The clinical features and survival analysis of 109 patients with neuropsychiatric systemic lupus erythematosus / 中华风湿病学杂志

Objective:To investigate the clinical characteristics, prognosis, and risk factors for poor prognosis of neuropsychiatric systemic lupus erythematosus (NPSLE) .Methods:Patients who were diagnosed as NPSLE between January 2009 to January 2019 in Peking University First Hospital were included. Patients with neuro-psychiatric symptoms caused by other reasons such as infection and metabolic disorders were excluded. Patients were retrospectively followed up by telephone or medical records. Continuous variables were compared by student t test or Wilcoxon rank sum test. Quantitative variables were compared by chi-square test. Survival was analyzed by Kaplan-Meier curve. Predictive factors of prognosis was estimated by using Cox regression analysis. Results:One hundred and nine NPSLE patients were included. Thirteen (11.9%) were male and 96 (88.1%) were female with a median age of 33 years old. Central nervous system involvement was predominant (89/109, 81.7%) . The most common types were headache, cerebrovascular disease and epilepsy. Cranial neuropathy was the most common type at the initial onset of systemic lupus erythematosus (SLE) , while cerebrovascular disease was more common when SLE relapsed. Patients who demonstrated NPSLE at the initiation of SLE had shorter survival time than those who got NPSLE when SLE relapsed [ (32±26) months vs (197±79) months, t=2.834, P=0.037]. Among the 105 patients with complete followed up data, the follow up time was 118.0 (1.4, 525.7) months and 53.1 (0.4, 363.0) months from the onset of SLE and NPSLE, respectively. The mortality rate was 14.3% (15/105) . The survival rates of 1-5 years were 96.2%, 94.3%, 91.0%, 89.9% and 88.3%, respectively. The survival time was (180±138) months and (33±32) months, t=3.861 , P<0.01) from the onset of SLE and NPSLE, respectively. The major causes of death were infection, NSPLE and cardiovascular disease. Cerebrovascular disease was the independent risk factor for death [ RR=3.413, 95% CI (1.049, 11.102) , P=0.041]. Conclusion:Cranial neuropathy is the most common type at the initial onset of SLE, while cerebrovascular disease is more common when SLE relapsed. Patients who had NPSLE at the initiation of SLE have shorter survival time than those who got NPSLE when SLE relapsed. Cerebrovascular disease is the independent risk factor of death of NPSLE patients.

Effects of microplastics and attached heavy metals on growth, immunity, and heavy metal accumulation in the yellow seahorse, Hippocampus kuda Bleeker.

Microplastics represent a new kind of environmental pollutant that has recently attracted extensive attention and become a research hotspot. Microplastics are similar in size to the food items of many marine organisms and are thus, often consumed by them, with potentially harmful and toxic effects. We examined the effects of microplastics on the growth of the yellow seahorse Hippocampus kuda. Seahorses were split into three groups fed Mysis + microplastics + heavy metals (group A), Mysis + microplastics (group B), and Mysis alone (group C). We analyzed and compared the accumulations of microplastics and heavy metals among the groups and monitored seahorse growth following the different treatments. Body length, body weight, condition factor, specific growth rate, and survival rate were all lower in group A compared with the other groups, but there was no significant difference in any of the parameters between groups B and C. The accumulation of microplastics was similar in groups A and B, and the accumulation of heavy metals was similar in groups B and C. These results suggest that the effect of microplastics on seahorse growth is caused by the accumulation of heavy metals, rather than by the microplastics themselves.