Objective: To investigate the physical and motor development of preterm small for gestational age infant (SGA) within 2 years after birth.
Methods: SGA born in Peking University Third Hospital from January 1, 2018 to December 31, 2022 and followed up regularly in the Center for Child Health and Deve-lopment were selected as study subjects. They were divided into preterm SGA group and full-term SGA group. Length, weight, head circumference, Peabody motor development score, vitamin A and D, bone mineral density and feeding status of SGA 0-3, 3-6, 6-10, 10-16, 16-21, 21-27 months after birth were collected through the electronic child health care follow-up system. The preterm infants were calculated according to the corrected gestational age. SPSS 25.0 statistical software was used to analyze the data.
Results: A total of 158 SGA completed the regular follow-up, including 87 preterm SGA and 71 full-term SGA. The birth length, weight and head circumference of the two groups were statistically significant (all P < 0.05). The body weight of preterm SGA caught up faster 0-3 months after birth, and the head circumference of preterm SGA was higher than that of full-term SGA 0-3 months [(38.18±2.14) cm vs. (37.12±1.66) cm] and 6-10 months [(43.04±1.54) cm vs. (42.35±1.70) cm] after birth. The differences were statistically significant (all P < 0.05). The scores of gross motor, fine motor and total motor development 3-6 and 6-10 months after birth were significantly higher in preterm SGA than in full-term SGA (all P < 0.05). Breastfeeding 0-3 months of age and 3-6 months of age was significantly associated with catch-up growth in preterm SGA (P < 0.05). There were no significant differences in vitamins A and D and bone mineral density between the two groups.
Conclusion: In the first year after birth, the weight and head circumference of preterm SGA increase faster than those of full-term SGA, and the motor development of preterm SGA is better than that of full-term SGA. After the first year of life, the physical indicators and motor development of the two groups tend to be consistent. Breastfeeding is the preferred feeding mode for preterm SGA, which promotes rapid catch-up growth in the early stage. The absence of maternal diabetes during pregnancy is also one of the positive factors for the occurrence of catch-up growth in SGA.
{"title":"[A follow-up study on the physical and motor development of premature infants with small for gestational age within 2 years after birth].","authors":"Ping Zheng, Kunhong Lin, Mengyuan Liu, Xuyan Zhao, Yangxin Xiao, Yan Xing","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the physical and motor development of preterm small for gestational age infant (SGA) within 2 years after birth.</p><p><strong>Methods: </strong>SGA born in Peking University Third Hospital from January 1, 2018 to December 31, 2022 and followed up regularly in the Center for Child Health and Deve-lopment were selected as study subjects. They were divided into preterm SGA group and full-term SGA group. Length, weight, head circumference, Peabody motor development score, vitamin A and D, bone mineral density and feeding status of SGA 0-3, 3-6, 6-10, 10-16, 16-21, 21-27 months after birth were collected through the electronic child health care follow-up system. The preterm infants were calculated according to the corrected gestational age. SPSS 25.0 statistical software was used to analyze the data.</p><p><strong>Results: </strong>A total of 158 SGA completed the regular follow-up, including 87 preterm SGA and 71 full-term SGA. The birth length, weight and head circumference of the two groups were statistically significant (all <i>P</i> < 0.05). The body weight of preterm SGA caught up faster 0-3 months after birth, and the head circumference of preterm SGA was higher than that of full-term SGA 0-3 months [(38.18±2.14) cm <i>vs</i>. (37.12±1.66) cm] and 6-10 months [(43.04±1.54) cm <i>vs</i>. (42.35±1.70) cm] after birth. The differences were statistically significant (all <i>P</i> < 0.05). The scores of gross motor, fine motor and total motor development 3-6 and 6-10 months after birth were significantly higher in preterm SGA than in full-term SGA (all <i>P</i> < 0.05). Breastfeeding 0-3 months of age and 3-6 months of age was significantly associated with catch-up growth in preterm SGA (<i>P</i> < 0.05). There were no significant differences in vitamins A and D and bone mineral density between the two groups.</p><p><strong>Conclusion: </strong>In the first year after birth, the weight and head circumference of preterm SGA increase faster than those of full-term SGA, and the motor development of preterm SGA is better than that of full-term SGA. After the first year of life, the physical indicators and motor development of the two groups tend to be consistent. Breastfeeding is the preferred feeding mode for preterm SGA, which promotes rapid catch-up growth in the early stage. The absence of maternal diabetes during pregnancy is also one of the positive factors for the occurrence of catch-up growth in SGA.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 6","pages":"1124-1131"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761939","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}
<p><strong>Objective: </strong>To evaluate the association of systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) with Behçet disease uveitis (BU), and to assess their predictive value for inflammatory activity and clinical prognosis in BU patients.</p><p><strong>Methods: </strong>There were 194 patients diagnosed with Behçet disease (BD) and 122 healthy controls. The BD patients were classified into two subgroups based on disease activity: An active phase cohort (<i>n</i>=90) and a stable phase cohort (<i>n</i>=104). Furthermore, the patients were categorized according to the presence or absence of uveitis into two cohorts: BU (<i>n</i>=49) and non-BU (<i>n</i>=145). Among the BU cohort, 26 patients were in the active inflammatory stage, while 23 patients were in the quiescent inflammatory stage. SII and SIRI were calculated using routine blood parameters, including platelet, neutrophil, lymphocyte, and monocyte counts. Spearman correlation analysis was performed to assess the associations of SII and SIRI with BU onset, inflammatory activity, and inflammatory markers. Receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal thresholds and predictive accuracy of SII and SIRI for BU onset and inflammatory activity.</p><p><strong>Results: </strong>SII and SIRI levels were significantly elevated in BD patients with ocular and vascular manifestations compared to those with stable disease (<i>P</i> < 0.05). No significant differences were observed in SII or SIRI levels among the patients with other clinical manifestations of BD. In the patients with BU, both SII and SIRI were significantly higher than in the non-BU and healthy control the groups (<i>P</i> < 0.001). Moreover, SII and SIRI levels were higher during the active inflamma-tory stage than in the inactive stage of BU (<i>P</i>=0.004). Spearman correlation analysis revealed that SII was positively associated with BD disease activity (<i>ρ</i>=0.303, <i>P</i> < 0.001), BU onset (<i>ρ</i>=0.442, <i>P</i> < 0.001), inflammatory activity (<i>ρ</i>=0.392, <i>P</i>=0.005), C-reactive protein (CRP, <i>ρ</i>=0.272, <i>P</i> < 0.001), and erythrocyte sedimentation rate (ESR, <i>ρ</i>=0.285, <i>P</i> < 0.001). SIRI was only positively correlated with BU onset (<i>ρ</i>=0.301, <i>P</i>=0.006). Logistic regression analysis demonstrated that eleva-ted SII was an independent risk factor for BU onset (<i>OR</i>=1.003, 95% <i>CI</i>: 1.001-1.004, <i>P</i> < 0.001). ROC curve analysis indicated that the optimal thresholds for SII were 711.800 [area under curve (AUC)=0.752] for predicting BU onset, 1 622.300 (AUC=0.741) for predicting inflammatory activity, and 1 634.200 (AUC=0.726) for predicting poor prognosis. The corresponding thresholds for SIRI were 1.260 (AUC=0.709), 1.390 (AUC=0.704), and 2.790 (AUC=0.678), respectively. Kaplan-Meier analysis indicated that elevated SII independently predicted adverse prognostic events (<i>HR</i>=
目的：评价全身免疫炎症指数（SII）和全身炎症反应指数（SIRI）与behet病葡萄膜炎（BU）的相关性，并评价其对BU患者炎症活动性和临床预后的预测价值。方法：194例诊断为behet病（BD）的患者和122例健康对照。根据疾病活动度将BD患者分为两组：活动期队列（n=90）和稳定期队列（n=104）。此外，根据是否存在葡萄膜炎将患者分为两组：BU （n=49）和non-BU （n=145）。在BU队列中，26例患者处于活动性炎症期，23例患者处于静止性炎症期。SII和SIRI使用常规血液参数计算，包括血小板、中性粒细胞、淋巴细胞和单核细胞计数。采用Spearman相关分析来评估SII和SIRI与BU发病、炎症活性和炎症标志物的关系。进行受试者工作特征（ROC）曲线分析，以确定SII和SIRI对BU发病和炎症活动的最佳阈值和预测准确性。结果：有眼部和血管表现的BD患者SII和SIRI水平明显高于病情稳定的患者（P < 0.05）。伴有其他临床表现的BD患者SII和SIRI水平无显著差异。伴有BU的患者SII和SIRI水平均显著高于非BU组和健康对照组（P < 0.001）。此外，炎症活动期SII和SIRI水平高于非炎症活动期（P=0.004）。Spearman相关分析显示，SII与BD疾病活动性（ρ=0.303, P < 0.001）、BU发病（ρ=0.442, P < 0.001）、炎症活动性（ρ=0.392， P=0.005）、c反应蛋白（CRP, ρ=0.272, P < 0.001）和红细胞沉降率（ESR, ρ=0.285, P < 0.001）呈正相关。SIRI仅与BU发病呈正相关（ρ=0.301， P=0.006）。Logistic回归分析显示SII升高是布鲁里溃疡发病的独立危险因素（OR=1.003, 95% CI: 1.001 ~ 1.004, P < 0.001）。ROC曲线分析显示，预测BU发病SII的最佳阈值为711.800[曲线下面积(AUC)=0.752]，预测炎症活动性SII的最佳阈值为1 622.300 (AUC=0.741)，预测不良预后SII的最佳阈值为1 634.200 （AUC=0.726）。相应的SIRI阈值分别为1.260 （AUC=0.709）、1.390 （AUC=0.704）和2.790 （AUC=0.678）。Kaplan-Meier分析显示SII升高独立预测不良预后事件（HR=3.440, 95%CI: 1.040 ~ 11.410， P=0.043）。结论：SII和SIRI可作为预测BD合并葡萄膜炎患者炎症活动及预后的潜在临床指标。尤其是SII，对布鲁里溃疡的发病和疾病活动性表现出优越的预测能力，为早期识别高危患者和临床决策提供了依据。
{"title":"[Role of the SII and SIRI in risk prediction, disease activity assessment, and prog-nostic evaluation of Behçet disease uveitis].","authors":"Yajing Gao, Zhengfang Li, Mengsi Ma, Lijun Wu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association of systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) with Behçet disease uveitis (BU), and to assess their predictive value for inflammatory activity and clinical prognosis in BU patients.</p><p><strong>Methods: </strong>There were 194 patients diagnosed with Behçet disease (BD) and 122 healthy controls. The BD patients were classified into two subgroups based on disease activity: An active phase cohort (<i>n</i>=90) and a stable phase cohort (<i>n</i>=104). Furthermore, the patients were categorized according to the presence or absence of uveitis into two cohorts: BU (<i>n</i>=49) and non-BU (<i>n</i>=145). Among the BU cohort, 26 patients were in the active inflammatory stage, while 23 patients were in the quiescent inflammatory stage. SII and SIRI were calculated using routine blood parameters, including platelet, neutrophil, lymphocyte, and monocyte counts. Spearman correlation analysis was performed to assess the associations of SII and SIRI with BU onset, inflammatory activity, and inflammatory markers. Receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal thresholds and predictive accuracy of SII and SIRI for BU onset and inflammatory activity.</p><p><strong>Results: </strong>SII and SIRI levels were significantly elevated in BD patients with ocular and vascular manifestations compared to those with stable disease (<i>P</i> < 0.05). No significant differences were observed in SII or SIRI levels among the patients with other clinical manifestations of BD. In the patients with BU, both SII and SIRI were significantly higher than in the non-BU and healthy control the groups (<i>P</i> < 0.001). Moreover, SII and SIRI levels were higher during the active inflamma-tory stage than in the inactive stage of BU (<i>P</i>=0.004). Spearman correlation analysis revealed that SII was positively associated with BD disease activity (<i>ρ</i>=0.303, <i>P</i> < 0.001), BU onset (<i>ρ</i>=0.442, <i>P</i> < 0.001), inflammatory activity (<i>ρ</i>=0.392, <i>P</i>=0.005), C-reactive protein (CRP, <i>ρ</i>=0.272, <i>P</i> < 0.001), and erythrocyte sedimentation rate (ESR, <i>ρ</i>=0.285, <i>P</i> < 0.001). SIRI was only positively correlated with BU onset (<i>ρ</i>=0.301, <i>P</i>=0.006). Logistic regression analysis demonstrated that eleva-ted SII was an independent risk factor for BU onset (<i>OR</i>=1.003, 95% <i>CI</i>: 1.001-1.004, <i>P</i> < 0.001). ROC curve analysis indicated that the optimal thresholds for SII were 711.800 [area under curve (AUC)=0.752] for predicting BU onset, 1 622.300 (AUC=0.741) for predicting inflammatory activity, and 1 634.200 (AUC=0.726) for predicting poor prognosis. The corresponding thresholds for SIRI were 1.260 (AUC=0.709), 1.390 (AUC=0.704), and 2.790 (AUC=0.678), respectively. Kaplan-Meier analysis indicated that elevated SII independently predicted adverse prognostic events (<i>HR</i>=","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 6","pages":"1067-1073"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761576","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}
Yan Ding, Lifang Wang, Chaoran Li, Zhemin Lu, Lianjie Shi
Rheumatoid arthritis is an autoimmune disease primarily characterized by chronic symmetric arthritis. While rheumatoid arthritis with elevated eosinophils exhibits distinct clinical features, the potential coexistence of immunoglobulin (Ig)G4-related disease warrants clinical vigilance. This article reports a case of a patient presenting with polyarticular swelling and pain accompanied by morning stiffness. Positive tests for anti-keratin antibody, anti-cyclic citrullinated peptide antibody, anti-perinuclear factor, and rheumatoid factor were observed with a significantly elevated erythrocyte sedimentation rate, leading to a definitive diagnosis of rheumatoid arthritis. The patient also exhibited elevated peripheral blood eosinophils and showed poor response to treatments, such as leflunomide and tripterygium glycosides. After switching to methotrexate and tocilizumab, the patient's joint symptoms improved significantly, but peripheral blood eosinophilia showed no notable improvement. During the course of the disease, the patient developed lymphadenopathy and parotid gland enlargement. Lymph node ultrasound revealed a hypoechoic nodule in the left supraclavicular area, abnormal lymph nodes in both axillae and the right inguinal region, and visible lymph nodes in the bilateral cervical and left inguinal areas. Parotid ultrasound indicated hypoechoic nodules within both parotid glands and widening of the parotid ducts. Further bone marrow aspiration biopsy showed no significant abnormalities, while lymph node pathological biopsy suggested infiltration of IgG4-positive cells. Subsequent serum IgG4 testing revealed elevated level of IgG4. The patient was ultimately considered likely to have rheumatoid arthritis complicated with IgG4-related disease. Treatment was adjusted to regular infusions of rituximab (500 mg every six months), resulting in significant improvement of joint swelling and pain, as well as marked reductions in C-reactive protein and eosinophil levels, achieving disease remission. Through case analysis and literature review, this article discusses the diagnosis and treatment of rheumatoid arthritis patients with elevated eosinophils. For patients with rheumatoid arthritis with elevated eosinophils, it is necessary to be vigilant of the possibility of concurrent IgG4-related diseases. The use of rituximab provides novel perspectives for clinical treatment strategies.
{"title":"[Rheumatoid arthritis combined with IgG4-related disease successfully treated with rituximab: A case report].","authors":"Yan Ding, Lifang Wang, Chaoran Li, Zhemin Lu, Lianjie Shi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Rheumatoid arthritis is an autoimmune disease primarily characterized by chronic symmetric arthritis. While rheumatoid arthritis with elevated eosinophils exhibits distinct clinical features, the potential coexistence of immunoglobulin (Ig)G4-related disease warrants clinical vigilance. This article reports a case of a patient presenting with polyarticular swelling and pain accompanied by morning stiffness. Positive tests for anti-keratin antibody, anti-cyclic citrullinated peptide antibody, anti-perinuclear factor, and rheumatoid factor were observed with a significantly elevated erythrocyte sedimentation rate, leading to a definitive diagnosis of rheumatoid arthritis. The patient also exhibited elevated peripheral blood eosinophils and showed poor response to treatments, such as leflunomide and tripterygium glycosides. After switching to methotrexate and tocilizumab, the patient's joint symptoms improved significantly, but peripheral blood eosinophilia showed no notable improvement. During the course of the disease, the patient developed lymphadenopathy and parotid gland enlargement. Lymph node ultrasound revealed a hypoechoic nodule in the left supraclavicular area, abnormal lymph nodes in both axillae and the right inguinal region, and visible lymph nodes in the bilateral cervical and left inguinal areas. Parotid ultrasound indicated hypoechoic nodules within both parotid glands and widening of the parotid ducts. Further bone marrow aspiration biopsy showed no significant abnormalities, while lymph node pathological biopsy suggested infiltration of IgG4-positive cells. Subsequent serum IgG4 testing revealed elevated level of IgG4. The patient was ultimately considered likely to have rheumatoid arthritis complicated with IgG4-related disease. Treatment was adjusted to regular infusions of rituximab (500 mg every six months), resulting in significant improvement of joint swelling and pain, as well as marked reductions in C-reactive protein and eosinophil levels, achieving disease remission. Through case analysis and literature review, this article discusses the diagnosis and treatment of rheumatoid arthritis patients with elevated eosinophils. For patients with rheumatoid arthritis with elevated eosinophils, it is necessary to be vigilant of the possibility of concurrent IgG4-related diseases. The use of rituximab provides novel perspectives for clinical treatment strategies.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 6","pages":"1203-1207"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762099","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}
Objective: To evaluate the characteristics and their change trends of major radiographic parameters of hips in axial spondyloarthritis (axSpA) patients with end-stage hip involvement from a single high-volume tertiary center over a 24-year period.
Methods: Between 2001 and 2024, the radiographic trends of hips in axSpA patients with end-stage hip involvement were retrospectively reviewed. These radiographic parameters included bony ankylosis, acetabular protrusio, dislocation, obturator foramen ratio (OFR), canal flare index (CFI) and neck shaft angle (NSA). The baseline demographic, disease-related and laboratory parameters before surgery were also collected. Trend analyses over the study period were assessed using the Jonkheere-Terpstra trend test or the Cochran-Armitage trend test for clinical and radiographic parameters. All the joints were divided into the 2001-2012 group and 2013-2024 group according to the year of surgery, and the intergroup comparisons were conducted to further elucidate temporal changes.
Results: The overall incidence of bony ankylosis, acetabular protrusio and dislocation before operation were 40.2%, 14.8% and 9.8%, respectively. The median value of OFR, CFI and NSA were 1.5 (1.2, 1.7), 3.2 (2.6, 3.8) and 141.0° (135.0°, 148.0°), respectively. Notably, only the value of OFR demonstrated increasing trend (P=0.001) among these radiographic parameters of hip, although some clinical parameters demonstrated increasing trend [hemoglobin (Hb) (P < 0.001), albumin (ALB) (P < 0.001), short form 12-item health survey (SF-12) physical component summary (PCS) (P=0.005), Harris hip score (HHS) (P=0.003)] or decreasing trend [erythrocyte sedimentation rate (ESR) (P < 0.001), C-reactive protein (CRP) (P < 0.001), Bath ankylosing spondylitis disease activity index (BASDAI) (P=0.013), Bath ankylosing spondylitis functional index (BASFI) (P < 0.001)]. The results of intergroup comparisons between 2001-2012 inpatient group (n=421) and 2013-2024 inpatient group (n=577) showed that no significant differences were found for these radiographic parameters of hip, although some clinical parameters were significantly different, including gender (P=0.004), body mass index (BMI) (P=0.002), age at disease onset (P < 0.001) and HHS (P < 0.001).
Conclusion: The radiographic parameters of hip in axSpA patients with end-stage hip involvement did not show a trend of improvement over time, despite observed improvements in disease activity control and functional status. This dissociation between clinical improvement and persistent structural damage presents considerable technical challenges for subsequent surgical reconstruction with total hip arthroplasty.
{"title":"[A long-term review for radiographic parameters of hips in axial spondyloarthritis patients with end-stage hip involvement: A 24-year trend analysis from a single high-volume tertiary center].","authors":"Xinfeng Wu, Siliang Man, Dazhao Chen, Yong Hua, Xijie Wen, Yingyue Ding, Liang Zhang, Xiujuan Hou","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the characteristics and their change trends of major radiographic parameters of hips in axial spondyloarthritis (axSpA) patients with end-stage hip involvement from a single high-volume tertiary center over a 24-year period.</p><p><strong>Methods: </strong>Between 2001 and 2024, the radiographic trends of hips in axSpA patients with end-stage hip involvement were retrospectively reviewed. These radiographic parameters included bony ankylosis, acetabular protrusio, dislocation, obturator foramen ratio (OFR), canal flare index (CFI) and neck shaft angle (NSA). The baseline demographic, disease-related and laboratory parameters before surgery were also collected. Trend analyses over the study period were assessed using the Jonkheere-Terpstra trend test or the Cochran-Armitage trend test for clinical and radiographic parameters. All the joints were divided into the 2001-2012 group and 2013-2024 group according to the year of surgery, and the intergroup comparisons were conducted to further elucidate temporal changes.</p><p><strong>Results: </strong>The overall incidence of bony ankylosis, acetabular protrusio and dislocation before operation were 40.2%, 14.8% and 9.8%, respectively. The median value of OFR, CFI and NSA were 1.5 (1.2, 1.7), 3.2 (2.6, 3.8) and 141.0° (135.0°, 148.0°), respectively. Notably, only the value of OFR demonstrated increasing trend (<i>P</i>=0.001) among these radiographic parameters of hip, although some clinical parameters demonstrated increasing trend [hemoglobin (Hb) (<i>P</i> < 0.001), albumin (ALB) (<i>P</i> < 0.001), short form 12-item health survey (SF-12) physical component summary (PCS) (<i>P</i>=0.005), Harris hip score (HHS) (<i>P</i>=0.003)] or decreasing trend [erythrocyte sedimentation rate (ESR) (<i>P</i> < 0.001), C-reactive protein (CRP) (<i>P</i> < 0.001), Bath ankylosing spondylitis disease activity index (BASDAI) (<i>P</i>=0.013), Bath ankylosing spondylitis functional index (BASFI) (<i>P</i> < 0.001)]. The results of intergroup comparisons between 2001-2012 inpatient group (<i>n</i>=421) and 2013-2024 inpatient group (<i>n</i>=577) showed that no significant differences were found for these radiographic parameters of hip, although some clinical parameters were significantly different, including gender (<i>P</i>=0.004), body mass index (BMI) (<i>P</i>=0.002), age at disease onset (<i>P</i> < 0.001) and HHS (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The radiographic parameters of hip in axSpA patients with end-stage hip involvement did not show a trend of improvement over time, despite observed improvements in disease activity control and functional status. This dissociation between clinical improvement and persistent structural damage presents considerable technical challenges for subsequent surgical reconstruction with total hip arthroplasty.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 6","pages":"1089-1095"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761976","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}
Yayun Zhao, Mengfan Ni, Xue Li, Bei Wang, Gong Cheng, Jing He, Yuebo Jin
<p><strong>Objective: </strong>Renal involvement is a common extra-glandular lesion in primary Sjögren syndrome (pSS), generally associated with poor prognosis. Early immunotherapy might alleviate renal injury and improve long-term renal function. Growing evidence suggests that rituximab (RTX) is effective for systemic manifestations in pSS. In this retrospective study, we preliminarily investigated the efficacy of RTX on renal involvement in pSS.</p><p><strong>Methods: </strong>Clinical and laboratory data from the clinical large-scale data application platform of peking University People' s Hospital were collected. From July 2013 to January 2025, 17 patients with secondary renal damage due to pSS who were treated with RTX in the Department of Rheumatology and Immunology and the Department of Nephrology of Peking University People' s Hospital were consecutively included. During the same period, 34 patients treated with conventional immunosuppressive drugs were matched for age, gender, and baseline disease conditions. The RTX group received glucocorticoid therapy along with RTX, while the control group received glucocorticoid therapy along with immunosuppressive drugs for 6 months. We evaluated the effect of different treatments by comparing general laboratory parameters, renal injury index, and immunological features before and after treatment in the two groups.</p><p><strong>Results: </strong>After 6 months, renal function indices showed significant reductions in levels of the urinary N-acetyl-β-glucosaminidase (NAG), beta2-microglobulin (β2-MG), creatinine, and urea nitrogen in the RTX group ( <i>P</i> < 0.01, <i>P</i> < 0.05). It was shown that the levels of 24 h urinary total protein (24h UTP), urinary retinol-binding protein in the RTX group were lower, while the serum potassium in the RTX group were higher than those in the control group, all with no significant difference (<i>P</i>>0.05). Regarding immunological features, the RTX group had significantly lower levels of immunoglobulin G (IgG, <i>P</i> < 0.05) and rheumatoid factor (RF, <i>P</i> < 0.05), and higher levels of complement 3 (C3) and complement 4 (C4) compared with the control group ( <i>P</i> < 0.05). The total European League Against Rheumatism Sjögren syndrome disease activity index (ESSDAI) score and renal score in the RTX group were significantly lower than those in the control group, with statistically significant differences ( <i>P</i> < 0.05). Furthermore, after the 6-month treatment, a higher proportion of patients in the RTX group were able to taper their prednisone dose to lower levels (0-5 mg, quaque die) compared with the control group (64.71% <i>vs</i>. 32.35%, <i>P</i>=0.038). In addition to these positive outcomes, the incidence of infection was 1/17 in the RTX group and 3/34 in the control group. No serious adverse events were observed during the trial.</p><p><strong>Conclusion: </strong>Through targeted depletion of pathogenic B cells, RTX had the potential to
目的：肾脏受累是原发性Sjögren综合征（pSS）中一种常见的腺外病变，通常与不良预后相关。早期免疫治疗可减轻肾损伤，改善长期肾功能。越来越多的证据表明，利妥昔单抗（RTX）对pSS的全身表现有效。在这项回顾性研究中，我们初步探讨了RTX对pSS肾脏受累的疗效。方法：收集北京大学人民医院临床大数据应用平台的临床和实验室数据。2013年7月至2025年1月，连续纳入北京大学人民医院风湿病免疫科和肾脏病科接受RTX治疗的17例pSS继发性肾损害患者。在同一时期，34名接受常规免疫抑制药物治疗的患者根据年龄、性别和基线疾病状况进行匹配。RTX组在RTX治疗的同时给予糖皮质激素治疗，对照组在治疗的同时给予免疫抑制药物治疗，疗程为6个月。我们通过比较两组患者治疗前后的一般实验室参数、肾损伤指数和免疫学特征来评价不同治疗的效果。结果：6个月后，肾功能指标显示RTX组尿n -乙酰-β-氨基葡萄糖苷酶（NAG）、β-微球蛋白（β2-MG）、肌酐、尿素氮水平显著降低（P < 0.01, P < 0.05）。结果显示，RTX组24h尿总蛋白（24h UTP）、尿视黄醇结合蛋白水平低于对照组，血清钾水平高于对照组，但差异均无统计学意义（P < 0.05）。免疫学方面，RTX组免疫球蛋白G （IgG, P < 0.05）、类风湿因子（RF, P < 0.05）水平显著低于对照组，补体3 （C3）、补体4 （C4）水平显著高于对照组（P < 0.05）。RTX组欧洲抗风湿病联盟Sjögren综合征疾病活动指数（ESSDAI）总分和肾脏评分均显著低于对照组，差异有统计学意义（P < 0.05）。此外，治疗6个月后，与对照组相比，RTX组患者能够将泼尼松剂量逐渐减少到较低水平（0-5 mg，快速死亡）的比例更高（64.71% vs. 32.35%， P=0.038）。除了这些阳性结果外，RTX组的感染发生率为1/17，对照组为3/34。试验期间未观察到严重不良事件。结论：通过靶向清除致病B细胞，RTX有可能改善pSS患者肾小球和小管间质损伤，并调节肾脏排泄和酸碱平衡。提示RTX可能优于传统的免疫抑制药物，并有助于糖皮质激素的逐渐减少。同时，药物依从性以良好的安全性得到保证。因此，RTX在临床实践中被认为是一个很有前途的选择。
{"title":"[Clinical efficacy and safety of rituximab in treating renal injury in primary Sjögren syndrome].","authors":"Yayun Zhao, Mengfan Ni, Xue Li, Bei Wang, Gong Cheng, Jing He, Yuebo Jin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Renal involvement is a common extra-glandular lesion in primary Sjögren syndrome (pSS), generally associated with poor prognosis. Early immunotherapy might alleviate renal injury and improve long-term renal function. Growing evidence suggests that rituximab (RTX) is effective for systemic manifestations in pSS. In this retrospective study, we preliminarily investigated the efficacy of RTX on renal involvement in pSS.</p><p><strong>Methods: </strong>Clinical and laboratory data from the clinical large-scale data application platform of peking University People' s Hospital were collected. From July 2013 to January 2025, 17 patients with secondary renal damage due to pSS who were treated with RTX in the Department of Rheumatology and Immunology and the Department of Nephrology of Peking University People' s Hospital were consecutively included. During the same period, 34 patients treated with conventional immunosuppressive drugs were matched for age, gender, and baseline disease conditions. The RTX group received glucocorticoid therapy along with RTX, while the control group received glucocorticoid therapy along with immunosuppressive drugs for 6 months. We evaluated the effect of different treatments by comparing general laboratory parameters, renal injury index, and immunological features before and after treatment in the two groups.</p><p><strong>Results: </strong>After 6 months, renal function indices showed significant reductions in levels of the urinary N-acetyl-β-glucosaminidase (NAG), beta2-microglobulin (β2-MG), creatinine, and urea nitrogen in the RTX group ( <i>P</i> < 0.01, <i>P</i> < 0.05). It was shown that the levels of 24 h urinary total protein (24h UTP), urinary retinol-binding protein in the RTX group were lower, while the serum potassium in the RTX group were higher than those in the control group, all with no significant difference (<i>P</i>>0.05). Regarding immunological features, the RTX group had significantly lower levels of immunoglobulin G (IgG, <i>P</i> < 0.05) and rheumatoid factor (RF, <i>P</i> < 0.05), and higher levels of complement 3 (C3) and complement 4 (C4) compared with the control group ( <i>P</i> < 0.05). The total European League Against Rheumatism Sjögren syndrome disease activity index (ESSDAI) score and renal score in the RTX group were significantly lower than those in the control group, with statistically significant differences ( <i>P</i> < 0.05). Furthermore, after the 6-month treatment, a higher proportion of patients in the RTX group were able to taper their prednisone dose to lower levels (0-5 mg, quaque die) compared with the control group (64.71% <i>vs</i>. 32.35%, <i>P</i>=0.038). In addition to these positive outcomes, the incidence of infection was 1/17 in the RTX group and 3/34 in the control group. No serious adverse events were observed during the trial.</p><p><strong>Conclusion: </strong>Through targeted depletion of pathogenic B cells, RTX had the potential to","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 6","pages":"1051-1060"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762066","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}
Jianxiao Zhao, Qian Ding, Wenjin Li, Quanquan Ma, Yixiao Lan, Lei Zhang, Jianmin Han
Objective: To study the effect of porous surface structure on fatigue strength of zirconia fabricated by stereolithography apparatus (SLA), and to provide reference for the surface design of 3D printed zirconia implants.
Methods: Zirconia specimens were fabricated by SLA. According to the surface structure, zirconia specimens were divided into non-porous group, 200 μm group and 400 μm group. The surface morphology was observed by 3D laser morphology microscope and scanning electron microscope, and the surface roughness, pore parameters and grain size were measured. The flexural strength of the specimen was measured by three-point bending test and Weibull analysis was performed. The fatigue strength of the specimens was measured by fatigue test, and the fatigue mechanism was analyzed by fractrography. The crystal phase before and after fatigue test of the specimen was analyzed by X-ray diffraction.
Results: The surface roughness of the area between the pores of non-porous group, 200 μm group and 400 μm group was (0.79±0.09) μm, (0.81±0.16) μm and (0.81±0.09) μm, respectively, with no significant difference among them. The surface grain size was (324.11±21.38) nm, (308.06±11.34) nm, (311.62±15.02) nm, respectively, with no significant difference among them. The results of three-point bending test showed that the three-point bending strength of the non-porous group [(1 030.70±111.71) MPa] was significantly higher than that of the porous groups (P < 0.001). The 200 μm group [(272.04±61.16) MPa] was significantly higher than the 400 μm group [(201.21±25.58) MPa] (P < 0.01). The fatigue strength of the non-porous group [(702.29± 21.62) MPa] was significantly higher than that of the porous groups (P < 0.001), and the fatigue strength of the 200 μm group [(159.57±9.30) MPa] was significantly higher than that of the 400 μm group [(125.36±6.11) MPa] (P < 0.001). The fracture analysis results showed that the crack origins were mainly internal defects, air holes, inclusions and the joint of printing layer, etc. There was no significant difference in the content of monoclinic phase before and after fatigue test among all the groups.
Conclusion: The surface porous microstructure could significantly reduce the fatigue strength of the zirconia specimens, and the larger pore size showed the lower fatigue strength. In the future, the material and printing process of 3D printing zirconia should be improved, and the surface structure design should be further optimized to improve the mechanical properties of 3D printing zirconia.
{"title":"[Effect of porous surface structure on fatigue strength of 3D printed zirconia].","authors":"Jianxiao Zhao, Qian Ding, Wenjin Li, Quanquan Ma, Yixiao Lan, Lei Zhang, Jianmin Han","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To study the effect of porous surface structure on fatigue strength of zirconia fabricated by stereolithography apparatus (SLA), and to provide reference for the surface design of 3D printed zirconia implants.</p><p><strong>Methods: </strong>Zirconia specimens were fabricated by SLA. According to the surface structure, zirconia specimens were divided into non-porous group, 200 μm group and 400 μm group. The surface morphology was observed by 3D laser morphology microscope and scanning electron microscope, and the surface roughness, pore parameters and grain size were measured. The flexural strength of the specimen was measured by three-point bending test and Weibull analysis was performed. The fatigue strength of the specimens was measured by fatigue test, and the fatigue mechanism was analyzed by fractrography. The crystal phase before and after fatigue test of the specimen was analyzed by X-ray diffraction.</p><p><strong>Results: </strong>The surface roughness of the area between the pores of non-porous group, 200 μm group and 400 μm group was (0.79±0.09) μm, (0.81±0.16) μm and (0.81±0.09) μm, respectively, with no significant difference among them. The surface grain size was (324.11±21.38) nm, (308.06±11.34) nm, (311.62±15.02) nm, respectively, with no significant difference among them. The results of three-point bending test showed that the three-point bending strength of the non-porous group [(1 030.70±111.71) MPa] was significantly higher than that of the porous groups (<i>P</i> < 0.001). The 200 μm group [(272.04±61.16) MPa] was significantly higher than the 400 μm group [(201.21±25.58) MPa] (<i>P</i> < 0.01). The fatigue strength of the non-porous group [(702.29± 21.62) MPa] was significantly higher than that of the porous groups (<i>P</i> < 0.001), and the fatigue strength of the 200 μm group [(159.57±9.30) MPa] was significantly higher than that of the 400 μm group [(125.36±6.11) MPa] (<i>P</i> < 0.001). The fracture analysis results showed that the crack origins were mainly internal defects, air holes, inclusions and the joint of printing layer, etc. There was no significant difference in the content of monoclinic phase before and after fatigue test among all the groups.</p><p><strong>Conclusion: </strong>The surface porous microstructure could significantly reduce the fatigue strength of the zirconia specimens, and the larger pore size showed the lower fatigue strength. In the future, the material and printing process of 3D printing zirconia should be improved, and the surface structure design should be further optimized to improve the mechanical properties of 3D printing zirconia.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 6","pages":"1165-1173"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762072","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}
<p><p>A case of systemic lupus erythematosus (SLE) complicated with contactin-1 (CNTN1) antibody-positive autoimmune nodopathy (AN) is reported, with the aim of providing insights for the early recognition and precise management of this rare comorbidity. A 48-year-old woman was admitted with a history of limb numbness and weakness for more than one year and 8 months of bilateral lower-limb edema. More than one year prior, she presented to another hospital with distal limb weakness and numbness; cerebrospinal fluid examination revealed albuminocytologic dissociation, electromyography showed findings consistent with peripheral neuropathy. She was diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and treated with intravenous immunoglobulin and methylprednisolone pulse therapy, but her symptoms continued to progress. Six months before admission, she developed bilateral leg edema; laboratory tests showed leukopenia (3×10<sup>9</sup>/L), proteinuria (urine protein/creatinine ratio 4.5 g/d) with hypoalbuminemia and hyperlipidemia, and serum anti-CNTN1 antibody positivity. Lumbar MRI revealed thickening of bilateral lumbosacral nerve roots, edema of the common peroneal nerve, and diffuse thickening of the brachial plexus. She was diagnosed with immune-mediated peripheral neuropathy and nephrotic syndrome, and treated with a single intravenous dose of rituximab (600 mg), followed by dexamethasone (15 mg/d for 5 days) transitioned to oral prednisone (60 mg/d, tapered). Limb weakness and numbness improved, leukocyte count normalized, but edema worsened. One week before the current admission, she developed alopecia; repeat testing showed worsened proteinuria (urine protein/creatinine 7.05 g/d), positive antinuclear antibody (1 ∶ 1000, cytoplasmic granular pattern), anti-double-stranded DNA (anti-dsDNA), anti-SSA, anti-Ro52 antibodies, and weakly positive anti-SSB antibody. SLE was suspected, and she was admitted to the Department of Rheumatology and Immunology, Peking University People' s Hospital. Repeat testing revealed elevated anti-dsDNA antibody (137 IU/mL), low C4, and seroconversion to negative for anti-CNTN1 antibody in both serum and CSF. Renal biopsy demonstrated atypical membranous nephropathy. Final diagnoses were SLE, CNTN1 antibody-positive AN, and lupus nephritis. She received intravenous methylprednisolone (40 mg/d) transitioned to oral prednisone (50 mg/d, tapered), hydroxychloroquine (0.2 g twice daily), and rituximab induction (500 mg weekly ×4) followed by 500 mg every 6 months as maintenance. During 2 years of follow-up, alopecia, limb weakness, and numbness improved, leukocyte count remained normal, and urine protein/creatinine decreased to 0.19 g/d. Autoimmune nodopathy, first formally recognized in July 2021, is a novel subtype of peripheral neuropathy. This is the third reported case worldwide of SLE coexisting with AN. The literature is reviewed, and possible shared pathogenic mechanisms, disease charac
{"title":"[Systemic lupus erythematosus complicated by autoimmune nodopathy: A case report].","authors":"Chun Wei, Yue Yang, Xinju Zhao, Xu Liu, Yuan Jia","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A case of systemic lupus erythematosus (SLE) complicated with contactin-1 (CNTN1) antibody-positive autoimmune nodopathy (AN) is reported, with the aim of providing insights for the early recognition and precise management of this rare comorbidity. A 48-year-old woman was admitted with a history of limb numbness and weakness for more than one year and 8 months of bilateral lower-limb edema. More than one year prior, she presented to another hospital with distal limb weakness and numbness; cerebrospinal fluid examination revealed albuminocytologic dissociation, electromyography showed findings consistent with peripheral neuropathy. She was diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and treated with intravenous immunoglobulin and methylprednisolone pulse therapy, but her symptoms continued to progress. Six months before admission, she developed bilateral leg edema; laboratory tests showed leukopenia (3×10<sup>9</sup>/L), proteinuria (urine protein/creatinine ratio 4.5 g/d) with hypoalbuminemia and hyperlipidemia, and serum anti-CNTN1 antibody positivity. Lumbar MRI revealed thickening of bilateral lumbosacral nerve roots, edema of the common peroneal nerve, and diffuse thickening of the brachial plexus. She was diagnosed with immune-mediated peripheral neuropathy and nephrotic syndrome, and treated with a single intravenous dose of rituximab (600 mg), followed by dexamethasone (15 mg/d for 5 days) transitioned to oral prednisone (60 mg/d, tapered). Limb weakness and numbness improved, leukocyte count normalized, but edema worsened. One week before the current admission, she developed alopecia; repeat testing showed worsened proteinuria (urine protein/creatinine 7.05 g/d), positive antinuclear antibody (1 ∶ 1000, cytoplasmic granular pattern), anti-double-stranded DNA (anti-dsDNA), anti-SSA, anti-Ro52 antibodies, and weakly positive anti-SSB antibody. SLE was suspected, and she was admitted to the Department of Rheumatology and Immunology, Peking University People' s Hospital. Repeat testing revealed elevated anti-dsDNA antibody (137 IU/mL), low C4, and seroconversion to negative for anti-CNTN1 antibody in both serum and CSF. Renal biopsy demonstrated atypical membranous nephropathy. Final diagnoses were SLE, CNTN1 antibody-positive AN, and lupus nephritis. She received intravenous methylprednisolone (40 mg/d) transitioned to oral prednisone (50 mg/d, tapered), hydroxychloroquine (0.2 g twice daily), and rituximab induction (500 mg weekly ×4) followed by 500 mg every 6 months as maintenance. During 2 years of follow-up, alopecia, limb weakness, and numbness improved, leukocyte count remained normal, and urine protein/creatinine decreased to 0.19 g/d. Autoimmune nodopathy, first formally recognized in July 2021, is a novel subtype of peripheral neuropathy. This is the third reported case worldwide of SLE coexisting with AN. The literature is reviewed, and possible shared pathogenic mechanisms, disease charac","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 6","pages":"1174-1179"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761805","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}
Yanyan Li, Xiangjun Liu, Gongming Li, Chun Li, Yuan Jia
Objective: To investigate and analyze the clinical behavior and therapeutic status of patients with antiphospholipid syndrome (APS).
Methods: Patients diagnosed with APS between September 2021 and October 2025 were enrolled in this investigation. Data collection included: demographic characteristics, disease duration, initial presenting symptoms, departments of first visit and diagnosis, time of the first visit and definite diagnosis, the interval of follow-up, previous and current medications. Assessments using the 36-item short form health survey (SF-36), hospital anxiety and depression scale (HADS), and general medication adherence scale (GMAS) were also conducted. Age- and gender-matched healthy controls were selected and completed parallel SF-36 and HADS evaluations during the same period.
Results: In the study, 196 patients with APS were investigated. The median age of onset was 36 years, the male to female ratio was 1:6.8, and median disease duration was 3.0 years. Rheumatology & Immunology was the most common department for the first hospital visit (33.2%, 65/196), followed by Hematology (21.9%) and Reproductive Endocrinology and Infertility Center (18.4%). Other departments included Neurology (5.6%), Vascular Surgery (5.1%), and Emergency (4.1%). The median time from symptom onset to APS diagnosis was 6.0 months, with 32.1%(63/196) of patients experiencing a diagnostic delay of over one year. Regarding follow-up adherence, 56.6% (111/196) of patients with APS maintained regular follow-ups at intervals of ≤3 months, while 7.1% (14/196) of the patients visited their doctor less than once a year. The primary pharmacological treatments for the APS patients included hydroxychloroquine, warfarin and other anticoagulants, and antiplatelet agents. According to the GMAS assessment, 76.1% of the patients demonstrated high or good medication adhe-rence. Among all SF-36 domains, the scores of general health (GH) in the APS patients were significantly lower compared with healthy controls (P < 0.05). According to the HADS, the proportion of anxiety symptoms was significantly higher in the APS patients compared with healthy controls (13.8% vs. 6.7%, P < 0.05).
Conclusion: In this study, delayed diagnosis in APS remained prevalent. Compared with healthy controls, the APS patients exhibited significantly impaired physical function and elevated anxiety symptoms. Regular follow-up monitoring should be emphasized, and greater attention must be paid to psychoeducational interventions.
目的：调查分析抗磷脂综合征（APS）患者的临床行为及治疗状况。方法：将2021年9月至2025年10月诊断为APS的患者纳入本研究。资料收集包括：人口学特征、病程、首发症状、就诊科室及诊断、就诊时间及确诊时间、随访间隔、既往及当前用药情况。使用36项简短健康调查（SF-36）、医院焦虑和抑郁量表（HADS）和一般药物依从性量表（GMAS）进行评估。选择年龄和性别匹配的健康对照，并在同一时期完成平行的SF-36和HADS评估。结果：本研究共调查了196例APS患者。中位发病年龄36岁，男女比例1:8 .8，中位病程3.0年。首次就诊最多的是风湿科和免疫科（33.2%,65/196），其次是血液科（21.9%）和生殖内分泌与不孕症中心（18.4%）。其他科室包括神经内科（5.6%）、血管外科（5.1%）和急诊科（4.1%）。从症状出现到APS诊断的中位时间为6.0个月，其中32.1%（63/196）的患者诊断延迟超过一年。在随访依从性方面，56.6%（111/196）的APS患者保持了≤3个月的定期随访，而7.1%（14/196）的患者就诊时间少于一年一次。APS患者的主要药物治疗包括羟氯喹、华法林等抗凝血药物和抗血小板药物。根据GMAS评估，76.1%的患者表现出高或良好的药物依从性。在所有SF-36域中，APS患者的一般健康（GH）得分显著低于健康对照组（P < 0.05）。根据HADS， APS患者出现焦虑症状的比例明显高于健康对照组（13.8% vs. 6.7%, P < 0.05）。结论：在本研究中，APS的延迟诊断仍然普遍存在。与健康对照组相比，APS患者表现出明显的身体功能受损和焦虑症状升高。应强调定期随访监测，并更加重视心理教育干预。
{"title":"[Clinic behavior and therapeutic status of patients with antiphospholipid syndrome].","authors":"Yanyan Li, Xiangjun Liu, Gongming Li, Chun Li, Yuan Jia","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate and analyze the clinical behavior and therapeutic status of patients with antiphospholipid syndrome (APS).</p><p><strong>Methods: </strong>Patients diagnosed with APS between September 2021 and October 2025 were enrolled in this investigation. Data collection included: demographic characteristics, disease duration, initial presenting symptoms, departments of first visit and diagnosis, time of the first visit and definite diagnosis, the interval of follow-up, previous and current medications. Assessments using the 36-item short form health survey (SF-36), hospital anxiety and depression scale (HADS), and general medication adherence scale (GMAS) were also conducted. Age- and gender-matched healthy controls were selected and completed parallel SF-36 and HADS evaluations during the same period.</p><p><strong>Results: </strong>In the study, 196 patients with APS were investigated. The median age of onset was 36 years, the male to female ratio was 1:6.8, and median disease duration was 3.0 years. Rheumatology & Immunology was the most common department for the first hospital visit (33.2%, 65/196), followed by Hematology (21.9%) and Reproductive Endocrinology and Infertility Center (18.4%). Other departments included Neurology (5.6%), Vascular Surgery (5.1%), and Emergency (4.1%). The median time from symptom onset to APS diagnosis was 6.0 months, with 32.1%(63/196) of patients experiencing a diagnostic delay of over one year. Regarding follow-up adherence, 56.6% (111/196) of patients with APS maintained regular follow-ups at intervals of ≤3 months, while 7.1% (14/196) of the patients visited their doctor less than once a year. The primary pharmacological treatments for the APS patients included hydroxychloroquine, warfarin and other anticoagulants, and antiplatelet agents. According to the GMAS assessment, 76.1% of the patients demonstrated high or good medication adhe-rence. Among all SF-36 domains, the scores of general health (GH) in the APS patients were significantly lower compared with healthy controls (<i>P</i> < 0.05). According to the HADS, the proportion of anxiety symptoms was significantly higher in the APS patients compared with healthy controls (13.8% <i>vs</i>. 6.7%, <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>In this study, delayed diagnosis in APS remained prevalent. Compared with healthy controls, the APS patients exhibited significantly impaired physical function and elevated anxiety symptoms. Regular follow-up monitoring should be emphasized, and greater attention must be paid to psychoeducational interventions.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 6","pages":"1107-1112"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761999","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}
Objective: To assess the association between socioeconomic status and vision impairment (Ⅵ) among Chinese elderly aged 65 years and above, and explore its comparison and contrast from 2008 to 2018.
Methods: Using the 2008 and 2018 waves of cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which included 12970 and 9702 participants, respectively. Logistic regression models with a stepwise forward approach were employed to assess the association between the household income, educated level, job before retirement and Ⅵ.
Results: In 2008, the prevalence of Ⅵ among the elderly aged 65 years and above in China was 16.92% (95%CI: 15.91%-17.98%), which increased to 18.45% (95%CI: 17.41%-19.53%) in 2018. In terms of household income, the highest and upper middle income groups had lower odds of Ⅵ compared with the lowest one in 2008. By 2018, only the upper middle had lower odds (OR=0.761, 95%CI: 0.603-0.961), with its disparity narrowing compared with 2008. For educated level, in 2008, individuals with primary school education, and those with junior high school education or above had lower odds of Ⅵ compared with illiterate individuals. By 2018, the disparity in Ⅵ between the illiterate individuals and those with primary school education widened, while the gap between the illiterate ones and those with junior high school education or above decreased. In addition, after controlling for other factors, the odds of Ⅵ for the individuals educated by junior high school and above was higher than for those educated by primary school (OR=0.691, 95%CI: 0.533-0.896; OR=0.592, 95%CI: 0.494-0.708). Regarding job before retirement, in 2008, compared with the professional, technical or managerial personnel, those engaged in agriculture or domestic work had higher odds of Ⅵ. In 2018, this disparity persisted (OR=1.707, 95%CI: 1.319-2.210; OR=1.925, 95%CI: 1.310-2.829), with the gaps widening compared with the reference group.
Conclusion: The prevalence of Ⅵ among Chinese elderly increased from 2008 to 2018, with socioeconomic status, specifically household income, educated level, and job before retirement, demonstrating associations with Ⅵ. To be specific, the gap in the odds of Ⅵ across household income strata decreased from 2008 to 2018; disparities among different educated levels generally diminished, while the gap between illiterate individuals and ones educated by primary school widened; and job-before-retirement groups exhibited expanding disparities over time.
{"title":"[Association between socioeconomic status and vision impairment among Chinese elderly].","authors":"Yuehui Wei, Weiyan Jian","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between socioeconomic status and vision impairment (Ⅵ) among Chinese elderly aged 65 years and above, and explore its comparison and contrast from 2008 to 2018.</p><p><strong>Methods: </strong>Using the 2008 and 2018 waves of cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which included 12970 and 9702 participants, respectively. Logistic regression models with a stepwise forward approach were employed to assess the association between the household income, educated level, job before retirement and Ⅵ.</p><p><strong>Results: </strong>In 2008, the prevalence of Ⅵ among the elderly aged 65 years and above in China was 16.92% (95%<i>CI</i>: 15.91%-17.98%), which increased to 18.45% (95%<i>CI</i>: 17.41%-19.53%) in 2018. In terms of household income, the highest and upper middle income groups had lower odds of Ⅵ compared with the lowest one in 2008. By 2018, only the upper middle had lower odds (<i>OR</i>=0.761, 95%<i>CI</i>: 0.603-0.961), with its disparity narrowing compared with 2008. For educated level, in 2008, individuals with primary school education, and those with junior high school education or above had lower odds of Ⅵ compared with illiterate individuals. By 2018, the disparity in Ⅵ between the illiterate individuals and those with primary school education widened, while the gap between the illiterate ones and those with junior high school education or above decreased. In addition, after controlling for other factors, the odds of Ⅵ for the individuals educated by junior high school and above was higher than for those educated by primary school (<i>OR</i>=0.691, 95%<i>CI</i>: 0.533-0.896; <i>OR</i>=0.592, 95%<i>CI</i>: 0.494-0.708). Regarding job before retirement, in 2008, compared with the professional, technical or managerial personnel, those engaged in agriculture or domestic work had higher odds of Ⅵ. In 2018, this disparity persisted (<i>OR</i>=1.707, 95%<i>CI</i>: 1.319-2.210; <i>OR</i>=1.925, 95%<i>CI</i>: 1.310-2.829), with the gaps widening compared with the reference group.</p><p><strong>Conclusion: </strong>The prevalence of Ⅵ among Chinese elderly increased from 2008 to 2018, with socioeconomic status, specifically household income, educated level, and job before retirement, demonstrating associations with Ⅵ. To be specific, the gap in the odds of Ⅵ across household income strata decreased from 2008 to 2018; disparities among different educated levels generally diminished, while the gap between illiterate individuals and ones educated by primary school widened; and job-before-retirement groups exhibited expanding disparities over time.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 6","pages":"1136-1144"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762013","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}
Objective: To evaluate the clinical features of sarcoidosis with ocular lesions as the initial manifestation and to analyze its treatment and prognostic outcomes.
Methods: A retrospective study was conducted to evaluate the clinical data of sarcoidosis patients from July 2010 to July 2025 in the Department of Rheumatology and Immunology, Beijing Tongren Hospital.
Results: Among the 23 patients, the male-to-female ratio was 1 ∶ 2.3, with a mean age of (45.1±14.1) years, a median disease duration of 0.5 (0.25, 1.50) years, and a median diagnosis time of 0.5 (0.20, 1.00) years. Fourteen patients presented with ocular lesions as the initial manifestations, while 9 patients had non-ocular lesions (such as respiratory system involvement or joint swelling/pain) as the initial manifestations. The most common ocular lesions were non-infectious uveitis and orbital masses. Orbital masses were most commonly encountered as lacrimal gland enlargement. Other ocular lesions included optic neuritis and optic perineuritis. The median follow-up time was 21.21 (5.00, 147.29) months. Following treatment, all the patients achieved significant clinical improvement, of whom 3 patients with non-infectious uveitis and 1 with optic perineuritis showed improved visual acuity and overall visual function. During the follow-up period, 2 patients with sarcoidosis experienced disease recurrence. After their treatment regimens were reinitiated, both patients achieved remission with a favorable prognosis. Compared with the patients with non-ocular-onset as the initial manifestation, the patients with ocular-onset as the initial manifestation had a significantly longer diagnosis time, and the difference was statistically significant (P =0.025). The C-reactive protein (CRP) level was 1.90 (0.50, 4.62) mg/L in the ocular-onset group and 11.70 (0.90, 31.45) mg/L in the non-ocular-onset group, and the difference was statistically significant (P =0.042). The erythrocyte sedimentation rate (ESR) was 14.00 (8.50, 24.00) mm/h in the ocular-onset group and 26.00 (15.50, 47.00) mm/h in the non-ocular-onset group, and the difference was statistically significant (P =0.033). The ocular-onset group had significantly lower levels of both CRP and ESR compared with the non-ocular-onset group.
Conclusion: Sarcoidosis with ocular-onset as the initial manifestation poses diagnostic challenges, as routine inflammatory markers have limited utility in suggesting the disease and thus it is easily overlooked. Therefore, enhancing clinicians' ability to recognize these ocular-onset features is crucial for achieving early diagnosis and enabling timely intervention.
{"title":"[Clinical features and prognosis of sarcoidosis with ocular lesions as the initial manifestation].","authors":"Jiajing Peng, Li Cui","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical features of sarcoidosis with ocular lesions as the initial manifestation and to analyze its treatment and prognostic outcomes.</p><p><strong>Methods: </strong>A retrospective study was conducted to evaluate the clinical data of sarcoidosis patients from July 2010 to July 2025 in the Department of Rheumatology and Immunology, Beijing Tongren Hospital.</p><p><strong>Results: </strong>Among the 23 patients, the male-to-female ratio was 1 ∶ 2.3, with a mean age of (45.1±14.1) years, a median disease duration of 0.5 (0.25, 1.50) years, and a median diagnosis time of 0.5 (0.20, 1.00) years. Fourteen patients presented with ocular lesions as the initial manifestations, while 9 patients had non-ocular lesions (such as respiratory system involvement or joint swelling/pain) as the initial manifestations. The most common ocular lesions were non-infectious uveitis and orbital masses. Orbital masses were most commonly encountered as lacrimal gland enlargement. Other ocular lesions included optic neuritis and optic perineuritis. The median follow-up time was 21.21 (5.00, 147.29) months. Following treatment, all the patients achieved significant clinical improvement, of whom 3 patients with non-infectious uveitis and 1 with optic perineuritis showed improved visual acuity and overall visual function. During the follow-up period, 2 patients with sarcoidosis experienced disease recurrence. After their treatment regimens were reinitiated, both patients achieved remission with a favorable prognosis. Compared with the patients with non-ocular-onset as the initial manifestation, the patients with ocular-onset as the initial manifestation had a significantly longer diagnosis time, and the difference was statistically significant (<i>P</i> =0.025). The C-reactive protein (CRP) level was 1.90 (0.50, 4.62) mg/L in the ocular-onset group and 11.70 (0.90, 31.45) mg/L in the non-ocular-onset group, and the difference was statistically significant (<i>P</i> =0.042). The erythrocyte sedimentation rate (ESR) was 14.00 (8.50, 24.00) mm/h in the ocular-onset group and 26.00 (15.50, 47.00) mm/h in the non-ocular-onset group, and the difference was statistically significant (<i>P</i> =0.033). The ocular-onset group had significantly lower levels of both CRP and ESR compared with the non-ocular-onset group.</p><p><strong>Conclusion: </strong>Sarcoidosis with ocular-onset as the initial manifestation poses diagnostic challenges, as routine inflammatory markers have limited utility in suggesting the disease and thus it is easily overlooked. Therefore, enhancing clinicians' ability to recognize these ocular-onset features is crucial for achieving early diagnosis and enabling timely intervention.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 6","pages":"1061-1066"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762027","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}
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