Anticardiolipin Antibody in Patients with Behçet's Disease with and without Vascular Thrombosis

Objective: The clinical value of IgG anticardiolipin antibody in patients with Behçet's disease with or without vascular thrombosis was evaluated.   Methods: IgG isotype of anticardiolipin (aCL) antibody was assessed in 40 Behçet's disease (BD) patients with venous or arterial thrombosis, 40 BD patients without venous or arterial thrombosis and 80 healthy subjects as controls. The levels of IgG aCL were determined by an indirect ELISA method. Color Doppler Sonography, Magnetic Resonance Imaging and conventional angiography were the procedures used for other clinical evaluations. Results: Out of 40 patients with vascular thrombosis, 20(50%) were positive for low to moderate level of IgG aCL. In patients without thrombosis 22(55%) were positive for low to moderate level of IgG aCL while in none (0%) of the healthy subjects the IgG aCL was positive, neither low nor moderate. The number of patients with headache but having a normal cerebral magnetic resonance imaging (MRI), was higher in anticardiolipin positive patients without vascular thrombosis as compared to those with vascular thrombosis, (P = 0.001). Arthritis was noticed in both patents groups. 15% of aCL positive patients without thrombosis had arthritis as compared to none in aCL negative patients without thrombosis (P = 0.02).   Conclusion: The results of this study indicate that although the frequency of IgG aCL was found to be higher in Iranian patients with BD in comparison with the previous reports, except in arthritis the observed elevated IgG aCL does not correlate with clinical disease manifestations, or vascular thrombotic complications.     

Management and outcomes of surgical patients with intestinal Behçet’s disease and Crohn’s disease in southwest China

BACKGROUNDGastrointestinal involvement in Behçet''s disease (GIBD) and Crohn’s disease (CD) are inflammatory diseases sharing a considerable number of similarities. However, different from CD, the operative and postoperative management of GIBD remains largely empirical because of the lack of comprehensive treatment guidelines.AIMTo compare surgical patients with GIBD and those with CD in a medical center and identify notable clinical features and effective postoperative treatment for surgical patients with GIBD.METHODSWe searched patients diagnosed with CD and GIBD who underwent operations for gastrointestinal complications from 2009 to 2015 at West China Hospital of Sichuan University. A total of 10 surgical patients with GIBD and 106 surgical patients with CD were recruited. Information including demographic data, medication, and operative and postoperative parameters were collected and analyzed. As the incidence of surgical GIBD is low, their detailed medical records were reviewed and compared to previous studies. Moreover, the prognoses of CD and GIBD were evaluated respectively between groups treated with biological and non-biological agents.RESULTSIndication for first surgery was often acute intestinal perforation for GIBD patients (7/10 vs 0/106, P < 0.001), whereas intestinal fistulae (0/10 vs 44/106, P = 0.013) and ileus (0/10 vs 40/106, P = 0.015) were the indications for surgical CD patients. Approximately 40% of patients with GIBD and 23.6% of patients with CD developed postoperative complications, 50% of patients with GIBD and 38.7% of patients with CD had recurrence postoperatively, and 40% (4/10) of patients with GIBD and 26.4% (28/106) of patients with CD underwent reoperations. The average period of postoperative recurrence was 7.87 mo in patients with Behçet''s disease (BD) and 10.43 mo in patients with CD, whereas the mean duration from first surgery to reoperation was 5.75 mo in BD patients and 18.04 mo in CD patients. Surgical patients with GIBD more often used corticosteroids (6/10 vs 7/106, P < 0.001) and thalidomide (7/10 vs 9/106, P < 0.001) postoperatively, whereas surgical patients with CD often used infliximab (27/106), azathioprine, or 6-mercaptopurine (74/106) for maintenance therapy.CONCLUSIONPatients suffering GIBD require surgery mostly under emergency situations, which may be more susceptible to recurrence and reoperation and need more aggressive postoperative treatment than patients with CD.     

罗红霉素产品的质量分析

用高效液相色谱法于６ｍｉｎ内可将罗红霉素与相关物质完全分离并测定其含量。据红外光谱、紫外光谱、薄层层析分离及其他理化性质证明国产罗红霉素与进口罗红霉素相同，并以日本标准品为基准确定国产罗红霉素效价     

肠白塞引发消化道出血 1 例

白塞病是一种影响多系统的慢性复发性疾病,当累及胃肠道时,称之为肠白塞,可有胃肠道溃疡、出血、穿孔等表现,但因缺乏特异性而极易误诊阑尾炎、炎性肠病等。本文报道 1 例肠白塞患者的诊疗经过,并结合文献复习,讨论其诊疗进展。     

LC-MS法测定人血浆中克拉霉素的浓度

目的:建立正常人血浆中克拉霉素浓度的LC-MS测定方法.方法:血浆样品经碱化后用乙醚提取,采用选择性离子检测方法测定其血药浓度.检测仪器为岛津LCMS-2010四极杆质谱检测器,离子源为ESI源,检测离子:克拉霉素m/z:748.5[M H] ,罗红霉素m/z:837.5[M H] ,14-羟基克拉霉素m/z:764.5[M H] ;色谱柱为Shim-pack ODS(5.0 μm,250 mm×2.0 mmI.D.);流动相为0.05%醋酸-乙腈(40:60v/v).结果:克拉霉素的线性范围为0.0625～8.00μg/ml,方法的回收率为86%～98%,日内和日间的精密度均小于17%.结论:该方法经考察符合血浆样品的测定要求,可以应用于临床血药浓度的测定和药代动力学研究.