Ankylosing spondylitis (AS) is a systemic disease, which mainly causes to axial joint chronic inflammation. Spine, thoracic and peripheral joints may have varying degrees of activity limitation, and somatic activity is also likely to decline. Ankylosis of the spine and movement disorder of hip are the mainly causes of AS patients' disability, which not only affect the patients' motor function, and but also affect their social interaction, role affordability, mental state and daily living skills. Exercise therapy is the treatment unarmed or with equipment, for injuries, disease, residual patients, to restore or improve dysfunction. There are a number of studies about exercise therapy for joint function of patients with AS, confirmed that exercise therapy plays a crucial role in the treatment of AS patients, on the basis of the medications control.

Objective In this study,we elucidated the role of high mobility group box chromosomal protein 1 (HMGB1) in collagen-induced arthritis (CIA) rat and the antagonist role of ethyl pyruvate by using a rat model of CIA as the research object by comparing the expression of HMGB1 in normal control group,CIA model group and ethyl pyruvate group.Methods Thirty-six rats were randomly divided into 3 groups (n=12):normal control group,CIA group and ethyl pyruvate group.Then the 6 rats were dissected at the 6th,9th week respectively.Thc expression of HMGB1 was analyzed by immunohistochemistry and Pathology-image analysis software in the cytoplasma.The expression of HMGB1 mRNA with real time-polymerse chain reaction (PCR) was evaluate,and the HMGB1 expression of each group were compared with t-test.Results The immunohistochemical results of HMGB1 showed that the expression intensity in the normal control group,CIA model group and ethyl pyruvate group was 2.1±0.6,7.3±1.2,6.0±1.2 respectively at the 6th week; and 2.2±0.7,12.4±4.5,5.5±1.0 at the 9th week respectively.The HMGB1 mRNA real time-PCR results had shown that the relative quantification of the normal control group and CIA model group were 1,2.865,2.602respectively at the 6th week and 1.005,4.694,1.729 at the 9th week.At those two points, the HMGB1 expressions of HMGB1 antagonist group were significantly higher than those of the normal controls (P＜0.05).In addition,there was statistical significant difference(P＜0.05) in the HMGB1 expression when compared with the placebo group.Furthermore, when the degree of HMGB1 expression among the three groups was compared,the HMGB1 antagonist group was decreased significantly (P＜0.05).Conclusion The results has demonstrated that HMGB1 could induce inflammation in the synovial tissue of CIA rats,and has provided the rationale that HMBG 1 could be the target of treating rheumatoid arthritis (RA).The results of this study have shown that ethyl pyruvate could antagonize the effect of HMGB1.This finding may provide a new therapeutic target for the treatment of RA.

Objective To compare the significance of DNA-associated autoantibodies to cell membrane(cmDNA)in systemic lupus erythematosus(SLE)detected with indirect immunofluorescence on human B lymphoma cell line Raji and pmmyelocytic line HL60.Methods Indirect immunofluorescence assay both on cell line Raji and HL60 was used to measure anti-cmDNA antibodies in sera of 306 SLE patients.192 patients with other rheumatic diseases and 50 healthy controls.Results Indirect immunofluorescence assay on cell line Raji was used to measure anti-cmDNA antibodies.72.5% SLE and 10.4% other rheumatic diseases were positive for anti-cmDNA,but negative in 50 blood donors(P<0.01).Indirect immunofluorescence assay on cell line HL60 was used to measure anti-cmDNA antibodies,76.1% SLE and 16.7% other rheumatic diseases were positive for anti-cmDNA,but negative in 50 blood donors(P<0.01).The sensitivity of anti-cmDNA were 72.5%and 76.1%,respectively.The specificity of anti-cmDNA was 91.7% and 86.8%,respectively.There was no significant difference in sensitivity and spocificity(P>0.05).The methods of culture,freeze and resuscitation on the two cells were similar.but cell line Raji was easier to resuscitate than cell line HL60.Observing with fluorescence microscope.we find that cmDNA was expressed on the both cells and the staining was stronger on cellline Raji than HL60.Conclusion Anti-cmDNA antibody has high positivity which is one of the most valuable marker in the diagnosis of SLE.We recommend to measure anti-cmDNA antibodies with indirect immunofluorescence assay on cell line Raji rather than HL60.

ObjectiveTo compare the significance of anti-cmDNA antibody in systemic lupus erythematosus (SLE) patients detected with IIF on human's B lymphoma cell line Raji and promyelocytic line HL60.The diagnostic value of anti-cmDNA antibody in SLE was also explored.MethodsThree hundred and six patients with SLE were included in this study.As control groups,we included 192 patients with other rheumatic diseases and 50 healthy controls.The testing method for anti-cmDNA antibody was set up.The assessment of the significance of anti-cmDNA antibody in SLE detected with IIF on cell line Raji and HL60 was carried out andthe diagnostic value of anti-cmDNA antibody in SLE was investigated.ANA and antidsDNA antibody were measured by IIF at the same time.Anti-Sm was measured by immuno-diffusion andWestern blotting.AnuA was tested by enzyme linked immunosorbent assay.The statistical methods used in this study including McNemar X2 test,Spearman related test and Logistic regression analysis.Results The fluorescence brightness of Raji cell line was stronger than HL60 cell line.There was no statistically significant difference in the sensitivity and specificity of anti-cmDNA antibody in SLE detected with IIF with Raji or HL60 cell lines (P＞0.05).The sensitivity of anti-cmDNA antibody detected with IIF on Raji cell line was higher than anti-dsDNA antibody and anti-Sm antibody(P＜0.01),while the specificity of anti-cmDNA antibody was similar to anti-dsDNA antibody (P＞0.05) and was lower than anti-Sin antibody (P＜0.01).The sensitivity of anti-cmDNA antibody was similar to AnuA(P＞0.05) and the specificity was lower than AnuA (P＜0.01).The sensitivity of ANA was higher than anti-cmDNA antibody (P＜0.01) and the specificity was much lower than anti-cmDNA antibody(P＜0.01).The sensitivities of anti-dsDNA antibody,anti-Sm antibody and AnuA were much higher when combined with anti-dsDNA antibody than any one antibody only (P＜0.05).Anti-cmDNA antibody was correlated with mucosa ulcer in SLE patients(OR=2.343,P=0.029).The ESR of SLE patients was also correlated with anti-cmDNA antibody(OR=l.031,P=0.012).Anti-cmDNA antibody was not correlated with SLEDAI (r=0.070,P=0.600).ConclusionRaji cell line is better than HL60 cell line in detecting anti-cmDNA antibody with IIF.Anti-cmDNA antibody has higher sensitivity and specificity in SLE.Combined detection of anti-cmDNA antibody and other autoantibodies can further improve the diagnostic accuracy of SLE.

Objective To assess the diagnostic value of anti-mutated citrullinated vimentin antibodies (anti-MCV) for rheumatoid arthritis (RA), and compare it with anti-cyclic citrullinated peptide antibodies (anti-CCP), rheumatoid factors (RF). Methods Commercially available enzyme-linked immunosorbent assay (ELISA) kit was used to detect anti-MCV antibodies in a group of 177 RA patients, 46 patients with other rheumatic diseases, and 48 healthy blood donors. At the same time, anti-CCP, RF were detected. T test and χ2 test were selected. Results The average concentration of anti-MCV was (523±376) U/ml in RA, (96± 55) U/ml in patients with other rheumatic diseases, (34±18) U/ml in healthy controls. Different threshold levels (20, 40, 60, 80, 100, 120, 140 U/ml) for positive results were calculated bythe areas under the ROC curve (the areas were 0.521, 0.706, 0.769, 0.791, 0.816, 0.826, 0.822), then the best diagnosis efficacy for RA was determined as more than 120 U/ml. At this level, the sensitivity and the specificity for anti-MCV were 80.1% and 80.9% for RA diagnosis. The positive and negative predictive value were 92% and 67.8%. Comparing with anti-CCP, anti-MCV showed comparable specificity but higher sensitivity. And it's also better than RF apparently. If all 3 antibodies were detected at the same time, or anti-MCV combine with one of them, the sensitivity would increase to 95.7%. In addition, Anti-MCV showed positive in 32 of 67(55.2%) patients with RA whose anti-CCP was negative, meanwhile 31 of 59 (52.5%) patients with RA whose RF was negative. Conclusion RF and anti-CCP are complementary in diagnosing RA. The combination detection of RF and anti-CCP could significantly improve the specificity for the diagnosis of RA.

Objective To describe CT manifestations of intrahepatic spontaneous portosystemic shunts(ISPS) of cirrhosis.Methods Spiral CT(SCT) scans and related clinical findings of 15 cirrhotic patients with ISPS were retrospectively reviewed.Results Three kinds of ISPS were showed :①Right posterior portal vein type was in 12 cases and showed tortuous intrahepatic tubular structures which were all in the posterior segment of the right lobe connecting the right posterior portal vein to the inferior vena cava(IVC) in the suprarenal region in all cases.②Hepatic venous type was in 2 cases,the portal vein communication with the hepatic vein in the liver.③Apex type was in 1 case,the vein arose from the apex of the liver and drains into the internal thoracic vein.Blood ammonia levels were elevated in all cases and symptoms associated with hepatic encephalopahty were present in 2 cases.Conclusion To deeply understand the ISPS,it is of benefit for differential diagnosis of focal hepatic lesions.

Objective To retrospectively evaluate the safety ,technical success rate and long‐term efficacy of the hepatic mul‐tiple cavernous hemangioma with super selective arterial cheoembolization .Methods 6 cases multiple hepatic cavernous hemangio‐ma by clinical diagnosed between 2004-2011 years in our hospital ,Through arterial super selective and completely filling cheoem‐bolization by Pingyang mycin lipiodol emulsion(PYM‐Lip) ,To assess the long‐term efficacy .by multi slice spiral CT enhanced scan‐ning and carry on relevant statistics processing in postoperative 6 ,12 ,36months .Results 26 lesions were embolismed in 6 cases multiple hepatic cavernous hemangioma ,Among the number of successful embolization were 15 of 1 cases ,2 of 4 cases ,3 of 1 cases , respectively .26 lesions was decreased with different degrees ,which the diameter of lesions were reduced with embolismed by CT enhanced scanning in postoperative 6 ,12 ,36months and diameter reduced> 50% ,diameter reduced≤50% ,lesions disappear was 38% (10/26) ,54% (14/26) ,8% (2/26) ,62% (16/26) ,23% (6/26) ,15% (4/26) ,69% (18/26) ,12% (3/26) ,19% (5/26) .Technical operation success rate 100% ,not serious complications occurred .There are statistically significant differences in the size of lesions before and after operation(P<0 .01) .Conclusion The technique success rate was high ,minimally invasive ,the complications was less ,the curative efficacy was obvious by transcatheter arterial super selective cheoembolizaton with hepatic multiple cavernous he ‐mangioma .

Objective To investigate the related factors of nosocomial infection after severe thoracic trauma so as to provide basis and interventions for lowering nosocomial infection rate.Methods A retrospective case series study was conducted in 148 cases of severe thoracic trauma surgically treated from January 2014 to January 2016.There were 98 males and 50 females with an average age of 34.7 years.The abbreviated injury scale (AIS) was ≥ 3 points.The incidence of nosocomial infection was statistically analyzed.The possible factors related to nosocomial infection were analyzed,including age,gender,previous basic diseases,coma,blood transplantation,surgical procedure,operation time,tracheal intubation time,postoperative tracheotomy,and postoperative ICU hospitalization.Results Nosocomial infection occurred in 18 cases,with infection rate of 12.2％.There were 11 cases of pulmonary infection,four urinary tract infection,two incision infection,and one thoracic cavity infection.There were four cases (22％) of Gram-positive bacteria as pathogen,both of which were Staphylococcus aureus.A total of 12 cases (67％) were Gram-negative bacteria,among which four were infected with Klebsiella pneumonia,three with Acinetobacter baumannii,three with Pseudomonas aeruginosa,and two with Escherichia coli.Two cases were infected by fungi.The incidence of infection was correlated with the patients' age (≥ 60 years),previous basic disease,coma,operation methods,operation time (≥3 hours),endotracheal intubation time (≥24 hours),tracheotomy after surgery,and postoperative hospitalization duration in the ICU (P ＜ 0.05),rather than gender and blood transplantation.Conclusions The most common pathogen of nosocomial infection in severe thoracic trauma patients is Gram-negative bacteria.The older age,previous basic diseases,coma,thoracotomy,long operation time,long tracheal intubation time,tracheotomy and long ICU hospital stay are the risk factors for nosocomial infection.More attention should be paid to these risk factors in order to minimize the occurrence of postoperative hospital infection,and to reduce the harm to patients.

There have been different views over the resection extent of hilar cholangiocarcinoma worldwide.In this review,we will describe expert-views on the resection extent of hepatic tissue,as well as the hilar vascular resection and reconstruction.We hope this article will be helpful to the optimal operation of hilar cholangiocarcinoma.

Objective To investigate the abnormal region of gray matter and its' structural changes closely related to mild cognitive impairment in patients with Parkinson's disease (PD) using voxel-based morphometry(VBM) method.Methods Thirty-seven clinically defined PD patients and 20 normal controls (NC),collected in our hospital from March 2011 to February 2013,were examined using T1WI three-dimensional brain volume sequence (3D-fast spoiled gradient echo,3D-FSPGR).We classified PD patients into 2 subgroups according to the extent of cognitive impairment:20 patients with mild cognitive impairment (MCI) and 17 patients with none mild cognitive impairment (nMCI).The data of three groups were analyzed using VBM based on SPM5 to generate gray matter map.Results As compared with NC group,PD patients showed extensively decreased gray matter volume,involving bilateral frontal,temporal,occipital and parietal lobes,insular,parahippocampal gyrus,amygdale and right uncus.As compared with PD-nMCI patients,decreased gray matter volume in PD-MCI patients was observed in bilateral midfrontal gyrus,inferior frontal gyrus,bilateral insular,left precentral gyrus,left superior temporal gyrus and right midtemporal gyrus.Conclusions Areas of decreased gray volume in PD patients locate in widespread brain regions involving limbic system and neocortex.Gray matter atrophy in bilateral midfrontal gyrus,inferior frontal gyrus,insular and left precentral gyrus is related to the mild cognitive impairment.