[A cross-sectional study on the clinical phenotypes of rheumatoid arthritis].

OBJECTIVE: To explore the characteristics and clinical phenotypes of rheumatoid arthritis (RA) and provide the basis for further understanding, interventions and outcomes of this disease. METHODS: RA patients attended at Peking University People's Hospital from 2018 to 2021 were enrolled in the study. Data collection included demographic data, the sites and numbers of joints involved, extra-articular manifestations (EAM), comorbidities and laboratory variables. Statistical and bioinformatical analysis was performed to establish clinical subtypes by clustering analysis based on the type of joint involved, EAM involvement and other autoimmune diseases overlapped. The characteristics of each subtype were analyzed. RESULTS: A total of 411 patients with RA were enrolled. The mean age was (48.84±15.17) years, and 346 (84.2%) were females. The patients were classified into 4 subtypes: small joint subtype (74, 18.0%), total joint subtype (154, 37.5%), systemic subtype (100, 24.3%), and overlapping subtype (83, 20.2%). The small joint subtype had no medium or large joint involvement, and 35.1% had systemic involvement. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels and platelet count (PLT) were lower than those in other subtypes, and the rates of positive rheumatoid factors (RF-IgA and RF-IgG) were significantly higher in the small joint subtype. The total joint subtype had both large and small joint involvement but no systemic involvement. The rate of morning stiffness and positive antinuclear antibodies (ANA) in this subtype were lower than those in other subtypes. In the systemic subtype, interstitial lung disease and secondary Sjögren syndrome were the most common systemic involvements, with prominent levels of disease activity score 28-joint count (DAS28-ESR and DAS28-CRP). The overlapping subtype was commonly combined with Hashimoto's thyroiditis or primary Sjögren syndrome. Female in the overlapping subtype was more common than in other subtypes. This subtype was characterized by hyperglobulinemia, hypocomplementemia and high rate of positive ANA, especially spotting type. CONCLUSION: Based on the clinical features, RA patients could be classified into 4 subtypes: small joint subtype, total joint subtype, systemic subtype, and overlapping subtype. Each subtype had its own clinical characteristics. They help for further understanding and a more individualized treatment strategy of RA.

[Progress in the epidemiological studies on coal mine dust exposure with workers' health damage].

Coal is one of the major fuels, which brings huge energy and economic benefits to global industry and daily life. large amounts of coal dust produced in the process of coal mining and transportation, which seriously threatens the health of related workers. Productive coal dust exposure not only directly leads to respiratory diseases, but also may cause health damage to various systems throughout the body. Numerous studies have shown that coal dust exposure is closely associated with decreased lung function, coal worker's pneumoconiosis, chronic obstructive pulmonary disease, lung cancer, and cardiovascular diseases, and the severity of diseases is affected by coal rank, coal dust concentration, cumulative dust exposure, coal dust composition, and individual lifestyle, etc. The article comprehensively summarized the progress of the epidemiological studies on the health hazards of coal miners from coal dust exposure, in order to provide clues for further researches on health damage and protect the health of the occupational population.

[Clinical characteristics of 500 hospitalized patients with liver cirrhosis: a retrospective analysis from a tertiary hospital in Beijing].

Objective: To understand the clinical characteristics of hospitalized patients with liver cirrhosis, so as to provide theoretical basis for disease diagnosis and treatment, formulation of intervention measures, and improve the level of disease diagnosis and treatment. Methods: Hospitalized patients who were initially diagnosed with liver cirrhosis at Peking University First Hospital from August 2017 to December 2018 were selected retrospectively as the research objects. Liver cirrhosis demographic data, etiology, severity classification, incidence of complications, diagnosis and prognosis were recorded. Statistical analysis was performed using SPSS software. Results: Among all liver cirrhosis cases, there were 291 males and 209 females, with a male-to-female ratio of 1.4:1 and an age of 59.5±12.9 years as at August 2017 to December 2018. HBV infection, alcoholic liver disease, and autoimmune liver diseases were the most common etiology of liver cirrhosis. HBV infection alone, HBV infection combined with other factors, alcoholic liver disease alone, alcoholic liver disease combined with other factors, autoimmune liver disease alone, and autoimmune liver disease combined with other factors were presented in 163 (32.6%), 57 (11.4%), 47 (9.4%), 63 (12.6%), 85 (17.0%), and 22 (4.4.0%) cases, respectively. Ascites (221 cases, 44.2%), followed by esophagogastric varices (214 cases, 42.8%), and other including hypersplenism (137 cases), liver cancer (126 cases), upper digestive system tract hemorrhage (66 cases), hepatic encephalopathy (40 cases), infection (37 cases), portal vein thrombosis (23 cases), hepatorenal syndrome (20 cases) were the most common complications. The most common site of infection was the abdominal cavity (20 cases), accounting for 54.1%; followed by respiratory tract infection (8 cases), accounting for 21.6% in patients with liver cirrhosis with concurrent infection. Among them, there were 32 cases of bacterial infection alone, one case of bacterial infection combined with fungal infection, one case of bacterial infection combined with viral infection, and three cases of unknown pathogens. There were 69 cases in Child Pugh grade C, and the average hospitalization times were 12.6 days in terms of prognosis. There were total seven cases of death, of which five cases were due to upper gastrointestinal hemorrhage and two due to hepatic encephalopathy. Conclusion: HBV infection, ascites, and upper gastrointestinal bleeding were the most common etiologies, complications, and causes of death in patients with liver cirrhosis at our hospital.

[Retrospective analysis of risk factors of liver cirrhosis combined with overt hepatic encephalopathy: a single -center case-control study].

Objective: To explore the risk factors of overt hepatic encephalopathy (OHE) in patients with liver cirrhosis. Methods: A retrospective study was designed. Patients with liver cirrhosis combined with /without OHE who were hospitalized to our hospital during the same period were selected as the case/control group. Clinical and laboratory data of both groups of patients were compared to analyze the risk factors affecting the occurrence of OHE. SPSS software was used for statistical analysis. A t-test or rank-sum test was used to compare the measurement data. Chi-square test or Fisher's exact probability method was used to compare the count data. Logistic regression was used for multivariate analysis. Results: A total of 500 patients with liver cirrhosis diagnosed in our hospital from August 2017 to December 2018 were selected as the case group, and 40 cases with cirrhosis without OHE who were hospitalized during the same period were randomly selected as the control group. The gender composition and age of the case and control group were comparable. Viral hepatitis (mainly hepatitis B) was the main etiology of liver cirrhosis in both groups. There were 52.5% patients in the case group and 57.5% patients in the control group, respectively. Alcoholic liver disease, autoimmune liver disease and so on were the other included causes. With regard to blood biochemical indicators, the serum creatinine levels of both groups were comparable, but in the case group, the serum total bilirubin level was higher (34.30 µmol / L vs. 18.65 µ mol/L, Z = -3.185, P < 0.05), while the serum sodium level was lower (137.00 mmol/L vs. 140.08 mmol/L, Z = -2.348, P < 0.05), and the prothrombin time was longer (14.60 s vs. 12.20 s) s. 078, P < 0.05), and international normalized ratio (1.33 vs. 1.07, Z = - 5.632, P < 0.05), and serum albumin level (30.6 g/L vs. 35.6 g/L, t = 3.386, P < 0.05) was lower. In terms of complications, patients in the case group had a higher proportion of combined gastrointestinal bleeding (30.0% vs. 10.0%, χ(2) = 5.000, P < 0.05), ascites (87.5% vs. 30.0%, χ(2) = 27.286, P < 0.05) and secondary infection (32.5% vs. 10.0%, χ(2) = 7.813, P < 0.05). In terms of severity classification, the proportion of Child-Pugh C in the case group was higher (62.5% vs. 10.0%, χ(2) =26.593, P < 0.05). In terms of outcome, there were 3 deaths in the case group and no deaths in the control group. Multivariate analysis showed that Child-Pugh class C (OR = 12.696), and combined ascites (OR = 10.655) were an independent risk factor for OHE in patients with liver cirrhosis. Conclusion: Our single-center retrospective clinical study shows that patients with cirrhosis combined with OHE are more critical and have more complications. In order to promptly diagnose and treat OHE, more attention should be paid to patients with combined ascites and Child-Pugh class C.

[The renal protective effect and mechanism of liraglutide in diabetic mice induced by high-fat diet].

Objective: To investigate the protective effect of liraglutide on kidney of diabetic mice induced by high-fat diet and its possible mechanisms. Methods: C57BL/6J male mice were randomly divided into normal chow diet (NC) group and high-fat diet (HFD) group, which were fed with normal chow diet and HFD for 12 weeks respectively. After diet challenge, the mice were randomly divided into normal control group, normal chow diet with liraglutide treatment (NC+Lira) group, HFD group and high-fat diet with liraglutide treatment (HFD+Lira) group. The mice in NC+Lira and HFD+Lira groups were given intraperitoneal injection of liraglutide (400 µg·kg(-1)·d(-1)) for 8 weeks, while mice in NC and HFD groups were given intraperitoneal injection of same amount of normal saline. Urinary albumin and creatinine levels were measured by enzyme-linked immunosorbent assay (ELISA). Renal morphology was observed by HE staining. The expression levels of silent mating type information regulation 2 homolog 1 (SIRT1) and thioredoxin-interacting protein (TXNIP) were determined by Western blot. Results: Compared with HFD group, liraglutide significantly lowered the body weight [(30.98±1.29) g vs (39.43±2.58) g], fasting blood glucose (FBG) [(7.21±0.15) mmol/L vs (9.55±0.29) mmol/L] and urinary albumin/creatinine ratio (ACR) [(205.48±17.14) µg/mg vs (319.86±34.14) µg/mg] in HFD+Lira group (all P<0.05). HE staining showed that glomerular hypertrophy of HFD group alleviated after liraglutide treatment. The expression level of TXNIP in the kidney of HFD mice significantly decreased after liraglutide treatment (0.41±0.10 vs 3.50±0.70), while expression level of SIRT1 significantly increased (0.75±0.15 vs 0.32±0.04) (both P<0.05). Conclusion: Liraglutide could improve diabetic nephropathy by up-regulation of SIRT1 expression and down-regulation of TXNIP expression in diabetic mice induced by HFD.

[Effect of triptolide on human oral cancer cell proliferation and PTEN gene mRNA expression in oral cancer].

Objective: To investigate the effect of triptolide on human oral cancer cell (HB) proliferation and phosphates and tensin homologue deleted on chromosome ten gene (PTEN) mRNA expression in oral cancer. Methods: The cancer cells were cultured in the medium containing triptolide of different concentrations for 24, 48 and 72 h. Methyl thiazolyl tetrazolium (MTT) method was used to test the rate of growth inhibition of cancer cells, flow cytometer to detect the change of cell cycle and reveres transcription-PCR (RT-PCR) to examine the expression of PTEN mRNA. The expression of PTEN protein was examined by Western blotting. Results: The rate of growth inhibition was (26.92 ± 0.14)%, (38.67 ± 0.11)%, (72.62 ± 0.89)% and (90.42 ± 0.28)%, respectively. The corresponding expression of PTEN mRNA was (3.59±0.21)%, (5.27±0.40)%, (7.18±0.44)% and (9.16±0.50)%, respectively and the corresponding A value of PTEN protein was 0.135±0.007, 0.410±0.020, 0.447±0.017 and 0.884±0.066, respectively. The proportion of G1 phase cells increased from (58.78±0.98)% to (84.13±0.47)%, but the proportion of S phase cells decreased from (25.40±0.43)% to (9.41±0.73)%. Conclusions: The triptolide not only had inhibitory effect on the HB proliferation, but also affected the cell cycle.

ESR dating of tooth enamel: comparison with U-series, FT and TL dating at the Peking man site.

Deer tooth samples from Zhoukoudian, the Peking Man Cave, were studied. Non-linear fitting is used to determine AD, from which ESR ages were calculated by both the disequilibria model (DU) and linear uptake model (LU). Comparison of ESR ages with those from U-series, FT and TL methods show that the enamel of deer teeth is a suitable material for ESR dating.