Objective:To evaluate the significance of the combination of rheumatoid factor (RF) and anti-filaggrin antibodies (AFAs) in the diagnosis of rheumatoid arthritis (RA). Methods:Sera from 266 RA patients and 186 controls were studied. RF and some kinds of AFAs (including antikeratin antibodies, anti-perinuclear factor and anticyclic citrullinated peptide antibodies) were detected using immunofluorescence and ELISA respectively. The distributions of these antibodies were compared to determine the significance of the combination of RF and AFAs. Results:The sensitivity and secificity of RF for the diagnosis of RA were 65.8% and 81.8% respectively, as compared with those of anti-CCP or RF positive were 86.5% and 80.6% respectively. Only a slight change was found in the secificity and negative predictive value between them. RF could not be detected in 91 patients while 64.8% of them could be found to have at least one kind of AFAs. Conclusion:AFAs, particular anticyclic citrullinated peptide antibodies, could be helpful for the diagnosis of RA especially in RF-negative patients.

Objective To evaluate the diagnostic specificity and sensitivity of anti-p68 antibody in rheumatoid arthritis (RA), and to analyze the relationship between anti-p68 antibody and the activity of RA . Methods Anti-p68 antibody was tested in the serum of 183 RA patients and 195 controls by indirect immunofluorescence (IIF). The clinical characteristics of RA between anti-p68 positive group and negative group were compared. Results ① The positive rate of anti-p68 antibody was 67.8% (124/183) in RA, 14.9% (17/114) in other rheumatic diseases and none in normal controls (0/81). Anti-p68 antibody was different from other auto-antibodies found in RA. ② Its sensitivity was 67.8% and specificity was 91.3% for RA, positive prediction rate was 87.9% and negative prediction rate was 75.1%. ③ There was statistic difference between the positive group and negative group in disease duration, RF and degree of X-ray changes. Conclusion ① Anti-p68 antibody is a new and specific serum maker for diagnosis of RA. ② The antibody is correlated with disease duration, RF and X-ray changes.

Objective To compare the expression level of interferon regulator factor 5 (IRF5) of the health controls and systemic lupus erythematosus (SLE) patients and analyze the relationship between IRF5 and SLE disease activity. Methods Peripheral blood monoeytes (PBMCs) from SLE patients and healthy donors were separated with Ficoll density gradient eentrifugation and total cellular RNA was isolated with Trizol from the PBMCs, the mRNA was reverse transcripted to cDNA. Real-time PCR was applied to determine the expression level of IRFS. The expression level of IRF5 between the two groups were compared. The correlations of expression level of IRF5 with SLE disease activity and other laboratory or clinical parameters of SLE patients were analyzed. Results The level of IRF5 was (2.1±2.2) in SLE patients and (1.5±1.2) in healthy controls, the difference was not statistically significant (P=0.161). And the levels of IRF5 in SLE patients were significantly correlated with their SLEDAI (r=0.616,P<0.01), but not correlated with other parameters such as bemoglobulin complements, immunoglobulin etc. Anti-dsDNA antibody positive patients had significantly higher expression of IRF5 compared to the anti-dsDNA-antibedy-negative patients. The IRF5 mRNA levels of SLE patients with fever or neuropsyehiatric symptoms were significantly higher than those of patients free of neuropsychiatrie involvement. Conclusion High expression level of 1RF5 may contribute to the pathogenesis of SLE in disease activity and antibody production.

Objective To evaluate the feasibility of endovascular repair for retrograde type A aortic dissection.Method 35 patients of retrograde type A aortic dissection admitted to Peking University People's Hospital from December 2001 to March 2014 were treated with endovascular repair.There were 33 males and 2 females with mean age of 46 ± 9 years.29 were on acute stage,2 on subacute stage and 4 on chronic stage.The entry tear was in the descending thoracic aorta in 32 cases,between the left subclavian artery and the left common carotid artery in one,and between the left common carotid artery and the innominate artery in two.Results Entry closure was achieved in all patients with a covered stent.2 patients died in 30 days postoperatively (5.7％).1 patient with two chimney developed acute renal artery embolized which was infused by false lumin (2.9％).One patient developed transient paraparesis after graft deployment(2.9％).During the follow-up period,the aortic remodeling is perfect,no entry tear was noted in the ascending thoracic aorta.All the endografts for preserving supra-aortic branches were patent.Conclusions The endovascular repair for retrograde type A aortic dissection is feasible and effective.

Objective:To establish the murine systemic lupus erythematosus (SLE) model of chronic graft versus host diseases(cGVHD). To analyze the pathological changes and serological and immunological features in the animals. Methods: Female (C57BL/10?DBA/2)F1 hybrids aged 6-8 weeks were randomly divided into model group and healthy controls (HC). Lymphocytes from female DBA/2 were injected intravenously to the model group on days 0, 3 and 8,while PBS were injected to the HC under the same condition as a control group. Bradford was applied to monitor the development of albuminuria quantitively. Sera were tested by enzyme linked immunosorbent assay (ELISA) and indirect immunofluorescence (IIF) for the presence of autoantibodies. To compare the differences of CD4+CD25+ Treg cells between the two groups by flow cytometry (FCM) and the differences in the expression of Foxp3 by real time polymerase chain reaction(RT-PCR). The kidneys of model mice were removed in the 12th week and were made frozen sections for direct immunofluorescence(DIF)and paraffin imbedding for PASM staining. Results: The titers of proteinuria in model group in the 6th week, 8th week, 10th week, and 12th week were significantly higher than those of the HC groups(P=0.004, 0.005,respectively). The titers of anti-dsDNA and anti-nucleosome antibodies were significantly increased in the model group compared with the HC (P

Background:The incidence of ischemic colitis(IC)is increasing in recent years with the aging of population,and the rate of delayed diagnosis or misdiagnosis is high because of the lacking of specific clinical characteristics. Aims:To study the clinical characteristics of IC so as to improve its early diagnosis and treatment. Methods:The clinical and endoscopic characteristics of 75 IC patients from Jan. 2009 to Dec. 2014 at Urumqi General Hospital were retrospectively analyzed. Results:IC usually occurred in elderly patients with age ≥60 years,females were more common. Most patients had underlying diseases,including hypertension,coronary heart disease,diabetes,hyperlipidemia and arrhythmia,etc. Colonoscopy and medications could also induce IC. The main clinical presentations were abdominal pain,hematochezia and diarrhea. The lesions were mostly located in left colon and of the transient type. Conclusions:IC should be suspected when elderly patients with underlying diseases,complaining abdominal pain,hematochezia and diarrhea,colonoscopy and pathologic study should be undertaken as early as possible. Prognosis is good when treated timely.

Objective To investigate the significance of plasma protein S and growth-arrest specific protein 6 (Gas6) in systemic lupus erythematosus (SLE).Methods Sandwich enzyme-linked immunosorbent assay (ELISA) was used to measure the protein S and Gas6 in the plasma of 103 SLE patients and 40 healthy controls.Mann-Whitney U-test,x2-test and Spearman's rank correlation were used for statistical analysis.Results The plasma concentrations of protein S and Gas6 were both significantly [protein S:30.6 (27.2,33.6) μg/ml,37.8(35.4,46.7) μg/ml,Z=6.04,P＜0.01; Gas6:402.6(239.2,757.8) pg/ml,913.6(765.0,1 290.6) pg/ml,Z=4.26,P＜0.01] decreased in plasma of SLE patients than that in healthy controls.There was a positive correlation between levels of protein S and Gas6 (r=0.312,P=0.001).The level of protein S in SLE patients was positively correlated with hemoglobin (Hb),WBC,platelet blood platelet (PLT),C3 and C4 (r=0.209,0.264,0.264,0.362,0.280,P＜0.01 or P＜0.05).Plasma protein S level was also found to be negatively correlated with auto-antibodies such as anti-double strand DNA (anti-dsDNA) antibody,anticardiolipin (ACL),anti-nucleosome antibody (AnuA) or IgG (r=-0.197,-0.264,-0.226,-0.229,P＜0.01or P＜0.05).The plasma Gas6 level was positively associated with age,disease duration and C-reaction protein (CRP) (r=0.229,0.198,0.263,P＜0.01 or P＜0.05).Patients with decreased Gas6 level showed higher incidence of fever,rash and serositis.Patients with decreased WBC or positive for proteinuria also showed decreased Gas6 (P＜0.05).Conclusion Protein S levels are significantly decreased in plasma of SLE patients and is associated with a series of severe disease manifestations such as hematological involvement,decreased complements and the presence of auto-antibodies.Decreased Gas6 levels in SLE patients are observed and they are correlated with age,disease duration and certain clinical characteristics such as rash,renal involvement and inflammatory response.

Objective To test serum decoy receptor 3 (DcR3) concentration in patients with rheumatoid arthritis (RA),and analyze its clinical significance.Methods The serum from 180 RA patients,29 osteoarthritis (OA) patients,60 systemic lupus erythematosus (SLE) patients,30 Sj(o)gren's syndrome (SS) patients and 100 healthy donators were selected.The serum DcR3 concentrations of the two groups were detected by enzyme-linked immunosorbent assay (ELISA).The correlation between serum DcR3 levels and clinical features of patients with RA were investigated.T test,x2 test and Spearman's correlation analysis were used for statistical analysis with software SPSS 16.0.Results Serum DcR3 levels in RA patients [(202±261)ng/ml] were significantly higher than those of the healthy controls [(32±31) ng/ml,t=5.33,P＜0.01],OA patients [(90±33)ng/ml,t=1.998,P＜0.01],SLE patients [(41±56)ng/ml,t=3.19,P＜0.01],and SS patients [(25±31) ng/ml,t=2.50,P＜0.01].The DcR3 cut value was 45.86 ng/ml for the diagnoses of RA,the sensitivity and specificity was 0.991 and 0.765 respectively.The levels of serum DcR3 in RA patients were related with rheumatoid factor (RF) IgM,RF-IgG,anti-cyclic citrullinated peptide antibodies (anti-CCP) and C3.Conclusion Serum DcR3 level is significantly elevated in RA and it is significantly associated with immunological index of RA including RF-IgM,RF-IgG,C3 and anti-CCP antibody,which may be a factor for unfavorable prognosis of RA patients.

ObjectiveTo analyze the correlated clinical significance by testing the serum tumor necrosis factor like ligand-1A(TL1A) levels of patients with rheumatoid arthritis(RA). MethodsThe serum from 100 RA patients and 50 healthy controls were selected. The serum TL1A concentrations of the two groups were detected by ELISA. The correlations between serum TL1A levels and clinical features or laboratory examinations of RA patients were investigated. Mann-Whitney U test, t-test, x2 test and Spearman correlation analysis were used for statistical analysis. ResultsThe levels of serum TL1A in RA patients [(959±1146) pg/ml]were significantly higher than those of the healthy controls[(529±154) pg/ml, t=3.683,P＜0.01]. The levels of serum TL1A in RA patients with positive rheumatoid factor(RF),occult rheumatoid factor immunoglobulin G (HRF-IgG) and anti-cyclic citrullinated peptide antibodies (anti-CCP)[(962±1043 ), ( 833±1104 ), (908±1115 ) pg/ml, respectively]were significantly increased when compared to those in RF, HRF-IgG and anti-CCP negative RA patients[(628±r343), (576±134),(628±401) pg/ml, respectively, t=3.224, 1.317, 1.003; P＜0.05]. The positive rates of RF, HRF-IgG and anti-CCP in the TL1A positive group(90％, 42％, 85％) were significantly higher than those of the TL1A negative group (56％, 11％,33％) (x2=-0.372, -2.402, -2.774; P＜0.05). ConclusionThe level of serum TL1A is significantly elevated in RA and it is significantly associated with auto-antibodies in RA including RF, HRF-lgG and antiCCP antibody, which may be a factor for unfavorable prognosis of RA patients.

Objective To compare the clinical response with etoricoxib 60 mg once daily with diclofenac sodium tablet 75 mg two times daily in the treatment of osteoarthritis of the knee or hip joint.Methods A 4-week multicenter,randomized,double-blinded and active comparator-controlled clinical trial was performed during January 2005 and June 2005 in 6 medical centers in China.Eligible patients (≥40 years old Chinese patients with osteoarthritis of the knee and hip) were randomized (1:1 ratio) to receive etoricoxib 60 mg once daily (n=90),or diclofenac sodium 75 mg twice daily (n=90).Primary efficacy end point is the change of WOMAC (Western Ontario and McMaster Universities osteoarthritis index) pain subscale from baseline to 4 weeks; non-inferiority bounds were pre-defined [if the upper bound of 95％ confidence interval (CI) for the difference is less than 10 mm on a 100-mm VAS WOMAC pain subscale] for the comparison of the change between the two groups.The secondary efficacy endpoints include WOMAC physical function subscale,WOMAC stiffness subscale,patient's global assessment of response to therapy (PGART),investigator's global assessment of disease status (IGADS),discontinuation due to lack of efficacy and rescue paracetamol tablet count.Safety was assessed by physical examination,adverse experience reported,and laboratory safety data.Results C6mpared to baseline,the changes of WOMAC pain subscale after 4 weeks treatment were statistically significant (P＜0.01) in both groups (etoricoxib group:51±16 vs 21± 19; diclofenac sodium group:53±16 vs 22±19).There was no difference in the change of WOMAC pain subscale between the two groups.The change in WOMAC stiffness subscale,WOMAC physical function subscale,PGART and IGADS in both groups were statistically significant (P＜0.01),but there was no difference between treatment groups according to the pre-defined non-inferiority criteria.No drug related serious adverse events were observed during the study.The difference in drug-related adverse event incidence between the two groups was not statistically significant.Etoricoxib and diclofenac sodium were generally safe and well tolerated.Conclusion Etoricoxib 60 mg administered once daily is efficacious and shows clinical efficacy notinferior to that of diclofenac sodium 75 mg administered twice daily for the treatment of osteoarthritis.Etoricoxib 60 mg administered once daily for 4 weeks is generally safe and well tolerated.