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 investigate the clinical application value of anti-Mullerian hormone in the evaluation of ovarian reserve function in the child-bearing female patients with RA. Methods A total of 90 child-bearing patients with RA aged from 20 to 50 years of age who were hospitalized from December 5, 2015 to April 30, 2017 were enrolled and healthy females with matched ages were enrolled as the control group. Electrochemiluminescence assay was used to determine the anti-Mullerian hormone (AMH) and the clinical data of all patients were retrospectively analyzed. SPSS software was applied to draw the ROC curve and calculate the area under the AMH curve. Risk factors were statistically analyzed using Logistic regression method. Results (1)A total of 90 patients with RA were included in the analysis[mean age (32. 2±6. 87) years, duration of disease (3. 03±2. 03) years]. AMH levels in RA patients [(2. 74±0. 16) ng/mL] were significantly lower than those in the control group [(3. 75±0. 17) ng/mL]. (2)Pearson correlation analysis showed that the increase of age (r=0. 965, P＜0. 001) and bFSH (r=0. 664, P＜0. 001) were associated with low AMH levels. The ROC curve analysis showed that the predictive sensitivity to the ovarian reserve reduction (DOR) was 0. 828 and the specifici ty was 0. 727 when AMH was 2. 27 ng/mL. (3)AMH levels in the patients with RA exposed to Tripterygium wilfordii preparation[(1. 86±0. 16) ng/mL] were significantly lower than those in unexposed patients [(3. 27±0. 14) ng/mL]. There was no statistically significant difference in AMH levels among the patients receiving other immunosuppressive agents(including methotrexate, leflunomide, hydroxychloroquine). (4)Logistic regression analysis indicated that the use of Tripterygium wilfordii preparation was the risk factor for DOR (OR=7. 31, P=0. 019, 95％ CI 1. 39 to 38. 54). Conclusion AMH levels can be used to evaluate ovarian function in child-bearing female patients with RA. Ovarian toxicity of Tripterygium wilfordii preparations should be alerted in the its clinical application in the treatment of RA.