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 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 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.

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 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.

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 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 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 observe the bone metabolism of psoriatic arthritis (PsA) and investigate the roles of some bone metabolism markers such as tartrate-resistant acid phosphatase 5b (TRACP5),C-terminal telopeptide of collagen-Ⅰ (CTX-Ⅰ) and BALP in PsA patients with bone destructions.Methods Sixty-five cases of psoriatic arthritis,30 cases of psoriasis and 30 cases of healthy people were enrolled.Bone mineral densities of lumbar spines and the left femoral necks were measured for all PsA patients using dual energy X-ray absorptiometry.The Serum levels of TRACP5b,CTX-Ⅰ,BALP of healthy controls,Ps and PsA patients were measured.The PsA group was further divided into bone destruction group and none bone destruction group by image datasets.The levels of TRACP5b,CTX-Ⅰ,BALP,PsAJAI,ESR and CRP from each group were detected.Mann-Whitney and x2 test were used for statistic analysis.Results TRACP5b levels of the healthy controls,Ps and PsA patients were (0.9±0.4),(0.7±0.5) and (2.0±1.4) U/L respectively,and were significantly higher in the PsA patients than those of the other two groups (Z=-3.698,-3.638; P＜0.05).The CTX-Ⅰ levels of these three groups were (0.9±0.8),(0.6±0.7) and (2.6±1.8) ng/ml respectively,and were also dramatically higher in the PsA patients than the other two groups (Z=-5.262,-5.734; P＜0.05).BALP levels of each group were (22±4),(22±4) and (25±7) U/L,and were also evidently higher in the PsA patients than patients in the other two groups (Z=-2.214,-2.000; P＜0.05).Meanwhile,the levels of TRACP5b [(2.6±1.4) U/L],CTX-Ⅰ [(3.1±1.8) ng/ml] and BALP [(26±7) U/L] were significantly higher in bone destruction group than those in the none bone destruction group [(1.2±1.0) U/L,(1.9±1.6) ng/ml,(23±6) U/L,Z=-3.544,-3.429,-2.083; P＜0.05].Conclusion The high levels of TRACP5b,CTX-Ⅰ and BALP in PsA indicate that there is bone metabolism imbalances in PsA.And the high levels of TRACP5b,CTX-Ⅰ and BALP in the bone destruction group suggest that the rises of TRACP5,CTX-Ⅰ and BALP levels may be related with bone erosions.

ObjectiveTo investigate the association of BANK1 single nucleotide polymorphisms (SNPs) with rheumatoid arthritis(RA) in Chinese Han. MethodsTwo hundreds and twenty-one RA patients and 310 healthy controls who were Chinses Han population from Huashan Hopital and Changzheng Hospital in Shanghai,China were included.DNAs were extracted from peripheral whole blood for study.Samples were genotyped for three variants rs10516487,rs17266594 and rs3733197 in BANK1 by unlabelled probe high resolution melting (HRM) assay.The genotype frequencies of the detected polymorphisms were analyzed in relation to RA and the production of autoantibodies in RA patients.ResultsThe Tr genotype frequency was much higher in RA patients than in healthy controls(X2=6.241,P=0.044).The frequencies of rs10516487 G allele,rs17266594 T allele and rs3733197 G allele were increased among RA patients compared with healthy controls,although they didn't reach statistical significance.The rs10516487 and rs17266594 were found in strong linkage disequilibrium(D'=0.993,r2=0.985).And also the major TGG haplotype of 3-SNP was significantly associated with RA patients[P=0.037,OR =1.345,95％CI (1.018-1.776)].ConclusionBANK1 rs17266594 polymorphism is susceptible to RA,while rs10516487 and rs17266594 are linked in Chinese Han population.BANK1 SNPs TGG haplotype may contribute to RA susceptibility,too.