1.Clinical and Immunological Characteristics of Elderly Onset Rheumatoid Arthritis
Zhengfang LI ; Chanyuan WU ; Mengsi MA ; Tingting LI ; Xue WU ; Xinyan MENG ; Sha ZHANG ; Lijun WU
Medical Journal of Peking Union Medical College Hospital 2025;16(1):59-64
To investigate the clinical features and peripheral blood immune cell subsets ofelderly (≥60 years old) onset rheumatoid arthritis (EORA) patients. The patients with rheumatoid arthritis (RA) who were hospitalized in the Department of Rheumatology and Immunology of the People's Hospital of Xinjiang Uygur Autonomous Region from March 2023 to December 2023 were selected as the study objects. The demographic data, clinical characteristics, extra-articular manifestations and laboratory examination results of the patients were collected. The patients were divided into EORA group and young adult (< 60 years old)onset rheumatoid arthritis (YORA) group, and the clinical features and peripheral blood immunological indexes of the two groups were compared. A total of 187 RA patients with an average age of (62.1±12.0) years were enrolled, including 89 patients in the EORA group and 98 patients in the YORA group. Compared with YORA group, EORA group had a higher proportion of male patients(39.3% Compared with YORA, EORA has higher male proportion, joint disease degree and disease activity. EORA is prone to interstitial lung disease, anemia and high inflammation, and the level of peripheral blood NK cells is higher.
2.The prevalence and related risk factors of hyperuricemia in Bozidum Kinghiz township of Xinjiang Aksu region
Yan ZHONG ; Nasha GU ; Zhengfang LI ; Xue WU ; Mansuer MIKELAYI· ; Yamei SHI ; Cainan LUO ; Xiaomei CHEN ; Qianqian WANG ; Chaohong YUE ; Yun FENG ; Xinyan MENG ; Guoli ZHANG ; Juan DENG ; Jing LI ; Lijun WU
Chinese Journal of Rheumatology 2024;28(5):312-320
Objective:To investigate the prevalence of hyperuricemia (HUA) in Bozidun Kirghiz township of Xinjiang Aksu region, and to explore the risk factors for the occurrence of HUA in the local area.Methods:A cross-sectional survey study was conducted by randomly selecting 9 villages in Bozidun Kirgiz Township by the whole-group sampling method and questionnaire were distributed to the households. The questionnaire included: demographic information, history of past illness, personal history, and all subjects were measured for height, weight, blood pressure, abdominal circumference, etc. The diagnostic of HUA if the serum uric acid (SUA) level >420 μmol/L in men or >360 μmol/L in women. The incidences of HUA in different age, sex, food type and life style behavior were analyzed. T test, non-parametric test and Chi-square test were used to analyze the differences among the groups, and logistic regression was used to analyze the risk factors. Results:①A total of 2 138 subjects were surveyed, among which 68 patients were with HUA, the prevalence of HUA in Bozidun Kirghiz township, Aksu region in the general population was 3.18%(68/2 138); the prevalence rate in men was 4.60%(45/978), 45 patients were identified; and the prevalence rate in women was 1.98%(23/1 160), 23 patients were identified. The peak age of HUA in male and female patients was 51~60 years old. ②The prevalence of HUA was lower in those who consumed dairy products ( χ2=6.91, P=0.017), nuts ( χ2=8.43, P=0.038) and eggs ( χ2=7.38, P=0.023), and lower in those who consumed more. Different intake of cereals ( χ2=0.87, P=0.647), meat( χ2=0.82, P=0.662), vegetables and fruits( χ2=5.22, P=0.073) had no effect on the prevalence of HUA.③In terms of different life behaviors, the prevalence of HUA in men who had been smoking was higher than those who had never smoked (57.78%, 28.89%, 13.33%, χ2=8.16, P=0.017). In the relationship between drinking and HUA, the prevalence rates of male always drinking, ever drinking and never drinking were 80.00%, 11.11% and 3.89%, respectively, the difference was statistically significant ( χ2=6.67, P=0.038). ④Multi-factor logistic regression analysis showed that high BMI, old age, high TG, increased Cr and increased WBC were risk factors for the occurrence of HUA [ OR(95% CI)=1.13(1.04, 1.23), 1.03(1.00,1.05),1.39(1.00, 1.93), 1.03(1.02, 1.05), 1.27(1.07, 1.49), all P<0.05]. Conclusion:The prevalence of HUA in Bozidun Kirgiz township in Aksu prefecture of Xinjiang is lower than that in other areas with continental climate. High BMI, old age, high TG, increased Cr and increased WBC count are risk factors for the development of HUA .
3.Positivity of antinuclear antibody and anti-double-stranded DNA antibody in three ethnic groups in Xinjiang Uygur Autonomous Region
Jiaqi WANG ; Xue WU ; Xinyan MENG ; Xiaomei CHEN ; Cainan LUO ; Zhengfang LI ; Lijun WU
Chinese Journal of Rheumatology 2024;28(8):571-574
Objective:To investigate the positivity rate and high titer of antinuclear antibody (ANA) and anti-dsDNA antibody in healthy Tajik, Kirgiz, and Han Chinese populations in Xinjiang.Methods:A total of 3 687 cases of Tajik residents, 2 140 cases of Kyrgyz residents, and 2 034 cases of Han residents were selected as the study subjects, and ANA and anti-dsDNA antibodies were detected and comparatively analyzed. Data were analyzed using SPSS 22.0 software with χ2 test. Results:The positive rate of ANA in Tajik group was 15.1% [(555/3 687), 10.2%(147/1 445) male, 18.2%(408/2 242) female], of which high titers accounted for 25.8%(143/555). It was 16.7%(357/2 140) in the Kyrgyz group [10.3% male(101/980), 19.4%(256/1 160) female], with high titers accounting for 14.8%; and in the Han group, the positivity rate was 16.6% [9.8%(70/720) male, 19.1%(267/1 314) female], with high titers accounting for 18.4%(62/1 337). There was no significant difference in ANA positivity rate among the three ethnic groups( χ2=3.64, P=0.162), but there were differences in the percentage of high titer of ANA in Tajik ethnic group compared with Han and Kyrgyz ethnic groups(25.8% vs. 18.4%, χ2=6.02, P=0.014; 25.8% vs.14.8%, χ2=14.71, P=0.001), which accounted for a high percentage. The highest number of ANA high titers in all three groups was in the age group of 51~60 years. The ANA karyotype with the highest percentage of high titers in the Tajik and Kyrgyz populations was granular, while it was homogeneous and in the Han it was homogeneous.The positive rate of anti-dsDNA antibody in the Tajik group was 0.71%(26/3 687), of which high titer accounted for 23.1%(6/126); in the Kyrgyz group, it was 0.75%(16/2 034), and high titer accounted for 31.3%(4/14); and in the Han group, the positive rate was 0.69%(14/2 034), of which high titer accounted for 28.6%(4/64), and there was no statistical significance of in the difference in the positive rate of anti-dsDNA antibody and the proportion of high titer among the three groups( χ2=0.06, P=0.972; χ2=0.37, P=0.832). Conclusion:The percentage of ANA and anti-dsDNA antibodies and high titers varied vary among the three ethnic groups in this study, and long-term follow-up is needed to monitor keep an eye on the incidence of autoimmune diseases in people with high autoantibody titers.
4.Application value of anti-carbamylated protein antibody in the diagnosis of rheuma-toid arthritis
Zhengfang LI ; Cainan LUO ; Lijun WU ; Xue WU ; Xinyan MENG ; Xiaomei CHEN ; Yamei SHI ; Yan ZHONG
Journal of Peking University(Health Sciences) 2024;56(4):729-734
Objective:To investigate the expression level and application value of anti-carbamylated protein(CarP)antibody in rheumatoid arthritis(RA).Methods:Demographic data and laboratory test results of RA patients,non-RA patients and healthy controls in the physical examination center were re-viewed from December 2018 to June 2019 in the Rheumatology and Immunology Department of the Peo-ple's Hospital of Xinjiang Uygur Autonomous Region.The serum concentrations of anti-CarP antibodies in all the subjects were measured by ELISA and statistically analyzed.Results:A total of 259 subjects were included in this study,including 158 in the RA group(45 serum-negative RA patients),59 in the non-RA group and 42 in the healthy control group.The concentration of anti-CarP antibody in RA group[8.31(5.22,15.26)U/mL]was higher than that in non-RA group[4.50(3.35,5.89)U/mL]and healthy control group[3.46(2.76,4.92)U/mL].The concentration of anti-CarP antibody in non-RA group was not significantly different from that in healthy control group(P=0.10).Receiver operating characteristic(ROC)curve analysis showed that the sensitivity of anti-CarP antibody in the diagnosis of RA was 58.2%,and the specificity was 93.1%.The sensitivity of the combined detection of anti-CarP antibody,anti-cyclic peptide containing citrulline(CCP)antibody and rheumatoid factor(RF)was 82.3%,and the specificity was 96.5%.The positive rate of anti-CarP antibody in serum-negative RA patients was 44.4%(20/45).Univariate Logisitic regression analysis showed that age,C-reactive pro-tein(CRP),erythrocyte sedimentation rate(ESR),RF,glucose-6-phosphate isomerase(GPI),anti-CCP antibody and anti-CarP antibody were risk factors for RA.Multivariate Logisitic regression analysis showed that anti-CCP antibody and anti-CarP antibody were independent risk factors for RA.Spearman correlation analysis showed that there was no significant correlation between anti-CarP antibody and swol-len joint count(SJC),tenderness joints count(TJC),ESR,disease activity score for 28 joints(DAS28),clinical disease activity index(CDAI),simplified disease activity index(SDAI).The concentration of anti-CarP antibody in RA with bone erosion(n=88)was higher than that in RA without bone erosion(n=70),and there was significant difference between the two groups(P<0.05).Conclusion:Anti-CarP antibody is an effective serological marker for the diagnosis of RA.The combined detection of RF,anti-CCP antibody and anti-CarP antibody can improve its diagnostic value,and anti-CarP antibody may be an effective assistant diagnostic tool for serum negative RA.The high serum concentration of anti-CarP antibody in patients with RA may indicate an increased risk of bone erosion and should be treated early,but further cohort studies are needed for follow-up observation.
5.Named Entity Recognition Method of Electronic Medical Records Based on ERNIE-BiGRU-Attention-CRF
Zhengfang WANG ; Junliang ZHANG ; Xiaoqian LI ; Yue YU ; Huizheng CHEN
Journal of Medical Informatics 2024;45(5):76-82,100
Purpose/Significance To improve the performance of named entity recognition(NER)model of Chinese electronic medi-cal records(EMR)for better organization and mining of medical information.Method/Process The ERNIE-BiGRU-Attention-CRF NER model of Chinese EMR is constructed.Firstly,the ERNIE1.0 pre-training model is used to generate word vectors with semantic features,and then BiGRU is utilized to capture the global semantic features and grammatical structural features,which are fed into the Attention mechanism to further enhance the capture of the semantic features,and finally,the CRF decoding layer is connected to output the label sequences with the maximum global probability.Result/Conclusion Comparison experiments and ablation experiments are car-ried out on the publicly available medical text dataset CCKS2017,and examples analysis is conducted using the generated model.The model proposed in this paper achieves better recognition results.
6.Liangxue-jiedu decoction alleviates acute-on-chronic liver failure by inhibiting TLR4/JNK/NF-κB signaling pathway
Zhengfang LIU ; Wen ZHOU ; Zhenting LI ; Qin LI ; Naishun LIAO
Acta Laboratorium Animalis Scientia Sinica 2024;32(8):1032-1038
Objective To investigate the therapeutic effect of Liangxue-jiedu decoction on acute-on-chronic liver failure(ACLF)model mice and the Toll-like receptor 4(TLR4)/c-Jun amino terminal kinase(JNK)/nuclear factor κB(NF-κB)signaling pathway.Methods An ACLF mouse model was established using combined treatment of carbon tetrachloride,lipopolysaccharide,and D-galactosamine.Biochemical analysis was performed to evaluate liver function indicators,including alanine aminotransferase,aspartate aminotransferase,and total bilirubin.Histopathological examination was conducted to assess liver tissue morphological changes.Quantitative PCR was used to detect the mRNA expression of tumor necrosis factor alpha(TNF-α),interleukin(IL)-6,IL-1 β,and TLR4 in liver tissues.A CCK8 assay was used to evaluate the optimal interventional concentration of Liangxue-jiedu decoction on Raw 264.7 cells.Enzyme-linked immunosorbent assay was used to detect the contents of TNF-α,IL-6,and IL-1βin the cell supernatant.Protein immunoblotting was performed to measure the expression of TLR4/JNK/NF-κB signaling pathway-related proteins,including TLR4,NF-κB,p-ERKl/2,ERK1/2,p-JNK,and JNK.Results Compared with the ACLF model group,the Liangxue-jiedu decoction-treated group showed reduced cell necrosis,fibrosis,and inflammatory cell infiltration in liver tissues;decreased serum levels of alanine aminotransferase,aspartate aminotransferase and total bilirubin;and lower expression of TNF-α,IL-6,IL-1β,and TLR4 mRNA.Liangxue-jiedu decoction reduced TLR4/JNK/NF-κB signaling pathway-related protein expression in liver tissues.The in vitro result also showed that Liangxue-jiedu decoction reduced TNF-α,IL-6,and IL-1 β secretion by macrophage cells and down-regulated the expression of TLR4/JNK/NF-κB signaling pathway proteins.Conclusions Liangxue-jiedu decoction effectively improved liver function in ACLF mice in a manner closely related to the downregulation of TLR4/JNK/NF-κB pathway proteins.
7.Analysis of the 15-year survival rate and its prognostic factors in late-onset systemic lupus erythematosus
Yamei SHI ; Xue WU ; Lijun WU ; Zhengfang LI ; Cainan LUO ; Kelayi MI
Chinese Journal of Geriatrics 2022;41(6):674-677
Objective:To analyze the 15-year survival rate, causes of death and prognostic factors of late-onset systemic lupus erythematosus(SLE).Methods:A total of 92 late-onset SLE patients aged >50 years hospitalized in the Rheumatology and Immunology Department of the People's Hospital of Xinjiang Autonomous Region from January 2006 to December 2016 were retrospectively collected.Clinical and serological data of the patients were analyzed and the diagnosis met the SLE classification criteria as revised by the American Society of Rheumatology in 1997.Survival rate, the cause of death, and the associated prognostic factors were analyzed.Outpatient or telephone follow-up was performed.Results:Of the 92 study patients, 8 were lost to follow-up(8 / 92, 8.7%)and 84 were able to follow up(84 / 92, 91.3%). Of the 84 able to follow up, 64 cases(64 / 84, 76.2%)survived, and 20 cases(20 / 84, 23.8%)died.Median survival time was 108 months.The 5-, 10-, and15-year survival rates were 86.0%, 77.9%and 59.6 %, respectively.Infection(55.0%)and multiple organ failure(15.0%)were the major cause of death in patients with late-onset SLE.Univariate analysis of the outcomes of patients with late-onset SLE showed that the age of onset( HR=1.113, P=0.001), hematology involvement( HR=3.610, P=0.023), and complicaed cardiovascular disease( HR=3.128, P=0.011)had a significant impact on the prognosis. Conclusions:The late-onset SLE has low survival rate and bad prognosis.Infection prevention and control of organ damage and focus on merging cardiovascular disease are critical to improve survival of late-onset SLE patients.
8.ValueofmagneticresonanceenterographyindiagnosingCrohn’sdisease:aMeta-analysis
Zhengfang WANG ; Desheng CAO ; Xingsheng LI ; Yu ZHAO ; Baoyuan WANG
Journal of Practical Radiology 2019;35(7):1086-1090
Objective Toevaluatetheclinicalvalueofmagneticresonanceenterography (MRE)indiagnosingCrohn’sdisease (CD).Methods ThearticlesconcerningthediagnosisofCD byusing MRE weresystematicallysearchedindatabasesincluding PubMed,EMbase,CochraneLibrary,WebofScience,CNKI,CBM,WanFangandVIPdata.Tworeviewersindependentlyscreenedliterature, extracteddata,andassessedbiasriskofincludedstudiesbyusingtheQUADAS-2.Then,thisMeta-analysiswasperformedbyusing Stata12.0software.Thepooledweightedsensitivity,specificity,positivelikelihoodratio(PLR),negativelikelihoodratio (NLR)and diagnosticoddsratio(DOR)werecalculated,thesummaryreceiveroperatingcharacteristiccurve(sROC)wasdrawnandtheAUC wascalculated.Results Atotalof16studieswereincluded,involving1276patientsand919bowelsegments.TheresultsofMeta-analysisshowed that,thepooledsensitivity,specificity,PLR,NLR,DORandAUCofMREdiagnosingCDwere0.87(95%CI:0.79,0.92),0.92(95%CI:0.89, 0.94),10.6(95%CI:7.4,15.2),0.15(95%CI:0.09,0.24),72.69(95%CI:32.7,161.51),0.95(95%CI:0.93,0.97),respectively.Theresultsof subgroupanalysissuggestedthat,thestudytype,MRT-field,pathogenicsiteanddiagnosticcriteriaplayedlittleeffectonthevalueof MREdiagnosingCD (P>0.05).Conclusion MREhadhigheraccuracyfordiagnosingCDand mayservedasanefficientimaging methodfordiagnosingCD.
9.Effects of donepezil on the expression of neurotrophic related factors in subventricular zone of cerebral infarction mice
Yongxin ZHANG ; Jianping WANG ; Kefei CUI ; Xiaojie FU ; Di ZHANG ; Zhengfang LU ; Yufeng GAO ; Jiang MAN ; Xianliang LIU ; Sijia LI ; Linghui LIAO ; Xiang LI
Chinese Journal of Behavioral Medicine and Brain Science 2018;27(11):961-965
Objective To investigate the effect of donepezil on subventricular zone ( SVZ) neuro-genesis related neurotrophic factors after cerebral infarction. Methods Mice were randomly assigned into three groups: vehicle-treated sham group (Sham+vehicle,n=18),vehicle-treated middle cerebral artery oc-clusion (MCAO) group (MCAO + vehicle,n=30) and donepezil-treated MCAO group (MCAO+donepezil, n=30). Middle cerebral artery occlusion( MCAO) was induced by thread-occlusion method. Nissl staining was used to measure the infarct volume and the modified neurological severity score(mNSS) was used to as-sess neurologic function and brain water content was detected to assess brain edema degree. Proliferative cells and neuroblasts were labeled with 5-bromodeoxyuridine ( BrdU) and doublecortin ( DCX). The SVZ BrdU+/DCX+cells were detected by immunofluorescence. The expression of glial cell line-derived neurotro-phic factor (GDNF),brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were detec-ted by Western blot. Results The infarct volume of MCAO + donepezil group ((13. 33±4. 55)%) was sig-nificantly lower than that of MCAO + vehicle group ((31. 33±3. 93)%,t=7. 34,P<0. 05). The neurologic deficits were significantly ameliorated after donepezil treatment,and the brain water content of MCAO + done-pezil group ((71. 82±10. 18)%)was significantly less than that of MCAO + vehicle group ((85. 93± 7. 54)%,F=13. 480,P<0. 05). All differences were statistically significant (P<0. 05). The area of BrdU+/DCX+cells within SVZ of MCAO + vehicle group ((6. 16±1. 79)%) was significantly larger than that of sham + vehicle group ((2. 25±1. 09)%),and was fewer than that of MCAO+donepezil group ((16. 19± 2. 16)%,F=102. 756,P<0. 05). MCAO significantly promoted the expression of GDNF,BDNF and NGF within SVZ compared with sham operation,and donepezil increased these protein levels(F=15. 114,27. 121, 27. 398,P<0. 05). Conclusion Donepezil regulates neurogenesis via increasesing the expression of GDNF, BDNF and NGF within SVZ after cerebral infarction.
10.Influence of cyclophosphamide and its metabolites on PTEN gene after acting on ovarian cancer cell line SKOV3
Zhengfang XIONG ; Bing LI ; Xianghui ZENG ; Liyun WANG
Chongqing Medicine 2018;47(4):453-455
Objective To study the effect of cyclophosphamide(CP) and its metabolites acrolein(ACR) on PTEN gene deleted on chromosome 10 after acting on ovarian cancer cellsSKOV3.Methods Different concentrations of CP and ACR were selected to act on recombinant PTEN protein.The phosphorylation activity of PTEN was detected by PNPP.The expression of PTEN protein was detected by Western blot.The binding mode of drug with protein was detected by the biotin combined with protein;meanwhile the expression change of P53/TP53 in PTEN gene pathway was analyzed.The target protein was obtained by immunoprecipitation(IP) after different drug concentrations acting on the cells.The phosphorylation activity of the target protein was detected by high performance liquid chromatography(HPLC).Results After the drug metabolites acting on recombinant PTEN protein,the phosphorylation activity was decreased with the increase of drug concentration,while the expression of ACR antibody action was increased with the drug concentration elevation.The expression of protein and biotin in different experimental groups was increased with the increase of drug concentration.The PTEN phosphorylation activity was decreased with the drug concentration increased in cells,and so did the expression of TP53 protein.Conclusion CP metabolite ACR induces the cytotoxicity by inhibiting PTEN protein phosphorylation activity.

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