To study the clinical features and diagnosis of synovitis,acne,pustulosis,hyperostosis,osteitis syndrome(SAPHO) syndrome.One case of SAPHO syndrome was reported and the related data of SAPHO syndrome were reviewed.The main clinical features of the patient were articulatio carpi synovitis,acne,cervical rib hyperostosis,articulatio sternoclavicularis and osteitis,So the diagnosis of SAPHO syndrome was made.Though SAPHO syndrome is rare with yet unknown prevalence,it still can be seen in clinical practice,and can be diagnosed by careful examination.

Objective To explore the misdiagnostic reasons of 24 cases with low back pain misdiagnosed as spondyloarthropathies and to raise the correctness of spondyloarthropathies diagnosis. Methods Using follow-up and counterchecking combined with review medical records, a retrospective analysis of 24 cases misdiagnosed as spondyloarthropathies in our hospital from 2001 to 2005 were done. Results Among the 24 patients misdiagnosed as spondyloarthropathies, 3 had sacral tubulocyst or parathyroid adenoma associated with hyperparathyroidism, 7 patients with benign or malignant tumors had persistent low back pain that aggrevated at night without morning stiffness. The pain could not be relieved by rest or exercise and could not be relieved by administration of multiple nonsteroidal anti-inflammatory drugs (NSAIDs). The final diagnosis of these 24 cases were as follows: 4 were malignant tumors (retroperitoneal adipose sarcoma, advanced gastric carcinoma, ovarian papillary epithelioma, acute lymphocytic leukemia), 6 were benign tumors (2 parathyroid adenoma associated with hyperparathyroidism, 1 intraspinal lipoma, 1 intraspinal ependymomas, 1 sacral tubulocyst and intraspinal and 1 schwannoglioma respectively). The other 14 cases were fibromyalgia syndrome (3), osteitis condensans (3), diffuse idiopathic skeletal hyperostosis (2), lubar intervertebral disc protrusion (1), congenital scoliosis (1), Wilson′s disease (1), ochronosis (1), Fanconi′s syndrome (1) and hypophosphatemic rhachiopathy (1). Although 11 patients had presented inflammatory low back pain defined by Calin, only 2 patients satisfied spondyloarthritides as defined by the classification criteria of the European Spondylarthropathy Study Group (ESSG). Conclusion The misdiagnosis of spondyloarthropathy can be improved by way of careful differential diagnosis of low back pain and holding the classification criteria of the European Spondylarthropathy Study Group (ESSG) as guideline.

Objective To study the clinical features of the patients with systemic lupus erythematosus (SLE) with Raynaud′ s phenomenon. Methods The clinical manifestations and laboratory findings of 42 SLE patients with Raynaud′ s phenomenon were analyzed and compared with those of 116 SLE patients without Raynaud′ s phenomenon. Results As compared with SLE patients without Raynaud′ s phenomenon, the SLE patients with Raynaud′ s phenomenon were more likely to have myalgia/myopathy(9.48％ vs 23.81％ , P

Objective To investigate the diagnostic value of SPECT,TCD and BAEP to vertebral basilar artery ischemia vertigo Methods 100 cases of vertebral basilar artery ischemia vertigo were inspected by SPECT,BAEP and TCD All the results were analyzed and compared Results Among 100 cases, it shows that the diagnostic rate of SPECT is 80 percent,BAEP is 58 3 percent and TCD is 78 percent Conclusion SPECT is found having the highest diagnostic rate,it sensitively and accurately reflects the position of cerebral ischemia Although BAEP having the lowest diagnostic rate, it can still effectively shows Brain Stem Ischemia Comparing with SPECT and BAEP, TCD is simple and convenient to carry out It sensitively reflects the conditions of cerebral vessel and cerebral blood stream,but it is insensitive to make sure the position Therefore, three of them offer the valuable,external and diagnostic proof to vertebral basilar artery ischemia vertigo,and they can have a role of inter reinforce

Objective To enhance the understanding of relapsing polychondritis (RPC).Method Clinical features,laboratory studies and prognosis of RPC in 20 patients were analyzed.Results The average age at the beginning of disease was 53 4 years (range from 35 to 86).The average course from initiation of clinical symptoms to diagnosis was 1 1 years.Of patients,90% had auricular chondritis,80% had respiratory system involvement,75% had nasal chondritis and 4 patients had severe tracheobronchial chondritis.Involvement in joints,skin,cardiovascular and neurotic system also existed in various frequencies,and 20% of the patients were associated with other rheumatic or autoimmune diseases.Conclusion Extensive laryngo tracheobronchial disease is a vital signal in RPC.Early diagnosis and treatment with corticosteroid and immunosuppressant can improve the prognosis.

Objective To investigate the clinical features and risk factors of spondyloarthropathy with anterior uveitis. Methods The clinical and laboratory data of 86 patients with spondyoarthropathy associated with anterior uveitis in our hospital were collected, analyzed and summarized from March 2005 to December 2008, and the patients were followed up as closely as possible. The data of the 86 patients were compared with 93 patients who had spondyloarthropathy without anterior uveitis at the same period. All data were analyzed by using SPSS11.5 software package. Results Compared with non-ophthalmia group, ophthalmia group had significantly longer course[(11 ±8)vs(5±6), P＜0.01], and higher proportion of positive family history(27.9%vs 9.7%, P＜0.01), the proportion of low back pain at night, morning stiffness, spinal deformity, limitation of waist-bending and severe sacroiliac joint lesions were all significantly higher(P＜0.05), HLA-B27 positive rate was significantly higher as well(92.2% vs 81.5%, P＜0.05). The attack of uveitis usually had seasonality and precipitating cause. The patients with anterior uveitis as first symptom had significant higher frequency of ophthalmitis(P＜0.01), the ratio of eye permanent lesions was also significantly higher(P＜0.01). The frequencies of attack were positively correlated with the course of disease(r=0.294, P=0.006), Logistic multiple regression analysis showed that the incidence risk of ophthalmia were related to the course of disease(P=0.013, OR=1.099, 95%CI 1.030～1.183)and severe sacroiliac joint lesions(P=0.012, OR=3.071, 95%CI 1.286 ～7.314). Conclusion The spondyloarthropathy associated with anterior uveitis had its own characteristics, We should pay attention to the risk factors of anterior uveitis,and prevent the recurrence of ophthalmia.

Objective To observe the therapeutic effect of hyaluronic sodium product (SHP) on osteoarthritis(OA).Methods Three hundreds and forty-eight cases were diagnosed as OA and five hundred-eighty knee joints damage caused by OA were treated by intracavitary injection of SHP once a week for three consecutive weeks.The changes of the number of patients with clinical symptoms (joint pain,swelling of joint and with or without difficulty in up and down stairs) and the laboratory test results were compared before and after the treatment.Results It showed that there was a significant difference of the changes of the number of patients with clinical symptoms and laboratory test results before and after the treatment,(P

Objective To analyze the clinical and laboratory manifestations of primary Sj(o)gren's syndrom (pSS) with neurological involvement.Methods One hundred and forty eight patients fulfilling the 2002 American-European pSS classification criteria were retrospectively analyzed.Neurological manifestations were diagnosed based on the clinical,biological,electrophysiological,and imaging findings.Biographical,clinical,and laboratory data were compared between patients with and without neurological manifestations.Statistical methods used were Mann-Whitney U test,Chi-square test and Fisher exact probability.Results The prevalence of neurological involvement in pSS was 20.3％ (30/148),and the incidence of peripheral neuropathy,the central neuropathy and combination of the central neuropathy with peripheral neuropathy were 10.1％(15/148),9.5％(14/148) and 0.7％(1/148),respectively.The clinical spectrum of peripheral neuropathies encountered in Sj(o)gren's syndrome (SS) patients varied,with the pure sensory neuropathies being the most common,followed by sensorimotor neurophathies.Motor neuron disease was the most common type of central neurophathies.Compared with those without neurological manifestations,the duration of peripheral nerve system/central nerve system (PNS/CNS)-pSS patients was relatively short [(55±76) months vs (100±108) months,Z=-2.682,P＜0.05],and the antinuclear antibody (ANA) titer and RF titer were lower [(234±248) vs (377±339),Z=-2.008,P＜0.05;(126±279) U/ml vs (359±1 445) U/ml,Z=-2.243,P＜0.05].In PNS/CNS-pSS patients,the most common clinical manifestations included numbness (50％),pain (23％),and muscle weakness (63％).Conclusion The prevalence of neurological involvement in pSS is high.The duration is relatively short and the disease activity is high,but the disease features are atypical and may be neglected by rheumatologists.

Objective To determine the prognostic factors in systemic sclerosis.Methods Clinical data of definite systemic sclerosis patients were collected,including disease onset age,sex,disease course,Raynaud's phenomenon,skin involvement,gastroesophageal reflux,interstitial pneumonia,cardiac lesions,kidney lesions and scleroderma renal crisis.serum antibodies to scl-70.RNP and anti-centromere antibody were detected.Pulmonary artery pressure was measured by ultrasound cardiography.Cox hazard ratio model was employed to assess the mortality risk of systemic sclerosis patients.Results No difference in Raynaud's phenomenon,gastroesophageal reflux,anti-nuclear antybody,anti-sol-70 antibody,anti-centromere antibody,interstitial pneumonia,diffusion capacity (DLco),coronary artery disease,and peripheral artery atherosclerotic disease could be found between the dead and alive systemic sclerosis patients(P>0.05).Dead systemic sclerosis patients had later disease,onset(older than 60 years old)(P=0.002).Male gender(P=0.023),more diffuse skin involvement(P=0.000),more positive anti-RNP antibody(P=0.014),more pulmonary artery hypertension(P=0.000).more cardiac lesions(P=0.000),more cerebral infarets (P=0.035),more kidney lesions(P=0.000),and more scleroderma renal crisis(P=0.000) could be found jn dead sclerosis patients.Cox regression analysis showed that,onset later than 60 years old(OR=5.441.95% CI 2.126～13.926,P=0.000),male sex (OR=5.531,95%CI 2.014～15.190,P=0.001),anti-RNP antibedy positivity (OR=2.664,95%CI 1.016～6.592,P=0.034),diffuse skin involvement(OR=3.432,95%CI 1.400～8.411,P=0.007),pulmonary artery hypertension (OR=25.718,95% CI 5.954～111.085,P=0.000),cardiac lesions (OR=4.141.95%CI 1.685～10.159,P=0.002),kidney lesions(OR=4.214,95%CI 1.654～10.737,P=0.003) and scleroderma renal crisis (OR=20.677,95% CI 4.161～102.764.P=0.000)were risk factors for mortality in systemic sclerosis.Severe pulmonary hypertension was the most strong predictive factor for mortality in systemic sclerosis (OR=55.809,95% CI 12.879～241.832.P=0.000).Conclusion Aggressive therapy should be given to those systemic sclerosis patients with onset later than 60 years old,male sex,diffuse skin involvement,anti-RNP antibody positivity,cardiac involvement,kidney lesions,scleroderma renal crisis and pulmonary artery hypertension,especially seevere pulmonary hypertension.

Objective Antibodies against citrulline-containing peptides such as anti-perinuclear factor (APF), anti-keratin antibodies (AKA), anti-filaggrin antibodies (AFA) and anti-cyclic citruilinated peptide (CCP) antibodies are very specific in RA. In recent years, detection of APF, AKA and anti-CCP antibodies have been widely used in clinical practice. Studies on the combined detection of these ACPA in diagnosing RA are limited in number. The aim of this study is to detect combined examination of APF, AKA, and anti-CCP antibodies and compare their values in the diagnosis of rheumatoid arthritis. The significance of combined detection of these ACPAs in rheumatoid arthritis is also investigated. Methods Five hunndred and fifly-one patients who suffered from arthritic problems during the recent two years were selected from the Department of Rheumatology and Immunology of Peking University People's Hospital. 304 of the patients were RA and 247 were diagnosed to have other rheumatic diseases based on the corresponding classification criteria. AKA and APF were tested by indirect immunofluorescence assay. Anti-CCP antibodies were tested antibodies, AKA and APF tests for RA were 76.2%, 43.6%, and 34.5%, respectively, and the specificities were highest specificity (100%), but it had a rather low sensitivity (28.3%). When two of the three ACPA were positive, the sensitivity and specificity for the diagnosis of RA was 48.4% and 99.2%, respectively. When either anti-CCP antibodies, AKA, or APF was treated as an individual parameter, the sensitivity was slightly increased (77.3%). However, the specificity decreased to 94.7%. Conclusion Anti-CCP antibodies are the most helpful makers for the diagnosis of rheumatoid arthritis among the three ACPAs which are used in clinical practice. The combined detection of anti-CCP antibodies, AKA, and APF cannot increase the diagnostic sensitivity and specificity of rheumaotid arthritis.