Objective To investigate the clinic features and risk factors for central nervous system (CNS) infection in patients with systemic lupus erythematosus. Methods Clinical data of 18 cases of hospitalized lupus patients with CNS infection were analyzed retrospectively.Thirty-three lupus patients without CNS infection were selected as control. Results There were significant differences between the CNS infection group and control group in the dosage of corticosteroid used for pulse therapy (22% vs 3%, P<0.05), the aver-age dosage of corticosteroid used within one year (35±18 vs 24±17, P<0.05), peripheral blood leukocyte count (4.4±3.4 vs 6.7±2.9, P<0.05) and lymphocyte count (0.7±0.6 vs 1.5±0.7, P<0.01), and clinical outcome (mortality rate was 22% vs 0, P<0.05). Conclusion The clinical manifestations of CNS infection may be atypical. Large-dosage corticosteroid therapy, higher daily dosage of corticosteroid used, decreased peripheral lymphocytes and leucocytes counts are risk factors of central nervous system infection in lupus patients.

Objective To explore relationship between antinucleosome antibody and desease activity of systemic lupus erythematosus(SLE). Methods Serum antinucleosome antibodies were measured by ELISA in the 88 patients with SLE. The relationship among antinucleosome antibodies, disease activity ( evaluated using SLEDAI), anti-dsDNA antibody and complements was analyzed. Results Antinucleosome antibody was positive in 70 patients with SLE (79.5%). There were correlations between the antinucleosome antibody and SLE disease activity, anti-dsDNA antibody, complement C3, erythrocyte sedimentation rate. Conclusion Antinucleosome antibody is a relatively sensitive marker in diagnosing SLE and evaluating SLE disease activity.

Objective To elucidate the significances of health education in the prevention and treatment of gout and hyperuricemia.Method Health education scientific knowledg was done through approaches of specific proclamation in clinic out patients,screening the directly-related members of patient family,training medical staffs and popular vehicle propaganda etc.Results Health education improved the diet structure and life mode of patients,promoted early diagnosis and treatment of patients.It also had favourness in timely detection of other patients in directly-related members of ones family.Conclusion Health education combined with conventional pharmacological therapy could produce a better efficacy than that of single pharmacological ones.

Objective To investigate the clinical significance of anti-β2 glycoprotein Ⅰ(anti-β2GP Ⅰ)antibodies in patients with systemic lupus erythematosus(SLE)and to assess their association with lupus thrombocytopenia.Methods Anti-β2GP Ⅰ antibodies were tested in 108 SLE patients(including 37thrombocytopenia patients),30 patients with rheumatoid arthritis(RA)and 30 healthy individuals by enzyme-linked immunosorbent assay(ELISA).The clinical features and laboratory findings were collected,and the associations of anti-β2GP Ⅰ antibody with laboratory findings and disease activity were analyzed.Results Sensitivities of anti-β2GP Ⅰ antibody were 19.44%(21/108)in SLE and 10%(3/30)in RA,respectively.The specificity of anti-β2GP Ⅰ antibody was 95.0% in SLE.The anti-β2GP Ⅰ antibody titers of the SLE group were significantly higher than normal group(P ＜ 0.05).There was no significant correlation between anti-β2GP Ⅰ antibodies and thrombocytopenia(r =-0.028,P ＞0.05).Anti-β2GP Ⅰ antibody was positively correlated to anticardiolipin antibody(r = 0.566,P ＜ 0.01).No associations were found between anti-β2GP Ⅰ antibody and other clinical and laboratory features.There was no statistical correlation between the level of anti-β2GP Ⅰ antibody and SLEDAI scores.Conclusions Anti-β2GP Ⅰ antibody had high specificity in SLE.There was no significant correlation between anti-β2GP Ⅰ antibodies and lupus thrombocytopenia.

Objective To investigate the feedback of eight-year program students to problem-based learning ( PBL ),and find out the existing problems and solutions.MethodsThe questionnaire survey was made in the eight-year program students.ResultsApplication of PBL could achieve good feedback.It helped to enhance the self-directed learning,expressing ability,accessing resource skill,and team spirit.ConclusionAlthough there are some problems in the practice of PBL,PBL is a good teaching method in eight-year program education.

Objective To investigate the release and intracellular localization of high mobility group box chromosomal protein 1(HMGBl)in the peripheral blood monocytes of rheumatoid arthritis(RA) patients and the inhibitive effect of thaiidomide.Methods 19 RA patients and 20 healthy controls were included in the study.Monocytes were separated from peripheral blood with Ficoll density gradient centrifugation.Monocytes were treated with 100 ng/ml tumor necrosis factor α(TNFa)or 100 ng/ml TNFα plus 40 μg/ml thalidomide and grown in an incubator at 37℃ with 5%CO,for 24 hours.The cuIture supernatants of the monocytes were collected.HMGB1 level in the culture medium was detected with Western blot.In addition,the intraceUular localization of HMGB1 in the fflonocytes was investigated with immunocytochemical analysis. Results Without stimulation. the release of HMGBl protein was significantly increased in the culture supernatants of peripheral blood monocytes from RA patients as compared with that from healthy controls(P<0.05).TNFα(100 ng/ml)did not further increase the release of HMGBl in the monocytes from the patients with RA.Thalidomide(40 μg/ml)could inhibit the release of HMGB1 in the monocytes from RA patients stimulated with TNFα(P<0.05).In the monocytes from RA patients,HMGBl was mainly localized in the nucleus.Treatment with TNFOL(100 ng/ml)for 24 hour resulted in a cytoplasmic translocation of HMGB1,which was inhibited significantly by thalidomide. Conclusion TNFα induces the release and cytoplasmic translocation of HMGBI in the peTipheral blood monocytes of RA patients and thalidomide inhibits the release and translocation of HMGB1.

Objecfive To observe the changes of regional cerebral blood flow (rCBF) in systemic lupus erythematosus (SLE) patients with neuropsychiatrie disorders and evaluate rCBF SPECT imaging in the detection of neuropsychiatric problems in SLE patients.Methods Twenty neuropsychiatrie SLE patients were enrolled in the study and were performed SPECT rCBF imaging anti CT/MRI scans,respectively.Twenty SLE patients without neuropsychiatrie manifestatiuns (SLE) and 20 healthy volunteers also underwent SPECT rCBF imaging as controls.Semiquantitative analysis was conducted as designed by selecting 3 consecutive crosssections and delineating ROI,which generated HQ and the results were compared between with SLE and controls.Results SPECT rCBF findings were almormal in 20 NPSLE.in which 19 of the 20 with abnormal SPECT findings showed focal uptake defects the other patient showed increased foeal uptake.Four N PSLE patients had ahnormal CT/MRI scans findings.Compared with the methods of rCBF and CT/MRI imaging,the difference was significant (P＜0.01).Nineteen SLE patients without neuropsychiatrie manifestations had normal SPECT findings.the other 1 patient showed focal uptake defect.SPECT findings were all normal in 20 healthy volunteers.Temporal cortex was the most commonly involved region,followed by frontal cortex.Specific values generated from semiquantitative analysis (HQ) of temporal and frontal regions in neruopsychiatrie SLE patients were lower than that in SLE patients and healthy volunteers (P＜0.01 and P＜0.05).Conclusion SPECT rCBF imaging has the potential to be a sensitive tool to detect the neuropsyehiatric disordersin SLE patients,and has important value in helping for early diagnosis and therapy.Hypoperfusion on ECD-SPECT under the territory of the middle cerebral artery (MCA) is the most common observation,and which temporal and frontal regions are the most frequently involved regions in neruopsychiatrie SLE patients.

Objective To determine the safety, pregnancy outcome and the affect on neonates in pregnant patients with systemic lupus erythematosus(SLE).Methods Sixty-two pregnant patients with SLE were evaluated retrospectively from 1999 to 2009 in our hospital. These patients were divided into two groups:selective pregnancy group and nonselective pregnancy group. The pregnancy outcomes, fetal outcomes, and lupus activity during pregnancy were compared between the two groups. The children of the SLE patients were followed up. Results There were 43 patients in the selective pregnancies group and 19 patients in nonselective pregnancies group. In the selective pregnancies group, lupus flare occurred in 10 pregnancies(23%), 35(81%)had a live birth, 7 had low birth weight infants and 7 had premature delivery; however, in the nonselective pregnancies group, lupus flare occurred in 16 pregnancies(84%), 13(68%) had abortion,6 had a live birth, but all neonates were low birth weight infants. The rates of lupus flare and pregnancy loss in the nonselective pregnancy group were higher than those of the selective pregnancy group(P＜0.05). None of the 22 children had SLE during the follow-up period. Conclusion Both selective and nonselective pregnancy may adversely affectmaternal and fetal outcomes, but patients with selective pregnancy have better outcomes either in lupus flare or maternal and fetal outcomes compared with those of the nonselective pregnancy.

Objective To demonstrate high mobility group box chromosomal protein 1(HMGBI) expression in synovium and joint,and to identify the role of HMGB1 in the pathogenesis of synovitis and joint destruction in adjuvant-induced arthritis(AA).Methods AA of 15 male rats were induced in SD rats by intradermal injection of 100?l Freud's complete adjuvant in the foot pad of the left hind paw.All rats were killed at the 18th day.Synovium and joints were collected for histopathology studies and determining the expression of HMGB1 by immunohistochemistry,and serum was collected for determining the expression of HMGB1 by western blotting analysis.Results Immunostaining of specimens from normal rats showed that HMGB1 was primarily confined to the nucleus of synoviocytes with occasional cytoplasmic staining.In contrast, inflammatory synovial tissues from AA rats showed a distinctly different HMGB1 staining pattern.Nuclear HMGBI expression was accompanied by a cytoplasmic staining in many mononuclear cells.The cytoplasmic HMGB1 expression in synovium of AA rats is significantly higher than that of normal rats.Additionally,HMGBI was highly expressed in the nuclei and cytoplasm of the subchondral chondrocytes and inflammatory cells in bone erosion in AA rats(P＜0.01),while fewer positive cytoplasmic staining of HMGB1 was found in chondrocytes and fewer positive nuclear staining was found in bone cells in normal rats.HMGB1 concentration was significantly higher in serum of AA rats than that in normal rats(P＜0.001).Conclusion The cytoplasmic HMGBI expression in synovium and joints is greatly upregulated;the level of HMGB1 in serum is increased in AA rats which suggests a patbogenetic role of HMGB1 in synovitis and bone destruction of adjuvant-induced arthritis.

Objective To investigate the effect of high mobility group box chromosomal protein 1 (HMGB-1) on the proliferation and inflammatory phenotype of human fibroblast like synoviocytes (FLS).Methods FLSs were isolated from the synovial tissues of rheumatoid arthritis (RA) patients undergoing joint replacement surgery.All the experiments described here utilize the FLSs between the third and sixth passages.FLS were incubated with HMGB1 at (100,500,2 000 ng/ml) or interleukin (IL)-1β (0.5 ng/ml) or lipopolysaccharide (LPS) (100 ng/ml) alone or HMGB1/IL-1β complexes or HMGB1/LPS complexes.Cell proliferation assay were used by CCK-8,IL-6,IL-8 and matrix metalloproteinase-3 (MMP-3) in culture supernatants were measured using enzyme-linked immunosorbent assays.The measurement data were compared with single factor analysis of variance.Results Stimulation with all concentrations of HMGB1,IL-1β and LPS alone did not affect the cell proliferation of FLS.HMGB1/IL-1β complexes and HMGB1/LPS complexes did not affect the cell proliferation of FLS,neither (F=0.415.P=0.915).Except high concentration of HMGB1 (2 000 ng/ml) could significantly stimulate the secretion of IL-6 from FLS [(23.0±1.1) ng/ml],HMGB1,IL-1β and LPS alone did not affect the production of IL-6,IL-8 and MMP-3.However,HMGB1/IL-1β complexes and HMGB1/LPS complexes increased IL-6,IL-8 and MMP-3 production from FLS (F=97.804,117.383,70.179,P=0.000).Conclusion Neither HMGB1,IL-1β,LPS alone nor HMGB1/IL-1β complexes or HMGB1/LPS complexes affect the cell proliferation of FLS.HMGB1 in complex with LPS or IL-1β boost IL-6,IL-8 and MMP-3 production in synovial fibroblasts from RA patients.