Fulin Tang

Peking Union Medical College Hospital, Peping, Beijing, China

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Publications (14)25.98 Total impact

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    ABSTRACT: The aim of this study was to analyze the characteristics of patients with diffuse connective tissue diseases (CTDs) complicated by pneumomediastinum and identify the risk factors associated with increased mortality in these patients. Twenty-eight patients with CTD-associated pneumomediastinum, who were admitted to our hospital from January 1997 to June 2012, were prospectively studied. Their demographic characteristics, time to death, and potential risk factors were assessed. Survival curves were depicted by the Kaplan-Meier method. Univariate and multivariate survival analyses were performed by Cox regression. Of the 28 patients, 21 had dermatomyositis; two, polymyositis; three, systemic lupus erythematosus; one, polyarteritis nodosa; and one, undifferentiated CTD. The mean follow-up period was 1,461 days (54-5,264). The cumulative estimated Kaplan-Meier survival rate was 68 % at 1 week, 50 % at 1 month, and 43 % at 1 year. According to univariate analysis, higher serum albumin level (HR 0.87, 95 % CI 0.78-0.98), "slow air leak" (defined as time to progression of dyspnea [newly acquired respiratory failure, mechanical ventilation required, or decrease in PaO2 >30 mmHg after pneumomediastinum]) >3 days (HR 0.07, 95 % CI 0.02-0.34), and early initiation of immunosuppressive agents (within 1 month of steroid therapy; HR 0.27, 95 % CI 0.09-0.81) were associated with better prognosis. Final regression analysis revealed that slow air leak was associated with a lower mortality risk. We found that slow air leak was independently associated with better prognosis. Furthermore, most patients (86 %) who survived for at least 1 month following the pneumomediastinum event subsequently survived beyond 1 year.
    Rheumatology International 05/2014; · 2.21 Impact Factor
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    ABSTRACT: Patients with rheumatoid arthritis (RA) are at risk to develop RA-associated interstitial lung disease (RA-ILD). This retrospective study aimed to investigate the potential association of the positivity of serum anti-cyclic citrullinated peptide antibody (anti-CCP2) and rheumatoid factor (RF) with RA-ILD in RA patients. A total of 285 RA patients were recruited at the inpatient service of Peking Union Medical College Hospital in China between 2004 and 2013. Individual patients were evaluated for the evidence of ILD. The concentrations of serum anti-CCP2 and RF in individual patients were measured. The potential risk factors for ILD in RA patients were assessed by univariate and multivariate models. There were 71 RA patients with RA-ILD, accounting for 24.9% in this population. The positive rates of anti-CCP2 and RF in the patients with RA-ILD were significantly higher than that in the patients with RA-only (88.7% vs. 67.3%, p<0.001; 84.5% vs. 70.6%, p = 0.02, respectively). Univariate and multivariate logistic regression analysis revealed that RA patients with positive serum anti-CCP2, but not RF, were associated with an increased risk of ILD (crude odds ratio [cOR] 3.83, 95% confidence interval [CI] 1.74-8.43, p<0.001; adjusted odds ratio [aOR] 3.50, 95% CI 1.52-8.04, p<0.001). Our findings suggest that positive serum anti-CCP2, but not RF, may be associated with RA-ILD in RA patients.
    PLoS ONE 01/2014; 9(4):e92449. · 3.53 Impact Factor
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    ABSTRACT: To investigate the clinical features, outcome, and risk factors of disease flares in patients with pregnancy-related lupus (PRL).
    PLoS ONE 01/2014; 9(8):e104375. · 3.53 Impact Factor
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    ABSTRACT: Previous studies on gene expression profiles in primary biliary cirrhosis (PBC) have exclusively focused on liver tissue or intrahepatic cells. Since the pathological process is systemic, other complementary studies in blood cells seemed to be reasonable. In this research, we try to explore differentially expressed genes in peripheral blood mononuclear cells (PBMCs) of PBC patients. Nine PBC patients and 9 healthy controls were recruited as Cohort 1 for a microarray study of screening. Total RNA of PBMCs from each individual was isolated and screened by oligonucleotide microarray (22 K). Then, differentially expressed genes were categorized into signaling pathways. Expression levels of three important genes, tyrosine kinase binding protein (TYROBP), C-C motif chemokine 5 (CCL5) and cathepsin L (CTSL) were confirmed by quantitative real-time polymerase chain reaction (qRT-PCR) in a second Cohort 2 (30 PBC patients and 20 healthy controls). Results show that sixty-five genes differentially expressed in PBC were identified, 20 of which were up-regulated and 45 of which were down-regulated. Twenty-seven signaling pathways were identified. TYROBP and CCL5 were proved to be down-regulated in PBC, and CTSL was proved to be up-regulated (p < 0.05) in PBC, which were all consistent with the screening study. In conclusions, the analysis of gene expression in PBMCs of PBC and the comparison of gene profiles between PBMCs and the liver may provide new clues to the pathogenesis of the disease.
    Clinical and Experimental Medicine 08/2013; · 2.83 Impact Factor
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    ABSTRACT: To evaluate the safety and efficacy of low-dose rituximab therapy for refractory thrombocytopenia in patients with SLE. Ten adult SLE patients with severe refractory thrombocytopenia (mean platelet count 10.4 × 10(9)/l) were enrolled in this prospective pilot study. All patients had failed traditional high-dose CSs and immunosuppressants including methylprednisolone pulse therapy. Patients were scheduled to receive i.v. rituximab at a dose of 100 mg once weekly for 4 weeks. Previous dose of CSs were gradually tapered, and immunosuppressants were withdrawn. Patients were followed at Weeks 4, 12, 24 and 36. All patients completed four courses of low-dose rituximab infusion. At Week 4, two (20%) patients achieved complete responses (CRs, platelet count >100 × 10(9)/l). The CR rate increased to 60% (six patients) at Week 12, was maintained at Week 24 and began to drop at Week 36 (four patients, 40%). Overall response (OR, platelet count >50 × 10(9)/l) was achieved in 5/10, 6/10, 7/10 and 5/10 patients at Weeks 4, 12, 24 and 36, respectively. Peripheral CD19(+) B cells were depleted (<5 × 10(6)/l) in all patients at Week 4, and gradually increased at Weeks 24 and 36. Serum C3, IgG, IgA and IgM levels did not change significantly (P < 0.05). Infusion reaction was observed in two patients. One patient developed pulmonary thrombosis at Week 14 and active tuberculosis at Week 25. Low-dose rituximab therapy is effective in treating severe thrombocytopenia in SLE patients who do not respond to vigorous glucocorticoid plus immunosuppressants, and in most cases is safe.
    Rheumatology (Oxford, England) 05/2011; 50(9):1640-4. · 4.24 Impact Factor
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    ABSTRACT: To identify proteomic biomarkers in cerebrospinal fluid (CSF) and develop a diagnostic proteomic model for neuropsychiatric systemic lupus erythematosus (NPSLE). CSF proteomic spectra were generated by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) combined with weak cation exchange (WCX) magnetic beads. The spectra were taken from 27 patients with NPSLE before and after treatment, and 27 controls including 17 patients with scoliosis and 10 patients with SLE but without neuropsychiatric manifestation. Discriminating peaks were processed by Biomarker Patterns Software to build a decision tree model for NPSLE classification. In addition, CSF samples of 12 patients with NPSLE, 12 patients with lumbar disc herniation, and 9 patients with other neurological conditions were used as a blind test group to verify the accuracy of the model. Twelve discriminating mass-to-charge (m/z) peaks were identified between NPSLE and controls: m/z peaks 7740, 11962, 8065, 7661, 6637, 5978, 11384, 11744, 8595, 10848, 7170, and 5806. The diagnostic decision tree model, built with a panel of m/z peaks 8595, 7170, 7661, 7740, and 5806, recognized NPSLE with both sensitivity and specificity of 92.6%, based on training group samples, and sensitivity and specificity of 91.7% and 85.7%, respectively, based on the blind test group. In addition, the root node m/z peak 8595 protein, which was downregulated in the CSF of patients with NPSLE after treatment, was identified and confirmed as ubiquitin by immunoprecipitation and ELISA. Potential CSF biomarkers for NPSLE are identified by MALDI-TOF-MS combined with WCX magnetic beads. The novel diagnostic proteomic model with m/z peaks 8595, 7170, 7661, 7740, and 5806 is highly sensitive and relatively specific for NPSLE diagnosis. The level of ubiquitin in CSF is a promising biomarker for active NPSLE.
    The Journal of Rheumatology 01/2011; 38(3):454-61. · 3.26 Impact Factor
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    ABSTRACT: Objective of the study is to assess the effects of adalimumab and MTX therapy on peripheral Th17 cells and IL-17/IL-6 secretion in RA patients. Twenty active RA patients were treated with oral MTX 15 mg per week (MTX group, n = 10), or hypodermal adalimumab 40 or 80 mg every other week (ADA group, n = 10). Peripheral blood samples were taken for laboratory evaluation at week 0 and week 12 of treatment, including flowcytometric detection of peripheral CD4(+) IL-17(+) cells, RT-PCR detection of mRNA expressions of IL-17, RORc and FoxP3, and ELISA determination of serum IL-17 and IL-6. Ten age and sex marched healthy volunteers were included as normal controls. Results showed that (1) DAS28 in both groups improved at week 12 compared to week 0 (3.9 ± 1.3 vs. 6.4 ± 1.4 and 3.2 ± 0.9 vs. 5.2 ± 0.9, respectively). (2) The percentage and MFI of peripheral CD4(+) IL-17(+) cells in RA patients were significantly higher comparing to normal controls (1.64 ± 0.97% vs. 0.75 ± 0.20%, p < 0.01; and 29.8 ± 9.7 vs. 19.8 ± 4.6, p < 0.05, respectively), and positively correlated with ESR and DAS28. Peripheral Th17 cells and serum IL-6 in RA patients decreased after treatment (from 1.60 ± 0.78% to 1.28 ± 0.41%, and from 17.15 ± 14.53 pg/ml to 6.97 ± 5.51 pg/ml, p < 0.05, respectively). Peripheral FoxP3 mRNA expression in active RA patients was significantly lower comparing to normal controls, and negatively correlated with ESR. Baseline Th17 percentage of RA patients negatively correlated with DAS28 improvement after treatment. In conclusion, adalimumab and MTX treatment down regulates peripheral Th17 cells and serum IL-6 level in RA patients. Baseline Th17 level negatively predicts the effect of adalimumb/MTX treatment.
    Rheumatology International 10/2009; 30(12):1553-7. · 2.21 Impact Factor
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    ABSTRACT: Abstract Aim: To investigate the feasibility, efficacy and safety of high-dose immunosuppressive therapy and autologous peripheral blood stem cell transplantation (PBSCT) with CD34+ cell selection in patients with refractory and severe autoimmune diseases. Methods: Eighteen patients with persistent systemic lupus erythematosus refractory to conventional treatment were enrolled into the study of peripheral blood stem cell transplantation in Peking Union Medical College Hospital from 1999 to 2005. After mobilization and conditioning, the enriched CD34+ cells were reinfused. Disease activity, adverse effects, haematopoietic and immunologic reconstitution were monitored and followed up for at least 6 months. Results: Overall treatment-related mortality was 5.6% with one patient dying of cytomegalovirus infection. The overall remission rate was 95.8% in the first year after PBSCT. Relapse occurred in three patients (17.6%) in 37, 26, and 19 months post-transplantation, respectively. Disease Activity Index scores of systemic lupus erythematosus survivors were decreased significantly (P 0.001). Conclusions: Short-term effect of autologous peripheral blood stem cell transplantation is promising although treatment-related mortality and relapses are observed in a subset of patients. High-dose immunosuppressive therapy followed by autologous peripheral blood stem cell transplantation with CD34+ cell selection is feasible and relatively safe in the treatment of severe and refractory autoimmune diseases. The long-term effect needs further evaluation and multicentre study.
    APLAR Journal of Rheumatology 01/2006; 9(1):49-55.
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    ABSTRACT: To explore the diagnostic value of anti-cyclic citrullinated peptide antibody (anti-CCP) detected by ELISA in patients with rheumatoid arthritis (RA). The synthesized cyclic citrullinated peptide was used as substrate for ELISA. Anti-CCP antibody was detected by ELISA in 191 patients with RA, 132 with rheumatic diseases other than RA, and 98 with nonrheumatic diseases. The antiperinuclear factor (APF), anti-keratin antibody (AKA), rheumatoid factor (RF), and HLA-DR4 gene complex were also tested in each RA patient. The results of these tests were compared with anti-CCP antibody to examine the correlation between them. Ninety (47.1%) patients with RA, 4 (3.0%) with other rheumatic diseases, and 2 (2.0%) with nonrheumatic diseases were found to be anti-CCP antibody positive by ELISA. The sensitivity of anti-CCP antibody was 47.1%, with a high specificity (97.4%) in RA. Anti-CCP antibody correlated with APF, AKA, RF, and HLA-DR4 gene complex. A new modified anti-CCP antibody test had a moderate sensitivity (47.1%) but a high specificity (97.4%) in patients with RA and was found as a valuable supplement to diagnosis of RA. Anti-CCP correlated with APF, AKA, RF, and HLA-DR4 gene complex, but did not completely overlap with them. Anti-CCP antibody could be regarded as a new diagnostic marker for RA.
    The Journal of Rheumatology 08/2003; 30(7):1451-5. · 3.26 Impact Factor
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    ABSTRACT: To explore the efficacy, safety and immune reconstitution of autologous peripheral blood stem cell transplantation (APBSCT) using T cell depleted grafts in the treatment of refractory rheumatoid arthritis (RA). One patient with RA was treated with APBSCT. The method included mobilization with 2 g/m(2) cyclophosphamide (CY) and subcutaneous injection of granulocyte-colony stimulating factor (G-CSF). Immunomagnetic selection of CD34(+) cells from the leukapheresis products was performed to deplete potentially autoreative lymphocytes. The conditioning regimen consisted of intravenous administration of 2 g/m2 CY and 90 mg/kg ATG, with subsequent reinfusion of the graft. G-CSF was used to help hematopoietic and immunologic reconstitution. Phenotype of the peripheral blood lymphocytes was analyzed to observe the immunologic reconstitution after transplantation. The patient completed the mobilization, conditioning regimen and transplantation successfully. The hematologic recovery was rapid and the patient achieved clinical remission. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) decreased to normal level and the rheumatoid factor (RF) turned negative after a follow-up of 12 months. An ongoing course of immunologic reconstitution was observed. APBSCT is effective and safey for refractory RA, and can induce improvement of disease activity. The course of immunologic reconstitution after transplantation remains to be observed in long-term followup.
    Zhonghua yi xue za zhi 07/2002; 82(11):748-51.
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    ABSTRACT: To compare the clinical and pathological manifestations of patients with antineutrophil cytoplasmic autoantibodies (ANCA) directed against proteinase 3 (anti-PR3) or myeloperoxidase (anti-MPO). One hundred and forty patients with ANCA were detected for anti-PR3 and anti-MPO by ELISA. The clinical features at presentation, histopathological characteristics and outcome of all patients who were tested positive for anti-PR3 or anti-MPO were analysed. In anti-PR3 group (n = 21), 16 cases (76.2%) had systemic vasculitis, in which Wegener's granulomatosis prevailed (13 cases, 61.9%). In anti-MPO group (n = 31), 19 cases (61.3%) were diagnosed as systemic vasculitis and 12 cases (38.7%) as microscopic angiitis. For vasculitic patients with anti-PR3 and anti-MPO, the disease duration at diagnosis was 9.6 +/- 2.0 m and 4.4 +/- 0.9 m respectively, P < 0.05; vasculitis activity index (BVAS) and mean number of affected organ were 22.5 +/- 2.1, 5.0 +/- 0.4 and 25.1 +/- 1.7, 4.8 +/- 0.4 respectively, P > 0.05; upper respiratory tract, eye and joint involvements were 11(68.8%), 7(43.8%), 11(68.8%) and 7(36.8%), 2(10.5%), 5(26.3%) respectively, P < 0.05. Although there was no statistical difference in renal involvement between these two groups, patients with serum creatine > 500 micromol/L were more commonly seen in anti-MPO group than in anti-PR3 group, which were 8(42.1%) and 2(12.5%) respectively, P < 0.05. Ten relapses were seen in anti-PR3 group and only 2 in anti-MPO group, but the acute mortality rate in anti-MPO group (5/19, 27.4%) was much higher than that in anti-PR3 group (1/16, 6.3%). Anti-PR3 and anti-MPO occurred mainly in systemic vasculitis. A large divergence was seen in the disease spectrum between patients with anti-PR3 and those with anti-MPO. In particular, upper respiratory tract, eye and joint involvements, granuloma formation and relapse were more prominent in anti-PR3 patients. By contrast, the anti-MPO patients had a more acute disease onset, more rapid progressive renal involvement and a higher acute mortality rate.
    Chinese Medical Sciences Journal 03/2002; 17(1):32-5.
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    ABSTRACT: To investigate the effect of intrathecal injection (i.t.) with methotrexate (MTX) plus dexamethasone (DXM) in treating central nervous system involvement in systemic lupus erythematosus (CNS lupus). Twenty-four CNS lupus patients that were refractory to conventional steroid therapy were selected for i.t. with MTX 10-20 mg plus DXM 10-20 mg. The effects and side effects of i.t. were closely observed. The symptoms and signs of 22/24 (91.7%) CNS lupus patients receiving i.t. improved considerably. Cerebrospinal fluid pressure, protein and WBC levels declined from 201.5 +/- 155.4 mm H2O, 145.2 +/- 87.6 mg/dl and 25.1 +/- 14.3/mm3 to 128.7 +/- 108.1 mm H2O, 60.8 +/- 38.3 mg/dl and 6.8 +/- 2.1/mm3 respectively. Transient side effects were observed in 4 patients: 1 with itching sensation of lower limbs, 2 with headache and 1 with incontinence. I.t. with MTX plus DXM is a promising method for treating CNS lupus and deserves further investigation.
    Chinese medical journal 08/2001; 114(7):764-6. · 0.90 Impact Factor
  • X Zhang, Y Dong, F Tang, F Zhang, H Li
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    ABSTRACT: To study the effect of high dose intravenous immunoglobulins(IvIg) in systemic lupus erythematosus (SLE)-associated thrombocytopenia. A case-control study was undertaken to assess the effectiveness of different therapeutic regimens (oral prednisone, IvIg, bolus methylprednisolone(MP), and IvIg plus bolus MP) in improving SLE-associated thrombocytopenia. For SLE-associated thrombocytopenia, IvIg, bolus MP, and IvIg plus bolus IvIg significantly shorten the time to reach a peak platelet count, which was (6.2 +/- 4.4) days, (7.3 +/- 4.9) days, and (3.8 +/- 2.4) days respectively in comparison with oral prednisone, which was (31.0 +/- 17.8) days (P< 0.01); if high dose IvIg and MP in combination, the time was also shorter than bolus MP alone (P < 0.05). The elevation of platelet count in groups receiving IvIg, bolus MP, and IvIg plus bolus MP were significantly higher than as in group receiving oral prednisone therapy(P < 0.05). High dose IvIg is a useful therapy in improving SLE-associated thrombocytopenia.
    Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae 02/2000; 22(1):82-4.
  • X Zhang, Y Dong, F Tang, H Li, F Zhang
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    ABSTRACT: To investigate central nervous system (CNS) involvements in systemic lupus erythematosus (SLE) so as to enhance our knowledge in diagnosing and treating CNS involvement of SLE. The clinical data of 171 in patients with CNS involvement of SLE in our hospital were retrospectively reviewed. The mean SLE disease duration at onset of CNS involvement was (2.21 +/- 1.87) years and in 163 (95.3%) it was associated with active disease. Cerebral spinal fluid abnormality was seen in 91.4% (138/151) of the patients with CNS involvement of SLE. Among them protein elevation was found in 113, pressure elevation in 69, white cell elevation in 51 and glucose reduction in 6. For the evaluation of CNS involvement of SLE, the sensitivity of cranial CT and MRI was 77.4% and 81.4% respectively (P > 0.50). The positive rate of antiribosomal P in patients with diffuse CNS involvement of SLE was significantly higher than that in patients without CNS involvement (P < 0.01). On the contrary, the positive rate of ACL in focal CNS involvement of SLE was significantly higher than that in diffuse type or in patients without CNS involvement (P < 0.01). The total mortality rate in 171 patients with CNS involvement of SLE was 18.7%. The Mortality rate in the period of 1993 to 1998 (4.0%, 3/75) was significantly lower than that of 1980 to 1992 (30.2%, 29/96), P < 0.01. 24 SLE patients with CNS involvement received intrathecal dexamethasone and methotrexate, 22 cases (91.7%) improved considerably. CNS involvement occurs in the early stage of SLE, most of the cases are associated with active disease. Cerebral spinal fluid analysis is the most essential test and cranial imaging serves as a supplementary approach, of which CT is preferred. ACL is associated with focal CNS involvement of SLE while antiribosomal P with diffuse CNS involvement of SLE, suggesting there might be different mechanisms in CNS involvement of SLE. Intrathecal therapy is an useful alternative for patients with CNS involvement of SLE refractory to conventional therapy.
    Zhonghua nei ke za zhi [Chinese journal of internal medicine] 10/1999; 38(10):681-4.