OBJECTIVETo study the changes in cardiac function of rheumatoid arthritis (RA) patients and: to observe the effect of xinfeng capsule ( XFC) on them.

METHODSSixty-eight RA patients were: randomly assigned to two groups by a lottery: 38 patients in the treatment group treated orally with XFC, 3 capsules, thrice a day, and 30 in the control group treated with fengshi gutong capsule (FSGTC), 4 capsules, twice a day, 30 days as one course of treatment, and two courses were given for both groups. A normal control (NC) group including 20 healthy subjects was set up. The clinical efficacy was compared between the two treated groups. The changes in cardiac function, including early diastolic peak flow velocity (E), late diastolic peak flow velocity (A), left ventricular fraction shortening (FS), and E/A, as well as uric acid (UA), erythrocyte sedimentation rate (ESR), α-acid glycoprotein (α-AGP), and hypersensitive C-reaction protein (hs-CRP), were observed. The regulation T cell was determined with flow cytometry.

RESULTS(1) The total effective rate in the treatment group and the control group was 92.1%: (35/38) and 70.0% (21/30), respectively. Significant difference was shown between them (P<0.05). (2)

CONCLUSIONSThe descendent of cardiac function exists in RA patients. XFC could improve cardiac: function of RA patients, which is superior to FSGTC. Its mechanism may be related to its effect on raising CD4 CD4(+)CD25 CD25(+)Treg and CD4 CD4(+)CD25 CD25(+)CD127(-) Treg cells, decreasing UA, α-AGP, and hs-CRP levels, reducing immune inflammation, adjusting the overall balance of immune response, and thus improving the cardiac function of RA patients.

Adult ; Aged ; Arthritis, Rheumatoid ; drug therapy ; physiopathology ; Capsules ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Heart Function Tests ; drug effects ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Antirheumatic Agents ; therapeutic use ; Arthritis, Rheumatoid ; complications ; drug therapy ; Atlanto-Axial Joint ; injuries ; Humans ; Joint Dislocations ; etiology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Syringomyelia ; diagnosis ; etiology ; physiopathology

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease chiefly affecting synovial membranes of multiple joints. The clinical manifestations are highly variable. Besides joint affection, extra-articular manifestations always occur in RA patients, such as lung, blood vessel, heart, endocrine glands, hematological system, and nervous system affections. In addition to Western medicine therapy, Chinese medicine also plays a significant role in the treatment of RA with good efficacy and less adverse reactions. This paper summarizes the effects of xinfeng capsule, a Chinese medicine, and the mechanisms of its action in ameliorating the extra-articular manifestations based on a series of clinical and experimental researches.
Animals ; Arthritis, Rheumatoid ; drug therapy ; immunology ; pathology ; physiopathology ; Biomedical Research ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Joints ; pathology ; Medicine, Chinese Traditional

The concept of using high-dose immunosuppressive treatment (HDIT) with autologous stem cell transplantation (ASCT) to treat patients with refractory rheumatoid arthritis has been provided by animal studies and anecdotal case reports. Over the past five years, an increasing number of patients with refractory rheumatoid arthritis have received HDIT with ASCT as an adjunct to intense immunosuppression. Here, we present a case of refractory rheumatoid arthritis in a 54-yr-old woman using HDIT with ASCT. Peripheral blood stem cells were mobilized with cyclophosphamide (4 g/m(2)) followed by G-CSF (5microgram/kg/day). Leukapheresis continued daily until the number of harvested progenitor cells reached 2 x 10(6) CD34+ cells/kg after CliniMax(R) CD34+ positive selection. For HDIT, high-dose cyclophosphamide (total dose 200 mg/kg) and antithymocyte globulin (total dose 90 mg/kg) were administered and CD34+ cells were infused 24 hr after HDIT. The patient tolerated the treatment well but experienced an episode of neutropenic fever. She achieved an early dramatic improvement of joint symptoms during therapy. Fifty percent of improvement of rheumatoid arthritis by the American College of Rheumatology (ACR 50) preliminary definition was fulfilled during the 6 months following ASCT. Although further long-term follow-up is required, the patient's activity of arthritis has been stable since receiving HDIT with ASCT.
Antilymphocyte Serum/*therapeutic use ; Arthritis, Rheumatoid/*drug therapy/physiopathology ; Combined Modality Therapy/methods ; Cyclophosphamide/*therapeutic use ; Female ; *Hematopoietic Stem Cell Transplantation ; Humans ; Immunosuppressive Agents/*therapeutic use ; Middle Aged ; Transplantation, Autologous ; Treatment Outcome

No abstract available.
Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/blood/*complications/diagnosis/drug therapy/physiopathology ; Biological Markers/blood ; Drug Therapy, Combination ; Facial Dermatoses/complications/diagnosis ; Female ; Hand Joints/physiopathology/radiography ; Humans ; Immunosuppressive Agents/therapeutic use ; Inflammation Mediators/blood ; Knee Joint/physiopathology/radiography ; Lupus Erythematosus, Systemic/blood/*complications/diagnosis/drug therapy ; Middle Aged ; Syndrome ; Treatment Outcome

Anti-Inflammatory Agents ; administration & dosage ; Arthritis ; diagnosis ; drug therapy ; etiology ; physiopathology ; Arthritis, Rheumatoid ; diagnosis ; Clofazimine ; administration & dosage ; Dapsone ; administration & dosage ; Delayed Diagnosis ; Diagnosis, Differential ; Humans ; Leprostatic Agents ; administration & dosage ; Leprosy ; complications ; diagnosis ; drug therapy ; physiopathology ; Male ; Middle Aged ; Prednisolone ; administration & dosage ; Rifampin ; administration & dosage ; Treatment Outcome

OBJECTIVETo determine the effectiveness and safety of Xinfeng Capsules (XFC) for the treatment of rheumatoid arthritis (RA) patients with decreased pulmonary function.

METHODSThis was a randomized controlled clinical trial of 80 RA patients. Participants were assigned to the trial group (40 cases) and the control group (40 cases) by block randomization. The trial group was treated with XFC, three pills each time three times daily for 2 months. The control group was treated with tripterygium glycoside (TPT), two pills each time three times daily for 2 months. Both groups were followed up after 2 months. The clinical effects, changes in joint and pulmonary function, and quality of life before and after treatment were observed; safety indices were also evaluated.

RESULTSPain, swelling, tenderness, and duration of morning stiffness of joints were obviously decreased after treatment in both the trial and the control groups compared with baseline (P<0.01). Compared with before treatment, hand grip strength increased significantly after treatment in the trial group (P=0.0000); pulmonary function parameters such as forced expiratory volume in the first second of expiration/forced vital capacity (FEV1/FVC), 50% of the expiratory flow of forced vital capacity (FEF50), carbon monoxide diffusing capacity (DLco) were increased (P<0.01 or P<0.05); measures of quality of life such as role-physical, body pain, vitality and mental health were also improved after treatment in the trial group (all P<0.05). Joint swelling in the trial group decreased compared with the control group (P=0.0043), while hand grip strength was increased after treatment (P=0.0000). The increase in FEF50, DLco, and the dimensions of quality of life such as vitality and mental health were all significantly greater in the trial group than the control group (P<0.05 or P<0.01).

CONCLUSIONSXFC not only relieved joint pain in RA patients, but also significantly improved the ventilation and diffusion function of the lungs. Therefore, XFC could improve the whole body function and enhance the quality of life of RA patients.

Adult ; Aged ; Arthritis, Rheumatoid ; blood ; drug therapy ; pathology ; physiopathology ; Blood Sedimentation ; C-Reactive Protein ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Joints ; pathology ; Male ; Middle Aged ; Quality of Life ; Respiratory Function Tests ; Surveys and Questionnaires ; Treatment Outcome

OBJECTIVETo observe the effect of resveratrol (Res) on in vitro proliferation and apoptosis of TNF-alpha induced rheumatoid arthritis fibroblast-like synoviocytes (RA FLS), and further to investigate the PI3 K/Akt/BAD signal mechanism.

METHODThe inhibition rate of RA FLS was examined by MTT assay. Cell cycle and the amount of apoptotic cells was measured by flow cytometry. PI3K/Akt/BAD signal transduction proteins expression was measured by western blot.

RESULTThe living cells measured by MTT dose and time-dependently reduced in Res groups. In Res groups, the fraction of living cells in the S-phase and G2/M-phase decreased respectively, while that in G1-phase increased, the difference was statistically significant compared with the TNF-alpha group (P < 0.05). Flow cytometry demonstrated that the apoptosis rate increased with increased Res concentration. Res inhibited TNF-alpha induced phosphorylation of Akt and BAD in RA FLS.

CONCLUSIONRes can inhibit RA FLS proliferation and induce apoptosis through inhibition of PI3K/Akt/BAD signalling pathway. Res may provide a new therapeutic approach in treatment of RA.

Aged ; Apoptosis ; drug effects ; Arthritis, Rheumatoid ; drug therapy ; immunology ; physiopathology ; Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Female ; Fibroblasts ; cytology ; drug effects ; Humans ; Male ; Middle Aged ; Stilbenes ; pharmacology ; Synovial Membrane ; cytology ; drug effects ; immunology ; Tumor Necrosis Factor-alpha ; immunology

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by inflammation and joint destruction that causes significant morbidity and mortality. However, the combined use of methotrexate, a synthetic disease-modifying antirheumatic drug (DMARD), and biologic DMARD has revolutionized treatment of RA. Clinical remission is now realistic targets, achieved by a large proportion of RA patients, and rapid and appropriate induction of remission by intensive treatment with biological DMARD and methotrexate is prerequisite to halt joint damage and functional disabilities. However, biological DMARD is limited to intravenous or subcutaneous uses and orally available small but strong molecules have been developed. Oral administration of tofacitinib targeting the Janus kinase (JAK) is significantly effective than placebo in active patients with methotrexatenaive, inadequately responsive to methotrexate or tumor necrosis factor (TNF)-inhibitors. The efficacy was rapid and as strong as adalimumab, a TNF-inhibitor. Meanwhile, association of tofacitinib on carcinogenicity and malignancy is under debate and further investigation on post-marketing survey would be warranted. On the other hand, discontinuation of a biological DMARD without disease flare is our next goal and desirable from the standpoint of risk reduction and cost effectiveness, especially for patients with clinical remission. Recent reports indicate that more than half of early RA patients could discontinue TNF-targeted biological DMARD without clinical flare and functional impairment after obtaining clinical remission. Contrarily, for established RA, fewer patients sustained remission after the discontinuation of biological DMARD and "deep remission" at the discontinuation was a key factor to keep the treatment holiday of biological DMARD.
Administration, Oral ; Antirheumatic Agents/*administration & dosage/adverse effects ; Arthritis, Rheumatoid/diagnosis/*drug therapy/metabolism/physiopathology ; Biological Products/administration & dosage ; Disability Evaluation ; Drug Administration Schedule ; Humans ; Janus Kinases/antagonists & inhibitors/metabolism ; Molecular Targeted Therapy ; Predictive Value of Tests ; Protein Kinase Inhibitors/administration & dosage ; Recovery of Function ; Remission Induction ; Signal Transduction/drug effects ; Treatment Outcome ; Tumor Necrosis Factor-alpha/antagonists & inhibitors/metabolism

Alopecia ; chemically induced ; diagnosis ; Antirheumatic Agents ; administration & dosage ; adverse effects ; Arthritis, Rheumatoid ; drug therapy ; Biopsy ; methods ; Cyclosporine ; administration & dosage ; Dermatologic Agents ; administration & dosage ; Drug Hypersensitivity Syndrome ; diagnosis ; etiology ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Prednisolone ; administration & dosage ; Skin ; pathology ; Sulfasalazine ; administration & dosage ; adverse effects ; Symptom Flare Up ; Treatment Outcome ; Vitiligo ; chemically induced ; diagnosis