Identification and validation of novel biomarkers for cold-dampness syndrome of rheumatoid arthritis based on integration of multiple bioinformatics methods / 中国中药杂志

This study aims to identify the novel biomarkers of cold-dampness syndrome(RA-Cold) of rheumatoid arthritis(RA) by gene set enrichment analysis(GSEA), weighted gene correlation network analysis(WGCNA), and clinical validation. Firstly, transcriptome sequencing was carried out for the whole blood samples from RA-Cold patients, RA patients with other traditional Chinese medicine(TCM) syndromes, and healthy volunteers. The differentially expressed gene(DEG) sets of RA-Cold were screened by comparison with the RA patients with other TCM syndromes and healthy volunteers. Then, GSEA and WGCNA were carried out to screen the key DEGs as candidate biomarkers for RA-Cold. Experimentally, the expression levels of the candidate biomarkers were determined by RT-qPCR for an independent clinical cohort(not less than 10 cases/group), and the clinical efficacy of the candidates was assessed using the receiver operating characteristic(ROC) curve. The results showed that 3 601 DEGs associated with RA-Cold were obtained, including 106 up-regulated genes and 3 495 down-regulated genes. The DEGs of RA-Cold were mainly enriched in the pathways associated with inflammation-immunity regulation, hormone regulation, substance and energy metabolism, cell function regulation, and synovial pannus formation. GSEA and WGCNA showed that recombinant proteasome 26S subunit, ATPase 2(PSMC2), which ranked in the top 50% in terms of coefficient of variation, representativeness of pathway, and biological modules, was a candidate biomarker of RA-Cold. Furthermore, the validation results based on the clinical independent sample set showed that the F1 value, specificity, accuracy, and precision of PSMC2 for RA-Cold were 70.3%, 61.9%, 64.5%, and 81.3%, respectively, and the area under the curve(AUC) value was 0.96. In summary, this study employed the "GSEA-WGCNA-validation" integrated strategy to identify novel biomarkers of RA-Cold, which helped to improve the TCM clinical diagnosis and treatment of core syndromes in RA and provided an experimental basis for TCM syndrome differentiation.

Clinical Observation on Orthopedics No.1 Prescription Combined with Celecoxib in Treating Knee Osteoarthritis with Middle Stage of Cold-dampness Syndrome / 中国实验方剂学杂志

Objective:To study the clinical efficacy of orthopedics No.1 prescription combined with celecoxib in the treatment of knee osteoarthritis （KOA） with middle stage of cold-dampness syndrome and investigate its effect on serum cytokines levels. Method:The 72 patients were randomly divided into control group and observation group， with 36 cases each. Patients in both groups were given basic treatment with oral celecoxib capsules （0.2 g/ time， 1 time/day）. On the basis of western medicine treatment， patients in observation group were treated with orthopedics No.1 prescription decoction-free granules by fumigation， 1 bag/time， 1 time/day， 5 times/week. Both groups received treatment for 4 weeks. The visual analog pain score （VAS）， American knee society knee score （KSS）， serum interleukin-1<italic>β </italic>（IL-1<italic>β</italic>）， tumor necrosis factor-<italic>α </italic>（TNF-<italic>α</italic>）， and transforming growth factor-<italic>β</italic>₁（TGF-<italic>β</italic>₁） levels were observed before and after treatment， and their clinical efficacy was evaluated. Result:After treatment， VAS score significantly decreased in both groups （<italic>P</italic><0.01）， and KSS score significantly increased （<italic>P</italic><0.01）， with better clinical effect in observation group. After treatment， serum IL-1<italic>β</italic> and TNF-<italic>α</italic> levels decreased significantly in both groups （<italic>P</italic><0.01）， and the levels in observation group were lower than those in control group after treatment （<italic>P</italic><0.05）. TGF<italic>-β</italic>₁content was significantly higher than that before treatment in two groups （<italic>P</italic><0.01）. Conclusion:Orthopedics No.1 prescription combined with celecoxib for the treatment of KOA with middle stage of cold-dampness syndrome can effectively relieve the clinical symptoms of patients with KOA， improve joint function， improve quality of life， reduce the contents of inflammatory factors IL-1<italic>β</italic> and TNF-<italic>α</italic> in serum， and increase the expression of TGF-<italic>β</italic>₁ level.

Clinical Efficacy of 30 Cases about Filiform-fire Needle Combined with Abdominal Acupuncture Therapy in Ankylosing Spondylitis / 浙江中医药大学学报

[Objective] To observe the clinical effects of filiform-fire needle combined with abdominal acupuncture in treating ankylosing spondylitis(cold-dampness syndrome). [Methods] Sixty patients who met the criteria of AS were included in the study. They were randomly divided into treatment group and control group for 30 patients in each group. The patients of control group were treated with Diclofenac sodium sustained -release tablet and Salazosul-fpyridine intestinal solution, while treatment group were treated with filiform-fire needle combined with abdominal acupuncture on the basis of western medicine mentioned above.All patients were treated and observed for three months, and they were evaluated by score of TCM symptoms, thoracic activity, spinal activity, finger-floor distance, pillow-wall distance and blood parameters, such as C-reactive Protein(CRP), Erythrocyte Sedimentation Rate (ESR)and Immune Globulin A(IgA). [Results] The total effective rate in treatment group was higher than that in control group(P＜0.05).After treatment, the two groups all got lower scores of TCM symptoms than before, and the scores of the treatment group were significantly lower than the control group(P＜0.05).The thoracic activity, spinal activity, finger-floor distance and pillow-wall distance of all patients improved in varying degrees, and the blood parameters of CRP, ESR and IgA decreased compared with that before treatment, and significantly the treatment group was superior to control group(P＜0.05).[Conclusion] The filiform-fire needle combined with abdominal acupuncture can effectively relieve pain, improve functional activity of the spine and peripheral joints, reduce inflammation, slow disease progression and raise the quality of life of the patients.