Objective To investigate the significance of antifilaggrin autoantibodies (AFA) in rheumatoid arthritis (RA).Methods Filaggrin was extracted from the skin of the patients who had breast cancer undergoing mammectomy.AFA were detected at the sera titer 1∶10 with Western blotting,and its clinical significance was investigated with the corresponding clinical materials.Results Antifilaggrin autoantibodies (AFA) were detected in 39 9%(71/178) of RA patients,and 6 cases of control group,with a specificity of 0 969.AFA were present in 48 4%(15/31) of the early and 29 2% of seronegative RA.AFA positive patients exhibited higher frequency of Sjgren′s syndrome;The average and onset ages of AFA positive patients were older than those of the negative ones,and there was correlation between AFA and age.The frequency and average titer of RF patients were higher in AFA positive than in negative ones.AFA was significantly correlated to RF,AKA and APF.Conclusion AFA are valuable diagnostic parameter for RA,especially in the early and seronegative RA.AFA is significantly correlated to AKA and APF,but they are not totally overlapped,None of the three antigens used bear all the epitopes recognised by antifilaggrin autoantibodies.Immunoblot detection of AFA,a simple and reliable test,may be complement to conventional IIF detection of AKA and APF.

Objective To study the clinical features and methods of early diagnosis of juvenile ankylosing spondylitis(JAS). Methods Twenty-four cases with JAS were prospectively analyzed and followed up. Results Among these 24 cases, ratio of male to female was 11∶1.The onset age was 8 to 15 years (mean 12 years). 63% cases aged 12~15 years. 63% cases had peripheral arthritis, 25% hips involved and only 2 patients (9%) had low back pain at onset . Eleven cases (46%) fulfilled modified New York diagnostic criteria for AS and 21 cases (88%) fulfilled the Shantou diagnostic criteria for AS. Additional 3 cases (13%) fulfilled the Shantou diagnostic criteria for AS after 2 years follow-up. Conclusion 90% cases with JAS has peripheral arthritis and hip involvement at onset. The Shantou diagnostic criteria for AS has higher sensitivity than modified New York diagnostic criteria for AS.

Objective To investigate the best pathway and safety of sacroiliac joint (SIJ) puncture.Methods The anticorrosive adult specimens were frozen after SIJ CT scan.Horizontal or coronary sectioning was done.The horizontal sectioning was done corresponding to CT scan.The structures of different sections were observed and compared with the corresponding CT scans.Results According to the horizontal sectioning,the SIJ included synovial portion and ligamentous portion.As shown by CT,only part of the space between sacrum and ilium was the synovial portion,which occupied the whole part of the lower 1/3 segment SIJ,and the posterior was not covered with bones.There are no important nerves and blood vessels passing through the route from the buttock to the posterior of SIJ.Thus,the pathway can be regarded as the best and safe one although the lumbosacral trunk and iliac blood vessels go through the anterior of SIJ in the pelvis.Conclusion The best pathway of SIJ puncture is the upper part of the lower 1/3 segment.The safety of puncture depends on not penetrating the pelvic cavity to avoid damaging the structures in pelvis.

Objective To study pathological feature of sacroiliitis of spondyloarthropathies (SpA) in different stages,and improve the threshold of early diagnosis of SpA.Method Samples of sacroiliac joints (SIJ) of 8 patients with ankylosing spondylitis (AS) and 5 patients with undifferential spondyloarthropathies (uSpA) were taken when SIJ steroid injection was performed.The pathological feature was studied.Results Synovitis,including lining cell hyperplasia and inflammatory cell infiltration in looseconnective tissue,local cartilage degeneration,fibrosis and inflammatory cell infiltration in subchondral bony plate and marrow cave were found in 6 (86%,6/7) samples in patients with normal/suspectable SIJ CT scan.In the CT Ⅱ and Ⅲ degree sacroiliitis,marked degeneration and fibrosis of cartilage,inflammatory cell infiltration,pannus formation and subchondral bony plate destruction were increasingly prominent.In the advanced sacroiliitis (CT Ⅳ degree),destruction and calcification of cartilage and subchondral bony plate were the major feature.Eosinopil (EO) was increased in the infiltration cells of synovium and subchrodral bony plate in 3 samples.Conclusion Synovitis,including hyperplasia of lining cell and the infiltration of inflammatory cell in loose connective tissue,and local cartilage degeneration and inflammatory cell infiltration,and destruction of subchondral bony plate are the early changes identified in sacroiliitis.Pathological examination can improve the threshold of early diagnosis of sacroiliitis in case it cannot be confirmed with CT scan.

Objective To understand the key points of the differential diagnosis between osteitis condensanse ilii(OCI)and early sacroiliitis.Methods From 1997 to 2004,33 cases of OCI were examined with HLA-B27 determination and sacroiliac joint CT scan,and needle biopsy was performed in some cases when needed.Data of clinical history,laboratory,CT scan,as well as pathological examination were collected and analyzed.Results Sacroiliitis was diagnosed in 17(51.5%)cases of the 33 X-ray OCI cases either by CT scan or by pathological examination.Clinical features of these 17 cases included:(1)HLA-B27 was positive in more than 80%of these cases;(2)The age in these cases was younger than that in the OCI cases;(3)About 1/3 of these cases were male,and most of the female were unmarried and nanparous;(4)Most of the cases were with the signs of sacroiliits;(5)? globulin/ ESR/CRP/alkali phosphatase were elevated in most cases.However,among OCI cases,the prevalence of HLA-B27 was similar to general population;all of the cases were female;most of them were pluripara,and few cases were with the signs of sacroiliitis or laboratory abnormalities.Conclusion In X-ray OCI,many cases might be early sacroiliitis.Attention should be paid to avoid misdiagnosis.

Objective To investigate the reasonable use of triptorygium wilformed hoof F(TⅡ) and other slow acting antirheumatic drugs(SAARDs).Method Sixty-five patients with rheumatoid arthritis(RA) treated by TⅡ and SAARDs included methotrexate(MTX),sulfasalize (SSZ),azathioprine(AZA) with single or combination among them and followed-up for four years.Results One of SAARDs single therapy was favorable for most RA patients,combined use was needed only in 28 percent cases.Conclusions Based on the heterogeneity of RA, the therapeutic schadule should be altered according to the individual responses.TⅡ effecacy is higher than that of other SAARDs in treatment of patients with RA.

Objective To investigate the characteristics and value of nasal area-distance curves.Methods Based on data from CT images, nasal cavity cross-sectional areas in 60 volunteers were reconstructed. The size of each nasal airway and the distance from nostril to the corresponding cross-sectional area were measured. Area-distance curves were then established according to data obtained. t test was used to analysis the data. Results Three types of curves were found and categorized according to their shapes.Type Ⅰ consisted of 56 sides (46.7%) ,type Ⅱ 40 sides(33.3%), and type Ⅲ 24 sides (20. 0% ). Forcurves of nasal valve area, smooth type was seen in 86 sides (71.7%), and concave type in 34 sides(28.3%). Curves in area of inferior turbinate head were seen with shallow notch(48 sides,40.0%) ,deep notch (54 sides,45.0%), and no notch( 18 sides,15.0% ). Curves in area of middle turbinate head wereseen with shallow notch (31 sides, 25.8%), deep notch (38 sides, 31.7%), and no notch ( 51 sides,42. 5% ). Nasal minimal cross-sectional area was located at nasal valve area in76 sides (63.3%), head of inferior turbinate in 26 sides ( 21.7% ), region anterior to nasal valve in 15 sides ( 12. 5% ), head ofmiddle turbinate in 1 side, and region anterior to choana in 2 sides. The cross-sectional area at nasal valve in men and women were (197.9 ±41.2) and (151.2 ±35.5) mm2, respectively. The cross-sectional area at choana in men and women were (361.8±97.9) and (296.3 ± 81.8) mm2, respectively. There wassignificant difference between men and women at both sites (t = 4.707 and 0. 007, P ＜ 0.01). The distance from nostril to nasal valve in men and women were (14. 0 ± 2.4) and ( 11.8 ± 2. 9) mm, which presented significant difference, too (t = 3. 232,P ＜ 0. 01). Conclusions CT nasal area-distance curve varied with individual, CT may provide information for evaluating nasal passage on individual basis

Objective To explore the effect of TGF-β microbubble targeting on the treatment of skeletal muscle injury in rats.MethodsEighty SD rats of 2 months old were randomly divided into experimental group(including TGF-β microbubble),pure drug group,microbubble group(exclusive drug) and control group,20 SD rats in each group.Four groups accepted ultrasonic transmission with consistent time and frequency.The contraction stress and stress relaxation of injured gastrocnemius muscle were measured,the changes of injured gastrocnemius muscle were observed by light microscope and electron microscope.Results There was no statistically significant difference in contraction stress of gastrocnemius muscle among all groups at 1,5,9 days after injury(P>0.05).And at 14 days,the contraction stress of gastrocnemius muscle of the experimental group and the pure drug group were obviously higher than those of the rest two groups,the differences were significant(P<0.05).The difference of gastrocnemius muscle contraction stress was statistically significant between the experimental group and the pure drug group(P<0.05).For the stress relaxation of gastrocnemius muscle,the experimental group was lower than the other three groups at 1 day after injury,the differences were significant(P<0.05).Light microscopy showed the number of muscle fiber in the experimental group increased obviously at 9 days after injury.There was no scarring at 14 days after injury.Electron microscope showed mitochondria and sarcoplasmic reticulum increased in the experimental group,and the new muscle cells and satellite cells were significantly more than those of the rest three groups.Conclusion TGF-β cell targeted therapy can obviously improve the shrinkage stress of skeletal muscle in rats after injury and recover the stress decay,which can obviously promote the injury repair and regeneration of skeletal muscle,and reduce scar formation at the same time.

Objective To evaluate the significance of MRI before surgery to remove polyaeryl-amide hydrogel (PAMHG) which has been used for augmentation mammaplasty. MethodsTwenty female patients with 40 breasts, having been injected PAMHG as augmentation mammaplasty, under-went bilateral breast axial T1WI, T2WI-fat saturation (FS) and sagittal T2WI-FS by 4-channal phased-assay breast coil at 3.0T (Philips) before removal surgery, in which 8 patients underwent axial multiphase contrast-enhanced MRI with THRIVE after Gd-DTPA (2.0 ml/s, 0.1 mmol/kg) adminis- tration. The results of MRI were compared with that of operation and pathology. ResultsPAMHG showed iso-intensity compared with breast gland on T1WI and hyperintensity on T2WI-FS. Low signal septa were noted within PAMHG in 40 breasts (20 patients), 90% (36/40) PAMHG without capsule, 10 % (4/40) with smooth capsule which showing homogenous low signal on T1WI and T2WI-FS. Subcutaneous lump of PAMHG was 70 % (28/40), lump of that in breast gland was 20% (8/40). Diffuse gel along spatium intermusculare of pectoralis major was 100 % (40/40), that along spatium intermusculare of intercostal muscle was 10 % (4/40). All PAMHG in breast of the 8 patients showed no enhancement, an irregular enhanced mass was found in gland of 1 patient. All distributions of PAMHG and appearances of its complications on T2WI-FS were consistent with the results of operation. ConclusionsT2WI-FS can accurately display the distribution of PAMHG and its complication before removal surgery. MRI plane scan combined with muhiphase contrast-enhanced MRI can differentiate PAMHG from the lesions in the gland and find the breast carcinoma, so that it can guide clinicians before surgery to remove PAMHG used for augmentation mammaplasty.

Objective To assess the value of preoperative MRI in predicting the incidence of cement leakage into adjacent discs during percutaneous vertebral augmentation (PVA) for osteoporotic vertebral compression fracture (OVCF).Methods Clinical and radiological characteristics of 127 patients who were treated with PVA for OVCF were analyzed retrospec tively.The following clinical data of these patients were analyzed,including gender,age,location of treated vertebral body and surgical approach.The image features of endplate injury,fracture line extended to the endplate,adjacent intervertebral dick injury and intravertebral cleft were evaluated on the preoperative MRI.The incidence of cement leakage into the adjacent disc were compared for the above factors with statistical methods.Results Totally 127 patients were enrolled in our study,including 179 treated vertebral bodies,358 endplates and 341 adjacent intervertebral discs.The incidence of intradiscal cement leakage was 57.73％ (56/97) in endplate injury sign,60.98％ (25/41) in fracture line extended to endplate sign,35.91％(51/142) in adjacent discs injury sign and 55.56％(20/36) inintravertebral cleft sign.The differences were statistically significant on preoperative MRI in patients with the above signs compared to those who had not (P＜0.05).The incidence of intradiscal cement leakage in percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) were 26.67％(16/60) and 42.86％(51/119),respectively,which was significant different (P=0.035).For bone cement volume ≤ 5 ml vertebral bodies,the incidence of intradiscal cement leakage was 31.19 ％ (34/109),lower than bone cement volume ＞ 5 ml vertebral bodies (47.14％ [33/70],P=0.031).There was no statistically significant association between intradiscal cement leakage and age,gender and location of treated vertebral body (P＞0.05).Conclusion Preoperative MRI can predict the leakage of bone cement into adjacent discs effectively during PVA.The PKP and the lower volume of bone cement injection can reduce the risk of intradiscal cement leakage.