To investigate the clinical features and peripheral blood immune cell subsets ofelderly (≥60 years old) onset rheumatoid arthritis (EORA) patients.

Antibody-drug conjugates(ADCs), as an emerging therapy for cancer treatment, have made significant progress in the past few decades. However, due to the heterogeneity of ADCs, they still face various issues and challenges in clinical therapy. Therefore, site-specific conjugation techniques have become a crucial area of research in ADCs, and in recent years, this field has witnessed numerous breakthrough advancements, empowering ADCs with enhanced performance. The review provides a comprehensive overview of the frontiers in site-specific conjugation technologies for ADCs. Categorized into seven major classes including lysine-based, cysteine-based, low-abundance amino acid-based and glycosylation site-based conjugation techniques, ribosomal incorporation of unnatural and noncanonical amino acids and enzyme-mediated conjugation techniques, it meticulously describes 21 classical and emerging techniques such as the THIOMAB technology and linchpin-directed modification, in order to offer valuable insights for the development of next-generation ADCs.

Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease with high prevalence and possible poor prognosis. Though the pathogenesis of pSS has not been fully elucidated, B cell hyperactivity is considered as one of the fundamental abnormalities in pSS patients. It has long been identified that Janus kinases-signal transducer and activator of transcription (JAK-STAT) signaling pathway contributes to rheumatoid arthritis and systemic lupus erythematosus. Recently, increasing numbers of studies have provided evidence that JAK-STAT pathway also has an important role in the pathogenesis of pSS via direct or indirect activation of B cells. Signal transducer and activator of transcription 1 (STAT1), STAT3, and STAT5 activated by various cytokines and ribonucleic acid contribute to pSS development, respectively or synergically. These results reveal the potential application of Janus kinase inhibitors for treatment of pSS, which may fundamentally improve the quality of life and prognosis of patients with pSS.

Objective:To investigate the clinical characteristics of patients with rheumatic diseases and abnormal liver function, as well as determine the proportion and severity of liver function abnormalities.Methods:Cross-sectional study. Data were collected from patients registered in the Chinese Rheumatism Date Center from 2011 to 2021. The rheumatic diseases analyzed in this study were rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjogren syndrome (SS), ankylosing spondylitis (AS), and gout. Patient data, including demographic characteristics [ such as age, sex, body mass index,(BMI), and smoking history], liver function test results [including alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase(ALP), and total bilirubin], and use of anti-rheumatic immune drugs and liver-protective drugs, were collected and compared between groups with normal and abnormal liver functions. In addition, the proportions of abnormal liver function were compared between sex and age groups.Results:A total of 116 308 patients were included in this study, including 49 659 with RA, 17 597 with SLE, 9 039 with SS, 11 321 with AS, and 28 692 with gout. The lowest proportion of liver function abnormalities was observed in patients with RA[11.02% (5 470/49 659)], followed by those with SS[17.97% (1 624/9 039)] and AS [18.22% (2 063/11 321) ], whereas patients with SLE [21.14% (3 720/17 597) ] and gout [28.73% (8 242/28 692)] exhibited the highest proportion of these abnormalities. Elevated ALT, mostly classified as grade 1, was the most commonly noted liver function abnormality, whereas elevated ALP was the least common. Some patients who took liver-protective drugs had normal liver function, with the lowest percentage observed in patients with gout [7.45% (36/483) ] and ranging from 21.7% to 30.34% in patients with RA, SLE, SS, and AS. The proportion of liver function abnormalities was higher in males than in females for all disease types [RA: 13.8%(1 368/9 906) vs. 10.3%(4 102/39 753); SLE: 33.6% (479/1 424) vs. 20.0% (3 241/16 173); SS: 25.4%(111/437) vs. 17.6%(1 513/8 602); AS: 20.1%(1 629/8 119) vs. 13.6% (434/3 202); and gout: 29.3% (8 033/27 394) vs. 16.1% (209/1 298)]. In RA, SLE, and AS, the proportions of liver function abnormalities were similar across all age groups. In SS, the proportion of liver function abnormalities increased with age [<40 years: 14.9%(294/1 979); 40-59 years: 18.1%(858/4 741); ≥60 years: 20.4%(472/2 319)], whereas a reversal of this trend was observed in gout [<40 years: 34.9%(4 294/12 320); 40-59 years: 25.5%(2 905/11 398);≥60 years: 21.0%(1 042/4 971)].Conclusions:The proportions of combined liver function abnormalities in patients with rheumatologic diseases were high, and the utilization rates of liver-protective drugs were low. It is necessary to pay more attention to monitoring patients′ liver function, timely administer liver-protective drugs, and optimize liver-protective regimens during the treatment of rheumatic diseases.

Blumea balsamifera belonging to Blumea of Compositae family is a perennial herb or subshrub ，which is the only source of Traditional Chinese medicine Aipian and ethnic medicine essential oil of B. balsamifera . B. balsamifera contains volatile oil，flavonoids，sesquiterpenoids，phenylpropanoids，etc.，and shows antibacterial ，anti-inflammatory，analgesic，treating burns and scalds，neuroprotective and antioxidant effects ，etc. In this paper ，the chemical constituents and pharmacological activities are summarized by reviewing the domestic and foreign research literatures ，and it is expected to provide a reference for the in-depth research and development and utilization of B. balsamifera .

Objective: The study aimed to investigate the diurnal variation in cervical disc hydration and its relationship with cervical degeneration. Materials and Methods: C3–C7 discs of 86 prospectively enrolled participants (37 males, 49 females; mean age ± standard deviation, 23.5 ± 2.5 years) were assessed using T2 mapping in the morning and evening. All discs were stratified by Miyazaki grade or C2–C7 Cobb angle and T2 values (T2). The degree of diurnal T2 variation (T2-DDV), defined as (morning T2 – evening T2)/morning T2 x 100%, was measured for the entire disc, annulus fibrosus (AF), nucleus pulposus (NP), and endplate zones. Results: T2 of the entire disc decreased significantly after the daytime load (p < 0.001), with a T2-DDV of 13.3% for all discs and 16.0%, 12.2%, and 13.0% for healthy (grade I), mild degenerative (grade II), and advanced degenerative (grade III/IV) discs, respectively. T2 of regional NPs and AFs decreased significantly from morning to evening (p ≤ 0.049) except in the healthy anterior inner AF (p = 0.092). Compared with healthy discs, mild degenerative discs displayed lower T2 and T2-DDV in regional NPs (p < 0.001). Advanced degenerative discs showed higher T2-DDV in the anterior inner AF compared with healthy discs (p = 0.050). Significant diurnal T2 changes in the endplate zones were observed only in healthy discs (p = 0.013). Cervical discs in the low Cobb angle group showed higher T2-DDV in the anterior AFs and anterior NP and lower T2-DDV in the posterior AF than those in the high Cobb angle group (p ≤ 0.041). Conclusion This study characterized the diurnal variation in hydration of the cervical discs as assessed using T2 mapping and revealed early chemo-mechanical coupling dysfunction in degenerating discs. Cervical sagittal alignment on MRI can affect the diurnal stress patterns of the cervical discs. T2 mapping is sensitive to disc biomechanical dysfunction and offers translational potential from biomechanical research to clinical application.

Objective:To analyze the clinical characteristics and risk factors of systemic lupus erythematosus (SLE) with Libman-Sacks endocarditis (LSE).Methods:Data of SLE patients with LSE ( n=20) who admitted in Peking Union Medical College Hospital from January 2012 to May 2021 were retrospectively collected. SLE patients without LSE ( n=60) were randomly selected as controls according to 1∶3 age and sex matched in the hospitalized patients during the same period. Clinical characteristics, laboratory and imaging examinations were analyzed. Data were expressed as Mean± SD, and t test was used to compare quantitative data in normal distri-bution. Data were expressed as M ( Q1, Q 3), and Wilcoxon signed-rank test or Wilcoxon rank sum test were used to compare quantitative data in non-normal distribution. The count data were compared with Chi-square test or Fisher's exact test. Univariate conditional logistic regression was used for univariable analyses. P values less than 0.05 were considered statistically significant. Results:There were 20 SLE patients with LSE, 18 females with an average age of (32±9) years (13 to 49 years). The disease duration of SLE was 16.04(0, 185.1) months when LSE was discovered, and vegetations were located at the mitral valve in 19 (95.0%) patients. Cerebral infarction (45.0% vs 10.0%, χ2=9.87, P=0.001) and antiphospholipid syndrome (APS) (50.0% vs 5.0%, χ2=22.32, P<0.001) were more common in SLE with LSE. In addition, SLE with LSE had lower platelet counts [(140±67)×10 9/L vs (189±115)×10 9/L, t=-2.29, P=0.026] and higher positive rate of lupus anticoagulant (LA) (80.0% vs 23.6%, χ2=19.65, P<0.001), lower positive rate of anti-SSA antibodies (21.1% vs 60.0%, χ2=6.38, P=0.012). Left atrial enlargement (anteroposterior diameter of left atrium>40 mm) was more common in SLE patients with LSE (35.0% vs 5.4%, χ2=9.37, P=0.002), and anteroposterior diameter of left atrium [(37±7) mm vs (33±4) mm, t=2.15, P=0.043] were larger and left ventricular ejection fraction [(63±10)% vs (68±6)%, t=-2.41, P=0.019] was lower. The risk of SLE with LSE complicated with APS was 19 times compared with SLE without LSE [ OR (95% CI)=19.00 (4.43, 81.38), P<0.001]. Conclusion:SLE patients with LSE have increased risk of APS and cerebrovascular diseases. For patients with positive LA, the possibility of LSE should be alerted.

Objective:To analyze the clinical characteristics and risk factors of rheumatic diseases complicated with Pneumomediastinum (PnM).Methods:A retrospective analysis of 94 inpatients with rheumatic diseases associated PnM from Peking Union Medical College Hospital and Shanxi Bethune Hospital between January 1998 and October 2018 was carried out. Patients were divided into idiopathic inflammatory myopathies (IIM) and the non-IIM group. Clinical features, laboratory examinations and treatment were compared between the two groups. Cox proportional hazard model was used to investigate the risk factors for prognosis.Results:A total of 94 patients were included in the study, with an average age of (45±14) years. Forty-five (48%) of them were male. There were 62 patients in the IIM group and the other 32 were in the non-IIM group. Sixty-nine patients had predisposing factors before PnM. Severe cough and assisted mechanical ventilation were the most common causes. Compared with the non-IIM group, the incidence of digital vasculitis (29% vs 6%, χ2=6.540, P=0.008), arthritis (60% vs 28%, χ2=8.409, P=0.004), interstitial lung disease (ILD)(98% vs 78%, χ2=11.129, P=0.002) were higher in the IIM group, treatment with cyclophosphamide was higher in the IIM group ( χ2=4.458, P=0.035). There was non-significant difference in mortality between the two groups during hospitalization (50% vs 59%) and 6 months after PnM (64% vs72%) ( P>0.05). Pulmonary infection was the only risk factor for poor prognosis [ HR=3.131, 95% CI (1.025, 9.561), P=0.045], in which bacteria infection was the most common cause (65/75, 86.7%). Conclusion:PnM is a severe complication of rheumatic diseases. To get a good prognosis, rheumatol-ogists should balance the benefit and risk of infection of immunosuppressive therapy.

Objective:The purpose of this study was to evaluate the effect of computer-assisted navigation in the removal of foreign bodies in the oral and maxillofacial regions.Methods:A retrospective analysis was performed on the patients who suffered from oral and maxillofacial foreign bodies and were treated with computer-aided navigation technology in the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Wuhan University from January 2014 to December 2018. All patients received the examination of spiral CT, and the CT data were imported into the computer navigation workstation to complete the presurgical planning. The surgical approach was through the original wound or local small incision, and the computer navigation system was used to accurately locate the foreign body and perform the foreign body removal. All patients underwent postoperative follow-up, and the oral and maxillofacial appearance and functional recovery were evaluated.Results:A total of 35 patients were involved in this study, including 29 males and 6 females, aged 2 to 77 years old(average age: 38.3±20.2 years). Foreign bodies included metals, fish bones, and broken glass. The operation time was 30-90 min [average time: (50.6±16.5) min]. The operation proceeded well in these patients. The foreign bodies were removed successfully. There was no infection in the wound or surgical incision, and the healing was normal. All patients recovered well in the oral and maxillofacial appearance and function during the one-to-twelve-month follow-ups after operation.Conclusions:Computer-assisted navigation is an effective technique that can be applied in the removal of oral and maxillofacial foreign bodies. It can accurately locate the foreign bodies and perform minimally invasive surgery, thereby reducing the impact on facial appearance.

Objective:The purpose of this study was to evaluate the effect of computer-assisted navigation in the removal of foreign bodies in the oral and maxillofacial regions.Methods:A retrospective analysis was performed on the patients who suffered from oral and maxillofacial foreign bodies and were treated with computer-aided navigation technology in the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Wuhan University from January 2014 to December 2018. All patients received the examination of spiral CT, and the CT data were imported into the computer navigation workstation to complete the presurgical planning. The surgical approach was through the original wound or local small incision, and the computer navigation system was used to accurately locate the foreign body and perform the foreign body removal. All patients underwent postoperative follow-up, and the oral and maxillofacial appearance and functional recovery were evaluated.Results:A total of 35 patients were involved in this study, including 29 males and 6 females, aged 2 to 77 years old(average age: 38.3±20.2 years). Foreign bodies included metals, fish bones, and broken glass. The operation time was 30-90 min [average time: (50.6±16.5) min]. The operation proceeded well in these patients. The foreign bodies were removed successfully. There was no infection in the wound or surgical incision, and the healing was normal. All patients recovered well in the oral and maxillofacial appearance and function during the one-to-twelve-month follow-ups after operation.Conclusions:Computer-assisted navigation is an effective technique that can be applied in the removal of oral and maxillofacial foreign bodies. It can accurately locate the foreign bodies and perform minimally invasive surgery, thereby reducing the impact on facial appearance.