Construction of logic gate computation for the assay of the nerve agent sarin based on an AChE-based dual-channel sensing system.

Nerve agents have posed a huge threat to national and human security, and their sensitive detection is crucial. Herein, based on the oxidation of Ce4+ and the aggregation-induced emission (AIE) of glutathione-protected gold nanoclusters (GSH-Au NCs), a cascade reaction was designed to prepare oxidized 3,3',5,5'-tetramethylbenzidine (oxTMB) and GSH-Au NCs crosslinked by Ce3+ (Ce3+-GSH-Au NCs). oxTMB had a broad UV-visible absorption range (500-700 nm) and was capable of quenching the fluorescence of Ce3+-GSH-Au NCs at 590 nm through the internal filtration effect (IFE). Thiocholine (TCh), the hydrolysis product of acetylthiocholine chloride (ATCl) catalyzed by acetylcholinesterase (AChE), reduced oxTMB completely, resulting in a decrease in the absorption of oxTMB and the recovery of IFE-quenched fluorescence of Ce3+-GSH-Au NCs. Nerve agent sarin (GB) hindered the production of TCh and the reduction of oxTMB by inhibiting the AChE activity, leading to the fluorescence of Ce3+-GSH-Au NCs being quenched again. The dual-output sensing system (AChE + ATCl + oxTMB + Ce3+-GSH-Au NCs) exhibited a low limit of detection to GB (2.46 nM for colorimetry and 1.18 nM for fluorimetry) and excellent selectivity toward common interferences being unable to inhibit AChE. Moreover, the intelligent logic gate constructed based on the sensing system showed promising applications in the field of smart sensing of nerve agents.

Rapid diffusion of H2 and strong adsorption of D2 in Ni-4PyC realized the efficient separation of H2/D2 by gas chromatography.

In this work, Ni-4PyC was selected as the material for the separation of hydrogen isotopes H2/D2, and the mechanism of hydrogen isotope H2/D2 separation was investigated by molecular simulation. The results showed that the adsorption selectivity of Ni-4PyC for D2/H2 increased from 1.26 to 1.46 when the temperature was decreased from 77 K to 20 K, indicating that Ni-4PyC effected chemical affinity quantum sieving on D2/H2. Also, the diffusion rates of H2/D2 were different at different temperatures. At 20 K, the kinetic selectivity of D2/H2 reached 1.30, indicating that Ni-4PyC had a kinetic quantum sieving effect on D2/H2 at low temperatures. However, when the temperature was higher than 30 K, the diffusion rate of H2 was faster than that of D2, and when the temperature was 77 K, Ni-4PyC exhibited the kinetic sieving effect with a kinetic selectivity of 1.59 for H2/D2. Due to the chemical affinity quantum sieving and kinetic sieving effects of Ni-4PyC on H2/D2, the adsorption capacity of Ni-4PyC for D2 was better than that for H2 and the diffusion rate of H2 was faster than that of D2 at 77 K. Therefore, Ni-4PyC was expected to achieve the separation of H2/D2. In order to verify the accuracy of the theoretical calculation results, an Ni-4PyC@γ-Al2O3 composite material was synthesized by a liquid phase epitaxy method and was used to separate H2/D2 at 77 K in a 0.6 m × 2 mm chromatographic column. Under optimal separation conditions, the resolution R reached 1.84 with a separation time t = 7.47 min. In addition, Ni-4PyC@γ-Al2O3 showed excellent separation performances for different ratios of H2/D2 mixtures. The stationary phase was repeatable and reproducible.

H2/D2 Separation Using UTSA-16@CAU-10-H@γ-AlOOH Composites as the Stationary Phase in Gas Chromatography via the Additive Effects of Kinetic Sieving and Chemical Affinity Quantum Sieving.

In this work, CAU-10-H@γ-AlOOH is prepared, and then UTSA-16 is loaded on CAU-10-H@γ-AlOOH to obtain UTSA-16@CAU-10-H@γ-AlOOH. Using the as-prepared composites as stationary materials by cryogenic gas chromatography at 77 K, while CAU-10-H@γ-AlOOH achieves the complete separation of ortho-H2 (o-H2) and D2 with a resolution R of 1.66 and a separation time t of 9.52 min, UTSA-16@CAU-10-H@γ-AlOOH achieves higher efficiency separation of hydrogen isotopes in a shorter separation time (4.56 min) with R = 1.7. Molecular simulation results show that CAU-10-H has both chemical affinity quantum sieving and kinetic sieving effects for H2/D2 at 77 K, and UTSA-16 can only exert the kinetic sieving effect. UTSA-16's load on CAU-10-H@γ-AlOOH weakens the adsorption of hydrogen isotopes, and the presence of Co2+ in UTSA-16 promotes the conversion of para-H2 to ortho-H2. In gas chromatography, H2 was preferentially desorbed from the system due to strong D2 adsorption caused by the chemical affinity quantum sieving effect and faster H2 diffusion caused by the kinetic sieving effect. These additive effects achieved efficient hydrogen isotope separation at 77 K.

H2/D2 separation in gas chromatography through a MOF-on-MOF strategy using γ-AlOOH@Al(OH)(1,4-NDC)@ZIF-67 as the stationary phase via additive effects of chemical affinity quantum sieving and kinetic sieving.

The reaction of porous γ-Al2O3 particles acting as both a sacrificial template and an aluminum source with 1,4-naphthalene diacid (H2NDC) resulted in the formation of γ-AlOOH@Al(OH)(1,4-NDC) composites, in which ZIF-67 was then loaded by the in situ crystallization method, leading to the formation of γ-AlOOH@Al(OH)(1,4-NDC)@ZIF-67 composites. The deliberately designed composite was used to separate H2/D2 at 77 K in a 1 m chromatographic column. The results demonstrated that the optimized composite can achieve the effective separation of H2/D2 in gas chromatography due to the additive effects of kinetic sieving and chemical affinity quantum sieving of Al(OH)(1,4-NDC) and ZIF-67. By optimizing chromatographic separation conditions, the resolution R reached 2.02 with the separation time t = 7.72 min. The composite also showed satisfactory repeatability and reproducibility.

Tonsillar Microbiome-Derived Lantibiotics Induce Structural Changes of IL-6 and IL-21 Receptors and Modulate Host Immunity.

Emerging evidence emphasizes the functional impacts of host microbiome on the etiopathogenesis of autoimmune diseases, including rheumatoid arthritis (RA). However, there are limited mechanistic insights into the contribution of microbial biomolecules especially microbial peptides toward modulating immune homeostasis. Here, by mining the metagenomics data of tonsillar microbiome, a deficiency of the encoding genes of lantibiotic peptides salivaricins in RA patients is identified, which shows strong correlation with circulating immune cells. Evidence is provided that the salivaricins exert immunomodulatory effects in inhibiting T follicular helper (Tfh) cell differentiation and interleukin-21 (IL-21) production. Mechanically, salivaricins directly bind to and induce conformational changes of IL-6 and IL-21 receptors, thereby inhibiting the bindings of IL-6 and IL-21 to their receptors and suppressing the downstream signaling pathway. Finally, salivaricin administration exerts both prophylactic and therapeutic effects against experimental arthritis in a murine model of RA. Together, these results provide a mechanism link of microbial peptides-mediated immunomodulation.

Enhancing the quantum yield of singlet oxygen: photocatalytic degradation of mustard gas simulant 2-chloroethyl ethyl sulfide catalyzed by a hybrid of polyhydroxyl aluminum cations and porphyrin anions.

By combining the anionic salt meso-tetra(4-carboxyphenyl)porphyrin (TCPP4-) and the Keggin polyoxometalate cation cluster [Al13O4(OH)24(H2O)12]7+ via a simple ion-exchange method, a hybrid (C48H26N4O8)[Al13O4(OH)24(H2O)12]2(OH)10·18H2O (Al13-TCPP) was prepared and thoroughly characterized as a prototype of polyoxometalate-porphyrin hybrids for the photocatalytic degradation of the mustard gas simulant 2-chloroethyl ethyl sulfide (CEES). The experimental results showed that the catalytic degradation rate of CEES in the presence of Al13-TCPP reached 96.16 and 99.01% in 180 and 90 min in methanol and methanol-water solvent mixture (v/v = 1 : 1), respectively. The reaction followed first-order reaction kinetics, and the half-life and kinetic constant in methanol and solvent mixture were 39.8 min, -0.017 min-1 and 14.7 min, -0.047 min-1. Mechanism analysis indicated that under visible light irradiation in air, CEES was degraded through a combination of oxidation and alcoholysis/hydrolysis in methanol and the methanol-water solvent mixture. The superoxide radical (O2˙-) and singlet molecular oxygen (1O2) generated by Al13-TCPP selectively oxidized CEES into a non-toxic sulfoxide. The singlet oxygen capture experiments showed that Al13-TCPP (Φ = 0.236) had a higher quantum yield of singlet oxygen generation than H4TCPP (Φ = 0.135) under visible light irradiation in air. The material Al13-TCPP has good reusability, and the degradation rate of CEES can still reach 98.37% after being recycled five times.

Imaging features of 18F-FDG PET/CT in different types of systemic vasculitis.

OBJECTIVE: To analyze 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) image features in different types of systemic vasculitis and explore its classification and diagnostic significance for systemic vasculitis. METHODS: Clinical and 18F-FDG PET/CT imaging data of 71 consecutive patients (34 males, 37 females, mean age 53.4 ± 20.5 years) who were examined at Peking University People's Hospital and diagnosed with active systemic vasculitis were analyzed retrospectively, and 18F-FDG PET/CT imaging features of different types of systemic vasculitis were analyzed in patients with positive 18F-FDG PET/CT findings. RESULTS: The proportions of large-, medium-, small-, and variable-vessel vasculitis were 36.6%, 15.5%, 29.6%, and 18.3%, respectively, and 93.0% of patients had positive findings on PET/CT, of which 63.6% had vascular involvement and 53.0% had extravascular involvement. Different types of vasculitis had different lesion sites, distribution patterns, and morphological changes. Large-vessel vasculitis mainly affected the aorta and its branches to the head and neck. Takayasu arteritis showed segmental involvement of the vascular and morphological changes of the vessel wall. Giant cell arteritis manifested as diffuse vascular involvement, which usually involved the temporal artery and the abdominal aorta and its branches. Medium-vessel vasculitis polyarteritis nodosa manifested as diffuse vascular involvement of both lower extremities. Small-vessel vasculitis anti-neutrophil cytoplasmic antibody-associated vasculitis manifested as granulomatous inflammation of extravascular regions. Variable-vessel vasculitis Behcet's disease involved both blood vessels and extravascular regions. CONCLUSION: Different types of systemic vasculitis show characteristic manifestations in 18F-FDG PET/CT images, which may be useful for the diagnosis and classification of systemic vasculitis. KEY POINTS: • Determining an early diagnosis of systemic vasculitis may be challenging. • Different types of systemic vasculitis show characteristic manifestations in 18F-FDG PET/CT images. • 18F-FDG PET/CT may be useful for the diagnosis and classification of systemic vasculitis.

Fluorine-18 labeled fluorodeoxyglucose positron emission tomography/computed tomography used in diagnosing connective tissue diseases in fever of unknown origin/inflammatory of unknown origin patients.

OBJECTIVE: To explore the significance of Fluorine-18 labeled fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in diagnosing connective tissue diseases (CTDs) in fever of unknown origin (FUO) or inflammation of unknown origin (IUO) patients. METHODS: Clinical and image data of 242 consecutive FUO/IUO patients who underwent PET/CT examination and eventually diagnosed CTDs were retrospectively analyzed, including distribution of diseases, clinical characteristics, and PET/CT imaging findings. The role of FDG PET/CT in differential diagnosis of CTDs was evaluated through clinical questionnaire survey. RESULTS: Patients diagnosed as CTDs accounted for 48.1% of FUO/IUO patients. Among them, adult-onset Still's disease was most frequently diagnosed. Other common diseases included systemic vasculitis, undifferentiated connective tissue disease, rheumatoid arthritis, idiopathic inflammatory myopathy, systemic lupus erythematosus, and polymyalgia rheumatica. On FDG PET/CT examination, 97.9% of the patients had positive findings. Inflammatory lesions were detected in 66.5% and non-specific abnormal uptakes were found in 31.4%. Detected lesions distributed consistently with corresponding susceptible organs and tissues in various diseases. Clinical questionnaire results shown that FDG PET/CT excluded malignant tumors, focal infections, or other typical CTDs in 45.5% of the patients; indicated important diagnostic clues or appropriate biopsy sites in 20.6% of patients; and directly suggested the diagnosis of a CTD in 33.1% of patients. CONCLUSION: FDG PET/CT could reveal inflammatory lesions in organs and tissues that reflect the clinical characteristics in different CTDs, thus providing an objective evidence for differential diagnosis, classification, and treatment decision of these diseases. Key Points • FDG PET/CT is a useful tool for differential diagnosing connective tissue diseases among patients with fever of unknown origin/inflammatory of unknown origin.

Hydrogen isotope separation on nickel-containing metal-organic framework@gama-alumina-based multicomponent composite packed column: Identification of individual role of each component.

A new optimized multicomponent composite, Na2Cr2O7/Na2CrO4/NaCl/MOF-74(Ni)@γ-Al2O3 (S1/S2/S3/MOF-74(Ni)@γ-Al2O3. Na2Cr2O7 = S1, Na2CrO4 = S2, NaCl = S3), was prepared and used as a gas chromatography stationary phase for the separation of H2 and D2 isotopes. Under the optimal chromatographic separation conditions, the resolution of the packed column for the separation of H2/D2 was 2.87, and the separation time was 7.15 min at 77 K. The control experiments showed that in the multicomponent composite, MOF-74(Ni), which has a chemical affinity quantum sieving effect, played a major role in the separation of H2/D2. As the support of MOF-74, γ-Al2O3 enhanced the mechanical strength of MOF-74 and reduced the gas resistance. The presence of Na2CrO4 in the column increased the H2/D2 separation resolution, while the presence of NaCl reduced the separation time, produced more symmetrical and narrow chromatographic peaks of Gaussian distribution. Furthermore, by optimizing the ratio of NaCl and Na2CrO4, (S2/S3/MOF-74(Ni)@γ-Al2O3) composite with a NaCl/Na2CrO4 mass ratio of 0.7:1 was synthesized and used to realize the high-resolution separation of H2/D2 (R = 2.56) with a short separation time (t = 5.91 min). Both composites also showed excellent repeatability/reproducibility for separation.

Multiple values of 18F-FDG PET/CT in idiopathic inflammatory myopathy.

This study aimed to investigate the multiple values of 18F-FDG PET/CT in detecting malignant tumors, evaluating myopathy, and determining interstitial lung disease in patients with idiopathic inflammatory myopathy (IIM). We retrospectively analyzed the data of 38 patients who were examined by 18F-FDG PET/CT and eventually diagnosed as IIM. We also collected the data of another 22 cases with negative PET/CT as the control. Pulmonary HRCT images were acquired simultaneously with regular 18F-FDG PET/CT imaging for each patient. Image analysis included the presence of malignant lesions, muscular FDG uptake, and interstitial lung disease and its imaging features. IIM was classified into polymyositis (PM), classic dermatomyositis (CDM), and clinical amyopathic dermatomyositis (CADM). All suspected malignant lesions were confirmed by histopathological examination. Interstitial lung disease was diagnosed by HRCT. Rapidly progressive interstitial lung disease (RP-ILD) was determined according to clinical follow-ups. The significance of 18F-FDG PET/CT in the detection of malignancy, observation of activity of myopathy, and determination of interstitial lung disease in IIM patients was explored based on the final clinical diagnosis. In the 38 patients with IIM, 3 cases were classified as PM, 18 as CDM, and 17 as CADM. PET/CT correctly detected 7 cases (18.4%) of malignant tumors, and all of which were found in CDM and PM patients. The muscular FDG uptake in IIM patients was higher than the control population, and it was higher in patients with myopathy (including PM and CDM) than in patients with CADM. The muscular FDG uptake in IIM patients was correlated with elevated serum creatine kinase level (r = 0.332, P = 0.042) and impaired muscle strength (r = -0.605, P < 0.001). Interstitial lung disease was detected by HRCT in 30 patients (78.9%), and 7 of them were eventually confirmed as RP-ILD, according to the clinical outcome. The FDG uptake in lung lesions of RP-ILD patients was higher than those with chronic interstitial lung diseases, even though no significant difference was found between the CT features of RP-ILD and chronic interstitial lung disease. When SUVmax ≥ 2.4 was employed as the threshold for RP-ILD prediction, the diagnostic efficiency was yield with a sensitivity of 100.0% (7/7), specificity of 87.0% (20/23), and accuracy of 90.0% (27/30), respectively. For IIM patients, 18F-FDG PET/CT has multiple values in identifying malignancies, observing the status of inflammatory myopathy, detecting interstitial lung disease, and predicting the occurrence of RP-ILD. Therefore, it is recommended to use PET/CT in the clinical course of diagnosis and management of IIM.

Characteristics of germinal center-like structures in patients with Sjögren's syndrome.

AIM: To analyze the relationship between ectopic germinal centers (GCs) in the salivary glands and the clinical/laboratory characteristics of patients with Sjögren's syndrome (SS). METHODS: Retrospectively, 126 patients with primary SS (pSS) and 16 patients with secondary SS (sSS) were analyzed. Minor salivary gland biopsies were evaluated for the presence of GC-like morphology by hematoxylin and eosin (H&E) and immunohistochemical (IHC) staining for CD21. Clinical and serological data were obtained from medical records. RESULTS: GC-like structures were observed in 36/126 (28.6%) pSS patients and 4/16 (25.0%) sSS patients. The mean inflammatory focus score of the gland was significantly higher in GC-positive samples than in GC-negative ones in both pSS and sSS patients (P = 0.007 and 0.024, respectively). In pSS, significantly elevated titers of rheumatoid factor (RF)-IgM (P = 0.023) and antinuclear antibodies (ANA) (P = 0.036), increased levels of IgA (P = 0.012) and IgG (P = 0.017) were encountered in GC-positive patients. The GC-positive group also presented higher prevalence of anti-SSA antibodies, lower levels of white blood cells, higher levels of erythrocyte sedimentation rate and γ-globulin, although not statistically significant. In sSS patients with ectopic GC formation, ANA titers were remarkably elevated. The anticyclic citrullinated peptide (anti-CCP)-IgG titers and the prevalence of antikeratin antibody (AKA)-IgG, antiperinuclear factor (APF)-IgG were also increased, yet not significantly. GCs were found to be associated with antibody and immunoglobulin production. CONCLUSION: This study indicates that SS patients with ectopic GCs have distinct features. Ectopic GC structures were particularly noted in patients with higher focus scores, and might play an essential role in sustaining antibody production as well as B cell activation.

Mo polyoxometalate nanoclusters capable of inhibiting the aggregation of Aß-peptide associated with Alzheimer's disease.

A neuropathological hallmark of Alzheimer's disease (AD) is aggregation of a forty-residue peptide known as amyloid beta forty (Aß40). While past work has indicated that blocking Aß40 aggregation could be an effective strategy for the treatment of AD, developing therapies with this goal has been met with limited success. Polyoxometalates (POMs) have been previously investigated for their anti-viral and anti-tumoral properties and we report here that three representative POM nanoclusters have been synthesized for use against Aß40 aggregation. Through the use of thioflavin T fluorescence, turbidity, circular dichroism spectroscopy, and transmission electron microscopy (TEM), we found that all three POM complexes can significantly inhibit both natural Aß40 self-aggregation and metal-ion induced Aß40 aggregation. We also evaluated the protective effect of POM complexes on Aß40-induced neurotoxicity in cultured PC12 cells and found that treatment with POM complexes can elevate cell viability, decrease levels of intracellular reactive oxygen species, and stabilize mitochondrial membrane potential. These findings indicate that all three representative POM complexes are capable of inhibiting Aß40 aggregation and subsequent neurotoxicity. While a complete mechanistic understanding remains to be elucidated, the synthesized POM complexes may work through a synergistic interaction with metal ions and Aß40. These data indicate that POM complexes have high therapeutic potential for use against one of the primary neuropathological features of AD.

Mo polyoxometalate nanoparticles inhibit tumor growth and vascular endothelial growth factor induced angiogenesis.

Tumor growth depends on angiogenesis, which can furnish the oxygen and nutrients that proliferate tumor cells. Thus, blocking angiogenesis can be an effective strategy to inhibit tumor growth. In this work, three typical nanoparticles based on polyoxometalates (POMs) have been prepared; we investigated their capability as antitumor and anti-angiogenesis agents. We found that Mo POM nanoparticles, especially complex 3, inhibited the growth of human hepatocellular liver carcinoma cells (HepG2) through cellular reactive oxygen species levels' elevation and mitochondrial membrane potential damage. Complex 3 also suppressed the proliferation, migration, and tube formation of endothelial cells in vitro and chicken chorioallantoic membrane development ex vivo. Furthermore, western blot analysis of cell signaling molecules indicated that Mo POMs blocked the vascular endothelial growth factor receptor 2-mediated ERK1/2 and AKT signaling pathways in endothelial cells. Using transmission electron microscopy, we demonstrated their cellular uptake and localization within the cytoplasm of HepG2 cells. These results indicate that, owing to the extraordinary physical and chemical properties, Mo POM nanoparticles can significantly inhibit tumor growth and angiogenesis, which makes them potential drug candidates in anticancer and anti-angiogenesis therapies.

[Analysis of risk factors in development of thrombosis in patients with antiphospholipid syndrome].

OBJECTIVE: To analyze the risk factors in the development of thrombosis in antiphospholipid syndrome (APS) patients. METHODS: We retrospectively analyzed the characteristics of thrombosis in 61 APS patients. Clinical and laboratory parameters such as sex, age, thrombocytopenia, smoking, hypertension, diabetes mellitus, hyperlipidemia and anti-phospholipid antibodies were investigated to find out the risk factors of thrombosis. RESULTS: Thrombosis was found in 70.49% APS patients, of whom, the prevalence of arterial and venous thrombosis were 36.67% and 39.34%, respectively. Deep vein thrombosis of lower extremity (37.7%) and cerebral infarction (24.59%) were the most common thrombosis events, and then pulmonary embolism, thrombotic microangiopathy and renal artery thrombosis were also common in APS patients. The positive anti-cardiolipin antibody and hypertension were the independent risk factors for venous and arterial thrombosis, respectively. CONCLUSION: Anti-cardiolipin antibody is associated with a higher risk of venous thrombosis, and hypertension is associated with arterial thrombosis.

[A multicenter study of coronary artery disease and its risk factors in rheumatoid arthritis in China].

OBJECTIVE: To learn about the prevalence and risk factors of coronary artery disease (CAD) in rheumatoid arthritis (RA). METHODS: Data were obtained from a 12-month retrospective investigation of the patients with RA, randomly selected from Departments of Rheumatology and Immunology in 21 big hospitals in China. The data were collected about their social conditions, clinical conditions, medications associated with RA, such as disease modifying anti-rheumatic drugs (DMARDs), non steroidal anti-inflammatory drugs (NSAIDs), glucocorticoid, biologic agents. A nonparameter test and multivariate logistic regression analysis were performed. RESULTS: In the study, 960 patients were enrolled. The prevalence of CAD was 3.5% in China, which was obviously higher than that of normal people. The prevalence of overweight and obesity, smoking, hypertension, diabetes mellitus, hypercholesterolemia and cerebrovascular disease were 35.1%, 12.3%, 17.0%, 7.7%, 0.4% and 3.0%, respectively. Compared with the control group, the CAD group had higher age [(64.7±9.3) years vs. (52.3±14.0) years,P<0.001], more rheumatoid nodules (14.7% vs. 3.1%,P=0.005), lower rate of hydroxychloroquine (HCQ) use (5.9% vs. 22.6%,P=0.021), higher prevalence rates of lung interstitial disease (17.5% vs. 7.0%,P<0.001), diabetes mellitus and hypertension (29.4% vs. 7.0%,P<0.001; 38.2% vs. 16.2%,P=0.001). There was no obvious correlation of CAD in RA with joint deformity, rheumatoid factor (RF) titer, glucocorticoid use, hypercholesterolemia and body mass index (BMI). Multivariate analysis showed higher age, diabetes mellitus and hypertension were independent predictors of CAD, and the use of HCQ was a protective factor of CAD. CONCLUSION: The prevalence of CAD is 3.5%. Higher age, diabetes mellitus and hypertension are independent predictors of CAD, and the use of HCQ is a protective factor of CAD.

[Survey of tumor necrosis factor inhibitors application in patients with rheumatoid arthritis in China].

OBJECTIVE: To investigate the current status of tumor necrosis factor (TNF) inhibitors application in rheumatoid arthritis (RA) patients in China and to analyze the related factors. METHODS: A retrospective survey was conducted in 21 hospitals from different parts of China. The patients with RA were randomly enrolled. Data of their social backgrounds, clinical conditions, usage and adverse effects of TNF inhibitors were collected. The costs of TNF inhibitors and the indirect costs of the disease were calculated. A multivariate Logistic regression analysis was performed to analyze the factors related to TNF inhibitors application. RESULTS: In the study, 1 095 RA patients from July 2009 to November 2010 were enrolled, of whom 112 had received TNF inhibitors, representing 10.2% of the total patients. The patients who received etanercept and infliximab were 7.4% (86/1 095) of the patients and 2.4% (26/1 095), respectively. There were 0.5% of the patients (5/1 095) who had received both of the TNF inhibitors. The patients who had accepted etanercept and treatment duration for less than 3 months and 3-6 months accounted for 38.5% and 25.0% respectively, while those treated with Infliximab were 38.1%. Their health assessment questionnaire (HAQ) scores were 1.1, 0.5 and 0.1, corresponding to treatment duration of infliximab for less than 3, 3-6 and 6-9 months and those were 1.3, 1.0, 0.3 corresponding to treatment duration of etanercept, respectively. Infliximab costs were RMB 24 525.0, 69 300.0 and 96 800.0 Yuan and etanercept costs were RMB 7 394.8, 9 158.6, 54 910.9 Yuan, respectively. Indirect costs for RA patients who accepted infliximab for less than 3, 3-6 and 6-9 months were RMB 365.6, 0 and 158.9 Yuan and those who accepted etanercept were RMB 2 158.4, 288.5 and 180.1 Yuan, respectively. Allergy and infection were the main side-effects of etanercept and both happened in 3.5% of all the patients. Liver damage happened in 2.3% of all the patients, while allergy and infection happened in 6.5% of all the patients who accepted infliximab. Logistic regression analysis showed that patients with higher education experience increased the odds of entering the TNF inhibitors group (OR: 1.292, 95%CI: 1.132-1.473, P=0.000). CONCLUSION: About one-tenth of RA patients in China have accepted TNF inhibitors. Higher education experience is the key factor for using TNF inhibitors.

[Clinical and immunological relevance of antiphospholipid antibodies in patients with lymphoma].

OBJECTIVE: To explore the prevalence, clinical and prognostic significance of anticardiolipin (aCL) IgG/M/A antibodies and anti-ß(2)-glycoprotein I (2-GPI) IgG/M/A antibodies in patients with lymphoma. METHODS: ACL IgG/M/A antibodies and anti-ß(2)-GPI IgG/M/A antibodies were determined by enzyme-linked immunosorbent assay (ELISA) in 129 lymphoma patients, 46 SLE patients, 38 rheumatoid arthritis (RA) patients, 24 primary Sjögren's syndrome (pSS) patients and 58 healthy controls. Laboratory and clinical features (thrombosis, event-free-survival time, etc.) were analyzed retrospectively from the clinical database. RESULTS: (1) Elevated APL level was found in 52/129 lymphoma patients (40.3%): aCL IgG/M/A antibodies in 11.6% (15/129) and anti-ß(2)-GPI IgG/M/A antibodies in 32.6% (42/129) of lymphoma patients. There were significant differences between the prevalence and level of APL in lymphoma patients and healthy controls. But no difference was found between the lymphoma patients and SLE, RA or pSS patients. (2) APL was correlated with lymphoma derived from T or NK/T cells (P < 0.05). (3) No difference was found between the incidence of thrombosis in lymphoma patients with or without APL. (4) A strong negative correlation was found between the elevated APL and the event-free survival. CONCLUSION: APL is elevated in 40.3% of lymphoma patients. And it is significantly higher than that in healthy controls and similar with that in SLE, RA or pSS patients. APL is correlated with lymphoma cell origin and shortened event-free survival.