[Efficacy of rituximab therapy for 10 patients suffering from systemic lupus erythematosus with intestinal involvement].

We retrospectively analyzed therapy efficacy and the adverse reactions of 10 patients suffering from systemic lupus erythematosus (SLE) with intestinal involvement treated with rituximab (RTX). Patients were hospitalized in the Department of Rheumatology and Immunology of the First Medical Center of PLA General Hospital from January 2015 to January 2023. Among the 10 patients, two were men and eight were women. The age of the cohort was (41.9±8.8) years. The age at disease onset was (28.8±9.2) years. The total course of the SLE diagnosis was(109.6±59.9) months. The course of the diagnosis of SLE with intestinal involvement was (89.3±50.2) months. The time from the appearance of intestinal symptoms to the diagnosis of SLE with intestinal involvement was 1.5 (1.0,8.0) months. The time from the diagnosis of SLE with intestinal involvement to RTX use was 13.0 (1.0,46.3) months. Follow-up duration after application of RTX treatment was (55.3±28.4) months. There were five cases of abdominal pain, four cases of abdominal distension, nine cases of diarrhea, three cases of nervous-system involvement, nine cases of lupus nephritis, and seven cases of serositis. All 10 patients underwent computed tomography and radiology of the abdomen. Eight patients had intestinal-wall edema, seven suffered intestinal dilation, four had target signs, three suffered congestion of mesenteric blood vessels, eight had increased mesenteric-fat density, and six had false intestinal obstruction. All 10 patients showed a low level of complement C3 (250-750 mg/L). Nine cases showed a low level of complement C4 (10-90 mg/L). The SLE disease activity index 2000 (SLEDAI-2K) at baseline in 10 patients was 20.5 (17.8, 30.0). After receiving RTX (0.5 g: day 1, day 14, or 375 mg/m2: day 1, day 14) induction treatment, the intestinal symptoms of 10 cases were relieved completely. Four patients had adverse reactions, of which three received a high-dose glucocorticoid combined with RTX treatment simultaneously. Adverse reactions manifested mainly as a reduced level of IgG and infection with herpes simplex virus in one case, reduced level of IgG and lung infection in one patient, lung infection in one case, and reduced IgG level in one patient. RTX may an efficacious treatment strategy for patients suffering from refractory SLE with intestinal involvement.

Regions Important for Hemagglutination Activity and Serotypes of Avibacterium paragallinarum HMTp210 Protein.

Avibacterium paragallinarum is an important respiratory pathogen of domestic chickens. Avibacterium paragallinarum has been subtyped into three serogroups and nine serovars according to the Page and revised Kume schemes. The major hemagglutinin antigen of A. paragallinarum is HMTp210, which is a large protein of about 2000 amino acids (aa), including a 70-aa signal peptide at its N-terminal end. However, the regions important for the hemagglutination (HA) activity and serotypes of HMTp210 remain unclear. In this study we constructed a series of A. paragallinarum strains expressing HMTp210 in-frame deletion mutants and determined their HA titers to identify the regions important for the HA activity and serotypes of HMTp210. Two distinct types of HA activities were found in HMTp210. The type 1 HA activity resided in the region spanning the full-length HA (aa 71-2084), whereas the type 2 resided in the region spanning aa 1003-2084. The putative ligand binding of the type 1 HA activity was located at aa 176-360, which had a structure similar to YadA of Yersinia enterocolitica. The putative ligand binding site of the type 2 HA activity was located at aa 1003-1125, which had a structure similar to UspA1 from Moraxella catarrhalis. The type 1 HA activity appeared to be Page serogroup specific, whereas type 2 appeared to be Kume serovar specific. Finally, sequence analyses of the regions spanning aa 1-400 and aa 1100-1600 of HMTp210 could be useful for the molecular serotyping (the Page and revised Kume schemes) of A. paragallinarum isolates.

Regiones importantes para la actividad de hemaglutinación y serotipos de la proteína HMTp210 de Avibacterium paragallinarum. La bacteria Avibacterium paragallinarum es un patógeno respiratorio importante de los pollos domésticos. Avibacterium paragallinarum se subtipificó en tres serogrupos y nueve serovares de acuerdo con los esquemas revisados de Page y Kume. El principal antígeno de la hemaglutinina de A. paragallinarum es la proteína HMTp210, que es una proteína grande de unos 2000 aminoácidos (aa), que incluye un péptido señal de 70 aminoácidos en su extremo N-terminal. Sin embargo, las regiones importantes para la actividad de hemaglutinación (HA) y de los serotipos de la proteína HMTp210 siguen sin estar determinados. En este estudio, se construyó una serie de cepas de A. paragallinarum que expresaban mutantes de deleción en marco de lectura de HMTp210 y se determinaron sus títulos de hemaglutinación para identificar las regiones importantes para la actividad de hemaglutinación y de los serotipos de HMTp210. Se encontraron dos tipos distintos de actividades hemaglutinación en la proteína HMTp210. La actividad de hemaglutinación de tipo 1 residía en la región que abarcaba la longitud completa (aminoácidos 71­2084), mientras que la de tipo 2 residía en la región que abarcaba entre los aminoácidos 1003­2084. El sitio supuesto de unión al ligando de la actividad de hemaglutinación tipo 1 se ubicó entre los aminoácidos 176­360, que tenía una estructura similar a la proteína YadA de Yersinia enterocolitica. El supuesto sitio de unión del ligando de la actividad de hemaglutinación tipo 2 se ubicó entre los aminoácidos 1003­1125, que tenía una estructura similar a la proteína UspA1 de Moraxella catarrhalis. La actividad de hemaglutinación tipo 1 parecía ser específica del serogrupo Page, mientras que la hemaglutinación tipo 2 parecía ser específica del serovar Kume. Finalmente, los análisis de secuencias de las regiones que abarcan los aminácidos 1­400 y aminoácidos 1100­1600 de HMTp210 podrían ser útiles para la serotipificación molecular (por el esquema revisado de Page y Kume revisado) de aislamientos de A. paragallinarum.

[Pathological features and immune microenvironment in HER-2 intratumoral heterogeneous breast cancers].

Objective: To observe the clinical pathology features, and immune microenvironment of HER-2 intratumoral heterogeneity breast cancer. Methods: Thirty cases of HER-2 intratumoral heterogeneous breast cancer were retrospectively analyzed in Tianjin Medical University Cancer Institute and Hospital from November 2017 to June 2020. HER-2 expression was detected by immunohistochemistry and verified by dual color silver-enhanced in-situ hybridization (D-SISH). HER-2 intratumoral positive and negative regions were divided. The pathological characteristics, subtype, and the level of tumor infiltrating lymphocytes (TILs) and the expression of programmed cell death-ligand 1 (PD-L1) were evaluated respectively. Results: The proportion of HER-2 positive cells of the breast cancer ranged from 10% to 90%. The pathological type was mainly invasive non-special typecarcinoma. Six cases presented different pathological types between HER-2 positive and negative regions. The HER-2-positive areas included 2 cases of carcinoma with apocrine differentiation, and the negative areas included 2 cases of invasive micropapillary carcinoma, 1 case of invasive papillary carcinoma, and 1 case of carcinoma with apocrine differentiation. In HER-2 positive regions, 17 cases were Luminal B and 13 cases were HER-2 overexpressed types. There were 22 cases of Luminal B and 8 cases of triple negative tumors in the HER-2 negative areas. The levels of TILs in HER-2 positive and negative areas accounted for 53.3% (16/30) and 26.7% (8/30), respectively, with a statistically significant difference (P=0.035). The positive expression of PD-L1 in HER-2 positive area and HER-2 negative area were 6 cases and 9 cases, respectively. Among 8 cases with HER-2 negative regions containing triple negative components, 4 cases were positive for PD-L1 expression. Conclusions: In the case of HER-2 intratumoral heterogeneity, it is necessary to pay attention to both HER-2 positive and negative regions, and evaluate subtype separately as far as possible. For HER-2 intratumoral heterogeneous breast cancer containing triple negative components, the treatment mode can be optimized by refining the intratumoral expression of PD-L1.

[Efficacy and safety of half-dose rituximab in the treatment of 23 cases with lupus nephritis].

The study aimed to analyze the efficacy and safety of rituximab in the treatment of 23 cases of lupus nephritis and explore the prospect of half-dose rituximab in lupus nephritis treatment. Twenty-three patients with lupus nephritis hospitalized in the Department of Rheumatology and Immunology at the First Medical Center of the PLA General Hospital from May 2013 to December 2021 were selected. Eighteen patients received rituximab 375 mg/m2 on the first and 14th days, 5 patients received 500 mg of rituximab on the first and 14th days, and rituximab was used as needed 6 months later. Methylprednisolone (80-120 mg) was given together with rituximab. Afterward, 1 mg/kg prednisone was used for 4 weeks, which was progressively tapered to maintenance doses or discontinued. B lymphocyte level, renal function, 24-h urine protein level, and systemic lupus erythematosus (SLE) disease activity index 2000 (SLEDAI2K) score before and after treatment were recorded. The efficacy and adverse reactions were analyzed. The results showed that 11 patients suffered from renal insufficiency [creatinine (162.7±58.6) µmol/L ] at baseline, while the creatinine level of 9 patients returned to normal 12 months after the treatment [ (66.3±10.1)µmol/L ]. Normal renal function of the other 12 patients was maintained during treatment. After 12 months, the 24-h urine protein level decreased from 4.00 (2.00,6.80) g in the baseline period to 0.10 (0.08,0.40) g. SLEDAI2K score decreased from 22 (18,26) in the baseline period to 3 (0,6) 12 months after the treatment. The B lymphocyte level reached 0.00 (0.00,0.01)% at 3 months. Of 23 patients, 13 patients achieved complete remission, and 7 patients achieved partial remission after 6 months of rituximab treatment. Five patients experienced adverse reactions related to rituximab, including 1 case of transfusion reaction, 1 case of perioral herpes with pulmonary infection, and 3 cases of decreased IgG levels. Therefore, rituximab regimen used in this study can be an effective treatment strategy for lupus nephritis.

Selenylation to charge transfer improvement at the counter electrode (CE)/electrolyte interface for nanocrystalline Cu1.8S1-xSex CEs.

Pt counter electrodes (CEs) have been widely used in dye-sensitized solar cells (DSSCs) due to their high conductivity and electrocatalytic activity. However, industrialization of DSSCs is limited by shortcomings of Pt CEs such as being expensive, and weak corrosion resistance in electrolytes. Reported in this paper is two simple approaches to Pt-free Cu1.8S1-xSex CEs. Nanocrystalline Cu1.8S1-xSex CEs were fabricated via two processes, that is, a solvothermal process to Cu1.8S1-xSex powder followed by CE fabrication, and a solvothermal process and CE fabrication to Cu1.8S films followed by selenylation to Cu1.8S1-xSex CEs. Photoelectric conversion efficiencies (PCE) of 4.02% and 4.16% were achieved respectively by the as-fabricated Cu1.8S1-xSex CEs. Compared with the cells with Cu1.8S CEs fabricated by the same processes, increases of 19% and 45% were achieved, respectively. The PCE improvement comes from the enhancement of charge transfer at the CE/electrolyte interface induced by the selenylation of the CEs.

[The prediction of disease progression by 18Fluorodeoxyglucose-positron emission computed tomography/CT in patients with dermatomyositis and interstitial lung disease].

To investigate the predictive value of [18F]fluorodeoxyglucose-positron emission computed tomography(PET)/CT for disease progression in patients with dermatomyositis (DM) and interstitial lung diseases (ILD). Sixty-seven DM patients who underwent [18F] FDG-PET/CT imaging were retrospectively analyzed from January 2012 to September 2017 at PLA General Hospital. Their clinical manifestations and imaging characteristics were recorded. Compared with those chronically progressed (C-ILD), patients with rapid progression (RP-ILD) had significantly higher erythrocyte sedimentation rate (ESR) and standardized uptake value (SUV) in lungs (P<0.05). In patients with RP-ILD, SUV in lungs was positively correlated with age, disease course, and ESR. Receiver operating characteristic curve analysis suggested that when lung SUV cut off value was 2.25, the sensitivity and specificity to predict disease progression was 77.8% and 72.8%, respectively. Old age, longer disease course, low creatine kinase level, higher ESR, and high SUV are prognostic factors for DM-associated ILD.

[The 478 th case: multiple myalgia with intramuscular nodules].

A 28-year-old man was admitted to the first medical center of Chinese People's Liberation Army General Hospital because of multiple myalgia and intramuscular nodules for more than 2 months. The patient complained of dysphagia, fever and weight loss 2 months ago. Magnetic resonance imaging and biopsy revealed nodular fasciitis. Inflammatory indicators including C-reactive protein, erythrocyte sedimentation rate, platelet count and fibrinogen were slightly elevated. Urine occult blood was positive. Abdominal ultrasound revealed left hydronephrosis. Because nodular fasciitis could not explain the whole situation, a needle biopsy of intramuscular nodules was performed. Pathological examination revealed intramuscular metastatic adenocarcinoma with poor differentiation. Gastric endoscope and positron emission tomography-computed tomography confirmed the diagnosis of advanced gastric adenocarcinoma with extensive metastases of esophagus, lymph nodes, muscles, ureter and bone. Although chemotherapy was given, the patient died of disease progression six months later.

[Short-term outcomes of total hip arthroplasty in the treatment of Tönnis grade 3 hip osteoarthritis in patients with spondyloepiphyseal dysplasia].

OBJECTIVE: Severe hip osteoarthritis, caused by bone or joint maldevelopment, biomechanical transformation and previous surgical intervention, is inclusively existed in spondyloepiphyseal dysplasia (SED). To investigate and discuss the short-term efficacy and possible effects of total hip arthroplasty in the treatment of Tönnis grade 3 hip osteoarthritis in patients with SED. METHODS: From January 2017 to June 2019, 374 patients with hip osteoarthritis were involved for total hip arthroplasty conducted by senior professional surgeons, of whom 9 patients (6 males and 3 females) with 12 hip osteoarthritis secondary to the SED met the inclusive and exclusive criteria and received the above-mentioned hip operation. The short-term outcomes were observed. RESULTS: All the patients were implanted with Johnson & Johnson ceramic on ceramic cementless hip prostheses within the arthroplasty. They were followed up for an average period of 20 months. Except for one muscular calf vein thrombosis case, no complications, such as aseptic loosening, joint dislocation, fracture, neurovascular injury, deep vein thrombosis and infection were observed in all the 9 patients. Before the surgery, the average Harris hip score was 35.55, while the average of the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) was 56.56. The level of quality of life indicated by SF-12 score was 41.56 on average. The mean pre-operation visual analogue scale (VAS) was 7.44. At the last follow-up, the average Harris hip score increased to 89.56, whereas the average WOMAC declined to 41.11. Compared with the baseline point, the average SF-12 score went up to 56.33. Dramatic drop of the mean VAS value to 2.67 was also observed at the last follow-up. In addition, post-operative increase of several pelvic-related parameters including pelvic incidence, pelvic tilt and sacral slope could be observed in the SED patients. The average measured pelvic incidence, pelvic tilt and sacral slope were 68.95°±4.60°, 52.75°±1.06° and 17.45°±1.77° before operation, respectively; whilst the mean value of these specific parameters increased to 76.98°±5.12°, 60.51°±4.35° and 18.10°±2.02°, respectively. The even leg lengths of the lower extremities were obtained after total hip arthroplasty. CONCLUSION: Total hip arthroplasty is satisfactory in the short-term pain relieve and function recovery for the management of Tönnis grade 3 hip osteoarthritis secondary to the SED.

Rosuvastatin promotes osteogenic differentiation of mesenchymal stem cells in the rat model of osteoporosis by the Wnt/ß-catenin signal.

OBJECTIVE: The aim of this study was to explore the promoting effect of rosuvastatin on the osteogenic differentiation of mesenchymal stem cells in the rat model of osteoporosis through the Wnt/ß-catenin signal. MATERIALS AND METHODS: A total of 30 rats were purchased from the Animal Research Center of Shanxi Medical University. All rats were randomly allocated into three groups, including: group A (control group, n=10), group B (ovariectomized group, n=10), and group C (rosuvastatin gavage group, n=10). The bone metabolism indexes, bone mineral density (BMD) and the Wnt/ß-catenin signaling pathway-related proteins in blood samples of rats in each group were measured, respectively. Furthermore, the bone marrow mesenchymal stem cells of rats were used for alkaline phosphatase (ALP) staining. All data were analyzed using the Statistical Product and Service Solutions (SPSS) 22.0 software (IBM Corp., Armonk, NY, USA). RESULTS: The rats firstly received 9 consecutive weeks of feeding with drug intervention. The imaging results revealed that trabecular thickness in group A was significantly higher than that of group B and group C, showing statistically significant differences (p<0.05). After 9 consecutive weeks of feeding with drug intervention, BMD of the femurs of rats in group A and group C was significantly higher than that of group B, showing statistically significant differences (p<0.05). However, there was no significant difference in BMD between group A and group C (p>0.05). The level of calcium representing bone absorption level in serum of rats in group B was remarkably higher than that of group A, and the difference was statistically significant (p<0.05). However, the level of ALP representing bone absorption level in the serum of rats in group B was significantly lower than that of group A (p<0.05). No significant differences were found in the levels of calcium and ALP that represented bone absorption level between group C and group A (p>0.05). Meanwhile. the levels of phosphorus in the three groups were similar, showing no statistically significant difference (p>0.05). Moreover, the expression of ALP-positive cells in the rats of group A and group C was markedly higher than that of group B (p<0.05). After drug intervention through feeding for 9 consecutive weeks, no evident difference was found in the relative expression of Wnt/ß-catenin signaling pathway-related protein glycogen synthase kinase-3ß (GSK-3ß) among the three groups. The relative expression of the protein phosphorylated GSK-3ß (p-GSK-3ß) in group C was significantly lower than that of group B (p<0.05). Furthermore, the relative protein expressions of ß-catenin and cyclin D1 in group C were significantly higher than those in group B (p<0.05). CONCLUSIONS: Rosuvastatin can improve bone metabolism in osteoporosis rats and increasing BMD of bone tissues in rats with osteoporosis. Besides, the Wnt/ß-catenin signaling pathway plays a crucial role in the regulation of the stem cell self-renewal and bone genesis.

[Comparison of clinical manifestations according to HLA-B(27) genotype in ankylosing spondylitis patients: real-world evidence from smart management system for spondyloarthritis].

Objective: The aim of this study was to set up a large, longitudinal and prospective database to compare the clinical manifestations in human leucocyte antigen (HLA)-B(27) positive and negative patients with ankylosing spondylitis(AS) based on real-world evidence in Chinese population. Methods: A total of 897 outpatients with confirmed AS were recruited consecutively by smart management system for spondyloarthritis (SMSP) from April 13, 2016 to June 6, 2017 in Chinese PLA General Hospital from 30 provinces and autonomous regions. 801 patients with HLA-B(27) data were included in the analysis. Demographic and clinical parameters including Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), ankylosing spondylitis disease activity score (ASDAS), arthritis, enthesitis, Bath ankylosing spondylitis metrology index (BASMI), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were compared between HLA-B(27) positive and negative groups. Results: A total of 801 patients were included in the analysis with an average age of (30.7±8.8) years. There were 659 males and 142 females and HLA-B(27) was present in 88.0%(705/801). Males were significantly more in HLA-B(27) positive patients [83.3%(587/705) vs. 75.0%(72/96); P=0.047].The average age at disease onset was (22.3±7.6)years in HLA-B(27) positive patients and (24.4±8.7) years in HLA-B(2)7 negative ones (P=0.028).There was significant difference in diagnose delay between two groups [14.3(2.5,43.6)months in HLA-B(27) positive patients vs. 20.3(5.0,67.4) months in HLA-B(27) negative ones, P=0.041]. Anterior uveitis was found to be significantly more common in HLA-B(27) positive patients [18.9% (133/705)vs.7.3%(7/96),P=0.005], and knee involvement less common in HLA-B(27) positive patients [4.0%(27/682) vs.10.0%(9/90), P=0.010], conversely. CRP[6.5(3.0, 16.4)mg/L vs. 3.5(1.6, 12.3)mg/L] and ESR[11.0(4.0, 24.0)mm/1h vs. 7.0(3.0, 16.0)mm/1h] were significantly higher in HLA-B(27) positive patients(P=0.005,0.013, respectively).But no differences in BASDAI,ASDAS,BASFI and BASMI were obtained between two groups. Conclusions: HLA-B(27) positive patients had a higher proportion of males, a younger age of onset and a greater risk for occurrence of anterior uveitis, suggesting a poorer prognosis.

Plasma pharmacokinetics and tissue depletion of cyromazine and its metabolite melamine following oral administration in laying chickens.

The study was designed to characterize the plasma pharmacokinetics and tissue depletion profiles (including eggs) of cyromazine (CYR) in chickens following oral administration alone or in combination with melamine (MEL). In order to assess the pharmacokinetic profile of CYR, chickens were administered 1 or 10 mg/kg (single oral doses), whereas residue studies were conducted in chickens fed CYR alone (5 or 10 mg/kg) or CYR (5 mg/kg) and MEL (5 mg/kg) for a period of 14 days. Estimates for the apparent volume of distribution (1.66 L/kg), clearance (7.17 mL/kg/min), and elimination half-life (2.82 h) were derived by noncompartmental analyses. The highest concentration of CYR occurred in liver but fell below detectable limits within 3 days following drug withdrawal from feed. Combined feeding of MEL with CYR did not significantly alter CYR tissue levels. CYR residues were detected only in egg white and were undetectable at the 2nd day postadministration. No MEL was found in eggs unless it had been added to the feed, and when present, it almost exclusively restricted to the egg white. Based upon the results of this initial study of CYR pharmacokinetics and residue depletion, it appears that use of CYR as a feed additive either alone (5 or 10 mg/kg) or in combination with MEL (both agents at 5 mg/kg) does not produce unsafe residue levels in edible products as long as appropriate withdrawal periods are followed for tissues (3 days) and eggs (2 days). However, our results indicate that adoption of a zero-day withdrawal period should be reconsidered in light of these results.

[Clinical analysis of nose rhabdomyosarcoma].

Objective:To improve the diagnosis of the nose rhabdomyosarcoma.Method:Twenty-four patients with nose rhabdomyosarcoma were studied retrospectively.Result:Among 24 patients with nose rhabdomyosarcoma, three patients were in stage Ⅰ, four patients were in stage Ⅱ, eleven patients were in stage Ⅲ, and six patients were in stage Ⅳ. Embryonal rhabdomyosarcoma is the commonest in all the pathological types. Most patients need comprehensive therapy, including surgery operation, radiotherapy, and multicycle chemotherapy. Prognosis was poor in most of the cases. The survival rate of one year was 70.8% (17/24), and survival rate of three years was 30.3% (8/24).Conclusion:Different surgical protocols should be adopted for different patients, and postoperative chemoradiotherapy should be adopted for advanced treatment. By means of multidisciplinary collaboration, the patient's survival time would be prolonged.

[Comparative study of different grading criteria of sacroiliac joint computed tomogrphy in ankylosing spondylitis].

Objective: To assess the value of different grading criteria of sacroiliac joint (SIJ) computed tomogrphy (CT) in ankylosing spondylitis (AS). Methods: Patients who had received SIJ CT examinations from June 2012 to December 2015 were enrolled.The CT scans were read by one rheumatologist.The difference between patients with sacroiliitis or without sacroiliitis was compared.The 1984 revision of modified New York (mNY) criteria, the criteria established by Lee (Lee criteria) and the Innsbruck criteria were used to evaluate SIJs on CT in patients with sacroiliitis. Results: Totally 2 714 patients were enrolled in this study.Thereinto 509 patients including 324 male and 185 female were detected with SIJs abnormality.The proportions of SIJs graded 3 or 4 by these three criteria were 79.37%, 82.91% and 76.32%, respectively.The consistency of grading between mNY criteria and Lee criteria was good (k=0.767, P<0.01). The correlation between Innsbruck criteria and other two criteria were satisfactory (r=0.866 and 0.839, respectively). There were more SIJs graded 3 by Lee criteria (64.44%), comparing with mNY criteria (60.90%). Forty five SIJs graded 1-3 by mNY criteria were graded 0 by Lee criteria, indicating that the latter criteria may have a better specificity. When evaluating the severity of SIJs, Innsbruck criteria has a better discrimination capability and the proportions of SIJs graded Ⅱ (A) to Ⅳ (B) were 10.71%, 8.94%, 26.82%, 20.92%, 10.12%, respectively. Conclusions: Lee criteria has a better diagnostic specificity with a reduction of difficulty in assessing procedure, while Innsbruck criteria is a more detailed grading system with a possibility to reflect the development of sacroiliitis.

[Septic arthritis in systemic lupus erythematosus: a retrospective analysis of 6 cases].

Base on the clinical characteristics of septic arthritis in a group of systemic lupus erythematosus patients, this study has found out that high systemic lupus erythematosus disease activity index, leucopenia, high cumulative dose of glucocorticoid, methylprednisolone intravenous pulse therapy and joint cavity puncture were closely correlated with septic arthritis. Once septic arthritis is suspected, culture specimens should be collected and appropriate antibiotics are suggested immediately. Also, surgical drainage is a very useful approach.

[A preliminary exploration of low-dose semicoronal CT of the sacroiliac joints in the diagnosis of ankylosing spondylitis].

OBJECTIVE: To evaluate the clinical value of low-dose semicoronal computerized tomography (CT) of sacroiliac joints (SIJ) in the early diagnosis of ankylosing spondylitis (AS). METHODS: Patients who were diagnosed with AS and had received axial CT examination of SIJs over the past 2 years were recruited. All of them simultaneously underwent a low-dose semicoronal CT of SIJs. The clinical data were recorded. Radiation dose was compared between low-dose CT and the previous conventional axial CT. Image quality of low-dose CT was assessed and correlation between image quality and weight or body mass index (BMI) was analyzed. CT images of the two groups were graded by modified New York criteria, the Lee criteria and the Innsbruck criteria. The kappa coefficient was used to assess the consistency of grading between the two groups. RESULTS: Thirty-three patients were enrolled in this study. The effective dose (ED) of semicoronal SIJ CT was 3.37 mSv which was 49% lower than conventional axial CT (6.56 mSv). Lower dose had the potential protection of gonads. The quality of images in male patients with BMI<25 kg/m(2) and all female patients were good or excellent. There was a significant negative correlation between image quality and BMI (r=-0.746, P=0.000; r=-0.784, P=0.000; respectively). All patients were diagnosed as sacroiliitis by modified New York criteria and the grading of two groups was consistent. The consistency of grading between two groups was satisfactory no matter which classification criteria was used. (k=0.897 with Lee criteria; k=0.814 with Innsbruck criteria; P>0.05). CONCLUSIONS: The radiation dose of semicoronal SIJ CT is significantly lower than that of the conventional axial CT with comparable efficacy of diagnosis.