Echocardiographic assessment of cardiac systolic function in patients with systemic lupus erythematosus using non-invasive pressure-strain loop / 中华超声影像学杂志

Objective:To observe the feasibility of evaluating right ventricular (RV) function by the method based on left ventricle (LV) pressure-strain ring (PSL) technique in patients with systemic lupus erythematosus (SLE), and to evaluate the efficacy of non-invasive PSL in the diagnosis of dysfunction of both LV and RV.Methods:Thirty-nine patients were enrolled with SLE who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from March 2020 to September 2021 and 57 sex- and age-matched healthy controls underwent assessment by conventional echocardiography, two-dimensional speckle tracking imaging (2D-STI) and myocardial work (MW). The echocardiographic parameters were compared between the groups. The correlations between RVMW parameters and conventional echocardiographic parameters, and between MW parameters and SLEDAI-2K score were analyzed by Spearman correlation analysis.Results:①The two groups did not show any difference at the conventional echocardiographic parameters of the LV systolic function ( P>0.05). In the SLE group, tricuspid regurgitation maximal velocity (TR V max) and right ventricular index of myocardial performance (RIMP) increased, tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular S′ (S′ tv) decreased (all P<0.05), and others did not show statistical difference (all P>0.05). ②The 2D-STI parameters: There were no significant differences in left ventricular global longitudinal strain (LV GLS) ( P>0.05), however RVGLS decreased ( P<0.05). ③The MW parameters of LV and RV: including global constructive work (GCW), global work index (GWI), global wasted work (GWW), and global work efficiency (GWE). In SLE group, LV GWE, RV GWE decreased and LV GWW, RV GWW increased ( P<0.05), others were no significant differences ( P>0.05). ④The correlation analysis: RV GWI positively correlated with TR V max ( rs=0.481). RV GCW positively correlated with TR V max ( rs=0.587). RV GWW positively correlated with right atrial area (RAA) and TR V max ( rs=0.429, 0.610), negatively correlated with S′ tv ( rs=-0.342). RV GWE positively correlated with S′ tv ( rs=0.326) and negatively correlated with RAA ( rs=-0.462) (all P<0.05). SLEDAI-2K score was negatively correlated with LV GLS ( rs=-0.333) and LV GWI ( rs=-0.326) ( P<0.05). Conclusions:The study has shown the impaired systolic function of both LV and RV in patients with SLE. PSL technique, especially RVMV based on LV PSL technique might emerged as a novel measure to evaluate systolic dysfunction in SLE patients.

Associations of Changes in Serum Inflammatory Factors, MMP-3, 25(OH)D and Intestinal Flora with Osteoporosis and Disease Activity in Rheumatoid Arthritis Patients.

BACKGROUND: To explore the associations of changes in serum inflammatory factors, matrix metalloproteinase-3 (MMP-3), 25-hydroxy vitamin D [25(OH)D], and intestinal flora with osteoporosis and disease activity in rheumatoid arthritis (RA) patients, so as to provide references for clinical diagnosis and treatment. METHODS: A total of 98 RA patients were selected as the objects of study (RA group), and divided into active-stage group (n = 56) and remission-stage group (n = 42) according to the disease activity score (DAS28). Another 50 healthy people receiving physical examination in our hospital during the same period were selected as the control group. The changes in serum inflammatory factors, MMP-3, 25(OH)D, and intestinal flora were compared among the three groups, and the osteoporosis of the subjects was analyzed in each group. Moreover, the associations of changes in serum inflammatory factors, MMP-3, 25(OH)D, and intestinal flora with osteoporosis and disease activity in RA patients were analyzed using the Pearson's method. RESULTS: Compared with those in the control group, the levels of serum MMP-3, interleukin-6 (IL-6), IL-10, and C-reactive protein (CRP). The Escherichia coli count were significantly increased, while the level of serum 25(OH)D, bone mineral density (BMD), and Lactobacillus and Bifidobacterium counts were significantly decreased in the active-stage group and remission-stage group, more obviously in active-stage group (p < 0.05). The osteoporosis and disease activity in RA patients were positively correlated with serum IL-6, IL-10, CRP, MMP-3, Escherichia coli and BMD, but negatively correlated with 25(OH)D, Lactobacillus and Bifidobacterium (p < 0.05), and not correlated with the sharp score (p > 0.05). CONCLUSIONS: There are certain associations of changes in serum inflammatory factors, MMP-3, 25(OH)D, and in-testinal flora with osteoporosis and disease activity in RA patients, showing certain value in clinical application.

A case of systemic sclerosis sine scleroderma and a literature review / 中华风湿病学杂志

Objective Systemic sclerosis sine scleroderma (ssSSc) is a rare type of systemic sclerosis,comparison between ssSSc and other types of systemic sclerosis (SSc),ssSSc is carried out in this study.Methods We reported a patient with Raynand's phenomenon,esophagus,intestine and lung involvement,positive ANA,anti-Scl-70 antibody,but had no skin sclerosis.Results For visceral involvement,ssSSc was not different from limited cutaneous systemic sclerosis (lcSSc),The incidence of pulmonary hypertension was higher in patients with ssSSc,lower with calcinosis,finger ulcer and acral dissolution,and the incidence of ssSSc and lcSSc interstitial lung disease was higher than that of diffuse cutaneous systemic sclerosis,(dcSSc).Conclusion Although ssSSc do not have skin sclerosis,however,visceral involvement is more extensive.Early diagnosis and treatmeat is extremely important.

Investigation of the risk of hepatitis B virus reactivation in arthritis patients undergoing anti-tumour necrosis factor alpha therapy / 中华内科杂志

Objective To investigate the prevalence of HBV infection and the risk of hepatitis B virus (HBV) reactivation in patients with inflammatory arthritis receiving tumour hecrosis factor alpha (TNFα) inhibitors.Methods The liver function,serology of HBV and viral loads (HBV DNA) were tested before using TNFα inhibitors,at 3 months and 6 months.Patients with chronic hepatitis B (CHB) infection (HBV DNA ＞ 1 × 103copies/ml) were eliminated.Results A total of 162 patients were investigated including 156 patients who finished the study.Eleven (7.05％) patients were HBsAg-positive.Two patients with HBV DNA ＞ 1 × 103copies/ml were eliminated before starting anti-TNFα therapy.Among HBsAgpositive patients,HBV reactivation was documented in only one of the 11 patients.This patient with rheumatoid arthritis developed elevation of glutamic-pyruvic transaminase (ALT) and HBV DNA copies three months after infliximab therapy.Therefore lamivudine was given for three months,which translated into the fall of ALT and HBV DNA copies back to normal level.After follow-up for six months,the virology and serology remained stable.In contrast,none of the other 155 patients had demonstrated evidence of HBV infection or HBV reactivation.Conclusion The kinetics of HBV viral loads should be carefully monitored in patients with inflammatory arthritis and HBsAg-positive during anti-TNFα therapy.HBV reactivation should be treated with antiviral medicine through out the period of anti-TNFα therapy.

[Epidemic analysis of HIV-1 incidence using BED-CEIA assay in Tianjin, China, 2010].

OBJECTIVE: To explore the epidemic characteristics of HIV-1 recent infection among high-risk populations in Tianjin and to provide reasonable evidence for intervention strategy. METHOD: Blood samples were detected using BED-CEIA to identify recent HIV-1 infection, and HIV/AIDS cases in Tianjin 2010 were collected to analyze epidemic data. RESULTS: 349 of reported HIV/AIDS cases were confirmed from total 777 207 people. ALL of 87 HIV-1 recent infections were males and mainly detected from men who have sex with men (MSM), voluntary counseling and testing (VCT) and STD outpatients, the HIV-1 incidence of each group was 1.48%, 0.38%, 0.17% respectively. There were not significant difference in recent HIV-1 infection rate between other areas and locals. The homosexual transmission was 80.46% among recent HIV-1 infections. CONCLUSION: The results of this study showed that the homosexual contact was primary route of HIV transmission in Tianjin. The infection of HIV was serious among MSM, effective interventions should be taken for HIV/AIDS control and prevention urgently.

Association of synovial cyclic citrullinated peptide expression with Th17/Treg imbalance and synovitis in rheumatoid arthritis patients / 中华风湿病学杂志

Objective To assess the association of synovial cyclic citrullinated peptide(CCP)expression with T helper 17(Th17) cells/Regulatory T cells (Treg) imbalance,the histological and clinical features of synovitis in rheumatoid arthritis (RA).Methods CCP expression in synovial specimens from 39 patients with RA and 35 controls was detected by immunohistochemistry assay(IH) using 6×His tagged anti-CCP single chain fragment V (ScFv) antibodies,which were generated by pHEN2 phagemid recombinant antibodies display system.The frequencies of Th17/Treg cells in the peripheral blood mononuclear cells (PBMCs) were determined by flow cytometry (FCM).Th17/Treg cells associated cytokines were analyzed by enzyme-linked immunosorbent assay (ELISA).The histological scores and clinical features of synovitis were included in the study.Chi-square test and ANOVA were used for statistical analysis.Results ① The prevalences of synovial C CP expression were significantly different between RA group and the control(76.9％ and 11.4％ respectively,X2=31.9,P＜0.01).② The frequencies of Th17 cells,Th17/Treg ratio,Th17 cells associated cytokines as IL-6,IL-17a,IL-23,TNF-α,and the Treg cells associated cytokines TGF-31,the serum and synovial fluid anti-CCP antibodies in the RA patients with synovial CCP positive expression were significantly higher in RA patients with CCP positive than those with CCP negative.Disease activity score DAS28 index and histological features quantified variations of the synovial biopsy specimens (synoviocyte hyperplasia,focal aggregates of lymphocytes,and diffuse infiltrat(e)s of lymphocytes) in RA were higher in synovial CCP positive expression patients than in the negative.Conclusion Synovial CCP expression is strongly associated with the Th17/Treg imbalance and synovitis,which may play a crucial role in the pathogenesis of RA.

[Survey on recent infection of human immunodeficiency virus among men who have sex with men in Tianjin during 2008 - 2009].

OBJECTIVE: To study the situation of HIV infections among men who have sex with men (MSM) in Tianjin during 2008 - 2009 and to provide reasonable evidence for intervention strategy. METHODS: Transect investigations in MSM were conducted three times during 2008 - 2009. Blood samples were collected and detected to identify the recent HIV infection with IgG-capture BED-enzyme immunoassay (BED-CEIA) before HIV incidence was estimated. RESULTS: 1799 specimens were tested and the HIV prevalence rates of each study were 6.7%, 8.6% and 6.2%, while the incidence rates were 2.7%, 2.5% and 2.8%, respectively. The estimated incidence rates among these testees were 5.36% and 5.52% per year in 2008 and 2009. RESULTS: of this study showed that the HIV incidence stabilized at high level among MSM in Tianjin, calling for the effective interventions be taken for HIV/AIDS control and prevention.