To study the clinical features and diagnosis of synovitis,acne,pustulosis,hyperostosis,osteitis syndrome(SAPHO) syndrome.One case of SAPHO syndrome was reported and the related data of SAPHO syndrome were reviewed.The main clinical features of the patient were articulatio carpi synovitis,acne,cervical rib hyperostosis,articulatio sternoclavicularis and osteitis,So the diagnosis of SAPHO syndrome was made.Though SAPHO syndrome is rare with yet unknown prevalence,it still can be seen in clinical practice,and can be diagnosed by careful examination.

Objective To explore the misdiagnostic reasons of 24 cases with low back pain misdiagnosed as spondyloarthropathies and to raise the correctness of spondyloarthropathies diagnosis. Methods Using follow-up and counterchecking combined with review medical records, a retrospective analysis of 24 cases misdiagnosed as spondyloarthropathies in our hospital from 2001 to 2005 were done. Results Among the 24 patients misdiagnosed as spondyloarthropathies, 3 had sacral tubulocyst or parathyroid adenoma associated with hyperparathyroidism, 7 patients with benign or malignant tumors had persistent low back pain that aggrevated at night without morning stiffness. The pain could not be relieved by rest or exercise and could not be relieved by administration of multiple nonsteroidal anti-inflammatory drugs (NSAIDs). The final diagnosis of these 24 cases were as follows: 4 were malignant tumors (retroperitoneal adipose sarcoma, advanced gastric carcinoma, ovarian papillary epithelioma, acute lymphocytic leukemia), 6 were benign tumors (2 parathyroid adenoma associated with hyperparathyroidism, 1 intraspinal lipoma, 1 intraspinal ependymomas, 1 sacral tubulocyst and intraspinal and 1 schwannoglioma respectively). The other 14 cases were fibromyalgia syndrome (3), osteitis condensans (3), diffuse idiopathic skeletal hyperostosis (2), lubar intervertebral disc protrusion (1), congenital scoliosis (1), Wilson′s disease (1), ochronosis (1), Fanconi′s syndrome (1) and hypophosphatemic rhachiopathy (1). Although 11 patients had presented inflammatory low back pain defined by Calin, only 2 patients satisfied spondyloarthritides as defined by the classification criteria of the European Spondylarthropathy Study Group (ESSG). Conclusion The misdiagnosis of spondyloarthropathy can be improved by way of careful differential diagnosis of low back pain and holding the classification criteria of the European Spondylarthropathy Study Group (ESSG) as guideline.

Objective To study the clinical features of the patients with systemic lupus erythematosus (SLE) with Raynaud′ s phenomenon. Methods The clinical manifestations and laboratory findings of 42 SLE patients with Raynaud′ s phenomenon were analyzed and compared with those of 116 SLE patients without Raynaud′ s phenomenon. Results As compared with SLE patients without Raynaud′ s phenomenon, the SLE patients with Raynaud′ s phenomenon were more likely to have myalgia/myopathy(9.48％ vs 23.81％ , P

Objective To investigate the diagnostic value of SPECT,TCD and BAEP to vertebral basilar artery ischemia vertigo Methods 100 cases of vertebral basilar artery ischemia vertigo were inspected by SPECT,BAEP and TCD All the results were analyzed and compared Results Among 100 cases, it shows that the diagnostic rate of SPECT is 80 percent,BAEP is 58 3 percent and TCD is 78 percent Conclusion SPECT is found having the highest diagnostic rate,it sensitively and accurately reflects the position of cerebral ischemia Although BAEP having the lowest diagnostic rate, it can still effectively shows Brain Stem Ischemia Comparing with SPECT and BAEP, TCD is simple and convenient to carry out It sensitively reflects the conditions of cerebral vessel and cerebral blood stream,but it is insensitive to make sure the position Therefore, three of them offer the valuable,external and diagnostic proof to vertebral basilar artery ischemia vertigo,and they can have a role of inter reinforce

Objective To enhance the understanding of relapsing polychondritis (RPC).Method Clinical features,laboratory studies and prognosis of RPC in 20 patients were analyzed.Results The average age at the beginning of disease was 53 4 years (range from 35 to 86).The average course from initiation of clinical symptoms to diagnosis was 1 1 years.Of patients,90% had auricular chondritis,80% had respiratory system involvement,75% had nasal chondritis and 4 patients had severe tracheobronchial chondritis.Involvement in joints,skin,cardiovascular and neurotic system also existed in various frequencies,and 20% of the patients were associated with other rheumatic or autoimmune diseases.Conclusion Extensive laryngo tracheobronchial disease is a vital signal in RPC.Early diagnosis and treatment with corticosteroid and immunosuppressant can improve the prognosis.

Objective To observe the therapeutic effect of hyaluronic sodium product (SHP) on osteoarthritis(OA).Methods Three hundreds and forty-eight cases were diagnosed as OA and five hundred-eighty knee joints damage caused by OA were treated by intracavitary injection of SHP once a week for three consecutive weeks.The changes of the number of patients with clinical symptoms (joint pain,swelling of joint and with or without difficulty in up and down stairs) and the laboratory test results were compared before and after the treatment.Results It showed that there was a significant difference of the changes of the number of patients with clinical symptoms and laboratory test results before and after the treatment,(P

Objective To investigate the clinical features and risk factors of spondyloarthropathy with anterior uveitis. Methods The clinical and laboratory data of 86 patients with spondyoarthropathy associated with anterior uveitis in our hospital were collected, analyzed and summarized from March 2005 to December 2008, and the patients were followed up as closely as possible. The data of the 86 patients were compared with 93 patients who had spondyloarthropathy without anterior uveitis at the same period. All data were analyzed by using SPSS11.5 software package. Results Compared with non-ophthalmia group, ophthalmia group had significantly longer course[(11 ±8)vs(5±6), P＜0.01], and higher proportion of positive family history(27.9%vs 9.7%, P＜0.01), the proportion of low back pain at night, morning stiffness, spinal deformity, limitation of waist-bending and severe sacroiliac joint lesions were all significantly higher(P＜0.05), HLA-B27 positive rate was significantly higher as well(92.2% vs 81.5%, P＜0.05). The attack of uveitis usually had seasonality and precipitating cause. The patients with anterior uveitis as first symptom had significant higher frequency of ophthalmitis(P＜0.01), the ratio of eye permanent lesions was also significantly higher(P＜0.01). The frequencies of attack were positively correlated with the course of disease(r=0.294, P=0.006), Logistic multiple regression analysis showed that the incidence risk of ophthalmia were related to the course of disease(P=0.013, OR=1.099, 95%CI 1.030～1.183)and severe sacroiliac joint lesions(P=0.012, OR=3.071, 95%CI 1.286 ～7.314). Conclusion The spondyloarthropathy associated with anterior uveitis had its own characteristics, We should pay attention to the risk factors of anterior uveitis,and prevent the recurrence of ophthalmia.

Objective To analyze the clinical and laboratory manifestations of primary Sj(o)gren's syndrom (pSS) with neurological involvement.Methods One hundred and forty eight patients fulfilling the 2002 American-European pSS classification criteria were retrospectively analyzed.Neurological manifestations were diagnosed based on the clinical,biological,electrophysiological,and imaging findings.Biographical,clinical,and laboratory data were compared between patients with and without neurological manifestations.Statistical methods used were Mann-Whitney U test,Chi-square test and Fisher exact probability.Results The prevalence of neurological involvement in pSS was 20.3％ (30/148),and the incidence of peripheral neuropathy,the central neuropathy and combination of the central neuropathy with peripheral neuropathy were 10.1％(15/148),9.5％(14/148) and 0.7％(1/148),respectively.The clinical spectrum of peripheral neuropathies encountered in Sj(o)gren's syndrome (SS) patients varied,with the pure sensory neuropathies being the most common,followed by sensorimotor neurophathies.Motor neuron disease was the most common type of central neurophathies.Compared with those without neurological manifestations,the duration of peripheral nerve system/central nerve system (PNS/CNS)-pSS patients was relatively short [(55±76) months vs (100±108) months,Z=-2.682,P＜0.05],and the antinuclear antibody (ANA) titer and RF titer were lower [(234±248) vs (377±339),Z=-2.008,P＜0.05;(126±279) U/ml vs (359±1 445) U/ml,Z=-2.243,P＜0.05].In PNS/CNS-pSS patients,the most common clinical manifestations included numbness (50％),pain (23％),and muscle weakness (63％).Conclusion The prevalence of neurological involvement in pSS is high.The duration is relatively short and the disease activity is high,but the disease features are atypical and may be neglected by rheumatologists.

Objective To evaluate the prevalence and clinical significance of IgG,IgA and IgM isotypes of anti-peptidylarginine deiminase 4 (anti-PAD4) antibodies in early rheumatoid arthritis (RA).Methods IgG,IgA and IgM isotypes of anti-PAD4 antibodies were measured in the sera of 88 RA patients with disease duration less than 2 years,62 patients with other rheumatic diseases and 57 healthy subjects.The diagnostic performance of IgG,IgA and IgM isotypes of anti-PAD4 antibodies and their relationship with disease duration,DAS28,ESR,CRP,anti-CCP antibodies and rheumatoid factor (RF) were evaluated.Data analysis were performed using t test,U test and Spearman's association analysis.Results ① The sensitivities of IgG,IgA,and IgM isotypes for early RA were 28.41％,36.36％ and 9.09％ respectively.The specificities of IgG,IgA and IgM isotypes were 94.12％,93.28％ and 95.80％ respectively.② IgA isotype was positively correlated with age (r=0.234,P=0.028),DAS28 (r=0.309,P=0.007),ESR (r=0.382,P=0.000) and CRP (r=0.291,P=0.008),while negatively correlated with disease duration (r=-0.295,P=0.006).③ IgA isotype was positively correlated with IgG isotype (r=0.451,P＜0.01).In the IgG negative patients,the positivity of IgA isotype was 29％(18/63),which indicated that the IgA isotype might be helpful in diagnosing RA in IgG isotype negative patients.Conclusion Anti-PAD4 antibodies can be detected in early RA,primarily with IgA and IgG isotypes.IgA isotype has negative correlation with disease duration,indicating that IgA isotype of anti-PAD4 antibody may play a role in the very early stage RA.

Objective To explore the prevalence and clinical features of hyperuricemia in elderly people and to analyze the influencing factors of hyperuricemia in elderly people. Methods Serum uric acid (SUA) levels in 1500 elderly people were examined by the uricase-peroxidase enzymatic method .Clinical parameters of hyperuricemia group and normal SUA group were comparatively analyzed. Logistic regression was used to analyze the influencing factors of SUA in elderly people. Results In 264 out of 1500 (17.6%) the SUA level were increased. The ratio of male to female in the hyperuricemia group was 256:8. The proportion of the patients with increased SUA levels, mean level of SUA, serum urea nitrogen, serum creatinine and serum triglyceride were all increased with age. As compared with the normal SUA group, the hyperuricemia group were more prone to have adiposis hepatica (P