ObjectiveTo evaluate the frequency of antinucleosome antibody(AnuA) in juvenile systemic lupus erythematosus(JSLE),comparing it to that observed for anti-dsDNA,anti-Sm antibodies,and explore the correlation of these antibodies with clinical manifestations and disease activity.MethodsWe included 80 children with JSLE and 56 children with other rheumatic diseases into this study.Clinical records were reviewed.AnuA,antinuclear antibody (ANA) and anti-Sm antibody were detected by ELISA,ⅡF and Western-blot respectively.Anti-DNA were detected by ELISA and ⅡF.Disease activity was assessed by SLEDAI score.ResultsAnuA showed sensitivity of 76.25％ and specificity of 98.21％.AnuA combine with anti-dsDNA antibody or anti-Sm antibody was detected,the sensitivities and specificities were 83.05％,86.44％ and 96.43％,98.21％,respectively.It showed that the sensitivity was higher than any one of the three.The presence of AnuA was associated with red blood cell count,hemoglobin level,ESR,hematuria,low complement levels and anti-dsDNA antibody (r=-0.499,-0.503,0.388,0.227,0.303,0.531,P=0.000,0.000,0.000,0.042,0.006,0.000).The presence of AnuA was associated with the SLEDAI score(P=0.000). Conclusion AunA hasthe highest sensitivity and specificityamongthese autoabtibodies,particularly,when combined with anti-dsDNA antibody or anti-Sm antibody.The level of AnuA is associated with the disease activity of JSLE.AnuA is not only useful for the diagnosis of JSLE but also for evaluation of the disease activity.

Ankylosing spondylitis (AS) is a systemic disease, which mainly causes to axial joint chronic inflammation. Spine, thoracic and peripheral joints may have varying degrees of activity limitation, and somatic activity is also likely to decline. Ankylosis of the spine and movement disorder of hip are the mainly causes of AS patients' disability, which not only affect the patients' motor function, and but also affect their social interaction, role affordability, mental state and daily living skills. Exercise therapy is the treatment unarmed or with equipment, for injuries, disease, residual patients, to restore or improve dysfunction. There are a number of studies about exercise therapy for joint function of patients with AS, confirmed that exercise therapy plays a crucial role in the treatment of AS patients, on the basis of the medications control.

Hyperuricemia is the second largest metabolic disease next to the diabetes and is an independent risk factor for other chronic diseases. With the increase of incidence rate, it has become one of the common chronic diseases in general practice. For the implementation of hierarchical medical system, it is necessary to establish a sound and effective community model for the management of hyperuricemia in China. This article reviews the literature at home and abroad to provide information for building a community management model of hyperuricemic patients.

Objective To investigate the synergistic effect of methotrexate (MTX) and cyclophos phamide (CTX) on cell cycle and cyclin D1 of periphery blood lymphocytes (PBLs) and bone marrow byflow cytometry. Methods Wistar rats were randomly divided into four groups including normal control, MTX and cyclophosphamide combination group, MTX and CTX only treatment groups respectively. PBLs were isolated for flowcytometry analysis for the changes of cell cycle and the expression of cyclin D1 at week 0, week 3,week 9, week18 and week 27. Mice were dissected and the changes of lymphoeytes cell cycle and the expressions of cyclin D1 in the bone marrow were measured at week 0, week 3, week 9, week 18 and week 27 increased and the ratio of phase S cells was decreased (P>0.05). In the CTX treatment group, there was no statistical difference in ratios of each phase. In the MTX and CTX combination treatment group, the proportion of phase G0/G1 cells decreased significantly and the percentage of phase S cells increased in both PBLs and bone marrow ceils (P<0.05). And there was no statistical significant difference in different time points after marrow between different groups or different dissecting time points. Conclusion MTX combined with CTX has been shown to have antagonistic effect on cell cycle. However, this effect is not via the cyclin DI pathway.

Juvenile idiopathic arthritis is a common connective tissue disease of children.The rate of disability is high.Therefore,early diagnosis is important.There are some study on the value of antibodies in juvenile idiopathic arthritts,such as rheumatoid factor,antiperinuclear factor,antikeratin antibody,antibodies to cyclic citrullinated peptides and so on.This review introduces the progress of them.

Objective In this study,we elucidated the role of high mobility group box chromosomal protein 1 (HMGB1) in collagen-induced arthritis (CIA) rat and the antagonist role of ethyl pyruvate by using a rat model of CIA as the research object by comparing the expression of HMGB1 in normal control group,CIA model group and ethyl pyruvate group.Methods Thirty-six rats were randomly divided into 3 groups (n=12):normal control group,CIA group and ethyl pyruvate group.Then the 6 rats were dissected at the 6th,9th week respectively.Thc expression of HMGB1 was analyzed by immunohistochemistry and Pathology-image analysis software in the cytoplasma.The expression of HMGB1 mRNA with real time-polymerse chain reaction (PCR) was evaluate,and the HMGB1 expression of each group were compared with t-test.Results The immunohistochemical results of HMGB1 showed that the expression intensity in the normal control group,CIA model group and ethyl pyruvate group was 2.1±0.6,7.3±1.2,6.0±1.2 respectively at the 6th week; and 2.2±0.7,12.4±4.5,5.5±1.0 at the 9th week respectively.The HMGB1 mRNA real time-PCR results had shown that the relative quantification of the normal control group and CIA model group were 1,2.865,2.602respectively at the 6th week and 1.005,4.694,1.729 at the 9th week.At those two points, the HMGB1 expressions of HMGB1 antagonist group were significantly higher than those of the normal controls (P＜0.05).In addition,there was statistical significant difference(P＜0.05) in the HMGB1 expression when compared with the placebo group.Furthermore, when the degree of HMGB1 expression among the three groups was compared,the HMGB1 antagonist group was decreased significantly (P＜0.05).Conclusion The results has demonstrated that HMGB1 could induce inflammation in the synovial tissue of CIA rats,and has provided the rationale that HMBG 1 could be the target of treating rheumatoid arthritis (RA).The results of this study have shown that ethyl pyruvate could antagonize the effect of HMGB1.This finding may provide a new therapeutic target for the treatment of RA.

Objective To study the clinical characteristics and prognosis of interstitial lung disease (ILD) associated with polymyositis (PM) and dermatomyositis (DM). Methods The clinical data of 107 DM related ILD,and its frequency rate was 26.2%. Arthritis as the first symptom had a higher presenting rate in patients with ILD than in patients with non- ILD. Arthritis, dry cough and short of breath occurred more dyspnea presented in patients with DM-ILD, and there was serious myalgia and muscle weakness in patients More DM-ILD patients had high HBDH and AST than those in PM-ILD. High CK and CK-MB were more The 7 of 8 severe cases had DM-ILD in which 5 died of respiratory failure (death rate was 17.9% in PM/elevated ESR and CRP tend to complicate with ILD. The DM patients who have characteristic skin rashes and high AST level are prone to develop ILD. The PM patients who have high CK and CK-MB are susceptible to

Objective To evaluate the safety and tolerance of tumor necrosis factor-or (TNF-α)antagonists in the treatment of rheumatic diseases. Methods The incidence of adverse events and their ultimate outcomes based on the clinical symptoms, signs and laboratory parameters of patients treated with etanereept or infliximab during January 2007 to October 2008 were analyzed. Results Severty eight patients were included. Most were rheumatoid arthritis (35%) and ankylosing spondylitis (41%) patients. Few of them were psoriasis arthritis (17%) patients and undifferentiated spondyloarthropathy (6%) patients. Among those patients, 59 patients were treated with etanercept, 7 patients (12%) had adverse events in which the majority were injection reactions, upper respiratory tract infection and tuberculosis. Nineteen patients were treated with infliximab, in which 3 patients (16%) had adverse events. One patient (AS) had upper respiratory tract infection. One case (AS) had red papules all over the body and palpitations in the first 24 hours after two infusions. One patient (RA) had fever without identifiable causes after the 4th infusion. Some of the adverse reactions might subside without intervention, while others were controlled after proper treatment. Conclusion Both etanercept and infliximab have good safety and tolerance in treating rheumatic diseases, the adverse reactions are generally mild and can be controlled by appropriate treatment.

Objective To explore the clinical value of early diagnosis of atherosclerosis in patients with systemic lupus erythematosus (SLE) using vascular echo-tracking technique and to detect changes of elastieity of carotid artery quantitatively in SLE patients.Methods Fifry patients with SLE were divided into SLE1 group(duration≤1 year),and SLE2 group(duration>1 year)based on different course.An ultrasonic echo-tracking method was used to measure patients'pressure strain elastic modulus (Ep),the stiffness constant(β),arterial compliance(AC),augmentation index(AI),pulse wave velocity (PWVβ) and intimamedia thickness(IMT)of the common carotid arteries in 50 patients with SLE and in 25 healthy control subjects.Results Among carotid artery elasticity indicators of three groups,there was no significant difference in AI(P>0.05).Ep,β,PWVβ parameters of SLE1 group and SLE2 group were statistically higher than that of the control group[Ep of SLE1 group,SLE2 group,control group was (69±20),(103±40),(48±18)kPa respectively;β was 5.2±1.9,8.0±3.1,4.2±1.3 respectively;PWVβ was 5.2±0.7,6.3±1.1,4.5±0.7]respectively,but AC(AC of SLE1 group,SLE2 group,control group was(1.1±0.3),(0.8±0.3),(1.2±0.6)mm2/k respectively]lower than the controls(P<0.01).Ep,β,PWVβ in SLE2 group was significantly increased compared with SLE1 group,but AC was decreased (P<0.01).Conclusion The application of echo-tracking technology can be used to diagnose early atherosclerosis.Complications of cardiovascular disease in SLE have high clinical value.

Objective To assess the diagnostic value of anti-mutated citrullinated vimentin antibodies (anti-MCV) for rheumatoid arthritis (RA), and compare it with anti-cyclic citrullinated peptide antibodies (anti-CCP), rheumatoid factors (RF). Methods Commercially available enzyme-linked immunosorbent assay (ELISA) kit was used to detect anti-MCV antibodies in a group of 177 RA patients, 46 patients with other rheumatic diseases, and 48 healthy blood donors. At the same time, anti-CCP, RF were detected. T test and χ2 test were selected. Results The average concentration of anti-MCV was (523±376) U/ml in RA, (96± 55) U/ml in patients with other rheumatic diseases, (34±18) U/ml in healthy controls. Different threshold levels (20, 40, 60, 80, 100, 120, 140 U/ml) for positive results were calculated bythe areas under the ROC curve (the areas were 0.521, 0.706, 0.769, 0.791, 0.816, 0.826, 0.822), then the best diagnosis efficacy for RA was determined as more than 120 U/ml. At this level, the sensitivity and the specificity for anti-MCV were 80.1% and 80.9% for RA diagnosis. The positive and negative predictive value were 92% and 67.8%. Comparing with anti-CCP, anti-MCV showed comparable specificity but higher sensitivity. And it's also better than RF apparently. If all 3 antibodies were detected at the same time, or anti-MCV combine with one of them, the sensitivity would increase to 95.7%. In addition, Anti-MCV showed positive in 32 of 67(55.2%) patients with RA whose anti-CCP was negative, meanwhile 31 of 59 (52.5%) patients with RA whose RF was negative. Conclusion RF and anti-CCP are complementary in diagnosing RA. The combination detection of RF and anti-CCP could significantly improve the specificity for the diagnosis of RA.