ObjectiveTo investigate the clinical effects and safety of Shuhe Granules （舒和颗粒） in patients with rheumatoid arthritis （RA） comorbid with insomnia. MethodsA single-arm prospective exploratory design was adopted. Thirty RA patients comorbid with insomnia and diagnosed with the traditional Chinese medicine （TCM） syndrome of kidney-heart deficiency and qi-blood disharmony were enrolled. On the basis of maintaining their original RA treatment regimens， all patients received oral Shuhe Granules， one dose per day， for 12 consecutive weeks. The outcomes were assessed before treatment and at weeks 4， 8， and 12 after treatment. Sleep and related psychosomatic function were evaluated using the insomnia severity index （ISI）， Pittsburgh sleep quality index （PSQI）， fatigue severity scale （FSS）， patient health questionnaire-9 （PHQ-9）， generalized anxiety disorder-7 （GAD-7）， and Montreal cognitive assessment （MoCA） scores. RA-related assessments included the 28-joint disease activity score based on C-reactive protein （DAS28-CRP）， pain visual analog scale （VAS）， tender joint count （TJC28）， swollen joint count （SJC28）， morning stiffness duration， and health assessment questionnaire （HAQ） score. Laboratory parameters included erythrocyte sedimentation rate （ESR）， serum C-reactive protein （CRP）， anti-cyclic citrullinated peptide antibody （anti-CCP）， and rheumatoid factor （RF） levels. A literature-based historical control group was established through literature retrieval and meta-analysis. The ISI， PSQI， DAS28-CRP， and pain VAS scores were compared between the treatment group in the present study and the historical control group. Safety assessments were also performed. ResultsCompared with baseline before treatment， ISI and PSQI scores decreased at weeks 4， 8， and 12， while MoCA scores increased at weeks 4， 8， and 12. FSS scores decreased at weeks 4 and 12. At weeks 8 and 12， GAD-7 scores， DAS28-CRP scores， duration of morning stiffness， TJC28， and SJC28 were reduced. At week 12， PHQ-9， pain VAS， and HAQ scores significantly decreased （P＜0.05）. FSS and DAS28-CRP scores at week 12 were lower than those at week 4， and CRP levels at week 8 were lower than those at week 4 （P＜0.05）. Compared with the historical control group， the treatment group showed superior improvement in ISI and PSQI scores （P＜0.001）； however， no statistically significant differences were observed between the two groups in DAS28-CRP or pain VAS scores （P＞0.05）. No serious adverse events occurred during the study， and the 4 reported mild adverse events were all considered unrelated to the study medication. ConclusionShuhe Granules significantly improve sleep quality， fatigue， emotional status， cognitive function， RA-related symptoms， and joint function in patients with RA comorbid insomnia， with good safety and tolerability.

Objective To investigate the value of iterative decomposition of water and fat with echo asymmetry and least-squares(IDEAL-IQ)sequence in evaluating the correlation between renal ectopic fat deposition and early diabetic kidney disease(DKD)in patients with diabetes mellitus(DM).Methods A total of 51 patients with T1DM or T2DM were enrolled in this study from the Endocrinology and Metabolism Department in Affiliated Jinhua Hospital,Zhejiang University School of Medicine during January 2022 to July 2023.All the patients were divided into two groups according to the results of urine albumin creatinine ratio(UACR):normal or slightly increased urinary micro albumin group(NAU,UACR<30 mg/g,n=27)and diabetic kidney disease group(DKD,UACR 30～300 mg/g,n=24).Meanwhile,55 healthy subjects in health examination were selected as control group(NC).Pearson correlation analysis was used to analyze the correlation between renal FF and other indicators.Logistic regression analysis was used to analyze the influencing factors of early DKD,and the diagnostic efficiency of renal FF for early DKD was analyzed by the ROC curve.Results Serum creatinine(Scr)and renal fat fraction(FF)value were higher in DKD group than in NC and NAU groups(P<0.05).Pearson correlation analysis showed that kidney FF were positively correlated with UACR and Hcy(P<0.05).Logistic regression analysis showed that after adjusting for confounding factors,renal FF was a contributing factor to early DKD.The ROC curve revealed that model 2 had the highest diagnostic efficiency,with AUC=0.801,sensitivity of 66.7%,specificity of 85.2%,accuracy of 80.0%,and a renal FF cut-off value was 2.46%.Conclusion IDEAL-IQ could non-invasively measure the renal fat content in DM patients,and the renal FF were significantly associated with DKD in early stage.

Humans ; COVID-19 ; Consensus ; SARS-CoV-2 ; China

Objective:To identify the co-expressed different expressed genes (DEGs) related to long-term responding in patients receiving vedolizumab or etrolizumab, whose expression could be tested to indicate the treatment efficacy when taking anti-α4β7 integrins.Methods:Two datasets were downloaded from Gene Expression Omnibus (GEO) to be analyzed. Limma, Gene Ontology (GO) and KEGG analysis were used to screen DEGs and possible pathways. The most significant module in the PPI networks was analyzed by Cytoscape. ROC curves were built to indicate the predictive potential.Results:A total of 433 DEGs were found between patients′ response and non-response to vedolizumab, and 15 DEGs between patients received vedolizumab and etrolizumab. The GO and KEGG analyses showed overlaps were enriched to some immune-related pathways closely matched to the mechanism of anti-integrins. Eight hub genes were distinguished from the PPI network: MNDA, AQP9, FPR1, FCGR3B, VNN2, TREM1, MYO1F and GAS2L3 (5 of them had been identified to be related to IBD in labs) . Conclusions:Efficacy of anti-α4β7 intergins is closely associated with inflammation-related and adhesion-related genes. The possible hub genes and related pathways are distinguished, which can be used as potential long-term response indicators towards suitable patients receiving anti-integrins.

Objective:To identify the co-expressed different expressed genes (DEGs) related to long-term responding in patients receiving vedolizumab or etrolizumab, whose expression could be tested to indicate the treatment efficacy when taking anti-α4β7 integrins.Methods:Two datasets were downloaded from Gene Expression Omnibus (GEO) to be analyzed. Limma, Gene Ontology (GO) and KEGG analysis were used to screen DEGs and possible pathways. The most significant module in the PPI networks was analyzed by Cytoscape. ROC curves were built to indicate the predictive potential.Results:A total of 433 DEGs were found between patients′ response and non-response to vedolizumab, and 15 DEGs between patients received vedolizumab and etrolizumab. The GO and KEGG analyses showed overlaps were enriched to some immune-related pathways closely matched to the mechanism of anti-integrins. Eight hub genes were distinguished from the PPI network: MNDA, AQP9, FPR1, FCGR3B, VNN2, TREM1, MYO1F and GAS2L3 (5 of them had been identified to be related to IBD in labs) . Conclusions:Efficacy of anti-α4β7 intergins is closely associated with inflammation-related and adhesion-related genes. The possible hub genes and related pathways are distinguished, which can be used as potential long-term response indicators towards suitable patients receiving anti-integrins.

Objective To explore the MRI characterisitics of primary dilated cardiomyopathy and isolated left ventricular non-compaction.Methods The patients who were diagnosed as primary dilated cardiomyopathy (n=18) and isolated left ventricular non-compaction (n=10) were enrolled,and the MRI was performed.The thickness of non-compaction myocardium (NC),compaction myocardium (C) in end-diastole,the feature of movement of myocardium,the number of non-compaction segment,the fraction shortening of non-compaction and the distribution were compared.Results Totally 823 segments were analyzed in primary dilated cardiomyopathy,in which 124 segments were non-compaction myocardium;397 segments were analyzed in isolated left ventricular non-compaction,in which 115 segments were non-compaction myocardium.The NC,NC/C,NC/(NC+C),and the fraction shortening of the isolated left ventricular non-compaction patients were higher than those of primary dilated cardiomyopathy patients (all P＜0.05).The features of distribution showed that the apical segment was mostly involved,and the basal segment was less involved or hardly involved.The anterior and lateral segments were more involved in the free wall,the septal was less involved.Conclusion The MRI characteristics of primary dilated cardiomyopathy and isolated left ventricular non-compaction are different,especially in the distribution,non compacted segments,NC and NC/C,which is important for diagnosis and differential diagnosis of the two diseases.