12 (41.4％) and 13 (34％) cases in BR and non-BR group,respectively (P＞0.05).BR in RA was not correlated with clinical parameters and presence of ILD.Logistic regression showed BR [OR:1.201,95％ CI.(1.023-1.411),P＜0.05] and ILD [OR:10.646,95％CI:(1.944-58.305),P＜0.01] were independent risk factors associated with respiratory symptoms in RA pts.Conclusion BR is a common lung lesion in pts with RA in China,and the dose was not correlated with ILD,the number of segment involved by BR is a risk factor for respiratory symptoms.

Objective:To investigate the frequency of metabolic syndrome (MS) in patients with psoriatic arthritis (PsA) and further analyze the correlation of MS and its components with clinical features of PsA.Methods:Data including demographics, clinical manifestations, laboratory tests, MS-associated features (height, weight, waist circumference, blood pressure, serum lipid spectrum, and so on) and history of complications (hypertension, diabetes mellitus, atherosclerosis, coronary heart disease, and cerebral vascular disease) were collected from PsA patients in our hospital from Jan 2017 to Sep 2019. The frequency of MS in PsA patients was calculated and the association between PsA clinical manifestations and MS as well as its components was investigated.Results:One hundred and sixty-two PsA patients who fulfilled the Classification Criteria for Psoriatic Arthritis (CASPAR) were recruited. Hypertension was identified in 36 (22.2%) patients, diabetes mellitus in 28(17.2%) patients, coronary heart disease in 11(6.7%) patients, and cerebral vascular disease in 7 (4.3%) patients. Based on the criteria of the International Diabetes Federation (IDF), 58(35.8%) patients were diagnosed as MS. Compared with MS-free patients, patients with MS, hypertension or diabetes mellitus were older [(54±10 vs 44±13; 56±11 vs 45±12; 54±11 vs 44±13, respectively, t=5.058 , 4.450, 5.150, P<0.01 for all], with higher disease activity [DAPSA scores 16.75(11.25, 26.7) vs 8.8(4.8, 16.4), 16.3(9.6, 27.8) vs 10.0 (5.1, 18.0), 14.4 (9, 25.7) vs 9.5 (5, 17.7), Z=4.539 , 3.046, 3.063, P<0.01]. There was a positive correlation between the sum of components of MS and DAPSA score ( r=0.27 , P<0.01), but multiple linear regression showed no correlation between each component with DAPSA score ( P>0.05) except for hypertension ( P<0.01, standard coefficient=0.334) and elevated fasting blood glucose ( P=0.023, standard coefficient=0.247). PsA patients with hypertension had higher ESR [16.5 (9.5, 34.25) mm/1 h vs 10 (5, 24.5) mm/1 h, Z=2.127, P=0.012]. CRP level was higher in patients with dyslipidemia [5.6(2.1, 17.8) mg/L vs 3.7(1.5, 6.5) mg/L, Z=2.543, P<0.01]. Prevalence of inflammatory back pain was also higher in dyslipidemia patients (41.3% vs 22.4%, χ2=5.901, P=0.016). DAPSA score was higher in dyslipidemia patients (14.1 vs9.9, P=0.031). Conclusion:MS and its components are not rare comorbidities in PsA patients. PsA patients with MS tend to be older with higher disease activity, which calls for more attention.

Objective To evaluate the therapeutic efficacy of endovascular embolism in treating aneurysms located at the bifurcation of middle cerebral artery. Methods During the period from Jan. 2009 to May 2013 at authors’ hospital, a total of 21 patients with intracranial aneurysms located at the bifurcation of middle cerebral artery were treated with interventional embolization. Of the 21 cases , steel coils were used in 7, stent-assistant embolization was adopted in 12, and dual-microcatheter technique was employed in 2. The results were analyzed. Results Postoperative angiography showed that complete embolization of the aneurysm was achieved in 14 patients, residual neck was detected in 2 patients and subtotal obliteration of the aneurysm was seen in 5 patients. Procedure-related complications occurred in 2 patients, including cerebral bleeding during operation (n = 1) and postoperative small area cerebral infarction. Seventeen patients were followed up for 6 months, and follow-up angiography showed that no recurrence of aneurysm was seen. Conclusion For un-ruptured, or ruptured with no big hematoma, intracranial aneurysms located at the bifurcation of middle cerebral artery, endovascular interventional embolization is the treatment of choice.

Objective To study anaphylactoid reactions induced by traditional Chinese medicine injections (TCMI) of Qingkailing (QKL) and Xuesaitong (XST) with RBL-2H3 cells;To provide some reference for improving the screening system of TCMI induced anaphylactoid reactions.Methods The IC50 induced by QKL and XST injections was determined by MTT assay. RBL-2H3 cells were stimulated with TCMI at different concentrations or with C48/80 or culture medium. Thirty minutes later, the supernatant was collected to determine the release of histamine andβ-hexosaminidase. The cell degranulation rate and the ultrastructure changes were observed. The ICR mice were given single injection of TCMI containing Evans Blue through tail vein. The number of the animal with blue ear, the total number of blue ears and the quantity of Evans Blue of extravasation were determined 30 minutes later.Results The IC50 of both QKL injection and XST injection was 12.5μL/mL. These two injections promoted RBL-2H3 cells to release histamine andβ-hexosaminidase at higher concentrations (P<0.05,P<0.01) in a dose dependent manner. Cell morphology showed a decrease of villous on the cell surface and an increase of the internal vacuolated structure. Both injections caused the blue ears of all animal with a rate of 100%. The quantity of Evans Blue of the extravasation was significantly increased (P<0.01). The results in vitro study were in close agreement with that in vivo.Conclusion Both QKL injection and XST injection may potentially cause anaphylactoid reactions. The RBL-2H3 cell model may be valuable to evaluate the anaphylactoid reactions induced by TCMI.

Objective To investigate the prevalence rate and the related risk factors of post traumatic stress disorder (PTSD) in rescue troops one year after Wenchuan earthquake as science proofs of mental interven-tion. Methods 1176 officers/soldiers from rescue troops were tested with the questionnaire composed by General state of health questionnaire, PTSD Checklist-Civilian Version (PCL-C), Symptom Checklist-90 (SCL-90), simple coping style questionnaire (SCSQ) and Eysenck Personality Questionnaire (EPQ). Students't test and correlation analysis were used to study the risk factors. Results One year after Wenehuan earthquake,the prevalence rate of PTSD was 3.45%. Compared with the norms of Chinese serviceman, some evaluative indexes' scores, including somatization(1.43±0.57),exterior(12.50±3.79)/interior and positive response factors(2.05±0.71), were higher(P<0.05), at the same time some evaluative indexes' scores, such as anxiety,depression,nervousness and negative response factor, were obviously lower(P<0.01). Correlation analysis showed total score of PLC-C was positively correlated with somatization, anxiety, depression and negative response factors, separately (P<0.01),but negatively correlated with exterior/interior and positive response factors, separately (P<0.01).Conclusion The psychological status of the earthquake-rescuers is basically normal one year after Wenchuan earthquake. The younger soldiers with less education,who have nervous,introversive character,are the emphasis crowd.

0.05).In patients with HSPN capillary wall staining for IgA was more frequently found than in IgAN(71.0% vs 43.5%,P=0.013).With creatinine level doubling as the end point,the follow-up data indicated that the renal survival was 87.1% in HSPN and 91.9% in IgAN and there was no statistically significant difference between HSPN and IgAN(P=0.481).Conclusion:Although significant pathological difference was found between HSPN and IgAN,the renal clinical manifestations and long term outcome were similar between the two diseases in adults.

Objective To evaluate the prevalence of subclinical atherosclerosis in rheumatoid arthritis (RA) and the related risk factors.Methods Fifty RA patients without overt atherosclerotic disease and 121 control subjects matched for age and sex were recruited.Duplex carotid sonography was used to measure intima-media thickness (IMT) and plaque formation assessment.Differences between RA and the control group were compared, and the risk factors were explored.RA patients then were divided into two subgroups according to IMT and the comparison between the two subgroups were completed.T test, Mann-Whitney U test, chi-square test, Pearson's correlation and Logistic regression analysis were used for statistical analysis.Results Although RA patients had lower level of serum lipids and body mass index than the control group, the mean IMT value was significantly higher in the RA group than that in the control group [(0.78±0.18) mm vs (0.62±0.14) mm, t=5.853, P=0.000], and plaque formation was more prevalent [56.0％(28/50) vs 36.4％ (44/121),x2=5.596, P=0.018].The difference was especially significant in the younger groups (＜50 years old group and 50-60 years old group).Logistic regression showed that the presence of RA [OR=7.34, 95％CI (2.53, 21.25)], male [OR=2.0, 95％CI (91.25, 3.17)] and old age [OR=1.1, 95％CI (1.04, 21.15)] were the independent risk factors for abnormal IMT (thickened or the presence of carotid plaques).The RA patients were divided into two subgroups according to IMT.Compared with patients with normal IMT, patients with abnormal IMT were older and more common in postmenopausal, and had longer RA duration and higher cholesterol level.In treatment, less patients with abnormal IMT had been taking methotrexate (MTX) for more than 3 months compared with patients with normal IMT.Among these parameters, old age [OR=1.13, 95％CI (1.03, 1.23)] was shown to be the independent risk factor for abnormal IMT in RA patients, and more than 3 months of MTX treatment [OR=0.12, 95％CI (0.02, 0.71)] was the protective factor.Conclusion Atherosclerosis occurs frequently and prematurely in patients with RA and the presence of RA is an independent risk factor for atherosclerosis.Early primary prevention for atherosclerosis should be recommended.MTX probably has a positive effect on preventing atherosclerosis for RA patients, which needs to be confirmed by further study.

Objective:To verify the fracture risk assessment tool ( FRAX) to estimate the probability of osteoporotic fracture in patients with rheumatoid arthritis ( RA ) with or without bone mineral density (BMD), and identify associated risk factors of osteoporosis .Methods: In the study, 200 patients with rheumatoid arthritis aged more than 40 years in Peking University First Hospital from Dec .2009 to Dec. 2012 were recruited.Clinical information was obtained from a questionnaire of their case history and medical records.FRAX tool was administered.Their lumber spine and left femoral BMD were determined by dual energy X ray absorptiometry.The gender, age, disease duration, menopause status, body mass index ( BMI) and accumulative dose of glucocorticoid were obtained in retrospect .Correlation analysis was conducted between the BMD and clinical information .Results:The study population ( female, 77.5%) had a mean age of 59.4 years, in which 10 (13%) patients showed a normal BMD, 67 (87%) were osteopenia or osteoporosis , while 32 patients (16%) had fragile fracture.Compared with the patients with normal BMD, the subjects with low BMD had significantly older age , longer period for corticoids usage , higher day dose and accumulated dose of corticoids .The 10-year fracture risk of sustai-ning major osteoporotic fractures and hip fracture was higher .No significant difference was observed be-tween the 10-year fracture risks calculated with BMD and without BMD .The values of the different area under the receiver operating characteristic ( ROC) curve ( AUC) for major and hip fractures calculated in three ways:without BMD, with the femoral neck BMD, and with T-score.The best result was for FRAX tool for hip fracture with the T-score ( AUC 0 .899 ) .A stepwise multivariate linear regression model was constructed to explore the relationship between the different clinical factors studied and a low BMD . Three statistically significant variables for lumber BMD were pain on visual assessment scale ( VAS ) (P=0.02), fracture history (P=0.003) and a higher steroid accumulated dose (P=0.008).Three statistically significant variables for left hip BMD were age (P<0.001), fracture history (P=0.05) and lower BMI ( P=0.03) .Conclusion:Low BMD is a common complication in RA patients .Risk factors for major fracture and hip fracture are increased .There is a positive correlation between FRAX calculated with and without BMD or T score .FRAX with the femoral neck T score or BMD presents a discriminatory capacity better than FRAX without BMD , according to the AUC ROC .

Objective To observe any effect of intensive training on the degree of depression and the expression of Kalirin-7 in the hippocampus of rats modeling with post-stroke depression,and to investigatc possible mechanisms.Methods Forty male Wistar rats were randomly divided into a post-stroke depression (PSD) group,a routine training group,an intensive training group and a sham-operation group (n =10 for each group).All except the sham-operation group were given the middle cerebral artery occlusion using the intraluminal thread method,and chronic mild stress was applied.The PSD group and the sham-operation group were not given any training.The routine training group was trained oncc a day,and the intensive training group was trained twice a day.The sucrose preference test,open field test and forced swimming test were conducted at the outset and after 14 and 28 days of training.The expression of Kalirin-7 in the left hippocampus was detected using Western blotting.Results After 14 days of training,significant differences were found in the test results of the sham-operation group compared with the other groups (P＜0.05).There were also significant differences in the average results on all 3 tests among all of the groups except the sham-operation group.At both 14 and 28 days after training,the average expression of Kalirin-7 in both the routine and intensive training groups was significantly higher than in the PSD group (P＜0.05),and that of the intensive training group was significantly higher than that of the routine training group at the same time points (P＜0.05).Conclusion Intensive training can relieve depression and increase the expression of the Kalirin-7 in the hippocampus,at least in rats.

Objective To investigate the outcomes of patients with rheumatoid arthritis (RA) treated by different combination of synthetic disease modifying antirheumatic drugs (DMARDs) under the guidance of treat-to-target strategy.Methods Forty-two RA patients with high disease activity were enrolled into this randomized,open-label and prospective study.It was comprised of a maximal 36-week induction phase and then followed by a maintenance phase up to 84 weeks.Combination of synthetic DMARDs was initiated in the induction phase,with or without low dose glucocorticoids (GCs) during the first 12 weeks.Patients who achieved low disease activity (LDA) were randomized into two maintenance groups.An increase of DAS28 by 0.6 was defined as relapse.The patients achieved LDA in the induction phase,relapsed during maintenance phase and possible relevant risk factors were analyzed.Results Twenty-seven (64％) patients achieved LDA during the induction phase.More non-smoking patients achieved LDA than those smoked [85％ (11/13) vs 55％(16/29),P＜0.05].During the maintenance phase,14 (61％) out of 27 patients relapsed.Patients taking GCs during the first 12 weeks had a significantly higher relapse rate compared to those without GC (83％ vs 36％,P=0.021).Patients who entered maintenance phase at week 12 had a significantly higher tendency to relapse compared to those who entered the maintenance phase at week 24 [75％(9/12) vs 33％(3/9),P=0.026].Conclusion Smoking seems to be a risk factor for RA patients who fail to reach LDA.Low dose GCs as a bridge therapy may require a longer duration.High relapse rates in both the maintenance groups indicat that a longer tight induction phase may be appropriate before downstairs therapy.