Objective To investigate the effects of constant magnetic field (CMF) on proliferation, apopto-sis and nitric oxide (NO) secretion of rat bone marrow-derived endothelial progenitor cells (EPCs) intervened by C-reactive protein (CRP). Methods EPCs were isolated from rat bone marrow by density gradient centrifugation and cultured on fibronectin-coated dishes. The cells were divided into five groups, i. e., control group, CRP (12 μg/ml) group, CRP plus CMF (0.1, 0. 5, 1.0 mT) groups. Samples were collected 24 hours after incubation. Cell proliferation was measured by MTT chromatometry. Apoptosis rate was detected by flow-cytometry. NO content of culture medium was measured by nitrate reductase method. Results As compared with control group, cell prolifer-ation in CRP group reduced significantly (0. 265±0. 008 vs 0. 316±0. 011, P < 0.05), NO secretion also de-creased significantly [(22.7±4.5) μmol/L vs (37.6±3.8) μmol/L, P < 0.05], cell apoptosis rate elevated sig-nificantly [(10.8±0. 8) % vs (4.2±0.5)% ,P < 0.05]. Cell proliferation in CRP plus 0. 5 mT or 1.0 mT CMF group (0. 295±0. 009,0. 302±0. 010) were much more than those in CRP group (P<0.05), NO secretion contents [(28.3±4.9) μmol/L, (29.2±5.6) μmol/L]were also much more than those in CRP group (P < 0.05) , apopto-sis rate [(7.4±0.5)% ,(6.9±0.6)%]was significantly lower than that in CRP group (P <0.05). Conclusion CMF at intensity of 0.5 mT and 1.0 mT can antagonize the effects of CR, promote proliferation of EPCs and secretion of NO and inhibit apoptosis rate of EPCs.

Objective To investigate the CT and MRI findings of Coats’disease in comparison with pathology.Methods CT,MRI and ultrasonic features,FFA findings of eight patients of Coats’disease with histo-pathologically confirmed were analyzed retrospectively.CT scanning,routine MRI scanning and ultrasonic examination were performed in all eight patients.Results Unilateral eyeball was involved in all eight cases.On CT scanning,the density of the vitreous body was increased homogeneously which boundary was clear(n=8).The retina was thick(n=8).The anterior chamber depth was shallow(n=5).Multiple calcified foci occured in lens and vitreous body(n=1).The volume of affected eyeball increased(n=1).The affected eyeball shrinked(n=1).The difference of volume of bilateral eyeball was not obvious(n=6). Lens were thick and dislocation(n=5).On MRI scanning,the lesions in the vitreous body showed iso T1 and iso T2 signal (n=6),short T1 and long T2 signal(n=1),long T1 and long T2 signal(n=1).The retina showed short T2 signal(n=3).The vitreous body was filled with lesions(n=5).The lesions looked like‘V’sticked to retina(n= 3).On ultrasonic examination low echo was showed in the vitreous body(n=6),the ball wall bulged(n=8),retinal detachment(n=8).The echo of the ball wall was obviously enhanced,which indica-ted ossification(n=1).Strong echo calcified plaque was showed in one case.FFA showed retinal telangiectasia(n=8),retinal capillary zone(n=2),mutiple chestnut shaped aneurysms(n= 6),retinal neovascularization(n= 1 ).Pathological examination showed retinal telangiectasia with foam macrophages and lipid deposition.Conclusion Coats’disease carries some typical CT and MRI features.To summarize the radiologic features,the findings of FFA and ultrasonic inspection are helpful to diagnosis.

Objective:Longitudinally extensive transverse myelitis (LETM) could be seen in patients with connective tissue disease (CTD), especially systemic lupus erythematosus (SLE) or primary Sj?gren′s syndrome (pSS). Some patients are combined with neuromyelitis optica spectrum disorders (NMOSD)(termed CTD-LETM-NMOSD) while others without (termed CTD-LETM-non-NMOSD). The aim of this study is to compare the clinical characteristics of CTD-LETM-NMOSD patients to CTD-LETM-non-NMOSD patients.Methods:We retrospectively collected data from 40 CTD patients with LETM who were admitted to the Department of Neurology or Rheumatology at Peking Union Medical College Hospital from Jan, 2006 to Dec, 2016. They were divided into CTD-LETM-NMOSD and CTD-LETM-non-NMOSD two groups. Demographic characteristics, clinical and laboratory features were obtained from the database. Relapse rates and clinical outcome were analyzed by Kaplan-Meier method.Results:Among 40 patients with CTD, 28 (70.0%) were NMOSD while 12 (30.0%) were not. The positivity rates of anti-SSA, antibodies to aquaporin-4 (anti-AQP4) were significantly higher in patients with NMOSD than those in patients with non-NMOSD ( P<0.05). Age, gender, clinical features, disease duration, anti-double-stranded DNA antibody, anti-ribosomal P antibody, antiphospholipid antibodies, expanded disability status scale (EDSS) scores, and magnetic resonance imaging (MRI) features were all comparable between two groups. CTD-NMOSD patients had significantly higher disease relapse rate (75.0% vs. 3/12, P<0.01). Conclusion:Anti-SSA and anti-AQP4 positivity is associated with NMOSD and higher relapse rates, which suggests that NMOSD in CTD-LETM patients may represent distinct characteristics and pathogenesis from patients with CTD-LETM-non NMOSD.

Objective: To investigate factors affecting X-ray structure of the spine in patients with ankylosing spondylitis (AS). Methods: A total of 206 AS patients were recruited. Clinical and laboratory parameters in AS patients were recorded in detail. Disease activity index [Bath ankylosing spondylitis disease activity index (BASDAI), ankylosing spondylitis disease activity score (ASDAScrp)], X-ray structural damage index-modified stoke ankylosing spondylitis spine score (mSASSS) and grading results of radiographic examination of sacroiliac joint were calculated. Statistical analysis using Statistical Package form Soci-science(SPSS) 17.0 Chi-square test, rank test, Logistics regression analysis and other statistical methods were used. Differences of mSASSS levels, spine involvement (mSASSS>0) and rates of bone bridge formation were compared between different groups. Results: Incidences of spine involvement (100%) and bone bridge formation(65.2%) in AS patients ≥40 years old were significantly higher than those in AS patients <40 years old (90.6%、31.9%)(χ²=4.651, P=0.031; χ²=16.647, P<0.01), and the level of mSASSS was also higher (Z=5.575, P<0.01). In AS patients with BMI ≥24 kg/m², disease duration ≥5 years (49.2%, 50.4%), rates of bone bridge formation was significantly higher than those in AS with BMI <24 kg/m², but the disease duration (34.5%, 19.7%)(χ²=4.014, P=0.045; χ²=18.173, P=0.03), and mSASSS values were significantly higher (Z=2.281, P=0.023, Z=4.828, P<0.01). Bone bridge formation rate in smoking patients (50.6%) was significantly higher than that in non-smoking patients (31.0%) (χ²=7.346, P=0.007) and mSASSS value was significantly higher (Z=2.045, P=0.041). Bone bridge formation rates in AS with high-ESR and high-CRP(48.6%, 49.0%) were significantly higher than those in patients with normal-ESR and normal-CRP(25.6%, 28.9%)(χ²=10.784, P=0.001; χ²=8.102, P=0.004) and mSASSS value was clearly higher(Z=2.379, P<0.01; Z=3.112, P<0.01). Bone bridge formation rate in AS with BASDAI≥4 or ASDAScrp≥2.1 groups (52.8%, 46.4%) were significantly higher than that in AS with BASDAI<4 or ASDAScrp<2.1 groups (34.2%, 30.7%) (χ²=5.681, P=0.017; χ²=4.646, P=0.031) and mSASSS values were significantly higher (Z=3.887, P<0.01; Z=3.895, P=0.004). Rates of bone bridge formation among different X-ray grading of sacroiliac joint (10.8%, 35.6%, 60.3%) and MRI findings (33.3%, 50.0%, 15.4%) differed with each other (χ²=25.714, P<0.01; χ²=6.855, P=0.032). Logistics regression analysis showed that BMI [OR(95%CI)=1.145(1.037, 1.265), P<0.01], disease duration [OR(95%CI)=1.144(1.055, 1.239), P<0.01], smoking [OR(95%CI)=2.832(1.343, 5.969), P<0.01] and sacroiliac joint X-ray staging [OR(95%CI)=2.584(1.337, 4.997), P<0.01] were risk factors for the bone bridge formation in spine of AS. Conclusion Spinal involvement in AS is related to disease activity. Bone bridge formation correlateswith disease duration, BMI and disease-status, especially with smoking.

Objective ToanalyzetheCTfeaturesandthediagnosticvalueofpulmonarychondroma.Methods Tencasesofpulmonary chondromaprovenbypathologywereretrospectivelyanalysed.Thenumber,location,size,shape,margin,calcificationpatternandCT valueofthelesions wereanalysedonnonGenhancedandenhanced CTscans.Results Allthe10casesofpulmonarychondroma showedsolitary,mildlylobulated,wellGcircumscribed masses.6lesionswerelocatedintherightlung,and4lesionswereintheleft lung.Thesizeofthelesionsrangedform1.3cm×0.8cmto10.7cm×9.8cm.OnplainCTimages,9lesions(90%)showedvaried calcification,withpunctatecalcificationin8lesionsandringcalcificationin1lesion.OncontrastGenhanced CTimages,6lesions showedslighthomogeneousenhancement(enhancedvalue≤14HU).Conclusion Pulmonarychondromaisusuallylocatedintheperiphery ofthelung.Thenodulehasasmoothboundary,withsignificantcalcificationandslightlyenhancement,whichcouldbehelpfulindiagnosis ofthedisease.

Objective To investigate the value of serum levels of peroxisome proliferater-activated receptor (PPAR)γin patients with rheumatoid arthritis (RA) and to explore the associations between serum PPARγwith disease activity of RA and RA-associated osteoporosis (OP).Methods One hundred and one cases of hospitalized patients with RA were enrolled.A total of 88 normal subjects during the same period were recruited as the control group.Levels of serum PPARγwere detected by enzyme linked immunosorbent assay (ELISA).Bone mineral density (BMD) was measured by dual energy X-ray absortiometry.All the clinical and laboratory indexes of RA patients were recorded in detail.T-test (or t'-test) was used for comparison of measurement data between the two groups,non-parametric test was applied for skewed distribution data.Comparison of incidence was analyzed with x2 test,correlation analysis was represented ascorrelation coefficient (r).Results Binary logistic regression analysis was used for multivariate regression analysis.Serum levels of PPARγ(3.38/4.00 ng/ml) in RA patients were higher than thosein normal subjects (2.63/1.76) ng/ml (Z=3.204,P=0.001).The positive rate of serum levels of PPARγin RA was 35.6％ (36/101),while the positive rate in the controls was (2.3％,2/88,x2=32.602,P＜0.01).The incidence of OP in RA was 34.7％(35/101;while the levels of serum PPARγ in RA without OP at femur area (femoral neck,total hip) and lumbar spine (L1,L1-4) were higher than that in RA with OP (P＜0.05).Serum levels of PPARγ between groups with different disease activity had no significant difference (P＞0.05).Serum levels of PPARγ in RA with negative RF or negative anti-CCP were higher than thosetin the RA group with positive RF or positive anti-CCP(P＜0.05).Serum levels of PPARγ in RA were negatively correlated with serum RF,anti-CCP,hemoglobin (P ＜0.05-0.001),and positively correlated with erythrocyte sedimentation rate,platelet,BMD at sites of femur neck andWard (P＜0.05-0.001).Results of binary logistic regression analysis showed that levels of serum PPARγwere protective factors in RA for OP at femurneck [OR=0.577,P=0.005,95％CI (0.394-0.846)],and total hip [OR=0.754,P=0.033,95％CI (0.581-0.978)].Condusion Serum levels of PPARγ in patients with RA are significantly increased,and negatively correlate with autoantibodies.Serum levels of PPARγare protective factors for OP in RA.

Objective To explore the value of patient global assessment (PGA) on evaluating disease activity in patients with axial spondyloarthritis (SpA),Methods A total of 222 patients with axial SpA were recruited.Scores of PGA,disease activity index [Bath ankylosing spondylitis disease activity index (BASDAI),ankylosing spondylitis disease activity score (ASDAS)crp] and spondyloarthritis research consortium of Canada (SPARCC) were calculated.Differences of PGA scores between different disease activity groups in axial SpA were compared and correlations between different disease activity index with PGA scores were analyzed.Statistical analyses were performed using Statistical Product and Service Solutions (SPSS) software (version 17.0).Comparison of frequency among different groups was performed by x2 test.Rank-sum test was used to compare the median of measurement data in different groups when the data were skewed in distribution.Cut-off value of PGA for assessing disease activity in axial SpA was calculated by ROC curve.Results Medians of PGA score in groups with BASDAI remission[3(1,4) vs 5(4,7)] and ASDAScrp remission [1(1,2) vs 4(2,5)] were lower than that in disease activity group (P＜0.01).BASDAI scores [1.80(1.20,2.90) vs 3.40(2.28,4.63) vs 5.15 (4.08,5.88)] and ASDAScrp scores [2.19(1.34,2.76) vs 2.86(2.08,3.54) vs 4.08(2.96,4.41)] were significant different among PGA groups (≤3,4-6 and ≥7) (P＜0.01).Differences of SPARCC scores [6.00(0,18.00) vs 7.50(3.75,18.00) vs 18.50(6.75,24.50)] were statistically significant among PGA groups (Z=7.427,P=0.037).Erythrocyte sedimentation rate (ESR) [12.00(5.00,23.00) mm/1 h vs 19.50(7.00,44.50) mm/1 h vs 18.00(7.75,54.75) mm/1 h],C-reactive protein (CRP) [7.85(2.37,22.49) mg/L vs 10.07(3.02,28.51) mg/L vs 21.28(7.14,37.74) mg/L] and Bath ankylosing spondylitis functional index (BASFI) [0.70(0.10,1.30) vs 2.25(0.60,3.30) vs 2.85(0.83,6.53)] were also different among PGA groups (P＜0.01,separately).Proportion of axial SpA patients in BASDAI disease activity group or ASDAScrp higher disease activity group were different among PGA groups (P＜0.01,separately),while represented as positive correlations (P＜0.01,separately).Correlation analyses revealed that PGA was positively correlated with ASDAScrp (r=0.694),BASDAI(r=0.616),SPARCC (r=0.271),ESR (r=0.288),CRP(r=0.215),occipital wall distance (r=0.196),finger-floor distance (r=0.385) and negatively correlated with Sschober's test (r=-0.195) (P＜0.05).Receiver operator characteristic (ROC) curve analysis found that PGA-BASDAI AUC was 0.813,the cut off value of PGA was 3.5 and PGA-ASDAScrp AUC was 0.860,the cut off value of PGA was 2.5.Conclusion PGA has good correlations with the disease activity indexes in axial SpA patients.It can also reflect the degree of inflammation in iconography.PGA may reflect disease activity especially when the value of PGA is around 3.

This experiment was divided into two parts:in vivo and in vitro.In the in vivo experi-ment,10 healthy and 10 ketotic cows were selected,and adipose tissues were collected.ELISA re-sults showed that malonaldehyde(MDA)content and reactive oxygen species(ROS)activity were higher in adipose tissues of cows with clinical ketotic compared with healthy cows,and glutathione peroxidase(GPP)activity was higher than that of cows with clinical ketotic.Western blot results showed that compared with the healthy group,adipose tissue of the ketotic group showed a signifi-cant increase in the expression level of TP53 induces glycolysis and apoptosis factors(TIGAR)protein,a significant up-regulation in the expression level of Nrf2-HMOX1 signaling pathway pro-tein,and a significant increase in the expression level of oxidative stress protein in adipose tissue of the ketotic group.The expression level of TIGAR protein was significantly up-regulated,the pro-tein level of Nrf2-HMOX1 signaling pathway was significantly up-regulated,and the protein levels of oxidative stress-related indexes SOD1,catalase(CAT)and glutathione S-transferase(GST)were significantly increased.It indicated that oxidative stress occurred in the adipose tissue of ketotic cows in vivo.In vitro experiments were carried out to detect the effect of TIGAR on oxida-tive stress in bovine adipocytes by adenoviral silencing or overexpression of TIGAR in isolated and cultured bovine primary adipocytes as well as by the addition of hydrogen peroxide in vitro for 2 h.The Western blot results showed that the hydrogen peroxide group showed enhanced oxidative stress compared with the control group,and the nuclear correlation factor 2 was significantly in-creased.correlation factor 2(Nrf2)pathway,decreased expression of Nrf2 and hemeoxygenase-1(HMOX1),and decreased expression of related oxidative stress proteins in the hydrogen peroxide group;compared with the hydrogen peroxide group,the protein expression levels of Nrf2-HMOX1 and related oxidative stress proteins were up-regulated in the group with overexpression of TIGAR and hydrogen peroxide,and the expression levels of related oxidative stress proteins were up-regu-lated in the group with overexpression of TIGAR and hydrogen peroxide.Expression level was up-regulated,and the expression of related oxidative stress proteins SOD1,CAT and GST increased.This indicates that overexpression of TIGAR alleviated hydrogen peroxide-induced oxidative stress in adipocytes.Protein expression of Nrf2-HMOX1 signaling pathway and oxidative stress-related proteins SOD1,CAT and GST were down-regulated in the silencing TIGAR plus hydrogen perox-ide group compared to the hydrogen peroxide group.It indicates that silencing TIGAR exacerbated the oxidative stress caused by hydrogen peroxide to adipocytes.

Objective To explore the serum levels of fibroblast growth factor 23 (FGF23) in patients with rheumatoid arthritis (RA) and to investigate the relationship between FGF23 and RA disease activity and the occurrence of osteoporosis (OP).Methods Serum levels of FGF23 from 174 cases of patients with RA and 88 normal subjects were detected by enzyme linked immunosorbent assay (ELISA).Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry.All the clinical and laboratory indexes of RA patients were recorded in details,disease activity score (DAS28) and health assess questionnaire (HAQ) were also calculated in the meantime.Radiographic changes in both hands of RA patients were assessed by Sharp's method.T test,nonparametric test,x2 test,correlation analysis and Logistic regressive analysis were used for statistical analysis.Results Serum levels of FGF3 [145.46(67.67,245.93) pg/ml] in RA patients were higher than the control group [32.64(12.34,44.70) pg/ml,Z=11.416,P＜0.01].The positive rate of serum levels of FGF23 (≥71.95 pg/ml) in RA was 74.7％(130/174),while the positive rate in control was 4.5％(4/88,x2=115.16,P＜0.01).The threshold of FGF23 serum levels for diagnosing RA was 48.56 pg/ml (AUC=0.932,Youden index=0.743,P＜0.01,sensitivity 89.1％,specificity 85.2％).In RA patients with serum FGF23 ≥48.56 pg/ml,compared with negative FGF23 group,VAS,HAQ,number of joint swelling and BMD at femoral neck,Ward,GT,Total hip,L4 and L1-4 were significantly higher in FGF23 positive group (P＜0.05).Linear correlation analysis found that in RA patients with serum FGF23 ≥48.56 pg/ml,anti-CCP was negatively correlated with serum FGF23 levels (r=-0.171,P=0.035).And DAS28 was positively correlated with serum FGF23 (r=0.163,P=0.045).BMD at femoral neck,Ward,GT,Total hip,L4 and L1-4 were negatively correlated with serum FGF23 (P＜0.05).Results of logistic regression analysis showed that sex (OR=8.518,95％CI (2.636,27.522),P＜0.01,age [OR=1.129,95％CI (1.079,1.180),P＜0.01] and Sharp score [OR=1.008,95％CI(1.003,1.013),P=0.001]were risk factors for OP in RA patients.BMI[OR=0.801,95％CI(0.707,0.909),P=0.001] was a protective factor for OP in RA patients.Conclusion Serum FGF23 level is significantly higher in RA patients.Meanwhile,the serum FGF23 level correlates with RA disease activity and BMD.

Objective To explore the changes of serum vitamin D binding protein (VDBP) levels in patients with rheumatoid arthritis (RA) and the clinical significance of association between serum VDBP with secondary osteoporosis (OP) in RA.Methods One hundred and sixty patients with RA were enrolled in the study.Eighty-three normal subjects were recruited as the control group.The concentration of serum VDBP was determined by enzyme-linked immuno sorbent assay (ELISA),and bone mineral density (BMD) was measured by dual energy X-ray absorptiometry.Clinical and laboratory indexes of RA patients were recorded in detail and disease activity (DAS28) score,health assessment questionnaire (HAQ) and Sharp score according to X-ray examination of both hands were calculated simultaneously.The t test was used to compare the metrological data between the two groups,and the x2 test was used to compare the intergroup rate.The correlation analysis was tested by Pearson correlation analysis,the ROC curve was used to analyze the threshold of the serum VDBP,and the multivariate logistic regression analysis was used for multivariate analysis.Results ① Serum levels of VDBP in RA patients were higher than that in control group [(414±12) ng/ml vs (79±12) ng/ml,t=20.082,P＜0.01].Positive rate of serum levels of VDBP was 67.0％(118/176) in RA patients,which was higher than that in the control group (4.8％)(x2 =87.651,P＜0.01).② The threshold of serum VDBP levels for diagnosing RA was 193.74 ng/ml (AUC=0.943,Youden index=0.796,P＜0.01).③ DAS28 sore in group with positive VDBP was significantly higher than that in group with negative VDBP (P9=0.025).There was significant difference regarding on the incidence of OP in female RA patients between groups with positive and negative VDBP [41.9％(54/129) vs 31.8％(14/44),x2=4.325,P=0.038].④ Linear correlation analysis found that DAS28in RA patients was positively correlated with serum VDBP levels (r=0.252,P=0.019).And anti-CCP was negatively correlated with serum VDBP levels (r=-0.150,P=0.049).⑤ Results of logistic regression analysis showed that sex [OR=9.841,95％CI (1.349,71.810),P=0.024],age [OR=1.154,95 ％CI (1.069,1.245),P＜0.01] and Sharp score [OR=1.102,95％CI (1.002,1.021),P=0.018] were risk factors for OP in RA patients.Conclusion Serum VDBP levels are significantly higher in patients with RA.Meanwhile,serum VDBP levels are correlated with disease activity and secondary OP in RA.