Objective To investigate the serum concentration of interleukin (IL)-17 in patients with active rheumatoid arthritis and the clinical implication. Methods Serum IL-17 level of 51 active RA patients were assessed by enzyme-linked immunosorbentassay (ELISA). The relationship between serum levels of IL-17 in active RA patients and clinic features were analyzed. Two independent samples t test, ANOVA for repeated, one-way ANOVA and Spearman's Chi-square test were used for statistical analysis. Results ① Serum IL-17 levels were elevated in active RA patients (365±63) pg/ml than in normal controls (86±13) pg/ml (P<0.01); ② Serum IL-17 levels in active RA was correlated with morning stiffiness duration, swelling index, Ritchie index, CRP, ESR, RF, X-ray score, DAS score (r =0.423, 0.213, 0.252, 0.276, 0.346, 0.251, 0.412, 0.398; P<0.05). ③ The levels of IL-17 between phase I (296±79) pg/ml and Phase II (360±89) pg/ml, phase II and phase HI (464±74) pg/ml, Phase I and Phase Ⅳ (369±83) pg/ml in RA group were statistically significantly different (P<0.05). Conclusion The levels of serum IL-17 in active RA patients are higher than the normal controls. The elevated serum IL-17 levels may be the useful markers for active RA.In addition,interleukin-17 is involved in disease progression and bony erosion of RA, and it maybe a new treatmenttarget of RA.

Objective We investigated interleukin (IL)-23 that might play a role in the pathogenesis of rheumatoid arthritis (RA) and whether it was correlated with disease activity and clinical manifestations in axial spondyloarthritis (SPA).In addition, the Spondyloarthritis Research Consortium of Canada (SPARCC) scores was used to examine whether recombinant human tumor necrosis factor-α receptor Ⅱ IgG Fc fusion protein for injection (rhTNFR:Fc) was effective for the reduction of magnetic resonance imaging (MRI)-proven sacroiliac joint (SIJ) inflammation.Methods The serum IL-23 levels of etanercept and conven-tional treatment groups were measured using enzyme-linked immunosorbent assay kits.At the same time, SIJ MRI SPARCC score levels were assessed by MRI, the change of clinical indicators of patients was observed.ANOVA, repeated measure data of ANOVA and Spearman's correlation analysis were used for statisical analysis.Results ① The basal serum IL-23 levels of the Etanercept group were (34.2±1.8) pg/ml and those of the conventional treatment group were (34.1 ±1.8) pg/ml (F=1 073.790, P=0.991), both were significantly higher than the healthy control group (18.1±0.8) pg/ml (P=0.005).After treatment, serum IL-23 levels of the rhTNFR: Fc treatment and conventional treatment group were (24.5 ±1.7) pg/ml and (25.2±1.7) pg/ml (F=232.488, P=0.242), (19.2±0.8) pg/ml and (21.6±1.3) pg/ml (F=114.135, P=0.025), (19.0±0.8) pg/ml and(19.4± 0.8) pg/ml (F=23.374, P=0.085) respectively.A significant decrease was observed in the two groups and the serum level of IL-23 of the rhTNFR:Fc group was lower than that of the conventional group at week 12.② SIJ MRI SPARCC scores of the rhTNFR:Fc group and the conventional drugs group were (20.1± 1.2) scores and(20.7±1.5) scores (F=2003.660, P=0.191), (12.5± 0.8) scores and (15.4±0.9) scores (F=1 680.430, P=0.004), (8.8±0.9) scores and (12.8± 0.9) scores (F=972.877, P=0.002), the scores of two group were significantly decreased after treatment.At week 12, 24 of the treatment, the rhTNFR:Fc group scores were lower than the conventional drugs group.③ The serum IL-23 levels, SLJ MRI SPARCC scores and clinical index (ESR, CRP, PGA, BASDAI, BASFI, BASMI and number of painful joints) were not correlated (P＞0.05), the SIJ MRI SPARCC scores and clinical indicators were not correlated (P＞0.05).Conclusion ① The serum IL-23 levels of the rhTNFR:Fc are higher than healthy controls.② rhTNFR:Fc treatment could significantly decrease IL-23 levels and improve the sacroiliac joint inflammation compared to conventional treatment.③ SIJ MRI is a good assessment method for the detection of SpA sacroiliac joint inflammation.

Objective To investigate the serum concentration of vascular endothelial growth factor (VEGF) and its soluble receptor 1 (sFlt-1) in patients with systemic lupus erythematosus (SLE) and its correlation with clinic and pathologic parameters.Methods serum levels of VEGF and sFlt-1 in a group of 60 patients with SLE and 30 healthy controls were assessed by ELISA.Results The VEGF and sFlt-1 serum levels were higher in active SLE group than the control group (P＜0.01).The VEGF/sFlt-1 ratio in the control group was lower than that in the active SLE group.inactive SLE group and LN group (P＜0.01).Particularly the ratio increased in WHO class Ⅴ LN group compared to WHO classⅡ,Ⅲ,Ⅳ LN group (P＜0.05).The semm level of sFlt-1 was correlated to proteinuria (rs=0.6244,P＜0.01) and ESR (rs=0.4235,P＜0.01) and the serum levels of VEGF and sFlt-1 were correlated to the systemic lupus erythematosus disease activation index (SLEDAI) (rs=0.5046,P＜0.01 and rs=0.5152,P＜0.01,respectively).The serum level of VEGF was correlated with renal tissue activation index (RAI) (rs=0.3386.P＜0.05) and the serum levels of VEGF and sFlt-1 were not correlated to blood pressure,serum creatine,blood ureanitmgen,C3,C4,C-reative protein.The muhi-factors stepwise regression analysis indicated that serum VEGF was positively correlated with SLEDAI (R2=0.1 75,P＜0.05),serum sFlt-1 was positively correlated with ESR and proteinurine (R2=0.497,P＜0.05).Conclusion Serum VEGF and sFlt-1 are elevated in patients with active SLE and they can reflect the activity of the disease.The overcxpression of serum VEGF might be correlated to the proliferated glomerulonephritis and the overexpression of sFlt-1 contribhtes to proteinurla.The imbalance between these two factors may act an important role in SLE pathogenesis.

Ferroptosis is a recently discovered form of cell death that is distinct from apoptosis,characterized pri-marily by the accumulation of intracellular iron and increased levels of lipid peroxidation.Resistance of tumor cells to ferrop-tosis can promote tumorigenesis and tumor progression.Various compounds can influence tumor development by triggering ferroptosis.Ferroptosis involves complex regulatory mechanisms,with mitochondria serving as both an iron storage and meta-bolic center,playing a crucial regulatory role in ferroptosis.This review discusses ferroptosis and its three stages and the role of ferroptosis in tumorigenesis,progression,and treatment,as well as the regulatory mechanisms of mitochondria in ferroptosis.

Objective To study the factors that may influence the quality of life (QoL) in patients with systemic sclerosis (SSc) by comprehensively evaluating of the patient's condition and to provide evidence for appropriate selection of treatment.Methods Out-patients with SSc in the First Affiliated Hospital of Guangxi Medical University from November 2015 to October 2016 were retrospectively enrolled into this cross-sectional study.Their clinical data were collected.Consecutive SSc patients and 30 healthy controls were recruited and were assessed by the MOS-36 Item Short-Form Health Survey (SF-36),Health Assessment Questionnaire (HAQ),Visual Analogue Scale (VAS) and the St.George's Respiratory Questionaire (SGRQ).The extent of skin involvement of SSc was assessed by the Modified Rodnan skin score (MRSS).The SSc group was divided to diffused SSc (dcSSc) and localized SSc (lcSSc) according's to extent of skin involvement.Pearson's correlation analysis was used to assess the associated clinical indications with the QoL.Results ① Sixty-eight SSc patients were studied [mean age (52±11) years,mean disease duration (35±48) months],in which 59(87％)patients had Raynaud's pheno-menon,9(13％) patients hadfinger ulcer,16(24％) patients were complicated with PAH,and anti-Scl-70 antibody was positive in 59(87％) cases.② The SSc patients had significantly lower SF-36 scale score,including physical function (PF) (64±29),role-physical (RP) (53 ±33),bodily pain (BP)(66±19),social function (SF) (53±20),general health (GH) (58±24),vitality (VT) (53±18),role emotional (RE)(47±35),mental health (MH) (45±21),compared with the healthy-control group (t=7.726,7.132,8.586,12.29,8.296,9.526,6.893,13.973,4.384),all P＜0.01).The SSc patients had significantly higher scale scores of HAQ (t=1 1.823),VAS (t=19.578) and SGRQ (t=14.043,16.688,21.210,20.053),all P＜0.01.③ Compared with lcSSc patients,the SF-36 of dcSSc patient in the PF (F=17.035,P=0.030),RP (F=17.579,P=0.033),BP (F=23.002,P=0.032),VT (F=35.737,P=0.008) were decreased.The HAQ and VAS scale of dcSSc patients were significantly higher than lcSSc patients (F=42.541 and 110.243,P＜0.01).④ The PF,RP,VT,SF,MH of SF-36 scale score in SSc patients was inversely associated with HRCT scores (r=-5.088,-2.896,-2.566,-3.450,-4.173),MRSS (r=-3.847,-3.044,-2.651,-2.571,-2.455),but positively correlated with Complement3 (C3)(r=2.372,2.133,2.370,2.493,2.387).BP,and HAQ scores,VAS were associated with Raynaud's phenomenon (r=2.502,-2.683,-3.703) and MRSS (r=2.141,-2.683,-3.703).And VAS score was correlated with arthralgia (r=-2.943).The symptom score,activity score,influence score of SGRQ were negatively associated with HRCT score (r=4.001,-3.213,2.478),smoking-state (r=-3.040,-2.007,-2.218),all P＜0.05.Conclusion The SSc patients have impaired physical and mental function in the QoL,limited mobility,increased physical pain compared to healthy controls.DcSSc patients have worse QoL index compared with lcSSc patients.For SSc patients with pulmonary fibrosis,extensive skin involvement,high C3 level might have poor QoL.

Objective To identify the clinical characteristics and therapeutic effect of systemic lupus erythematosus (SLE) patients with diffuse alveolar hemorrhage (DAH).Methods Clinical characteristcs,diagnosis,treatment and outcome in 34 patients hospitalized in The First Affiliated Hospital of Guangxi Medical University from January 2006 to December 2016 were retrospectively analyzed.Results The incidence of DAH involvement of SLE was about 0.39％.Median age was 19 (interquartile range (IQR) 11.75 ～ 32) years.The duration of SLE before clinical DAH was 6 months (IQR 2 ～ 15.75) months.The main clinical manifestations of DAH were cough,dyspnea and fever.The SLE disease activity index (SLEDAI) score was 19.5 (16 ～ 25)points and anti-dsDNA antibody titer elevated markedly (38.2％).The overall mortality rate was 73.5％,however patients who chose department of rheumatism have lower mortality (52.9％).And treatment of CTX was associated with mortality (OR =0.059,95％ CI 0.006 ～ 0.554,P =0.013),as well as steroids and immunosuppressant combination therapy.Conclusions The clinical symptoms of SLE with DAH is often atypical.There is manifestation of cough,fever,dyspnea and etc.Imaging and broncoscopy can assist the diagnosis and its prone to the pulmonary infection and high mortality.Early diagnosis and application of CTX combined with conventional dose of hormone theraphy can in early diagnosis and reduce the mortality.

Objective:To study the clinical features and prognostic risk factors of gastrointestinal (GI) involvement in systemic lupus erythematosus (SLE), and improve clinicians' understanding of GI involvement in SLE.Methods:The clinical data of SLE patients admitted to the First Affiliated Hospital of Guangxi Medical University from September 1, 2012 to September 1, 2019 were retrospectively analyzed. Two hundred and forty-three patients with GI system involvement were the GI system affected group, and 486 patients with-out GI system involvement at the same period were randomly selected as the control group. The clinical mani-festations, laboratory tests and treatment effects of the two groups were compared by t test, Wilcoxon signed-rank test and χ2 test and Logistic regression was used to analyze the prognostic risk of SLE with GI system involvement. Results:① There were 243 SLE patients with GI involvement, with the proportion of GI involvement in SLE patients of 6.4%(243/3 820), and as the first manifestation with GI system symptoms accounted for 20.2%(49/243). The common causes were lupus hepatitis accounted for 52.3%(127/243), lupus mesenteric vasculitis (LMV) for 35.0%(85/243), pseudo Intestinal obstruction (IPO) for 9.9%(24/243), lupus-related pancreatitis for 8.6%(21/243), and protein-losing enteropathy (PLE) as 7.0%(17/243). ② Compared with the control group, the group with GI involvement had a lower average age [(38±14) year vs(32±15) year, t=-2.47, P=0.014], a shorter median duration of illness [12.0(3.0, 72.0) months vs 5.0(1.1, 24.8) months, Z=-5.67 , P<0.001], a higher median systemic lupus erythematosus disease activity index (SLEDAI) score [10(6,28) vs 16(9, 37), Z=2.24 , P<0.001], the occurrence of skin rash (38.7% vs 53.5%, χ2=14.46), arthritis (36.4% vs 46.7%, χ2=7.12 , P=0.008), myositis (43.0% vs 56.4%, χ2=11.53 , P=0.001), pericarditis [(216±111)×10 9/L vs (175±114)×10 9/L, t=-4.69 , P<0.001], thrombocytopenia, and hydroureterosis (1.0% vs 12.8%, χ2=47.47 , P<0.001) were high, but the incidence of pulmonary arterial hypertension (PAH) (31.2% vs 10.7%, χ2=36.99 , P<0.001) was low; Serum alanine aminotransferase (ALT) [17(10, 29) U/L vs 59(16, 127) U/L, Z=9.65 , P<0.001], aspartate aminotransferase (AST) [25.0 (18.0, 37.0) U/L vs 82.5(25.0, 289.0) U/L, Z=10.57 , P<0.001], alkaline phosphatase (ALP) [58(46, 76) U/L vs 82(56, 187)U/L, Z=8.42 , P<0.001], Creatine kinase (CK) [44.0(28.0, 83.0) U/L vs 58.5(34.0, 176.0) U/L, Z=4.46 , P<0.001], lactate dehydrogenase (LDH) [(309±206) U/L vs (443±332) U/L, t=5.64 , P<0.001], fasting blood glucose (FBS) [(5.0±1.5) mmol/L vs (5.3±1.7) mmol/L, t=2.16 , P=0.031], triglyceride (TG) [(2.0±1.3) mmol/L vs (2.7±2.2) mmol/L, t=4.55 , P<0.001] increased, albumin (ALB) [(30±7) g/L vs (27±7) g/L, t=5.87 , P<0.001)] and high-density lipoprotein (HDL) [(1.1±0.8) mmol/L vs (0.9±0.5) mmol/L, t=-4.20 , P<0.001] decrease, and anti SSB antibody positive rate (16.0% vs 9.5%, χ2=5.60 , P=0.018) decreased.③ After 3 months' follow-up, 203 patients with SLE GI involvement were relieved, 30 patients (12.3%) died, and 9 patients (1.8%) died in the control group. Ninety-five (46.8%) patients in the remission group had a significantly higher rate of cyclophosphamide treatment when compared with 5(12.5%) in the non-remission group ( χ2=16.23, P<0.001) . Logistic regression analysis showed that no increase of PAH, elevated erythrocyte sedimentation rate (ESR), ALT, glutamyl transpeptidase (GGT), indirect bilirubin (IBIL) and high SLEDAI scores, hydroureteral dilatation, decreased ALB and HDL were independent related factors for SLE GI involvement, while ascites and elevated FBS were SLE GI involvement factors of poor prognosis. Conclusion:SLE patients with GI involvement have a high mortality rate, and lupus hepatitis and LMV are common. Hydroureterosis, high SLEDAI score, abnormal liver function are risk factors for GI involvement. Jaundice and elevated FBS are the risk factors for poor prognosis, and treatment with cyclophosphamide is the protective factor.

Objective:To analyze the clinical characteristics and influencing factors of vascular involvement in Beh?et′s Disease (BD) to improve and provideunderstanding of insights for clinicians to better understand this condition.Methods:Clinical data from 220 BD patients admitted to the First Affiliated Hospital of Guangxi Medical University from January 2012 to May 2022 were collected. Clinical manifestations and laboratory findings were compared between BD patients with and without vascular involvement, as well as between those with improved conditions and those with progressive conditions. Binary logistic regression was used to analyze the influencing factors.Results:①The average age of the 220 BD patients was 36.5±15.3 years. Among them, 23 patients (10.5%) had vascular involvement, including 20 males (87.0%).②Compared to BD patients without vascular involvement, those with vascular involvement had significantly higher rates of smoking [6.1%(12/197) vs.34.8%(8/23), χ2=17.19, P<0.001], cardiac involvement [1.5%(3/197) vs. 13.0%(9/23), χ2=6.42, P=0.011], and elevated C-reactive protein(CRP) levels (78.3% vs. 56.3%, χ2=4.08, P=0.043).③ Among BD patients with vascular involvement, 11 cases (47.8%) had venous lesions, and 20 cases (87.0%) had arterial lesions, with 8 cases (34.8%) having both venous and arterial involvement. The most common type of vascular involvement was arterial dilatation (11 cases), mainly aneurysms (10 cases), and deep venous thrombosis of the lower extremities (7 cases).④The 23 BD patients with vascular involvement were followed up for an average of 18.3 months. Among them, 16 patients (69.6%) showed stable improvement, while 7 patients (30.4%) experienced disease progression, including 4 deaths (1 male and 3 females). A total of 91.3% (21/23) of the patients received glucocorticoid therapy. Immunosuppressive therapy was administered to 82.6% (19/23) of the patients, with 65.2% (10/23) receiving with cyclophosphamide and 43.5% receiving with thalidomide. Additionally, 13% (3/23) of the patients were treated with cyclosporine and methotrexate, respectively, and 8.7% (2/23) were treated with received mycophenolate mofetil. Anticoagulant therapy was given to 21.7% (5/23) of the patients, using either warfarin or low molecular weight heparin. Biologic therapy was administered to 17.4% (4/23) of the patients, and surgical intervention was performed in 43.5% (10/23) of the patients. ⑤Binary logistic regression analysis identified male gender [ OR(95% CI)=5.70(1.60, 20.90), P=0.009] as an indepe-ndent risk factor for vascular involvement in BD. Conclusion:The incidence of vascular involvement in BD is 10.5%, with a higher prevalence in males. Arterial involvement is more common than venous involvement, with arterial aneurysms being the most common manifestation. Clinicians should pay attention to CRP and total cholesterol levels in BD patients.

Background and objective Lung cancer is a leading cause of cancer-related deaths.Non-small cell lung cancer(NSCLC)is the most common pathological subtype,with adenocarcinoma being the predominant type.FAT atypical cadherin 1(FAT1)is a receptor-like protein with a high frequency of mutations in lung adenocarcinoma.The protein encoded by FAT1 plays a crucial role in processes such as cell adhesion,proliferation,and differentiation.This study aims to investigate the expression of FAT1 in lung adenocarcinoma and its relationship with immune infiltration.Methods Gene expression levels and relevant clinical information of 513 lung adenocarcinoma samples and 397 adjacent lung samples were obtained through The Cancer Genome Atlas(TCGA)and Genotype-Tissue Expression(GTEx)data.The mRNA expression levels of the FAT1 gene in lung adenocarcinoma tissues were analyzed,along with its association with the prognosis of lung adenocarcinoma patients.Pathway enrichment analysis was conducted to explore the signaling pathways regulated by the FAT1 gene.Immu-noblotting was used to detect the differential expression of FAT1 in lung epithelial cells and various lung cancer cell lines,while immunohistochemistry was employed to assess FAT1 expression in lung cancer and adjacent tissues.Results FAT1 gene muta-tions were identified in 14%of lung adenocarcinoma patients.TCGA database data revealed significantly higher FAT1 mRNA expression in lung adenocarcinoma tissues compared to adjacent lung tissues.Kaplan-Meier analysis indicated lower survival rates in lung adenocarcinoma patients with higher FAT gene expression.Pathway enrichment analysis suggested the involve-ment of FAT1 in tumor development pathways,and its expression was closely associated with immune cell infiltration.Immu-nohistochemical validation demonstrated significantly higher expression of FAT1 in cancer tissues compared to adjacent lung tissues.Conclusion FAT1 mRNA is highly expressed in lung adenocarcinoma tissues,and elevated FAT1 mRNA expression is associated with poor prognosis in lung adenocarcinoma patients.FAT1 may serve as a potential biomarker for lung cancer.