Objective To study the characteristic and management method of steroidogenic diabetes in patients with rheumatic disease. Methods The follow-up data of steroidogenic diabetes in 38 patients with rheumatic disease were analyzed retrospectively. Results The nosogenesis of steroidogenic diabetes and fast blood sugar level was related with steroid dosage, using time, age, obesity and hypertipoidemia. The blood-fasting sugar level was not so obviously increased. Blood sugar at bedtime was (24.40±5.92)mmol/L,before breakfast was (9.52±3.64)mmol/L, after breakfast was (20.38±7.19)mmol/L, before lunch was(10.69±3.23)mmol/L, after lunch was (21.81±6.92) mmol/L, before dinner was (12.17±3.63)mmol/L. There was significant difference between blood sugar at bedtime and that in others (P<0.01 or<0.05). Most patients needed insulin to control blood sugar. Decreasing the daily dosage of steroid might be beneficial to the reduction of corticosteroid induced diabetes. Most patients could stop insulin injection when the daily dosage of steroid decreased to a certain level. Conclusions The prescription of corticesteroid in rheumatic diseases can cause temporal increase of blood sugar. Intensive follow-up aad blood sugar monitor is important for the diagnosis of steroidogenic diabetes. Promptly administration of insulin is required for blood sugar control.

Objective To investigate the mechanism on JAK/STAT1 signal pathway in SAHA down-regulation of indoleamine 2,3-dioxygenase (IDO) in gallbladder carcinoma cells.MethodsWe treated gallbladder carcinoma SGC-996 cells with IFN-γ and SAHA.Western blotting was used to detect the expression of IDO,signal transducer and activator of transcription 1 (STAT1) phosphorylation and interferon regulatory factor genes-1 (IRF-1).Confocal microscopy analysis was used to detect STAT1 translocation.Transient transfections and reporter genes assay was used in detecting the activation of γ-activated sites (GAS) and interferon stimulated response elements (ISRE).ResultsIDO expressed in SGC-996 cells in dose- and time-dependent manners when stimulated with IFN-γ.SAHA down-regulated the expression of IDO induced by IFN-γ in a dose-dependent manner.SAHA blocked the expression of IRF-1 induced by IFN-γ.SAHA inhibited the IFN-γ-induced STAT1 phosphorylation and nuclear translocation.SAHA down-regulated IFN-γ-induced activation of GAS and ISRE.ConclusionsSAHA may down-regulate IDO expression through inhibiting the activation of members in JAK/STAT1 signal pathway.This may provide a new immunotherapeutic strategy to break tumor immune tolerance in gallbladder carcinoma.

Objective:To evaluate the changes of quality of life in patients with axial spondyloarthritis (ax-SpA) after treatment with non-steroidal anti-inflammatory drugs (NSAIDs) by the 36-item Short Form Health Survey (SF-36).Methods: 120 patients diagnosed with ax-SpA were collected in the first Affiliated Hospital of Zhengzhou University from October 2014 to September 2015.They all agreed to be treated with the special drugs and assessed by special scale.Then they all signed the agreement.In the 3 months,double-blind,parallel controlled trial patients were randomized to 200 mg twice daily (bid) imrecoxib,or 200 mg twice daily (bid) celecoxib.They were assessed for the changes of quality of life at enrollment and after three months of NSAIDs therapy by the SF-36 of Chinese edition.The correlation between quality of life and erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),Bath Ankylosing Spondylitis Disease Activity Index (BASDAI),Bath Ankylosing Spondylitis Functional Index (BASFI),Spondylo Arthritis Research Consortium of Canada (SPARCC) was analyzed.Results: A total of 116 ax-SpA patients completed the study and 4 patients were lost to follow-up.We used the SF-36 scale to assess the quality of life in patients with ax-SpA before and after 3 months,NSAIDs treatment.The treatment effects were not statistically significant difference between the two drugs (P>0.05).After all the patients were treated with NSAIDs for 3 months,there was statistically significant difference (P<0.05) of the physical functioning,role-physical,bodily pain,general health,social functioning,role-emotional;and there was no statistically significant difference (P>0.05) of vitality and mental health.The positively significant correlations had been identified between BASDAI and PF,RP,BP,GH,VT,SF,RE (P<0.05),while no significant correlation was found between BASDAI and MH (P>0.05).A positively significant correlation had been identified between BASFI and PF,RP,BP,GH,SF,RE,MH (P<0.05),while no significant correlation was found between BASFI and VT (P>0.05).The ESR was positively correlated with SF,RE (P<0.05);and CRP was positively correlated with SF,MH (P<0.05);and SPARCC was positively correlated with PF (P<0.05).BASDAI and BASFI were the important influence factors of PF (P<0.05);and BASDAI was the important influence factor of BP,GH,VT,RE(P<0.05);BASFI was the important influence factor of RP,SF,MH(P<0.05).Conclusion: Non-steroidal anti-inflammatory drugs can improve the quality of life of the ax-SpA patients.Imrecoxib and celecoxib have the equivalent curative effect.SF36 scale is suitable for the assessment of the quality of life in patients with ax-SpA.

Objective To observe the effect of recombinant human tumor necrosis factor receptor-Fc fusion protein (rhTNFR-Fc, etanercept) on the expression of transforming growth factor-β1 (TGF-β1) in bleomycin induced interstitial lung disease of rats. Methods Forty-five male Sprague-Dawley (SD) rats were randomly divided into three groups (control group, model group and rhTNFR-Fc treatment group, 15 rats in each), on the 7th, 14th and 28th days, five rats of each group were killed. The lungs were incised to make pathological sections which were stained with HE and Masson, and the expression of TGF-β1 was detected by immunohistochemical technique. Results There was no collagen deposition, alveolitis and fibrosis changes in the control group. The alveolitis and fibrosis of the treatment group was less severe than that in the model group (P<0.01). The expression of TGF-β1 in the model group was significantly higher than that in the control group (P<0.01). In the 7th and 14th days, the expression of TGF-β1 in the treatment group was signific-antly higher than that in the control group (P<0.01). Although that in the 28th day was a slightly higher but no statistical significance (P>0.05) could be detected. In the treatment group, the expression of TGF-β1 was lower in the 7th day (P>0.05) and was significantly lower in the 14th and 28th days than that in the model group (P<0.01). Conclusion Recombinant human tumor necrosis factor receptor-Fc fusion protein can alleviate the severity of alveolitis and pulmonary fibrosis induced by Bleomycin-A5 in rats, which may be due to the inhibition of TGF-β1 overexpression.

Objective To analyze the clinical characteristics of respiratory involvement in relapsing polychondritis(RPC). Methods The clinical data of 38 patients with respiratory (larynx, trachea and bronchus) involvement in RPC were retrospectively analyzed. Results The incidence of respiratory involvement in patients with RPC was 51.35%(38/74), and the most common symptoms were cough, wheezing, chest tightness and dyspnea. The incidences of erythrocyte sedimentation rate (ESR) increasing, C- reactive protein (CRP) increasing, fibrinogen increasing, D- dimer increased and rheumatoid factor (RF) positive in patients with respiratory involvement were significantly higher than those in patients without respiratory involvement: 47.37% (18/38) vs. 30.56% (11/36), 52.63% (20/38) vs. 33.33% (12/36), 31.58% (12/38) vs. 25.00% (9/36), 21.05% (8/38) vs. 13.89% (5/36) and 36.84%(14/38) vs. 5.56% (2/36), and there were statistical differences (P<0.05). CT was the main method to discover the respiratory involvement, and MRI could detect early cartilage inflammation lesions. Laryngoscope and bronchoscope could early detect mucosa and cartilage damage. Pathology was given priority to lymphocytes and neutrophils infiltration. Some patients had epithelium metaplasia and even canceration. Primary treatment methods were glucocorticoids combined with immunosuppressant. Airway stenosis and infection was the main factors influencing the prognosis of patients. Conclusions The respiratory involvement is not uncommon in RPC, and early CT, MRI, laryngoscope and bronchoscope examination is an important means of early diagnosis.Early glucocorticoid combined immunosuppressive therapy is the key to achieve good prognosis.

Objective:To study the clinical and immunological features of two case of rare antisynthetase syndrome (ASS), so as to improve the level of diagnosis and treatment.Methods:Two cases with rare antisynthetase syndrome admitted to the First Affiliated Hospital of Zhengzhou University from July 2020 to August 2022 were collected.Results:The two rare ASS were anti-Zo antibody and anti-Ha antibody positive patients, both of which had interstitial lung disease (ILD) as the main clinical manifestation and positive anti-Ro52 antibody. Two rare antisynthetase autoantibodies manifested cytoplasmic ANA indirect immunofluorescence (IIF) staining pattern, but it is different from the cytoplasmic dense speckled pattern of several common ASS antibodies. After treatment with glucocorticoids and immunosuppressants, case 1 died of respiratory failure due to a long course of disease and late diagnosis, the lung lesions of case 2 improved significantly.Conclusion:When encountering the cytoplasmic ANA fluorescent pattern in ILD patients, especially with anti-Ro52 antibody, it is necessary to screen more myositis specific antibodies to rule out the possibility of rare ASS.