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BACKGROUND@#Clinical outcomes of undifferentiated arthritis (UA) are diverse, and only 40% of patients with UA develop rheumatoid arthritis (RA) after 3 years. Discovering predictive markers at disease onset for further intervention is critical. Therefore, our objective was to analyze the clinical outcomes of UA and ascertain the predictors for RA development.@*METHODS@#We performed a prospective, multi-center study from January 2013 to October 2016 among Chinese patients diagnosed with UA in 22 tertiary-care hospitals. Clinical and serological parameters were obtained at recruitment. Follow-up was undertaken in all patients every 12 weeks for 2 years. Predictive factors of disease progression were identified using multivariate Cox proportional hazards regression.@*RESULTS@#A total of 234 patients were recruited in this study, and 17 (7.3%) patients failed to follow up during the study. Among the 217 patients who completed the study, 83 (38.2%) patients went into remission. UA patients who developed RA had a higher rheumatoid factor (RF)-positivity (42.9% vs. 16.8%, χ = 8.228, P = 0.008), anti-cyclic citrullinated peptide (CCP) antibody-positivity (66.7% vs. 10.7%, χ = 43.897, P < 0.001), and double-positivity rate of RF and anti-CCP antibody (38.1% vs. 4.1%, χ = 32.131, P < 0.001) than those who did not. Anti-CCP antibody but not RF was an independent predictor for RA development (hazard ratio 18.017, 95% confidence interval: 5.803-55.938; P < 0.001).@*CONCLUSION@#As an independent predictor of RA, anti-CCP antibody should be tested at disease onset in all patients with UA.
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Objective To find out the iodine nutritional status of Longyan downtown residents,evaluate the effectiveness of control measures and provide a scientific basis for developing control strategies.Methods Infants aged 0 to 2 year-old,children aged 8 to 10,adults aged 18 to 45 and pregnant and lactating women were selected as survey subjects.Children goiter was detected with B ultrasound.Residents per capita daily salt intake was investigated by weighing method.Three urinary samples and a milk sample of lactating women were randomly collected.Urinary iodine and milk iodine content were determined by arsenic cerium catalytic spectrophotometric assay.Blood samples were collected and thyroid function (including serum TT3,FT3,TT4 and FT4) and thyroid stimulating hormone(TSH) were measured with direct chemiluminescence immunoassay,and thyroglobulin antibody(TgAb),thyromicrosome antibody(TMAb),and thyroglobulin (Tg) were measured with radioimmunoassay (RIA) in serum.ResultsThe goiter rate of children aged 8 to 10 was 1.8％ (2/110),and median thyroid volume was 2.75 ml.Household iodized salt coverage rate was 100.00％(318/318),and qualified iodized salt was 94.03％ (299/318).The daily per capita salt intake was (6.13 ± 3.56)g.The average medians of urinary iodine of the infants,children,adults,pregnant and lactating women were 181.8,315.2,196.6,158.7,136.4 μg/L,respectively.The median of milk iodine of lactating women was 155.6 μg/L.The proportions of serum TT3,FT3,TT4,FT4 and TSH which higher than normal were 3.6％ (11/308),0.6％ (2/309),23％ (7/309),1.0％ (3/313) and 1.3％ (4/312),respectively.While the proportions of serum TT3,FT3,TT4,FT4 and TSH that lower than normal were 2.3％ (7/308),11.7％(36/309),2.3％(7/309),12.8％(40/313),and 1.6％(5/312),respectively,of which 16 cases of both TgAb and TMAb were higher than normal.ConclusionsExisting salt iodine level is appropriate for 0 to 2 year-old infants and young children,18 to 45 year-old adults,pregnant and lactating women in downtown Longyan city.The iodine intake of children aged 8 to 10 is excessive.Thyroid function monitoring is recommended to be included in the routine monitoring.
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Objective To evaluate the clinical significance of sinus heart rate turbulence(HRT)and the heart rate variability(HRV)in the patients with essential hypertension(EH).Methods HRV and HRT examination were carried out in sixty patients with EH.A subgroup of patients receive metoprolol+nifedipine(n=26)or nife- dipine alone(n=34)were investigated seperately to evaluate the effect of ?-blocker on the HRV and HRT.Fifty healthy persons were served as control.In the HRT determination,turbulence onset(TO)was defined as sinus heart rate acceleration,after ventrieular mature beat while turbulence slope(TS)as sinus heart rate deceleration slope after ventricular premsture beat.Normal value of TO was2.5 ms/RR period. SDNN,RMSSD,LF/HF in HRV were analysed from 24 hours ambulatory electrocardiography(before and after 1 month medication).Results ① In hypertensive group,52 patients showed positive TO(86.6%),48 patients pos- itive TS(80.0%)and 46 patients TO+TS(76.7%),compared with hypertension group only 2(4%)positive TO and 3(6%)positive TS in the healthy control.Forty-two cases SDNN(70.0%),41 cases RMSSD(68.3%)and 38 cases LF/HF(63.3 %)were positive in hypertensive group,while only 1(2 %)SDNN,1(2 %)RMSSD and 3(6 %) LF/HF in control. ② Metoprolol didn't change the positive percentage of parameters in HRT but parameters showing Heart rate variablity in HRV was decreased significantly found between TO,TS and TO+TS.Conclusion HRT and HRV is two indices for determination the dysfunction of autonomic nervous system in hypertension.?-re ceptor blocker inhibit sympathic activity,miligate the decreasing of HRV,but the bipbase accelerative and decelera- tive phenomena of HRT didn't change,HRT seems to be a more sensitive index for monitoring of autonomic sysfunc tion in hypertension.