Objective To investigate the effect of DMARDs on the prevention of early-onset atherosclerosis in rheumatoid arthritis ( RA) patients for exploring an appropriate schedule to reduce cardiovascular events. Methods Seventy-two patients with early RA were included in this study. Erythrocyte sedimentation rate ( ESR) and high sensitivity C reactive protein ( hs-CRP) were detected before and after treatment to evaluate inflammation. Carotid intima-media thickness ( cIMT) and endothelium-dependent flow-mediated vasodilatation (ED-FMD) were monitored. Disease Activity Score in 28 Joints (DAS28) and health assessment questionnaire-disability index ( HAQ-DI) was used to assess severity degree of RA and life quality of the patients, respectively. The patients were treated with methotrexate (MTX), hydroxychloroquine (HCQ) and sulfasalazine (SSZ) alone or combined based on severity of RA. Results After 1 year of treatment, ESR, hs-CRP, DAS28 and HAQ-DI were significantly improved (all P<0. 01). At the same time, the serum lipid levels also had obvious changes. However, there was no obvious difference in body mass index ( BMI) after 1 year. The cIMT ratio value was significantly decreased compared to baseline (0. 43±0. 08 mm vs. 0. 50±0. 16 mm, P=0. 002), and FMD% also significantly improved from basic value of 5. 26 to 7. 57 after treatment (P=0. 041). Conclusion Early intervention of RA by using DMARDs can effectively control the disease and slow the progression of atherosclerosis, but also reduce cardiovascular mortality.

Objecfive To study T cell subsets distribution in peripheral blood from patients with ankylosing spondylitis(AS)and the role of cell immunity in AS.Methods 30 patients with untreated active phase AS and 30 healthy volunteers were enrolled.The expression of CD4+ and CD8+ T cell subsets were evaluated by flow eytome try.The correlation among T cell subsets and Bath AS function index(BASFI).Bath AS measurement index(BASMI),course of disease,age,ESR,hyper-sensitive C-reactive protein (hs-CRP) were analyzed.Results The level of CD4+ T cell and CD4/CD8+ratio were significantly lower than that of healthy volunteers[(29.24±9.22)% vs.(40.09±6.86) %,(0.96±0.49 ) vs.(1.70±0.67 ),P ＜ 0.01 ],and CD8+ T cell were significantly higher than that of healthy volunteers [(32.91±6.86) % vs.(25.60± 5.97 ) %,P ＜ 0.01 ].The level of CD4+ T cell subsets in peripheral blood of AS patients was negatively correlated with BASMI (r =-0.479,P ＜ 0.01 ),and CD8+ T cell subsets were positively correlated with ESR,hs-CRP,BASFI and BASMI ( r = 0.373,0.430,0.462,0.530,P ＜0.05 ).The ratio of CD4+/CD8+ was negatively correlated with hs-CRP,BASFI and BASMI (r = -0.465,- 0.473,- 0.426,P ＜ 0.05 ).CD4+,CD8+,ratio of CD4/CD8 were not significantly correlated with age and course of disease in patients with AS.Conclusion T cell subsets are significantly abnormal in peripheral blood of patients with AS,and the imbalance degree of T cell is correlated with severity and activity of AS,suggesting that T cell subsets imbalance plays an important role in the pathologensis of AS.

Objective To investigate and analyze the adverse effect(AE) of methotrexate(MTX)in rheumatoid arthritis(RA).MethodsThree hundred and twenty-five RA patients were investigated with a questionnaire in clinical service of department of Rheumatology and Immunology, Peking University People's Hospital. SPSS 11.5 software was used for statistical analysis. Results① The total prevalence of AE was 34.2％. Among these, gastrointestinal AE were the most common, others included elevated liver enzymes,leucocytopenia,alopecia and dental ulcer. The incidence of drug withdrawal of MTX was 13.2％, elevated liver enzymes was the most common reason of withdrawal, other reasons were gastrointestinal AE, leucocytopenia,dental ulcer and alopecia. The gastrointestinal AE and dental ulcer occurred within one week after initiating the medication in average, while elevated liver enzymes and leucocytopenia usually occurred at about 1～2 months after the medication. ②The incidence of AE increased with the dosage. ③ Folic acid could significantly decrease the total incidence of AE(P＜0.05). The incidence of gastrointestinal AE, elevated liver enzymes,leucocytopenia and dental ulcer couldbe reduced by folic acid supplementation(P＜0.05).Conclusion The AE of MTX in RA treatment are common, many of which are slight and could be improved by reducing the dosage or symptomatic treatment. The AEs of MTX can be improved by folic acid supplement treatment.

Objective To screen for the miR-155 expression in synovial fibroblasts of rheumatoid arthritis (RASFs) and osteoarthritis (OASFs) and to evaluate the function of miR-155 on RASFs and its possible target mRNAs. Methods The expression levels of miR-155 in RASFs and OASFs were detected by real-time PCR. MiR-155 mimic and miR-155 inhibitor, as well as scrambled control were transfected into cultured RASFs by Lipofectamine 2000. Forty-eight hours later, MMP-3 levels in the cell culture supernatant were detected by ELISA and fibroblast proliferation was assayed by 3H -TdR incorporation test. Fibroblast invasive ability was tested by transwell system. IKBKE which previously identified as actual target of miR-155 was examined by real-time PCR. Comparisons between groups were performed with t test or one-way ANOVA analysis. Results It was shown that miR-155 was up-regulated in RASFs (1.79 ±1.94) and it was higher than that in OASFst (0.11±0.17), P<0.05]. Up-regulation of miR-155 could decrease MMP-3 levels (P<0.05). The proliferation and invasion of RASFs transfected with miR-155 were both evidently suppressed (P<0.05), while reducing the endogenous miR-155 could significantly enhance RASF proliferation (P<0.05). The expression of IKBKE of RASFs transfected with miR-155 was obviously down-regulated compared to those transfected with the scrambled control (P<0.05). Conclusion miR-155 is up-regulated in RASFs which may be a protective factor against the inflammatory effect, at least partially by attenuating the expression of IKBKK.

Objective ① To Screen for the miRNAs differently expressed in the peripheral blood mono-nuclear cells (PBMCs) of rheumatoid arthritis (RA) by microarray experiments.② To further evaluate the expression of miR-155 in PBMCs of RA.③ To determine the relevance between the expression of miR-155 and clinical as well as laboratory features.④ To test whether inflammatory mediators can induce miR-155 expression in PBMCs of RA.Methods ① Total RNA was isolated from peripheral blood mononuclear cells obtained from 5 patients of RA and 5 normal controls.Expression profiling of miRNAs was performed in a microarray analysis.② MiR-155 was identified for further study by stem-loop real-time RT-PCR based on SYBR-Green.PBMC from 26 patients of RA and 23 normal controls were collected.③ Association between miR-155 and the clinical and laboratory features of RA was evaluated.④Induction of miR-155 following stimulation with TNF-α, IFN-γ and LPS of cultures of RA PBMCs was examined by real-time RT-PCR.Statistical analysis was done with student's t test, paired t test, and ANOVA, Spearman correlation.Results ① Expression profiling of miRNAs revealed significant differential expression of 14 miRNAs, of which signal intensity changed over two times.MiR-155 was up-regulated in PBMCs of RA than in normal controls (t=9.218, P=0.001).② The expression level of miR-155 had a positive correlation with serum CRP level (r=0.57, P=0.002).③ Expression of miR-155 was markedly up-regulated in PBMCs of RA after stimulated with TNF-α,IFN-γ and LPS, especially with TNF-α.Conclusions The expression of miR-155 is induced by stimulating with TNF-α, IFN-γ and LPS.MiR-155 may be a regulator in RA pathogenesis.Further studies are required to elucidate the function of miR-155.

Objective To investigate the association between the tumour necrosis factor-α-863(TNF-α-863) polymorphism and gout in Han population from the city of Tangshan.Methods We recruited 80 gout patients and 80 healthy individuals into this study.The polymorphisms of TNF-α-863 site were analyzed by polymerase chain reaction-ligase detection reaction(PCR-LDR).The frequencies of different TNF-α-863 genotypes/alleles were analyzed in the gout group and the control subjects.Results No significant differences were observed in the genotype frequencies(x2=2.8807,P=0.0897) and allelic frequencies(x2=4.2646,P=0.1187) of TNF-α-863 site in the comparison between gout and control groups.Conclusion The result of our study suggests that the polymorphism of TNF-α-863 site may not related to gout in Han population in Tangshan.

Objective:To explore the association between chest high resolution CT (HRCT) scoring and prognostic factors of interstitial lung disease (ILD) in patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM).Methods:The patients with DM admitted to Kailuan General Hospital between January 2017 and December 2019 were included into the study including 13 patients with positiveanti-MDA5 antibody (7 survivors, 6 deaths) and 18 patients with anti-synthase (ARS)-antibody positive. All patients underwent chest HRCT prior to treatment. The consolidation, ground-glass opacity (GGO) and fibrosis were scored to assess HRCT findings. The clinical manifestations were compared between the two groups. Cox regression analysis adjusted for age and sex was used to determine the prognostic factors for anti-MDA5 antibody-related ILD.Results:Compared with ARS patients, glutamyl transferase (GGT) and ferritin levels were significantly higher in MDA5-ILD patients [70.0(37.0, 122.5) vs 21.0(16.5, 33.5), Z=-3.37, P=0.001; 977.0(502.5, 1 366.0) vs 307.1(72.3, 546.9) , Z=-3.44, P=0.001]. The cumulative survival rate was significantly lower in patients with positive anti-MDA5 antibody than in those with positive anti-ARS antibody (100% vs 70%, P=0.001). The DM complicated with acute/subacute interstitial pneumonia (A/SIP) were found to significantly relate to death. There were no significant differences in chest HRCT scoringbetween the survivors and the deceased patients [ HR=1.08, 95% CI(0.95, 1.23), P=0.229; HR=0.97, 95% CI(0.72, 1.30), P=0.814]. Conclusion:Anti-MDA5 antibody is an important index for early diagnosis of DM complicated with acute/subacute interstitial pneumonia (A/SIP). The chest HRCT scoreis is not associated with the prognosis of anti-MDA5 antibody-related ILD patients.

Objective To investigate the effects of different dietary patterns on brachial ankle pulse wave velocity in northern industrial cities. Methods According to the selection criteria,from 2014 to 2015, 22436 health checkup persons were selected as the subjects of Kailuan Group,they were followed up with health examination and questionnaire investigation, at the same time, the brachial ankle pulse wave velocity was detected. According to the dietary advice given by the Chinese dietary guidelines,the proportion of animal and plant food in the food frequency questionnaire and the supply of nutrients are divided into 4 groups,which are the traditional Chinese diet group (3 585 cases),the Western diet group (13 639 cases),the balanced diet group (1 309 cases),the Mediterranean diet group (3 903 cases). Logistic multivariate regression analysis was used to analyze he risk factors of atherosclerosis. Results The mean value of brachial ankle pulse wave velocity in 22 436 cases was ( 1 462. 46 ± 320. 69) cm/s, and the incidence of peripheral arteriosclerosis was 50. 78%(11 392/22 436). The incidence of arteriosclerosis around the balanced diet group, the Mediterranean diet group,the traditional Chinese diet group and the Western diet group were 48. 82%( 639/1 309), 49. 12%(1 917/3 903),50. 49%(1 810/3 585),51. 51%(7 026/13 639),and the difference between the groups was statistically significant (P＝0. 024); after adjusting other related risk factors,compared with the balanced diet group,the risk of peripheral arteriosclerosis in the Mediterranean diet group,the traditional diet group and the Western diet group was 121(95%CI:0. 557～2. 258),1. 015(95%CI:0. 663～1. 554),1. 033(95%CI:0. 677～1. 575), respectively. Conclusion The incidence of peripheral arteriosclerosis increased gradually in the balanced diet group,the Mediterranean diet group,the Chinese traditional diet group and the Western diet group, but there was no statistical significance in the risk of peripheral arteriosclerosis after adjusting other related risk factors. This Conclusion requires more large samples,long-term follow-up study to further confirm.

OBJECTIVETo investigate the association between exposure to the famine during early life and elevated resting heart rate (RHR) in adulthood.

METHODFrom June 2006 to October 2007, the employees of kailuan group who took part in the health examination were selected. Of those, 18 619 cases who was born during October 1, 1956 to September 30, 1964 in Hebei province were finally included in the analysis based on the inclusion and exclusion criteria. All the subjects were received questionnaire survey, smoking and drinking, physical examination, Lab examination and the measurement of RHR. The subjects of famine exposure group (3 190 cases) were born from October 1, 1959 to September 30, 1961, semi-exposure group (3 851 cases) were born from October 1, 1958 to September 30, 1959 and from October 1, 1961 to September 30, 1962, control group (11 578 cases) were born from October 1, 1956 to September 30, 1958 and from October 1, 1962 to September 30, 1964. The RHR and the detection rate of elevated RHR were compared among the three groups. The Multivariate logistic regression model was used to analyze the association between of exposure to famine during early life and elevated RHR in adulthood.

RESULTSThe RHR level was higher in famine exposure group and semi-exposed group than control group, which were (74.34 ± 9.71), (74.41 ± 9.48) and (73.90 ± 9.45) beat per minute (bpm) (P values were 0.003 and 0.020, respectively). In all of the subjects. The results of multivariate logistic regression showed that exposure of famine during early life increased the risk of elevated RHR in adulthood after adjustment for age, gender and other confounders (OR = 1.10, 95% CI: 1.01-1.21). In men, exposure of famine during early life also increased the risk of elevated RHR in adulthood (OR = 1.15, 95% CI: 1.04-1.28); In women, there was no association between the famine exposure and elevated RHR (OR = 0.92, 95% CI: 0.74-1.14).

CONCLUSIONExposure of famine during early life increases the risk of elevated RHR in adulthood. This negative effect existed mainly in the male.

Adult ; Alcohol Drinking ; China ; Female ; Heart Rate ; Human Development ; Humans ; Logistic Models ; Male ; Risk Factors ; Smoking ; Starvation

Objective To explore the relationships between metabolic syndrome (MS) and rheumatoid arthritis (RA).Methods Two hundred and forty RA patients who fulfilled the 1987 revised American College of Rheumatology (ACR) classification criteria,and 250 age and sex matched healthy controls were enrolled.The frequency of metabolic syndrome was assessed using three Metabolic Syndrome definitions (Guidelines on Prevention and Treatment of Blood Lipid Abnormality in Chinese Adults 2016,International Diabetes Federation 2005,National Cholesterol Education Program 2005).Data were analyzed by Chi-square test and t test,risk factors were identified by Logistic regression.Results ① According to the definition used,the frequency of metabolic syndrome varied from 28.3％ to 35％ in RA,which was significantly higher than controls.② In RA with MS group defined by guidelines on Prevention and Treatment of Blood Lipid Abnormality in Chinese Adults 2016,the age,the diseases duration,erythrocyte sedimentation rate (ESR),DAS28,health assessment questionnaire (HAQ) scores and dose of glucocorticoid used were higher than controls [(12±6) years vs (10±7) years,t=6.96,P=0.01,(32±9) mm/1 h vs (26±6) mm/1 h,t=4.66,P=0.008,(3.7±1.2) vs (2.6±1.0),t=3.78,P=0.01,(1.6±0.5) vs (1.2±0.5),t=3.42,P=0.017],the percentage of patients who received anti-tumor necrosis factor α therapy was lower than the control group (39.7％ vs 23.7％,x2=6.881,P=0.009).③ In multivariate analysis,long disease duration,high ESR and HAQ scores were independently associated with the presence of MS [OR(95％CI):1.489(0.382,0.624),1.555(0.423,0.729),1.603(0.423,0.858),P＜0.01].Being treated with anti-tumor necrosis factor α was an independent protector of the presence of metabolic syndrome in RA patients [OR=0.582,95％CI(0.453,0.742),P＜0.01].Conclusion The frequency of metabolic syndrome in RA is higher compared to controls,while diseases duration,ESR,and HAQ are independent predictors for the presence of metabolic syndrome in patients with RA,anti-TNF-α therapy may be protective factor for the presence of metabolic syndrome in patients with RA.