ABSTRACT
OBJECTIVE@#To investigate changes in intestinal flora in patients with primary Sj?gren syndrome (pSS) and explore the relationship between pSS disease activity and intestinal flora structure.@*METHODS@#Fecal samples were collected from 18 female pSS patients, including 9 patients with active disease (group A) and 9 with disease inactivity or low activity (group B), with 10 healthy subjects as the control group. The total bacterial DNA was extracted from the fecal samples for PCR amplification, and Illumina Hiseq 2500 high-throughput sequencing was performed for the v3-v4 region of 16Sr DNA gene to obtain the biological information of the intestinal flora. The intergroup OTU analysis, structural diversity analysis, significant difference analysis and LEFSE analysis were performed with information mining of the literature think tanks.@*RESULTS@#The dilution curves generated based on the OTUshannon index for analysis of sample complexity showed that the measured data were relatively complete and could reflect the diversity of the microorganisms in the subjects. Analysis of the Alpha diversity index showed that the Shannon index differed significantly between group A and group B, and the Simpson index differed significantly between group A and group B and between group A and the control group ( < 0.05). Sequence analysis the 3 groups all consisted mainly of 4 phylum (, , , showed that the intestinal flora in and ) and 4 genera (, , , and ), all showing no significant differences among the 3 groups ( > 0.05) with the exception of genus, which differed significantly among the 3 groups ( < 0.05). The 16S v3-v4 region in the genus , , , , , , , , , , -, and differed significantly among the 3 groups ( < 0.05). The high-dimensional biometrics and genomic characteristics of the intestinal microorganisms differed significantly among the 3 groups ( < 0.05). According to the size of LDA SCORE (effect size), the core flora in group A included the genera , , -, , -, , , , and , as compared with the genera , , , , , -, , - and in the control group.@*CONCLUSIONS@#Patients with pSS have significant changes in the diversity of intestinal flora, especially in some specific bacteria in genus and in 16S v3-v4 region of the bacteria. The differences in the core bacteria in the intestinal flora of pSS patients suggest the role of flora structure changes in the pathogenesis of pSS.
Subject(s)
Female , Humans , Bacteria , DNA, Bacterial , Feces , Gastrointestinal Microbiome , RNA, Ribosomal, 16S , Sjogren's SyndromeABSTRACT
OBJECTIVE@#To investigate changes in intestinal flora in patients with primary Sj?gren syndrome (pSS) and explore the relationship between pSS disease activity and intestinal flora structure.@*METHODS@#Fecal samples were collected from 18 female pSS patients, including 9 patients with active disease (group A) and 9 with disease inactivity or low activity (group B), with 10 healthy subjects as the control group. The total bacterial DNA was extracted from the fecal samples for PCR amplification, and Illumina Hiseq 2500 high-throughput sequencing was performed for the v3-v4 region of 16Sr DNA gene to obtain the biological information of the intestinal flora. The intergroup OTU analysis, structural diversity analysis, significant difference analysis and LEFSE analysis were performed with information mining of the literature think tanks.@*RESULTS@#The dilution curves generated based on the OTUshannon index for analysis of sample complexity showed that the measured data were relatively complete and could reflect the diversity of the microorganisms in the subjects. Analysis of the Alpha diversity index showed that the Shannon index differed significantly between group A and group B, and the Simpson index differed significantly between group A and group B and between group A and the control group ( < 0.05). Sequence analysis the 3 groups all consisted mainly of 4 phylum (, , , showed that the intestinal flora in and ) and 4 genera (, , , and ), all showing no significant differences among the 3 groups ( > 0.05) with the exception of genus, which differed significantly among the 3 groups ( < 0.05). The 16S v3-v4 region in the genus , , , , , , , , , , -, and differed significantly among the 3 groups ( < 0.05). The high-dimensional biometrics and genomic characteristics of the intestinal microorganisms differed significantly among the 3 groups ( < 0.05). According to the size of LDA SCORE (effect size), the core flora in group A included the genera , , -, , -, , , , and , as compared with the genera , , , , , -, , - and in the control group.@*CONCLUSIONS@#Patients with pSS have significant changes in the diversity of intestinal flora, especially in some specific bacteria in genus and in 16S v3-v4 region of the bacteria. The differences in the core bacteria in the intestinal flora of pSS patients suggest the role of flora structure changes in the pathogenesis of pSS.
Subject(s)
Humans , Bacteria , Classification , Genetics , Biodiversity , DNA, Bacterial , Genetics , Feces , Microbiology , Gastrointestinal Microbiome , RNA, Ribosomal, 16S , Genetics , Sjogren's Syndrome , MicrobiologyABSTRACT
Objective@#To explore the correlation between menopausal hormone therapy（MHT）and breast lesions in perimenopausal women,and to provide evidence for safe use of MHT. @*Methods@#The 40-60 year-old women who visited Hangzhou Women's Hospital and met the diagnostic criteria for perimenopausal syndrome were recruited. The intervention group received MHT and was divided into three subgroups according to the MHT regimen：estrogen-progesterone cycle therapy（A）,estrogen-progesterone continuous therapy（B）,estrogen therapy（C）. The control group did not receive MHT. All the patients received regular mammography to quantify and evaluate breast lesions. The generalized estimating equation was used to analyze the changes of breast lesions between different groups.@*Results@#There were 80 cases in the intervention group,with 49 in group A,26 in group B,5 in group C,and 80 cases in the control group. After two years of follow-up,there was no statistically significant differences of time,group and interaction in breast density,volume of breast fibrous tissue and the volume of breast between three intervention groups and the control group（P>0.05）; there was no statistically significant differences of group and interaction in positive rate of calcification and breast mass between the intervention group and the control group（P>0.05）. @*Conclusion@#Receiving MHT intervention for two years did not increase the risk of breast lesions.
ABSTRACT
Objective To investigate the clinical significance of abnormally expressed PD-1 on CD 4+CD 2 8+/-T cells in peripheral blood of patients with systemic lupus erythematosus ( SLE ) . Methods Peripheral blood samples were collected form 50 patients with primary SLE and 40 healthy subjects and used to isolated mononuclear cells. Expression of CD4+CD28-, CD4+CD28+, CD4+CD28+PD-1+and CD4+CD28-PD-1+T cells in peripheral blood samples of the two groups were detected by flow cytometry. Clinical data of SLE patients were collected. Based on SLE disease activity index (SLEDAI), SLE patients were classified into two groups: stable group (SLEDAI<10) and active group (SLEDAI≥10). Based on the condition of renal damage, they were also divided into two groups: lupus nephritis group and non-lupus ne-phritis group. Differences in T cell expression were compared among these groups. Statistical analysis was performed to analyze the relationships of different T cell subsets with laboratory and clinical parameters rela-ting to SLE and SLEDAI. Results The percentages of peripheral CD4+CD28-, CD4+CD28+PD-1+and CD4+CD28-PD-1+T cells of active group were higher than those of stable and healthy control groups ( P<0. 05). Moreover, patients with lupus nephritis had higher percentages of these T cell subsets than those without (P<0. 01). SLE patients who were positive for anti-dsDNA or anti-SmRNP antibody, or had de-creased complement C3, thrombocytopenia or decreased lymphocytes had higher percentages peripheral CD4+CD28-T cells than those in the corresponding negative group. SLE patients who were positive for anti-dsDNA or anti-SmRNP antibody, or had decreased complement C3, complement C4 or lymphocytes showed en-hanced expression of peripheral CD4+CD28+PD-1+T cells as compared with those in the corresponding nega-tive group. SLE patients positive for anti-dsDNA antibody, or with decreased complement C3 or lymphocytes or suffering from alopecia had higher percentages of peripheral CD4+CD28-PD-1+T cell than those in the cor-responding negative group. Differences between different groups were statistically significant (P<0. 05). Conclusion Abnormal expression of CD4+CD28-T cells and PD-1 on CD4+CD28-and CD4+CD28+T cells in peripheral blood of patients with SLE has certain correlation with laboratory parameters and clinical indicators.
ABSTRACT
Objective To investigate the effect of total glucosides of paeony ( TGP ) on the expression of Toll-like receptor 9 (TLR9) in peripheral blood B lymphocytes of the patients with systemic lupus erythematosus (SLE). Methods Sixty SLE patients and thirty healthy volunteers were enrolled, peripheral blood mononuclear cells ( PBMC) were isolated from blood samples and divided into 4 groups, which were incubated with CpG-ODN(final concentration was 1 μmol·L-1), CpG-ODN+TGP ( TPG final concentration was 1í10-4 mol·L-1 ) ,TGP and RPMI medium ( as the blank control group) for 48 hours, respectively. FLA ( Flow cytometry analysis) was used to detect the expression of TLR9 on peripheral blood B lymphocytes after incubated. Results ①In the health people, TLR9 expression in the group of CpG-ODN was(9. 10±2. 12) %, which was higher than the blank control group(4. 96±2. 11) % (P<0. 01).②In the SLE patients, the TLR9 expression in the group of CpG-ODN was(14. 86±3. 42)% , which was significantly higher than the blank control group(9. 20±3. 43) %(P<0. 01). The TLR9 expression in the group of CpG-ODN+TGP was (11. 95±3. 63)%, which was lower than that in the group of CpG-ODN (P<0. 05). The TLR9 expression in the group of CpG-ODN with lightly active degree SLE patients was (10. 74±3. 17)%, which was higher than the blank control group(5. 19±2. 05) % (P<0. 01). For SLE from the moderately to vigorously active degree, the expression of TLR9 in the group of CpG-ODN(16. 51±1. 72) % was higher than the blank control group(10. 80±2. 37) %(P<0. 01), but that in the group of CpG-ODN+TGP (13. 59±2. 58) % was lower than the group of CpG-ODN (P<0. 01). Conclusion Our data indicate that TGP antagonize upregulation effect of CpG-ODN on the expression of TLR9 in peripheral blood B lymphocytes.
ABSTRACT
Objective To investigate the effect of total glucosides of paeony(TGP) on hepatic dysfunction caused by Methotrexate (MTX) and Leflunomide (LEF) in patients with moderate or severe rheumatoid arthritis (RA).Methods From July 2010 to February 2011,204 cases with definite-diagnosed rheumatoid arthritis were included in three hospitals in Anhui province.All these patients suffered from moderate or severe rheumatoid arthritis and they were divided randomly into two groups,the therapeutic groups were treated with TGP combined with MTX and LEF and the control group were treated without TGP.The incidence of hepatic dysfunction was observed.Statistical anylysis was carried out by using t test and x2 test.Results One hundred and ninty-four patients had completed observation for at least 12 weeks.In the therapeutic group,only 10 of 105 patients had hepatic dysfunction compared to 31 of 89 patients in the control group.The incidence of hepatic dysfunction of the therapeutic group was significantly lower than the control group.After 12 weeks treatment with TGP,the effective respohse rates of the therapeutic group was 81.9％,which was higher than 74.6％ in the control group.The good response rate in the therapeutic group was 21.6％,which was better than 11.7％ in the control group.Although the difference between the two groups was not statistically significant,we could observed the tendency of increasing in effectiveness and the good response rate in the therapeutic group when compared with the control group.Conclusion TGP can decrease the incidence of hepatic dysfunction during the treatment with MTX and LEF,and it may improve the therapeutic effecacy of patients with RA.
ABSTRACT
Objective To detect the frequency of peripheral blood CD4+ CD25high Tr and CD4+CD25lowT cells and expression of programmed death-1 ( PD-1 ) on their surface in the patients with systemic lupus erythematosus(SLE) and their clinical signifcance is analyzed.Methods The expression of PD-1 on the CD4+ CD25highTr and CD4+CD25lowT cells was examined in patients with 33 active SLE,18 inactive SLE and 38 healthy controls(HC) by flow cytometry.Clinical manifestations and laboratory findings of SLE were collected.Patients were divided into two groups according to their disease activity.SLE disease activity index(SLEDAI) score≥10 was defined as high disease activity and ＜10 as inactivity.The percentage of CD4+ CD25highTr and CD4+CD25lowT cells and proportions of expression of PD-1 on their surface were compared between not only inactive or active SLE patients and healthy controls (HC),but also between patients with lupus nephritis and without lupus nephritis.Correlation with clincal manifestations and laboratory findings was analyzed.Results (1)The proportions of CD4+CD25highTr and CD4+CD25low T cells were significantly decreased in active and inactive SLE patients as compared with HC.(2)The percentage of CD4+ CD25lowPD-1 +Tr and in active and inactive SLE patients were higher than HC.The proportions of CD4+CD25lowPD-1+ T cells were significantly increased in HC and inactive SLE patients as compared with inactive SLE patients.(3) The proportions of CD4+CD25highPD-1+Tr in SLE patients with nephritis were higher than those in patients without nephritis.But the percentage of CD4+ CD25 lowPD-1 + T cells was significantly decreased in SLE patients with nephritis as compared those without nephritis.(4)A positive correlation was observed for proportions of CD4+CD25highPD-1 + T cells with SLEDAI score.Proportions of CD4+ CD25high Tr,CD4+ CD25low PD-1 + T cells was inversely correlated with SLEDAI score.Conclusion The aberrations of proportions of CD4+CD25highpD-1+,CD4+CD25lowPD-1+,CD4+CD25high and CD4+CD25low T cells were observed in patients with SLE.The abnormality of PD-1 and PD-L1 pathway may play an important role in the function and number of Tr.
ABSTRACT
Objective To investigate the association between a few single nucleotide polymorphisms (SNPs)in Fc receptor like 3(FcRL3)and rheumatoid arthritis(RA)in Han nationality of Anhui patients.Methods One hundred and forty RA patients along with one hundred and eighty-seven healthy controls were included in the study.SNPs of FcRL3-1(rs0158440),FcRL3-2(rs2225828),FcRL3-3(rs7528684).FcRL34(rs11284799),FcRL3-5(rs945635),FcRL3-6(rs3761959),FcRL3-7(rs2210913),FcRL3-8(rs2282284)and FcRL3-9(rs2282283)in the FcRL3 gene were genotyped by MALDI-TOF technology.Haplotypes were estimated using PHASE v 2.1 software.Results The frequency of FcRL3-3-1 69C alleles in RA patients was significantly increased compared with healthy controls(X~2=7.348,P=0.007,OR=1.558,CI:1.130～2.150).The decreased compared with healthy controls.ConclusionFcRL3 may be associated with RA susceptibility in Anhui Han population.
ABSTRACT
Objective The aim of this study is to examine the expressions of Toll like receptor (TLR) 7 and TLR9 in the peripheral blood B lymphocytes of SLE patients and to analyze the correlation between TLR7/9 and clinical parameters. Methods lntracellular expression of TLR7/9 in the peripheral blood CD19+Blymphocytes was analyzed in 50 SLE patients and 30 healthy controls by flow cytometry. The difference of intracellular TLR7/9 expression levels in two groups was compared. Furthermore,the correlation between TLR7/9 expression and clinical parameters such as ESR, CRP, complement 3 (C3), complement 4 (CA), the level of serum IgG, anti-double stranded DNA antibody, anti-nuclear antibodies, SLEDAI score and urine protein excretion level, were analyzed. Results Compared with healthy subjects, the proportion of B cells expressing TLR7 and TLR9 was higher among SLE patients. Positive correlation was observed between TLR7 expression levels and clinical measurement of the SLEDAI and ESR. Negative correlation was observed between TLR7 expression levels and serum C3 levels. Positive correlation was observed between TLR9 expression levels and SLEDAI scores. Negative correlation was observed between TLR9 expression levels and serum C3 levels. Conclusion TLR7 and TLR9 expression is increased in the peripheral blood B cells of SLE patients, and correlates well with clinical parameters.
ABSTRACT
Objective To evaluate the efficacy of total glucosides of paeony(TGP) in the treatment of undifferentiated spondyloarthropathies(uSpA) and investigate its mechanism.Methods One hundred and sixteen cases of uSpA were randomly assigned to 2 groups,one group was treated with TGP and diclofenac sodium,the other group with SASP and diclofenac sodium.The efficacy and side effects of the two groups were compared after 12 weeks treatment.The level of IL-6,IL-10 and TNF-? was determined at the same time.Result After 12 weeks treatment,the major clinical manifest and the indexes of disease activity were no difference of statistical significance in the two groups.The incidence of parenterally side effects was 8.6% in TGP group,and 25.9% in SASP group.There was difference at statistical significance between the two groups(? 2 =6.042,P=0.014).Before treatment,the level of IL-6,IL-10 and TNF-? in the serum of two groups were no statistical difference,while there was obviously difference after 12 weeks treatment(t= 2.672,2.483 and 2.088,P=0.009,0.014 and 0.039).Conclusion The efficacy of TGP and SASP has no significant difference in the treatment of uSpA.But the incidence of parenterally side effects in the TGP group was less than SASP group.The mechanism of efficacy of TGP may be related to inhibiting the production of IL-6,IL-10 and TNF-?.
ABSTRACT
OBJECTIVE To investigate the clinical features and risks factors of nosocomial bacterial infection in patients with systemic lupus erythematosus(SLE).METHODS Five hundred and ninety-seven patients with SLE were classed into two groups,the group of nosocomial bacterial infection and the control group according to the results of bacteriological examinations.A comparison was performed between the two groups.RESULTS According to the infection sites,36% occurred in the respiratory tract and lungs,29.0% in the urinary tract,19.9% in the blood system and 15.1% in other tissues and organs.From them,75.8% onsets of nosocomial bacterial infection were chronic or insidious.The pathogens of nosocomial bacterial infection were mostly opportunistic,45.6% were G-bacilli,40.9% G+cocci and 13.9% were other bacteria.The eight major risk factors included lung disease,the more than 3 damaged organs or systems,plasma albumin under 30 g/L,long application of large dose glucocorticoid(GC),treatment of super-dose GC,therapeutic alliance of GC and cytotoxic immunosuppressant usage,use of broad-spectrum antibiotics before hospitalization and the time in hospital over 3 weeks.CONCLUSIONS The respiratory tract and lungs are the commonest site of nosocomial bacterial infection in patients with SLE.Most of the pathogens may be opportunistic of G-bacilli and G+cocci.The clinical features are untypical.It may decrease the incidence of the nosocomial bacterial infection to diminish by decreasing dose and the course of GC treatment after the patient's condition improved,select prudently application of super-dose GC,therapeutic alliance of GC and cytotoxic immunosuppressants,cautiously use of broad-spectrum antibiotics and shorten the duration of hospitalization.
ABSTRACT
Objective To investigate the clinical manifestations and laboratory findings of patients with the late onset systemic lupus erythematosus(LOSLE) and the elderly onset SLE. Methods Forty one patients with SLE onset beyond the age of 50 years(including 20 patients SLE onset beyond the age of 60 years) were identified and compared with 41 patients who had SLE onset before the age of 50 (General SLE). Patients in the group of general SLE were selected by 1 to 1 individual matching according to sex, course of diseases, date of admission. The presenting clinical features, laboratory findings, incidence rate of complication, efficacy of glucocorticoid and the prognosis of patients in two groups of LOSLE and general SLE were compared and analyzed. In addition, 20 cases of elderly onset SLE were also compared and analyzed. Results There were significant differences in symptoms between groups of LOSLE and General SLE. The LOSLE group had less occurrence of rash (39 0% vs 73 2%, P
ABSTRACT
Objective To improve the understanding of osteoarticular pain presented as rheumatic syndromes of cancers and malignant skeleton metastasis associated. Methods To analyse the clinical data of 32 patients initially manifested as osteoarticular pain. Results Forteen patients of 32 cases was diagnosed as cancer associated rheumatic syndromes, characterized by gradually deteriorated chronic recurrent vague pain. The effect of non-steroid anti-inflammatory drugs (NSAIDs) and glucocorticoid was not satisfactory. Pain subsided after removal of carcinous mass. Eighteen patients had malignant skeleton metastasis, vague pain at onset, but gradually progressed to be, severe persistent pain. NSAIDs and glucocorticoid were ineffective. Narcotic analgesics could produce short time relief. The nature and distribution of tumour were comparatively extensive. The clinical misdiagnosis rate was high. Conclusion Clinical doctors often neglect the coexistence of tumor because they are not familiar with the relation between osteoarticular pain and tumor. So patients who is over sixty and is not sensitive to commonly used analgesics and glucocorticoid with osteoarticular muscular pain should be considered the possibility of malignant tumor after excluding diffuse connective tissue disease.