Showing papers by "Peking Union Medical College Hospital published in 2007"

Antimicrobial susceptibility among organisms from the Asia/Pacific Rim, Europe and Latin and North America collected as part of TEST and the in vitro activity of tigecycline

Abstract: OBJECTIVES To describe antimicrobial susceptibility among bacterial isolates associated with hospital infections collected from 266 centres in Asia/Pacific Rim (n = 1,947), North America (n = 24,283), Latin America (n = 1,957) and Europe (n = 8,796) METHODS Isolates were collected from blood, respiratory tract, urine, skin, wound, body fluids and other defined sources between January 2004 and August 2006 Only one isolate per patient was accepted In vitro MICs for the isolates were determined according to the CLSI (formerly NCCLS) guidelines RESULTS Key organisms collected were Acinetobacter baumannii (n = 2,902), Enterobacter spp (n = 5,731), Escherichia coli (n = 6,504), Klebsiella pneumoniae (n = 4,916), Pseudomonas aeruginosa (n = 5,128), Serratia marcescens (n = 2,313), Enterococcus faecalis (n = 2,701), Enterococcus faecium (n = 1,035) and Staphylococcus aureus (n = 5,753) Rates of methicillin resistance among S aureus and of vancomycin resistance among enterococci were highest in North America (2,016/3,809, 529% and 571/2,544, 224%, respectively) and lowest in Europe (337/1,340, 251% and 36/916, 39%, respectively) Tigecycline was the only antimicrobial to maintain activity against all Gram-positive isolates (MIC(90) values of 93% susceptibility in all regions) antimicrobials against the Gram-negative species, except for A baumannii and P aeruginosa Piperacillin/tazobactam and amikacin were the most active against P aeruginosa Extended-spectrum beta-lactamase producers among K pneumoniae occurred most frequently in Latin America (124/282, 440%) CONCLUSIONS Tigecycline is a novel broad-spectrum antimicrobial that is active against the common organisms associated with infections

Molecular Epidemiology of Clinical Isolates of Carbapenem-Resistant Acinetobacter spp. from Chinese Hospitals

Abstract: Carbapenem resistance in Acinetobacter spp. is an emerging problem in China. We investigated the molecular epidemiology and carbapenemase genes of 221 nonrepetitive imipenem-resistant clinical isolates of Acinetobacter spp. collected from 1999 to 2005 at 11 teaching hospitals in China. Genotyping by pulsed-field gel electrophoresis (PFGE) found 15 PFGE patterns. Of these, one (clone P) was identified at four hospitals in Beijing and another (clone A) at four geographically disparate cities. Most imipenem-resistant isolates exhibited high-level resistance to all beta-lactams and were only susceptible to colistin. bla(OXA-23)-like genes were found in 97.7% of isolates. Sequencing performed on 60 representative isolates confirmed the presence of the bla(OXA-23) carbapenemase gene. Analysis of the genetic context of bla(OXA-23) showed the presence of ISAba1 upstream of bla(OXA-23). All of the 187 A. baumannii isolates identified by amplified RNA gene restriction analysis carried a bla(OXA-51)-like oxacillinase gene, while this gene was absent from isolates of other species. Sequencing indicated the presence of bla(OXA-66) for 18 representative isolates. Seven isolates of one clone (clone T) carried the plasmid-mediated bla(OXA-58) carbapenemase gene, while one isolate of another clone (clone L) carried the bla(OXA-72) carbapenemase gene. Only 1 isolate of clone Q carried the bla(IMP-8) metallo-beta-lactamase gene, located in a class 1 integron. Of 221 isolates, 77.8% carried bla(PER-1)-like genes. Eleven different structures of class 1 integrons were detected, and most integrons carried genes mediating resistance to aminoglycosides, rifampin, and chloramphenicol. These findings indicated clonal spread of imipenem-resistant Acinetobacter spp. and wide dissemination of the OXA-23 carbapenemase in China.

Effect of TGF-β/Smad signaling pathway on lung myofibroblast differentiation

Abstract: Aim: Myofibroblasts play important roles in the pathogenesis of lung fibrosis. Transforming growth factor (TGF)-β1 has been widely recognized as a key fibrogenic cytokine. The major signaling pathway of TGF-β1 is through cytoplasmic Smad proteins. Our study investigated the role of individual TGF-β1/Smad signal proteins in mediating α-smooth muscle actin (α-SMA) gene expression, which is a well-known key marker of myofibroblast differentiation. Methods: We transiently cotransfected α-SMA promoter-luciferase fusion plasmid (p895-Luc) and Smad expression plasmids and measured Luc activity in TGF-β1-treated human fetal lung fibroblasts. We induced Smad3 knockout mice lung fibrosis by bleomycin. α-SMA protein expression was assessed by Western blotting. Collagen protein was analyzed by measuring hydroxyprolin. Myofibroblast morphology was assessed by immunohistochemistry. Results: We found that the overexpression of Smad3, not Smad2 markedly increased TGF-β1-induced α-SMA promoter activity and α-SMA protein expression in vitro , whereas the overexpression of dominant negative mutant Smad3 and Smad7 repressed TGF-β1-induced α-SMA gene expression. Compared to wild-type mice, Smad3 knockout mice showed attenuated lung fibrosis after bleomycin treatment, manifested by lower collagen production and myofibroblast differentiation. Conclusion: Our study suggested TGF-β1/Smad3 is a major pathway which regulated the myofibroblast differentiation. This result indicates a potential significance for future attempts of attenuating the progression of human lung fibrosis by the inhibition of the Smad3 cascade.

Identification of platinum-resistance associated proteins through proteomic analysis of human ovarian cancer cells and their platinum-resistant sublines.

Abstract: Chemoresistance is a major therapeutic obstacle in cancer patients, and the mechanisms of drug resistance are not fully understood. In the present study, we established platinum-resistant human ovarian cancer cell lines and identified differentially expressed proteins related to platinum resistance. The total proteins of two sensitive (SKOV3 and A2780) and four resistant (SKOV3/CDDP, SKOV3/CBP, A2780/CDDP, and A2780/CBP) human ovarian cancer cell lines were isolated by two-dimensional gel electrophoresis (2-DE). The differentially expressed proteins were identified using matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS). In total, 57 differential protein spots were identified, and five proteins, including annexin A3, destrin, cofilin 1, Glutathione-S-transferase omega 1 (GSTO1-1), and cytosolic NADP+-dependent isocitrate dehydrogenase (IDHc), were found to be co-instantaneous significance compared with their parental cells. The expression of the five proteins was validated by quantitative PCR and western blot, and the western blot results showed complete consistency with proteomic techniques. The five proteins are hopeful to become candidates for platinum resistance. These may be useful for further study of resistance mechanisms and screening of resistant biomarkers.

Renalase gene is a novel susceptibility gene for essential hypertension: a two-stage association study in northern Han Chinese population

Abstract: Renalase, a novel flavin adenine dinucleotide-dependent amine oxidase, is secreted by the kidney, degrades circulating catecholamines, and modulates cardiac function and systemic blood pressure (BP). Its discovery may provide novel insights into the mechanisms of BP regulation and the pathogenesis of essential hypertension (EH). We designed a two-stage case-control study to investigate whether the renalase gene harbored any genetic variants associated with EH in the northern Han Chinese population. From the International Collaborative Study of Cardiovascular Disease in Asia (InterASIA in China), 1,317 hypertensive cases and 1,269 normotensive controls were recruited. These total 2,586 subjects were taken as the main study population in this study. In stage 1, all the eight selected single nucleotide polymorphisms (SNPs) of the renalase gene were genotyped and tested within a subsample (503 cases and 490 controls) of the main study population. By single locus analyses, three SNPs, rs2576178, rs2296545, and rs2114406, showed significant associations with EH (P < 0.05). In stage 2, these three SNPs were genotyped on the remaining individuals and analyzed using all the individuals. After Bonferroni correction for multiple comparisons, the associations of rs2576178 and rs2296545 with EH were still significant in stage 2. The cases had higher frequencies of rs2576178 G allele and rs2296545 C allele than the controls (0.55 versus 0.49, P < 0.0001; 0.61 versus 0.55, P < 0.0001). Particularly, under the codominant model, the adjusted odds ratios for rs2576178 GG genotype and rs2296545 CC genotype were 1.58 (95% CI, 1.25 to 2.00; P = 0.0002) and 1.61 (95% CI, 1.26 to 2.04; P = 0.0002), respectively. We also found risk-associated haplotypes and diplotypes, which further confirmed the significant association between the renalase gene and EH. These findings may provide novel genetic susceptibility markers for EH and lead to a better understanding of EH pathophysiology. In addition, further replications in other populations and functional studies would be warranted.

NONCODE v2.0: decoding the non-coding.

Abstract: The NONCODE database is an integrated knowledge database designed for the analysis of non-coding RNAs (ncRNAs). Since NONCODE was first released 3 years ago, the number of known ncRNAs has grown rapidly, and there is growing recognition that ncRNAs play important regulatory roles in most organisms. In the updated version of NONCODE (NONCODE v2.0), the number of collected ncRNAs has reached 206 226, including a wide range of microRNAs, Piwi-interacting RNAs and mRNA-like ncRNAs. The improvements brought to the database include not only new and updated ncRNA data sets, but also an incorporation of BLAST alignment search service and access through our custom UCSC Genome Browser. NONCODE can be found under http://www.noncode.org or http://noncode.bioinfo.org.cn.

18F-labeled mini-PEG spacered RGD dimer (18F-FPRGD2): synthesis and microPET imaging of αvβ3 integrin expression

Abstract: Purpose We have previously reported that 18F-FB-E[c(RGDyK)]2 (18F-FRGD2) allows quantitative PET imaging of integrin αvβ3 expression. However, the potential clinical translation was hampered by the relatively low radiochemical yield. The goal of this study was to improve the radiolabeling yield, without compromising the tumor targeting efficiency and in vivo kinetics, by incorporating a hydrophilic bifunctional mini-PEG spacer.

Biocompatibility of electrophoretical deposition of nanostructured hydroxyapatite coating on roughen titanium surface: In vitro evaluation using mesenchymal stem cells

Abstract: A nano hydroxyapatite (HAp) layer was coated on a roughen titanium surface by means of electrophoretic deposition with an acetic anhydride solvent system. The objectives of this current study are to investigate whether nano-HAp can improve mechanical strength at a lower sintering temperature and biocompatibility. Densification temperature was lowered from usual 1000 to 800 degrees C. The coating interfacial bonding strength, phase purity, microstructure, and biocompatibility were investigated. Degradation of HA phase was not detected in XRD. A porous TiO2 layer acts as a gradient coating layer with an intermediate thermal expansion coefficient between hydroxyapatite and titanium that reduces the thermal stress. From SEM image, the coating does not contain any crack. Mesenchymal stem cell (MSC) is the progenitor cell for various tissues in mature animals, which can improve integration of bone tissue into implant. In this in vitro study, rabbit MSCs culture indicated that the HAp/Ti nanocomposite biomaterial had good biocompatibility and bioactivity. Around materials and on its surface cell grew well with good morphology. Proliferation of the MSCs on the nano-HAp coating was higher than its micron counterpart in XTT assay. These properties show potential for the orthopaedic and dental applications.

Factors contributing to high costs and inequality in China's health care system.

Abstract: China the largest developing country in the world has experienced great economic development in recent years. Since reform and the opening-up policy were implemented in 1978 the national economy has grown at an average rate of 9.6% each year and in 2005 Chinas gross domestic product (GDP) per capita reached US $1698. Along with economic development have come social challenges. The gap between rich and poor has widened. In 2005 Chinas Gini coefficient an indicator of income distribution difference was estimated at more than 0.48 (for comparison the US Gini coefficient was 0.45 in 2004). Although the proportion of the population with incomes below the poverty level has decreased dramatically over the past 3 decades about 21.5 million individuals are absolutely poor (annual income < US $85) and another 35.5 million are underprivileged (annual income US $85-$115) in China. More than half of the poor reside in remote western counties. One result of economic inequality is wide disparity in access to many social programs especially in the health care system. (excerpt)

Menopause-specific quality of life satisfaction in community-dwelling menopausal women in china

Abstract: The present study aimed to evaluate the satisfaction with quality of life of menopausal women living in an urban community of Beijing, People's Republic of China, using the Chinese version of the menopause-specific quality of life questionnaire (MENQOL) Menopause-related complaints were assessed for 353 women aged 40-60 years during their menopausal transition (MT) or postmenopause (PM) using MENQOL The Kruskal-Wallis non-parametric test and Pearson correlation were used for statistical analysis The mean age of the subjects was 5120 +/- 462 years The most frequent symptom was 'experiencing poor memory' (841%) and the least frequent was 'dissatisfaction with personal life' (269%) Mean scores of vasomotor and sexual symptoms in PM women were higher than in MT women (260 +/- 174 and 339 +/- 235 vs 196 +/- 146 and 210 +/- 148, respectively; p = 00001) The prevalence of menopause-related symptoms varied between self-assessed health status groups (chi(2) = 2912, p = 00001) In conclusion, MENQOL is a good self-administered tool in the assessment of climacteric complaints, with convenient application The most frequent climacteric symptom of Chinese women living in an urban community was 'experiencing poor memory' PM women seemed to suffer from more symptoms, especially in vasomotor and sexual domains, than did MT women Symptom reports might be associated with self-assessed health status

Bactericidal Activities of Meropenem and Ertapenem against Extended-Spectrum-β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae in a Neutropenic Mouse Thigh Model

Abstract: The purpose of this study was to examine the in vivo efficacies of meropenem and ertapenem against extended-spectrum-beta-lactamase (ESBL)-producing isolates with a wide range of MICs. Human-simulated dosing regimens in mice were designed to approximate the free drug percent time above the MIC (fT>MIC) observed for humans following meropenem at 1 g every 8 h and ertapenem at 1 g every 24 h. An in vivo neutropenic mouse thigh infection model was used to examine the bactericidal effects against 31 clinical ESBL Escherichia coli and Klebsiella pneumoniae isolates and 2 non-ESBL isolates included for comparison at a standard 10(5) inoculum. Three isolates were examined at a high 10(7) inoculum as well. Meropenem displayed greater in vitro potency, with a median MIC (range) (microg/ml) of 0.125 (0.03 to 32), than did ertapenem, with 0.5 (0.012 to 128). Seven of the 31 ESBL isolates were removed from the efficacy analysis due to their inability to establish infection in the mouse model. When MICs were MIC>or=23%) and meropenem (fT>MIC>or=75%). Ertapenem showed bacterial regrowth for seven of eight isolates, with MICs of>or=2 microg/ml (fT>MIC MIC=30 to 65%). At a 10(7) inoculum, both agents eradicated bacteria due to adequate exposures (fT>MIC=20 to 45%). Due to low MICs, no difference in bacterial kill was noted for the majority of ESBL isolates tested. However, for isolates with raised ertapenem MICs of>or=2 microg/ml, meropenem displayed sustained efficacy due to its greater in vitro potency and higher resultant fT>MIC.

Protein-losing enteropathy in systemic lupus erythematosus: analysis of the clinical features of fifteen patients.

Abstract: Objective:Protein-losing enteropathy (PLE) is an unusual manifestation of systemic lupus erythematosus (SLE), so its clinical manifestations and management are not well understood. In this study, we try to characterize the basic clinical features and the management of PLE by retrospectively analyzin

Comparative proteomic analysis of human pancreatic juice: methodological study.

Abstract: Pancreatic cancer is the most lethal of all the common malignancies. Markers for early detection of this disease are urgently needed. Here, we optimized and applied a proteome analysis of human pancreatic juice to identify biomarkers for pancreatic cancer. Pancreatic juice samples, devoid of blood or bile contamination, were collected from patients with pancreatic cancer (n = 5), benign pancreatic diseases (n = 6), or cholelithiasis (n = 3) during endoscopic retrograde cholangiopancreatography (ERCP). After ultramembrane centrifugation sample preparation, pancreatic juice proteins were separated by 2-DE and identified by MALDI-TOF-MS. A 2-DE dataset of pancreatic juice from patients with cholelithiasis was established, consisting of 76 protein spots representing 22 different proteins. Disease-associated obstruction of the pancreatic duct strongly effected the protein composition of pancreatic juice. Concurrently, pancreatic juice from patients with pancreatic cancer was compared to nonmalignant controls with comparable obstruction of pancreatic ducts. Seven protein spots were identified that consistently appeared at changed levels in pancreatic juice from patients with pancreatic cancer. In conclusion, comparative proteomic analysis of human pancreatic juice can be used to identify biomarkers of pancreatic cancer.

Whole-body diffusion-weighted imaging: technical improvement and preliminary results.

Abstract: Purpose To optimize the free-breathing whole-body diffusion-weighted imaging (WB-DWI) protocol by using the short TI inversion-recovery diffusion-weighted echo-planar imaging (STIR-DWEPI) sequence and the built-in body coil. Additionally, to evaluate the feasibility of tumor screening using high-resolution three-dimensional (3D) maximum intensity projection (MIP) images. Materials and Methods The prescan procedure of STIR-DWEPI was modified using the data from 30 volunteers. During each exam, an optimized center frequency (CF) was used to minimize the slice offsets in consecutive scan stations. Prescan time was reduced from 50 seconds to 20 seconds with improved station profile. Total scan time was 30 minutes for five stations and 1.2 m coverage. A total of 30 patients with histologically-proven malignant disease were scanned under the final protocol using a built-in body coil. The image quality and the degree of background body signal suppression were assessed. Results Free-breathing WB-DWI was 100% successfully performed in all patients, without slice misregistration, fat contamination, significant distortion, or nonuniformity. The reconstructed 3D-MIP images were adequate to depict malignant lesions in all 30 patients. The results of WB-DWI were found to be comparable to those of single-photon emission computed tomography (SPECT) and positron emission tomography (PET). Conclusion Stable and high-resolution WB-DWI is feasible using the technical improvements described in this study. WB-DWI might have important clinical value for the detection of primary and metastatic malignancies within the whole body. The potential for diagnosis and therapeutic assessment of tumors should be further assessed in a larger patient cohort. J. Magn. Reson. Imaging 2007;26:1139–1144. © 2007 Wiley-Liss, Inc.

Differentially expressed genes in human endometrial endothelial cells derived from eutopic endometrium of patients with endometriosis compared with those from patients without endometriosis

Abstract: Background The pathogenesis of endometriosis remains poorly defined. The aberrant angiogenesis that occurs in eutopic endometrium may play a role in the lesion formation and survival. The difference in gene expression profile between human endometrial endothelial cells (HEECs) from eutopic endometria of patients with and without endometriosis would be a factor that affects the occurrence of endometriosis. Methods To explore the difference, we performed in vitro culture and identified the endothelial origin, as well as observed growth features, of HEECs from the two different sources. We also identified their differences in gene expression profiles by combined suppression subtractive hybridization (SSH) with Genechip, and confirmed the results by quantitative reverse transcription-polymerase chain reaction. Results The HEECs derived from endometriosis patients exhibited a potent survival ability in vitro compared with those from non-endometriosis patients. In the HEECs from EM patients, an altered secretion pattern of extracellular matrix (ECM) components and up-regulation of GREM1 were found. These findings may be used to interpret the remarkable change of phenotype in HEECs from endometriosis patients. The synergistic action of these differentially expressed genes is to promote cell proliferation and concomitantly to inhibit apoptosis. Among the up-regulated ECM genes, TSP2 was the only one which exhibits the capacity to suppress angiogenesis; it may therefore function as an antagonist to the aberrant angiogenesis and may confine its extent and severity. Conclusion It may be postulated that differential regulation of some of these genes in eutopic HEECs plays a facilitating role during the peritoneal vascularization of ectopic endometrial lesions by enhancing angiogenic activity via a paracrine effect.

A new technique of vaginal reconstruction with the deep inferior epigastric perforator flap: a preliminary report.

Abstract: Background: Vaginal reconstruction after tumor resection or in congenital vaginal agenesis remains a challenging area in surgery, with many techniques previously described underlining the continued search for an ideal method In this preliminary report, a series of patients are presented who underwent vaginal reconstruction using a deep inferior epigastric artery perforator (DIEP) flap Methods: Between May of 2004 and February of 2005, five patients underwent vaginal reconstruction using the pedicled DIEP flap Four patients had congenital vaginal agenesis and one had a complete vaginal resection because of a tumor Results: The flaps ranged in size from 9 X 10 cm to 11 X 12 cm All flaps survived, although one patient developed a posterior space hematoma that required draining Of the five patients, two were sexually active and enjoyed satisfactory penetrative intercourse after reconstruction Conclusions: This series demonstrates that a new vagina can be created from the pedicled DIEP flap and that the reconstruction is reliable, with low donor-site morbidity The major disadvantage of this technique is the conspicuous abdominal scar

Biological comparison of ovarian cancer resistant cell lines to cisplatin and Taxol by two different administrations.

Abstract: Drug resistance is one of the major obstacles to chemotherapy of ovarian cancer. Studies with cell lines can serve as an initial screen for agents that might modulate drug resistance. To establish more appropriate models of drug resistance and explore whether the differences exist in the different drug resistant sublines selected by different treatments, we induced SKOV3 cell line using cisplatin (CDDP) and Taxol over a period of 16 months by the pulse (SKOV3/CDDP-P and SKOV3/Taxol-P) and intermittent incremental (SKOV3/CDDP-80 and SKOV3/Taxol-25) method, respectively. The resistant phenotype of the four resistant sublines, SKOV3/CDDP-P, SKOV3/CDDP-80, SKOV3/Taxol-P and SKOV3/Taxol-25, was very stable and the resistance index was 4.12, 11.50, 261.98 and 622.76, respectively. In cell morphology, the cells from pulse treatment had remarkable changes compared with the cells from intermittent incremental treatment. SKOV3/CDDP-80 and SKOV3/Taxol-P grew more slowly than SKOV3/CDDP-P and SKOV3/Taxol-25. Multidrug resistance gene 1, multidrug resistance protein 1, lung resistance protein and glutathione S-transferase pi mRNA expression of SKOV3/CDDP-P and SKOV3/Taxol-25 had greater changes than that of SKOV3/CDDP-80 and SKOV3/Taxol-P. The results suggest there are great differences between the resistant cell lines resulting from pulse and intermittent incremental method. The resistant cells selected by the intermittent method were more resistant than the cells selected by the pulse method. The two resistant sublines selected by the pulse method may serve as appropriate models for the study of mechanisms of drug resistance in ovarian cancer.

Psychophysical performance and Mandarin tone recognition in noise by cochlear implant users

Abstract: Objective: The present study was aimed to examine the relationship between psychophysical performance in temporal and spectral resolution and Mandarin tone recognition in noise by cochlear-implant (CI) listeners. Design: Seventeen Nucleus-24 implant users, 10 postlingually deafened and 7 prelingually deafened, participated in the experiments. A 3-interval, forced-choice procedure was used to measure gap detection and pure-tone frequency discrimination at 250 to 4,000 Hz in octave steps. A 4-alternative forced-choice procedure was used to measure Mandarin tone recognition in quiet and in noise. Signal-to-noise ratios (SNRs) varied from +10 to -10 dB. All stimuli were delivered to the clinical processor via a speaker in a sound free field. The obtained data were compared to data collected from normal-hearing control subjects, as well as cochlear-implant users who performed similar tasks using single-electrode stimulation via a research interface. Results: Postlingually-deafened CI subjects generally performed better than prelingually-deafened subjects. The average gap detection threshold was 30 ms with a range from 4 to 128 ms. The average frequency difference limen was 100 Hz with a range from 12 to 192 Hz, regardless of the standard frequency. The average tone recognition was 80% correct in quiet, which dropped to 55% at +10 dB SNR and essentially chance performance at -5 dB SNR. In comparison, the normal-hearing control subjects maintained essentially perfect performance over this SNR range. Only frequency discrimination at 1,000 Hz was significantly correlated with tone recognition in quiet but all psychophysical measures were correlated to tone recognition in noise. Conclusions: The present result suggests that the CI users can rely on either temporal or spectral cues to perform tone recognition in quiet, but need both cues for tone recognition in noise. Future CI processors need to extract and encode these acoustic cues to achieve better performance in tone perception and production.

The influence of p38 mitogen-activated protein kinase inhibitor on synthesis of inflammatory cytokine tumor necrosis factor alpha in spinal cord of rats with chronic constriction injury.

Abstract: BACKGROUND:Tumor necrosis factor α (TNF-α) could trigger p38 mitogen-activated protein kinase (MAPK) activation. Conversely phosphorylated p38 (p-p38) could induce the upregulation of TNF-α. In this study, we examined the hypothesis that chronic constrictive injury (CCI) of the sciatic nerve could p

Distinctive rheumatic manifestations in 98 patients with human immunodeficiency virus infection in China.

Abstract: OBJECTIVE: To analyze the spectrum and risk factors of rheumatic manifestations in patients with human immunodeficiency virus (HIV) infection. METHODS: Ninety-eight consecutive inpatients with HIV infection admitted to Peking Union Medical College Hospital from 1999 to 2006 were studied. Demographic data, routes of transmission, clinical features, and laboratory findings were collected and a database was established. Laboratory studies included blood CD3+, CD4+, CD8+, CD19+, CD16+CD3+, CD4+CD28+, CD8+CD28+, HLA- DR+CD8+, and CD8+CD38+ lymphocyte counts, and antinuclear antibody tests. Hepatitis C virus (HCV) infection was also investigated in each patient. Risk factors for the rheumatic manifestations of HIV infection were assessed by logistic regression analysis. RESULTS: Rheumatic manifestations were found in 53 (54.08%) HIV patients. Vasculitis was the most common finding (20 cases; 20.41%), including 15 cases of Behcet-like disease, 2 cases each of Henoch-Schonlein purpura and digital gangrene, and one case of central nervous system vasculitis. Other common rheumatic manifestations included Sjogren-like syndrome/diffuse infiltrative lymphocytosis syndrome (DILS; 11 cases; 11.22%), lupus-like syndrome (10 cases; 10.20%), of which 5 cases had renal involvement, and myositis (8 cases; 8.16%) including one case of zidovudine-induced myositis. No case of spondyloarthropathy was observed. Logistic regression analysis showed that Centers for Disease Control CD4+ T cell staging, erythrocyte sedimentation rate, and HCV infection were risk factors for HIV patients to develop rheumatic manifestations [p = 0.01, odds ratio (OR) = 31.80; p = 0.02, OR = 2.93; p = 0.01, OR = 17.47, respectively]. CONCLUSION: Rheumatic disorders such as vasculitis, Sjogren-like syndrome/DILS, lupus-like syndrome, and myositis were common in Chinese patients with HIV, while articular disorders were rare. CD4+ T cell depletion and HCV coinfection may predispose patients with HIV to develop rheumatic manifestations.