To clarify clinical characteristics of immune thrombocytopenia (ITP) subsets associated with autoimmune diseases (AIDs).Five thousand five hundred twenty patients were reviewed retrospectively. One hundred four ITP patients were included for analysis. Clinical manifestations at first thrombocytopenic episode were recorded.Systemic lupus erythematosus (SLE) and primary Sjogren syndrome (pSS) accounted for a large part in AIDs associated with secondary ITP. SLE-ITP, pSS-ITP, and primary ITP (pITP) patients were different in several aspects in clinical and immunological characteristics. A subgroup of patients in pITP patients with some obvious autoimmune features (defined as AIF-ITP) such as positive ANA but failing to meet the diagnosis criteria now used for a specific kind of connective tissue diseases were also different with other pITP patients in some immunological features, indicating the difference in the pathogenesis mechanism of those autoimmune featured ITP patients.ITP patients were heterogeneous in clinical characteristics. Further study about the different pathogenesis of ITP subsets especially those AIF-ITP patients who only presented with thrombocytopenia will help us have a better understanding of pathogenesis of ITP and a better management of ITP patients.
To study the clinical features and associated risk factors of interstitial lung disease (ILD) in clinically amyopathic dermatomyositis (CADM) in Chinese patients. Forty-one Chinese Han patients with a diagnosis of CADM in West China Hospital from August 2008 to 2011 were retrospectively analyzed. The prevalence of ILD in CADM patients is 60.98 %, in which 26.83 % for acute/subacute interstitial pneumonia (A/SIP) and 34.15 % for chronic interstitial pneumonia (CIP). Mortality of A/SIP is 63.64 %, with a 6-month survival rate of 54.50 %. Levels of erythrocyte sedimentation rate, serum ferritin, alanine aminotransferase, aspartate aminotransferase, creatine kinase, lactate dehydrogenase, hydroxybutyric dehydrogenase, and immunoglobulin A (IgA) are higher in CADM-ILD patients than CADM patients without ILD. Levels of serum ALB and lymphocyte count in peripheral blood are significant lower in A/SIP than in CIP group. Sign of ground glass opacities in high-resolution computed tomography (HRCT) images is more common in A/SIP group, and diffusion function is worse in these patients compared with CIP group. The prevalence of ILD in Chinese CADM patients is strikingly high, and A/SIP is a major cause of death in CADM patients. Laboratory findings combined with HRCT examination and pulmonary function tests can provide valuable predictive information of ILD or A/SIP in CADM patients.
Gαq, the alpha subunit of Gq, a member of the Gq/11 sub‐family, was reported to inhibit phosphatidylinositol‐3‐Kinase (PI3K) activation and prevent the activation of Akt. Previous studies demonstrated that mice losing Gαq in their immune system could spontaneously develop inflammatory arthritis. In this study, we showed that the Gαq expressions at mRNA and protein levels in the peripheral blood lymphocytes (PBLs) from patients with rheumatoid arthritis (RA) were significantly decreased in comparison of which in healthy individuals. The expression levels of Gαq mRNA in PBLs from patients with RA were correlated with RA disease activity (DAS28), anti‐cyclic citrullinated protein antibodies, C‐reactive protein and rheumatoid factor. We also demonstrated that Gαq controlled the apoptosis of RA PBLs through regulating the activity of Mcl‐1 and caspase‐3. These data suggested that Gαq might be involved in the pathogenesis of RA by regulating PBLs apoptosis.
Oriented cores recovered from the Cajon Pass deep drill hole near the San Andreas fault in southern California were examined under both optical and electronic microscopes to study the distributrion and orientation of microfractures in the rocks. The objective was to determine whether there may be any systematic relationship between the microfractures in the rocks and the stress field in this area and to test the hypothesis that the observed shear wave birefringence can be caused by in situ microfractures. Three sets of microfractures, all dipping subvertically, appear in the rock cores studied. The oldest set (set 2) consists of mineralized microfractures with an orientation of N40*-50*E. A younger set (set 3), less prominent in appearance, consists of mineralized microfractures with an orientation of N68ø-76øE. The most recent set (set 1) consists of open microfractures with fresh walls, with orientation of N14ø-28øW. The two mineralized sets of microfractures were most likely formed in situ. The last set of microfractures with fresh walls was probably formed during core extraction and stress release. Based on elementary consideration in fracture mechanics, the second and the last sets (sets 3 and 1, respectively) of microfractures are consistent with a mean orientation of the present state of stress at the Cajon Pass drilling site, with a mean direction of the maximum horizontal stress at about N70øE, as determined from recent analyses of stress-induced well bore breakouts, hydraulic fractures, and shear wave birefringence. The oldest set of microfractures (set 2) could have formed during an earlier strain event when the crystalline basement beneath the Cajon Pass area experienced an earlier strain episode when the basement block occupied a more northerly position during which the maximum horizontal stress was oriented at about N45øE. On the other hand, it could also have formed under the same state of stress as the present one, but the basement block could have rotated counterclockwise.
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