Objective To compare and analyze the different clinical features between male and female patients with rheumatoid arthritis (RA), by detecting the gender difference to make clinical decisions. Method The clinical features of 95 male RA patients(MRA) were analyzed and compared with those of 248 female RA patients (FRA) by retrospective analysis method. Results The mean onset age of MRA [18-79 (51.40±15.55) years old] was older than that of FRA[18-75(43.54 ±15.46) years old](P=0.0002). The morning stiffness time of MRA [(1.58 ±1.34) h] was shorter than that of FRA [(2.10 ±1.51) h](P = 0.0357). There was statistical difference in the first involved joint between MRA and FRA (P=0.0170), the prevalence of knee,metatarsonphalangeal joint,shoulder and ankle of MRA was higher than those of FRA, ' but conversely the wrist prevalence of FRA was higher than that of MRA.The prevalence of secondary Sj(o)gren syndrome of MRA(13.68%, 13/95) was rather lower than that of FRA(35.08%, 87/248)(P = 0.0007). MRA had lower positive rate of ANA (2.11% ,2/95) and lower value of IgM [(1.42 ±0.75) g/L] than FRA [(10.48% ,26/248), (1.69 ±0.86) g/L] (P < 0.05). There was no statistical difference between MRA and FRA in articular radiographic changes, most extraarticular manifestations and lab results (P >0.05). Conclusions MRA patients have older onset age and milder articular symptom than FRA patients. The disease severity of MRA is similar to that of FRA. Weighted joints are more involved in MRA. FRA is more inclined to have secondary Sj(o)gren syndrome.

Objective To investigate the clinical features and outcome of retroperitoneal fibrosis (RPF).Methods Thirty-three cases of RPF treated in the Department of Rheumatology and Immunology were analyzed retrospectively,including the clinical characteristics and laboratory data.Results RPF occurred predominantly in elderly men with untypical clinical manifestations such as back pain,abdominal pain and lower limb edema.In laboratory tests,the inflammatory parameters such as erythrocyte sedimentation rate and C-reactive protein increased significantly,and renal function failure was frequent finding in patients with urethral obstruction.All patients had retroperitoneal soft tissue image or urethral obstruction on computed tomography or magnetic resonance imaging,four of which had histological diagnosis of idiopathic RPF.Twenty-three patients received surgical interventions.Eighteen patients received medical treatment alone including corticosteroids,immunosuppressants,and tamoxifen.Nine patients received corticosteroids after surgical intervention.Surgery and medical treatments are effective for idiopathic RPF.Conclusion Image examination is valuable in diagnosis and differential diagnosis of PRF.Pathological diagnosis is the golden standard.Long-term low dose corticosteroids and immunosuppressants may prevent relapse of idiopathic RPF.

Objective To investigate the clinical significance of serum interferon-λ1(IFN-λ1) levels in patients with systemic lupus erythematosus(SLE).Methods ELBA was used to evaluate the serum level of interferon-λ1 in 60 patients with SLE and 20 healthy individuals as normal control.SPSS10.0 statistic software was employed to investigate the relation between the serum IFN-λ1 level,the laboratory index and SLE disease activity index(SLEDAI).Results The serum IFN-λ1 level in SLE patients(74.2±16.1 pg/ml) was higher than that of the normal controls(70.4±12.6 pg/ml,P=0.339).The serum IFN-λ1 level in SLE patients with leucopenia(80.1±18.1 pg/ml) was higher than those of the normal control(P=0.052) and the SLE patients without leucopenia(70.6±13.7 pg/ml,P=0.024).The serum IFN-λ1 level was not correlated with SLEDAI,complements C3,C4,24-hour-proteinuria.Conclusion IFN-λ1 may be involved in the pathogenesis of leukopenia in SLE and it has not been proved that its level was correlated with the disease activity.

Objective:To investigate the correlationship between levels of erythrocyte receptor type1(E-CR1) and disease activity and abnormal criteria of immunology in systemic lupus erythematosus (SLE)and to study the E-CR1 levels in pathogenesis of SLE.Methods:The fluorescence intensity in sera from 72 patients with SLE and 20 cases of normal controls was detected by flucytometry.Complement(C3,C4),immunoglobulins(IgG,IgA and IgM),gammaglobulins(?-G),erythrocyte sediment rate(ESR) and blood cell counts,including white blood cell(WBC),red blood cell(RBC),hemoglobin(HGB),hematocrit(HCT),mean corpuscular volume(MCV)and platelet(PLT) were detected at the same time.The scoring instruments of systemic lupus activity measure (SLAM) were used to evaluate disease activity.Results:The E-CR1 levels in patients with SLE were lower significantly than that in normal controls (P

Objective To discuss the role of p38MAPK signal pathway in the process of TWEAK inducing rheumatoid arthritis(RA) fibroblast-like synoviocyte(FLS) to synthesize MMP-9 and look for a new target for RA treatment. Methods RA FLS were primarily cultured and stimulated with TWEAK. Western blot was used to detect the expression of p-p38MAPK and p65 in RA FLS. FLS were pretreated by SB203580 or not. ELISA was used to detect the concentration of MMP-9 in cell-cultured fluid. The mRNA expression of MMP-9 was measured by RT-PCR. Results TWEAK( 100 ng/ml) can make p38MAPK phosphorylated and increased the expression of p65 protein in the cell nucleus. SB203580 can partially inhibit the expression of MMP-9 and MMP-9 mRNA produced by RA FLS which is induced by TWEAK. Conclusion TWEAK induced RA FLS to synthesize MMP-9, in that process, the p38MAPK signal trausduction pathway was in active state, and induced the expression of NF-κB.

Objective To study the expression of thymus and activation-regulated chemokine(TARC)in the kidney of MRL/lpr mice and to elucidate the molecular pathogenesis of lupus nephritis.Methods The 24-hour urine protein of 4 MRL/lpr mice of 16 weeks of age and 4 age-and sex-matched BALB/c mice was measured.The expressions of TARC mRNA and protein in the kidneys of MRL/lpr mice and BALB/c mice were detected by reverse transcription polymerase chain reaction and Western blot,respectively.Results The 24-hour urine protein and the expression level of TARC mRNA were significantly higher in MRL/lpr mice than in BALB/c mice(P＜0.05).The expression of TARC protein was detectable only in MRL/lpr mice.Conclusion The expression of TARC increases in the kidney of mice with systemic lupus erythematosus,suggesting that TARC may be involved in lupus nephritis in mice.

Objective:To investigate the inductive function of tumor necrosis factor(TNF)-? to dentritic cell(DC) and its effect on erythroid hematopoiesis.Methods:Human CD34~+ cells was separated and purified by MACS method.With the existence of stem cell factor(SCF),interleukin-3(IL-3) and erythropoietin(EPO),CD34~+ cells were cultured together with TNF-? through external fluid.The expanding times of cells and their superficial markings were analysed by flow cytometry.Meanwhile,the morphological transformation of expanding cells was observed by microscope.Results:TNF-? could inhibit the development of glycophorin A(GPA;a specific erythroid marker) positive cells,while stimulates the growth of those GPA negative of non-erythroid cells.These cells usually possess the morphological characteristic of DCs and express phenotypical markers of DCs accordingly.Those erythroid progenitor cells which contact directly with DCs appear to have the change of cellular apoptosis.Conclusion:The inhibition of TNF-? to erythroid hematopoiesis is probably related to the induction of DCs proliferation.The possible reason for cellular apoptosis of erythoid progenitor cells may be their direct contact with DCs.

Objective To study the mental status and its influencing factors of patients with rheumatic disease. Methods Three hundreds and eighty-one patients with rheumatic diseases were assessed with the self-rating anxiety scale, self-rating depressive scale, Eysenck Personality Questionnaire symptom checklist-90, and demographic characteristics questionnaire. The comparison among groups were tested by t tests, Spearman's correlation analysis. Results Patients with anxiety symptoms accounted for 35.96%, and pre-valence rate of depression was 48.03%. The gender (r=0.87, OR=2.34) and duration (r=0.006, OR=1.006) were the risk factors and the C4 (r=-2.63, OR=0.07) was the protective factor. In patients with systemic lupus erythematosus, depression was related to education (Z=2.228, P=0.026), disease duration (Z=-2.015,P=0.044), IgG level (t=-2.266, P=0.027), T cell subsets CD8 (Z=1.981, P=0.047) and CD3 (Z=1.967, P=0.049). Anxiety was related to education (Z=2.452, P=0.014), duration (Z=-2.054, P=0.04), complement C3 (t=2.035, P=0.045), C4 (Z=-2.204, P=0.028) and IgG level (t=-2.126, P=0.036). The value of CRP(Z=-1.984, P=0.047) and IgM (t=2.243, P=0.028) of rheumatoid arthritis patients were higher in the depression group. The depression group was different in disease duration (Z=-2.631, P=0.009), gender ( χ2=4.415, P=0.042), ESR (Z=2.17, P=0.023) and CD3 cell (Z=2.023, P=0.043) in Sj?gren's syndrome patients. Correlation analysis showed positive correlation between the score of SDS, SAS and the P value (r=0.21, P=0.01) (r=0.14, P=0.007) N dimension (r=0.52, P=0.01) (r=0.55, P=0.007) of EPQ. There were negative correlation between the score of SDS, SAS and the E dimension (r=-0.23, P=0.01) (r=-0.14, P=0.006) of EPQ. Conclusion The prevalence of depres-sion and anxiety is higher in patients with depressive and anxious symptoms. They are in older age, female gender, poor education, longer duration, lower complement and lower T cell subsets when compared with those patients without depression and anxiety. Patients who have an introverted, instable, nervous temperament are more likely to be depressed and anxious. Psychological assessment intervention and therapy should be carried out as early as possible.

Objective To assess the efficacy and safety of leflunomide in active ankylosing spondylitis.Methods Totally 62 cases of active ankylosing spondylitis were included,and divided randomly into leflunomide group(n=26)and methotrexate group(n=36).The patients in leflunomide group received an oral leflunomide loading dose of 50 mg or 40 mg once daily for the first 3 days followed by a maintenance dose of 50 mg or 40 mg once weekly,according to whether the bodyweight was more than 50 kg or less than 50 kg,respectively.The patients in methotrexate group were prescribed oral methotrexate 5 mg once in the first week,10 mg once in the second week,15 mg once in the third week and thereafter weekly.Sulfasalazine was prescribed 0.75 three times daily in both groups.The Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)and The Bath Ankylosing Spondylitis Metrology Index(BASIM)scoring instruments were used to assess the responsiveness to leflunomide and methotrexate at entry,three months,six months,twelve months and eighteen months after treatment,respectively.Laboratory data including peripheral blood counts(WBC,HGB,RBC),erythrocyte sedimentation rates(ESR),liver enzymes,serum creatinine,urinary sediments were detected at the same time.Sacroiliac joints CT scan and other involved joints x-ray radiograph examinations were taken at entry,six months,twelve months and eighteen months after treatment,respectively.Results Twenty-two cases in leflunomide group and 29 cases in methotrexate group were followed up to eighteen months.BASDAI in leflunomide group was significantly lower(P

Objective To study the immunological changes and clinical features of pachydermodactyly.Methods Thirteen cases of pachydermodactyly were studied and the literature about this disease was reviewed.Results The mean disease onset age was (16?3)years,11 of whom were male,2 were female;clinical feature was chronic non-inflammatory bulbous swelling of proximal interphalangeal joints,most of which distributed symmetrically;there were no abnormal results in immunological examination;X-ray showed only soft tissue swelling with no articular or bone damage.Conclusion Pachydermodactyly belongs to rheumatological diseases,and should be differentiated from other arthritis involving PIP joints.