[Associated factors of different fatigue dimensions in elderly patients with rheumatoid arthritis].

Objective: To investigate the associated factors of different dimensions of fatigue in elderly patients with rheumatoid arthritis (RA). Methods: A cross-sectional analysis was performed in the elderly outpatients with RA (age ≥ 60 years) in the First Affiliated Hospital of Sun Yat-sen University from January 2018 to June 2019. Fatigue was measured by Multidimensional Fatigue Inventory-20 (MFI-20) and 36-item Short Form Health Survey-Vitality (SF-36-VT). Physical fatigue and mental fatigue were subsequently measured by MFI-20 subscales. Results: A total of 104 patients were included. Male-to-female ratio was 1∶3.3. The average age was (68±6) years. The MFI-20 score and SF-36-VT score were 60±14 and 64±20, respectively. The score of physical fatigue measured by MFI-20 was 14±3, and mental fatigue scored 10±4 (P<0.001). Arthralgia, disease activity, disability, insomnia, depression and anxiety were correlated with fatigue assessed by MFI-20 (correlated coefficient: 0.48-0.62). Multivariable regression analysis showed that arthralgia and depression were associated with physical fatigue (Standardized regression coefficients were 0.44 and 0.38, respectively). Insomnia, depression and anxiety were associated factors of mental fatigue (Standardized regression coefficients were 0.20, 0.32 and 0.24, respectively). Conclusions: Elderly patients with RA experiencehigh level of fatigue, mainly presenting as physical fatigue. Arthralgia and depression mainly affect physical fatigue, and arthralgia is a critical factor. Insomnia, depression and anxiety are associated with mental fatigue.

Effects of sevoflurane inhalation anesthesia on cognitive and immune function in elderly patients after abdominal operation.

OBJECTIVE: To observe the effects of sevoflurane inhalation anesthesia on cognitive and immune function in elderly patients after abdominal operation. PATIENTS AND METHODS: 371 elderly patients who were diagnosed and received abdominal operation in the General Surgery Department of Jiangxi Provincial People's Hospital from January 2015 to December 2017 were retrospectively analyzed. 203 patients undergoing sevoflurane inhalation anesthesia were regarded as the sevoflurane group, and 168 patients anesthetized with propofol were taken as the propofol group. The Mini-Mental State Examination (MMSE) scores of patients at 1 d (T1) before the operation and at 1 d (T2), 3 d (T3), and 7 d (T4) after operation were recorded, and the levels of T lymphocyte subsets [cluster of differentiation (CD)3+, CD4+ and CD4+/CD8+] and natural killer (NK) cells in the patients' serum at each time point were determined and analyzed. RESULTS: The MMSE scores at all time points after the operation in the sevoflurane group were remarkably higher than those in the propofol group (p<0.05), displaying statistically significant differences. The MMSE scores at T2, T3, and T4 were markedly decreased compared with that at T1 in the two groups (p<0.05). The levels of CD16+/CD56+ at T2 and T3 in the sevoflurane group were significantly increased compared with those in the propofol group (p<0.05). Compared with that at T1, the levels of CD16+/CD56+ at T2, T3, and T4 in the two groups declined, showing statistically significant differences (p<0.05). Compared with those at T1, the levels of CD3+, CD4+ and CD4+/CD8+ at T2 and T3 were markedly decreased in the two groups of patients (p<0.05). CONCLUSIONS: Applying sevoflurane as an anesthetic for abdominal operation in elderly patients is a more effective method for alleviating perioperative cognitive dysfunction and improving immune function inhibition in elderly patients, so it is worthy of clinical promotion.

[Clinical study of maternal and infant outcomes in patients with lupus nephritis complicated with pregnancy].

Objective: To investigate the outcomes and associated factors for adverse pregnancy outcomes (APO) in pregnant patients with lupus nephritis (LN). Methods: The clinical data of 139 LN pregnant patients from from 2009 to 2017 in the First Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. Results: Totally, 105 LN were diagnosed before pregnancy and 34 were newly diagnosed during pregnancy. One or more APO occurred in 71.2% of patients with LN and 40 (28.8%) were without any APO. Thirty-six (25.9%) of pregnancies resulted in fetal loss. A total of 54 pregnancies were preterm birth with 20 at gestational age <34 weeks, 13 were intrauterine growth retardation (IUGR), 3 were fetal distress, and 8 were neonatal lupus, pregnancy induced hypertension occurred in 18 cases, of which, 2 cases were gestational hypertension and 16 were preeclampsia. There was no eclampsia occurred.In multivariate analysis, predictors of APO included active lupus during pregnancy (OR=8.9, 95%CI: 3.7-21.7, P<0.001), rash (OR=7.3, 95%CI: 2.2-24.5, P=0.001), cylindruria (OR=5.3, 95%CI: 1.6-17.0, P=0.005) and antiphospholipid syndrome (OR=11.4, 95%CI: 1.5-88.3, P=0.02) were risk factors for pregnancy loss. Variables that were independently predictive of preterm birth included anticardiolipin antibody positive (OR=8.8, 95%CI: 1.5-51.5, P=0.02) and active lupus during pregnancy (OR=7.9, 95%CI: 2.3-24.5, P=0.001). Conclusions: Pregnancies in LN are still at high risk of APO in terms of pregnancy loss and preterm birth. Stable disease can help to reduce the risk of APO.

CircRNA_0023642 promotes migration and invasion of gastric cancer cells by regulating EMT.

OBJECTIVE: Non-coding circular RNAs (circRNAs) have displayed dysregulated expression in various tumor tissues. However, their role in the progression of cancers remains largely unknown. We aimed at examining the expression, functions, and molecular mechanisms of a new circRNA (circRNA_0023642) in gastric cancer (GC). PATIENTS AND METHODS: We evaluated the expression levels of circRNA_0023642 in GC tissues, adjacent normal tissues and cells lines using qRT-PCR. The functional roles of circRNA_0023642 in GC were determined by Cell Counting Kit-8 (CCK-8) assay, colony formation assay, transwell assay, and flow cytometric analysis. Western blot was used to analyze the effect of circRNA_0023642 on the expression of EMT-related proteins. RESULTS: We found that circRNA_0023642 was upregulated in GC tissues and cell lines. Functionally, down-regulation of circRNA_0023642 displayed the tumor-inhibitory effects by suppressing cell proliferation, migration, and invasion as well as inducing apoptosis. Mechanically, our results revealed that the abnormal expression of circRNA_0023642 could influence the EMT signaling pathway, which was demonstrated by measuring the expression levels of N-cadherin, vimentin snail, and E-cadherin. CONCLUSIONS: Our findings suggest that circRNA_0023642 serves as a metastasis activator by promoting EMT and may represent a novel molecular therapeutic target for GC.

[Pregnancy outcome of planning pregnancies in patients with SLE].

Objectives: To investigate the pregnancy outcomes in systemic lupus erythematosus (SLE) patients with planning pregnancy.And to evaluate the value of fetal umbilical artery Doppler. Methods: A total of 130 SLE patients with planning pregnancy were prospectively recruited from January 2013 to January 2017 at the First Affiliated Hospital of Sun Yat-sen University. Results: Thirty eight (29.2%) patients had active lupus, 30 with mild activity, 5 with moderate activity and 3 with severe activity.Active disease in the first, second and third trimesters occurred in 6, 11 and 21 cases respectively.Lupus nephritis (76.3%) and hematological system involvement (39.5%) were the most common manifestation.Seven cases had pre-eclampsia during pregnancy.One or more adverse outcomes occurred in 40 patients, including 28 with premature, 12 with pregnancy loss, 9 with intrauterine growth restriction, and 8 with fetal distress.All of the pulsatility index, resistance index and S/D value of patients with adverse outcomes were higher than that of patients without adverse outcomes (P<0.05). Conclusions: In SLE patients with planning pregnancy, disease flares were infrequent, and outcomes were favorable. Fetal umbilical artery Doppler can be used as a noninvasive monitoring method for SLE patients at late pregnancy.

[Clinical features and adverse pregnancy outcomes of new onset systemic lupus erythematosus during pregnancy].

Objective: To investigate the clinical characteristics and adverse pregnancy outcomes in pregnant women with new onset systemic lupus erythematosus (SLE) during pregnancy. Methods: The clinical data of 263 pregnancies with SLE in the First Affiliated Hospital of Zhongshan University from 2001 to 2015 were collected and analyzed retrospectively. Results: Of all the 263 pregnancies, 188 were diagnosed before pregnancy and 75 were newly diagnosed during pregnancy. Among the 75 new onset SLE, 27, 31, 14 and 3 cases were diagnosed during first trimester, second trimester, third trimester and puerperium, respectively. Active lupus was noted in 81.3% of the patients with new onset SLE. The main clinical manifestations of new onset SLE were lupus nephritis (57.3%) and thrombocytopenia (38.7%). SLEPDAI scores as well as the prevalence of lupus nephritis, and thrombocytopenia in patients with new onset SLE was higher than those in the previously diagnosed ones (P<0.05). Among the 75 new onset SLE pregnancies, adverse pregnancy outcomesoccurred in 53 patients, including 34 with pregnancy loss, 15with premature, 8with intrauterine growth restriction, 5with fetal distress and5 with neonatal lupus. Compared with patients withnon-newonset SLE, patients with newonset SLEhad a higher prevalence of adverse pregnancy outcomes (56.4% vs 70.7%, P<0.05), and pregnancy loss (21.8% vs 45.3%, P<0.01) but less live birth (78.2% vs 54.7%, P<0.05). Conclusion: Most of the patients with new onset SLE occurred during the first and second trimester. The most common clinical features of new onset SLE were lupus nephritis and thrombocytopenia. Patients with new onset SLE were more prone to active lupus, lupus nephritis and thrombocytopenia, as well as more adverse pregnancy outcomes and pregnancy loss.

[The clinical manifestation and analysis of eosinophilic granulomatous vasculitis].

OBJECTIVE: To evaluate the clinical features, treatment and prognosis of Eosinophilic Granulomatous Vasculitis. METHODS: We analyzed retrospectively the clinical and laboratory features, treatment and prognosis of 43 patients with Eosinophilic Granulomatous Vasculitis who admitted to the Department of Rheumatology of the First Affiliated University Hospital of Sun Yat-sen University between 2005 and 2014. RESULTS: Of the 43 patients, 31 patients (72.1%) had allergic symptoms in the disease course and 16 patients (37.2%) had asthma and lung wheezing sound when performing the physical examination.Organs involvements included skin, acra, lung, kidney, central and peripheral nervous system, digestive system and heart.Positive antineutrophilic cytoplasmic antibody (ANCA) which mainly with MPO-ANCA was found in 18 patients (41.9%). Thirty-nine patients (90.7%)had high blood eosinophil level while all patients (100%) had elevated IgE.Two patients died of multiple organ failure in their acute phase, and the others had favorable prognosis after receiving the treatment of glucocorticoid combine with cyclophosphamide or methotrexate. CONCLUSIONS: Eosinophilic Granulomatous Vasculitiscould make damage to organs and tissues.Only 72.1% patients had allergic symptoms and 37.2% patients had asthma and lung wheezing sound.More than half patients have the negative ANCA.Glucocorticoidcombine with cyclophosphamide or methotrexate can achieve satisfactory therapeutic effects.

[Transplantation of adipose derived mesenchymal stem cells alleviated osteoarthritis induced with anterior cruciate ligament transection].

OBJECTIVE: To explore the therapeutic potential of transplantation of adipose derived mesenchymal stem cells (ADMSCs) in rats osteoarthritis caused by anterior cruciate ligament transection. METHODS: Rats peritoneal adipose tissues were used to extract ADMSCs.Cell morphological appearance was documented and flow cytometric cell cycle was used to identify ADMSCs. Anterior cruciate ligament transection was used to induce knee osteoarthritis in rats. ADMSCs were injected into the knee cavities. Knee joint pathology was performed to observe the treatment effects. QRT-PCR and Western blot were used to identify the targets of ADMSCs. RESULTS: ADMSCs were successfully extracted, separated, cultured and identified. Two and eight weeks after ADMSCs transplantation, pathology showed significantly attenuation of arthritis including osteophyte and synovitis, reflecting in significantly improvement of both osteophyte and synovitis grading compared to the controls. QRT-PCR and Western blot revealed that collagen Ⅱ expression was significantly up-regulated after ADMSCs transplantation compared to the controls.MMP-13, but not other MMP-1, MMP-3 or MMP-9 was reduced when ADMSCs were co-cultured with primary chondrocytes. DDR-2 expression in chondrocyte was heavily up-regulated when stimulated by TNF-α in vitro. However, ADMSCs could reverse the effect when co-cultured with chondrocyte, implying that ADMSCs may suppress the expression of DDR-2. IL-1ß suppressed the cartilage differentiation of ADMSCs, and Actinomycin D (DDR-2 inhibitor) could reverse the effect. CONCLUSION: ADMSCs can attenuate osteoarthritis induced by anterior cruciate ligament transection in rats by suppressing the expression of MMP-13, and the upstream target spot may be DDR-2.

A set of polymorphic trinucleotide and tetranucleotide microsatellite markers for silver crucian carp (Carassius auratus gibelio) and cross-amplification in crucian carp.

Silver crucian carp (Carassius auratus gibelio Bloch), as a gynogenetic fish, is a promising model for the study of the evolutionary genetics of vertebrates. We have developed 59 polymorphic trinucleotide and tetranucleotide markers for the silver crucian carp through the biotin capture method and radioactive-labeling hybridization. The number of alleles ranged from 2 to 12 in the population, and the average proportion of heterozygotes (including tri- and diallelic) at polymorphic loci was 76.8%. In addition, these loci were successfully applied to a close relative, the crucian carp (Carassius auratus), by cross-amplification, as shown by the range of alleles (2-19), observed heterozygosity (0.1765-0.9706), expected heterozygosity (0.2392-0.9421), and polymorphism information content (0.2186-0.9236).