1.Safety analysis of Yttrium-90 resin microsphere selective internal radiation therapy on malignant liver tumors
Jia CAI ; Shiwei TANG ; Rongli LI ; Mingxin KONG ; Hongyan DING ; Xiaofeng YUAN ; Yuying HU ; Ruimei LIU ; Xiaoyan ZHU ; Wenjun LI ; Haibin ZHANG ; Guanwu WANG
Chinese Journal of Clinical Medicine 2025;32(1):24-29
Objective To explore the safety of Yttrium-90 resin microsphere selective internal radiation therapy (90Y-SIRT) on malignant liver tumors. Methods A retrospective analysis was conducted on 64 patients with malignant liver tumors who underwent 90Y-SIRT from February 2023 to November 2024 at Weifang People’s Hospital. The clinical characteristics of the patients and the occurrence of adverse reactions after treatment were analyzed to assess the safety of 90Y-SIRT. Results Among the 64 patients, there were 52 males (81.25%) and 12 females (18.75%); the average age was (56.29±11.08) years. Seven patients (10.94%) had tumors with maximum diameter of less than 5 cm, 38 patients (59.38%) had tumors with maximum diameter of 5-10 cm, and 19 patients (29.68%) had tumors with maximum diameter of greater than 10 cm. There were 47 cases (73.44%) of solitary lesions and 17 cases (26.56%) of multiple lesions; 53 cases (82.81%) were primary liver cancers and 11 cases (17.19%) were metastatic liver cancers. Of the 64 patients, 63 successfully completed the Technetium-99m macroaggregated albumin (99mTc-MAA) perfusion test and received the 90Y-SIRT; one patient received 90Y-SIRT after the second 99mTc-MAA perfusion test due to a work error. The most common adverse reactions included grade 1 alanine aminotransferase (ALT) elevation in 26 cases (40.62%) and grade 2 in 2 cases (9.37%), grade 1 aspartate aminotransferase (AST) elevation in 27 cases (42.18%) and grade 2 in 7 cases (10.93%); grade 1 nausea in 17 cases (26.56%) and grade 2 in 6 cases (9.37%); grade 1 abdominal pain in 12 cases (18.75%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%); grade 1 vomiting in 11 cases (17.18%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%). Conclusion The adverse reactions of 90Y-SIRT for treating malignant liver tumors are mild, indicating good safety.
2.Current status of eating behaviors and its predictive role in overweight and obese of adolescents
Chinese Journal of School Health 2025;46(1):53-57
Objective:
To explore the current status and influencing factors of eating behaviors in adolescents, so as to provide a theoretical foundation for health promotion education among adolescents.
Methods:
Based on the database from Survey of Chinese Family Health Index (2021), by a random number table method, 1 065 teenagers were selected from the provincial capitals of 22 provinces and 5 autonomous regions in China, as well as 4 municipalities directly under the central government. A general characteristic questionnaire, Patient Health Questionnaire-9 (PHQ-9), Short Form of the Family Health Scale (FHS-SF), 10-item Short Version of the Big Five Personality(BFP-10), Content-based Media Exposure Scale (CM-E) and Sakata Eating Behavior Scale Short Form(EBS-SF) were used to collect information. Multivariate stepwise linear regression analysis was employed to identify and analyze related factors of eating behaviors among adolescents. Receiver operating characteristic was used to validate the predictive ability of the EBS-SF score for overweight and obesity among adolescents.
Results:
The average scores of BFI-10,C-ME, FHS-SF, PHQ-9 and EBS-SF were (33.08±4.64)(19.20±4.55)(38.48±6.65)(6.09±5.63)(16.75±4.36), respectively. Multivariate linear regression showed that family type (other types), agreeableness, conscientiousness, family health and depression were the main related factors of EBS-SF scores among adolescents( B =2.61,-0.42,0.20,-0.11,0.23, P <0.05).The analysis of receiver operating characteristic curve showed that the EBS-SF scores had a good ability in predicting obesity among male adolescents ( AUC= 0.73, P <0.01).
Conclusions
Family type, big five personality, family health,depression are the related factors of eating behaviors among adolescents. EBS-SF scores are predictive of obesity in adolescents, which would provide a new perspective for promoting healthy eating habits among adolescents.
3.Analysis of clinical and pathological characteristics of drug-induced live injury based on hepatotoxicity injury patterns
Honghai XU ; Shiwei ZHU ; Hui ZHANG ; Yufeng GAO ; Hua WANG
Chinese Journal of Clinical and Experimental Pathology 2024;40(2):172-178
Purpose To explore the clinical and pathologi-cal features and the relationships between pathological features and drugs of patients with drug-induced liver injury(DILI)based on the hepatotoxicity injury patterns.Methods The clin-ical data,laboratory indicators,drugs,and liver biopsy of 50 cases of DILI were collected,the expression of CK19 was detec-ted by immunohistochemistry EnVision two-step method,and the reticular scaffold of liver tissue was displayed by Reticular fiber staining.Results Among the 50 patients with DILI,there were 29 cases of hepatocellular DILI,11 cases of cholestatic DILI,and 10 cases of mixed DILI,respectively,with the hepatocellu-lar DILI accounting for the highest proportion(58%).7 catego-ries of drugs induced DILI,with herbal ranking first(52%).Different types of drugs could cause different types of DILI,with herbal induced 17 cases hepatocellular DILI(58.62%)and an-ti-infectious and anticancer drugs induced all 3 cases cholestatic DILI(27.27%).Different types of DILI displayed various pathological characteristics.Hepatocellular congestion,feathery degeneration,and small bile duct thrombosis primarily occur in cholestasis and mixed DILI,while bridging necrosis,sub-large and large necrosis were mainly seen in hepatocellular DILI.Conclusion Based on hepatotoxicity injury patterns,DILI ex-hibits a variety of clinical and pathological characteristics,and there is some relationship between pathological characteristics and drugs.Liver puncture pathological biopsy plays an important role in improving the diagnosis and treatment of DILI.
4.Effect of intervention model based on comprehensive nutrition management on glucose and lipid metabolism and pregnancy outcome of gestational diabetes mellitus patients
Chenxia ZHANG ; Congcong JIN ; Xiaofang WEI ; Xianmei CUI ; Xiaoqin CHEN ; Shiwei LIU
Chinese Journal of Clinical Nutrition 2024;32(1):8-14
Objective:To explore the effect of intervention model based on comprehensive nutrition management on glucose and lipid metabolism and pregnancy outcome in patients with gestational diabetes mellitus (GDM).Methods:104 GDM patients admitted to Shanxi Bethune Hospital from February 2022 to March 2023 were randomly divided into control group and experimental group, with 52 cases in each group. The control group implemented routine management measures and nutrition guidance, while the experimental group implemented an intervention model based on comprehensive nutrition management on the basis of routine management. The indexes of glucose and lipid metabolism (glycosylated hemoglobin, fasting blood glucose, 2 h postprandial blood glucose, total cholesterol, triglyceride and low density lipoprotein cholesterol), pregnancy outcome, self-management ability and self-efficacy were compared between the two groups before and after intervention.Results:Before the intervention, there was no significant difference in general situation, glucose and lipid metabolism index, self-management ability and self-efficacy between the two groups ( P>0.05). After the intervention, the level of glucose and lipid metabolism index in the experimental group was significantly lower than that in the control group, with statistical significance ( P<0.05). The incidence of adverse pregnancy outcome in the experimental group was significantly lower than that in the control group, with statistical significance ( P<0.05). The scores of self-management ability and self-efficacy in the experimental group were significantly higher than those in the control group, with statistical significance ( P<0.05). Conclusion:The intervention model based on comprehensive nutrition management can effectively improve the glucose and lipid metabolism index and pregnancy outcome of GDM patients, and significantly improve their self-management ability and self-efficacy related to nutrition management, which has high clinical application and promotion value.
5.Evaluation of the clinical relevant effect of hospital-wide blood glucose management in perioperative cholelithiasis patients with type 2 diabetes
Jie YANG ; Shiwei LIU ; Wanrong DOU ; Le JIANG ; Qianqian YANG ; Ruixue DUAN ; Chenxia ZHANG ; Jie ZHENG
Chinese Journal of Clinical Nutrition 2024;32(1):44-49
Objective:To evaluate the clinical relevant effect of hospital-wide blood glucose management in perioperative cholelithiasis patients with type 2 diabetes.Methods:The subjects of the study were patients with type 2 diabetes mellitus complicated with cholelithiasis who were treated at the Baiqiu'en Hospital in Shanxi from September 2022 to October 2023. The patients were divided into hospital-wide blood sugar management group and conventional treatment group, according to different blood glucose management they received. The differences in preoperative blood glucose control, length of stay, postoperative complications, and hospitalization expenses between the two groups were compared.Results:Compare based on the median (quartiles) of the observed indicators, patients with cholelithiasis who underwent hospital-wide blood glucose management based on insulin pumps had a higher proportion of time in range [72.00(70.21, 82.90)% vs. 64.80 (61.55,70.50)%, P<0.001)], lower average blood glucose level [9.00 (8.55, 10.44) mmol/L vs. 11.50 (10.50, 12.50) mmol/L, P<0.001], and shorter hospital stay [8.00 (7.00,13.00) days vs. 10.00 (8.00, 12.00) ) days, P<0.05]. Moreover, the incidence of postoperative complications was lower [5(11.11)% vs. 15(33.33)%, P<0.05], and hospitalization expenses were lower [16 535.34 (14 271.44, 29 569.23) yuan vs. 18 633.85 (17 482.66) yuan , 22 855.02) yuan, P<0.05] in patients who received hospital-wide blood glucose management. Conclusion:Hospital-wide blood glucose management based on insulin pumps showed favorable effects in the perioperative clinical application in cholelithiasis patients with type 2 diabetes, and could contribute to shortening the average length of stay, reducing hospitalization costs, and reducing postoperative complications.
6.Effect of Dunhuang medical prescription Dabupi Decoction combined with oxaliplatin on inflammatory immunity of gastric cancer-bearing mice based on IL-17/NF-κB signaling pathway
Yuanding ZENG ; Yun SU ; Hongxia GONG ; Shiwei NIU ; Han ZHANG
Chinese Journal of Immunology 2024;40(1):92-96
Objective:To study anti-tumor effect of Dunhuang medical prescription Dabupi Decoction on gastric cancer-bearing mice and effect of Dabupi Decoction combined with oxaliplatin on inflammatory immunity of gastric cancer-bearing mice based on IL-17/NF-κB signaling pathway.Methods:Mouse model of MFC gastric cancer subcutaneously bearing tumor was established and ran-domly divided into model group,oxaliplatin group,high,medium and low doses of Dabupi Decoction combined with oxaliplatin groups[21.58,10.79,5.40 g/(kg·d)],with 10 mice in each group,male and female cage rearing.Administration began after 8 days of inoculation and continued for 14 days;next day after the last administration,eyeball blood was taken,mice were killed,tumor tissues were taken and weighed,and tumor inhibition rate was calculated.ELISA was used to detect contents of IL-17 and IL-6 in mice serum,immunohistochemistry(IHC),RT-qPCR and Western blot were used to detect IL-17,IL-6,NF-κB and p-NF-κB mRNA and protein expressions in mice tumor tissues,respectively.Results:Tumor inhibition rates of oxaliplatin group,high,medium and low doses of Dabupi decoction combined with oxaliplatin groups were 33.02%,52.92%,46.33%and 39.52%,respectively,and tumor quality of each treatment group was significantly lower than that of model group(P<0.01).High,medium and low doses of Dabupi Decoction combined with oxaliplatin groups were higher than that of oxaliplatin group.Compared with model group,contents of IL-17 and IL-6 in serum and expressions of IL-17,IL-6,NF-κB p65 and pNF-κB p65 mRNA and protein in tumor tissues in each treatment group were significantly reduced(P<0.01,P<0.05).Compared with oxaliplatin group,levels of IL-17 and IL-6 in serum and expres-sions of IL-17,IL-6,NF-κB p65 and pNF-κB p65 mRNA and protein in tumor tissues in high and medium doses of Dabupi Decoction combined with oxaliplatin groups were significantly reduced(P<0.01,P<0.05).Conclusion:Dunhuang medical prescription Dabupi Decoction has a certain anti-tumor effect on MFC gastric cancer-bearing mice,which can regulate inflammatory immunity and inhibit occurrence and development of gastric cancer by inhibiting IL-17/NF-κB signaling pathway.
7.Assessment value of X-ray angiography in postoperative recurrence,curative effect and the reduction of the perfusion of liver tumor of interventional TACE for liver cancer
Suling XU ; Yaogang ZHANG ; Shiwei XU ; Yadi SHEN
China Medical Equipment 2024;21(2):48-53
Objective:To investigate the assessment value of X-ray angiography in postoperative recurrence,curative effect and reduction of the perfusion of liver tumor of interventional transarterial chemoembolization(TACE)for liver cancer.Methods:A total of 59 patients with liver cancer who were treated in The Third the People's Hospital of Bengbu from January 2015 to December 2020 were selected.All patients underwent the examination of routine X-ray angiography one week before surgery and four weeks after surgery.The obtained image sequences were imported into the workstation equipped with imaging technology software of color coded digital subtraction angiography(ccDSA)to conduct analysis.The region of interest(ROI)was manually defined on the ccDSA images before and after TACE.And then,the time intensity curve was obtained,and the quantitative perfusion parameters included the time to peak(TTP),area under curve(AUC),maximum slope(MS)were exported from that.The receiver operating characteristics(ROC)curve was drawn,and the area under curve(AUC)of that was calculated to analyze the assessment efficacy of perfusion parameters on the postoperative recurrence,curative effect and reduction of the perfusion of liver tumor of TACE for liver cancer.Results:In the 59 patients who were included in the study,39 cases occurred postoperative recurrence and 20 cases did not occurred postoperative recurrence according to the definition of postoperative recurrence,and the perfusion TTP(7.38±1.22)s of patients with postoperative recurrence was significantly lower than that(9.03±1.01)s of patients without postoperative recurrence,and the difference of that between them was significant(t=5.198,P<0.05).The AUC and MS of patients with postoperative recurrence were significantly lower than those of patients without postoperative recurrence(t=2.868,31.499,P<0.05),respectively.There were not significant differences in TTP,AUC and MS between patients with and without postoperative recurrence before surgery(P>0.05).According to the determination criteria of curative effect,35 cases were effectiveness,and 24 cases were ineffectiveness,and the postoperative TTP(9.09±1.08)s of patients with effectiveness was significantly higher than that(7.84±2.07)s of patients without effectiveness(t=3.029,P<0.05),and AUC and MS of patients with effectiveness were significantly higher than those of patients without ineffectiveness(t=3.852,54.366,P<0.05),and there were not significant differences in preoperative TTP,AUC and MS between patients with and without effectiveness(P>0.05),and the values of TTP,AUC and MS of the group with effectiveness and group without effectiveness after surgery were significantly higher than those before surgery,and the differences of them between two groups were significant(t=3.029,3.852,54.366,P<0.05),respectively.According to the grading criteria of subjective angiographic endpoints(SACE),33 cases were grade Ⅲ,and 26 cases were grade Ⅳ,and there were not significant in TTP,AUC and MS between patients with grade Ⅲ and patients with grade IV(P>0.05).The postoperative TTP,AUC and MS of patients with grade Ⅳ were significantly lower than those of patients with grade Ⅲ(t=7.679,3.498,58.968,P<0.05),respectively.The sensitivities of TTP,AUC and MS were respectively 66.70%,89.70% and 59.00% in assessing postoperative recurrence of interventional TACE for liver cancer,and the specificities of them were respectively 55.00%,55.00% and 55.00%,and the AUC values of them were respectively 0.629(95% CI:0.478-0.779),0.827(95% CI:0.723-0.931)and 0.512(95% CI:0.356-0.667).The sensitivities of TTP,AUC and MS were respectively 64.10%,79.50% and 61.50% in assessing postoperatively curative effect of interventional TACE for liver cancer,and the specificities of them were respectively 55.00%,65.00% and 55.00%,and the AUC values of them were respectively 0.609(95% CI:0.462-0.756),0.808(95% CI:0.698-0.918)and 0.580(95% CI:0.413-0.747).The sensitivities of TTP,AUC and MS were respectively 69.20%,82.10% and 53.80% in assessing the postoperative reduction of the perfusion of liver tumor of interventional TACE for liver cancer,and the specificities of them were respectively 70.00%,75.00% and 55.00%,and the AUC values of them were respectively 0.745(95% CI:0.613-0.877),0.842(95% CI:0.724-0.960)and 0.507(95% CI:0.360-0.654).Conclusion:The TTP,AUC and MS of perfusion parameters that are obtained by ccDSA quantitative analysis for the data after X-ray angiography examination have a certain application value in assessing the postoperative recurrence,curative effect and the reduction of the perfusion of liver tumor of interventional TACE for liver cancer.
8.Comparison of per- and polyfluoroalkyl substance exposure levels in neonatal cord blood between an e-waste recycling area and a general exposure area
GERILI ZAYA ; Jingguang LI ; Yuxin WANG ; Shiwei CUI ; Lei ZHANG ; Xin SUN
Journal of Environmental and Occupational Medicine 2024;41(8):876-883
Background Per- and polyfluoroalkyl substances (PFAS) are a class of persistent organic pollu-tants. Industrial production and consumer use of PFAS are the primary sources of exposure in urban areas. E-waste recycling activities are also a significant source of environmental PFAS exposure. Objective To compare exposure profiles between traditional and emerging PFAS in neonatal cord blood collected from an e-waste recycling area and a general exposure area characterized by modern economic development (hereafter referred to as general exposure area). Methods Based on a birth cohort study conducted in 2018, 85 pregnant women were recruited (36 participants from an e-waste recycling area and 49 participants from a general exposure area). Neonatal cord blood was collected at delivery. Ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was used to detect 28 common PFAS in the blood. A structured questionnaire was used to gather sociodemographic characteristics of the pregnant women. Mann-Whitney U tests were used to compare PFAS exposure levels in neonatal cord blood between the e-waste recycling area and the general exposure area. Multiple linear regression models were used to explore the influence of residing in the e-waste recycling area on neonatal PFAS exposure, with area as the independent variable and the natural logarithm of PFAS exposure levels as the dependent variable. Results A total of 22 PFAS were positive in neonatal cord blood, of which 13 congeners were 100% detectable in the samples from both areas. The median ∑PFAS exposure levels in neonatal cord blood were 14.19 ng·mL−1 and 14.02 ng·mL−1 for the e-waste recycling area and the general exposure area, respectively, with linear perfluorooctanoic acid (L-PFOA) showing the highest median concentration (5.49 ng·mL−1 and 6.39 ng·mL−1, respectively). The results of Mann-Whitney U tests showed that the median exposure levels of long-chain perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), perfluorododecanoic acid (PFDoDA), and perfluorotridecanoic acid (PFTrDA), as well as emerging alternatives 6:2 chlorinated polyfluorinated ether sulfonate (6:2 Cl-PFESA) and 8:2 chlorinated polyfluorinated ether sulfonate (8:2 Cl-PFESA), were higher in the e-waste recycling area than in the general exposure area. In contrast, the median exposure levels of short-chain perfluoropentanoic acid (PFPeA) and perfluorohexanoic acid (PFHxA), as well as perfluorooctanoic acid (PFOA) branched isomers, including perfluoro-6-methylheptanoic acid (iso-PFOA), perfluoro-5-methylheptanoic acid (5m-PFOA), and perfluoro-4-methylheptanoic acid (4m-PFOA), were lower in the e-waste recycling area than in the general exposure area (P<0.05). The multiple linear regression models showed that, compared to the general exposure area, neonatal cord blood in the e-waste recycling area had significantly higher exposure levels of long-chain PFDA, PFUnDA, PFDoDA, PFTrDA, and emerging alternatives 6:2 Cl-PFESA and 8:2 Cl-PFESA, with odds ratios of 1.95 (95%CI: 1.39-2.75), 2.10 (95%CI: 1.58-2.75), 2.12 (95%CI: 1.39-3.25), 2.64 (95%CI: 1.63-4.22), 3.46 (95%CI: 2.34-5.10), and 3.25 (95%CI: 2.01-5.26), respectively. Conversely, the exposure levels of short-chain PFPeA, PFHxA, and branched PFOA (br-PFOA) were significantly lower, with odds ratios of 0.44 (95%CI: 0.38-0.52), 0.30 (95%CI: 0.16-0.57), and 0.50 (95%CI: 0.38-0.67), respectively. Conclusion PFAS are widely present in neonatal cord blood in both the e-waste recycling area and the general exposure area. Compared to the general exposure area, the neonatal cord blood samples in the e-waste recycling area show higher exposure levels of certain long-chain perfluoroalkyl carboxylic acids (PFCA) and emerging PFAS alternatives, while the neonatal cord blood samples in the general exposure area show higher exposure levels of some short-chain PFCA and PFOA branched isomers.
9.Urogenital solitary fibrous tumor: a review of 20 cases
Hongwei SHEN ; Bo JIANG ; Xin WANG ; Changwei JI ; Yongming DENG ; Shiwei ZHANG ; Hongqian GUO
Journal of Modern Urology 2024;29(2):130-135
【Objective】 To explore the diagnosis, treatment, prognosis and long-term follow-up of urogenital solitary fibrous tumor (SFT) and to differentiate the characteristics between benign and malignant SFT. 【Methods】 Clinical data of 20 patients with urogenital SFT treated in our hospital during Jan.2004 and Aug.2021 were respectively analyzed, including the general characteristics, clinical symptoms, imaging results, treatment methods, pathological results, and long-term follow-up results. 【Results】 Of the 20 cases, 9 cases had tumor in kidney, 7 in pelvic cavity, 3 in bladder and 1 in prostate.Six patients showed non-specific clinical symptoms, including lower extremity weakness, urodynia, dysuria, frequent urination with changes in stool habits, low back pain, and abdominal wall mass with abdominal pain, and the other 14 cases were asymptomatic.The median diameter of SFT was 5.2 cm (range:1.7-15.0 cm).All patients received surgical treatment, including robotic-assisted surgery in 8 cases, open surgery in 5 cases, laparoscopic surgery in 5 cases, and transurethral resection of tumor in 2 cases.CT plain scan showed high, low and mixed density soft tissue masses, and enhanced CT showed enhanced results.Pathology results revealed frequent nuclear divisions, morphological variations and necrosis in malignant SFT, which had higher expression of Ki-67 than benign SFT.The results of the modified Demicco prognostic risk stratification model showed that all malignant SFT cases were at intermediate risk. The DFS of the SFT radical tumor resection group was slightly longer than that of the simple tumor resection group but the difference was not statistically significant (P=0.203). 【Conclusion】 Markers such as CD34, Bcl2, STAT6 and CD99 are used to diagnose SFT, while Ki-67 and tumor necrosis are used to differentiate benign and malignant SFT.The modified Demicco prognostic risk stratification model plays an important role in predicting the prognosis of SFT.Surgical resection is the most common treatment with excellent prognosis.In addition, benign SFT has much better prognosis than malignant case.
10.Clinical Characteristics and Treatment Options of Peripheral Spondyloarthritis
Lulu ZENG ; Xiaojian JI ; Lidong HU ; Jiawen HU ; Yinan ZHANG ; Jiaxin ZHANG ; Xingkang LIU ; Shiwei YANG ; Feng HUANG
Medical Journal of Peking Union Medical College Hospital 2024;16(1):50-58
To compare the differences in clinical features and treatment choices between peripheral spondyloarthritis(pSpA) and axial spondyloarthritis(axSpA), and better understand the clinical characteristics and medication needs of pSpA. Our study is a retrospective cohort study. The patients who first visited the First Medical Center of Chinese PLA General Hospital between January 2016 and December 2022 and were diagnosed with axSpA or pSpA according to the classification criteria established by the Assessment of SpondyloArthritis International Society were selected as the study subjects. Demographic data, clinical characteristics, laboratory tests, and treatment information of these patients were obtained through the electronic medical records management system and the intelligent management system for spondyloarthritis. The research compared the distribution of swollen and tender joints between pSpA and axSpA patients, as well as that between pSpA1(excluding patients with psoriatic arthritis) and axSpA patients. Additionally, we analyzed differences in clinical features and treatment options among these groups. A total of 1639 patients were included in the study, of which 184 had pSpA(including 97 with psoriatic arthritis), and 1455 had axSpA. Compared to axSpA patients, pSpA patients had fewer male patients(62.5% pSpA patients tend to have a later onset of disease, a lower proportion of male and HLA-B27 positivity, more associated peripheral arthritis, dactylitis, psoriasis, and a more common family history of psoriasis. The disease burden in terms of treatment for pSpA is not lower than that for axSpA. Due to the presence of more peripheral symptoms, psoriasis, and higher levels of inflammation, they also require more medication.


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