Objective To investigate the effect of parathyroid hormone (PTH) on the transition and connective tissue growth factor (CTGF) expression of human renal proximal tubular epithelial cell line HK-2 . Methods The expression of CTGF mRNA and protein of HK-2 cells were measured by real time RT-PCR and Western blot respectively . The effect of PTH on the phenotypic transformation of HK-2 cells was examined by light microscopy . The expression of α-smooth muscle actin (α-SMA) in HK-2 cells was detected by immunofluorescence . Results Basal level of CTGF mRNA and the protein expression were detected in HK-2 ceils . PTH upregulated the expression of CTGF mRNA and protein with the maximal response at the concentration of 10-10 mol/L and the best stimulating time was at 72 h . After exposure to PTH (10-10tool/L) for 12 hours, the highest level of luciferase activity was 1 .96 fold as compared to control (1 .888±0 .078 vs 0 .989±0 .030, P＜0 .01 ) . Untreated cells showed negligible expression of ±-SMA,whereas ±-SMA expression was significantly increased in cells treated with PTH . Conclusion PTH up-regulates CTGF expression and induces transition of HK-2 cells .

Objective To evaluate the left ventricular twist in patients with coronary heart disease (CHD) with two-dimensional strain echocardiography (2DSE). Methods Thirty-eight patients with CHD and 31 control subjects proved with selected coronary angiography were enrolled. Two-dimensional images from LV short-axis views at the levels of mitral annulus and apex in 3 continuous cardiac cycles were recorded. LV ejection fraction (LVEF) was calculated with bi-plane Simpson's method, torsion and torsional rate were obtained in each plane, and the corresponding curve was accessed. Results No statistical difference of conventional echocardiographic parameters such as LV diameter, left atria diameter, LVEF, FS, E/A and E-wave deceleration time were detected, while significant difference of torsional direction (P＜0.01) and global torsion rate (P＜0.05) were found between the two groups. Conclusion The global torsional rate and torsional direction have higher sensitivity than conventional echocardiography in the diagnosis of CHD.

Objective To evaluate the effect of parathyroid hormone (PTH) on the expression of connective tissue growth factor (CTGF) in human renal tubular epithelial cells, and to explore the role of MAPK signaling pathway. Methods Real time RT-PCR, Western blot, and reporter gene assay were employed to detect PTH-induced CTGF expression in HK-2 cells. Inhibitors (PD98059 and U0126) of MAPK signaling pathway were used to confirm involved signal pathway. Results HK-2 cells had basic expression level of CTGF mRNA and protein, which were increased significantly after treatment with PTH. The luciferase activity was up-regulated to a higher level as compared with control group after treatment with 10-10 mol/L PTH for 12 h [(1.8884±0.0780) vs (0.9891±0.0300) A, P<0.01]. Moreover, a small amount of p-ERK1/2 was detected in normal HK-2 cells, but it was increased significantly in response to PTH activation, most remarkably when treated with 10-10 mol/L PTH for 30 min. Inhibitors of MAPK signaling pathway, PD98059 and U0126, noticeably inhibited the expression of CTGF mRNA and protein as well as gene promoters in HK-2 cells. Conclusion PTH can induce higher expression of CTGF in HK-2 cells probably via MAPK signaling pathway.

Objective To investigate the influence of Leptin on the proliferation of peripheral blood regulatory T cells in patients with rheumatoid arthritis (RA).Methods Peripheral blood mononuclear cells (PBMCs) were isolated from 6 RA patients.RA PBMCs were stimulated with anti-CD3 (3 μg/ml)/anti-CD28(2 μg/ml) antibody for 72 h,anti-CD3 (3 μg/ml)/anti-CD28 (2 μg/ml) antibody and Leptin (100 ng/ml) for 72 h,anti-CD3 (3 μg/ml)/anti-CD28 (2 μg/ml) antibody and Leptin (100 ng/ml) and interleukin (IL)-6 receptor antagonist (0.5 μg/ml) for 72 h.Regulatory T cells (Treg) were detected by flow cetometry.IL-6 level and TGF-βlevels in the supernatants of RA PBMCs culture were detected by Enzyme linked immunosorbent assay(ELISA).Statistical analysis between the two groups were performed by Wilcoxon Signed Rank Test.Results ①) Our results suggested that compared to the control group,RA PBMCs were stimulated by leptin for 72 h had lower percentage of Treg[13.6(11.6,14.8)％ vs 9.8(7.0,10.0)％,Z=-2.201,P＜0.05];Compared to the control group,the level of IL-6 and TGF-β were elevated when RA PBMCs treated with leptin for 72 h [548.9(508.6,608.4)ng/L vs 631.8(538.4,672.6) ng/L,Z=-1.992,P＜0.05;1175.0(1 045.4,1 373.1) ng/L vs 1 580.2(1 315.3,1 906.5) ng/L,Z=-2.201,P＜0.05];② The percentage of Peripheral Treg was increased [9.8(7.0,10.0)％ vs 12.3(9.7,13.8)％,Z=-1.997,P＜0.05] and the level of IL-6 was decreased [631.8(538.4,672.6) ng/L vs 522.7(339.3,593.3) ng/L,Z=-2.201,P＜0.05] when RA PBMCs was stimulated with IL-6 receptor antagonist and anti-CD3/anti-CD28 antibody and Leptin for 72 h.Conclusion The study has shown that Leptin can down-regulate the percentage of RA peripheral blood Treg via increasing IL-6 secretion.

Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.

ObjectiveTo examine the clinical features of fractures and related risk factors in patients with rheumatoid arthritis(RA) in China.MethodsSix hundred and eighty-one RA patients were randomly selected from department of rheumatology of 18 hospitals of China.Data were obtained from the questionnaire,including age,sex,disease duration,the involvement of joints,treatment regimen,features of fractures etc.The possible risk factors of fracture in patients with RA were analyzed with a multi-variate Logistic regression analysis.Results① In 681 RA patients of the survey,48 patients had 54 fractures,and the incidence of fractures was about 8％.② Fractures occurred at various sites.Foot/ankle,femur,spine and wrist were the mostfrequent sites.③ The Logistic regression analysis showed that several factors increased the risk of fracture in RA patients,including long disease duration (OR:1.245,95％CI:0.987-1.570,P=0.065),male gender(OR:0.433,95％CI:0.199-0.942,P=0.035),more deformed joints(OR:1.042,95％CI:1.006-1.079,P=0.023),family history of RA (OR:2.201,95％CI:0.984-4.923,P=0.055),and high scores of SF-36(OR:1.017,95％CI:1.002-1.033,P=0.028).④ According to the degree of correlation from strong to weak,the risk factors of fracture were disease duration,SF-36,sex,number of deformed joints and family history of rheumatoid arthritis.ConclusionThe incidence of fracture is high in patients with rheumatoid arthritis.Several factors could increase the risk of fractures in RA patients,including long disease duration,male gender,more deformed joints,and family history of RA.In order to prevent the occurrence of fractures,cautions should be taken to prevent the development of fractures and treat the disease aggressively to suppress the disease activity of RA.