北京大学学报（医学版）最新文献

{"title":"[Analysis of clinical features of ruccrent interstitial lung disease in patients with anti-EJ positive antisynthetase syndrome].","authors":"Yujing Zhu, Lei Wang, Chengyin Lyu, Wenfeng Tan, Miaojia Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the clinical characteristics of 57 patients diagnosed with anti-glycyl tRNA synthetase (anti-EJ) positive antisynthetase syndrome (ASS), a subtype of anti-glycyl tRNA positive ASS, complicated by interstitial lung disease (ILD), and to investigate the factors asso-ciated with ILD recurrence.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 57 anti-EJ positive ASS patientswho were treated at the First Affiliated Hospital of Nanjing Medical University from January 1, 2020 to June 30, 2024. The data collected included demographic information, clinical characteristics, laboratory test results, chest CT findings, and pulmonary function tests. The characteristics of ILD recurrence were also analyzed.</p><p><strong>Results: </strong>All the 57 patients with anti-EJ positive ASS were diagnosed with ILD. The mean age at disease onset was (58.18±10.27) years, with a mean disease duration of 3.00 (2.00, 16.00) months. Among the patients, 70. 18% were female, 87.72% experienced a cough, 70. 18% had expectoration, 89.47% reported respiratory difficulties, and 14.04% developed respiratory failure. The results of pulmonary function test showed that the percentage of forced vital capacity (FVC) in the normal predicted value (FVC%), the percentage of forced expiratory volume in the first second (FEV1) in the normal predicted value (FEV1%) and the percentage of diffusion lung carbon monoxide (DLCO) in the normal predicted value (DLCO%) were 59.36±21.41, 58.34±19.46 and 58.17±27.95, respectively. The oxygenation index was (363.24±99.42) mmHg. Chest CT imaging showed that nonspecific interstitial pneumonia (NSIP) was the most common radiographic pattern. Among the 46 patients who completed a follow-up of more than 12 months, 21 cases (45.65%) showed recurrence of ILD. The average age of onset for the recurrence group was (61.38±8.63) years, while that for the non-recurrence group was (55.28±11.85) years, with a difference approaching statistical significance (<i>P</i>=0.056). Further analysis showed that the ESR (erythrocyte sedimentation rate) level was significantly higher in the recurrence group than in the non-recurrence group [(50.48±29.64) mm/h <i>vs.</i> 30.28±23.97) mm/h, <i>P</i>=0.025], and the IgM (immune globulin M) level was also significantly higher in the recurrence group (<i>P</i>=0.042). Moreover, the CD8+T proportion was significantly higher in the recurrence group than in the non-recurrence group (25.48±11.81 <i>vs.</i> 18.59± 8.53, <i>P</i>=0.027). Despite the fact that the recurrence group had a higher baseline age, higher ESR, IgM, and CD8+T proportion, multivariate binary logistic regression analysis showed that these indicators were not independent risk factors for ILD recurrence.</p><p><strong>Conclusion: </strong>ILD is the most common clinical manifestation in patients with anti-EJ positive ASS, with a significant impact on pulmonary function. Althoug","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"56 6","pages":"980-986"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Current status and influential factors of self-management ability in patients with systemic lupus erythematosus].","authors":"Li Wang, Chao Gao, Huanhuan Ren, Yanping Shen, Xiaowei Huang, Hong Yao, Dandan Han","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the current status of self-management ability in patients with systemic lupus erythematosus (SLE), and to analyze the related factors affecting the self-management ability of SLE patients.</p><p><strong>Methods: </strong>A total of 180 SLE patients who were selected from the outpatient department and ward of the Department of Rheumatology and Immunology of a Tertiary Hospital in Beijing from January 2024 to March 2024. General information questionnaire, SLE self-management ability assessment scale, general self-efficacy scale (GSES) and family concern index questionnaire (APGAR) were used for questionnaire investigation, so as to investigate the current status and related influencing factors of self-management ability in patients with SLE.</p><p><strong>Results: </strong>A total of 170 questionnaires were effectively collected, and the total score of self-management ability was (90.94±14.26) points, of which 103 patients were 89-110 points, accounting for 60.6%; 60 patients were 67-88 points, accounting for 35.3%; 7 patients were 0-66 points, accounting for 4.1%; The results of univariate analysis showed that personal monthly income, follow-up frequency, family caring index, self-efficacy and SLE self-management ability score had statistical significance (<i>P</i> < 0.05). Spearman rank correlation analysis showed that family caring index, self-efficacy scores were positively correlated with the scores of various dimensions and the total score of SLE self-management scores (<i>P</i> < 0.001). Multivariate Logistic regression analysis showed that family caring index (<i>OR</i>=1.503, 95%<i>CI</i>=1.186-1.906), self-efficacy (<i>OR</i>=1.103, 95%<i>CI</i>=1.038-1.172), personal monthly income of 5 000-8 000 yuan/month (<i>OR</i>=0.120, 95%<i>CI</i>=0.022-0.645) and 1-2 weeks return frequency (<i>OR</i>=0.044, 95%<i>CI</i>=0.003-0.575) were significant influencing factors for SLE patients' self-management ability.</p><p><strong>Conclusion: </strong>The results of this study indicate that patients with SLE have a good level of self-management ability. In the process of chronic disease management, medical staff should formulate detailed and layered intervention measures to further improve self-management ability with SLE patients, and at the same time, help SLE patients establish good family caring index and patient self-efficacy, which is conducive to improving self-management ability of SLE patients, so as to effectively promote disease management and improve the quality of life.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"56 6","pages":"1029-1035"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[IgA vasculitis with necrosis of the small intestine secondary to monoclonal gammopathy of renal significance: A case report].","authors":"Yan Ding, Chaoran Li, Wensheng Huang, Linzhong Zhu, Lifang Wang, Doudou Ma, Juan Zhang, Lianjie Shi","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Monoclonal gammopathy of undetermined significance combined with renal damage is named monoclonal gammopathy of renal significance. There are few reports about IgA vasculitis in patients with monoclonal gammopathy of undetermined significance. Here, we report a case of monoclonal gammopathy of renal significance, who had manifestations of IgA vasculitis, including purpura, gastrointestinal bleeding and joint pain. The patient had elevated serum creatinine levels, prompting further investigation through immunofixation electrophoresis and bone marrow aspiration biopsy. Immunofixation electrophoresis showed IgA-λ-type monoclonal immunoglobulin, while the bone marrow aspiration biopsy suggested plasmacytosis. Kidney biopsy indicated membranous hyperplastic glomerulonephritis, light and heavy chain deposition, IgA-λ. The patient was diagnosed with monoclonal gammopathy of renal significance. In light of the elevated serum creatinine, the patient was treated with chemotherapy regimen (bortezomib +cyclophosphamide +dexamethasone). After chemotherapy, there was no significant improvement in the patient's renal function. Subsequently, the patient experienced abdominal pain, skin purpura, joint pain and severe gastrointestinal bleeding. Gastroenteroscopy did not find the exact bleeding position. Angiography revealed hyperplasia of left jejunal artery. Surgical operation found that the bleeding site was located between the jejunum and ileum, where scattered hemorrhagic spots and multiple ulcers were present on the surface of the small intestine, with the deepest ulcers reaching the serosal layer. And the damaged intestine was removed during the operation. Intestinal pathology showed multiple intestinal submucosal arteritis, rusulting in intestinal wall necrosis and multiple ulcers. Considering intestinal lesions as gastrointestinal involvement of IgA vasculitis, methylprednisolone was used continually after the operation, and the patient's condition was improved. However, after half a year, the patient suffered a severe respiratory infection and experienced a recurrence of serious gastrointestinal bleeding. It was considered that the infection triggered the activity of IgA vasculitis, accompanied by gastrointestinal involvement. Finally, the patient died from gastrointestinal bleeding. The present case represented a patient with monoclonal gammopathy of renal significance and IgA vasculitis, prominently presenting with renal insufficiency and severe gastrointestinal bleeding, making the diagnosis and treatment process complex. Patients with IgA monoclonal gammopathy who presented with abdominal pain, purpura, and arthralgia should be vigilant for the possibility of concomitant IgA vasculitis. The treatment of cases with IgA vasculitis combined with monoclonal gammopathy of renal significance was rather challenging. Plasma cell targeting therapy might be an effective regimen for IgA vasculitis with monoclonal gammopathy. However, patients with poor ren","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"56 6","pages":"1101-1105"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Application status of methotrexate in patients with rheumatoid arthritis].","authors":"Yijun Han, Xiaoli Chen, Changhong Li, Jinxia Zhao","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the current status of methotrexate (MTX) application in rheumatoid arthritis (RA) patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The clinical and laboratory data of RA patients who attended in the Department of Rheumatology and Immunology of Peking University Third Hospital from January 1, 2022 to November 31, 2023 were collected retrospectively. In order to figure out the relationship between MTX use and RA disease control, we recorded information including the starting dose, maximum dose, current dose, reasons of discontinuation of MTX, &lt;i&gt;etc&lt;/i&gt;. The &lt;i&gt;t&lt;/i&gt; test, Mann-Whitney &lt;i&gt;U&lt;/i&gt; test, Chi-square test, Fisher' s exact probability and multivariable Logistic regression were used for analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 239 RA patients were enrolled, including 201 females and 38 males with a mean age of (54.5±14.3) years. Among them, 101 patients reached the therapeutic target [clinical remission or low disease activity assessed by 28-joint disease activity score (DAS28)-erythrocyte sedimentation rate (ESR)], accounting for 42.2% of the RA patients. Twenty-six patients met the European League Against Rheumatism (EULAR) definition of difficult-to-treat (D2T) RA, accounting for 10.9% of RA patients. The proportion of the RA patients who had ever used MTX was 84. 1%, and those who were currently on it accounted for only 39.7%. The MTX dose was generally low, with a starting dose of (9.5±3.0) mg/week, the maximum dose of 15.0 (10.0, 15.0) mg/week, and the current dose being (12.4±2.7) mg/week. The most common reasons for MTX dose reduction or discontinuation were adverse reactions, mainly including abnormalities of hepatic function, gastrointestinal discomfort, leucopenia, &lt;i&gt;etc.&lt;/i&gt; Those who were currently on MTX had a higher rate of treatment to target (52.6% &lt;i&gt;vs.&lt;/i&gt; 35.4%, &lt;i&gt;P&gt;&lt;/i&gt;0.05), lower disease activity score (DAS28-ESR, 3.6±1.8 &lt;i&gt;vs.&lt;/i&gt; 4.2±1.8, &lt;i&gt;P&lt;/i&gt; &lt; 0.05), and fewer tender joint counts (4.8±8.3 &lt;i&gt;vs.&lt;/i&gt; 8.6±10.4, &lt;i&gt;P&lt;/i&gt; &lt; 0.05) as compared with those who were not taking the drug, while swollen joint count, pain visual analog score and patient' s global score, C-reactive protein (CRP) level and ESR level were not significantly different between the two groups. Compared with those who did not reach the target of treatment, those who did had a higher rate of current MTX application (48.5% &lt;i&gt;vs.&lt;/i&gt; 33.3%, &lt;i&gt;P&lt;/i&gt; &lt; 0.05), but the history of MTX did not differ between the two groups (84.2% &lt;i&gt;vs.&lt;/i&gt; 84.1%, &lt;i&gt;P&lt;/i&gt;&gt;0.05). The maximum dose of MTX (median 15.0 mg/week &lt;i&gt;vs.&lt;/i&gt; 13.7 mg/week, &lt;i&gt;P&lt;/i&gt;&gt;0.05) and the current dose [(12.9±2.5) mg/week &lt;i&gt;vs.&lt;/i&gt; (11.8±2.8) mg/week, &lt;i&gt;P&lt;/i&gt;&gt;0.05] was higher in those who achieved the target, while the starting dose [(9.6±2.8) mg/week &lt;i&gt;vs.&lt;/i&gt; (9.5±3.1) mg/week, &lt;i&gt;P&lt;/i&gt;&gt;0.05] and the rate of prior MTX (84.2% &lt;i&gt;vs.&lt;/i&gt; 83.3%, &lt;i&gt;P&lt;/i&gt;&gt;0.05) was comparable between the two groups. The D2T RA patients had a higher r","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"56 6","pages":"994-1000"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Immunological characteristics of patients with anti-synthetase syndrome overlap with rheumatoid arthritis].","authors":"Liang Zhao, Chenglong Shi, Ke Ma, Jing Zhao, Xiao Wang, Xiaoyan Xing, Wanxing Mo, Yirui Lian, Chao Gao, Yuhui Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical and immunological characteristics of anti-synthetase syndrome (ASS) patients overlap with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on ASS patients with arthritis who were treated at Peking University People' s Hospital. Data collected included demographic information, clinical manifestations, laboratory features, lymphocyte subsets in peripheral blood, and treatments. The patients with ASS were divided into two groups based on the presence or absence of RA for comparative analysis.</p><p><strong>Results: </strong>A total of 104 ASS patients with arthritis were included, among whom 23.1% (24/104) were diagnosed with RA. The ASS with RA group had a significantly higher incidence of rapidly progressive interstitial lung disease (RP-ILD) (41.7% <i>vs</i>. 17.6%, <i>P</i>=0.032), number of tender joints [10 (7, 14) <i>vs</i>. 4 (0, 8), <i>P</i> < 0.001], number of swollen joints [4 (2, 8) <i>vs</i>. 2 (0, 4), <i>P</i>=0.012], and rate of bone erosion (47.8% <i>vs</i>. 2.5%, <i>P</i> < 0.001) compared with the non-RA group. Levels of platelets [(289.57±68.74)×10³/μL <i>vs</i>. (247.94±77.04)×10³/μL, <i>P</i>=0.022], erythrocyte sedimentation rate (ESR) [43 (19, 59) mm/h <i>vs</i>. 18 (10, 44) mm/h, <i>P</i>=0.019], and C-reactive protein (CRP) [19.20 (4.80, 55.36) mg/L <i>vs</i>. 5.68 (1.10, 14.96) mg/L, <i>P</i>=0.006] were found significantly higher in the ASS with RA group than those in non-RA group. Analysis of immune cells in peripheral blood mononuclear cell (PBMC) showed that significantly decreased proportions of CLA⁺ Treg cells [(11.12±4.10)% <i>vs</i>. (17.22±8.49)%, <i>P</i>=0.003], B cells [8.56% (4.80%, 11.90%) <i>vs</i>. 14.55% (8.75%, 20.29%), <i>P</i>=0.025], and natural killer (NK) cells [7.56% (4.65%, 13.20%) <i>vs</i>. 13.25% (7.46%, 19.25%), <i>P</i>=0.045] in the overlap group compared with non-RA group. Proportion of Naïve Th cells [(52.66±17.66)% <i>vs</i>. (40.76±14.96)%, <i>P</i>=0.033)] was significantly increased in overlap group compared with non-RA group. Overlap group had lower rate of complete clinical response than non-RA group (16.7% <i>vs</i>. 43.8%, <i>P</i>=0.031).</p><p><strong>Conclusion: </strong>Among ASS patients with arthritis, those with RA have more severe lung and joint involvement and a lower treatment response rate, highlighting the need for early recognition and aggressive intervention.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"56 6","pages":"972-979"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of characteristics related to the disease activity of systemic lupus erythematosus and construction of an evaluation model].","authors":"Hongyan Wang, Xinming Li, Kechi Fang, Huaqun Zhu, Rulin Jia, Jing Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To stratify systemic lupus erythematosus (SLE) patients clinically, to analyze the clinical characteristics of patients with and without disease activity, and to explore the application va-lue of key clinical indicators in assessing disease activity, as well as to construct an evaluation model.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on clinical data of the SLE patients diagnosed at Peking University People' s Hospital from May 1995 to April 2014. Demographic information, clinical manifestations, laboratory tests, and antibody detection results were collected. The patients were divided into active and inactive groups based on systemic lupus erythematosus disease activity index 2000(SLEDAI-2000)scores. <i>t</i>-tests, Mann-Whitney <i>U</i> tests, and <i>χ</i>² tests were used to compare the differences between the groups. Spearman correlation analysis was used to evaluate the relevant clinical indicators associated with SLE activity in the active disease group. Based on the results of statistical analysis, a Logistic regression model was constructed, and the performance of the model was evaluated.</p><p><strong>Results: </strong>No significant differences were found in demographic characteristics between the two groups. In the active disease group, positive rates of antinuclear antibodies (ANA) and anti-double-stranded DNA antibodies (anti-dsDNA) were increased; white blood cell count (WBC), red blood cell count (RBC), hemoglobin (HGB), lymphocytes (LY), total protein (TP), albumin (ALB), and complement 3(C3) levels were significantly decreased; while immunoglobulin A and G levels were markedly elevated. The correlation analysis results showed that hemoglobin, albumin, C3, and complement 4(C4) had higher correlation indices compared with other clinical indicators. Among these, C3 exhibited a certain negative correlation with disease activity. The Logistic regression model based on 12 significantly different indicators (<i>P</i> < 0.05) achieved an accuracy of 91.4%, sensitivity of 94.4%, specificity of 81.0%, and the area under curve (AUC) of the receiver operating characteristic (ROC) was 0.944.</p><p><strong>Conclusion: </strong>This study comprehensively evaluated a range of clinical indicators related to SLE disease activity, providing a thorough understanding of both laboratory and clinical markers. The Logistic regression model, which was primarily constructed using laboratory test indicators, such as inflammatory markers, immune response parameters, and organ involvement metrics, demonstrated a high degree of accuracy in assessing the disease activity in SLE patients. Consequently, this model might provide a new basis for the diagnosis and treatment of SLE patients, offering significant clinical diagnostic value.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"56 6","pages":"1017-1022"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical significance of antiphospholipid antibodies in Behcet disease with thrombosis].","authors":"Yukai Li, Hongyan Wang, Liang Luo, Yun Li, Chun Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the distribution and clinical significance of antiphospholipid antibody (aPL) in patients with Behcet disease (BD).</p><p><strong>Methods: </strong>A total of 222 BD patients admitted to the Department of Rheumatology and Immunology in Peking University People' s Hospital from February 2008 to July 2024 were selected retrospectively. General data of the patients including age and gender were collec-ted. Clinical manifestations (including oral ulcers, genital ulcers, and thrombosis) and laboratory indexes (including aPL, human leukocyte antigen-B51, and anti-endothelial cell antibody) were collec-ted. The recurrence of thrombosis in the BD patients with thrombosis was followed up. Chi-square test was used to compare the clinical symptoms and laboratory indicators between aPL positive group and aPL negative group. Log-rank test was used to compare the recurrence rates of the aPL positive group and the aPL negative group, and <i>P</i> correction was performed by Two-stage method. Finally, Graphpad prism was used for plotting.</p><p><strong>Results: </strong>The prevalence of single aPL, double aPL and triple aPL positivity in the BD patients were 22.1%, 0.5% and 1.4%, respectively. The positive rates of anti-cardiolipin antibody, anti-β2 glycoprotein Ⅰ antibody and lupus anticoagulant (LAC) were 10.4%, 1.8% and 13.1%, respectively. The incidence of thrombosis in the aPL positive group was significantly higher than that in the aPL negative group (44.9% <i>vs</i>. 16.9%, <i>P</i> < 0.001). The erythrocyte sedimentation rate [(20.78±4.91) mm/h <i>vs</i>. (15.85±4.29) mm/h, <i>P</i>=0.005], C-reactive protein [(12.97±5.17) mg/L <i>vs</i>. (7.49± 4.22) mg/L, <i>P</i>=0.010] and IgM [(1.55±0.95) g/L <i>vs</i>. (1.12±0.72) g/L, <i>P</i> < 0.001] in the aPL positive group were significantly higher than those in the aPL negative group. LAC positivity was an independent risk factor for thrombosis in the BD patients (<i>OR</i>=8.51, 95%<i>CI</i>: 2.71-26.72, <i>P</i> < 0.001). The recurrence rate of the aPL positive group was higher than that of the aPL negative group, but there was no statistical difference (69.23% <i>vs</i>. 52.17%, <i>P</i>=0.932).</p><p><strong>Conclusion: </strong>Positive LAC and aneurysm are independent risk factors for thrombosis in BD patients. At the same time, positive antiphospholipid antibody can also significantly increase the risk of thrombosis in BD patients, which has important significance for guiding the treatment of BD.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"56 6","pages":"1036-1040"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of balloon occlusion combined with intra-sac injection of thrombin in the treatment of ruptured abdominal aortic aneurysm].","authors":"Shilu Zhao, Jingyuan Luan, Qichen Feng, Qijia Liu, Guangxin Yang, Zichang Jia, Jinman Zhuang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the safety and effectiveness of balloon occlusion and intra-sac thrombin injection in the endovascular repair of ruptured abdominal aortic aneurysm.</p><p><strong>Methods: </strong>From October 2019 to October 2022, the clinical data of 16 patients with rAAA treated with balloon occlusion technique and intra-sac thrombin injection combined with EVAR were retrospectively analyzed, including 13 males and 3 females, aged 42-85 years, with a median age of 70.5 years. The time of preoperative first aid (from hospital arrival to operation start), average operation time, stay in intensive care unit (ICU), average hospitalization time, success rate of surgical treatment, perioperative (30 d) mortality rate, incidence of complications, the maximum diameter and volume change of the aneurysm were observed and recorded.</p><p><strong>Results: </strong>Among the 16 patients with ruptured abdominal aortic aneurysm, the technical success rate was 100.0% (16/16). One patient died of multiple organ dysfunction 6 hours after operation. The success rate of surgical treatment was 93.8% (15/16). The preoperative first aid time was (53.3±6.2) min, the average operation time was (89.9±17.1) min, the stay in the intensive care unit (ICU) was (1.7±0.8) d, and the average hospitalization time was (7.8±1.3) d. The intraoperative balloon occlusion time was (32.4±4.1) min. The postoperative renal function of all the patients had no significant deterioration compared with that preoperative. Abdominal compartment syndrome (ACS) occurred in 1 patient after operation, which improved after CT puncture and drainage. The median follow-up time was 36 months. During the follow-up period, 1 patient died of acute myocardial infarction 2 years after operation, and the remaining 14 patients survived. Among the 14 follow-up patients, 1 type Ⅱ endoleak occurred, and no other types of endoleak occurred. By the end of the follow-up, the maximum diameter of the aneurysm sac in 14 patients was significantly lower than that before operation [(44.6±8.0) mm <i>vs.</i>(66.0±15.5) mm, <i>P</i> < 0.001], and in 12 patients with CTA, the volume of the aneurysm sac was significantly shrunk than that before operation [(311.7±170.3) mm³ <i>vs</i>. (168.6±68.1) mm³, <i>P</i> < 0.05].</p><p><strong>Conclusion: </strong>Balloon occlusion during endovascular repair is safe and effective in the treatment of ruptured abdominal aortic aneurysm; intraoperative thrombin injection of the aneurysm sac can significantly reduce the incidence of intraoperative and postoperative abdominal compartment syndrome and endoleak and, to a certain extent, improve the success rate of treatment.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"56 6","pages":"1052-1057"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expression and significance of ferroptosis marker 4-HNE in <i>in vitro</i> model of systemic sclerosis].","authors":"Kelin Zhao, Xue Xia, Naixu Shi, Han Zhou, Jingwen Gai, Ping Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the expression and physiological significance of the ferroptosis marker 4-hydroxynonenal (4-HNE) in myofibroblasts induced by transforming growth factor-β1 (TGF-β1), providing theoretical evidence for its potential role in the diagnosis and treatment of fibrosis in systemic sclerosis (SSc).</p><p><strong>Methods: </strong>Mouse embryonic fibroblasts (NIH3t3) were cultured and divided into two groups after 12 h of starvation: the control group (cultured in 1% serum-containing medium) and the TGF-β1 group (cultured in 10 μg/L TGF-β1 with 1% serum-containing medium). Cell morphology changes in both groups were observed under a microscope. To confirm successful establishment of the SSc cell model, fibrosis markers were analyzed using reverse transcription quantitative real-time PCR (RT-qPCR) and Western blot. Next, flow cytometry was employed to assess the intracellular levels of reactive oxygen species (ROS) in both groups. Finally, Western blot and immunofluorescence staining were used to measure the expression of 4-HNE in the TGF-β1-treated cells.</p><p><strong>Results: </strong>Microscopic observations revealed that TGF-β1 treatment caused the NIH3t3 cells to transition from a typical spindle shape to a flat, polygonal shape with multiple protrusions, indicating fibroblast activation. The RT-qPCR and Western blot analyses showed that the expression of the fibrosis marker Vimentin was significantly upregulated in the TGF-β1 group compared with the control group (<i>P</i> < 0.01), confirming that TGF-β1 effectively promoted fibrosis-related gene and protein expression. Flow cytometry results indicated that TGF-β1 significantly elevated intracellular ROS levels, suggesting the induction of oxidative stress. Furthermore, both Western blot and immuno-fluorescence staining demonstrated a significant increase in 4-HNE expression in the TGF-β1-treated cells (immunofluorescence intensity <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>TGF-β1 promotes fibroblast activation and fibrosis while inducing ROS production, leading to a marked increase in 4-HNE expression. Given the role of 4-HNE as a marker of lipid peroxidation and its elevated levels in the SSc cell model, this study suggests that 4-HNE could serve as a potential biomarker for fibrosis in SSc. The findings highlight the importance of investigating the mechanisms of 4-HNE in fibrosis and suggest that targeting this pathway could offer new therapeutic opportunities for treating SSc.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"56 6","pages":"950-955"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ovarian function in patients of childbearing age with systemic lupus erythematosus].","authors":"Dandan Chen, Yun Li, Qingyi Lu, Xiaohong Xiang, Feng Sun, Yingni Li, Jing Zhao, Hongyan Wang, Chun Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To explore the ovarian function and its influencing factors in women of childbearing age with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>A total of 107 female patients diagnosed with SLE at Peking University People' s Hospital from January 2017 to May 2024, aged between 20 and 40 years, were included in the study. At the same time, 40 matched healthy women aged between 20 and 40 years were selected as controls. Serum levels of anti-Müllerian hormone (AMH) were measured using the chemiluminescence method in both the control group and the SLE patients. The general clinical characteristics and medication history (including hormones, immunosuppressants, and biological agents) of the SLE patients were obtained through case retrieval. Changes in serum AMH levels before and after treatment with biological agents in the SLE patients were analyzed.</p><p><strong>Results: </strong>(1) The AMH levels in the SLE patients were significantly lower than those in the healthy control group [1.475 (0.344, 3.030) μg/L <i>vs</i>. 2.934 (1.893, 4.761) μg/L, <i>P</i> < 0.001]. (2) The level of AMH in the SLE patients with normal menstruation was significantly higher than that in the patients with irregular menstruation [1.931 (0.638, 3.414) μg/L <i>vs</i>. 0.335 (0.159, 1.527) μg/L, <i>P</i>=0.004]. No statistical differences were found in clinical characteristics and laboratory indicators between the groups with decreased AMH group and normal AMH group. (3) The multivariate logistic regression analysis revealed that age (<i>OR</i>=1.124, 95%<i>CI</i>: 1.033-1.224, <i>P</i>=0.007) and disease duration (<i>OR</i>=1.100, 95%<i>CI</i>: 1.017-1.190, <i>P</i>=0.018) were identified as significant risk factors for the decline in AMH levels. (4) After 6 months of treatment with telitacicept, the AMH level was significantly higher than that before treatment [2.050 (0.763, 4.259) μg/L <i>vs</i>. 1.988 (0.473, 2.822) μg/L, <i>P</i>=0.043]. There was no significant difference in AMH level between patients receiving rituximab treatment for 6 months [2.026 (0.376, 2.267) μg/L <i>vs</i>. 1.545 (0.503, 3.414) μg/L, <i>P</i>=0.127].</p><p><strong>Conclusion: </strong>Ovarian function is decreased in SLE patients of childbearing age, and age and disease duration are the risk factors. The utilization of biological agents demonstrates favorable safety profiles regarding ovarian function in childbearing-age patients with SLE.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"56 6","pages":"1023-1028"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}