The impact of early inte rstitial pneumonia on the prognosis of patients with anti-melanoma differentiation-associated gene 5 antibody positive dermatomyositis / 中华风湿病学杂志

Objective:To explore the association between chest high resolution CT (HRCT) scoring and prognostic factors of interstitial lung disease (ILD) in patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM).Methods:The patients with DM admitted to Kailuan General Hospital between January 2017 and December 2019 were included into the study including 13 patients with positiveanti-MDA5 antibody (7 survivors, 6 deaths) and 18 patients with anti-synthase (ARS)-antibody positive. All patients underwent chest HRCT prior to treatment. The consolidation, ground-glass opacity (GGO) and fibrosis were scored to assess HRCT findings. The clinical manifestations were compared between the two groups. Cox regression analysis adjusted for age and sex was used to determine the prognostic factors for anti-MDA5 antibody-related ILD.Results:Compared with ARS patients, glutamyl transferase (GGT) and ferritin levels were significantly higher in MDA5-ILD patients [70.0(37.0, 122.5) vs 21.0(16.5, 33.5), Z=-3.37, P=0.001; 977.0(502.5, 1 366.0) vs 307.1(72.3, 546.9) , Z=-3.44, P=0.001]. The cumulative survival rate was significantly lower in patients with positive anti-MDA5 antibody than in those with positive anti-ARS antibody (100% vs 70%, P=0.001). The DM complicated with acute/subacute interstitial pneumonia (A/SIP) were found to significantly relate to death. There were no significant differences in chest HRCT scoringbetween the survivors and the deceased patients [ HR=1.08, 95% CI(0.95, 1.23), P=0.229; HR=0.97, 95% CI(0.72, 1.30), P=0.814]. Conclusion:Anti-MDA5 antibody is an important index for early diagnosis of DM complicated with acute/subacute interstitial pneumonia (A/SIP). The chest HRCT scoreis is not associated with the prognosis of anti-MDA5 antibody-related ILD patients.

Study on the association between cumulative serum uric acid and brachial-ankle pulse wave velocity / 中华风湿病学杂志

Objective To investigate the correlation between cumulative serum uric acid (cumUA) and brachial-ankle pulse wave velocity (baPWV).Methods Among the workers who participated in the four health check-up of Kailuan Group from 2010 to 2017,subjects who completed one PWV test were selected.The subjects who met the selection criteria were 20 688,subjects who lacked the first three uric acid tests and sex data were excluded.The subjects who had ischemic stroke (excluding lacunar infarction),transient ischemic attack and myocardial infarction were excluded.Decreased subjects were excluded and the extreme value were also excluded,20 295 subjects eventually meet the inclusion criteria and were included for statistical analysis.Stepwise linear regression,multivariate logistic regression and natural spline function were used to analyze the relationship between cumUA and baPWV and the influence of cumUA on baPWV.Results Among 20 295 subjects,the incidence of baPWV ≥ 14 m/s (criteria for judging atherosclerosis) increased with the increase of cumUA.There was significant difference in the incidence of baPWV ≥ 14 m/s (53.07％,54.35％,56.42％,58.41％,61.91％) among different cumUA partition groups (β=0.11,P＜0.01).In stepwise linear regression analysis,after adjusting for other confounding factors,it was found that cumUA was positively correlated with baPWV.In multivariate logistic regression analysis,after adjusting for other confounding factors,the results showed that baPWV ≥aPWVm were all risk factors for the third,fourth and fifth subgroups of cumUA compared with the first subgroup,and the OR05％CI) was 1.35(1.13,1.62) (P=0.01),1.60(1.29,1.97) (P＜0.01) and 2.14(1.64,2.80) (P＜0.01),respectively.Natural spline analysis exhibited a similar J curve relationship between cumUA and increased baPWV.Conclusion CumUA is a risk factor for increased baPWV.

Study on correlation between serum uric acid level and brachial ankle pulse wave velocity in patients with systemic lupus erythematosus / 中国综合临床

Objective To investigate the relationship between serum uric acid ( UA) level and brachial?ankle pulse wave velocity ( baPWV) in patients with systemic lupus erythematosus ( SLE) and lupus nephritis (LN)??Methods A total of 110 hospitalized,out?patient and healthy examinees from January 2017 to September 2017 were selected from Kailuan General Hospital??They were divided into three groups:(1)Fifty?five healthy controls were examined at the same time,and those who had no history of hypertension, myocardial infarction and stroke were excluded by physical examination??(2)Thirty?four SLE patients without LN were diagnosed according to the SLE classification standard revised by the American Society of Rheumatology ( ACR) in 1997,excluding those with lupus nephritis??( 3) 21 SLE patients with LN were diagnosed according to the SLE classification standard revised by the American Society of Rheumatology (ACR) in 1997??Pearson correlation coefficient and multivariate linear regression model were used to analyze the related factors affecting baPWV??Results The level of baPWV and the proportion of baPWV (≥1400 cm／s) in SLE without LN group and SLE with LN group were higher than those in healthy control group (all P＜0??05)??In SLE without LN group, baPWV was positively correlated with age, systolic blood pressure (SBP) and total cholesterol ( CHOL) ( r＝ 0??623,0??528,0??402, P＜0??01 or P＜0??05), and negatively correlated with blood uric acid(UA) ( r＝－0??371,P＜0??05),but the correlation was not significant??The correlation between UA and baPWV disappeared after after correction of age,SBP,diastolic blood pressure (DBP) by partial correlation analysis??In SLE with LN group,baPWV was positively correlated with SBP, DBP and serum creatinine ( Cr) ( r＝0??815, 0??725, 0??464, P＜0??01 or P＜0??05)??Multivariate stepwise regression analysis showed that SBP was independently correlated with baPWV in SLE group ( t＝2??54,P＝0??026); UA in SLE group without LN was independently negatively correlated with baPWV(t＝－2??96,P＝0??042); UA(t＝4??24,P＝0??013) and SBP(t＝7??70,P＝0??002) were independently positively correlated with baPWV in SLE group with LN??Logistic regression analysis showed that SLE was a risk factor for baPWV (≥1 400 cm／s),and the OR (95% CI) was 4??31 ( 1??56－11??88),P＝0??005,and there was statistical significance after adjusting for age,SBP,DBP,body mass index ( BMI)??However,UA was not a risk factor for baPWV (≥1 400 cm／s) (P values were 0??163 and 0??519,respectively)??Conclusion The degree of arteriosclerosis in SLE patients is higher than that in normal subjects,and the level of UA in SLE patients may be related to baPWV??

Analysis of risk factors of metabolic syndrome in patient with rheumatoid arthritis / 中华风湿病学杂志

Objective To explore the relationships between metabolic syndrome (MS) and rheumatoid arthritis (RA).Methods Two hundred and forty RA patients who fulfilled the 1987 revised American College of Rheumatology (ACR) classification criteria,and 250 age and sex matched healthy controls were enrolled.The frequency of metabolic syndrome was assessed using three Metabolic Syndrome definitions (Guidelines on Prevention and Treatment of Blood Lipid Abnormality in Chinese Adults 2016,International Diabetes Federation 2005,National Cholesterol Education Program 2005).Data were analyzed by Chi-square test and t test,risk factors were identified by Logistic regression.Results ① According to the definition used,the frequency of metabolic syndrome varied from 28.3％ to 35％ in RA,which was significantly higher than controls.② In RA with MS group defined by guidelines on Prevention and Treatment of Blood Lipid Abnormality in Chinese Adults 2016,the age,the diseases duration,erythrocyte sedimentation rate (ESR),DAS28,health assessment questionnaire (HAQ) scores and dose of glucocorticoid used were higher than controls [(12±6) years vs (10±7) years,t=6.96,P=0.01,(32±9) mm/1 h vs (26±6) mm/1 h,t=4.66,P=0.008,(3.7±1.2) vs (2.6±1.0),t=3.78,P=0.01,(1.6±0.5) vs (1.2±0.5),t=3.42,P=0.017],the percentage of patients who received anti-tumor necrosis factor α therapy was lower than the control group (39.7％ vs 23.7％,x2=6.881,P=0.009).③ In multivariate analysis,long disease duration,high ESR and HAQ scores were independently associated with the presence of MS [OR(95％CI):1.489(0.382,0.624),1.555(0.423,0.729),1.603(0.423,0.858),P＜0.01].Being treated with anti-tumor necrosis factor α was an independent protector of the presence of metabolic syndrome in RA patients [OR=0.582,95％CI(0.453,0.742),P＜0.01].Conclusion The frequency of metabolic syndrome in RA is higher compared to controls,while diseases duration,ESR,and HAQ are independent predictors for the presence of metabolic syndrome in patients with RA,anti-TNF-α therapy may be protective factor for the presence of metabolic syndrome in patients with RA.

Effect of dietary pattern on the brachial ankle pulse wave velocity in the northern industrial urban population / 中国综合临床

Objective To investigate the effects of different dietary patterns on brachial ankle pulse wave velocity in northern industrial cities. Methods According to the selection criteria,from 2014 to 2015, 22436 health checkup persons were selected as the subjects of Kailuan Group,they were followed up with health examination and questionnaire investigation, at the same time, the brachial ankle pulse wave velocity was detected. According to the dietary advice given by the Chinese dietary guidelines,the proportion of animal and plant food in the food frequency questionnaire and the supply of nutrients are divided into 4 groups,which are the traditional Chinese diet group (3 585 cases),the Western diet group (13 639 cases),the balanced diet group (1 309 cases),the Mediterranean diet group (3 903 cases). Logistic multivariate regression analysis was used to analyze he risk factors of atherosclerosis. Results The mean value of brachial ankle pulse wave velocity in 22 436 cases was ( 1 462. 46 ± 320. 69) cm/s, and the incidence of peripheral arteriosclerosis was 50. 78%(11 392/22 436). The incidence of arteriosclerosis around the balanced diet group, the Mediterranean diet group,the traditional Chinese diet group and the Western diet group were 48. 82%( 639/1 309), 49. 12%(1 917/3 903),50. 49%(1 810/3 585),51. 51%(7 026/13 639),and the difference between the groups was statistically significant (P＝0. 024); after adjusting other related risk factors,compared with the balanced diet group,the risk of peripheral arteriosclerosis in the Mediterranean diet group,the traditional diet group and the Western diet group was 121(95%CI:0. 557～2. 258),1. 015(95%CI:0. 663～1. 554),1. 033(95%CI:0. 677～1. 575), respectively. Conclusion The incidence of peripheral arteriosclerosis increased gradually in the balanced diet group,the Mediterranean diet group,the Chinese traditional diet group and the Western diet group, but there was no statistical significance in the risk of peripheral arteriosclerosis after adjusting other related risk factors. This Conclusion requires more large samples,long-term follow-up study to further confirm.

Clinical validation of the 2012 classification criteria for early rheumatoid arthritisin: a domestic multi-center cohort / 中华风湿病学杂志

Objective To evaluate the value of 2012 classification criteria for early rheumatoid arthritis (ERA),2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria,and 1987 ACR classification criteria in the diagnosis of early rheumatoid arthritis (RA).Methods Patients who had at least one swollen and tender joint with disease duration no more than 2 years,and age more than 16 years were enrolled.The patients were diagnosed as RA or other non-RA by 2 experienced rheumatologists.The clinical and laboratory parameters were recorded.The sensitivity and specificity of three RA classification criteria were compared by McNemar test,The areas under the receiver operating characteristic curve (ROC) curve (AUC) of each RA classification criteria were analyzed using MedCalc software.Results Atotal of 310 patients were enrolled in this study,including 182ERA and 128 non-RA.The sensitivity(88.5％) of ERA criteria was much higher than that of the 1987 ACR criteria (45.6％,x2=75.013,P＜0.05),and not significantly different with the 2010 ACR/EULAR criteria (91.8％,X2=1.042,P＞0.05).The specificity of ERA criteria (91.4％) of 2010 ACR/EULAR criteria (87.5％,x2=1.8,P＞0.05) was similar to that of the 1987 ACR criteria (96.1％,x2=3.1,P＞0.05).The AUC of ERA criteria was 0.962 [95％CI(0.934,0.980)],which was slightly better than that of the 2010 ACR/EULAR criteria 0.959 [95％CI(0.931,0.978)],Z=0.380,P=0.7038,and much higher than that of the 1987 ACR criteria 0.885 [95％CI (0.845,0.919)],Z=4.517,P＜0.01.Conclusion Overall evaluation,the diagnostic value of ERA criteria is better than 1987 ACR and 2010 ACR/EULAR criteria in early rheumatoid arthritis.Compared to 2010 ACR/EULAR classification criteria,ERA criteria is more simple and practical.

Altered expression of miR-155 in peripheral blood mononuclear cells of rheumatoid arthritis patients / 中华风湿病学杂志

Objective ① To Screen for the miRNAs differently expressed in the peripheral blood mono-nuclear cells (PBMCs) of rheumatoid arthritis (RA) by microarray experiments.② To further evaluate the expression of miR-155 in PBMCs of RA.③ To determine the relevance between the expression of miR-155 and clinical as well as laboratory features.④ To test whether inflammatory mediators can induce miR-155 expression in PBMCs of RA.Methods ① Total RNA was isolated from peripheral blood mononuclear cells obtained from 5 patients of RA and 5 normal controls.Expression profiling of miRNAs was performed in a microarray analysis.② MiR-155 was identified for further study by stem-loop real-time RT-PCR based on SYBR-Green.PBMC from 26 patients of RA and 23 normal controls were collected.③ Association between miR-155 and the clinical and laboratory features of RA was evaluated.④Induction of miR-155 following stimulation with TNF-α, IFN-γ and LPS of cultures of RA PBMCs was examined by real-time RT-PCR.Statistical analysis was done with student's t test, paired t test, and ANOVA, Spearman correlation.Results ① Expression profiling of miRNAs revealed significant differential expression of 14 miRNAs, of which signal intensity changed over two times.MiR-155 was up-regulated in PBMCs of RA than in normal controls (t=9.218, P=0.001).② The expression level of miR-155 had a positive correlation with serum CRP level (r=0.57, P=0.002).③ Expression of miR-155 was markedly up-regulated in PBMCs of RA after stimulated with TNF-α,IFN-γ and LPS, especially with TNF-α.Conclusions The expression of miR-155 is induced by stimulating with TNF-α, IFN-γ and LPS.MiR-155 may be a regulator in RA pathogenesis.Further studies are required to elucidate the function of miR-155.

The effects of exposure to the famine during early life with elevated resting heart rate in the adult / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the association between exposure to the famine during early life and elevated resting heart rate (RHR) in adulthood.</p><p><b>METHOD</b>From June 2006 to October 2007, the employees of kailuan group who took part in the health examination were selected. Of those, 18 619 cases who was born during October 1, 1956 to September 30, 1964 in Hebei province were finally included in the analysis based on the inclusion and exclusion criteria. All the subjects were received questionnaire survey, smoking and drinking, physical examination, Lab examination and the measurement of RHR. The subjects of famine exposure group (3 190 cases) were born from October 1, 1959 to September 30, 1961, semi-exposure group (3 851 cases) were born from October 1, 1958 to September 30, 1959 and from October 1, 1961 to September 30, 1962, control group (11 578 cases) were born from October 1, 1956 to September 30, 1958 and from October 1, 1962 to September 30, 1964. The RHR and the detection rate of elevated RHR were compared among the three groups. The Multivariate logistic regression model was used to analyze the association between of exposure to famine during early life and elevated RHR in adulthood.</p><p><b>RESULTS</b>The RHR level was higher in famine exposure group and semi-exposed group than control group, which were (74.34 ± 9.71), (74.41 ± 9.48) and (73.90 ± 9.45) beat per minute (bpm) (P values were 0.003 and 0.020, respectively). In all of the subjects. The results of multivariate logistic regression showed that exposure of famine during early life increased the risk of elevated RHR in adulthood after adjustment for age, gender and other confounders (OR = 1.10, 95% CI: 1.01-1.21). In men, exposure of famine during early life also increased the risk of elevated RHR in adulthood (OR = 1.15, 95% CI: 1.04-1.28); In women, there was no association between the famine exposure and elevated RHR (OR = 0.92, 95% CI: 0.74-1.14).</p><p><b>CONCLUSION</b>Exposure of famine during early life increases the risk of elevated RHR in adulthood. This negative effect existed mainly in the male.</p>

Effects and Mechanism of Atherosclerosis Prevention by DMARDs in Patients with Rheumatoid Arthritis / 医药导报

Objective To investigate the effect of DMARDs on the prevention of early-onset atherosclerosis in rheumatoid arthritis ( RA) patients for exploring an appropriate schedule to reduce cardiovascular events. Methods Seventy-two patients with early RA were included in this study. Erythrocyte sedimentation rate ( ESR) and high sensitivity C reactive protein ( hs-CRP) were detected before and after treatment to evaluate inflammation. Carotid intima-media thickness ( cIMT) and endothelium-dependent flow-mediated vasodilatation (ED-FMD) were monitored. Disease Activity Score in 28 Joints (DAS28) and health assessment questionnaire-disability index ( HAQ-DI) was used to assess severity degree of RA and life quality of the patients, respectively. The patients were treated with methotrexate (MTX), hydroxychloroquine (HCQ) and sulfasalazine (SSZ) alone or combined based on severity of RA. Results After 1 year of treatment, ESR, hs-CRP, DAS28 and HAQ-DI were significantly improved (all P<0. 01). At the same time, the serum lipid levels also had obvious changes. However, there was no obvious difference in body mass index ( BMI) after 1 year. The cIMT ratio value was significantly decreased compared to baseline (0. 43±0. 08 mm vs. 0. 50±0. 16 mm, P=0. 002), and FMD% also significantly improved from basic value of 5. 26 to 7. 57 after treatment (P=0. 041). Conclusion Early intervention of RA by using DMARDs can effectively control the disease and slow the progression of atherosclerosis, but also reduce cardiovascular mortality.

Effects related to experiences of famine during early life on diabetes mellitus and impaired fasting glucose during adulthood / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the effects of famine-experience during early life on diabetes mellitus and impaired fasting glucose in the adulthood.</p><p><b>METHODS</b>In a total of 101 510 employees who took part in the health examination at the Kailuan Group between 2006 to 2007 were recruited. All the study subjects were born in Hebei province between 1956-10-01 and 1964-09-30 but those who had incomplete data were excluded. 19 347 subjects were finally included for analysis. Members from the famine-exposed group were born between Oct. 1, 1959 and Sep. 30, 1961. There was a semi-exposed group with members born between Oct. 1, 1958 and Sept. 30, 1959 and from Oct. 1, 1961 to Sept. 30, 1962 but members from the control group were born from Oct. 1, 1956 to Sept. 30, 1958 and from Oct. 1, 1962 to Sept. 30, 1964. Prevalence rates on diabetes mellitus and the detection rate of impaired fasting glucose among the three groups were compared. Logistic regression model was used to analyze the effects of famine-experience during early life with the prevalence of diabetes mellitus and the detection rate of impaired fasting glucose during adulthood.</p><p><b>RESULTS</b>Prevalence of diabetes mellitus and the detection rate of impaired fasting glucose in the famine-exposed adult-cohort groups were 8.99%, 8.96% while 8.05% and 9.35% in the semi-exposure groups, 7.71% and 8.20% in the control group. Results from the multivariate logistic regression analysis showed that experiences of famine during early life increased the risk of diabetes mellitus and impaired fasting glucose in adulthood with the odds ratios as 1.218 (95% CI: 1.056-1.404, P = 0.007) and 1.142 (95% CI: 0.994-1.312, P = 0.061). After stratification by sex, odds ratios in males were 1.163 (95% CI: 1.001-1.350, P = 0.048)and 1.213(95% CI:1.039-1.417, P = 0.015). The odds ratios in females were 1.319 (95% CI: 0.920-1.891, P = 0.132) and 0.990 (95% CI: 0.679-1.444, P = 0.959).</p><p><b>CONCLUSION</b>Experiences of famine during early life increased the risk of diabetes mellitus and impaired fasting glucose in the adulthood. However, this negative effect existed mainly in the males, according to the results from our study.</p>

A multicenter study of fracture in patients with rheumatoid arthritis in China / 中华风湿病学杂志

ObjectiveTo examine the clinical features of fractures and related risk factors in patients with rheumatoid arthritis(RA) in China.MethodsSix hundred and eighty-one RA patients were randomly selected from department of rheumatology of 18 hospitals of China.Data were obtained from the questionnaire,including age,sex,disease duration,the involvement of joints,treatment regimen,features of fractures etc.The possible risk factors of fracture in patients with RA were analyzed with a multi-variate Logistic regression analysis.Results① In 681 RA patients of the survey,48 patients had 54 fractures,and the incidence of fractures was about 8％.② Fractures occurred at various sites.Foot/ankle,femur,spine and wrist were the mostfrequent sites.③ The Logistic regression analysis showed that several factors increased the risk of fracture in RA patients,including long disease duration (OR:1.245,95％CI:0.987-1.570,P=0.065),male gender(OR:0.433,95％CI:0.199-0.942,P=0.035),more deformed joints(OR:1.042,95％CI:1.006-1.079,P=0.023),family history of RA (OR:2.201,95％CI:0.984-4.923,P=0.055),and high scores of SF-36(OR:1.017,95％CI:1.002-1.033,P=0.028).④ According to the degree of correlation from strong to weak,the risk factors of fracture were disease duration,SF-36,sex,number of deformed joints and family history of rheumatoid arthritis.ConclusionThe incidence of fracture is high in patients with rheumatoid arthritis.Several factors could increase the risk of fractures in RA patients,including long disease duration,male gender,more deformed joints,and family history of RA.In order to prevent the occurrence of fractures,cautions should be taken to prevent the development of fractures and treat the disease aggressively to suppress the disease activity of RA.

Association study between polymorphism of tumour necrosis factor-α-863 and gout / 中国综合临床

Objective To investigate the association between the tumour necrosis factor-α-863(TNF-α-863) polymorphism and gout in Han population from the city of Tangshan.Methods We recruited 80 gout patients and 80 healthy individuals into this study.The polymorphisms of TNF-α-863 site were analyzed by polymerase chain reaction-ligase detection reaction(PCR-LDR).The frequencies of different TNF-α-863 genotypes/alleles were analyzed in the gout group and the control subjects.Results No significant differences were observed in the genotype frequencies(x2=2.8807,P=0.0897) and allelic frequencies(x2=4.2646,P=0.1187) of TNF-α-863 site in the comparison between gout and control groups.Conclusion The result of our study suggests that the polymorphism of TNF-α-863 site may not related to gout in Han population in Tangshan.

A multicenter study of costs of drugs in rheumatoid arthritis in China / 中华风湿病学杂志

Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.

The expression and the function of miR-155 on rheumatoid arthritis synovial fibroblasts / 中华风湿病学杂志

Objective To screen for the miR-155 expression in synovial fibroblasts of rheumatoid arthritis (RASFs) and osteoarthritis (OASFs) and to evaluate the function of miR-155 on RASFs and its possible target mRNAs. Methods The expression levels of miR-155 in RASFs and OASFs were detected by real-time PCR. MiR-155 mimic and miR-155 inhibitor, as well as scrambled control were transfected into cultured RASFs by Lipofectamine 2000. Forty-eight hours later, MMP-3 levels in the cell culture supernatant were detected by ELISA and fibroblast proliferation was assayed by 3H -TdR incorporation test. Fibroblast invasive ability was tested by transwell system. IKBKE which previously identified as actual target of miR-155 was examined by real-time PCR. Comparisons between groups were performed with t test or one-way ANOVA analysis. Results It was shown that miR-155 was up-regulated in RASFs (1.79 ±1.94) and it was higher than that in OASFst (0.11±0.17), P<0.05]. Up-regulation of miR-155 could decrease MMP-3 levels (P<0.05). The proliferation and invasion of RASFs transfected with miR-155 were both evidently suppressed (P<0.05), while reducing the endogenous miR-155 could significantly enhance RASF proliferation (P<0.05). The expression of IKBKE of RASFs transfected with miR-155 was obviously down-regulated compared to those transfected with the scrambled control (P<0.05). Conclusion miR-155 is up-regulated in RASFs which may be a protective factor against the inflammatory effect, at least partially by attenuating the expression of IKBKK.

The investigation and analysis of the adverse effects of methotrexate in the treatment of rheumatoid arthritis / 中华风湿病学杂志

Objective To investigate and analyze the adverse effect(AE) of methotrexate(MTX)in rheumatoid arthritis(RA).MethodsThree hundred and twenty-five RA patients were investigated with a questionnaire in clinical service of department of Rheumatology and Immunology, Peking University People's Hospital. SPSS 11.5 software was used for statistical analysis. Results① The total prevalence of AE was 34.2％. Among these, gastrointestinal AE were the most common, others included elevated liver enzymes,leucocytopenia,alopecia and dental ulcer. The incidence of drug withdrawal of MTX was 13.2％, elevated liver enzymes was the most common reason of withdrawal, other reasons were gastrointestinal AE, leucocytopenia,dental ulcer and alopecia. The gastrointestinal AE and dental ulcer occurred within one week after initiating the medication in average, while elevated liver enzymes and leucocytopenia usually occurred at about 1～2 months after the medication. ②The incidence of AE increased with the dosage. ③ Folic acid could significantly decrease the total incidence of AE(P＜0.05). The incidence of gastrointestinal AE, elevated liver enzymes,leucocytopenia and dental ulcer couldbe reduced by folic acid supplementation(P＜0.05).Conclusion The AE of MTX in RA treatment are common, many of which are slight and could be improved by reducing the dosage or symptomatic treatment. The AEs of MTX can be improved by folic acid supplement treatment.

Clinical significance and expression of T cell subsets in peripheral blood from patients with ankylosing spondylitis / 中国综合临床

Objecfive To study T cell subsets distribution in peripheral blood from patients with ankylosing spondylitis(AS)and the role of cell immunity in AS.Methods 30 patients with untreated active phase AS and 30 healthy volunteers were enrolled.The expression of CD4+ and CD8+ T cell subsets were evaluated by flow eytome try.The correlation among T cell subsets and Bath AS function index(BASFI).Bath AS measurement index(BASMI),course of disease,age,ESR,hyper-sensitive C-reactive protein (hs-CRP) were analyzed.Results The level of CD4+ T cell and CD4/CD8+ratio were significantly lower than that of healthy volunteers[(29.24±9.22)% vs.(40.09±6.86) %,(0.96±0.49 ) vs.(1.70±0.67 ),P ＜ 0.01 ],and CD8+ T cell were significantly higher than that of healthy volunteers [(32.91±6.86) % vs.(25.60± 5.97 ) %,P ＜ 0.01 ].The level of CD4+ T cell subsets in peripheral blood of AS patients was negatively correlated with BASMI (r =-0.479,P ＜ 0.01 ),and CD8+ T cell subsets were positively correlated with ESR,hs-CRP,BASFI and BASMI ( r = 0.373,0.430,0.462,0.530,P ＜0.05 ).The ratio of CD4+/CD8+ was negatively correlated with hs-CRP,BASFI and BASMI (r = -0.465,- 0.473,- 0.426,P ＜ 0.05 ).CD4+,CD8+,ratio of CD4/CD8 were not significantly correlated with age and course of disease in patients with AS.Conclusion T cell subsets are significantly abnormal in peripheral blood of patients with AS,and the imbalance degree of T cell is correlated with severity and activity of AS,suggesting that T cell subsets imbalance plays an important role in the pathologensis of AS.