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1.
Chinese Journal of Internal Medicine ; (12): 775-784, 2023.
Article in Chinese | WPRIM | ID: wpr-985988

ABSTRACT

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with complicated pathogenesis and diverse clinical manifestations. The current recommendations of the Chinese Rheumatology Association are based on a comprehensive investigation of evidence based medicine, domestic and international guidelines for SLE, and experts' proposals, and aim to provide a more scientific and authoritative reference for the diagnosis and management of SLE. The recommendations focus on four aspects; clinical manifestations, laboratory evaluation, diagnosis and disease assessment, and disease treatment and monitoring. The goal of the recommendations is to standardize the diagnosis and treatment of SLE in China so as to improve the prognosis of SLE patients.


Subject(s)
Humans , Lupus Erythematosus, Systemic/complications , Prognosis , Rheumatology , China , Severity of Illness Index
2.
Chinese Medical Journal ; (24): 1465-1470, 2021.
Article in English | WPRIM | ID: wpr-878196

ABSTRACT

BACKGROUND@#Disease activity indices (DAIs) including disease activity score 28 (DAS28), simplified disease activity index (SDAI), and clinical disease activity index (CDAI) have been widely used in clinical practice and research studies of rheumatoid arthritis (RA). The objective of our study was to evaluate the correlation and concordance among different DAIs in Chinese patients with RA.@*METHODS@#A cross-sectional study, including patients enrolled in the Chinese registry of rheumatoid arthritis from November 2016 to August 2018, was conducted. The correlations were evaluated using Spearman correlation coefficient and concordance with Bland-Altman plots, quadratic weighted kappa, and discordance rates in the crosstab. For other indices, the optimal cutoff points corresponding to SDAI remission were explored through receiver operating characteristic curve analysis.@*RESULTS@#A total of 30,501 patients were included, of whom 80.46% were women. Most individuals were with moderate disease activity or high disease activity. High correlations among DAS28-erythrocyte sedimentation rate (ESR) and DAS28-C-reactive protein (CRP), SDAI and CDAI were observed. Similarly, the weighted kappa value among the indices was high. In Bland-Altman plots, a positive difference between DAS28-ESR and DAS28-CRP was observed, with an absolute difference of >1.2 in 3079 (10.09%) patients. In crosstab, approximately 30% of the patients were classified into different groups. Concordance values between SDAI remission and the optimal cutoff points of DAS28-ESR, DAS28-CRP, and CDAI were 3.06, 2.37, and 3.20, respectively.@*CONCLUSIONS@#Although DAIs had high correlations and weighted kappa values, the discordance between DAIs was significant in Chinese patients with RA. The four DAIs are not interchangeable.


Subject(s)
Female , Humans , Male , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , China , Cross-Sectional Studies , Registries , Severity of Illness Index
3.
Acta Academiae Medicinae Sinicae ; (6): 749-754, 2020.
Article in Chinese | WPRIM | ID: wpr-878673

ABSTRACT

Objective To explore the clinical characteristics and risk factors of systemic lupus erythematosus(SLE)complicated with cytomegalovirus infection(CMV). Methods The medical records of patients diagnosed with SLE at discharge in the Department of Immunology at Peking Union Medical College Hospital between July 1,2017 and April 1,2019 were retrospectively reviewed,and the clinical and laboratory data related to CMV infection were analyzed. Results Of the 231 patients with SLE,115(49.8%)had CMV infection.Among them,78(67.8%)were asymptomatic CMV infection and 37(32.2%)were diagnosed with CMV disease.Univariate analysis showed the number of organs involved(


Subject(s)
Humans , Cyclophosphamide/therapeutic use , Cytomegalovirus Infections/epidemiology , Immunosuppressive Agents/therapeutic use , Lupus Erythematosus, Systemic/drug therapy , Methylprednisolone/therapeutic use , Prednisolone/therapeutic use , Retrospective Studies , Risk Factors , Serum Albumin, Human/analysis
4.
Acta Academiae Medicinae Sinicae ; (6): 717-722, 2020.
Article in Chinese | WPRIM | ID: wpr-878669

ABSTRACT

Objective To explore the clinical characteristics of relapsing polychondritis(RP)patients presented with arthropathy. Methods We retrospectively analyzed the clinical data of 201 RP patients who were hospitalized in our center between December 2005 and February 2019.After 16 patients with co-existing other autoimmune diseases and malignancies were ruled out,185 RP patients entered the final analysis,among whom 16 RP patients were presented with arthropathy and 169 without arthropathy.The demographic data,clinical manifestations,laboratory findings,and prognosis were compared between these two groups. Results Five of the 16 RP patients with arthropathy at presentation were misdiagnosed as rheumatoid arthritis.Compared with RP patients without arthropathy at presentation,RP patients with arthropathy at presentation had a longer disease course[(37.50±66.50)months


Subject(s)
Humans , Arthritis, Rheumatoid , Delayed Diagnosis , Diagnostic Errors , Joint Diseases/diagnosis , Polychondritis, Relapsing/diagnosis , Prognosis , Retrospective Studies
5.
Journal of Peking University(Health Sciences) ; (6): 1056-1062, 2020.
Article in Chinese | WPRIM | ID: wpr-942116

ABSTRACT

OBJECTIVE@#To explore the effectiveness and safety of golimumab in the treatment of severe/refractory cardiovascular Behcet syndrome (BS).@*METHODS@#We retrospectively analyzed the clinical data of nine patients diagnosed with severe/refractory cardiovascular BS and treated with golimumab from February 2018 to July 2020 in Peking Union Medical College Hospital. We analyzed levels of erythrocyte sedimentation rate (ESR) and high-sensitivity C-reactive protein (hsCRP), imaging findings, and the doses of glucocorticoids and immunosuppressive agents during the period of combined treatment with golimumab.@*RESULTS@#Nine patients were enrolled, including 8 males and 1 female, with a mean age and median course of (37.0±8.6) years and 120 (60, 132) months, respectively. Seven patients presented with severe aortic regurgitation combined with other cardiovascular involvement secondary to BS. Two patients presented with large vessel involvement, including multiple aneurysms and vein thrombosis. Prior to golimumab treatment, seven patients were treated with glucocorticoids and multiple immunosuppres-sants [with a median number of 3 (1, 3) types] while still experienced disease progression or elevated inflammation biomarkers during postoperative period. Eight patients with disease progression, uncontrolled inflammation and history of severe postoperative complications required effective and fast control of inflammation during perioperative period. One patient had adverse reaction with tocilizumab and switched to golimumab during perioperative period. The patients were treated with golimumab 50 mg every 4 weeks, along with concomitant treatment of glucocorticoid and immunosuppressants. After a median follow-up of (16.3±5.6) months, all the patients achieved clinical improvement. Vascular lesions were radiologically stable and no vascular progressive or newly-onset of vascular lesions was observed. The eight patients who experienced cardiac or vascular operations showed no evidence of postoperative complications. The ESR and hsCRP levels decreased significantly [16.5 (6.8, 52.5) mm/h vs. 4 (2, 7) mm/h, and 21.24 (0.93, 32.51) mg/L vs. 0.58 (0.37, 1.79) mg/L (P < 0.05), respectively]. The dose of prednisone was tapered from 35 (15, 60) mg/d to 10.0 (10.0, 12.5) mg/d. No prominent adverse reactions were observed.@*CONCLUSION@#Our study suggests that golimumab is effective in the treatment of severe/refractory cardiovascular BS. Combination immunosuppression therapy with golimumab contributes to control of inflammation, reduction of postoperative complications and tapering the dose of glucocorticoids or immunosuppressants.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Antibodies, Monoclonal/therapeutic use , Behcet Syndrome/drug therapy , Drug Therapy, Combination , Retrospective Studies , Treatment Outcome
6.
Chinese Medical Journal ; (24): 892-898, 2020.
Article in English | WPRIM | ID: wpr-827680

ABSTRACT

BACKGROUND@#Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to the levels of disease severity (patient-assessed) and proportions of treatment cost to household income.@*METHODS@#This was a subgroup study of a cross-sectional study in patients with RA and their physicians. The patients were subdivided into different subgroups based on their self-assessed severity of RA and on the proportions of treatment cost to household income (50%). The Treatment Satisfaction Questionnaire for Medication version II was used to assess patients' treatment satisfaction.@*RESULTS@#When considering all medications, effectiveness, convenience, and global satisfaction scores were lower in the severe and moderate RA subgroups than those in the mild and extremely mild RA subgroups (all P 50% subgroup (all P 50% subgroups (F = 12.646, P = 0.005). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup (F = 8.794, P = 0.032).@*CONCLUSION@#Higher disease severity and higher financial burden were associated with lower patient satisfaction.

7.
Journal of Forensic Medicine ; (6): 276-279, 2018.
Article in Chinese | WPRIM | ID: wpr-984937

ABSTRACT

With the development of the computer simulation technology and the digital simulation technology, the traditional calculation method has been gradually replaced by the digital method to deal the road traffic accident scene and analyse the process. The PC-Crash software simulation system can reconstruct the traffic accidents within 32 vehicles, and the accuracy of reconstruction has been fully verified, which is widely used by the transport police department and the accreditation agency. In this paper, the research of road traffic accident reconstruction using PC-Crash software is reviewed, and the application of road traffic accident reconstruction technology based on PC-Crash software and some existing problems in forensic practice are discussed, which provides reference for the research and identification of road traffic accident simulation and reconstruction and theoretical basis for accident treatment.


Subject(s)
Humans , Accidents, Traffic , Computer Simulation , Models, Theoretical , Police , Software
8.
Chinese Pharmacological Bulletin ; (12): 577-583, 2018.
Article in Chinese | WPRIM | ID: wpr-705087

ABSTRACT

Aim To investigate the effects of gastrodin on SH-SY5Y cell autophagy induced by methamphet-amine (METH) and the underlying mechanisms. Methods SY5Y cells were treated by METH with the concentration of 0.5,1.0,1.5,2.0,2.5,3.0 mmol·L-1for 24 h. The morphological changes were ob-served by microscopy,the expression of LC3-Ⅱ,Bec-lin-1,Akt,p-Akt,mTOR and p-mTOR were detected by Western blot. Gastrodin was added to the medium 1 h before METH treatment. Results The SY 5 Y cells were morphologically featured by shrinkage and den-drite disruption after exposed to METH(0~3 mmol· L-1),and autophagic vacuoles occurred in cytoplasm. The expression of LC3-Ⅱ increased over METH dose. Confocal results showed that LC3-Ⅱsignificantly in-creased in METH group as compared with control, while decreased in METH+ Gastrodin group. The ex-pression levels of LC3-Ⅱand Beclin-1 significantly in-creased (P<0.01) in METH group, p-mTOR and p-Akt decreased, and mTOR and Akt showed no signifi-cant difference as compared with control. However, the gastrodin could decrease the expression of LC3-Ⅱand Beclin-1 and increase the expression of mTOR,p-mTOR,Akt and p-Akt as compared with METH-trea-ted groups. Conclusions METH can induce SY5Y cells autophagy. The protective effect of gastrodin a-gainst METH-induced autophag may be related to gast-rodin regulation mTOR and Akt signaling pathway.

9.
Journal of Kunming Medical University ; (12): 129-133, 2018.
Article in Chinese | WPRIM | ID: wpr-751945

ABSTRACT

Amphetamines abuse is defined as a chronic recurrent encephalopathy, and it is a global public health problem which seriously threatens the health of human and the social stability. Long-term abuse and addiction of amphetamines leads to structural and functional changes of specific encephalic regions. Further researches on these encephalic regions, the network of brain and biological information may be helpful to understanding drug abuse mechanism and possible therapeutic measures. Recently, a series of functional imaging techniques, including magnetic resonance imaging (MRI), functional magnetic resonance imaging (f MRI), magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), and positron emission tomography (PET), were used to detect different brain structural changes of the volume and density of encephalic regions, functional changes of cerebral blood flow and brain cognition. The results showed functional imaging techniques play significant roles to detect different structural and functional changes of the brain. Based on these results, the researchers aim to clarify the mechanisms of drug abuse. That is the main focus of this review.

10.
Chinese Medical Journal ; (24): 1276-1282, 2017.
Article in English | WPRIM | ID: wpr-330629

ABSTRACT

<p><b>BACKGROUND</b>Approximately 15-20% cases of systemic lupus erythematosus (SLE) are diagnosed in children. There have been a few studies reporting the epidemiological data of pediatric-onset SLE (cSLE) in China, neither comparing the differences between cSLE and adult-onset SLE (aSLE). The aim of this study was to describe the impact of age of onset on clinical features and survival in cSLE patients in China based on the Chinese SLE Treatment and Research group (CSTAR) database.</p><p><b>METHODS</b>We made a prospective study of 225 cSLE patients (aged Results: The mean age of cSLE patients was 12.16 ± 2.92 years, with 187 (83.1%) females. Fever (P < 0.001) as well as mucocutaneous (P < 0.001) and renal (P = 0.006) disorders were found to be significantly more frequent in cSLE patients as initial symptoms, while muscle and joint lesions were significantly less common compared to aSLE subjects (P < 0.001). The cSLE patients were found to present more frequently with malar rash (P = 0.001; odds ratio [OR], 0.624; 95% confidence interval [CI], 0.470-0.829) but less frequently with arthritis (P < 0.001; OR, 2.013; 95% CI, 1.512-2.679) and serositis (P = 0.030; OR, 1.629; 95% CI, 1.053-2.520). There was no significant difference in SLE disease activity index scores between cSLE and aSLE groups (P = 0.478). Cox regression indicated that childhood onset was the risk factor for organ damage in lupus patients (hazard ratio 0.335 [0.170-0.658], P = 0.001). The survival curves between the cSLE and aSLE groups had no significant difference as determined by the log-rank test (0.557, P = 0.455).</p><p><b>CONCLUSIONS</b>cSLE in China has different clinical features and more inflammation than aSLE patients. Damage may be less in children and there is no difference in 5- year survival between cSLE and aSLE groups.</p>


Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Age Factors , Age of Onset , China , Epidemiology , Lupus Erythematosus, Systemic , Epidemiology , Mortality , Pathology , Odds Ratio , Proportional Hazards Models , Prospective Studies , Registries , Severity of Illness Index
11.
Chinese Medical Journal ; (24): 2588-2594, 2015.
Article in English | WPRIM | ID: wpr-315288

ABSTRACT

<p><b>BACKGROUND</b>Myocarditis is an uncommon but serious manifestation of systemic lupus erythematosus (SLE). This study aimed to investigate clinical characteristics and outcomes of lupus myocarditis (LM) and to determine risk factors of LM in hospitalized Chinese patients with SLE.</p><p><b>METHODS</b>We conducted a retrospective case-control study. A total of 25 patients with LM from 2001 to 2012 were enrolled as the study group, and 100 patients with SLE but without LM were randomly pooled as the control group. Univariable analysis was performed using Chi-square tests for categorical variables, and the Student's t-test or Mann-Whitney U-test was performed for continuous variables according to the normality.</p><p><b>RESULTS</b>LM presented as the initial manifestation of SLE in 7 patients (28%) and occurred mostly at earlier stages compared to the controls (20.88 ± 35.73 vs. 44.08 ± 61.56 months, P = 0.008). Twenty-one patients (84%) experienced episodes of symptomatic heart failure. Echocardiography showed that 23 patients (92%) had decreased left ventricular ejection fraction (<50%) and all patients had wall motion abnormalities. A high SLE Disease Activity Index was the independent risk factor in the development of LM (odds ratio = 1.322, P < 0.001). With aggressive immunosuppressive therapies, most patients achieved satisfactory outcome. The in-hospital mortality was not significantly higher in the LM group than in the controls (4% vs. 2%,P = 0.491).</p><p><b>CONCLUSIONS</b>LM could result in cardiac dysfunction and even sudden death. High SLE disease activity might potentially predict the occurrence of LM at the early stage of SLE. Characteristic echocardiographic findings could confirm the diagnosis of LM. Early aggressive immunosuppressive therapy could improve the cardiac outcome of LM.</p>


Subject(s)
Adult , Female , Humans , Male , Case-Control Studies , China , Echocardiography , Lupus Erythematosus, Systemic , Multivariate Analysis , Myocarditis , Diagnosis , Retrospective Studies , Risk Factors
12.
Chinese Medical Journal ; (24): 2390-2392, 2012.
Article in English | WPRIM | ID: wpr-283753

ABSTRACT

We describe a case of systemic sclerosis (SSc) complicated with portal hypertensive ascites which did not improve with diuretics and ascitic drainage. When corticosteroid added, her ascites diminished dramatically. Though portal hypertension can be imputed to other causes, such as polycystic liver in this case, it can occur in limited SSc with positive anti-centromere antibody and respond to corticosteroid treatment.


Subject(s)
Aged , Female , Humans , Adrenal Cortex Hormones , Therapeutic Uses , Hypertension, Portal , Diagnostic Imaging , Drug Therapy , Radiography , Scleroderma, Systemic , Diagnostic Imaging , Drug Therapy
13.
Chinese Journal of Rheumatology ; (12): 9-12, 2012.
Article in Chinese | WPRIM | ID: wpr-671568

ABSTRACT

ObjectiveThe purpose of this study was to assess the efficacy,safety and optimal dose of tacrolimus monotherapy in patients with refractory lupus nephritis(LN) who were resistant to cyclophosphamide(CYC).MethodsA total of 14 LN patients (2 men and 12 women) with persistent proteinuria who were resistant to CYC treatment more than 8 g for half a year were enrolled.Tacrolimus was initiated at 2 mg/d (patient weight<60 kg) or 3 mg/d(patient weight≥60 kg) which was administered in two divided doses.Prospective data on daily proteinuria,serum album level and serologic lupus activity were collected and followed for 6 months.ANOVA and Pearson correlation analysis were used for statistical analysis.Results Mean age at baseline was(30±9) years.Mean urinary protein decreased significantly from(6.2±5.1) g at baseline to (1.1±0.9) g at 6 months (F=16.21,P<0.01).Mean serum album level increased significantly from (27.9±9.7) g/L at baseline to(37.8±2.2) g/L at 6 months(F=16.71,P<0.01 ).Complete or partial response was observed in 86% of patients receiving tacrolimus therapy.The effective dosage in this study was 0.03-0.06mg·kg-1·d-1 of the patients who had complete response or partial response to tacrolimus.The tacrolimus level in partially and completely responding patients was less than 3 ng/ml.There was no significant difference among blood tacrolimus levels of complete,partial,and no response patients [(1.6-±0.4),(2.0±0.6) and (22±1.1) ng/nl],respectively).No definite correlation was found between efficacy and tacrolimus level.Tacrolimus was well tolerated at current dose,besides one with new onset hypertension and one with alopecia.ConclusionOur results suggest that tacrolimus at low dosage and serum level is potentially effective and safe for the treatment of patients with LN and persistent proteinuria resistant to CYC.The optimal dosage of tacrolimus for LN may be 0.03-0.06 mg·kg-1·d-1.

14.
China Journal of Orthopaedics and Traumatology ; (12): 466-468, 2011.
Article in Chinese | WPRIM | ID: wpr-351704

ABSTRACT

<p><b>OBJECTIVE</b>To explore the prognostic significance of hidden blood loss in total hip arthroplasty.</p><p><b>METHODS</b>From May 2008 to July 2009, Harris hip score was used to evaluate the functions of 71 patients undergoing single side total hip arthroplasty (including 47 males and 24 females with a mean age of 68.3 years, ranged from 48 to 75 years). The blood loss in the operation was analyzed to study the correlation between hidden blood loss and the functional rehabilitation.</p><p><b>RESULTS</b>All 71 patients undergoing THA were involved in the result analysis. The mean total blood loss was 1473 ml and the hidden blood loss was 545 ml (37%). Hidden blood loss significantly correlated with functional rehabilitation (P = 0.001), but there were no correlations between functional rehabilitation and age, gender, operative limb of patients (P = 0.067, 0.527, 0.926, 0.072).</p><p><b>CONCLUSION</b>Hidden blood loss maybe a useful prognostic information contributing to the functional rehabilitation of total hip arthroplasty.</p>


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Hip , Rehabilitation , Blood Loss, Surgical , Prognosis , Recovery of Function
15.
Chinese Medical Journal ; (24): 1796-1801, 2011.
Article in English | WPRIM | ID: wpr-353926

ABSTRACT

<p><b>BACKGROUND</b>Hemodynamic evaluation is crucial for the management of patients with pulmonary hypertention. Clinicians often prefer a rapid and non-invasive method. This study aimed to examine the feasibility of transthoracic echocardiography for the measurements of hemodynamic parameters in patients with pulmonary hypertension.</p><p><b>METHODS</b>A prospective single-center study was conducted among 42 patients with pulmonary hypertension caused by different diseases. Transthoracic echocardiography and right-heart catheterization were performed within 24 hours. Pulmonary artery systolic, diastolic and mean pressure (PASP, PADP and PAMP), cardiac output (CO), and pulmonary capillary wedge pressure (PCWP) were measured by both methods. A linear correlation and a Bland-Altman analysis were performed to compare the two groups of hemodynamic parameters.</p><p><b>RESULTS</b>A good correlation was found between invasive and non-invasive measurements for PASP (r = 0.96), PADP (r = 0.85), PAMP (r = 0.88), CO (r = 0.82), and PCWP (r = 0.81). Further agreement analysis done by the Bland-Altman method showed that bias and a 95% confidence interval for PASP, PADP, and CO were clinically acceptable while great discrepancies existed for PAMP and PCWP.</p><p><b>CONCLUSIONS</b>The non-invasive measurements by PASP, PADP, and CO in patients with pulmonary hypertension correlate well with the invasive determinations. Transthoracic echocardiography (TTE) was inappropriate for estimating PCWP and PAMP.</p>


Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Cardiac Catheterization , Cardiac Output , Echocardiography , Hemodynamics , Hypertension, Pulmonary , Prospective Studies , Pulmonary Wedge Pressure
16.
Journal of Experimental Hematology ; (6): 734-737, 2011.
Article in Chinese | WPRIM | ID: wpr-313905

ABSTRACT

This study was purposed to investigate the mechanism of thrombocytopenia in patients with systemic lupus erythematosus (SLE) through detecting anti-megakaryocyte antibodies in SLE patients. The serum anti-megakaryocyte antibodies in 36 SLE cases with thrombocytopenia were detected by using indirect immunofluorescence, the detected results were compared with detected results of 30 SLE cases without thrombocytopenia and 30 healthy persons. The results showed that the positive incidences of anti-megakaryocyte antibody in serum of 36 SLE cases with thrombocytopenia, 30 SLE cases without thrombocytopenia and 30 healthy persons were 19.4% (7/36), 6.7% (2/30) and 3.3% (1/30) respectively. As compared with SLE patients without thrombocytopenia and healthy persons, SLE patients with thrombocytopenia had higher incidence of anti-megakaryocyte antibodies, moreover there was significant difference between SLE patients with thrombocytopenia and healthy persons (p < 0.05), while there was no significant difference between SLE patients with or without thrombocytopenia (p > 0.05). It is concluded that autoantibodies against megakaryocytes exist in SLE patients and may partially contribute to the incidence of thrombocytopenia in SLE patients. The detection of anti-megakaryocyte antibodies with a enough case number is needed to make a final conclusion on thrombocytopenia pathogenesis in SLE.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Autoantibodies , Blood , Fluorescent Antibody Technique, Indirect , Lupus Erythematosus, Systemic , Blood , Allergy and Immunology , Megakaryocytes , Allergy and Immunology
17.
Chinese Journal of Rheumatology ; (12): 690-692, 2011.
Article in Chinese | WPRIM | ID: wpr-671634

ABSTRACT

ObjectiveTo investigate the clinical features and risk factors of patient with Wegener's granulomatosis complicated with pulmonary infection.Methods Patients with Wegener's granulomatosis admitted to our hospital in the past 11 years were retrospectively analyzed.Comparisons between groups were performed by t tests or Fisher test.ResultsPulmonary infection occurred in 27 cases with an incidence rate of 29%.Twenty-six percent of pulmonary infections occurred at the initial diagnosis,and 44% occurred within 6 months,while 30% occurred later than 6 months.The clinical manifestations of pulmonary infection were productive cough (89%),hemoptysis (63%),fever and fatigue (56%),chest pain and pactoralgia (33%).The most common causative pathogen were bacteria(59% ),fungi(37% ),and tubercle bacillus(37% ).Sinus infection(P=0.01),hypoproteinemia(P=0.03),hypoimmunoglobulinemia (P=0.007),and methylprednisolone pulse therapy(P=0.002) were the risk factors for pulmonary infection.ConclusionThe occurrence of Wegener's granulomatosis complicated with pulmonary infection is high within 6 months.The most common clinical manifestation is productive cough.The most common causative pathogens are bacteria,tubercle bacillus and fungi.Sinus infection,hypoproteinemia,hypoimmunoglobulinemia,and methylprednisolone pulse therapy are risk factors of pulmonary infection.

18.
Chinese Journal of Rheumatology ; (12): 604-607, 2011.
Article in Chinese | WPRIM | ID: wpr-671592

ABSTRACT

ObjectiveTo study the clinical features, arterial involvement, therapeutic strategies and outcomes of Takayasu arteritis (TA). MethodsThe clinical symptoms, arterial images, inflammatory parameters and follow-up information of 173 patients with TA were retrospectively studied. Comparisons between groups were performed by t-test. ResultsThere were 136 female and 37 male patients in this study. The mean age at onset was(26±11 ) years. Hypertension, pulse deficit or asymmetrical pulse, and fever were present in 46.6%, 41.1%, 28.7% of patients, respectively. The distribution of arterial involvement were 64.7%in aorta, 9.8% in pulmonary artery, 19.1% in innominate artery, 65.9% in common carotid arteries, 65.3%in the subclavian artery, 36.2% in the renal artery, 12.1% in the vertebral artery, and 5.8% in coeliac axis.Elevated erythrocyte sedimentation rate(ESR) was found in 61.0% patients. Active tuberculosis or history of tuberculosis was implicated in 45 patients(26.0%). Ten patients(5.8%) were hepatitis B virus carriers.Among 105 followed-up patients, 98 patients(94.2%) achieved persistent remission, 17 patients relapsed when corticosteroids were tapered. ConclusionCorticosteroids combined with or steroid alone, supplemented with endovascular intervention procedures or surgical bypass procedures when necessary, can effectively control the clinical symptoms and inflammatory parameters and improve the quality of life of patients.

19.
Chinese Journal of Rheumatology ; (12): 400-403, 2011.
Article in Chinese | WPRIM | ID: wpr-671564

ABSTRACT

Objective To investigate the presentationand significance of circulating autoantibodies to erythropoietin receptor (EPOR) in sera from patients with systemic lupus erythematosus (SLE). Methods One hundred and twenty-four consecutive patients with SLE, seven with autoimmune hemolytic anemia (AIHA), 19 patients with iron deficiency anemia (IDA) and 45 normal individuals were involved in this study. In all patients with SLE, the disease activity was evaluated using the European consensus Lupus Activity Measurement scale. Antibodies to EPOR were detected by enzyme-linked immunosorbent assay (ELISA). All data were tested with Chi-squared or Student's t tests by SPSS software. Results A higher frequency of antibodies to EPOR were detected in SLE patients than healthy controls (20.2% vs 2.2%, P=0.004), however, they could not be detected in AIHA and IDA patients. Moreover, anti-EPOR antibodies were detected in 17 (33.3%) of 51 SLE patients with anemia, compared with that in 8 (11.0%, P=0.002) of 73 patients without anemia. Furthermore, patients with antibodies to EPOR had more severe anemia and often presented as microcytic anemia (P =0.005) than those without anti-EPOR antibodies. Finally, anti-EPOR antibodies seemed to be more likely to occur in patients with skin rash (P=0.014), low levels of C3 component of complement (P=0.01), positive anti-dsDNA antibodies (P=0.000) and higher disease activity scores (P= 0.024). Conclusion The higher incidence of antibodies to EPOR in SLE patients with anemia suggest that anti-EPOR antibodies might play a vital role in the development of anemia in SLE patients. Thus, detecting anti-EPOR antibodies in SLE patients with anemia may be helpful.

20.
Chinese Medical Sciences Journal ; (4): 1-12, 2010.
Article in English | WPRIM | ID: wpr-299467

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the role of TNF receptor-associated factor 2 (TRAF-2) and TRAF6 in CD40-induced nuclear factor-kappaB (NF-kappaB) signaling pathway and whether CD40 signaling requires TRAF2.</p><p><b>METHODS</b>Human B cell lines were transfected with plasmids expressing wild type TRAF2 or dominant negative TRAF2, TRAF2-shRNA, or TRAF6-shRNA. The activation of NF-kappaB was detected by Western blot, kinase assay, transfactor enzyme-linked immunosorbent assay (ELISA), and fluorescence resonance energy transfer (FRET). Analysis of the role of TRAF-2 and TRAF-6 in CD40-mediated NF-kappaB activity was examined following stimulation with recombinant CD154.</p><p><b>RESULTS</b>TRAF2 induced activity of IkappaB-kinases (IKKalpha, IKKi/epsilon), phosphorylation of IkappaBalpha, as well as nuclear translocation and phosphorylation of p65/RelA. In contrast, TRAF6 strongly induced NF-kappaB activation and nuclear translocation of p65 as well as p50 and c-Rel. Engagement of CD154-induced nuclear translocation of p65 was inhibited by a TRAF6-shRNA, but conversely was enhanced by a TRAF2-shRNA. Examination of direct interactions between CD40 and TRAFs by FRET documented that both TRAF2 and TRAF6 directly interacted with CD40. However, the two TRAFs competed for CD40 binding.</p><p><b>CONCLUSIONS</b>These results indicate that TRAF2 can signal in human B cells, but it is not essential for CD40-mediated NF-kappaB activation. Moreover, TRAF2 can compete with TRAF6 for CD40 binding, and thereby limit the capacity of CD40 engagement to induce NF-kappaB activation.</p>


Subject(s)
Animals , Humans , B-Lymphocytes , Cell Biology , Physiology , CD40 Antigens , Metabolism , Cell Line , Extracellular Signal-Regulated MAP Kinases , Metabolism , Fluorescence Resonance Energy Transfer , I-kappa B Kinase , Metabolism , NF-kappa B , Genetics , Metabolism , Proto-Oncogene Proteins c-fos , Metabolism , Signal Transduction , Physiology , TNF Receptor-Associated Factor 2 , Genetics , Metabolism , TNF Receptor-Associated Factor 6 , Genetics , Metabolism , Transcription Factor RelA , Metabolism , p38 Mitogen-Activated Protein Kinases , Metabolism
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