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Endoscopy is of low yield in the identification of gastrointestinal neoplasia in patients with dermatomyositis: A cross-sectional study

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World Journal of Gastroenterology 2017年第26期23卷 4788-4795页

作者： Trilokesh D Kidambi Gabriela Schmajuk Andrew J Gross James W Ostroff Jonathan P Terdiman Jeffrey K Lee division of Gastroenterology University of California division of rheumatology University of California division of rheumatology San Francisco Veterans Affairs Medical Center

To determine the prevalence of gastrointestinal neoplasia among dermatomyositis patients who underwent an esophagogastroduodenoscopy and/or colonoscopy. METHODSA cross-sectional study examining the results of upper endoscopy and colonoscopy in adults with dermatomyositis at an urban, university hospital over a ten year period was performed. Chart review was performed to confirm the diagnosis of dermatomyositis. Findings on endoscopy were collected and statistical analyses stratified by age and presence of symptoms were performed. RESULTSAmong 373 adult patients identified through a code based search strategy, only 163 patients had dermatomyositis confirmed by chart review. Of the 47 patients who underwent upper endoscopy, two cases of Barrett’s esophagus without dysplasia were identified and there were no cases of malignancy. Of the 67 patients who underwent colonoscopy, no cases of malignancy were identified and an adenoma was identified in 15% of cases. No significant differences were identified in the yield of endoscopy when stratified by age or presence of symptoms. CONCLUSIONThe yield of endoscopy is low in patients with dermatomyositis and is likely similar to the general population; we identified no cases of malignancy. A code based search strategy is inaccurate for the diagnosis of dermatomyositis, calling into question the results of prior population-based studies. Larger studies with rigorously validated search strategies are necessary to understand the risk of gastrointestinal malignancy in patients with dermatomyositis.

关键词： Endoscopy Dermatomyositis Colon cancer Screening

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Blood glucose changes surrounding initiation of tumor-necrosis factor inhibitors and conventional disease-modifying anti-rheumatic drugs in veterans with rheumatoid arthritis

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World Journal of Diabetes 2018年第2期9卷 53-58页

作者： Patrick R Wood Evan Manning Joshua F Baker Bryant England Lisa Davis Grant W Cannon Ted R Mikuls Liron Caplan Denver Veterans Affairs Medical Center Division of Rheumatology University of Colorado Philadelphia Veterans Affairs Medical Center Division of Rheumatology University of Pennsylvania Omaha Veterans Affairs Medical Center Division of Rheumatology University of Nebraska Denver Health and Hospital Division of Rheumatology University of Colorado George Wahlen Veterans Affairs Medical Center Division of Rheumatology University of Utah

AIM To determine the scope of acute hypoglycemic effects for certain anti-rheumatic medications in a large retrospective observational study. METHODS Patients enrolled in the Veterans Affairs Rheumatoid Arthritis (VARA) registry were selected who, during follow-up, initiated treatment with tumor necrosis factor inhibitors (TNFi's, including etanercept, adalimumab, infliximab, golimumab, or certolizumab), prednisone, or conventional disease-modifying anti-rheumatic drugs(DMARDs), and for whom proximate random blood glucose (RBG) measurements were available within a window 2-wk prior to, and 6 mo following, medication initiation. Similar data were obtained for patients with proximate values available for glycosylated hemoglobin A1C values within a window 2 mo preceding, and 12 mo following, medication initiation. RBG and A1C measurements were compared before and after initiation events using paired t-tests, and multivariate regression analysis was performed including established comorbidities and *** Two thousands one hundred and eleven patients contributed at least one proximate measurement surrounding the initiation of any examined medication. A significant decrease in RBG was noted surrounding 653 individual hydroxychloroquine-initiation events(-3.68 mg/dL, P = 0.04), while an increase was noted for RBG surrounding 665 prednisone-initiation events(+5.85 mg/d L, P < 0.01). A statistically significant decrease in A1C was noted for sulfasalazine initiation, as measured by 49 individual initiation events(-0.70%, P < 0.01). Multivariate regression analyses, using methotrexate as the referent, suggest sulfasalazine (β =-0.58, P = 0.01) and hydroxychloroquine(β =-5.78, P = 0.01) use as predictors of lower post-medicationinitiation RBG and A1C values, respectively. Analysis by drug class suggested prednisone (or glucocorticoids) as predictive of higher medication-initiation event RBG among all start events as compared to DMARDs, while this analysis did not

关键词： Disease modifying anti-rheumatic drugs Drug toxicity Glucocorticoids Rheumatoid arthritis Tumor necrosis factor inhibitors

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Power Doppler ultrasonographic assessment of the ankle in patients with inflammatory rheumatic diseases

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World Journal of Orthopedics 2014年第5期5卷 574-584页

作者： Takeshi Suzuki division of rheumatology Mitsui Memorial Hospital

Ankle involvement is frequent in patients with inflammatory rheumatic diseases, but accurate evaluation by physical examination is often difficult because of the complex anatomical structures of the ankle. Over the last decade, ultrasound(US) has become a practical imaging tool for the assessment of articular and periarticular pathologies, including joint synovitis, tenosynovitis, and enthesitis in rheumatic diseases. Progress in power Doppler(PD) technology has enabled evaluation of the strength of ongoing inflammation. PDUS is very useful for identifying the location and kind of pathologies in rheumatic ankles as well as for distinguishing between inflammatory processes and degenerative changes or between active inflammation and residual damage. The aim of this paper is to illustrate the US assessment of ankle lesions in patients with inflammatory rheumatic diseases, including rheumatoid arthritis, spondyloarthritis, and systemic lupus erythematosus, focusing on the utility of PDUS.

关键词： Ankle Power Doppler Ultrasound Rheumatoid arthritis Psoriatic arthritis Spondyloarthritis Tenosynovitis Enthesitis

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Helicobacter pylori-associated immune thrombocytopenia:Clinical features and pathogenic mechanisms

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World Journal of Gastroenterology 2014年第3期20卷 714-723页

作者： Masataka Kuwana division of rheumatology Department of Internal MedicineKeio University School of Medicine

Immune thrombocytopenia (ITP) is an autoimmune disease mediated by anti-platelet autoantibodies. There is growing evidence that the eradication of Helicobacter pylori (H. pylori) effectively increases platelet count in a considerable proportion of ITP patients infected with this bacterium. In the majority of ITP patients responding to H. pylori eradication therapy, the anti-platelet autoantibody response is completely resolved with no relapse for more than 7 years, indicating that the disease is cured. Therefore, adult patients with suspected ITP should be examined for H. pylori infection, and eradication therapy is recommended if the infection is present. Notably, however, the efficacy of H. pylori eradication therapy in ITP patients varies widely among countries, with a higher response rate in Japan compared with the United States and European countries other than Italy. The pathogenesis of H. pylori-associated ITP is still uncertain, although the mechanisms are known to involve multiple factors. H. pylori may modulate the Fcγ-receptor balance of monocytes/macrophages in favor of activating Fcγ receptors, and H. pylori components may mimic the molecular makeup of platelet antigens. Further studies of the pathogenic process of H. pylori-associated ITP may be useful for the development of new therapeutic strategies for ITP.

关键词： Autoantibody, Childhood, Helicobacter pylori, Fcγ receptor, Immune thrombocytopenia, Idiopathic thrombocytopenic purpura, Systemic lupus erythematosus

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Protective Effect of Norcantharidin on Collagen-Induced Arthritis Rats

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Chinese Journal of Integrative Medicine 2018年第4期24卷 278-283页

作者： SHEN Hong-bo HUO Ze-jun BAI Yun-jing HE Xiao-juan LI Chang-hong ZHAO Yu-kun GUO Qing-qing Department of Traditional Chinese Medicine Peking University Third Hospital division of rheumatology PLA Army General Hospital Institute of Basic Research in Clinical Medicine Academy of Chinese Medical Sciences division of rheumatology Peking University Third Hospital

Objective： To observe the effect of norcantharidin（NCTD） on collagen-induced arthritis（CIA） rats. Methods： Sixty Sprague-Dawley（SD） rats were randomly divided into 6 groups（n=10）： normal group, CIA model group（model group）, NCTD low-dose group [1.35 mg/（kg·d）], NCTD middle-dose group [2.7 mg/（kg·d）], NCTD high-dose group [5.4 mg/（kg·d）] and methotrexate（MTX） group [1.8 mg/（kg/w）]. Anesthetized rats were sacrificed by luxation of cervical vertebra after 4 weeks of administration. The arthritis scores were evaluated twice a week. The pathological changes in the ankle joints of rats were observed by hematoxylin-eosin（H＆E） staining. The serum levels of interleukin（IL） 1β, IL-6, tumor necrosis factor（TNF）-α, vascular endothelial growth factor（VEGF）, IL-17 and transform growth factor（TGF） β were detected by enzyme linked immunosorbent assay（ELISA）. The mRNA expression of retinoid-related orphan nuclear receptor γ t（ROR γ t） and forkhead box P3（Foxp3） in peripheral blood lymphocytes were confirmed by real-time polymerase chain reaction. Results： MTX and high-dose NCTD not only decreased the arthritis scores but also alleviated the pathological changes in CIA rats＇ ankle joints compared with the model group（P〈0.05 or P〈0.01）. All doses of NCTD significantly inhibited the serum levels of IL-6, IL-17 and TNF-α in CIA rats（P〈0.05）. Only middle-and high-dose of NCTD prominently decreased serum IL-1β and TGF-β levels of CIA rats（P〈0.05）. However, NCTD has no effect on vascular endothelial growth factor（VEGF） level in CIA rats. The Foxp3 mRNA expression in all NCTD groups were increased significantly than in the model group（P〈0.05）. The mRNA expression of RORγt in NCTD high-dose group was decreased apparently in comparison with the model group（P〈0.05）. Conclusion： NCTD showed therapeutic effect on CIA rats by inhibition of cytokines and regulation of Th17/Treg cells.

关键词： norcantharidin collagen-induced arthritis cytokine Th17/Treg forkhead box P3 retinoid related orphan nuclear receptor γt

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Factors affecting the path ogenesis of ankylosing spondylitis

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Chinese Medical Journal 2001年第2期114卷 99-100页

作者：周昌德 division of Allergy-Immunology rheumatology Department of Medicine Veterans General Hospital Taipei 11217 China

Ankylosing spondylitis (AS) occurs more frequently in young males than in females. The prevalence of AS in Taiwan, according to our previous study, is about 0.3%.1 AS mainly affects the spine, however, it can also result in peripheral arthritis that occurs in the toes, ankles, knees, hip joints and the tendon and ligaments around those joints.2 In addition, the spine of some AS patients may develop kyphoscoliosis due to late diagnosis or failure to cooperate in following the routine medication and exercises prescribed by their doctors.

关键词： spondylitis affecting

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Overexpression of proto-oncogene bcl-2 in rheumatoid synovium

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Chinese Science Bulletin 1997年第24期42卷 2087-2090页

作者： LIANG Haiying, WANG Yongchao, CHEN Zhiqiang, CHEN Huanmian and JIANG Ming division of rheumatology, Peking Union Medical College Hospital, Beijing 100073, China 2. Key Laboratory of Cell Prolifer ation and Regulation Biology, Beijing Normal University, Beijing 100875, China division of rheumatology Peking Union Medical College Hospital Beijing 100073 China

RHEUMATOID arthritis (RA) is an autoimmune disease which progressively and systematicallyinvades the joints of bones. A severe chronic situation may lead to the damage of cartilages,bones and tendons and eventually handicap the patients. One of the main histopathological fea-tures of rheumatoid synovium is a marked increase of the thickness and the number of cells inthe synovial lining layer. It is well known that the synovial lining cells secrete many cell fac-

关键词： rheumatoid synovium synovial lining cells bcI-2 apoptosis.

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Juvenile dermatomyositis:advances in clinical presentation,myositis-specific antibodies and treatment

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World Journal of Pediatrics 2020年第1期16卷 31-43页

作者： Jian-Qiang Wu Mei-Ping Lu Ann M.Reed Department of rheumatology Immunology and Allergy Children's HospitalZhejiang University School of MedicineHangzhou 310052China Department of Pediatrics Division of Pediatric RheumatologyDuke University School of MedicineDurham 27710USA

Background Juvenile dermatomyositis(JDM)is a chronic autoimmune disease characteristic by inflammation of small vessels within the skin,muscle and vital *** the clinical features and treatment of JDM have not been fully *** sources Databases underwent through PubMed for articles about the clinical features,myositis-specific antibodiesof JDM and its treatment,and we selected publications written in English which were relevant to the topic of this *** Clinical features and myositis-specific antibodies may predict the severity and prognosis of *** the mortality rate has been lower with traditional treatments,such as corticosteroid,intravenous immunoglobulin,and diseasemodifying anti-rheumatic drugs such as methotrexate,their usages are *** biological therapies seem to be effective for refractory JDM patients,but more clinical trials are *** JDM is a sever disease of *** need to better understand recent advances of JDM in the context of clinical features including skin manifestations,muscle weakness and organ damage,myositis-specific antibodies and their associated outcomes and the treatment of disease.

关键词： Biologic agents Extramuscular manifestations Juvenile dermatomyositis Myositis autoantibodies

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The role of CD6 in autoimmune diseases

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Cellular & Molecular Immunology 2018年第11期15卷 1001-1002页

作者： David A.Fox division of rheumatology and Clinical Autoimmunity Center of Excellence University of MichiganAnn ArborMIUSA

In a recent publication in the Cellular and Molecular Immunology,Consuega-Fernandez and colleagues present new data from patients with psoriasis,linking the CD6 lymphocyte surface structure to the pathogenesis of this disease.1 In this commentary,I will discuss these new findings in the context of accumulating evidence for important roles of CD6 in a variety of autoimmune *** CD6 was one of the earliest“CD antigens”to be described,it is only recently that attention has refocused on the potential for CD6 as a treatment target in immune-mediated diseases.

关键词： autoimmune Immunology diseases

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Rituximab as a treatment for human immunodeficiency virusassociated nemaline myopathy:What does the literature have to tell us?

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World Journal of Clinical Cases 2022年第4期10卷 1454-1456页

作者： Jucier Gonçalves Júnior Samuel Katsuyuki Shinjo division of rheumatology São Paulo UniversitySão Paulo 01246-903Brazil

We presented a letter about a case of a 37-year-old Black female with a history of human immunodeficiency virus and an undetectable viral *** was evaluated with weakness in the scapular(grade III)and pelvic girdles(grade II),elevation of creatine phosphokinase levels and muscle biopsy compatible with nemaline *** was treated with rituximab showing improvement of the condition.

关键词： Case report Human immunodeficiency virus Nemaline myopathy Rituximab rheumatology Therapy

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