Objective The purpose of this study is to confirm the putative association between the Fc?RⅢA-158F/V allele and rheumatoid arthritis (RA) by genotyping the Fc?RⅢA-158F/V polymorphism in patients and controls. Methods One hundred and ninety-two RA patients were recruited and all patients fulfilled the American College of Rheumatology 1987 revised criteria for RA. The demographic data including age, sex and disease duration were collected. The 192 RA patients and 179 control subjects were genotyped for Fc?RⅢA-158F/V polymorphism with a reliable polymorphism assay, nested PCR to investigate whether the Fc?RⅢA-158F/V polymorphism was a risk factor for RA. Results The frequency of Fc?RⅢA-158V/V homozygous was higher in RA patients (OR=3.1, P

Objective To determine the protein and mRNA levels of interleukin-17 (IL-17) in the peripheral blood of patients with systemic lupus erythematosus (SLE), and to analyze the relationship between IL-17 and disease activity. Methods Twenty-six hospitalized SLE patients and twenty-one normal controls were studied. Plasma protein and mRNA of IL-17 in peripheral blood were measured by ELISA and Real-time RT-PCR respectively. Results IL-17 level and its mRNA level increased in SLE patients compared with that in normal controls. Plasma concentration of IL-17 showed a significant positive correlation with SLEDAI score and anti-dsDNA antibody level, and a significant negative correlation with serum C3 level. Conclusions Plasma IL-17 protein and mRNA expression level in SLE patients increased significantly and had close relationship with disease activity, which might suggest that IL-17 play an important role in the pathogenesis of SLE.

Objective To investigate infectious complications and analyze their risk factors in patients with systemic lupus erythematosus (SLE) and provide clue for antibiotics treatment. Methods Patients with SLE admitted to our hospital between 2002 and 2007 were. reviewed, and the characteristics of their infections including the infection sites, pathogens and the drug resistance of pathogenic bacteria were investigated. The suspected risk factors of infections in patients with SLE were selectod and then analyzed by chi-square test and Logistic regression. Results The prevalence of infection in this group of patients was 24.4% (130/533). One patient died from respiratory tract infection. The common infection sites were respiratory tract (56.9%), urinary tract (23.8%) and skin (18.5%). Bacteria were the most common pathogens of infections in SLId pa-tients (53.3%), the majority of which were gram-negative bacteria. The second major pathogen was fungus (39.2%), and the third was the combination of bacteria and fungus. There were 7 patients with tuberculosis. The common strains causing infections in SLE patients were. Escheriehia coli, Klebsiella pneumonea, Pseu-domonas aeruginosa, Staphylococcus aureus and Candida albican. Antimicrobial susceptibility tests showod that the drug resistant rates increased rapidly. The gram-negative ones were sensitive to eefoperazone-sulbac-tam and carbopenems. The infection-related risk analysis suggested that the independent risk factors of infections in SLE patients included old age, hypopruteinemia, moderate anemia and high dose of eorticos-teruids treat-ment. Conclusion Those patients with infection-related risk factors should be monitored closely for infec-tions. Respiratory tract and urinary tract are the most common infectious sites in SLId patients, and gram-nega-tive bacteria are the major pathogens, so antibiotics such aa cefoperazone-sulbactam or carbopenems may be good choices before the result of antimicrobial susceptibility test information is available.

Objective To compare the correlation between ACCP, IgA-RF, IgG-RF, IgM-RF and disease activity, bone erosion of rheumatoid arthritis. Method The correlation analysis between ACCP, IgA-RF, IgG-RF, IgM-RF and disease activity score (DAS), Ritchie′s articular index (RAI) were made SPSS software. ACCP, IgA-RF, IgG-RF, IgM-RF were compared between patients with erosive disease and with non-erosive disease. Results IgM-RF was associated with RAI, but ACCP, IgA-RF and IgG-RF were not associated with RAI. The above parameters were not associated with DAS by Spearman correlation analysis. The association between above parameters and bone erosion was not detected, however. Conclusion IgM-RF is associated with disease activity. ACCP and IgA-RF, IgG-RF are not associated with disease activity. No association is found between above parameters and bone erosion.

Literatures on arrhythmia induced by acute organophosphorous pesticide poisoning published in domestic journals from 1979 to 2010 were searched. Total 3468 cases of acute organophosphorous poisoning were collected and analyzed. The average abnormal ECC rate was (53 ±15)%(35. 4% -68. 4% ) in acute organophosphorous poisoning, the most common ECG abnormalities were ST-T segment changes (26. 5% ) and sinus tachycardia (16. 6% ). The rate and severity of ECG abnormalities were increased with the severity of organophosphorous poisoning(x2 = 33. 253,P < 0. 01). The most common causes of death in acute organophosphorous poisoning were ventricular tachycardia and ventricular fibrillation (26.2%).

Objective To explore the correlation of anti-ganglioside antibodies with clinical features of systemic lupus erythematosus (SLE). Methods Samples of serum were collected from 48 patients with SLE. Three were male and 45 were female. Their average age was 33±12 (15～59). The serum anti-ganglioside antibodies of 10 patients with rheumatoid arthritis (RA), 4 with Sj(o)gren's syndrome (SS), 1 patient with mixed connective tissue disease (MCTD), 1 with polymyositis (PM), and 97 healthy controls(HC) were alsoexamined. Levels of anti-GM1-IgM/IgG, anti-GQ1b-IgM/IgG antibodies in the serum were examined by amodified ELISA. Anti-dsDNA-IgG antibody of SLE was tested according to the ELISA kit protocol. The associations of anti-GM1-IgM/IgG and anti-GQ1b-IgM/IgG antibodies with clinical features were analyzed. x2test, one-way ANOVA, Dunnett t-test were used for statistical analysis. Results By using modified ELISA,the upper limit of reference value of anti-GM1-IgM/IgG antibodies, anti -GQ1b-IgM/IgG antibodies in the serum of Chinese SLE patients were 0.411, 0.408, 0.481 and 0.441 res-pectively. 19% patients with SLE were sero-positive for anti-GM1 antibody, 4% for IgM antibody isotype and 15% for IgG antibody isotype. Anti-GM1-IgG antibody was significantly increased in the serum of patients with SLE (0.33±0.09), higher than that of the HC (0.27±0.05) (P<0.05), RA (0.29±0.08), SS(0.27±0.06), PM ( 0.288 ), but one of the MCTD( 0.423 ).There was no significant associations between anti-GM1-IgM/IgG, anti-GQ1b-IgM/IgG antibodies and NPSLE and anti-dsDNA-IgG antibody (P>0.05). Conclusion Peripheral autoimmune response against GM1 can be detected in SLE patients, and it may be involved in the pathogenesis of SLE. No association of antiGM1-IgM/IgG antibodies or anti-GQ1b-IgM/IgG antibodies with clinical features of SLE can be discovered.

Objective To investigate the distribution of urate crystal as well as the relationship bet ween the features of the crystals and the attacks of joint pain and/or swollen by foot dual-energy CT.Methods Eight-four patients (68 were diagnosed as gout, 11 were patients with hyperuricemia and 5 were diagnosed as other types of arthritis) who recently experienced foot swelling and/or pain were enrolled and all of them were performed foot dual-energy CT.The relationship between the features of the urate crystals and the attacks of gouty arthritis was determined by Chi test and the potential risk factors were identified by Logistic multiple regression analysis.Results Two hundred and seventyeight urate crystal depositions were found in 68 gout patients,and the most common deposition sites were the distal parts of the first toe(18.2％),the first metatarso-phalangeal joint ( 16.8％ ),calcaneus ( 17.5％ ),the lower end of tibia ( 11.8％ ).Furthermore,patients with the urate crystals deposited in the first metatrasophalangeal joint or the lower end of of tibia were more likely to experience acute episodes of gout attack (P＜0.01,P＜0.05 respectively).In addition,the shape,size and quantity of urate crystals also affected episodes of acute attack of gout.Conclusion Dual-energy CT,which is a non-invasive method,could clearly reveal urate crystal depositions and is helpful for the diagnosis and follow-up of patients with gout.The location,shape,size and quantity of urate crystals and soft tissue swelling,bone erosion may affect the acute attack of gout.

Objective To evaluate the effect of using standardized patients (SP) in psychiatry class teaching.Methods A standardized patient was used when giving instructions on seven years clinic medicine students of Fudan university,the effect of this teaching model was assessed.Results Totally 96.19％ of students believed that standardized patients teaching model was better than the traditional model.Students in classes of using standardized patients scored higher than students in classes without using standardized patients.Conclusion The standardized patients teaching mode,recognized by almost all students,is believed to help students to better master the knowledge of psychiatry.

Objective To evaluate a new enzyme-linked immunospot assay (TSPOT-TB) for the diagnosis of latent tuberculosis infection in patients with rheumatic diseases.Methods The rapid TSPOT-TB assay was applied to detect ESAT-6 and CFP-10 specific T cells in blood samples from 126 rheumatic disease patients.A PPD skin test was performed on all patients simultaneously.Results The positive rate of TSPOT assay was 23.8% and that of PPD skin test was 34.9%.The overall agreement between the 2 tests was 71.4%.Among PPD (-) patients (n=82),11 were TSPOT (+) ( 13.4% ).Among PPD (+) patients (n=44),25 were TSPOT(-) ( 56.8% ).The patients who got BCG vaccination showed a significantly higher rate of positive results of PPD skin test than those who did not(41% vs 19%,P＜0.05).While in TSPOT assay,the BCG vaccination did not show any influence on TSPOT results (22% vs 27%,P＞0.05).Conclusion BCG vaccina-tion affects the results of PPD test in patients with rheumatic diseases,but has no influence on TSPOT results.The infection rate of latent tuberculosis in patients with rheumatic diseases in our study is 23.8% detected by TSPOT.

Objective To compare the efficacy of the conventional PPD skin test and a new enzymelinked immunospot assay(TSPOT-TB)for diagnosing latent tuberculosis infection(LTBI)in patients with rheumatic diseases.Methods Two hundred and sixty rheumatic patients were enrolled,and all were screened for LTBI based on clinical history,chest X-ray,PPD skin test or TSPOT.Results The positive rate of TSPOT assay was 24.1%and that of PPD skin test was 39.4%.The overall concordance rate between the 2tests was 61.0%.Among PPD negative patients (n=149).29 were TSPOT(+)(19.5%).Among PPD(+)patients(n=98),69 were TSPOT(-)(70.0%).The patients who got BCG vaccination or had history of tuberculosis infection showed a significantly higher rate of positive result of PPD skin test than those who did not (P<0.05 or P<0.01).While in TSPOT assay,the BCG vaccination or history of tuberculosis infection did not show influence on TSPOT results(P>0.05).Of the 127 patients who received biological agents after screening for LTBI,9 patients were pretreated with isoniazide.Twenty-seven patients stopped biological agent treatment because of the positive results of PPD or TSPOT.Twenty three patients who had positive PPD but negative TSPOT results received biological agent treatment without isoniazide,and none of them developed active tubereulosis after 6 to 18 months of follow-up.Conclusion BCG vaccination affects the result of PPD test in rheumatic patients,but has no influence on TSPOT results.The infection rate of latent tuberculosis of rheumatic patients in our research is 23.8%detected by TSPOT.