Objective To investigate features of skin lesions of patients with systemic sclerosis (SSc),and to analyze the relationship of skin manifestations with clinical classification,autoantibodies and internal organ involvement.Methods Clinical data were collected from 120 patients with SSc in Department of Dermatology of Zhongshan Hospital Affiliated to Fudan University and Department of Scleroderma of Shanghai TCM-integrated Hospital between 2012 and 2014,and analyzed retrospectively.Results Among the 120 patients with SSc,118 (98.3％) had Raynaud's phenomenon,116 (96.7％) had skin sclerosis,including 101 (84.2％) with sclerosis of skin over the dorsum of fingers,90 (75％) had swollen skin,including 84 (70％)with swollen fingers,77 (64.2％) had poikiloderma,75 (62.5％) had thinned lip,74 (61.7％) had telangiectasia,63 (52.5％) had radial furrowing around the mouth,57 (47.5％) had mask-like face,49 (40.8％) had hyperplasia of nail cuticle,35 (29.2％) had petechiae of the nailfolds,25 (20.8％) had depressed fingertip,24 (20.0％) had atrophy of the finger pulp,24 (20.0％) had distal finger shortening,and 15 (12.5％) had fingertip ulcer.Anti-Scl-70 antibody and anti-centromere antibody (ACA) were positive in 42 (35.0％) and 31 (25.8％) patients respectively.The incidence of swollen fingers,fingertip ulcer,atrophy of the finger pulp was significantly higher in the anti-Scl-70 antibodypositive group than in the-negative group(P ＜ 0.05),and the incidence of sclerosis of skin over the dorsum of fingers,poikiloderma,fingertip ulcer and atrophy of the finger pulp was all significantly higher in the antiScl-70 antibody-positive group than in the ACA-positive group (P ＜ 0.05).The main internal organ involvement included interstitial lung disease (50％,44/88),cardiac involvement (47.8％,55/115),pulmonary arterial hypertension (35.7％,41/115),esophageal involvement (28.3％,34/120) and kidney involvement (9.2％,11/120).Patients with diffuse cutaneous systemic sclerosis (dcSSc) showed significantly higher incidence of cardiac involvement and poikiloderma compared with those with limited cutaneous systemic sclerosis (lcSSc) (P ＜ 0.01).Swollen fingers,sclerosis of skin over the dorsum of fingers,poikiloderma,telangiectasia,lip thinning,and radial furrowing around the mouth most commonly occurred in patients with early SSc,and swollen fingers and sclerosis of skin over the dorsum of fingers were highly correlated with the occurrence of pulmonary arterial hypertension.Telangiectasia,depressed fingertip and fingertip ulcer were significantly correlated with the occurrence of interstitial lung disease,and atrophy of the finger pulp was significantly correlated with the occurrence of cardiac involvement (both P ＜ 0.05).Conclusions Raynaud's phenomenon,swollen fingers,sclerosis of skin over the dorsum of fingers,poikiloderma,telangiectasia,lip thinning and radial furrowing around the mouth can be helpful for the early diagnosis of SSc.Pulmonary arterial hypertension commonly occurs in the early stage of SSc.Depressed fingertip and fingertip ulcer indicate the occurrence of interstitial lung disease,and the atrophy of the finger pulp indicates cardiac involvement.

Objective To investigate clinical characteristics of systemic sclerosis (SSc),and to explore the correlation between visceral involvement and autoantibodies.Methods Clinical data,laboratory examination and auxiliary examination findings were collected from 63 patients with SSc in the Department of Dermatology of Zhongshan Hospital affiliated to Fudan University between 2012 and 2015,and the correlation of autoantibodies with visceral involvement and clinical phenotypes was analyzed.Results The 63 patients with SSc included 29 with diffuse SSc,29 with limited SSc and 5 with overlapsyndrome.Of the 63 patients,30 had pulmonary interstitial fibrosis,32 had lung function impairment which manifested as reduced diffusing capacity for carbon monoxide,and 12 had increased pulmonary arterial pressure.Among 29 patients with anti-DNA topoisomerase Ⅰ (SCL-70) antibody,19 (65.52％) had pulmonary interstitial fibrosis,while 11 (32.35％) of 34 patients without anti-SCL-70 antibody had pulmonary interstitial fibrosis.Pulmonary interstitial fibrosis also occurred in 13 (68.42％) of 19 patients with anti-Sjogren's syndrome antigen A (SSA) antibody,as well as in 17 (38.64％) of 44 patients without anti-SSA antibody.The incidence of pulmonary interstitial fibrosis was significantly higher in the patients with anti-SCL-70 or anti-SSA antibody than in the patients without anti-SCL-70 or anti-SSA antibody respectively (x2 =6.901,4.720,respectively,both P ＜ 0.05).Among the 63 patients,22 had fingertip ulcers,and 16 (72.73％) of the 22 patients had pulmonary interstitial fibrosis,while 14 (34.15％) of 41 patients without fingertip ulcers had pulmonary interstitial fibrosis,and the incidence of pulmonary interstitial fibrosis significantly differed between the two groups (x2 =8.544,P ＜ 0.01).Of the 63 patients,50 (79.40％) initially presented with Raynaud's phenomenon,and the average duration between the occurrence of Raynaud's phenomenon and the diagnosis of SSc was 48.3 months.Conclusions Patients with SSc usually present with a high incidence of pulmonary interstitial fibrosis,which is complicated by lung function impairment and pulmonary hypertension.Raynaud's phenomenon usually occurs as the initial symptom.There is a high incidence of pulmonary interstitial fibrosis in the patients with fingertip ulcers and anti-SCL-70 and anti-SSA antibodies.

Objective To investigate the changes of electrocardiogram in elderly patients with acute cerebral ischemic infarction (CIS),and to analyze the relationship between the electrocardiogram and the prognosis of the patients.Methods 132 elderly patients with acute CIS in the hospital from January 2013 to December 2016 were enrolled.12 lead electrocardiogram was performed within 48 hours after onset and 7 days after onset,and the relationship between electrocardiogram abnormality and infarct type,severity,and prognosis were analyzed.The independent predictors of poor prognosis based on improved Rankin's score at discharge were evaluated.Results 83 cases (62.88％) had abnormal electrocardiogram.The main type of abnormal electrocardiogram was S-T segment abnormalities,followed by arrhythmia.The severity of illness in patients with abnormal electrocardiogram were significantly more serious than in those who did not detect abnormal electrocardiogram (P ＜ 0.05).The severity of illness in patients detected abnormal electrocardiogram over 2 times were significantly more serious than in those who detected abnormal electrocardiogram only within 48 hours after onset or 7 days after onset (P ＜ 0.05).Shorter time from onset to admission,complete anterior circulation infarction according to Oxfordshire Community Stroke Project (OCSP)classification,abnormal electrocardiogram (＞ 2 times) were independent risk factors for poor prognosis at discharge (P ＜ 0.05).Conclusions Electrocardiogram abnormity is common in elderly patients with CIS,and abnormal electrocardiogram detected over 2 times may indicate poor prognosis,which will benefit for the treatment schemes of patients.

Objective:The results of syphilis antibody screening in Peking University Third Hospital from 2016 to 2020 were analyzed,to explore the characteristics of sex, age and distribution of patients with positive syphilis antibody.Methods:A retrospective study was conducted to collect the results of syphilis antibody in outpatients and inpatients of Peking University Third Hospital from 2016 to 2020. Syphilis antibodies were screened in 626 528 patients aged 1-98 years, 4 232 were retested positive by TPPA test, including 2 132 males (50.4%) and 2 100 females (49.6%). Chemiluminescence immunoassay (CMIA) was used for syphilis antibody screening, and Treponema pallidum particle agglutination (TPPA) test was used for reexamination. SPSS20.0 data statistical analysis software was used to analyze the detection rate, age, sex, department and clinical diagnosis of patients with positive syphilis antibody by χ2 test.Results:Among 626 528 patients who were positive for treponema pallidum antibody screening, 4 232 were retested positive by TPPA test, accounting for 0.68% of the total number of patients tested. The number of syphilis tests increased year by year, however the positive detection rate decreased. The positive detection rate of syphilis antibody in 2020 decreased by 18.9% compared with 2016. The positive rate of syphilis antibody in male patients was higher than that in female patients, accounting for 0.80% and 0.59% of the total number of patients tested respectively. The positive rate of syphilis antibody of different genders increased with age, the total positive rate of 0-20, 21-40, 41-60, 61-80,>80 years old were 0.15%, 0.45%, 0.95%, 1.07% and 1.41%, respectively. While the increase rate of males was higher than that of females. The positive rate of male over 80 years old was 18.13 times of the group of 0-20 years old, and 5.54 times in women. The top 6 departments with positive syphilis antibody detection rate were emergency department, oncology department, respiratory department, geriatrics department, endocrinology department and neurology department, and the positive rates were 1.79% (104/5 810),1.46% (55/3 767),1.20% (74/6 167),1.20% (22/1 833),1.10% (32/2 909),1.09% (94/8 624), respectively. From the analysis of clinical diagnosis, the proportion of positive syphilis antibody in infertile patients (0.64%, 672/104 911) was higher than that in naturally conceived patients (0.10%, 24/23 969).Conclusions:From 2016 to 2020, the positive detection rate of syphilis antibody in Peking University Third Hospital decreased year by year. However, the positive detection rate increased with the age of patients. The positive rate of syphilis antibody in male was higher than that in female. The positive rate of syphilis antibody in pregnant women was lower than that in infertile patients.

Objective:The results of syphilis antibody screening in Peking University Third Hospital from 2016 to 2020 were analyzed,to explore the characteristics of sex, age and distribution of patients with positive syphilis antibody.Methods:A retrospective study was conducted to collect the results of syphilis antibody in outpatients and inpatients of Peking University Third Hospital from 2016 to 2020. Syphilis antibodies were screened in 626 528 patients aged 1-98 years, 4 232 were retested positive by TPPA test, including 2 132 males (50.4%) and 2 100 females (49.6%). Chemiluminescence immunoassay (CMIA) was used for syphilis antibody screening, and Treponema pallidum particle agglutination (TPPA) test was used for reexamination. SPSS20.0 data statistical analysis software was used to analyze the detection rate, age, sex, department and clinical diagnosis of patients with positive syphilis antibody by χ2 test.Results:Among 626 528 patients who were positive for treponema pallidum antibody screening, 4 232 were retested positive by TPPA test, accounting for 0.68% of the total number of patients tested. The number of syphilis tests increased year by year, however the positive detection rate decreased. The positive detection rate of syphilis antibody in 2020 decreased by 18.9% compared with 2016. The positive rate of syphilis antibody in male patients was higher than that in female patients, accounting for 0.80% and 0.59% of the total number of patients tested respectively. The positive rate of syphilis antibody of different genders increased with age, the total positive rate of 0-20, 21-40, 41-60, 61-80,>80 years old were 0.15%, 0.45%, 0.95%, 1.07% and 1.41%, respectively. While the increase rate of males was higher than that of females. The positive rate of male over 80 years old was 18.13 times of the group of 0-20 years old, and 5.54 times in women. The top 6 departments with positive syphilis antibody detection rate were emergency department, oncology department, respiratory department, geriatrics department, endocrinology department and neurology department, and the positive rates were 1.79% (104/5 810),1.46% (55/3 767),1.20% (74/6 167),1.20% (22/1 833),1.10% (32/2 909),1.09% (94/8 624), respectively. From the analysis of clinical diagnosis, the proportion of positive syphilis antibody in infertile patients (0.64%, 672/104 911) was higher than that in naturally conceived patients (0.10%, 24/23 969).Conclusions:From 2016 to 2020, the positive detection rate of syphilis antibody in Peking University Third Hospital decreased year by year. However, the positive detection rate increased with the age of patients. The positive rate of syphilis antibody in male was higher than that in female. The positive rate of syphilis antibody in pregnant women was lower than that in infertile patients.

Objective To explore the preventive and therapeutic effects of Caryopteris incana decoction in a rat model of primary dysmenorrhea with cold coagulation and blood stasis syndrome.Methods Sixty healthy specific pathogen-free SD female rats were randomly divided into six groups of ten rats each:normal group,model group,ibuprofen group,C.incana high-dose group,C.incana medium-dose group,and C.incana low-dose group.All groups except the normal group were treated with cold stimulation combined with estradiol benzoate and oxytocin to establish a rat model of primary dysmenorrhea with cold coagulation and blood stasis syndrome.On the fifth day of modeling,the rats were intragastrically administered the study drugs for 10 days.Their symptoms were observed and recorded.The writhing response and hemorheological indices were measured.The serum levels of TXB2,6-keto-prostaglandin F1α(6-Keto-PGF1α),estradiol(E2),and progesterone(PROG)were measured.Additionally,the levels of prostaglandin F2α(PGF2α),prostaglandin E2(PGE2),nitric oxide(NO),and calcium(Ca2+)in the uterine tissues were measured.The organ indices of the uterus and ovary were calculated,and histopathological changes were observed.Results Compared with the normal group,the rats in the model group showed obvious symptoms of cold coagulation and blood stasis syndrome and writhing reaction.The morphology of uterus and ovary showed obvious hyperplasia,inflammation,edema and other lesions.The plasma viscosity,packed cell volume and whole blood viscosity were significantly increased(P＜0.01).The serum levels of thromboxane B2 and E2 and the E2/PROG ratio were significantly increased(P＜0.01),the levels of 6-Keto-PGF1α and PROG were significantly decreased(P＜0.01).The uterine index and ovarian index were significantly increased(P＜0.01).The levels of PGF2α and Ca2+and the PGF2α/PGE2 ratio in uterine tissue were significantly increased(P＜0.01),while the levels of PGE2 and NO were significantly decreased(P＜0.01).Compared with the model group,Caryopteris incana significantly improved the symptoms of model rats,improved the morphological lesions of the uterus and ovary,prolonged the latency time of the writhing reaction,and reduced the number of writhing episodes(P＜0.01);significantly reduced the plasma viscosity,packed cell volume,and whole blood viscosity(P＜0.01);significantly reduced the serum levels of TXB2 and E2 and the E2/PROG ratio,increased the serum levels of 6-Keto-PGF1αand PROG,and reduced the uterine and ovarian indices(P＜0.01,P＜0.05);significantly reduced the levels of PGF2αand Ca2+and the PGF2α/PGE2 ratio in uterine tissue(P＜0.01,P＜0.05);and significantly increased the levels of PGE2 and NO in the uterine tissue(P＜0.01).Conclusions Caryopteris incana decoction can effectively improve the clinical symptoms of primary dysmenorrhea in rats with cold coagulation and blood stasis syndrome,and it has a good control effect.Its mechanism may be correlated with the levels of TXB2,6-Keto-PGF1α,E2,and PROG in serum and PGF2α,PGE2,NO,and Ca2+in uterine tissue.