Objective To understand the clinical characteristics of systemic lupus erythematosus with Antiphospholipid syndrome (SLE-APS).Methods The clinical data of 39 cases of SLE-APS were collected and analyzed retrospectively. Results Thirty-one patients had 48 thrombosis episodes in total, among which the most common presenting manifestations were deep venous thrombosis and stroke. 12 of 26 married women had fetal morbidity. The prevalence of anticardio lipin antibody (aCL) and lupus anticoagulant ( LA) was 72% and 41% , respectively. 24 patients had SLE at first,on an average of 9. 5 years later they had the characteristics of APS, 12 patients had thrombosis episodes or fetal morbidities ,4. 8 years later they developed into SLE,and 3 patients had the characteristics of SLE and APS from the onset The SLEDAI was less than 5 in five cases when they had thrombosis episodes or fetal morbidities.Conclusions The incidence of thrombosis episodes or fetal morbidities increased in SLE-APS patients. APS occurred before, after or at the same time with SLE. SLE patients might have the clinical features of APS during the steady stage. It's very important to ask the medical history in detail and measure aCL in lupus patients to find the risk factor of APS and prevent the APS' occurrence.

Objective To explore the value of high frequency color Doppler ultrasound for the early diagnosis of asymptomatic hyperuricemia in patients with joint disease.Methods Blood pressure,uric acid,total cholesterol,triglyceride and blood glucose were measured in 44 asymptomatic individual with hyperuricemia (the AH group) and 52 healthy persons (the control group),and the joints of the first metatarsalphalan geal,ankles,knees,wrists,elbows and the first metacarpophalangeal joints in the two groups were examined by high frequency and color Doppler ultrasound.T test,Chi-square test,and Fisher exact test were used for statistical analysis.Results ① The incidence rate of hypertension,diabetes and hyperlipidemia in the AH group [43.2％(19/44),22.7％(10/44),13.6％(6/44)] was significantly higher than the control group (x2=27.995,13.129,7.564;P＜0.01);② Double contour sign were found in the first metatarsal-phalangeal,ankles,knees and elbows of the AH group,in contrast to none in the control group (P＜0.05).The incidence of synovial thickening in the first metatarsal-phalangeal [1.5％(8/528)],ankles of the AH group [1.3％(7/528)]was significantly higher than that of the control group [0(0/624),0.2％(1/624)] (x2=9.521,P＜0.01;x2=5.634,P＜0.05).Similar results were found in the two groups in bone erosion in knees [1.7％(9/528) vs 0.3％(2/624)],in knees effusion [6.0％(32/528) vs 0.96％(6/624)] (x2=5.793,P＜0.05;x2=23.623,P＜0.01).The tophi was found in the fight first metatarsal-phalangeal,bilateral knees and the left first metacarpophalangeal 4 joints in 528 joints of the AH group,in contrast to none in the control group (P＜0.05).The difference in hyperechoic spots was no statistically significant between the two groups (P＞0.05).Conclusion Hyperuricemia is related to hypertension,diabetes and high blood lipids.There are some similar specific sonographic findings of gouty arthritis in the asymptomatic individuals with hyperuricemia.Therefore,these findings support that frequent ultrasound examination is a useful tool for the early diagnosis of asymptomatic hyperuricemia with joint disease,especially the screening of the first meta-tarso-phalangeal joint,ankle joint and knee joint.

Objective To study the roles of apoptosis and expression of the related genes in minor labial salivary gland of patients with primary Sjogren′s syndrome (pSS). Methods Biopsies of minor submucosal labial salivary gland (SG) were obtained from 30 patients with pSS and 10 control individuals. The in situ end labeling and immunohistochemical staining were used to detect the apoptotic cells and the expression of Fas, FasL and Bcl-2. Results The percentage of apoptotic acinar and ductal epithelial cells (AEC and DEC) in labial salivary glands of patients with pSS was significantly higher than that of control respectively, but the percentage of apoptotic infiltrating mononuclear cells (IMC) showed no significant difference compared with that of control, pSS AEC and DEC showed increased expression of Fas/FasL and decreased expression of Bcl-2, whereas pSS IMC showed increased expression of Fas, Fas/FasL and Bcl-2. There was significant positive correlation between the percentage of apoptotic cells and the cells expressing Fas and FasL in pSS AEC DEC and IMC, respectively, and there was significant negative correlation between the percentage of the apoptotic cells and that of cells expressing Bcl-2 in pSS DEC and IMC, but there wasn′t correlation between the percentage of the apoptotic cells and that of cells expressing Bcl-2 in pSS AEC. Conclusions The apoptotic cells increased in the epithelial cells and decreased in IMC of the labial salivary glands may be one of the mechanisms leading to the glandular destruction found in pSS. In pSS labial salivary glands, the expression of Fas and FasL may promote apoptosis, while the expression of Bcl-2 may inhibit apoptosis. The increased expression of Bcl-2 in pSS IMC indicates that IMC may be able to escape apoptosis, resulting in inflammatory cell foci.

OBJECTIVE:To investigate the effect and cost of Multidimensional iron oral liquid and Polysaccharide iron com-plex capsules in the treatment of iron deficiency anemia during pregnancy. METHODS:By retrospective study,80 cases of iron de-ficiency anemia during pregnancy were divided into control group and trial group in accordance to different therapy plans,with 40 cases in each group. Control group was given Multidimensional iron oral liquid orally,10 ml each time,bid,after breakfast and supper,for consecutive 4 weeks;trial group was given Polysaccharide iron complex capsules orally,0.30 g each time,qd,for con-secutive 4 weeks. Clinical efficacy,erythrocyte related lab indexes,satisfactory rate and ADR were compared between 2 groups, and cost-effectiveness analysis was adopted for economic evaluation. RESULTS:The total effective rate of experimental group was 95.0%,which was higher than 85.0% of control group,but without statistical significance(P>0.05);hemoglobin level,erythro-cyte count and average volume of erythrocyte of trial group were significantly higher or more than control group,and satisfactory rate(95.0% vs. 65.0%)were significantly higher than control group,with statistical significance(P<0.05);no obvious ADR was found in 2 groups. Total cost of trial group and control group were 243.60 and 166.32 yuan,and cost-effective ratio was 2.56 and 1.96;incremental cost-effective ratio was 7.73. Results of sensitivity analysis were same to the result. CONCLUSIONS:Both Multi-dimensional iron oral liquid and Polysaccharide iron complex capsules can improve anemia in patients with iron deficiency anemia during pregnancy. Polysaccharide iron complex capsules show better therapeutic efficacy and satisfactory rate,but it is relatively ex-pensive. Drugs should be selected according to economic situation.

Objective To investigate the expression of matrix metalloproteinases 1 (TIMP-1)products inhibitor on smooth muscle cell (SMC) proliferation in rat autologous vein graft.Methods Autogenous vein transplantation model was established in 30 Wistar rats. The vein grafts were harvested at different time after grafting. The change of TIMP-1 was detected by using hematoxylin and eosin, immunohistochemistry and in situ hybridization (ISH). Results 1. Changes of histopathology in vein grafts: Intimal hyperplasia (IH) could be seen in 7 - 14 days, the peak at 2 ~ 4 weeks after operation.2. ISH results: TIMP-1mRNA positive cells appeared at 24 hours, increased significantly in 72 hours and reached the peak at 1 ~ 2 week after operation. There was significant difference between day 1 and 2 week.TIMP-I expression was not detected in normal vessels (P <0. 01). 3. Immunohistochemistry results: There was trace TIMP-I expression in normal vessels. The expression of TIMP-1 appeared at 72 hours after vein graft, increased mostly in 1 week, reached the peek at 2 week and reduced later. There was significant difference between day 1 and 2 week (P < 0. 01). Conclusions 1. The activation of TIMP-1 exists in autogenous vein grafts. 2. The intima experienced hyperplasia in spite of increased secretion of endogenous TIMP-1 after autogenous vein grafts.

Objective]To discuss the effect of sciatic nerve injury on the expressions of tumor necrosis factor-alpha(TNF-α), interleukin-1β(IL-1β)and interleukin-10(IL-10)in anterior cingulate cortex(ACC),and further to explain their roles resided in the development of neuropathic pain.[Method]With use of the methods of behavioral test,western blot and immunohistochemistry, we examine the effects of spared sciatic nerve injury(SNI)on the expressions of TNF-α,IL-1β,and IL-10 in ACC,and observe the effect of the neutralizing antibody of TNF-α,IL-1β on the rat mechanical allodynia.[Result]In present experiment ,SNI increased the protein levels of TNF-α,IL-10,but not IL-1β in ACC. Increased TNF-α-IR and IL-10-IR in ACC is located in neurons ,but not astrocytes and microglia at 7 d following L5-VRT. Pre-treatment with anti-TNFα antibody but not anti-IL-1βantibody into ACC significantly increased the rat paw withdrawal threshold to von Frey hairs.[Conclusion]These data suggested that the increased TNF-αin ACC neurons might be responsible for the development of neuropathic pain.

Objective To evaluate the value of high-frequency color Doppler ultrasound in the examination of pathological changes in the peripheral joints of patients with early rheumatoid arthritis (RA).Methods Peripheral joints of 30 consecutive patients with early rheumatoid arthritis (disease duration ＜1year) and 15 healthy volunteers were assessed with ultrasound searching for joint effusion,synovial hypertrophy,tendon lesion and bone erosions.The joints examined including bilateral elbows,wrists,knees,ankles,metacarpophalangeal joints (MCP),proximal interphalangeal joints (PIP) and metatar-sophalangeal joints (MTP).Data were analyzed with t-test and kappa test.Results Joint effusion and/or synovial hypertrophy were found in 471 joints (41.3％).Four hundred and four (35.4％) joints had joint effusion,359(31.5％) had synovial hypertrophy.Power Doppler signals were found in 128 (35.7％) joints with synovial hypertrophy.Periarticular tendon lesions were found in 90(25％) joints of all wrists,ankles and the 2nd to 5th metacarpophalangeal joints.Bone erosions were detected in 27 (2.4％) joints.The most likely involved joint in all peripheral jints was wrist which had the highest positive rate of effusion,synovial hypertrophy,bone erosion and power Doppler signals in the synovial membrane.Other joints which were easily involved with synovitis were knee,ankle,elbow,MTP,MCP and PIP.The positive rate of synovitis was highest in the MTP of all small joints exception the wrist.Synovitis present most frequently in the 2nd MCP of all MCPs,the 3rd PIP of all PIPs and the 2nd MTP of all MTPs.The kappa coefficient between clinical examination and ultrasound in the detection of peripheral joints synovitis was 0.21,showing very poor agreement.Conclusion High-frequency color Doppler ultrasound exa.mination is an effective method in assessing the pathological changes of peripheral joints of patients with early rheumatoid arthritis.It may improve the early diagnosis of RA and useful in assessing disease activity comprehensively.

ObjectiveTo investigate the protective effect of Cordyceps militaris polypeptide against acute alcoholic liver injury in rats and related mechanism. MethodsA total of 60 Wistar rats were randomly divided into blank control group, model group, and low-, medium-, and high-dose Cordyceps militaris polypeptide groups. All rats except those in the blank control group were given 10 ml/kg 56° liquor by gavage once a day; the rats in the blank control group were given distilled water of the same dose by gavage once a day. At 1 hour after gavage with liquor, the rats in the model group and low-, medium-, and high-dose Cordyceps militaris polypeptide groups were given distilled water or Cordyceps militaris polypeptide solution (6 ml/kg) by gavage. Blood samples were collected from the orbit 4 weeks later. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and the activity of superoxide dismutase (SOD) and level of malondialdehyde (MDA) in the liver were measured for each group, and the pathological changes in the liver were observed under a light microscope. Analysis of variance was applied for comparison between multiple groups, and the SNK-q test was applied for comparison between any two groups. ResultsCompared with the model group, the low-, medium-, and high-dose Cordyceps militaris polypeptide groups showed significant reductions in the serum levels of ALT and AST and the level of MDA in the liver (all P＜0.05), as well as a significant increase in the activity of SOD in the liver (all P＜0.05), while these indices showed significant differences between the low-, medium-, and high-dose Cordyceps militaris polypeptide groups (all P＜0.05). The liver pathological sections from the low-, medium-, and high-dose Cordyceps militaris polypeptide groups showed alleviated hepatocyte fatty degeneration and necrosis induced by alcohol under a light microscope. ConclusionCordyceps militaris polypeptide has a protective effect against acute liver injury induced by alcohol, and its mechanism of action may be related to its antioxidant effect.

Bladder cancer is one of the common tumors of urinary system. Early detection and treatment can reduce the recurrence rate and mortality. Currently, it is difficult to balance the diagnostic specificity and sensitivity of traditional diagnostic methods. However, Raman spectroscopy, as a molecular diagnostic technology, can reveal the difference between normal urinary tract epithelial tissue and urinary tract epithelial cell carcinoma of the bladder at the molecular level, which has the characteristics of faster and more accurate diagnosis compared with traditional diagnostic techniques. This paper reviews the research progress of Raman spectroscopy in the diagnosis of bladder cancer.

Brucellosis is a common global zoonotic disease caused by Brucella, which has a variety of clinical manifestations. Fever, sweating and musculoskeletal pains appear in partial brucellosis patients. The most common complication of brucellosis is osteoarthritis, including spondylitis, sacroiliitis, and peripheral arthritis such as osteomyelitis, bursitis, and tenosynovitis. The spine and sacroiliac are the most frequent affected sites of brucellosis osteoarthritis; however, the reports of peripheral arthritis such as osteomyelitis, bursitis, and tenosynovitis are low. Early and proper treatment is vital for patients with brucellosis osteoarthritis. The therapy of drugs and surgery are two current options for treatment of brucellosis osteoarthritis. In this review, clinical manifestations and treatments of brucellosis osteoarthritis are discussed in detail, which are helpful to deepen clinicians' knowledge in brucellosis.