Objective To analyse the clinical features and risk factors of interstitial lung disease in primary SjSgren's syndrome (pSS).Methods A retrospective study was employed.All 130 pSS patients who were hospitalized during 2004 to 2006 were enrolled into this study.Thirty-seven clinical and laboratory variables were used as the research factors and interstitial lung involvement as the related factor.The data were analyzed with the Logistic regression model.Results of 130 patients,22(16.9%) had interstitial lung involvement.Twelve patients were asymptomic when pulmonary involvement was detected.Variables in the univariate analysis which were significantly associated with lung fibrosis were age,exocrine glands(including parotid,sublingual gland and submandibular gland) swelling,oral ulceration and fever.Positive rate of antiU1RNP antibody in group of lung damage was significantly higher than non-lung damage group [5/22(22.7%)vs 6/108 (5.6%),P=0.021].In the Logistic regression model.variables which were significantly associated with pulmonary involvement were exocrine glands swelling (OR=3.739,95%CI 1.069～16.079,P＜0.05).oral ulceration (OR=3.739,95%CI 1.069～16.079,P＜0.05)and fever (OR=3.067,95%CI 1.198～20.067,P＜0.05).Conclusions This study indicates that some of the pulmonary damages of pSS are subclinical.Exocrine glands swelling,oral ulceration and fever are the risk factors for interstitial pulmonary involvements in pSS.

Objective To compare the specificity and sensitivity of antibodies against SSA and SSB,anti-M3 receptor polypeptide antibodies,anti-α-fodrin(IgG)antibodies in primary SjSgren's syndrome (pSS).Methods One hundred and ten pSS patients(mean age was 49.2±14.8.mean disease duration was 5.6±4.6),80 systemic lupus erythmatosis(SLE)patients(mean age was 25.5 4-4.6,mean disease duration was 2.5±1.2)and 80 rheumatoid arthritis(RA)patients(mean age was 44.6±3.5.mean disease duration was 4.2±1.1)were studied.Enzyme-linked immunosorbent assay was used to measure these antibodies.Results The seropositive rates of anti-SSA,anti-SSB antibodies,anti-M3 receptor polypeptide antibodies and anti-α-fodrin(IgG)antibodies were 45.5%,30.9%,78.2%and 77.3%,respectivelv in pSS.They were much higher than those in RA and SLE patients(P<0.05).Specificities of SSA、SSB antibodies,anti-M3 receptor antibodies and anti-α-fodrin IgG were 83.8%,97.7%.92.0%and 90.O% respectively.With the combination of these antibodies in the diagnosis of pSS.the Sellsitivity can be increased at least to 88.2%and the specificity was not decreased significantly.Conclusion Combination of these antibodies can significantly improve the sensitivity of these antibodies in the diagnosis of pSS.Anti-SSA and SSB antibodies,anti-M3 receptor antibodies and anti-α-fodrin(IgG)antibodies are specific antibodies for the diagnosis of pSS.

Objective To evaluate the quality of autoantibodies detection in China. Method Standardized samples were sent to 73 laboratories that are able to detect autoantibodies. The autoantibodies detected included antinuclear antibody (ANA), anti-dsDNA antibody, anti-extractable nuclear antigen (ENA) antibody, anti-mitochondrial antibody (AMA) and anti-smooth muscle antibody (ASMA). The analysis of testing results was double-blinded. Result The consistent rates of ANA, anti-dsDNA antibody, anti-ENA antibody, anti-mitochondrial antibody and anti-smooth muscle antibody were 86.2%, 75.4%, 62.7%, 100% and 61.1% respectively. Conclusion The overall accuracy has been elevated, but still needs to be improved.

Objective To immunize BALB/c mice with type 3 musearinic acetylcholine receptor polypeptide (M3RP) and to evaluate the role of M3RP in SS. Methods Four-week-old BALB/e mice were immunized with M3R polypeptide 213-228 (M3RP) on days 0, 14, 35, 56, and were re-immuniged on days 65, 84, 105, and one mouse was killed every 2 to 3 weeks. The mice of the control group were immunized with submaxillary gland homogenate, GST, and PBS. The animals were analyzed for the presence of anti-SSA,anti-SSB, RF, ANA, anti-a-fodrin and anti-M3RP in sera by immunofluorescenee or ELISA. The cytokines of IFN-γ IL-2 and IL-10 were measured with ELISA. Salivary glands were examined by H＆E staining and immunohistochemical analysis. Volume of water drinking by each groups were calculated. Results BALB/e mice immunized with M3RP and submaxillary gland homogenate developed an immune response directed against M3RP, α-fodrin and ANA, but no antibodies against SSA, SSB and RF were found. Furthermore, lym-phocytic infiltrates in the salivary glands of immunized animals were observed 50 days after first immunization of M3RP and submaxillary gland homogenate. The serum IFN-α in mice of M3RP, submaxillary gland ho-mogenate, GST and PBS was (62±6), (89±5), (30±5) and (19±6) pg/ml respectively, and IL-2 was (12.6±1.6), (19.8±0.4), (3.9±0.9), and (4.9±1.1) pg/ml respectively (P<0.05). No difference was found in the level of serum IL-10 among the four group. Expression of α-fodrin was found only in submaxillary gland in M3RP and submaxillary gland homogenate groups of mice, but not in PBS and GST controls when studied by immunohistochemical analysis. Conclusion These results suggest that BALB/c mice immunized with M3RP are reminiscent of human SS, and M3RP as an autoantigen participates the development of SS.

Objective To investigate the expression of C-erbB-2 and anti-nuclear antigen Ki-67 in thyroid tumor, and its significance in pathologic diagnosis and prognosis the patient. Methods SP immunohistochemical technique was used to detect the expression of C-erbB-2 and Ki-67 in thyroid tissue of 90 cases of thyroid carcinoma and 20 cases of thyroid adenoma. Results High expression of both C-erbB-2 and Ki-67 in thyroid carcinoma, and their expression was weak in thyroid adenoma. The positive rate of C-erbB-2 expression in thyroid carcinoma was statistically higher than that in thyroid adenoma (48.9% vs 20.0%, P

Objective To examine the role of synthetic cyclic citrullinated peptide (CCP) in T cell autoreactivity in rheumatoid arthritis (RA) by detecting T cell proliferation. Methods Twenty-nine RA, 8 primary Sjo gren syndrome (pSS) and 16 osteoarthritis (OA) patients were included in this study. Proliferation of T cells was measured by methyltetiazolium incorporation following incubation with CCP. Results T cell response to CCP was more common in RA patients than in controls. The response rate to CCP was higher in late RA than in early RA. However, the response wasn′t associated with disease activity. A strong association between T cell proliferation and RF, anti-CCP antibody was observed. Conclusions T cell proliferation in response to CCP was found in the majority of RA patients, even in early RA, suggesting that the citrullinated peptide play an important role in the pathogenesis of RA.

Objective To establish the enzyme-linked immunosorbent assay (ELISA)method in detecting the anti-M3RP antibody in Sj(o)gren's syndrome (SS) patients.and to explore the significance of this autoantibody in the diagnosis of SS.Methods The synthesized M3 receptor polypeptide was used as antigen in EUSA to detect the anti-M3RP antibody in sera of patients with SS.other CTDS and healthy controls.and the association between the clinical features of SS and anti-M3RP antibody was analyzed.Results Antibodies against M3RP were detected in 84.6%patients with pSS and 81-3% with sSS.8.8%with other CTD and 1%in heahhy controls.The positive rates of antibodies in pSS and sSS were higher than those in other CTDs and healthy controls.The presence of anti-M3RP antibodies had no significant correlation with clinical manifesta-tions and internal organ involvement.Furthermore.the positive rates of anti-M3RP antibodies in anti-α-fodrin.SSA,SSB,and ANA antibodies negative SS patients were 85%.89-3%,88.9%and 95.2%,respectively.body is a complementary parameter in the diagnosis of antibody-negative SS.

Objective To investigate and analyze the behavior and therapeutic status of rheumatoid arthritis (RA) patients. Methods Out patients diagnosed with rheumatoid arthritis in our hospital from May to August 2007 were enrolled. The data including sex, age of onset, site of first hospitalization and medication status were collected and analyzed. Results In this 181 RA patients, the mean age of onset was (53±11) year-old, mean history duration was (10±8) years, the ratio of male to female was 1:4.2. The orthopedics department was the most common site of first hospital visit (32.0%, 58/181) and rheumatology department was the most common site to clarify the diagnosis (62.4% ,113/181). The diagnosis delay caused by patients themselves was (5.9±17.2) months and the delay caused by doctors was (9.0±22.0) months. More than half of the patients were not treated appropriately before they came to our hospital. Methotrexate was the most commonly used DMARDs (67.3%), followed by leflunomide (46.4%), sulfasalazine (37.5%) and hydroxyehloroquine (19.6%). Conclusion In this cohort, the proportion of patients who come to rheumatology department immediately after disease onset is low. There is delay between symptoms and final diagnosis. More than half of the patients are not treated appropriately.

Objective To study the relationship between elevated serum level of immunoglobulin A (IgA) and other abnormality in immunological parameters in patients with primary Sjogren's syndrome (pSS)and those with viscera involvement based on determinations of serologic,other laboratory and clinical features.Methods Serum IgA level of 108 patients with pSS,seven males and 101 females with an age of 30～78 years and length of disease course of 0.2～20.0 years,was detected by turbidimetry.Clinical and laboratory parameters in patients were compared between different groups.Remits Elevated serum IgA level was found in 48 (44.4%) of 108 patients with pSS.Elevated erythrocyte sedimentation rate(ESR) was found in 91.7 percent of those with elevated sertum IgA and 63.3 percent in those with normal IgA(P<0.05).Serum positivity of rheumatoid factor(RF) was significantly higher in those with elevated serum IgA (70.8%)than those with normal IgA (48.3%,P<0.05).Pulmonary interstitial fibrosis could be found in 22.9 percent of those with elevated serum IgA,and in 8.3 percent of those with normal IgA(P<0.05).Occurrences of primary biliary cirrhosis and autoimmune hepatitis were higher in those with elevated serum IgA than in those with normal IgA,but not reaching statistical significance.Conclusion Serum IgA level misht play an important role in occurrence and development of pSS,and could be used as an indicator reflecting activity and severity of the disease,as well.

Objective To study clinical features of liver damage in primary Sj(o)gren syndrome (pSS) and its related factors.Methods One hundred and forty-nine patients of confirmed pSS hospitalized at Peking University People's Hospital were analyzed retrospectively.Results Seventeen of 149 patients of pSS (11.4%) showed liver damage,10 diagnosed as autoimmune hepatitis and seven as primary biliary liver cirrhosis.Increased serum levels of IgG,IgM and γ-globulin accounted for 88.2% and 50.8%,35.3% and 5.3%,and 94.1% and 47.7% of those complicated with and without liver damage,respectively,with statistically significant difference (P ＜ 0.05).Positive serum anti-mitochondria antibody subtype M2 (AMA-M2) was 35.3% in pSS patients with liver damage,significantly higher than that in those without liver damage (1.5%) (P ＜ 0.05).Independent risk factors significantly associated with liver damage included age (OR = 1.013,95% CI 0.971-1.058),course of illness (OR = 1.089,95% CI 1.032-1.150),serum level of γ-globulin (OR = 4.021,95% CI 1.246-12.982),positive AMA-M2 (OR = 11.82,95% CI 0.005-0.157),and positive anti-SSA (OR = 101.333,95% CI 12.653-811.560).Conclusions Liver damage occurred rather high in pSS patients and increased serum levels of IgG,IgM,γ-globulin and anti-SSA can be used to predict their complication with liver damage.Age,course of illness,serum level of γ-globulin,positive AMA-M2 and positive anti-SSA are all significantly associated with liver damage in pSS patients.