1.The characteristics and associated factors of hand dysfunction in patients with rheumatoid arthritis
Yaowei ZOU ; Ying YANG ; Zhiming OUYANG ; Jie PAN ; Peiwen JIA ; Kuimin YANG ; Huwei ZHENG ; Tao WU ; Jianzi LIN ; Jianda MA ; Yingqian MO ; Lie DAI
Chinese Journal of Internal Medicine 2025;64(2):119-127
Objective:To investigate the characteristics of hand dysfunction and its associated factors in patients with rheumatoid arthritis (RA).Methods:A cross-sectional study. Patients with RA were recruited from January 2019 to April 2024 at the Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University. Demographic and clinical data were collected, including age, gender, active smoking, disease duration, time of morning stiffness, rheumatoid factor and anti-cyclic citrullinated peptide antibody, disease activity, radiographic indicators, and hand function assessment. Hand function was assessed by grip strength measures and self-reported items related to hand function in the Stanford Health Assessment Questionnaire. Factors related to hand function were analyzed by logistic regression analyses.Results:A total of 1 079 RA patients were recruited [mean age: (53.0±12.6) years]. Overall, 72.6% (783/1 079) patients experienced a decrease in grip strength, 57.2% (617/1 079) patients experienced a decreased grip strength in both hands, with the average grip strength of the left and right hands decreasing by 16.3% and 14.1%, respectively, compared to normal values; 39.9% (430/1 079) patients had self-reported hand dysfunction. There were 185 (17.1%) older RA patients (age ≥65 years). The proportion of older RA patients with decreased grip strength [89.7% (166/185) vs. 69.0% (617/894)] and degree of decrease in grip strength compared to normal values (left hand:-35.3%±30.6% vs. -12.3%±38.6%; right hand:-32.6%±32.3% vs. -10.3%±42.1%) were significantly higher than that in young patients, and the proportion of older patients with self-reported hand dysfunction was also significantly higher [53.0% (98/185) vs. 37.1% (332/894), all P<0.001]. Multivariate logistic regression analysis showed that pain visual analogue scale ( OR=1.375, 95% CI 1.020-1.854) was independently associated with grip strength decrease in older RA patients, while the 28-joint tender joint count ( OR=1.151, 95% CI 1.063-1.246) and provider global assessment of disease activity ( OR=1.381, 95% CI 1.171-1.628) were associated with self-reported hand dysfunction. Conclusions:Hand dysfunction is common in RA patients, especially among older RA patients, which is related to pain, joint tenderness and provider global assessment of disease activity. This result implies the importance of pain management in RA patients.
2.The characteristics and associated factors of hand dysfunction in patients with rheumatoid arthritis
Yaowei ZOU ; Ying YANG ; Zhiming OUYANG ; Jie PAN ; Peiwen JIA ; Kuimin YANG ; Huwei ZHENG ; Tao WU ; Jianzi LIN ; Jianda MA ; Yingqian MO ; Lie DAI
Chinese Journal of Internal Medicine 2025;64(2):119-127
Objective:To investigate the characteristics of hand dysfunction and its associated factors in patients with rheumatoid arthritis (RA).Methods:A cross-sectional study. Patients with RA were recruited from January 2019 to April 2024 at the Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University. Demographic and clinical data were collected, including age, gender, active smoking, disease duration, time of morning stiffness, rheumatoid factor and anti-cyclic citrullinated peptide antibody, disease activity, radiographic indicators, and hand function assessment. Hand function was assessed by grip strength measures and self-reported items related to hand function in the Stanford Health Assessment Questionnaire. Factors related to hand function were analyzed by logistic regression analyses.Results:A total of 1 079 RA patients were recruited [mean age: (53.0±12.6) years]. Overall, 72.6% (783/1 079) patients experienced a decrease in grip strength, 57.2% (617/1 079) patients experienced a decreased grip strength in both hands, with the average grip strength of the left and right hands decreasing by 16.3% and 14.1%, respectively, compared to normal values; 39.9% (430/1 079) patients had self-reported hand dysfunction. There were 185 (17.1%) older RA patients (age ≥65 years). The proportion of older RA patients with decreased grip strength [89.7% (166/185) vs. 69.0% (617/894)] and degree of decrease in grip strength compared to normal values (left hand:-35.3%±30.6% vs. -12.3%±38.6%; right hand:-32.6%±32.3% vs. -10.3%±42.1%) were significantly higher than that in young patients, and the proportion of older patients with self-reported hand dysfunction was also significantly higher [53.0% (98/185) vs. 37.1% (332/894), all P<0.001]. Multivariate logistic regression analysis showed that pain visual analogue scale ( OR=1.375, 95% CI 1.020-1.854) was independently associated with grip strength decrease in older RA patients, while the 28-joint tender joint count ( OR=1.151, 95% CI 1.063-1.246) and provider global assessment of disease activity ( OR=1.381, 95% CI 1.171-1.628) were associated with self-reported hand dysfunction. Conclusions:Hand dysfunction is common in RA patients, especially among older RA patients, which is related to pain, joint tenderness and provider global assessment of disease activity. This result implies the importance of pain management in RA patients.
3.Clinical characteristics of overlapping syndromes of low muscle mass in patients with rheumatoid arthritis and their impact on physical function
Peiwen JIA ; Ying YANG ; Yaowei ZOU ; Zhiming OUYANG ; Jianzi LIN ; Jianda MA ; Kuimin YANG ; Lie DAI
Journal of Peking University(Health Sciences) 2024;56(6):1009-1016
Objective:To investigate the clinical characteristics of overlapping syndromes of low mus-cle mass in Chinese patients with rheumatoid arthritis(RA)and their impact on physical function.Methods:Consecutive patients with RA were recruited from September 2019 to April 2024 at Department of Rheumatology and Immunology,Sun Yat-Sen Memorial Hospital.Clinical data including disease acti-vity,physical function and radiographic assessment were collected.All patients also finished measure-ment of body composition,grip strength,and gait speed,and overlapping syndromes of low muscle mass as well as malnutrition,sarcopenia,sarcopenic obesity,and cachexia were evaluated.The Stanford health assessment questionnaire-disability index(HAQ-DI)was used to evaluate physical function.Logistic regression was used to analyze the related factors of physical dysfunction.Results:A total of 1 016 RA patients were recruited.Their mean age was(52.4±12.5)years,and 82.5%were female.There were 557 cases(54.8%)with overlapping syndromes of low muscle mass and all of them were malnutrition.On this basis,326 cases(32.1%)exhibited sarcopenia,124(12.2%)sarcopenic obesity,and 33(3.2%)cachexia.There were 584(57.4%)of RA patients having physical dysfunction,with varying degrees of severity:421(41.4%)mild,124(12.2%)moderate,and 39(3.8%)severe.Compared with patients without overlapping syndromes of low muscle mass(n=459)or with malnutrition only(n=231),RA patients with both malnutrition and sarcopenia(n=326)had significantly higher core disease activity indicators and higher rate of physical dysfunction(69.6%vs.42.0%vs.56.6%).However,compared with patients without overlapping syndromes of low muscle mass,patients with malnutrition only had lower HAQ-DI score(median 0.0 vs.0.1)and lower rate of physical dysfunction(42.0%vs.56.6%).Multivariate Logistic regression analysis showed that simultaneously overlapping malnutrition and sarcopenia were associated factors of physical dysfunction(OR=2.021,95%CI:1.067-3.828),but malnutrition only was not.Conclusion:Simultaneously overlapping malnutrition and sarcopenia can deteriorate disease activity and physical dysfunction in RA patients.The screening and evaluation of over-lapping syndromes of low muscle mass,especially sarcopenia should be emphasized in patients with RA.
4.Reliability and validity of Chinese version of health-related social capital scale for community-dwelling older adults
Xinyu KE ; Yanzhang LI ; Liyang YU ; Bei TANG ; Yan ZHANG ; Yuhang FENG ; Peiwen DAI
Chinese Journal of Behavioral Medicine and Brain Science 2023;32(10):940-944
Objective:To explore the psychometric characteristics of the Chinese version of the health-related social capital scale.Methods:From March to May 2020, after the original scale was translated into Chinese following the Brislin improved translation model, 251 community-dwelling senior citizens aged 65 and above were selected by convenient sampling method. Data analysis was conducted using SPSS 22.0 and AMOS 22.0, including tests of significance, correlation analysis, exploratory factor analysis, and confirmatory factor analysis.Results:Exploratory factor analysis extracted three factors: social participation, social cohesion, and reciprocity, which accounted for a cumulative contribution rate of 61.72%. Confirmatory factor analysis showed that the three-factor model fitted well(χ 2/ df=1.22, RMSEA=0.04, CFI=0.98, GFI=0.93, IFI=0.98, TLI=0.97). Social capital was significantly correlated with perceived social support positively ( r=0.36, P<0.01), and with loneliness negatively ( r=-0.30, P<0.01). The three factors were significantly correlated with the total scale ( r=0.85, 0.50 and 0.52, respectively, all P<0.01). And correlations between the items of each factor were 0.24-0.55, 0.30-0.59, 0.44-0.70, respectively(all P<0.01). The Cronbach's α coefficients of the total scale and three factors were 0.74, 0.72, 0.65 and 0.62, respectively(all P<0.01), and their retest reliability were 0. 92, 0. 87, 0. 82 and 0. 96, respectively(all P<0.01). Conclusion:The Chinese version of health-related social capital scale conforms to the three-factor model with good reliability and validity, which can be used to assess the social capital status of community-dwelling older adults in China.
5.The role of TrkA/TrkB in radiation-induced hippocampal neurogenesis impairment
Haohao WU ; Xin DING ; Meiling XU ; Peiwen DAI ; Junjun ZHANG ; Shengjun JI ; Ye TIAN
Chinese Journal of Radiological Medicine and Protection 2017;37(4):241-245
Objective To investigate the roles of TrkA and TrkB in radiation-induced hippocampal neurogenesis impairment.Methods Fifty-six rats were randomized into radiation group and sham control group.Radiation group received whole brain irradiation at a single dose of 10 Gy.The hippocampus were separated from rats in day 1,day 3,day 14 and 1 month after irradiation.Western blot and RT-PCR were applied to detect the protein levels and mRNA levels.Golgi staining was used to observe the dendritic spine of hippocampus.Immunofluorescence was performed to detect neural precursor's proliferation.Results Compared with control group,the numbers of dendritic spine significantly decreased after irradiation and its shape change obviously.Immunofluorescence showed a significant decrease in neural precursor's proliferation comparing with control group (t =6.49,P < 0.05).Protein level of TrkA expression increased (t =2.64,3.06,4.80,2.64,P < 0.05),while the levels of TrkB protein expression decreased significantly (t =4.59,3.06,2.81,2.57,P < 0.05).The mRNA level of TrkA expressions increased (t =4.57,3.06,5.39,5.86,P < 0.05),while the mRNA level of TrkB decreased (t =14.87,11.69,4.98,P < 0.05).Conclusions As a signaling pathways downstream of NGF and BDNF,TrkA and TrkB may play an important role in radiation-induced neurogenesis impairment.

Result Analysis
Print
Save
E-mail