有氧运动对系统性红斑狼疮患者运动能力生活质量和心境影响的临床研究

目的 探讨有氧运动对稳定期系统性红斑狼疮(SLE)患者运动能力、生活质量、心理状态和疾病的影响.方法 确诊为稳定期的SLE患者分为2组,其中训练组24例和对照组25例,训练组患者每周进行3-4次有氧运动训练,运动强度以最大心率储备值的20%～40%为目标心率,2组患者分别在入组前,入组1、3、6个月后分别进行总体自我感觉(VAS),SLE疾病活动指数(SLEDAI),身体工作能力(PWC170),生活质量(SF-36)和心理量表(POMS)评定.结果 2组患者入组前各指标差异无统计学意义(P>0.05),人组前后资料显示2组患者的VAS,PWC170,POMS和SF-36指标均有不同程度的改善,入组6个月后2组间相比较VAS(P<0.05),PWC170(P<0.01)和SF-36中的社会功能训练组明显好于对照组(P<0.05). VAS和POM中的5项负而情绪和总分呈负相关(r=-6.26～-0.393,P<0.01),和POM中的2项正面情绪呈正相关(r=0.534～0.611,P<0.01).结论 稳定期SLE患者可以通过医疗监督下的有氧运动来改善患者的运动能力、生活质量和心理状态,并且对疾病无不良影响.     

儿童原发性干燥综合征五例并文献复习

Objective To further understand the clinic manifestations of childhood primary Sjogren's Syndrome(pSS) and enhance early diagnosis. Methods Five cases of pSS from Renji Hospital, Shanghai, were reported and their clinical features were analysoed. And literatures from Medline database and Weipu database were reviewed and discussed. Results ①Childhood pSS had various clinic presentations that were non-specific and sicca symptoms were absent or occur late in most cases. ② The most common presentations were recurrent parotiditis and cutaneous manifestations with various locations and forms. ③ American-European Criteria for SS were not suitable for the diagnosis of childhood pSS. Conclusion Recurrent parotiditis and cutaneous manifestations in children can be used as clues for the diagnosis of childhood pSS but needs to be further confirmed by the positive results of salivary gland biopsy and autoantibodies examination, particularly SSA/SSB.     

巨噬细胞游走抑制因子与系统性红斑狼疮早发动脉粥样硬化

近年来研究发现,系统性红斑狼疮(systemic lupus ery-thematosus,SLE)患者易发生早发动脉粥样硬化(prematureatheresclemsis:年轻患者,<50岁即发生动脉粥样硬化和心脑血管事件)[1,2]当然一些传统的危险因素可能参与SLE早发动脉粥样硬化的发生,但这些因素并不能完伞解释SLE患者如此高的早发动脉粥样硬化发病率[1].     

儿童原发性干燥综合征五例并文献复习

Objective To further understand the clinic manifestations of childhood primary Sjogren's Syndrome(pSS) and enhance early diagnosis. Methods Five cases of pSS from Renji Hospital, Shanghai, were reported and their clinical features were analysoed. And literatures from Medline database and Weipu database were reviewed and discussed. Results ①Childhood pSS had various clinic presentations that were non-specific and sicca symptoms were absent or occur late in most cases. ② The most common presentations were recurrent parotiditis and cutaneous manifestations with various locations and forms. ③ American-European Criteria for SS were not suitable for the diagnosis of childhood pSS. Conclusion Recurrent parotiditis and cutaneous manifestations in children can be used as clues for the diagnosis of childhood pSS but needs to be further confirmed by the positive results of salivary gland biopsy and autoantibodies examination, particularly SSA/SSB.     

儿童原发性干燥综合征五例并文献复习

Objective To further understand the clinic manifestations of childhood primary Sjogren's Syndrome(pSS) and enhance early diagnosis. Methods Five cases of pSS from Renji Hospital, Shanghai, were reported and their clinical features were analysoed. And literatures from Medline database and Weipu database were reviewed and discussed. Results ①Childhood pSS had various clinic presentations that were non-specific and sicca symptoms were absent or occur late in most cases. ② The most common presentations were recurrent parotiditis and cutaneous manifestations with various locations and forms. ③ American-European Criteria for SS were not suitable for the diagnosis of childhood pSS. Conclusion Recurrent parotiditis and cutaneous manifestations in children can be used as clues for the diagnosis of childhood pSS but needs to be further confirmed by the positive results of salivary gland biopsy and autoantibodies examination, particularly SSA/SSB.     

初发系统性红斑狼疮患者雌激素受体表达及与骨量异 常的关系

目的探讨初发系统性红斑狼疮(Systemic lupus erythematosus,SLE)患者的骨量情况,研究其雌激素受体α(ER-α)和雌激素受体β(ER-β)的表达水平及与骨量之间的关系,为临床防治SLE患者骨质疏松提供依据。方法收集未用激素治疗的初发SLE患者临床资料,采用双能X线检测受检者腰椎(L1-4)和股骨近端的骨密度(bone mineral density,BMD),运用实时定量PCR法检测外周血淋巴细胞ER-α和ER-β的表达水平。结果初发SLE患者骨密度明显低于正常对照组(P0.05),骨量减少的发生率明显增高;初发SLE患者ER-β基因mRNA表达水平高于正常对照组(P0.01),但骨量减少组和骨量正常组之间的无显著差异(P0.05)。ER-α表达水平在初发SLE组和正常对照组之间的无显著差异(P0.05)。ER-α和ER-β表达水平与SLE患者骨量间不存在相关性(r=0.028,P=0.862;r=0.134,P=0.398)。结论 SLE患者较正常人群更容易出现骨量减少;SLE患者体内ERβ基因表达增高,但与其骨量减少之间无明显相关性。     

强直性脊柱炎合并髋关节受损的诊治策略

强直性脊柱炎（Ankylosing Spondylitis,AS）是一种慢性炎症性疾病,主要侵犯骶髂关节、脊柱骨突、脊柱旁软组织及外周关节,引起炎性疼痛、晨僵、活动受限等症状,严重者可出现关节强直。同时可伴发关节外表现,包括眼葡萄膜炎、肠道炎症、指/趾炎、皮疹等,通常为单独出现或重叠存在,其中以眼和肠道的病变最为常见。根据累及部位和临床表现的不同,可将AS分为以脊柱关节受累为主的中轴型和以外周关节受累为主的外周型。     

11例神经精神狼疮的误诊分析

目的 分析11例神经精神狼疮误诊原因,并总结其诊治经验.方法 回顾性分析11例神经精神狼疮误诊患者的临床资料,分析首诊的误诊原因,并总结其诊治经验.结果 11例患者从发病到确诊时间为0.2～6.0（3.2±1.3）个月.3例表现为精神异常、躁狂患者误诊为精神病,2例表现为下肢麻木、尿潴留患者误诊为脊髓炎,2例表现为昏迷患者误诊为脑炎,1例表现为偏瘫患者误诊为脑梗死,1例妇科取环术后出现发热、精神异常患者误诊为术后感染,1例反复咳嗽、胸闷、发热后出现精神异常患者误诊为肺部感染,1例表现为头晕、记忆力下降患者误诊为短暂性脑缺血发作.结论 神经精神狼疮临床表现复杂多样,病程较短者或初发患者易被误诊,临床医生对本病认识不足是导致误诊的主要原因;掌握神经精神狼疮临床特点、拓宽临床思维是减少误诊的关键.     

巨噬细胞移动抑制因子启动子区基因多态性与成人斯蒂尔病的关系研究

目的 研究成人斯蒂尔病(AOSD)患者巨噬细胞移动抑制因子(MIF)基因5’端启动子区-173和-794位点核苷酸多态性与疾病易感性的关系.方法 采用酶联免疫吸附法检测82例AOSD患者和55名健康志愿者血浆MIF的表达.从AOSD患者和健康者中提取基因组DNA.聚合酶链反应-限制性片段长度多态性分析法(PCR-PFLP)检测5’端启动子区-173位点核苷酸多态性,并对-794位点微卫星序列PCR产物直接进行基因分型.病例组与健康对照组之间-173 G/C SNP和-179 CATT重复序列的基因与基因型频率比较采用Pearson x2检验,血浆MIF数值采用非参数Mann-Whitney U检验.结果 AOSD患者组血浆MIF水平为(119±113) ng/ml,显著高于健康对照组(55±29) ng/ml(P＜0.01).携带有-173*C等位基因的个体疾病易感性增加[ OR=1.776;95％可信区间(CI) 1.101～2.864;P=0.017];携带有-794*5-CATT等位基因的个体患AOSD风险增加(OR=1.81;95％CI 1.27～2.58;P=0.001).结论 MIF基因启动子区-173和-794位点核苷酸多态性影响AOSD的易感性.     

蛋白磷酸化流式细胞分析技术在疾病研究中的应用

蛋白磷酸化流式细胞分析技术凭借其多参数分析以及单细胞水平的优势,在蛋白质组学研究疾病机制以及药物筛选、药效鉴定等方面逐渐地显示出广阔的应用前景,本文就该技术在研究疾病机制方面的应用及其面临的挑战做一综述。