Objective:To investigate the prevalence of hyperuricemia (HUA) in Bozidun Kirghiz township of Xinjiang Aksu region, and to explore the risk factors for the occurrence of HUA in the local area.Methods:A cross-sectional survey study was conducted by randomly selecting 9 villages in Bozidun Kirgiz Township by the whole-group sampling method and questionnaire were distributed to the households. The questionnaire included: demographic information, history of past illness, personal history, and all subjects were measured for height, weight, blood pressure, abdominal circumference, etc. The diagnostic of HUA if the serum uric acid (SUA) level >420 μmol/L in men or >360 μmol/L in women. The incidences of HUA in different age, sex, food type and life style behavior were analyzed. T test, non-parametric test and Chi-square test were used to analyze the differences among the groups, and logistic regression was used to analyze the risk factors. Results:①A total of 2 138 subjects were surveyed, among which 68 patients were with HUA, the prevalence of HUA in Bozidun Kirghiz township, Aksu region in the general population was 3.18%(68/2 138); the prevalence rate in men was 4.60%(45/978), 45 patients were identified; and the prevalence rate in women was 1.98%(23/1 160), 23 patients were identified. The peak age of HUA in male and female patients was 51~60 years old. ②The prevalence of HUA was lower in those who consumed dairy products ( χ2=6.91, P=0.017), nuts ( χ2=8.43, P=0.038) and eggs ( χ2=7.38, P=0.023), and lower in those who consumed more. Different intake of cereals ( χ2=0.87, P=0.647), meat( χ2=0.82, P=0.662), vegetables and fruits( χ2=5.22, P=0.073) had no effect on the prevalence of HUA.③In terms of different life behaviors, the prevalence of HUA in men who had been smoking was higher than those who had never smoked (57.78%, 28.89%, 13.33%, χ2=8.16, P=0.017). In the relationship between drinking and HUA, the prevalence rates of male always drinking, ever drinking and never drinking were 80.00%, 11.11% and 3.89%, respectively, the difference was statistically significant ( χ2=6.67, P=0.038). ④Multi-factor logistic regression analysis showed that high BMI, old age, high TG, increased Cr and increased WBC were risk factors for the occurrence of HUA [ OR(95% CI)=1.13(1.04, 1.23), 1.03(1.00,1.05),1.39(1.00, 1.93), 1.03(1.02, 1.05), 1.27(1.07, 1.49), all P<0.05]. Conclusion:The prevalence of HUA in Bozidun Kirgiz township in Aksu prefecture of Xinjiang is lower than that in other areas with continental climate. High BMI, old age, high TG, increased Cr and increased WBC count are risk factors for the development of HUA .

Objective:To investigate the positivity rate and high titer of antinuclear antibody (ANA) and anti-dsDNA antibody in healthy Tajik, Kirgiz, and Han Chinese populations in Xinjiang.Methods:A total of 3 687 cases of Tajik residents, 2 140 cases of Kyrgyz residents, and 2 034 cases of Han residents were selected as the study subjects, and ANA and anti-dsDNA antibodies were detected and comparatively analyzed. Data were analyzed using SPSS 22.0 software with χ2 test. Results:The positive rate of ANA in Tajik group was 15.1% [(555/3 687), 10.2%(147/1 445) male, 18.2%(408/2 242) female], of which high titers accounted for 25.8%(143/555). It was 16.7%(357/2 140) in the Kyrgyz group [10.3% male(101/980), 19.4%(256/1 160) female], with high titers accounting for 14.8%; and in the Han group, the positivity rate was 16.6% [9.8%(70/720) male, 19.1%(267/1 314) female], with high titers accounting for 18.4%(62/1 337). There was no significant difference in ANA positivity rate among the three ethnic groups( χ2=3.64, P=0.162), but there were differences in the percentage of high titer of ANA in Tajik ethnic group compared with Han and Kyrgyz ethnic groups(25.8% vs. 18.4%, χ2=6.02, P=0.014; 25.8% vs.14.8%, χ2=14.71, P=0.001), which accounted for a high percentage. The highest number of ANA high titers in all three groups was in the age group of 51~60 years. The ANA karyotype with the highest percentage of high titers in the Tajik and Kyrgyz populations was granular, while it was homogeneous and in the Han it was homogeneous.The positive rate of anti-dsDNA antibody in the Tajik group was 0.71%(26/3 687), of which high titer accounted for 23.1%(6/126); in the Kyrgyz group, it was 0.75%(16/2 034), and high titer accounted for 31.3%(4/14); and in the Han group, the positive rate was 0.69%(14/2 034), of which high titer accounted for 28.6%(4/64), and there was no statistical significance of in the difference in the positive rate of anti-dsDNA antibody and the proportion of high titer among the three groups( χ2=0.06, P=0.972; χ2=0.37, P=0.832). Conclusion:The percentage of ANA and anti-dsDNA antibodies and high titers varied vary among the three ethnic groups in this study, and long-term follow-up is needed to monitor keep an eye on the incidence of autoimmune diseases in people with high autoantibody titers.

Objective:To investigate the expression level and application value of anti-carbamylated protein(CarP)antibody in rheumatoid arthritis(RA).Methods:Demographic data and laboratory test results of RA patients,non-RA patients and healthy controls in the physical examination center were re-viewed from December 2018 to June 2019 in the Rheumatology and Immunology Department of the Peo-ple's Hospital of Xinjiang Uygur Autonomous Region.The serum concentrations of anti-CarP antibodies in all the subjects were measured by ELISA and statistically analyzed.Results:A total of 259 subjects were included in this study,including 158 in the RA group(45 serum-negative RA patients),59 in the non-RA group and 42 in the healthy control group.The concentration of anti-CarP antibody in RA group[8.31(5.22,15.26)U/mL]was higher than that in non-RA group[4.50(3.35,5.89)U/mL]and healthy control group[3.46(2.76,4.92)U/mL].The concentration of anti-CarP antibody in non-RA group was not significantly different from that in healthy control group(P=0.10).Receiver operating characteristic(ROC)curve analysis showed that the sensitivity of anti-CarP antibody in the diagnosis of RA was 58.2％,and the specificity was 93.1％.The sensitivity of the combined detection of anti-CarP antibody,anti-cyclic peptide containing citrulline(CCP)antibody and rheumatoid factor(RF)was 82.3％,and the specificity was 96.5％.The positive rate of anti-CarP antibody in serum-negative RA patients was 44.4％(20/45).Univariate Logisitic regression analysis showed that age,C-reactive pro-tein(CRP),erythrocyte sedimentation rate(ESR),RF,glucose-6-phosphate isomerase(GPI),anti-CCP antibody and anti-CarP antibody were risk factors for RA.Multivariate Logisitic regression analysis showed that anti-CCP antibody and anti-CarP antibody were independent risk factors for RA.Spearman correlation analysis showed that there was no significant correlation between anti-CarP antibody and swol-len joint count(SJC),tenderness joints count(TJC),ESR,disease activity score for 28 joints(DAS28),clinical disease activity index(CDAI),simplified disease activity index(SDAI).The concentration of anti-CarP antibody in RA with bone erosion(n=88)was higher than that in RA without bone erosion(n=70),and there was significant difference between the two groups(P＜0.05).Conclusion:Anti-CarP antibody is an effective serological marker for the diagnosis of RA.The combined detection of RF,anti-CCP antibody and anti-CarP antibody can improve its diagnostic value,and anti-CarP antibody may be an effective assistant diagnostic tool for serum negative RA.The high serum concentration of anti-CarP antibody in patients with RA may indicate an increased risk of bone erosion and should be treated early,but further cohort studies are needed for follow-up observation.

Objective:To analyze the 15-year survival rate, causes of death and prognostic factors of late-onset systemic lupus erythematosus(SLE).Methods:A total of 92 late-onset SLE patients aged >50 years hospitalized in the Rheumatology and Immunology Department of the People's Hospital of Xinjiang Autonomous Region from January 2006 to December 2016 were retrospectively collected.Clinical and serological data of the patients were analyzed and the diagnosis met the SLE classification criteria as revised by the American Society of Rheumatology in 1997.Survival rate, the cause of death, and the associated prognostic factors were analyzed.Outpatient or telephone follow-up was performed.Results:Of the 92 study patients, 8 were lost to follow-up(8 / 92, 8.7%)and 84 were able to follow up(84 / 92, 91.3%). Of the 84 able to follow up, 64 cases(64 / 84, 76.2%)survived, and 20 cases(20 / 84, 23.8%)died.Median survival time was 108 months.The 5-, 10-, and15-year survival rates were 86.0%, 77.9%and 59.6 %, respectively.Infection(55.0%)and multiple organ failure(15.0%)were the major cause of death in patients with late-onset SLE.Univariate analysis of the outcomes of patients with late-onset SLE showed that the age of onset( HR=1.113, P=0.001), hematology involvement( HR=3.610, P=0.023), and complicaed cardiovascular disease( HR=3.128, P=0.011)had a significant impact on the prognosis. Conclusions:The late-onset SLE has low survival rate and bad prognosis.Infection prevention and control of organ damage and focus on merging cardiovascular disease are critical to improve survival of late-onset SLE patients.

Objective:To describe the clinical features and immunological of Uygur systemic lupus erythematosus (SLE) subjects.Methods:Atotal of 484 adult patients (≥18 years) followed in the People's Hospital of the Xinjiang Uygur Autonomous Region were included into this study including 211 Uygur patients with SLE and 273 Han patients with SLE.Results:① Of the 211 Uygur SLE patients, 195 (92.4%) were female and 16(7.6%) were male (female:male=12.2∶1), the mean age at SLE onset was 15-64(35±12) years, mean disease duration was 0.1-228(21±35) months.② Of the 211 Uygur SLE patients, the most prevalent clinical presentationswere renal involvement 56.4%(119/211), hematological 56.4%(119/211), rash 50.2% (106/211), arthralgia/arthritis 49.8%(105/211), weakness 47.9%(101/211). The significant difference observed between the Uygur and Han SLE patients was Raynaud phenomenon( χ2=6.066, P=0.014) .③ The positive rates of antinuclear antibodies were 94.8%(200/211), 54.5%(115/211) for anti-dsDNA antibodies, 47.9% (101/211) for anti-SSA antibodies, 35.1%(74/211) for anti-U 1-RNP antibodies, and 28.4%(60/211) for anti-AHA antibodies. The positivity of anti-AHA antibodies ( χ2=4.952, P=0.026) was higher in Uygur SLE patients than thatin Han SLE patients. More Uygur SLE patients were anemic ( χ2=6.904, P=0.009), with decrease of complement ( χ2=6.330, P=0.012). Conclusion:This study can not find any significant differences between the Uygur SLE patients and Han SLE patients in common clinical manifestations in Xinjiang. The Uygur SLE patients are more likely to have anemia and decrease of complement, which may be related to race and diet habits.

Objective:To explore the depression of patients with systemic lupus erythematosus (SLE) during the coronavirus disease 2019 (COVID-19) pandemic.Methods:Patients with SLE and healthy subjects(control group) from August 16, 2020 to September 2, 2020 in Urumqi, Xinjiang were collected. The depression and sleep quality were assessed by Self rating Depression Scale (SDS) and Pittsburgh sleep quality index (PSQI). The nonparametric data were represented by median (quartile spacing), and the rank sum test was used to compare the continuous variables between the two groups. Pearson correlation test was used for continuous variables, and Spearman correlation test was used for rank variables or classified variables. Statistical product and service solutions.Results:The prevalence rate of depression in the SLE group (41.9%) was significantly higher than that in healthy control group (32.1%). The difference was statistically significant ( χ2= 10.312, P<0.01). The prevalence rate of poor sleep in the SLE group (31.8%) was significantly higher than that in healthy control group (21.6%). The difference was statistically significant( χ2=3.885, P=0.049). The total score of VAS ( OR=1.366, P<0.01) , PSQI( OR=1.198, P<0.01) were the risk factor of depression in patients with SLE. Conclusion:SLE patients have a higher prevalence of depression during pandemic quarantinee-period, pain and poor sleep quality are risk factors. We need to pay attention to the psychological status of SLE patients.

Objective:To investigate the risk factors of uveitis in ankylosing spondylitis (AS).Methods:This retrospective study included 206 patients with AS who visited the department of rheumatology and immunology of People's Hospital of Xinjiang Uygur Autonomous Region between January, 2018 and December, 2018. Those patients with uveitis were enrolled in the uveitis group. AS patients without uveitis were included in the non uveitis group as control. The basic clinical data, laboratory indexes and imaging data were analyzed retrospectively by t-test, Wilcoxon rank sum test, Chi square test and binary logistic regression. Results:Thirty-seven patients with uveitis and 169 patients without uveitis were included. Compared with the non uveitis group, patients with uveitis were older in age [(40±11) years vs (36±11) years, t=-2.06, P<0.05], longer in disease duration [10(5, 16) years vs 5(2, 10) years, Z=-3.16, P<0.01], more peripheral arthritis [51.4%(19/37) vs 32.5%(55/169), χ2=4.66, P<0.05] and peripheral enthesitis [40.5%(15/37) vs 11.8%(20/169), χ2=17.34, P<0.01], and higher human leukocyte antigen (HLA)-B27 positive rate [100%(37/37) vs 85.8%(145/169), χ2=5.95, P=0.01]. However, there were no significant difference in gender, race, cervical tenderness, smoking history and volume, a positive family history of uveitis, a positive family history of AS and BMI. There was no significant difference in bloodplatelet (PLT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR). By the binary logistic regression analysis, we found that peripheral enthesitis [ OR(95% CI)=4.289(1.832, 10.040), P<0.01], and longer disease duration [ OR(95% CI)=1.072(1.014, 1.134), P<0.05] were independently related to AS related uveitis. Conclusion:This study suggests that the risk of uveitis is increased in AS patients with longer disease duration and peripheral enthesitis.

Objective:To evaluate the efficacy and safety of belimumab in the treatment of systemic lupus erythematosus (SLE).Methods:Retrospective analysis was made in 41 patients with SLE who were treated with belimumab in our hospital. The demographic data, clinical features, laboratory test results and treatment-related adverse events (AE) were collected and analyzed. Paired sample t test and Wilcoxon test were used to compare and analyze the changes of laboratory indexes before and after treatment. Results:The follow-up time of the 41 patients was (3.0±1.0) months, and 19 patients stopped belimumab because of the Covid-19 pandemic, the duration for belimumab withdrawal was (2.6±0.9) months. The most common clinical manifestation was impaired renal function (63.4%, 26 cases), followed by musculoskeletal impairment (58.5%, 24 cases). Before and after treatment, the dose of glucocorticoid was significantly decreased [15(9, 35) mg/d vs 13(8, 25) mg/d, Z=-3.573, P<0.01], the systemic lupus erythematosus disease activity index (SLEDAI)-2000 was significantly decreased [5(4, 8) vs 2(2, 4), Z=-4.446, P<0.01], the anti-double-stranded DNA (dsDNA) antibody [enzyme-linked immune-sorbent assay (ELISA)] level was significantly decreased [96(26, 300) vs 36(10, 139), Z=-3.436, P<0.01], the complement C3 level was significantly increased [(0.62±0.22) g/L vs (0.74±0.20) g/L, t=-5.454, P<0.01], the complement C4 level was significantly increased [(0.13±0.07) g/L vs (0.17±0.07) g/L, t=-5.851, P<0.01), the hemoglobin level was significantly increased [(117±15) g/L vs (125±16) g/L, t=-4.236, P<0.01) and A/G level was significantly increased [(1.30±1.36) vs (1.49±0.29), t=-5.174, P<0.01]. Four patients (13.8%) had adverse events during treatment with belimumab, including 1 case of upper respiratory tract infection, 2 cases of urinary tract bacterial infections and 1 case of herpes zoster. Conclusion:Belimumab is safe and effective in the treatment of SLE. It can significantly reduce the dosage of glucocorticoid and improve anemia, but the specific mechanism needs to be further studied.

Objective:To investigate the efficacy and safety of tofacitinib (TOF) in the treatment of psoriatic arthritis (PsA).Methods:The clinical data of 5 patients with PsA from September 2018 to December 2020 in People's Hospital of Xinjiang Uygur Autonomous Region were collected. Five patients were treated with a variety of disease-modifying anti-rheumatic drugs (DMARDs), two of them had ever been treated with biologic disease-modifying antirheumatic drugs (bDMARDs) [recombinant human tumor necrosis factor-alphareceptor Ⅱ: IgG Fc (rhTNFR: Fc, Adalimumab], but failed to show efficacy or relapse after drug withdrawal. Multiple joints were involved in 2 patients. These five patients were treated with tofacitinib. Their data were collected and analyzed 3-month and 6-month after treatment respectively, including the changes of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), severity of pain measured by visual analogue scale (VAS), joint pain count (TCJ), joint swelling count (SCJ), health assessment questionnaire (HAQ), 28 joint disease activity score (DAS28 CRP), psoriasis area and severity index (PASI), and PsA disease activity index (DAPSA). Adverse reactions were observed and analyzed.Results:These 5 cases were treated with TOF 5 mg twice daily. Three months after treatment, swelling joints count and psoriatic rash were significantly improved, and pain was significantly relieved in 4 cases. Six months after treatment, the ESR, CRP, VAS, TCJ, SCJ, HAQ, DAS28 CRP, PASI, and DAPSA decreased further. According to DSA28-CRP score, peri-pheral joints involvement of 3 cases were improved, and 2 cases reached low disease activity state. The overall effective of PASI were observed in 4 cases. According to the DAPSA score, 1 case reached the PsA disease remission state and 4 cases reached the PsA low disease activity state. No remarkable adverse reactions occurred.Conclusion:With good therapeutic effect and less adverse reactions, TOF is a potential treatment option for PsA.

Objective: To explore the clinical value of serum autoantibodies and human leukocyte antigen (HLA-B₂₇) molecular testing in Uygur patients with human immunodeficiency virus (HIV) infection. Method: A total of 727 HIV-infected Uygur patients who visited Kuche infectious diseases hospital during May 2016 to March 2017 were include in this study. The other 390 healthy people were enrolled as controls. Serum antinuclear antibodies (ANA), anti-cyclic citrullinated peptide (CCP) antibody, anti-extractable nuclear antigen (ENAs) antibody and HLA-B₂₇ molecule were tested. Result: Among 727 HIV-infected Uygur patients, 317 were males and 410 were females with mean age (35.52±13.44) years old. The mean duration of disease was (6.34±3.05) years. There were 697 (95.87%) patients receiving highly active antiretroviral therapy (HAART) with mean duration of treatment (5.52±3.47) years. The mean CD4⁺T cell count was (520±271) cells/μl in 202 HIV-infected patients, and mean virus load was (108 139±20 498) copies/ml in 20 HIV-infected patients. Rheumatic manifestations were recorded in 238 (32.74%) HIV-infected Uygur patients, mainly with dry mouth and dry eye (15.41%) , alopecia (9.90%) , arthralgia (8.94%) , ect. Compared with the health controls, positive ANA was more common in HIV infected Uygur patients (33.43% vs. 17.43%, P<0.001) with low titers (ANA titer:1∶100) . HIV-infected Uygur patients had higher positive anti-u1-RNP antibodies positive rate (1.10%), but lower anti-SSA antibodies positive rate (0.14%) and anti-CCP antibodies positive rate (0.28%). Patients with positive ANA in HAART group were significantly less than that in non-treatment group (32.71% vs. 50.00%, P=0.049). There were no correlations between ANA and duration of HAART, CD4⁺T cell counts and virus load (r values 0.061, 0.047, 0.121, respectively. P>0.05). Only one female patient was HLA-B₂₇ positive (0.14%), which was significantly lower than that in healthy controls (3.08%) (P<0.001). Also, only one patient was diagnosed with rheumatoid arthritis (RA). Conclusion Autoimmune manifestations are common in HIV-infected Uygur patients. Several autoantibodies are positive, but the coincidence of rheumatic diseases is rare. It′s noted that patients with autoimmune manifestations should be considered as a differential diagnosis of HIV infection.