Objective To investigate the pathogenesis and clinical features of ankylosing spondylitis (AS) concurrent with multiple myeloma (MM).Methods The clinical characteristics,pathogenesis,diagnosis and treatment of 3 cases who were diagnosed as AS concurrent with MM were analyzed and relevant literatures were reviewed.Results MM was confirmed in patients who had long-term stable AS.A wide variety of manifestations,including persistent pain in spine and thorax,pathologic fracture,anemia,kidney damage and nervous system abnormalities were frequently presented.These patients were insensitive to nonsteroidal anti-inflammatory drug treatment,and they had a unfavorable prognosis.Conclusion Patients who are diagnosed as AS concurrent with MM can present with a variety of clinical features.Manifestations which are difficult to explain clinically by AS and poor response to treatment especially when the patients have longterm stable AS are potential clues for MM.

Objective To investigate the lipid profiles of patients with primary Sjogren's syndrome (pSS) and to analyze the correlation between abnormal serum lipids and the inflammationsof SS. Methods One hundred and fourteen pSS patients and 20 gendermatehed healthy controls were studied. Serum lipids were measured in both groups. Results There was statistically significant difference between SS and healthy controls, and the serum HDL-c and apoA<,1 concentrations were significantly lower in patients (P<0.05). The incidence of abnormal serum lipids was 39.5% in these patients. Patients with abnormal lipids had longer course of disease, higher ESR level, lower salivary flow rate and more frequent parotid gland enlargement than those without abnormal lipids(P<0.05). Logistic regression analysis revealed statistically significant association between serum lipids levels and occurrence of parotid gland enlargement. Conclusion Findings from this study suggest that patients with SS have altered lipid profiles and the decrease of apoA, and HDL-c levels may be the correlated factors of SS. The inflammation of SS may cause changes in lipids metabolisms.

Objective To investigate the effect of combination therapy by observing the salivary glands function and related organ pathology after given methotrexate (MTX) and cyclophosphamide (CTX) intermittently in induced mice model of Sjogren's syndrome (SS). To further explore the synergistic effect of combination therapy by detecting the immunological regulatory factor B cell activation factor belonging to the TNF family (BAFF) expression. Methods The ingredients of Lewis rat's exocrine glands homogenate were injected into female C57BL/6 mice to set up the mice model of SS. After established the SS mice model successfully, they were randomly divided into six SS model group, including low-dose MTX treatment group (0.02 mg/w), high-dose MTX treatment group (0.06 mg/w), CTX pause treatment group (1.2 mg/3 w), CTX alternate day treatment group (0.6 mg/2 d), MTX+CTX combination treatment group (MTX 0.02 mg/3 w+ CTX 1.2 mg/3 w). Treatment effects were assessed both clinically and histologically. Results Eighteen weeks after the first treatment, the improvement of the salivary secretion of the CTX alternate day treatment group and MTX+CTX combination treatment group were higher than other groups, which showed statistically significant difference (P<0.01). Compared with the SS model control group, HE staining showed that the lymphocytic infiltration of exoerine glands was decreased in the treatment group. In the CTX alternate day treatment group and MTX+CTX combination treatment group, few amount of inflammatory cell infiltration were found, and the expression intensity of BAFF mRNA and protein were decreased markedly in salivary gland than others by RT-PCR and immunohistochemistry assay (P<0.01). Conclusion MTX and CTX can inhibit lymphocytic infiltration of the salivary glands, inhibit BAFF transcriptional level and production of BAFF protein, leading to an increase of fluid production. It suggests that modulation of signaling via BAFF pathways may be a mechanism of action. MTX and CTX combination therapy is more effective than single-agent therapy. The inhibitory effects of MTX and CTX on BAFF-mediated inflammatory pathways are primarily synergistic.

Objective To evaluate the value of IgA and IgG antibodies against α-fodrin in both serum antibodies in SS is also assessed.Methods Samples from 39 patients with SS(25 primary and 14 secondary),8 patients with systemic lupus erythematosus(SLE),and 15 patients with rheumatoid arthritis (RA)as well as 10 healthy blood donors were collected.Anti-α-fodrin antibodies were measured using ELISA.Results The titer of serum anti-α-fodrin was higher in SS than in other connective tissue diseases group and healthy group(P<0.01).IgA type anti-α-fodrin antibodies was detected in 60%.44% of serum and saliva in patients with pSS respectively.IgG antibodies were detected in 43% of sera,and 29% of saliva of patients with pSS.The sensitivity and specificity of serum anti-α-fodrin IgA in SS was 54%and 85%.The level of anti-α-fodrin was positively associated with xerostomia and parotid swelling (P<0.05),and was negatively associated with xeroma,renal tubule acidosis,lung interstitial disease and hepatic damages(P>0.05).Conclusion Saliva and serLlm anti-α-fodrin level may be diagnostic for SS.It may be a useful screening marker.

Objective To investigate the relationship between tubal sterilization and endometrial hyperplasia and endometrial cancer. Methods The clinical data of 4 987 peoples with diagnostic curettage in Datong, Shanxi Province from January 2008 to January 2017 were retrospectively analyzed. According to the pathological type, 2 891 cases were in abnormal endometrium group (simple hyperplasia, complex hyperplasia, and atypical hyperplasia, endometrial cancer) (experimental group) and 2 096 cases were in normal endometrium group (proliferative endometrium, secretory endometrium, atrophic endometrium) (control group). The relationship between tubal sterilization and endometrial hyperplasia and endometrial cancer was analyzed. Results The proportion of age, education level, sterilization, duration of sterilization and menopausal years were significantly different between the two groups (χ2values were 36.47, 15.05, 33.11, 34.50, 5.19, all P< 0.05). There was no significant difference in the other variables (all P> 0.05). Multivariate Logistic regression analysis showed that age ≥60 years (OR= 5.64, 95 % CI 1.42-16.08, P=0.012), sterilization (OR= 4.76, 95 % CI 1.31-12.69, P = 0.015), duration of sterilization ≥10 years (OR= 15.58, 95 % CI 2.05-118.54, P= 0.008) were high risk factors for endometrial abnormalities. Conclusions Tubal sterilization is a risk factor for the development of endometrial hyperplasia and endometrial cancer.The postoperative patients should be strengthened anti-cancer census.