OBJECTIVE: To investigate the clinical characteristics of overlapping syndromes of low muscle 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 measurement 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 overlapping syndromes of low muscle mass, especially sarcopenia should be emphasized in patients with RA.
Humans ; Arthritis, Rheumatoid/physiopathology* ; Female ; Male ; Sarcopenia/complications* ; Middle Aged ; Cachexia/diagnosis* ; Malnutrition/etiology* ; Obesity/physiopathology* ; Body Composition ; Syndrome ; Hand Strength ; Adult ; Muscle, Skeletal/physiopathology* ; Surveys and Questionnaires

There lack scientific methods for evaluating the treatment of cancer pain with external therapies of traditional Chinese medicine (TCM). The level of clinical study in this field needs to be improved. The authors assert that when external therapies of TCM are applied to treat cancer pain, different types of cancer pain should be distinguished and treatment should be applied according to such a differentiation. Under this framework scientific evaluation can be conducted. The authors also assert that the findings of randomized, blinded and controlled trials should be given particular attention, and it is necessary to include titration of morphine into clinical trails of external therapies for the treatment of cancer pain, not only complying with the three-ladder principle for treating cancer pain suggested by the World Health Organization, but also not influencing the effect evaluation of external therapies of TCM on cancer pain. Patient diaries recording pain were revised as observation indexes. The primary indicator of efficacy was the pain intensity score and the secondary indicators were the equivalent of morphine and the remission rate of pain. The time to onset, remission duration and comparison of assessment of pain influence can mirror the characteristics of external therapies of TCM on cancer pain.

Objective To observe the clinical efficacy of applying Sweat Reduction Formula (SRF) externally in the treatment of cancer-linked hyperhidrosis. Methods 45 tumor patients, who exhibited excessive perspiration, were selected and recruited randomly into an experimental group (Sweat Reduction Formula group) with 24 patients in it and a control group (Placebo group) with 21 patients in it. The experimental group was treated with SRF and the control group was administrated with placebo. Neuropad diagnostic patches were used to observe the period of time that required for any visual changes in color before and after medication. These observations were then matched with the commonly seen signs and symptoms scoring table, to evaluate the changes of symptoms and KPS. Results The color changing time of the experimental group was 14.45±3.91 min. and 19.51±5.30 min. before and after medications respectively. And the changing time in the control group was 13.49±4.96 min. After medication. The results were highly significant with P<0.05. There were also different levels of significant improvements in terms of spontaneous perspiration, night sweating, dry mouth, feverish sensation over hand-foot centers and body, aversion to cold etc after the treatment in the experimental group. Conclusion It would be more objective to evaluate the clinical efficacy of applying SRF on navel to treat cancer-linked hyperhidrosis with neuropad diagnostic patches.

Objective To investigate the effect of Pingfei Oral Liquid (POL) on the distribution of mast cells (MCs) and the expression of interleukin 6 (IL-6) in the lung tissue of radiation pneumonia rats. MethodsForty-five SD rats were randomized into 3 groups : normal control,model group and POL group. The rat model of radiation lung fibro-sis was set up by a single X-ray dose of 20Gy irradiation over the whole chest of the rats. POL (20 g·kg-1·d-1,once a day, five times a week) was given orally one week before irradiation and the treatment lasted 5 weeks. MCs in the lung tissue were stained with toluidine blue firstly and then were counted 2, 4 and 8 weeks after irradiation. IL-6 protein expression of lung tissue was measured by immunohistochemical assay 8 weeks after irradiation, and mRNA ex-pression was determined with RT-PCR 4 weeks after irradiation. ResultsIt's showed the aggregation of large amount of pulmonary mast cells and increase of IL-6 protein expression 8 weeks after irradiation (P < 0.01).IL-6 mRNA expression in the irradiated lung of rats increased 4 weeks after irradiation (P < 0. 01). POL could reduce the aggrega- tion of MCs (P < 0. 01) and the expression of IL-6 protein (P < 0. 01) and mRNA (P < 0. 05) in the lung tissue. ConclusionPOL can prevent radiation pneumonia in rats by reducing the aggregation of mast cells and inhibiting IL-6 expression in the lung tissue.

OBJECTIVE: To study the antineoplastic mechanism of Pingfei Mixture. METHODS: Thirty C57BL mice bearing Lewis pulmonary carcinoma were randomly divided into 3 groups: saline control group, Pingfei Mixture group and cisplatin group. Fifteen days later, tumor tissues and spleens were taken out and made into unicellular suspension. Argyrophil staining was taken to carcinoma cells and cultured T cells. KL-2 style cell image analysis system was used to analyze the rate between AgNORs and nuclear region (I.S). RESULTS: There were dense brownish-black granules in tumor cell nuclear of saline control group. The brownish-black granules of Pingfei Mixture group and cisplatin group were less than those of saline control group. The differences of T cell I.S in these three groups were significant. The I.S of Pingfei Mixture was higher than that of the other groups, and the I.S of the cisplatin group was the lowest. CONCLUSION: Pingfei Mixture can inhibit tumor cell proliferation, although the effect is inferior to cisplatin. Pingfei Mixture can also promote T cell proliferation and its effect was superior to cisplatin.

Background and purpose:Irinotecan(CPT-11) is a derivative of camptothecin,an inhibitor of DNA topoisomerase I.CPT-11 is oxidized to inactivated metabolites(including APC)by CyP3A enzymes and activated to SN-38 by Carboxylesterase-2(CES-2).CPT-11 has been shown to exhibit excellent antitumor activity against colorectal cancer.Our research is to evaluate the efficacy and toxicity of CPT-11 combined with 5-FU/CF in the treatment of advanced or metastatic colorectal cancer.Methods:thirty-two cases of advanced or metastatic colorectal cancer patients were treated,and thirty cases were evaluable for efficacy.of which 19 cases were grouped with one cycle every two weeks and 13 cases were grouped with one cycle every three weeks.Results:In 30 evaluable patients,2 cases had complete response,11 cases had partial response,14 cases had stable disease and 3 cases with progressive disease.The response rate of the whole group was 43.3% and the stability rate was 46.7%.The clinical beneficial response rate was 83.3%.Median time to progression was 7.2 months and median overall survival time was 13.8 months. Dose limiting toxicity was delayed diarrhea and neutropenia.There was no death during the treatment.Conclusions:CPT-11 combined with 5-Fu/CF is an effective and well tolerated regimen in the treatment of advanced or metastatic colorectal cancer.which can relieve symptoms and improve quality of life of the patients.It can be used as the first-line or second-line therapy for advanced or metastatic colorectal cancer.