OBJECTIVE: To assess the impact of long-term biologic therapy on metabolic biochemical parameters in moderate to severe plaque psoriasis patients. METHODS: The study included patients over 18 years old who had been treated by biological agents for at least 24 weeks for moderate to severe plaque psoriasis from Novermber 2015 to January 2024. According to the biological agents the patients used, they were divided into three groups: interleukin-17 (IL-17) inhibitor group, IL-23 and IL-12/23 inhibitor group and tumor necrosis factor-α (TNF-α) inhibitor group. The metabolic biochemical parameters of each group were evaluated and compared before and after the administration of the biologic therapies. RESULTS: A total of 174 patients with moderate to severe plaque psoriasis were included in the long-term treatment with biologics, including 127 males (73.00%), 47 females (27.00%), with a median age of 38.00 (31.50, 49.00) years and a median duration of psoriasis of 12.00 (10.00, 20.00) years. The median duration of biologic treatment was 61.00 (49.00, 96.25) weeks, ranging from 26 to 301 weeks. There were 101 patients in the IL-17 inhibitor group, 38 patients in the IL-23 and IL-12/23 inhibitor group, and 35 patients in the TNF-α inhibitor group. After long-term treatment with IL-17 inhibitors, no statistically significant changes were observed in body weight, body mass index (BMI), alanine aminotransferase (ALT), aspartate aminotransferase (AST), fasting glucose (GLU), total cholesterol (TC), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) compared with baseline measurements (P>0.05). However, low-density lipoprotein cholesterol (LDL-C) levels were significantly reduced [(2.90±0.75) mmol/L vs. (3.05±0.79) mmol/L, t=－2.100, P=0.038], while uric acid (UA) levels showed a significant increase [(401.13±99.13) μmol/L vs. (364.94±91.11) μmol/L, t=5.215, P < 0.001]. The group with normal UA levels before treatment showed a significant increase after long-term application of biological agents compared with before treatment [(370.69± 89.59) μmol/L vs. (324.66±64.50) μmol/L, t=5.856, P < 0.001]. Following long-term application of IL-23 and IL-12/23 inhibitors, no statistically significant differences were observed in body weight, BMI, ALT, AST, GLU, TC, TG, HDL-C and UA levels when compared with baseline measurements (P> 0.05). However, LDL-C levels exhibited a significant reduction from baseline [(2.85±0.74) mmol/L vs. (3.12±0.68) mmol/L, t=－2.082, P=0.045]. After long-term treatment with TNF-α inhibitor, there were no significant differences in body weight, BMI, ALT, AST, GLU, TC, TG, HDL-C, LDL-C and UA compared with baseline measurements (P>0.05). CONCLUSION Long-term application of IL-17 inhibitors in moderate to severe plaque psoriasis patients may result in elevated uric acid levels, particularly in patients with normal uric acid levels before treatment. The long-term use of IL-17 inhibitors, IL-23 inhibitors or IL-12/23 inhibitors might reduce LDL-C levels.
Humans ; Psoriasis/blood* ; Male ; Female ; Adult ; Middle Aged ; Interleukin-17/antagonists & inhibitors* ; Interleukin-23/antagonists & inhibitors* ; Tumor Necrosis Factor-alpha/antagonists & inhibitors* ; Interleukin-12/antagonists & inhibitors* ; Biological Therapy ; Biological Products/therapeutic use* ; Triglycerides/blood* ; Cholesterol, LDL/blood* ; Cholesterol, HDL/blood*

Objective:To analyze the epidemiological characteristics and economic burden of palmoplantar pustulosis (PPP) in China.Methods:A population-based retrospective study was conducted using the data from China′s Urban Basic Medical Insurance data from January 1, 2012, to December 31, 2016. International Classification of Diseases code and diagnoses in Chinese for PPP were used to identify cases and estimate the prevalence, incidence, and cost. Subgroup analyses were performed according to age and sex, and sensitivity analyses were conducted to evaluate the robustness of the results. Age-adjusted prevalence rates were calculated based on the 2010 national census data.Results:The crude prevalence and incidence rate of PPP in 2016 were 2.730/100 000 (95% CI: 2.218/100 000-3.242/100 000) and 1.556/100 000 (95% CI: 1.154/100 000-1.958/100 000), and the prevalence rate of females (2.910/100 000) was higher than that of males (2.490/100 000, χ2=97.48, P=0.001). The incidence rate of females (1.745/100 000) was also higher than that of males (1.418/100 000, χ2=85.02, P=0.001). The age peak of incidence and prevalence of patients with PPP was in the 30-39-year age group and a small peak existed in the 0-3-year age group among people under 20 years old. From 2012 to 2016, the average number of visits was (2.44±0.04) per patient, and the total per-capita cost per year was (982.40±39.19) yuan. Conclusion:In 2016, the prevalence and incidence rate of PPP in China were higher in females than in males, and the highest age peak was in the 30-39-year age group.

Objective:To analyze the epidemiological characteristics and economic burden of palmoplantar pustulosis (PPP) in China.Methods:A population-based retrospective study was conducted using the data from China′s Urban Basic Medical Insurance data from January 1, 2012, to December 31, 2016. International Classification of Diseases code and diagnoses in Chinese for PPP were used to identify cases and estimate the prevalence, incidence, and cost. Subgroup analyses were performed according to age and sex, and sensitivity analyses were conducted to evaluate the robustness of the results. Age-adjusted prevalence rates were calculated based on the 2010 national census data.Results:The crude prevalence and incidence rate of PPP in 2016 were 2.730/100 000 (95% CI: 2.218/100 000-3.242/100 000) and 1.556/100 000 (95% CI: 1.154/100 000-1.958/100 000), and the prevalence rate of females (2.910/100 000) was higher than that of males (2.490/100 000, χ2=97.48, P=0.001). The incidence rate of females (1.745/100 000) was also higher than that of males (1.418/100 000, χ2=85.02, P=0.001). The age peak of incidence and prevalence of patients with PPP was in the 30-39-year age group and a small peak existed in the 0-3-year age group among people under 20 years old. From 2012 to 2016, the average number of visits was (2.44±0.04) per patient, and the total per-capita cost per year was (982.40±39.19) yuan. Conclusion:In 2016, the prevalence and incidence rate of PPP in China were higher in females than in males, and the highest age peak was in the 30-39-year age group.

Objective:To investigate the predictive value of the quantitative parameters of dual-layer detector spectral CT in arterial and venous phases for the differentiation degree and the E-cadherin protein expression of gastric cancer.Methods:This was a cross-sectional study. The preoperative data from the dual-layer detector spectral CT images among 183 patients with gastric adenocarcinoma confirmed by operation and pathology was retrospectively analyzed from October 2021 to October 2022 in the First Affiliated Hospital of Fujian Medical University. According to the differentiation degree and E-cadherin protein expression of gastric cancer, all patients were divided into the moderately well differentiated group ( n=82) and the poorly differentiated group ( n=101), as well as the E-cadherin-negative group ( n=80) and the E-cadherin-positive group ( n=103). The CT images in arterial and venous phases were used to reconstruct the virtual monoenergetic images (VMI) at 40, 50, 60, 70, 80, 90, and 100 keV, effective atomic number (Z eff) images and iodine concentration (IC) images. The CT values (CT keV) from VMI, Z eff and IC were measured, and the normalized Z eff (NZ eff) and the normalized IC (NIC) were calculated. Independent-sample t test or Mann-Whitney U test were used to compare the differences in quantitative parameters between groups. The logistic regression analysis was used to screen for the independent predictors, after which a combined prediction model was constructed. The receiver operating characteristic curves were used to evaluate the predictive efficiency of the parameters for the differentiation degree and the E-cadherin protein expression of gastric cancer. Results:There were statistically significant differences in CT 40 keV to CT 70 keV, NZ eff and NIC in dual-phase, as well as Z eff and IC in the venous phase between the moderately well differentiated group and the poorly differentiated group ( P<0.05). The combined prediction model was constructed by CT 40 keV ( OR=1.03, 95% CI 1.02-1.05, P<0.001) in arterial phase and CT 40 keV ( OR=1.05, 95% CI 1.03-1.07, P<0.001) and Z eff ( OR=1.32, 95% CI 1.06-1.65, P=0.015) in venous phase, of which the area under the curve (AUC) for the prediction of the moderately-well group and the poor group was 0.932 (95% CI 0.897-0.967), with a sensitivity of 90.1% and a specificity of 85.4%. Between the E-cadherin-negative group and the E-cadherin-positive group, CT 40 keV and NZ eff in arterial phase, as well as CT 40 keV to CT 70 keV, Z eff, NZ eff, IC and NIC in venous phase, had statistically significant differences ( P<0.05). The AUC for the combined prediction model established by CT 40 keV ( OR=1.02, 95% CI 1.01-1.04, P<0.001) and Z eff ( OR=1.33, 95% CI 1.09-1.63, P=0.006) in venous phase was 0.800 (95% CI 0.736-0.864), with a sensitivity of 95.0% and a specificity of 60.2%. Conclusion:The combined prediction model from the quantitative parameters of dual-layer spectral detector CT can be used to predict the differentiation degree and the E-cadherin protein expression of gastric cancer preoperatively.

Objective:To comparative analyze mammographic and clinicopathological findings of ductal carcinoma in situ (DCIS) and DCIS with microinvasion (DCISM), and to investigate the predictive factors for DCISM.Methods:A total of 626 patients with DCISM and DCIS confirmed by surgery and pathology in the Affiliated Hospital of Qingdao University from January 2016 to July 2020 were collected and underwent preoperative mammography. The X-ray findings of DCISM and DCIS patients were classified and diagnosed according to the Breast Imaging Reporting and Data System (BI-RADS) criteria. The differences in clinicopathological and radiographic findings between DCISM and DCIS patients were analyzed using χ 2 test or Fisher exact test. The risk factors of DCISM were evaluated by using univariate and multivariate binary logistic regression analysis. Results:Among the 626 cases, 171 were diagnosed as DCISM, 455 were diagnosed as DCIS. Large diameter (≥2.7 cm), high nuclear grade, comedo type, axillary lymph node metastasis, high Ki67 proliferation index, negativity of estrogen receptor and progesterone receptor were found to be predictors of DCISM in the univariate analysis (all P<0.05). And large diameter (≥2.7 cm)(OR 2.229,95% CI 1.505-3.301, P<0.001), high nuclear grade(OR 1.711,95%CI 1.018-2.875, P=0.043) and axillary lymph node metastasis(OR 4.140,95% CI 1.342-12.773, P=0.013) were found to be independent predictors of DCISM in the multivariate analysis (all P<0.05). Mammographically, the lesion types, the presence and distribution of calcification were statistically significant between DCIS and DCISM patients (χ 2=17.42, 9.65, 9.10, P<0.05). Up to 17.6% (80/455) of DCIS were occult leisions, and DCISM showed more lesions with calcification in mass, asymmetry, and architectural distortion (49.1%, 84/171). Grouped calcifications were usually associated with DCIS (41.5%, 120/289), while regional calcification were commonly found in DCISM (35.9%, 47/131). Conclusions:Lesions with calcification and regional calcification were more likely associated with DCISM on mammography. Large diameter (≥2.7 cm), high nuclear grade and axillary lymph node metastasis were found to be independent predictors of DCISM.

Objective:To evaluate the diagnostic value of digital breast tomosynthesis (DBT) and digital mammography (DM) for radial lesions.Methods:The data of 76 patients (78 lesions) with radial lesions confirmed by operation and pathology on DBT between December 2016 and May 2020 in the Affiliated Hospital of Qingdao University were analyzed retrospectively. Taking pathological results as the gold standard, 78 lesions were divided into benign radial lesions ( n=46) and malignant radial lesions ( n=32), and their DBT features were compared. According to the standard of breast imaging report and data system (BI-RADS), the wheel-spoke structure, central density, overall size, central size and surrounding burr length of the two groups of radial lesions were compared on DBT. Results:The detection rates of DM and DBT for 78 radial lesions were 59.0% (46/78) and 100% (78/78), the difference had statistically significant ( P<0.05). The diagnostic accuracy rates of DM and DBT for 78 radial lesions was 65.2% (30/46) and 74.4% (58/78), the difference had no statistically significant ( P>0.05). The sensitivity, specificity, misdiagnosis rates, missed diagnosis rates of DM and DBT in the diagnosis of malignant radial lesions were 64.3%(18/28) and 84.4%(27/32), 66.7% (12/18) and 67.4%(31/46), 33.3%(6/18) and 32.6%(15/46), 35.7%(10/28) and 15.6%(5/32), respectively. The difference was not statistically significant ( P>0.05). There were significant differences in the overall size of lesions [18.0 (14.9, 29.2) mm, 26.5 (20.2, 34.9) mm], central size [3.5 (2.5, 4.5) mm, 4.5 (3.5, 5.5) mm] and peripheral burr length [(11±6) mm, (13±4) mm] between benign and malignant radial lesions on DBT ( P<0.05). When the central size of the lesion was 5 mm, there was significant difference in the distribution of benign and malignant radial lesions ( P<0.05), and when the overall size of the lesion was 2 cm, there was significant difference in the distribution of benign and malignant radial lesions ( P<0.05). Conclusion:DBT can improve the detection and diagnosis accuracy of radial lesions, and provide an important basis for clinicians to make surgical treatment decisions.

Objective To compare the diagnostic value of digital breast tomosynthesis (DBT), digital mammography(DM),and ultrasonography(US)for the non-calcified ductal carcinoma in situ(DCIS) of the breast.Methods To retrospectively analyze the imaging and clinical data of ductal carcinoma in situ which was confirmed by surgical pathology and displayed as non-calcified lesions in mammography in 110 patients.DBT,DM and US were performed in all the 110 cases.The breast imaging report and data system (BI-RADS)classification and breast density classification were evaluated using the 5th edition of BI-RADS. In our study, BI-RADS 4B, 4C, and 5 were regarded to be in agreement with the pathologic findings, BI-RADS 1,2,3,and 4A were considered to be negative.BI-RADS c and d were classified as dense breasts, BI-RADS a and b were classified as fatty breasts.The imaging findings of the non-calcified ductal carcinoma in situ were evaluated.The differences in the detection rate and the diagnostic accuracy among the DBT,DM and US in all cases and in different breast density were compared using χ2 test. Results The detection rates of DBT,DM,and US for non-calcified DCIS in all cases were 84.5%(93/110),70.9%(78/110),95.5% (105/110).Pairwise comparisons among the three techniques showed statistically significant difference(P<0.05). The diagnostic accuracy of DBT, DM, and US were 70.0% (77/110), 44.5% (49/110), and 69.1% (76/110),respectively.The diagnostic accuracy of DBT and US were significantly higher than that of DM(P<0.01). Of the 110 patients, 89 patients were classified as dense breasts and non-dense breasts in the remaining 21 patients.The detection rates of DBT,DM,and US for non-calcified DCIS in dense breasts were 82.0%(73/89),65.2%(58/89),and 96.6%(86/89).Pairwise comparisons among the three techniques showed statistically significant difference(P<0.01).The diagnostic accuracy of DBT,DM,and US for non-calcified DCIS in dense breast were 65.2% (58/89), 38.2% (34/89) and 66.3% (59/89), respectively.The diagnostic accuracy of DBT and US were significantly higher than that of DM in dense breast(P<0.01).The detection rate and diagnostic accuracy for DBT,DM,and US in non-dense breasts were not statistically different(P>0.05).By DBT and DM,most cases of non-calcified DCIS presented as a mass lesion with an irregular shape, indistinct margin,and isodense composition.Conclusion US is more advantageous to the detection of the non-calcified DCIS and the non-calcified DCIS in the dense breast.

OBJECTIVE To investigate the correlation between benign paroxysmal positional vertigo (BPPV) and bone mineral density (BMD) in menopausal women with BPPV.METHODS 50 patients between the ages of 50-80 years old of menopausal women with Idiopathic benign paroxysmal positional vertigo(iBPPV)as case group,and postmenopausal healthy people of same age doing physical examinations in hospital medical examination center were selected as control group.The lumbar spine(L1-L4) and femoral neck were measured respectively using dual energy X-ray absorptiometry and expressed in T value.The case group and the control group were divided into three age groups,and the T values of three age groups were statistically analyzed.RESULTS There was significant correlation between the case group and control group(The t values are-3.68、-5.98 and-3.33,respectively,P＜0.05).Pearson correlation analysis showed that there was a negative correlation between iBPPV and bone mineral density(BMD) (r=-0.496,P＜0.05).CONCLUSION There was a correlation between benign paroxysmal positional vertigo and BMD in menopausal women.The results of this study may be helpful for the diagnosis,treatment,prognosis and precaution of iBPPV.

AIM:To investigate the renal function and pathological changes in Npc1 mutant ( Npc1-/-) mice. METHODS:Different genotypes of Niemann-Pick disease type C1 (Npc1) mice were identified by PCR.Subsequently, the renal function of Npc1-/-and Npc1 +/+mice at postnatal day 60 ( P60) was evaluated by measuring the activity and con-tent of important indicators in the serum including ALT , AST, LDH, urea, UA and Cr.Furthermore,β-galactosidase stai-ning and Masson staining were performed to examine the aging and fibrosis of the renal tissues , respectively .RESULTS:Compared with the Npc1 +/+mice, the body weight and kidney weight had a significant reduction ( P<0.01) in the Npc1-/-mice.The results of hepatic and renal functions showed that the activities of ALT , AST and LDH, and contents of urea, UA and Cr had marked increases (P<0.05) in the Npc1-/-mice.Moreover, the results of senescence-associatedβ-galacto-sidase staining in the renal tissues demonstrated accelerated aging in the Npc1-/-mice (P<0.01), and these results were confirmed by Masson staining, which clearly showed the formation of collagen fibers (P<0.01).CONCLUSION:Muta-tion of the Npc1 gene results in abnormal lipid metabolism , which accelerates kidney senescence by promoting fibrosis in the renal tissue and subsequently causes reduction in renal function .

Objective To objectively analyze the manifestation of sleep disorders in patients with Parkinson' s disease (PD) using polysomnogram (PSG) and multiple sleep latency test (MSLT). Method Twenty-six patients (PD group)with PD and 31 controls without CNS diseases( control group) underwent all night ambulatory video-polysomnographic monitoring and MSLT on the next day. Sleep architecture, mean sleep latency,sleep onset rapid eye movement (REM) periods(SOREMPs) and sleep attacks(Sas) of the two groups were analyzed. Results When compared to the controls, percentage of NREM stage 2 sleep,percentage of REM sleep, mean sleep latency in the PD patient group were significantly decreased (32.8% ±13.1% vs40.2% ±9.1%,t = -2.515;8.6% ±5.3% vs 11.5% ±5.1%,t = -2.054;(9.6 ± 4. 4) min vs ( 15.7 ± 3. 1 ) min, t = - 6. 1 64, all P ＜ 0. 05 ), while arousal index was significantly increased ( (41.8 ± 32. 1 )/h vs ( 28.6 ± 1 1. 0 )/h, t = 2. 151, P ＜ 0. 05 ). The prevalence of excessive daytime sleepiness (EDS; 7/26, 26. 9% ) was higher in the PD patient group than in the controls (1/31,3. 2%; ×2 =4. 764,P＜0. 05). Multivariate linear regression analysis showed that after adjusting for sleep efficiency, apnea hypopnea index, arousal index, decreasing mean sleep latency in PD patients was significantly associated with both age( β = -0. 328) and levodopa equivalents( β = -0. 008; t = -2. 829,-2. 352,all P ＜ 0.05). SOREMPs occurred in 5 of 26 (19.2%) PD patients and Sas occurred in 3 ( 11.5% ) PD patients but did not occur in the controls. Conclusion Changes in sleep architectures and EDS are more common in PD patients. Physicians should be highly vigilant in recognizing Sas, which are uncommon in PD patients.