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Objective:To investigate the Chinese version of rheumatoid arthritis stigma scale (ISMI-RA) and test its reliability and validity.Methods:The English version of ISMI-RA was translated into Chinese, translated back and culturally adapted in strictly accordance with the Brislin translation model. A total of 20 patients were selected for preliminary investigation and some items were revised to create the Chinese version of ISMI-RA. From April 2020 to April 2021, 258 patients with rheumatoid arthritis were investigated by convenience sampling method, Pearson correlation intraclass correlation coefficient (ICC) coefficient and Cronbach's α coefficient were used to evaluate the test-retest reliability and internal consistency of the scale. The stigma scale for chronic illness-8 was used as the standard, and the correlation coefficient was calculated to verify the criterion validity. Confirmatory factor analysis was used to evaluate the construct validity of the scale.Results:The internal consistency Cronbach's α coefficient was 0.86, the Cronbach's α coefficient of each dimension was 0.34-0.93, and Pearson correlation analysis of retest reliability showed that it was 0.94. The Cronbach's α coefficient of stigma resistance subscale was as low as 0.34, and the Cronbach's α coefficient of stigma resistance subscale was 0.90 after removal. The retest reliability was 0.98. The criterion coefficient between this scale and the stigma scale for chronic illness-8 was 0.73 ( P<0.001), and the criterion coefficient of the subscales were 0.52-0.71. The theoretical factor structure of ISMI-RA that is composed of five factors showed suboptimal model fitting [root-mean-square error of approximation ( RMSEA)=0.10, Tucker-Lewis index ( TLI)=0.88, comparative fit index (CFI)=0.89)], and the model fitting effect was better after removing the dimension of resistance to stigma and three items ( RMSEA=0.09, CFI=0.94, TLI=0.93). Conclusion:The Chinese version of ISMI-RA has good reliability and validity, and can be used as an evaluation tool to measure the level of stigma in rheumatoid arthritis patients, and to provide a basis for clinical development of intervention programs to facilitating the rehabilitation process.
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Objective:To design an oral methotrexate auxiliary device and explore the effect of methotrexate in patients with rheumatoid arthritis.Methods:Totally 30 patients with rheumatoid arthritis were selected and observed continuously for 12 months, from January to June in 2021, in the Affiliated Changzhou No. 2 People ′s Hospital of Naijing Medical University. The subjects took the medicine routinely in the first 6 months after entering the group, and the methotrexate oral drug assistant device was given in the latter 6 months to remind them to take the medicine correctly. Medication administration of patients before and after using the auxiliary device was compared, and the evaluation indexes such as disease activity, medication compliance and anxiety were observed. Results:Without the auxiliary device, there were 14 cases (46.67%) of medication error, 13 cases (43.33%) of medication time error, 9 cases (30.00%) of missed administration, while after the use of the auxiliary device, there were 4 cases (13.33%) of medication error, 2 cases (6.67%) of medication time error and 2 cases (6.67%) of missed administration, and the differences were statistically significant ( χ2=8.10, 9.09, 5.14, all P<0.05). Moreover, before using the auxiliary device, the scores of disease activity and medication compliance were 3.92 ± 0.95, 84.97 ± 6.49, respectively, while with the help of the auxiliary device, those scores changed to 3.29 ± 0.83, 92.40 ± 4.17 respectively. All the differences were statistically significant ( t=10.06, -10.37, both P<0.01). 16 cases (53.33%) were anxious after using the assistive device, which was also better than 26 cases (86.67%) before using the device. The difference was statistically significant ( χ2=8.10, P<0.01) . Conclusions:Oral administration aid for methotrexate can help rheumatoid arthritis patients to take methotrexate correctly and safely, reducing disease activity and anxiety, improving drug compliance. It is worthy to clinical promotion.
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Objective To investigate urine levels of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule 1(KIM-1), and its relevant influencing factors in young patients with hyperuricemia.Methods Sixty young subjects with hyperuricemia were randomly selected from physical check-up examination population (the hyperuricemic group), and 60 young subjects with normouricemia were randomly selected at the same time from physical check populationexamination (the control group).Urine NGAL and KIM-1, and other biochemical indicators were evaluated.Clinical data, iab tests, testing items and biochemical indicators between the two groups were analyzed by using t test or analysis of variance test.Regression analysis between the above indicators and urinary NGAL/creatinine (cr) and urine KIM-1/cr ratios were carried by using single regression analysis.Analyzed relevant Relevant influencing factors of urinary NGAL/cr and urine KIM-1/cr ratios were analyzed by using multiple linear regression.Results Urine NGAL/cr and urine KIM-1/cr ratios in the hyperuricemic group were higher than the control group (t=22.152 5, t=24.725 5, P＜0.01).Single regression analysis showed that serum uric acid level and urine NGAL/cr ratio, KIM-1/cr ratio was positively correlations correlated (r=0.63, P＜0.01;r=0.41, P＜0.01).Multiple linear regression analysises showed that serum uric acid,systolic blood pressure, HbA1c, serum creatinin and cholesterol level were the independent factors of urine NGAI/cr ratio.Age, blood uric acid level, systolic blood pressure, HbA1c and serum creatinin levels were independent factors of KIM-1/cr ratio.Conclusion There are high levels in of urine NGAL/cr and KIM-1/cr ratios in population with hyperuricemia.Hyperuricemia, high systolic pressure, diabetes mellitus, declined kidney function and hypercholesterolemia are independent factors of urine high NGAL/creatinin ratio.Oldage,hyperuricemia, high systolic pressure, diabetes mellitus and declined kidney function are independent factors of high urine KIM-1/cr ratio.
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objective To examine nuclear transIocation of peroxisome proliferator-activated receptor γ(PPARγ)in rats following focal cerebral ischemia/reperfusion(I/R),and to explore the significance of altered PPARγ,nuclear translocation in ischemic brain injury.Methods Healthy adult male SD rats underwent 60-min cerebral artery occlusion followed by reperfusion of 4,8,or 24 h,respectively.The cytoplasmic-to-nuclear shuttling of PPARγ was characterized by Western blot,immunohistochemical and immunofluoreseence staining.The effects of PPARγ agonist rosiglitazone (Ros) and antagonist GW9662 on I/R-induced PPARγ nuclear translocation were also examined in the present study. Furthermore,TTC staining war adopted to determine the change in cerebral infarction volume. Results (1)Western blot analysis revealed an increase of PPARγ in the nucleus and a simultaneous reduction in the cytosol following ischemia and reperfusion for 4 h(tcytosol=9.03,tmuclear=27.19,P=0.00).Prolonged the reperfusion further enhanced this I/R induced PPARγ translocation in a time-dependent manner.Using immunohistochemistry and immunofluorescence,nuclear PPAR γ positive staining increased from 48.3%in the sham control to 80.3% following ischemia and reperfusion for 24 h.(2)Western blot analysis revealed that PPARγ agonist Ros further increased I/R-induced nuclear enrichment of PPARγ,whereas PPARγ antagonist GW9662inhibited I/R-stimulated change in PPARγ.(3)When compared to the L/R group using TTC staining,Ros treatment significantly decreased the infarction volume by 48.40%(15.46±4.94 versus 29.96±3.39,t=5.93.P=0.00),whereas GW9662 increased by 58.95%(47.62±4.93 versus 29.96±3.39,t=7.23,P=0.00).Conclusions Cerebral I/R injury induces PPARγ translocation from the cytosol to the nucleus.This change may represent an intrinsic neuroprotective response against brain I/R injury.