Objective To investigate the effect of tunor necrosis factor alpha (TNF-α) antagonist treatment and traditional disease-modifying antirheumatic drugs treatment on the quality of life of male patients with ankylosing spondylitis (AS).Methods In 42 patients with AS open-label study,patients were grouped after consent,and divided into the TNF-α antagonist treatment group and the non-TNF-α antagonist treatment group.All patients were treated for 4 months.The clinical and laboratory indexes and quality of life changes were analyzed before and after the treatment.T test,Pearson's correlation analysis were used for statistical analysis with software version 13.0.Results There were no significant differences in age,disease course,disease activity and the quality of life between the two groups before treatment.Disease activity and the quality of life of the two groups after treatment were improved compared with that of before treatment.After treatment,the Bath ankylosing spondylitis disease activity index (BASDAI) score [(1.9±1.6) scores,(3.0±1.3) scores,t=-2.429,P=0.020],erythrocyte sedimentation rate (ESR) [(9±6) mm/1 h,(18±17) mm/1 h,t=-2.286,P=0.031] and C reactive protein(CRP) levels [(18±21) mg/L,(62±85) mg/L,t=-2.258,P=0.035] of the TNF-α antagonists treatment group decreased significantly than those non-TNF-α antagonist treatment group,while the hemoglobin (Hb) levels [(143±15) g/L,(138±18) g/L,t=2.545,P=0.015] were significantly increased in TNF-α antagonist treatment group.The improvement extent of quality of life was more evident in TNF-α antagonists treatment group,such as,the average score [(72± 15) scores,(55±19) scores,t =3.254,P=0.002].The average degree of improvement in quality of life and BASDAI score,Bath ankylosing spondylitis functional index (BASFI) score were negatively related to the improvement in the TNF-α treatment group (r=-0.497,P=0.018; r=-0.558,P=0.007).Conclusion TNF-α antagonist treatment can not only improve the AS disease activity,but can also improve the quality of sexual life of male patients,which may direct affect on male reproductive system.

Objective To identify the clinical features and risk factors of rheumatoid arthritis-associated interstitial lung disease (RA-ILD).Methods The clinical and laboratory data of 595 patients with RA hospitalized in Chaoyang Hospital.550 cases of patients were performed pulmonary high-resolution CT examination.Risk factors were analyzed with logystic regression analysis.Results ① There were 237 (39.8％)patients with RA-ILD.13.5％ of RA-ILD occurred before the dia-gnosis of RA,69.7％ of RA-ILD occurred within ten years after the diagnosis of RA,16.8％ of RA-ILD occurred more than ten years after the diagnosis of RA.② The most common manifestations of HRCT were reticular opacity (57.8％),pleural thickening (57％),ground-glass opacity (53.2％),followed by septal thicke-ning,nodules,bullae,cellular-like changes and bronchiectasis.③ Pleural disease,bronchiectasis,pulmonary hypertension in RA patients were associated with RA-ILD.④ Compared with the RA-N-ILD patients,RA-ILD patients had a higher proportion of male patients,higher rate of smoking,older mean age at onset,shorter duration,more swollen joints higher levels of lactate dehydrogenase,globulin,erythrocyte sedimentation,C-reactive protein and rheumatoid factor,the difference was statistically significant (P＜0.05).The forced vital capacity,forced expiratory volume in one second,carbon monoxide diffusion rate was lower,the difference was statistically significant (P＜0.05).Logistic regression analysis showed that age,smoking,elevated lactate dehydrogenase,RF-positive rate were relevant factors of RA-ILD.Conclusion ILD is common in RA,and most of it occurrs within ten years after the diagnosis of RA,and often coexists with other lung disease.Age,smoking,elevated lactate dehydrogenase,RF-positive rate

Objective To explore the relationship between osteopontin (OPN),its downstream product thrombin-cleaved osteopontin (NTOPN) and radiographic changes in osteoarthritis (OA).Methods The levels of OPN and NTOPN in serum and synovial fluid were tested by enzyme-linked immuno sorbent assay (ELISA) kit in 22 OA patients and 21 health controls.The correlation between the above parameters and clinical data such as radiology changes of OA patients was analyzed.Results The serum level of OPN in the OA group was positively correlated with C reactive protein (CRP) (r =0.574,P =0.005).The serum level of OPN in the OA group was slightly lower than that in the healthy control group [(1.8 ± 0.5) μg/L vs (1.7 ± 1.1) μg/L,P ＞ 0.05].Similarly,the serum level of NTOPN in the OA group was significantly higher than that in control group [(21.1 ± 11.7) μg/L vs (14.7 ± 3.6) μg/L,P ＜ 0.05].Meanwhile,serum NTOPN level in female patients was significantly higher than that in male patients [(23.2 ± 11.80) μg/L vs (11.1 ± 4.9) μg/L,P ＜ 0.05].In synovial fluid of OA group,the level of OPN was (7.75 ± 2.33) μg/L,NTOPN was (0.91 ± 0.49) μg/L and the ratio of NTOPN/OPN was 0.12 ± 0.08.The level of OPN of synovial fluid in the OA group was positively correlated with CRP (r =0.574,P =0.005).NTOPN-to-OPN ratio of synovial fluid in the OA group was positively correlated with Kellgren-Lawrence grade (r =0.535,P =0.022).Conclusions The serum level of OPN is correlated with severity of inflammation in the OA patients.Meanwhile,NTOPN-to-OPN ratio of synovial fluid is correlated with OA severity.As a downstream bioactive product of OPN,NTOPN may play an important role in OA pathogenesis.Whether these parameters can be used as predictors of joint lesion severity and inflammatory status is worth further study.

The colorimetric method has been well developed to detect the sensitivity of most antiproliferative drugs with the advantages of objectivity and accuracy. Many parameters including the dosage and the absorbance of crystalline violet, the extraction time of the solvent, plate effect and marginal effect were investigated, then the optimized method was applied further to measure the biological activity during the refolding of recombinant human IFN-? inclusion bodies.

Objective By analyzing the clinical and radiographic manifestations of calcium pyrophosphate deposition disease (CPDD) to improve the recognization of the disease.Methods Clinical features,diagnosis and treatment of an old female patient with CPDD was reported with literature review.Results An old female patient presented with swollen and pain on the right knee without obvious causes eight years ago,which was characterized by slightly reddness of joint surface,warm of local skin.Thcn she gradually developed swollen and pain in left knee,right ankle,both wrists,bilateral meta-carpophalangeal (MCPJ) and right elbow joints with few joint symptoms and the joints swollen and pain could relieved spontaneouslyitself in about one week.X-ray showed the thin strip of cartilage calcifications in wrist triangular fibrocartilage disc,meniscus of knee and the pubic symphysis were parallel to the surface of cartilage.Examination of microscopy with refractive filter demonstrated that short rod crystals refraction in joint fluid.CPDD was diagnosed and treated with flushing of joint cavity and injections of betamethasone as well as nonsteroidal anti-inflammatory drug orally.Symptoms relieved after therapy.Conclusion Understanding the disease characteristics of CPDD is beneficial to for accurate diagnosis and treatment.

Objective To investigate the clinical and imaging features of patients with calcium pyrophosphate deposition (CPPD).Methods The clinical data and X-rays material of knee joint of 20 patients with CPPD were retrospectively analyzed.Pearson/Spearman's correlations analysis was used for statistical analysis with software version 15.0.Results The 20 patients with CPPD had demonstrated that the typical accumulation of calcium,which accounted for about 1.5％o(20/13 536) among patients over 55 years old who had knees X-ray at the same period in Chaoyang Hospital.Female patients of CPPD was 80％ (16/20).Seventeen patients completed follow-up visits.The age of onset for CPPD ranged from 44 to 85 years old,the percentage of CPPD patients over 70 years old was 71％(12/17).Among the 17 cases of followed,14 cases (82％) were patients with paroxysmal arthritis with the initial site of knee joint (79％) and ankle joint (21％).Most patients suffered from moderate to severe pain,while some might have local congestion and increased skin temperature.Five patients had more than two different joints attacked by arthritis.The distribution of the affected areas was knee,ankle,hip,elbow,wrist and metacarpophalangeal joints.The median number of attack was 1.5 times a year,and the median duration of attack was 8.5 days.Among the 14 patients,Six cases of them had no recurrence after treatment,but six cases had recurrent attacks within a year.The imaging of lateral articular facet showed that calcium deposit was extended and thickness of calcification was increased.Plus osteophyte formation stage was 100％ with an average of 3.0±1.6 and 85％ sclerosis of articular facet.The rate of attacks of arthritis had a positive correlation with calcium deposition range of lateral articular facet (r=0.663,P=0.010) and a negative correlation with sclerosis of articular facet (r=-0.548,P=0.042).Conclusion Old patients with paroxysmal joint pain,patients with knee joint or other big joints as the initial joints involved,patients with long duration disease,patients who had more than two joints at attack and patients with calcium deposition in imaging,should be suspected for CPPD clinically.Moreover,patients with a wide range of calcium deposition are high likely to suffer from recurrent arthritis attack.

Objective To investigate the clinical features of connective tissue diseases (CTD) related organizing pneumonia (OP). Methods The clinical and radiological features, therapy and outcome of 57 CTD-OP patients diagnosed by biopsy were retrospectively analyzed. T test, x2 test, Pearson/Spearmanˊs correla-tion analysis were used for statistical analysis with software version 15.0. Results CTD-OP accounted for 44% of all the OP. There were 36 cases (63%) with the initial clinical manifestation of OP in CTD-OP patients. The underling primary disease of CTDs included Sj?grenˊs syndrome (22, 38%), polymyositis/dermatomyositis (13, 23%), RA (13, 23%) and undifferentiated connective tissue diseases (9, 16%). At baseline, the clinical symptoms of cough and malaise [54% vs 83%, x2=7.749, P=0.005; 49% vs 71%, x2=4.007, P=0.045] were significantly lower in the CTD-OP patients than in the COP patients. The signs of moist rales and crackles (54% vs 32%, x2=4.160, P=0.041; 49% vs 27%, x2=4.529, P=0.033) were more common in the CTD-OP patients than in the COP patients. The TLC%, FVC% of the lung function reduced significantly in CTD-OP patients than in COP patients [(72 ±18)% vs (97 ±29)%, t=-2.475, P=0.027;(75 ±26)% vs (96 ±23)%, t=-2.174, P=0.039). The dosage of corticosteroids [(44 ±14) mg/d vs (37 ±10) mg/d, t=2.541, P=0.013] were significantly higher in the CTD-OP patients than in the COP patients. The complete recovery rate was slightly lower in CTD-OP than in COP (22% vs 29%, x2=0.384, P=0.483) with a tendency towards higher recurrence rate in CTD-OP (33% vs 14%, x2=4.007, P=3.958). Conclusion CTD-OP is probably the common cause of OP. OP can be the initial manifestation of CTD. The primary disease of the CTD-OP includes Sjogrenˊs syndrome, polymyositis/dermatomyositis, rheumatoid arthritis and undifferentiated connective tissue diseases. Compared with COP, CTD-OP patients may have milder clinical symptoms, but the more severe damage of the lung, the higher the recurrence rate, therefore, CTD-OP is worthy of more attention from rheumatologists.

Objective To explore the application of gastric(enteric)-pharyngeal anastomosis for cervical esophageal carcinoma. Methods The clinical data of 12 cases with surgical management of cervical esophageal carcinoma were retrospectively analyzed. Results The resectability of cervical esophageal carcinoma was 100%,no case complicated with pharyngeal fistula.Swallowing function of all cases was in a good state.The overall follow-up was 1 to 7 years,among them 9 surviving,3 dead.The surviving 5 cases are over 3 years,the ongest beyond 7 years. Conclusions Gastric(enteric)-pharyngeal anastomosis is a good primarily rehabilitating method of the cervical esophageal defect after surgical treatment of cervical esophageal carcinoma.

Two patients underwent liver transplantation of blood type incompatibility were collected from Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA. Case 1: A male who had primary hepatic carcinoma underwent classic orthotopic liver transplantation; the blood of donor was type A, and the blood of recipient was type O. Case 2: A female having history of type B hepatitis underwent classic orthotopic liver transplantation due to pregnancy combining with severe liver disease and coagulation disorder; the blood of donor was type B, and the blood of recipient was type O. Immunohistochemistry staining was used to observe pathological changes and deposition of various immunoglobulin and complement in two cases following liver transplantation of blood type incompatibility under optic microscope and to investigate diagnostic standard of humoral rejection. The results showed that linear or granular depositions of IgG, IgM, IgA, C4c, C4d, and Clq were found in endothelial cells of hepatic sinusoid, suggesting that IgG and other immunoglobulin exhibited a strongly positively diffused deposition on the endothelial cells of hepatic sinusoid, while expression of C4d and other complements was also found. All those mentioned above could be considered as evidences to prove onset of humoral rejection in transplanted liver tissue.

Objective To study the clinical value of anti-ribosomal P0 protein antibodies (anti-P0). Methods Line immuno-assay and immunoblotting methods were used to detect anti-P0 and rRNP antibodies of 49 SEE patients and 61 patients with other rheumatic diseases.The expressions of anti-P0 were compared with those of rRNP antibodies.Possible relations between anti-P0 and clinical features and other antibodies in SLE were explored.Results 36.7%and 6.1% of SEE patients showed positive anti-P0 and rRNP antibodies respectively.Anti-P0 was always negative in patients with other rheumatic diseases (P＜0.01).Among SLE pa tients,incidence of skin rash was 77.8%(35.5%) ff anti-P0 was found to be positive (negative) (P＜0.05). Besides,for patients with positive and negative anti-P0,the chance of positive anti-SmD1 was 61.1% and 19.4% respectively (P＜0.01).Sensitiviy of anti-P0 for SLE diagnosis was 36.73% with specificity and positive predictive value as high as 100%,and 66.30% as the negative predictive value.Conclusion Sera anti-P0 is highly specific for SLE and it is associated with the occurence of rash and the expression of anti-StuD 1 anti bodies in SEE.