Serum neopterin, tumor necrosis factor-alpha and soluble tumor necrosis factor receptor II (p75) levels and disease activity in Egyptian female patients with systemic lupus erythematosus

OBJECTIVE: To determine the clinical value of assaying serum levels of neopterin, tumor necrosis factor-alpha (TNF-alpha) and soluble tumor necrosis factor receptor II (p75) (sTNFRII) in patients with systemic lupus erythematosus (SLE), manifested clinically with lupus nephritis (LN), neuropsychiatric lupus erythematosus (NPLE), and/or vasculitis compared with established parameters (complements C3 and C4). PATIENTS AND METHODS: Serum concentrations of neopterin, TNF-alpha and sTNFRII were studied in 40 female patients with SLE at various degrees of disease activity and in 10 healthy controls, matched for age and sex, using an ELISA kit. Disease activity was assessed by the SLE disease activity index (SLEDAI) score. Thirty-five, 30 and 28 of our patients presented with LN, NPLE and/or vasculitis, respectively, as the main clinical manifestation. RESULTS: Serum levels of neopterin, TNF-alpha and sTNFRII were significantly increased, while the TNF-alpha/sTNFRII ratio, C3 and C4 levels of SLE patients were significantly lower than those of healthy controls. Neopterin and sTNFRII were the only parameters that showed significantly higher levels in SLE patients with mild activity compared to normal subjects and were the only parameters that showed a significant elevation in membranous nephritis and in mild NPLE compared to patients without nephritis and NPLE. Patients with vasculitis had significant elevation of serum neopterin, TNF-alpha and sTNFRII levels compared to patients without vasculitis. We found significant correlations between all measured variables and the SLEDAI score. Also, serum neopterin levels showed significant positive correlation with serum TNF-alpha, sTNFRII and TNF-alpha/sTNFRII levels. Serum neopterin and sTNFRII could be used to identify SLE patients from normals with a sensitivity and specificity of 100%. Multivariate linear regression analysis showed that serum sTNFRII was the only significant independent variable among parameters for prediction of SLE disease activity. CONCLUSION: We suggest that serum sTNFRII and neopterin are more sensitive markers of disease activity than TNF-alpha, C3 or C4. However, sTNFRII may be a clinically useful independent marker for prediction of SLE disease activity and to differentiate normal subjects from those having mild SLE.     

Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study

Introduction: Rheumatoid arthritis (RA) patients who have active disease with longer disease duration have been reported to have increased risk of cardiovascular events compared to the normal population. Objective: The primary aim of our study is to ascertain the prevalence of significant asymptomatic coronary artery disease (CAD) in Asian RA patients who are in remission using multi‐detector computed tomography (MDCT). The secondary aims of our study are the usage of pulse wave velocity and the biomarkers N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) and high‐senstivity C‐reactive protein (hs‐CRP) to detect subclinical atherosclerosis in RA patients. Methods: We performed a comparative cross‐sectional study of 47 RA patients who were in remission with a control group of non‐RA patients with a history of atypical chest pain in Sarawak General Hospital from November 2008 to February 2009. All patients underwent 64‐slice MDCT, assessment of arterial stiffness using the SphygmoCor test and blood analysis for NT‐proBNP and hsCRP. Results: There were 94 patients in our study with a mean age of 50 ± 8.8 years. The RA and control patients in each group were matched in terms of traditional CV risk factors. Our RA patients had a median disease duration of 3 years (IQR 5.5). MDCT showed evidence of CAD in nine (19.1%) RA patients and three (6.4%) control patients (P = 0.06). There was no significant association between pulse wave velocity (PWV) and presence of CAD in our RA group. There was no significant correlation between PWV with levels of proBNP or hsCRP in our RA patients. Conclusions: In our current pilot study with the limitation of small sample size, RA was not associated with an increased risk of CAD in our RA patients who were in remission. Larger studies of CAD in Asian RA patients are needed to confirm our current finding.     

多层螺旋CT仿真内镜技术在胃间质瘤与胃癌鉴别诊断中的临床应用

目的探讨多层螺旋CT(MSCT)仿真内镜技术(CTVE)在胃间质瘤与胃癌鉴别诊断中的临床应用价值。资料和方法临床疑似胃占位性病变71例,行MSCT扫描并进行CTVE重建。CTVE诊断结果与胃镜或手术后病理结果进行对照。结果经病理证实胃间质瘤18例,胃癌26例,CTVE敏感度为93.2%,特异度为96.3%。CTVE显示腔内型间质瘤呈类球形腔内肿块伴顶端溃疡形成;腔外型间质瘤表现为丘状隆起、桥形皱襞;BorrmannⅠ、Ⅱ型胃癌呈息肉样向胃腔内突出,或伴不规则溃疡;BorrmannⅢ、Ⅳ型胃腔不同程度变窄,伴不规则溃疡形成、胃壁皱襞消失。结论 CTVE在胃间质瘤与胃癌鉴别诊断方面有一定的临床应用价值,但需要注意结合轴位图像及临床资料做出诊断。     

Bioassay chamber for angiogenesis with perfused explanted arteries and electrospun scaffolding

OBJECTIVE: The purpose of this study was to test the hypothesis that explanted perfused arteries can serve as the initial endothelial cell culture source to evaluate the onset of angiogenesis in a cellulose acetate electrospun scaffold. METHODS: Electrospun scaffolds with fiber diameters roughly controlled in three broad ranges: 0.01 to 0.2, 0.2 to 1, and 1 to 5 microm (Nanomed Nanotechnol Biol Med 2:37-41, 2006), were used in cell culture to determine which provides the best culture topology. This scaffold was then tested in a bioassay chamber whose cellular source was an explanted abdominal aorta from donated euthanized mice. Scaffolds were draped over a cannulated vessel perfused for 24 h. Cell viability, density, and morphology were quantified. RESULTS: The largest fiber diameter group provided the best culture topology for human umbilical vein endothelial cells, showing high cell viability and density, and enhanced elongated cell morphology. Addition of single-walled carbon nanotubes decreased cell density significantly but chitosan heightened cell density and promoted spontaneous capillary tube like structure. Viability of endothelial cells increased with higher flow in the bioassay chamber. CONCLUSIONS: Endothelial cells showed a growth preference towards larger diameter fibers. Addition of chitosan improved culture conditions. Thus, this study provides a proof of principle for the possibility of co-culturing tissue engineered vascular networks from a perfused explant.     

济南市艾滋病流行特征与趋势分析

[目的]全面了解济南市艾滋病流行特征,探讨切实有效的防治模式.[方法]对济南市近年来有关艾滋病疫情资料进行分析.[结果]1998年以来,累计发现抗-HIV阳性者95例,其中HIV感染者65例,艾滋病病人30例.HIV感染者和艾滋病病人逐年增加.95例中,流动人口80例;男性71例,女性24例;20～39岁青壮年71例;经性接触感染者29例,静脉注射吸毒感染者28例.[结论]济南市HIV感染者和艾滋病病人逐年上升,以性接触、静脉吸毒途径感染为主,外来流动人员占多数.     

Haemochromatosis patients' research priorities: Towards an improved quality of life

Background

Chronic diseases are associated with a range of functional and psychosocial consequences that can adversely affect patients' quality of life (QoL). Haemochromatosis (HC) is a genetically heterogeneous disorder characterized by chronic iron overload that can ultimately lead to multiple organ dysfunction. Clinical diagnosis remains challenging due to the nonspecificity of symptoms and a lack of confirmatory genotyping in a substantial proportion of patients. Illness perception among HC patients has not been extensively investigated, lacking relevant information on how to improve their QoL.

Methods

We present the results of the first worldwide survey conducted in nearly 1500 HC respondents, in which we collected essential demographic information and identified the aspects that concern HC patients the most.

Results

Out of all the participants, 45.3% (n = 676) voiced their concern about physical and psychological consequences such as HC-related arthropathies, which can ultimately affect their social functioning. A similar proportion of patients (n = 635, 42.5%) also consider that better-informed doctors are key for improved HC disease management. Taking a patient-centred approach, we expose differences in patients' disease perspective by social and economic influences.

Conclusions

We identify potential targets to improve patients' health-related QoL and reflect on strategic measures to foster gender equity in access to health resources. Finally, we make a call for a highly coordinated effort across a range of public policy areas to empower participants in the HC research process and design.

Patient or Public Contribution

Nearly 1500 patients with hereditary HC responded to an anonymized online survey in which research and clinical priorities were addressed regarding this chronic and rare disease.