Objective To study the role of transforming growth factor-?1(TGF-?1) and bone morphogenetic protein 2 (BMP2) in the ankylosing spondylitis, and to evaluate whether synovial levels of TGF-?1/ BMP2 mRNA and TGF-?1/BMP2 protein expression correlate with disease activity and macroscopic observation during arthroscopy. Metheds TGF-?1/BMP2 mRNA and protein were detected by in situ hybridization and immunohistochemistry.The vascular morphology of synovial membrane was assessed for vascular morphology, tortuous vessels, straight vessels, vascular density, synovial hypertrophy, by 2 blinded observers and Reece's method using a validated VAS methods. They were significantly higher in AS than that in RA in different synovial regions. Results TGF-?1 mRNA and TGF-?1 expression were significantly higher in early AS than that in early RA in perivascular region and sublining interstitial tissue. BMP2 mRNA and BMP2 expression were significantly higher in AS than that in RA in different synovial regions.No significant relation was found between TGF-?1/BMP2 expression and CRP/ESR/platelet count in early AS. A positive relation was found between the TGF-?1 and synovial hypertrophy in synovium lining layer region, and between TGF-?1 and straight vessels,vascular density in perivascular region, and between BMP2 and synovial hypertrophy in sublining region in early AS. Conclusion Expression of TGF-?1 mRNA and TGF-?1 protein is higher in AS synovial tissue than that in RA. BMP2 mRNA and BMP2 expression are significantly higher in AS than that in RA.

The functional experimental teaching reform plays a very important role in raising the teaching resources,consummating the experimental teaching management system,enhancing the student to practice the ability and so on and has obtained the good effect.But it also faces some problems waiting urgently to be solved and further perfected,to which this article has made the analysis and the discussion from the management science angle.The goal lies in deepening the educational reform in functional experiment unceasingly to provide the model.

Objective To analyze the clinical characteristics of amyopathic dermatomyositis (ADM).Methods Twenty six patients diagnosed as ADM from January 2006 to January 2010 in PLA General Hospital were retrospectively analyzed.The clinical manifestation,laboratory findings,imaging manifestations,treatment and prognosis of the 26 patients were recorded.Results There were 18 females and 8 males with age of 30-68 years.Overall disease course after diagnosis was 2-18 months.All patients had Gottron rash and interstitial pneumonia.Fifteen patients had history of pulmonary infections.Three patients had comorbidity of tumor.Creatine phosphokinase,creatine phosphokinase isoenzyme,glutamicoxaloacetic transaminase and lactate dehydrogenase were normal in all 26 patients.Four patients had positive anti-Jo-1 antibodies.Antinuclear antibodies were positive in nine patients.Electromyogram was slightly abnormal in 5 patients.Muscle biopsy was abnormal in 19 patients.Twenty patients had improved after receiving corticosteroids and immunosuppressive agents.Six patients died.Conclusions It has been estimated that ADM represents approximately 20％ of all cases of dermatomyositis.It seems that patients with ADM have greater incidence of lung involvement and combined cancer.ADM patients need to be treated positively to improve the prognosis.

Objective To investigate spinemagnetic resonance imaging(MRI) findings in patients with axial spondyloarthritis (SpA) and to analyze the correlation between imaging and clinical manifestation.Methods The clinical data of patients with axial SpA were recorded.All patients underwent whole spine MRI scanning.The MRI findings of spinal involvement were explored.Moreover,the correlation between lesions in spinal MRI and Bath Ankylosing Spondylitis Disease Activity Index(BASDAI),Bath Ankylosing Spondylitis Functional Index (BASFI),Bath Ankylosing Spondylitis Metrology Index (BASMI),nocturnal pain visual analogue scale (VAS) score,back pain VAS score,global disease activity VAS score,Ankylosing Spondylitis Disease Activity score (ASDAS),erythrocyte sedimentation rate,C-reactive protein was analyzed.Results Thirty-three patients with axial SpA were included in this study.The image abnormalities of the spine were confirmed in 29 axial SpA patients by MRI,including Romanus lesion,Andersson lesion,the inflammation of facet joints and syndesmophyte.In correlation study,BASMI was positively correlated to the numbers of acute Romanus lesions,chronic Romanus lesions,chronic Andersson lesions and whole spinal lesions(r =0.440,P＜0.05; r =0.483,P＜0.05; r=0.421,P＜0.05; r=0.589,P ＜ 0.05 respectively).There was a statistically significant correlation between chronic Andersson lesions and BASFI(r =0.392,P ＜0.05).But no significant associations were found between MRI lesions and other clinical findings.Conclusions MRI lesions in axial SpA were associated with findings reflecting the spinal function,which can better guide the clinical treatment.

Objective To improve the understanding of severe anaphylactic reactions to infliximab retreatment. Methods Delayed hypersensitivity to infliximab in two patients with ankylosing spondylitis who had previously received infliximab and resumed after discontinuation over 4 years were reported and the related literatures were reviewed. Results Two patients ( 1 male, 1 female ) who were diagnosised with ankylosing spondylitis for more than 10 years, both individuals had received infliximab treatment during a clinical trial approximately 4-5 years prior to further therapy. On day 6 after subsequent infusion, one patient had pruritic skin rash covering her whole body, followed by flustered, dyspnea, hypotension and anaphylactic shock, she was successfully treated with epinephrine and glucocorticoid. Another patient experienced a skin rash and itching 9 days after reinfusion, he was successfully treated with antihistaminics.Conclusion A distant infliximab retreatment is associated with high rates of reinfusion reactions, including fever, urticaria, myalgia, arthralgia,even hypotension, dyspnea, laryngeal edema and anaphylactic shock.We recommend careful monitoring of those patients who receive infliximab retreatment, particularly after a lengthy interval.

20% improvement in 4/7 primary indices.Sharp declines in several parameters were noticed during 3 to 6 months.Pain in 9 patients disappeared.There was also a statistically significant decrease in TNF ? transcripts in the PBMC.Conclusion Thalidomide is a reasonably promising drug for treating resistant ankylosing spondylitis and its biological mechanism is related to the gene expression suppression of proinflammatory cytokine TNF ?.

Objective To study the clinical features of sacroiliitis and differential diagnosis.Methods Totally 509 patients with chief complaints of back pain and diagnosed as sacroiliitis from January 2007 to January in Chinese PLA General Hospital were enrolled.The clinical manifestations,laboratory examinations,imaging and pathological data of the 509 patients were retrospectively analyzed.Results There were totally 406 male patients and 103 female patients.Among all 509 patients,436 were diagnosed as ankylosing spondylitis (AS)/ spondyloarthropathy (SpA),including 385 men.Thirty-six cases were diagnosed as sclerosing osteitis.Ten cases were diagnosed as sacroiliac joint degeneration.Ten cases were diagnosed as pyogenic sacroiliitis or sacroiliac joint tuberculosis.Four cases were diagnosed as diffuse idiopathic bone hypertrophy.Four cases were diagnosed as palmoplantar pustulosis arthritis.Four cases were diagnosed as metabolic bone disease.One case was diagnosed as sacroiliac joint gout.Four cases were diagnosed as neoplastic disease.HLA-B27 positive rate was 86.9％ in AS/SpA.Erythrocyte sedimentation rate and C-reactive protein were increased mildly-to-moderately in AS/SpA patients.Erythrocyte sedimentation rate and C-reactive protein increased obviously in sacroiliac joint infection and tumor diseases.Imaging characteristics were sacroiliac joint bone destruction.Magnetic resonance imaging showed sacroiliac joint bone marrow edema,but range was not beyond anatomical structure in AS/SpA.Conclusions Based on disease distribution of sacroiliitis,AS/SpA is predominant while non-ankylosing spondylitis is not uncommon.Differential diagnoses of sacroiliitis should be considered to avoid malpractice,especially in patients with negative HLA-B27.

Objective To evaluate the specificity and limitations of sacroiliac joint magnetic resonance imaging (MRI) in the diagnosis of axial spondyloarthritis (SpA)in patients with chronic low back pain.Methods We retrospectively analyzed clinical data of 390 patients with chronic low back pain in Department of Rheumatology,the PLA General Hospital from January 2013 to December 2015,including clinical manifestations,laboratory examinations and MRI data of sacroiliac joints.Results There were 238 men and 152 women recruited.A total of 326 cases were diagnosed as axial SpA,including 216 men and 110 women with mean age (27.10 ± 8.64) years and mean duration (7.64 ± 3.50) months.Among these 326 patients,243 (74.5％) were HLA-B27 positive.The other 64 patients were considered as diagnoses rather than SpA (non-SpA),consisting of 22 men and 42 women with mean age (31.29 ± 7.76) years and mean duration (5.75 ±2.90)months.Non-SpA group had 10 (15.6％) patients with HLA-B27 positive.There were 68.1％ and 65.0％ SpA patients showing bone marrow edema and bone erosion of sacroiliac joint in MRI imaging respectively.Although there were 25.0％ non-SpA patients with bone marrow edema and 7.8 ％ with bone erosion in MRI of sacroiliac joint,the scores of bone marrow edema 0.00 (0.00,0.75) and bone erosion [0.00(0.00,0.00)] were significantly lower compared with those in axial SpA group [bone marrow edema scores 2.00 (0.00,4.00),bone erosion scores 1.00 (0.00,3.00);P ＜ 0.05].The scores of fat infiltration [1.00 (0.00,4.25),1.00 (0.00,4.00)] and bone sclerosis [0.00 (0.00,1.00),0.00(0.00,1.75)] were not statistically different between two groups.Diagnostic sensitivity of bone marrow edema and bone erosion for axial SpA were 56.4％ and 64.1％ respectively,specificity were 93.8％ and 92.2％ respectively.The positive predictive value of bone marrow edema and bone erosion for axial SpA were 9.09 and 8.21,negative predictive value were 0.46 and 0.38.Diagnositic sensitivity of fatty infiltration and bone sclerosis for axial SpA group were 29.1％ and 57.7％,specificity were 64.1％ and 46.9％.The positive predictive value of fatty infiltration and bone sclerosis for axial SpA were 0.81 and 1.08,negative predictive valne were 1.10 and 0.90.Conclusion Sacroiliac joint MRI is a valuable method to diagnose axial SpA in patients with chronic low back pain.Yet it still has some limitations.Clinical presentations and spinal MRI would be helpful in some patients.

Objective The aim of this study was to generate human cholesteryl ester transfer protein ( CETP) transgenic rabbits and analyze their biological properties.Methods We generated human CETP transgenic rabbits by DNA microinjection, and detected the expression of human CETP by real-time PCR and Western blot assay.The activity of CETP was measured using an activity assay kit.Results Human CETP transgenic rabbits were successfully generated by DNA microinjection.Compared with wide type rabbits, the expression of human CETP was dramatically increased in the liver of the human CETP transgenic rabbits.The plasma CETP activity was also much higher in the liver of human CETP transgenic rabbits than that of control rabbits.Conclusions The model of human CETP transgenic rabbits is successfully established by DNA microinjection.It will provide a useful tool for the studies of CETP biological function and its involvement in the mechanisms of cardiovascular diseases.

Base on the clinical characteristics of septic arthritis in a group of systemic lupus erythematosus patients,this study has found out that high systemic lupus erythematosus disease activity index,leucopenia,high cumulative dose of glucocorticoid,methylprednisolone intravenous pulse therapy and joint cavity puncture were closely correlated with septic arthritis.Once septic arthritis is suspected,culture specimens should be collected and appropriate antibiotics are suggested immediately.Also,surgical drainage is a very useful approach.