Interstitial Cystitis, mostly affecting middle-aged women, has been rarely associated with Sjögren's syndrome. We report a 51-year-old woman who presented with painful micturition, pollakiuria, lower abdominal pain, and urinary urgency. In addition, the patient exhibited xerostomia, keratoconjunctivitis sicca, and leukopenia. The cystoscopy and pathological examinations confirmed the diagnosis of interstitial cystitis. Subsequent testing revealed a positive antinuclear antibody, leading to referral to the department of Rheumatology and Immunology for a labial gland biopsy, which resulted in a diagnosis of primary Sjogren's Syndrome. This case highlights the association between Sjögren's syndrome and interstitial cystitis, emphasizing the need for clinicians to maintain a suspicion for systemic autoimmune disorder when encountering patients with recurrent urinary tract symptoms without any other identifiable underlying cause.

Background: Systemic lupus erythematosus (SLE) is a highly heterogeneous autoimmune disease characterized by aberrant Th17/Treg balance and autoantibody production. While glucocorticoids remain the cornerstone of treatment, their long-term adverse effects necessitate the development of steroid-sparing agents. The basic leucine zipper transcription factor ATF-like (BATF) serves as an essential pioneer factor for Th17 differentiation, yet its precise therapeutic potential in SLE remains underexplored. This study aims to validate the BATF/RORgt/IL-17 axis as a critical therapeutic target in SLE through integrative bioinformatics analysis of human cohorts and in vivo experimental validation using a combined regimen of Traditional Chinese Medicine (Langchuangding, LCD) and Prednisone. Methods: Transcriptomic profiles of peripheral blood mononuclear cells (PBMCs) from 61 SLE patients and 20 healthy controls (HC) were retrieved from the Gene Expression Omnibus (GEO: GSE50772). Differentially expressed genes (DEGs) and immune pathway signatures were analyzed. For in vivo validation, 40 female MRL/lpr mice (SLE model) and 10 normal Kunming mice were randomly divided into five groups. Over a 10-week intervention, body weight and organ indices were monitored. The mRNA and protein expression levels of BATF, RORgt (Rorc), and IL-17 in renal tissues were quantified using qPCR and ELISA. Serum autoantibodies (ANA, anti-dsDNA, anti-Sm-DNA) were also measured. Results: Bioinformatics analysis revealed significant upregulation of BCL6 and IL10 in SLE PBMCs, alongside a global interferon signature, establishing a pronounced systemic inflammatory state. In MRL/lpr mice, the Model group exhibited severe splenomegaly, elevated autoantibodies, and robust overexpression of renal BATF, RORgt, and IL-17. The Combined therapy (LCD + Prednisone) demonstrated superior efficacy, significantly attenuating body weight loss, normalizing spleen indices, and drastically suppressing the BATF/RORgt/IL-17 cascade at both transcriptional and translational levels (p < 0.001 vs. Model). Serum ANA, anti-dsDNA, and anti-Sm-DNA levels were also maximally reduced in the Combined group. Conclusion: The BATF/RORgt/IL-17 axis is a pivotal pathogenic driver in SLE, bridging epigenetic chromatin remodeling with downstream Th17-mediated autoimmunity. The synergistic application of LCD and Prednisone effectively dismantles this axis, offering a promising steroid-sparing, individualized therapeutic strategy for SLE management.

Rickettsia felis, an emerging flea-borne pathogen with global distribution potential, is a neglected cause of undifferentiated febrile illness, although reported human cases remain sparse. The development of molecular diagnostic methods, along with the application of metagenomic next-generation sequencing (mNGS), has improved the diagnostic accuracy of infectious fevers. A case of Rickettsia felis infection was diagnosed by mNGS in a 55-year-old patient with pre-existing ankylosing spondylitis. Five previously reported cases of Rickettsia felis infection were systematically reviewed, with a comprehensive analysis of their epidemiological characteristics, clinical manifestations, and therapeutic regimens. This study highlights the clinical features and diagnostic approaches of the disease through a case report and literature review.

Background This study aims to assess the efficacy and safety of Qingpeng ointment (QPO), a Tibetan medicine for alleviating symptoms in individuals with acute gouty arthritis (AGA). Methods This study was a randomized, double-blind, placebo-controlled trial that involved individuals with AGA whose joint pain, as measured on a visual analog scale (VAS) from 0 to 10, was equal to or greater than 3. The participants were randomly assigned to either the QPO or the placebo group and received their respective treatments twice daily for seven consecutive days. In case of intolerable pain, the participants were allowed to use diclofenac sodium sustained-release tablets as a rescue medicine. The primary outcomes measured were joint pain and swelling, while the secondary outcomes included joint mobility, redness, serum uric acid levels, C-reactive protein levels, and the amount of remaining rescue medicine. Any adverse events that occurred during the trial were also recorded. Results A total of 203 cases were divided into two groups, with balanced baselines: 102 in the QPO group and 101 in the placebo group. For joint pain, differences between the groups were notable in the VAS scores [1.75 (0, 3.00) versus 2.00 (1.00, 3.50); P = 0.038], changes in VAS [5.00 (3.00, 6.00) versus 4.00 (2.00, 6.00); P = 0.036], and disappearance rate [26.47% compared to 15.84%; P = 0.046] after treatment. Concerning joint swelling, significant between-group differences were observed in the VAS scores [1.00 (0, 2.30) versus 2.00 (0.70, 3.00); P = 0.032] and disappearance rate [33.33% compared to 21.78%; P = 0.046] at treatment completion. The QPO group exhibited a statistically significant mobility improvement compared to the placebo group ( P = 0.004). No significant differences were found in other secondary outcomes. Five patients, four from the QPO group and one from the other, encountered mild adverse events, primarily skin irritation. All of these cases were resolved after dosage reduction or discontinuation of the medication. Conclusions Compared to the placebo, QPO exhibits positive effects on AGA by alleviating pain, reducing swelling, and enhancing joint mobility, without causing significant adverse effects. Trial Registration ISRCTN34355813. Registered on 25/01/2021.

Background: The mechanism of macropinocytosis has been reported in receptor sorting used by motile cells. Besides, the role of macropinocytosis was previously recognized in cancer progression. We evaluated the prognostic value of macropinocytosis gene expression in ovarian cancer (OC).

文章对范永升教授运用二型九证法诊治系统性红斑狼疮(SLE)的9种证型相关的临床医案进行了梳理分析,列举医案充分体现了二型九证法诊治SLE具有较好的临床适用性,同时对临床应用二型九证法的注意事项进行了说明.范永升教授提出的二型九证法为临床诊治SLE提供了良好的范式,值得应用和推广.

Rheumatoid arthritis (RA) is a chronic inflammatory joint disorder that inflicts damage to the joints of the hands and wrist. The aim of this study was to investigate the protective effect of β-Arrestin-2 (βArr2) on RA in vivo and in vitro. The βArr2 adenovirus (βArr2-Ad) or the control (Con-Ad) was injected into the ankle joint cavity of collagen-induced arthritis (CIA) mice. According to the results, an improvement was shown in the symptoms and pathological injury of RA after an upregulation of βArr2. Correspondingly, the inflammatory response was attenuated, as evidenced by the decreased serum pro-inflammatory cytokines levels and NF-κB pathway-related proteins. Nucleotide-binding domain leucine-rich repeat and pyrin domain containing receptor 3 (NLRP3) inflammasome activation was inhibited in CIA mice treated with βArr2-Ad injection, as reflected by the diminished IL-18 level and declined protein levels of inflammasome components in the ankle joint. Likewise, the anti-inflammatory effect of macrophages was also validated by in vitro experiments. In summary, βArr2 effectively ameliorates ankle inflammation in CIA mice via NF-κB/NLRP3 inflammasome, providing theoretical and clinical basis for RA therapy.

[目的]总结首届全国名中医范永升教授治疗系统性红斑狼疮相关肺动脉高压的学术经验.[方法]通过整理、回顾、分析范永升教授诊治系统性红斑狼疮相关肺动脉高压相关医案,从中医病因病机、治则治法、用药特色、辨证论治等方面,全面总结归纳范永升教授诊治系统性红斑狼疮相关肺动脉高压的学术经验,并列举医案1则予以佐证.[结果]范永升教授认为系统性红斑狼疮临床表现复杂多样,可出现多系统、多脏器损伤,而系统性红斑狼疮合并肺动脉高压为系统性红斑狼疮累及心、肺的特殊类型,可属于中医"五脏痹""胸痹""厥证"范畴,并认为引起系统性红斑狼疮的中医病因在于"肾虚、热毒、血瘀",其病机在于患者先天禀赋之不足,加之热毒、血瘀及痰浊等病理因素的参与,最终引起心肺受损,宗气不足,肺脉痹阻,肺气失宣,心肺气血运行不畅而导致肺动脉高压.根据本病的病因病机及临床特点分为初期气阴亏虚证,慢性期气滞血瘀证、寒凝脉络证、热毒痰瘀证和终末期阳虚脉痹证共5个证型,进行分期、分证型辨证论治,分别予以益气养阴、疏肝行气、温阳通络、解毒祛瘀、活血利水治疗.所举医案中患者处于疾病慢性期,证属寒凝脉络,治拟益气温阳、散寒通络,方用黄芪桂枝五物汤合当归四逆汤加减,临床疗效令人满意.[结论]范永升教授将系统性红斑狼疮相关肺动脉高压分为3期、5型进行辨证施治,并灵活借鉴现代医学研究成果,能改善患者临床症状,其学术经验值得同道借鉴.

目的 观察解毒祛瘀滋阴方对系统性红斑狼疮狼疮活动的影响作用及机制探讨.方法 选择2018年6月-2019年12月医院收治的系统性红斑狼疮患者168例.应用随机数字表法,将其分为对照组和观察组,每组84例.对照组口服醋酸泼尼松和硫酸羟氯喹片治疗,待病情稳定后,酌情减量.观察组在对照组治疗的基础上,口服解毒祛瘀滋阴方治疗.两组均持续治疗12周.比较两组治疗前后中医证候积分和治疗疗效,比较两组治疗前后SLEDAI评分,比较两组治疗前后外周血中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)水平,比较两组治疗过程中不良反应发生情况.结果 观察组治疗后总有效率92.86％ (78/84)高于对照组82.14％ (69/84)(P＜0.05);观察组治疗后皮肤红斑、关节疼痛、乏力和发热等中医证候积分低于对照组(P＜0.05);观察组治疗后SLEDAI评分低于对照组(P＜0.05);观察组治疗后NLR和PER水平低于对照组(P＜0.05);两组治疗后不良反应比较差异无统计学意义(P＞0.05).结论 解毒祛瘀滋阴方联合西药治疗系统性红斑狼疮疗效确切,可有效的改善临床症状及体征,降低系统性红斑狼疮的活动性,控制病情,安全性高,而该方案对炎性指标的调节作用可能是其疗效优势形成重要原因.

系统性红斑狼疮(SLE)属于难治性自身免疫性疾病,糖皮质激素是临床上治疗SLE的关键和基础药物,但长期或较大剂量使用糖皮质激素可引起许多不良反应,如何在有效治疗SLE的前提下减少其用量和不良反应是临床亟需解决的问题.范永升教授针对这一问题,在前期探索和实践的基础上提出"三维一体"理论,即以辨证施治为核心,结合糖皮质激素不同剂量阶段、不同不良反应表现,制定了行之有效的中医治疗策略.现通过对临床实例的整理,反映这一理论在临床中的运用.

Exploring the dynamic changes of metabolites and metabolic pathways during the development of the disease can help to further understand the etiology and pathogenesis of systemic lupus erythematosus (SLE). In this study, serum metabolomics based on gas chromatography/mass spectrometry (GC/MS) was employed to investigate the metabolic alterations at different stages of SLE using lupus-prone mice (MRL/lpr) of 9, 11, and 13 weeks of age. Multivariate statistical analysis was performed to view the alterations of metabolic profiles between MRL/lpr mice and age-matched C57BL/6 mice, and t-test and fold change criteria were used to identify differential metabolites at each stage. 11 changed metabolites were found in MRL/lpr mice at 9 weeks of age, which were mainly involved in the tricarboxylic acid (TCA) cycle, glycolysis, and butanoate metabolism; with the increase of week age, the TCA cycle was still disturbed, and the biosynthesis of fatty acids was significantly upregulated since 11 weeks of age; in addition, urea, urate, and indole-3-lactate were increased at 13 weeks of age. We found a time course of metabolic alterations in MRL/lpr mice, which may be related to the progression of SLE. These findings could provide a reference for studying the mechanism of SLE and judging the pathological stage and severity of the disease. The MS data have been deposited in Mendeley (https://www.mendeley.com/).

间质性肺病是皮肌炎常见并发症,病死率极高.目前西医治疗以糖皮质激素和免疫抑制剂为主,不良反应明显,疗效不尽如人意.范永升教授长期从事风湿免疫病的临床与科研工作,对皮肌炎合并间质性肺病的诊疗积累了丰富经验,认为中西医结合治疗此病有一定的优势.根据本病的临床特点分为急性期的风热犯肺证、寒邪袭肺证、痰热郁肺证,慢性期的肺脾气虚证、阴虚血瘀证、阳虚络痹证共6个证型进行分期、分证型治疗.临床证治表明能有效改善患者临床症状,文章列举临床案例两则加以分析,以供参考.

范永升教授认为系统性硬化病合并间质性肺病的病位主要在肺脾以及三焦腠理;本病发生的基本病机为脾胃虚弱,少阳三焦衰,肺之腠理间质不得宣通;阳虚寒凝日久则气血不通、经络瘀阻,甚至累及心肾,出现心肾阳虚证候.临床可分为阳虚寒凝、肺失宣降证,气阴不足、肺失宣降证,瘀血阻络、肺失宣降证以及心肾阳虚、肾不纳气证4个基本证型.分别采用温阳散寒、通络宣肺,益气养阴、祛瘀宣肺,活血祛瘀、益气宣肺以及温阳利水、纳气平喘等治法.范教授治疗本病重视培土生金法、温阳散寒法以及宣肺通络法.

[目的]从卫气营血理论探析干燥综合征(燥痹)的病机与治疗.[方法]以中医学相关文献和现代临床研究为理论基础,运用温病学的卫气营血理论,讨论分析燥痹的中医病机与治则治法,探讨燥痹的辨证论治方法,并附一典型病例予以验证.[结果]燥痹的起病、发展过程与温病传变有许多相似之处,其发病不同时期的临床表现可参照温病卫气营血理论进行辨证论治.燥痹分为发病初期燥邪侵犯肺卫,进展期出现气分或卫气营分同病,慢性期燥邪潜伏营、血分,此时阴亏、气虚、血瘀互见,治疗上在不同发病时期采用不同的治则和治法,分别采用辛凉甘润法、清泄阳明法以及益气养阴祛瘀法等施治,能够有效缓解患者临床症状,副作用小,患者接受度较高.所附验案属燥邪侵犯肺卫,宜清热宣肺、祛痰止咳,予银翘散加减,取得较好疗效.[结论]燥痹的治疗可参照卫气营血理论进行辨证施治,能有效控制病情,对指导临床有实用价值,值得同道借鉴.

范永升教授治认为干燥综合征合并间质性肺病属中医“燥痹”“肺痿”范畴.本病的病因病机为内伤燥热,耗气伤津,久而精血亏虚,甚或阴虚血瘀;同时燥热犯肺,出现“肺热叶焦”而成“肺痿”;阴损及阳,本病亦可出现阳虚“肺冷”证候.治疗原则为滋脾润燥宣肺.阴虚燥热宜养阴清燥润肺;气阴耗伤宜益气养阴润肺;阴虚血瘀宜养阴祛瘀润肺;阳气亏虚宜益气温阳敛肺;精血亏虚宜温润滋补.根据本病发展的不同阶段可分为阴虚燥热、肺失宣降证,阴虚血瘀、肺失宣降证,气阴亏虚、肺失宣降证,阳虚气弱、肺失宣降证等四大证型.用药特点为重视滋脾润肺、酌情宣利肺气以及适时化痰祛瘀.并举临床案例1则.

Systemic lupus erythematosus (SLE) is common in rheumatism. Th17 cells can participate in the occurrence and development of SLE. Arsenic trioxide, also known as As2O3, is widely used in the treatment of leukemia and other malignancies. However, the therapeutic effect of As2O3 on SLE and Th17 cells has not been reported. MRL_1pr mice were randomly divided into 2 groups, including control group and As2O3 group. The mice were intraperitoneally injected with As2O3 at 0.4 mg/kg/d every other day for 55 days. Body weight, 24 h urinary protein, serum IgG, and anti-dsDNA antibody were measured. Flow cytometry was used to detect the distribution of Th17 cell subsets. ELISA was applied to test the secretion of interleukin-17 (IL-17) and IL-21 in Th17 cells. The effect of As2O3 on the Th17 transcription factor ROR gamma t in PBMCs was detected by real-time PCR. In the As2O3 group, the expression of 24-hour urinary protein, serum immunoglobulin (IgG), and anti-dsDNA antibody was significantly decreased, while body weight was significantly elevated compared with the control group (P < 0.05). The proportion of Th17 cell subsets in the As2O3 group was significantly lower than that in the control group. The serum levels of IL-17 and IL-21 were significantly decreased, whereas the RORyt mRNA expression was reduced compared with the control group (P < 0.05). As2O3 can inhibit the expression of Th17 cell-associated transcription factor in MRL_1pr mice, which in turn restrains the production of Th17 cells and the secretion of cytokines, and improves the immune pathological process, indicating that As2O3 has a therapeutic effect on SLE.

系统性红斑狼疮(SLE)是一种自身免疫性疾病,以女性多见.近年来,人们对SLE免疫学发病机制研究有了新的进展,诸多研究显示:Th17/Treg细胞免疫失衡参与了SLE异常免疫应答过程[1-2].解毒祛瘀滋阴方是范永升教授治疗SLE的经验方,已证实具有良好的临床疗效.本研究以Th17/Treg细胞免疫失衡为切入点,探讨解毒祛瘀滋阴方对这一免疫平衡的调控作用.

[目的]总结全国名中医范永升教授运用黄芪桂枝五物法治疗风湿病学术经验。[方法]通过跟诊学习、整理和分析范永升教授应用黄芪桂枝五物汤为基本方的临床医案总结范永升教授运用黄芪桂枝五物法治疗风湿病学术经验。[结果]范永升教授运用黄芪桂枝五物法治疗多种风湿病（系统性红斑狼疮、类风湿关节炎、硬皮病、干燥综合征等）,取黄芪桂枝五物汤益气温经通阳法,临床又根据实际情况灵活变通应用桂枝与白芍的用量及比例,桂枝用量多在6-12g之间,芍药用量多为30g,桂枝与芍药的比例为2:5～1:5,白芍用量多倍于桂枝。[结论]范永升教授运用黄芪桂枝五物法治疗风湿病首先体现了益气温阳、扶正固本的学术思想;同时将仲景"观其脉证,知犯何逆,随证治之"的原则灵活应用于风湿病的临床,体现了圆机活法的学术思想;再次衷中参西,将现代医学的研究成果为我所用,体现了博采众长、与时俱进的学术胸襟。

[目的]总结全国名中医范永升教授治疗类风湿关节炎合并间质性肺病学术经验.[方法]通过整理医案,从中医病因病机、治则治法、辨证论治、治疗要领等方面,全面总结范永升教授诊治类风湿关节炎合并间质性肺病的学术经验,并列举医案1例予以佐证.[结果]范永升教授治认为类风湿关节炎的病位主要在脾胃和肝肾;正气虚弱是本病发生的根本原因,风寒湿热等病邪是疾病发生的外在因素,痰瘀为病理产物;间质性肺病发生的根本原因是少阳三焦衰弱,因此临证必须紧抓少阳三焦衰弱这个根本病机.本病的治疗原则为扶正祛邪.扶正主要从益气健脾和补益肝肾入手;祛邪则根据风寒湿热以及痰瘀等的夹杂灵活运用祛风、散寒、除湿、清热、化痰以及通络等治法.范教授临证重视扶助正气、强调适时祛邪以及不忘宣利肺气,所列举医案充分佐证了范教授临床灵活应用扶正祛邪的这一治疗原则.[结论]范永升教授运用中医审因辨证治疗类风湿关节炎合并间质性肺病取得了较好的疗效,为临床用药提供了有益参考,其学术经验值得推广应用.

狼疮性肾炎（lupus nephritis，LN）是系统性红斑狼疮（systemic lupus erythematosus，SLE）累及肾脏的一种临床表现，是SLE的严重并发症之一。约>50%的SLE患者临床上有肾脏受累［1］，在我国继发性肾脏病中占首位［2］。