BACKGROUND:Rheumatoid arthritis is widely prevalent worldwide,with its high incidence and universality that considerably affects patients' quality of life.Previous studies have focused on a few immune cells or cytokines,whereas this study comprehensively provides a more complete view of the immune mechanisms in rheumatoid arthritis.OBJECTIVE:To explore the causal relationship between 731 immune cell phenotypes and rheumatoid arthritis using the Mendelian randomization method,thereby providing evidence of causality.METHODS:The 731 immune cell phenotypes used in this study were sourced from the GWAScatalog database,jointly developed by the National Human Genome Research Institute(NHGRI)and the European Bioinformatics Institute(EBI).The rheumatoid arthritis data were from the Finngen database,developed by the Finnish Institute for Molecular Medicine(FIMM).The inverse variance weighting method was employed as the primary analytical approach.Additionally,multiple analytical methods,including MR-Egger,weighted mode,simple mode,and weighted median,were concurrently utilized to complement the final results.Sensitivity analyses(Cochran's Q test,MR-Egger regression,and MR-presso analysis)were also conducted to verify the stability and feasibility of the data.RESULTS AND CONCLUSION:(1)After excluding results through heterogeneity testing,the inverse variance weighting analysis indicated that 10 absolute cell counts,15 median fluorescence intensities of surface antigen levels,1 morphological characteristic,and 9 relative cell counts had a causal relationship with the occurrence of rheumatoid arthritis.(2)According to cell classification,this study found that seven types of B cells,seven types of classical dendritic cells,six types of mature T cells,four types of monocytes,three types of myeloid cells,three types of TBNK cells(lymphocyte subset T cells,B cells and natural killer cells),and five types of Tregs had a causal association with the occurrence of rheumatoid arthritis.(3)Through comprehensive bidirectional two-sample MR analysis,we demonstrated the complex causal relationships between multiple immune phenotypes and rheumatoid arthritis,highlighting the intricate interaction patterns between the immune system and rheumatoid arthritis.These results provide new biomarkers for the early screening and diagnosis of rheumatoid arthritis in China,and help to improve the diagnostic accuracy and sensitivity.

BACKGROUND:Rheumatoid arthritis is widely prevalent worldwide,with its high incidence and universality that considerably affects patients' quality of life.Previous studies have focused on a few immune cells or cytokines,whereas this study comprehensively provides a more complete view of the immune mechanisms in rheumatoid arthritis.OBJECTIVE:To explore the causal relationship between 731 immune cell phenotypes and rheumatoid arthritis using the Mendelian randomization method,thereby providing evidence of causality.METHODS:The 731 immune cell phenotypes used in this study were sourced from the GWAScatalog database,jointly developed by the National Human Genome Research Institute(NHGRI)and the European Bioinformatics Institute(EBI).The rheumatoid arthritis data were from the Finngen database,developed by the Finnish Institute for Molecular Medicine(FIMM).The inverse variance weighting method was employed as the primary analytical approach.Additionally,multiple analytical methods,including MR-Egger,weighted mode,simple mode,and weighted median,were concurrently utilized to complement the final results.Sensitivity analyses(Cochran's Q test,MR-Egger regression,and MR-presso analysis)were also conducted to verify the stability and feasibility of the data.RESULTS AND CONCLUSION:(1)After excluding results through heterogeneity testing,the inverse variance weighting analysis indicated that 10 absolute cell counts,15 median fluorescence intensities of surface antigen levels,1 morphological characteristic,and 9 relative cell counts had a causal relationship with the occurrence of rheumatoid arthritis.(2)According to cell classification,this study found that seven types of B cells,seven types of classical dendritic cells,six types of mature T cells,four types of monocytes,three types of myeloid cells,three types of TBNK cells(lymphocyte subset T cells,B cells and natural killer cells),and five types of Tregs had a causal association with the occurrence of rheumatoid arthritis.(3)Through comprehensive bidirectional two-sample MR analysis,we demonstrated the complex causal relationships between multiple immune phenotypes and rheumatoid arthritis,highlighting the intricate interaction patterns between the immune system and rheumatoid arthritis.These results provide new biomarkers for the early screening and diagnosis of rheumatoid arthritis in China,and help to improve the diagnostic accuracy and sensitivity.

Objective To compare the short-term efficacy and safety of low temperature plasma radiofre-quence ablation(LA)vs.high voltage long duration pulsed radiofrequency(HL-PRF)in the treatment of cervico-genic headache(CEH).Methods Eighty patients with cervicogenic headache were divided two groups:one treated with low temperature plasma radiofrequence ablation group as group L(n = 50)and the other treated with high voltage long duration pulsed radiofrequency group as group H(n = 30).The two groups were compared in terms of the score by the Visual Analog Scale,score by the Range of Motion Scale,postoperative pain relief rate,postop-erative complication incidence,1,4,12,and 24 weeks after the operation,as well as the therapeutic effectiveness and safety.Results Both groups showed significantly lower VAS and ROM scores after operation(P<0.05).Compared with group L,group H had significantly lower VAS(all P<0.05)but insignificantly lower ROM scores(all P>0.05)at each time point.At T4,group H had significantly higher therapeutic effectiveness rate(P<0.05)and higher incidence of scalp numbness at T3,as compared to group L(P<0.05).Conclusion The low tempera-ture plasma radiofrequency ablation and high voltage long duration pulsed radiofrequency both are effective and safe in the treatment of CEH,the latter approach can achieve better therapeutic effectiveness 24 weeks after the operation than the former.

OBJECTIVE To conduc t qualitative and quantitative analysis for the chemical compounds in 3 species of wild Veratrum（V. nigrum ，V. maackii ，V. dahuricum ）from Inner Mongolia. METHODS HPLC-Q-Exactive-MS/MS technology was used to identify the chemical components of V. nigrum ，V. maackii and V. dahuricum by consulting SciFinder ，ChemSpider database and related literatures and comparing with the reference substance. The contents of polydatin ，oxyresveratrol and resveratrol in 3 species of wild Veratrum were determined by HPLC. RESULTS A total of 31 compounds were identified ，including 13 stilbenes， 11 flavonoids，4 organic acids ，2 glycosides，1 brasilin. Most of the compounds were shared by 2 or 3 species of wild Veratrum， only 2 flavonoids kaempferol and luteolin were owned by V. dahuricum . The total contents of polydatin ，oxyresveratrol and resveratrol in 3 species of wild Veratrum were in the range of 6.618-11.292 mg/g，and the total contents of them in V. nigrum were the highest ，followed by V. maackii and V. dahuricum . The contents of polydatin and resveratrol in V. maackii were the highest ，and the content of oxyresveratrol in V. nigrum was highest. CONCLUSIONS Most of the components of 3 species of wild Veratrum are similar，only kaempferol and luteolin are unique to V. dahuricum . The contents of polydatin ，oxyresveratrol and resveratrol are significantly different among 3 species of wild Veratrum.

Objective:To investigate the effect of predictive nursing intervention on immune function, psychological state and self-efficacy of patients with advanced gastric cancer (AGC) in tumor immunotherapy.Methods:Fifty patients with AGC who underwent tumor immunotherapy from February 2016 to November 2018 were enrolled in the study. They were divided into two groups according to the principle of numerical randomization. The control group (25 cases) was routinely used. In the nursing mode, the observation group (25 cases) used predictive nursing intervention. The venous blood was collected at the time of admission, 1 day and 2 days before discharge, and the T lymphocyte subsets were measured. The Self-rating Anxiety Scale (SAS), the Self-rating Depression Scale (SDS), Self-Efficacy Scale, and Quality of Life were used to assess the patient's mental state, subjective feelings, and quality of life.Results:There were no significant differences in CD 3+, CD 4+, CD 8+ and CD 4+/CD 8+ between the two groups before intervention ( P>0.05). CD 3+, CD 4+, CD 8+ and CD 4+/CD 8+ after intervention was 0.576 3±0.071 7, 0.496 3±0.067 7, 0.292 1±0.061 4, 1.75±0.48 in the observation group and 0.552 4±0.074 2, 0.489 2±0.070 4, 0.294 1±0.062 5, 1.63±0.51 in the control group. There were significant differences in CD 3+, CD 4+, and CD 4+/CD 8+ between the two groups after intervention ( t values were 3.158, 1.954, 2.347, all P<0.05). There was no significant difference in SAS and SDS scores between the two groups before intervention ( P>0.05). The SAS, SDS score after intervention in the observation group was (51.4±4.2), (50.8±3.5) points, and (55.7±3.6), (56.5±4.0) points in the control group, there was significant difference between the two groups ( t values were 3.887, 5.362, all P<0.01). There was no significant difference in self-efficacy between the two groups and the total score ( P>0.05). The total score of self-efficacy after intervention was (137.7±14.4) in the observation group, and (121.5±11.8) points in the control group, there was significant difference between the two groups( t value was 4.351, P<0.01). The quality of life score was (52.5±13.4) points in the observation group and (45.3±11.0) points in the control group, there was significant difference between the two groups ( t value was 2.077, P<0.05). The excellent and good rate of the quality of life score was 76.0%(19/25) in the observation group, and 56.0%(14/25) in the control group, there was no significant difference between the two groups ( χ2 value was 2.228, P>0.05). Conclusions:Tumor immunotherapy for the treatment of patients with AGC uses predictive care and significantly relieves their mental state and self-efficacy, promotes the recovery of their physical functions and improves the quality of life.

OBJECTIVE： To prepare Ganshen granules， formulate its quality standards primarily and establish its HPLC fingerprint. METHODS： Using feeding speed， roller speed， roller pressure and roller clearance as factor， grain forming rate as index， single factor test and orthogonal test were used to optimize the granulation technology of Ganshen granules. According to 2015 edition of Chinese Pharmacopeia （part Ⅳ） （shorted for pharmacopeia）， moisture， granulation and dissolution were determined. TLC was used for the qualitative identification of Lycium barbarum， Astragalus membranaceus， Codonopsis pilosula in the Ganshen granules. HPLC method was used to determine the contents of betaine， calycosin-7-glucoside and lobetyolin in Ganshen granules. Fingerprints of 10 batches of Ganshen granules were drawn. RESULTS： The optimal dry granulation technology of Ganshen granules included that 25 r/min feeding speed， 8 r/min roller speed， 7 MPa roller pressure and 1.1 mm roller clearance， The grain forming rate is 85.83％. The moisture， granulation and solubility of Ganshen granule were all in line with pharmacopeia standard. TLC of L. barbarum， A. membranaceus and C. pilosula showed the same color spots on the corresponding positions of the reference chromatogram. The linear range of sample mass of betaine is 4.32-8.64 μg， and the linear range of mass concentration of calycosin-7-glucoside and lobetyolin were 5-30 and 10-60 μg/mL， respectively. RSDs of precision， reproducibility and stability tests （24 h） were all lower than 2.0％ （n＝5）. Average recoveries were 97.02％， 99.25％ and 101.04％ （all RSD＜1.7％， n＝6 or n＝9）. The contents of them were 4.298、0.054、0.025 mg/g， respectively. The similarity of HPLC fingerprints of 10 batches of Ganshen granules to control fingerprint was higher than 0.95. CONCLUSIONS： The optimal granulation technology of Ganshen granule is stable and feasible， and established quality standard and HPLC fingerprint can provide reference for quality control of Ganshen granule.