[The expression and clinical significance of proprotein convertase subtilisin kexin 9 in rheumatoid arthritis].

Objective: To assess the expression and significance of proprotein convertase subtilisin kexin 9 (PCSK9) in patients with rheumatoid arthritis (RA). Methods: Sixty-five RA patients and forty-seven healthy controls were recruited in this study. The body mass index (BMI) and serum total cholesterol(TC), triglyceride(TG), high density lipoprotein(HDL), lipoprotein a, low density lipoprotein(LDL), very low density lipoprotein(VLDL), apolipoprotein A(ApoA), apolipoprotein B(ApoB) and the ratio of LDL-C/HDL-C were tested. Other parameters included disease activity score 28(DAS28), rheumatoid factor (RF), anti-cyclic citrullinated peptide (CCP) antibody, erythrocyte sedimentation rate (ESR), c-reactive protein (CRP). Serum PCSK9 level was measured by ELISA and compared between RA patients and healthy controls. Results: (1) The serum PCSK9 levels in RA patients were higher than those in healthy controls[(409.36±223.52) µg/L vs (292.19±109.79) µg/L, P<0.05]. (2) Compared with subgroup of moderate and low active disease and patients in remission, PCSK9 was significantly higher in patients with highly active disease (P<0.05). (3) The serum PCSK9 levels were positively correlated with RF, TC, TG, LDL, very low density lipoprotein (VLDL), ApoB, with r values as 0.303, 0.490, 0.320, 0.451, 0.319, 0.463, respectively (P<0.05). (4) Multiple stepwise regression analysis showed that DAS28, RF, TC and LDL-C/HDL-C were relevant factors for PCSK9 in RA patients. Conclusions: The serum PCSK9 level is elevated in RA patients, which is related to RF, disease activity, TC, TG, LDL, VLDL, ApoB. This suggests that PCSK9 is potentially linked to inflammatory reaction and lipid metabolism in rheumatoid arthritis.

[The application and influence factors of FACIT Fatigue Scale in SLE patients].

Objective: To evaluate the application and influence factors of the Functional Assessment of Chronic Illness Therapy (FACIT-Fatigue) scale in patients with systemic lupus erythematosus (SLE). Methods: SF-36 questionnaires were used to estimate the health-related quality of life (HRQOL) of SLE patients in Chinese Han population.FACIT-Fatigue scale was applied to measure fatigue.Disease activity was determined by SLE disease activity index (SLEDAI), meanwhile demographic parameters such as gender, disease duration, etc. were recorded. Results: A total of 223 patients with SLE were enrolled in the survey.FACIT-Fatigue scale was negatively correlated with SF-36 (P<0.05). FACIT-Fatigue scale of patients with SLE were correlated with education, erythrocyte sedimentation rate (ESR), C3, and SLEDAI score (P<0.05). The degree of bodily pain, the status of mental health and the amount of complement C3 were the independent factors of FACIT-Fatigue (P<0.1). Conclusion: FACIT-Fatigue scale is related to disease activity, quality of life, age and ESR in patients with SLE.There fore, reduce the disease activity and improve the quality of life of SLE patients may be helpful to reduce the fatigue of patients with SLE.

[Changes to sleep patterns in young migrants at high altitude].

Objective: To explore the relationship between the level of acclimatization and the changes to sleep architecture in migrants at high altitude. Methods: Nocturnal sleep recordings of 50 subjects aged between 18 and 25 years [mean age (20.9±2.0) years] were analyzed. Those young volunteers were divided into 3 700 m-3 m group(n=10, migrated to an altitude of 3 700 metres for 3 months), 3 700 m-1 y group(n=10, for 1 year) , 5 380 m-3 m group(n=8), 5 380 m-1 y group(n=9), and compared with a control group(n=13, at 1 400 m altitude). Results: When the migrants stayed at 5 380 m for 3 months or 1 year, the wake time increased significantly during sleep[(81.81±59.80)min vs(47.19±24.98) min, P=0.026; (77.94±25.64)min vs(47.19±24.98)min, P=0.040]. Concerning the percentage of total sleep time(TST) in each stage, participants in the 5 380 m-3 m group had a shift in sleep stage distribution with near absence of slow wave sleep(SWS) and a significant increase of N1 , but N2 and rapid eye movement(REM) did not differ. Interestingly, there were entirely concordant changes among the other 3 groups of results, decreased N2 and increased REM. Conclusions: The migrants' abilities to acclimatize themselves to plateau were varied according to the arrived altitude and the length of stay. The sleep of short- time migrants was characterized by increased N1 and decreased SWS, whereas that of well acclimatized migrants was characterized by less N2 and more REM. The efficient recovery in SWS may be an objective reference in high altitude acclimatization.