Exploring the link between dietary omega-3 and omega-6 fatty acid intake and rheumatoid arthritis risk: NHANES 1999-2020 study.

OBJECTIVES: The association between the ingestion of n-3 and n-6 fatty acids and rheumatoid arthritis (RA) remains unclear. To address this, this study utilised data from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2020. METHODS: Dietary intake information on n-3 and n-6 fatty acids was gathered through 24-hour interviews about dietary recall and adjusted based on weight. RA patient data was collected using questionnaires. Associations were evaluated using logistic regression and spline analyses. The study included a total of 50,352 participants in a cross-sectional manner. RESULTS: In the adjusted Model 2, higher odds ratios (ORs) of 0.72 (95% CI: 0.60-0.86) and 0.76 (95% CI: 0.62-0.92) were observed for n-3 and n-6 fatty acid intake, respectively, compared to the lowest category. CONCLUSIONS: The results suggest a negative correlation between the ingestion of n-3 and n-6 fatty acids and the risk of rheumatoid arthritis in US adults.

Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System in Diagnosing Hepatocellular Carcinoma: Diagnostic Performance and Interobserver Agreement.

OBJECTIVES: To determine the diagnostic performance and inter-reader agreement of the contrast-enhanced ultrasound liver imaging reporting and data system (CEUS-LI-RADS) for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. METHODS: In this prospective study, CEUS-LI-RADS categories (LR-5 for predicting HCC) were assigned by six blinded readers and compared to the definitive HCC diagnosis in patients with liver cirrhosis per the 2017 China Liver Cancer Guidelines (CLCG). CEUS features were recorded in 96 patients with 96 histology-proven lesions. The diagnostic performance of LR-5 was described by the sensitivity, specificity and accuracy. Multi-reader agreement was assessed by using intraclass correlation coefficients (ICC). RESULTS: In cirrhotic patients, the specificity of LR-5 (range: 92.7-100.0 %) was statistically higher than that of CLCG for each reader (range: 28.6-64.3 %). However, the sensitivity (range: 38.6-63.6 %) and accuracy (range: 53.4-70.7 %) were statistically lower in CEUS-LIRADS than in CLCG (sensitivity range: 88.6-100.0 %; accuracy range: 77.6-86.2 %). Only fair to moderate inter-reader agreement was achieved for the CEUS-LI-RADS category (ICC = 0.595) and washout appearance (ICC range: 0.338 to 0.555). Neither nodule-in-nodule nor mosaic architecture was observed more often in HCC (all P > 0.05), with poor inter-reader consistency for both (both ICC < 0.20). CONCLUSION: CEUS-LI-RADS category 5 has a high specificity but a low accuracy for identifying HCC in high-risk patients. Inter-reader agreement is not satisfactory concerning CEUS-LIRADS category and washout appearance. Moreover, the clinical value of ancillary features favoring HCC is quite limited.

A prognostic model for oral squamous cell carcinoma using 7 genes related to tumor mutational burden.

BACKGROUND: Oral squamous cell carcinoma (OSCC) is a rising problem in global public health. The traditional physical and imageological examinations are invasive and radioactive. There is a need for less harmful new biomarkers. Tumor mutational burden (TMB) is a novel prognostic biomarker for various cancers. We intended to explore the relationship between TMB-related genes and the prognosis of OSCC and to construct a prognostic model. METHODS: TMB-related differential expressed genes (DEGs) were screened by differential analysis and optimized via the univariate Cox and LASSO Cox analyses. Risk Score model was constructed by expression values of screened genes multiplying coefficient of LASSO Cox. RESULTS: Seven TMB-related DEGs (CTSG, COL6A5, GRIA3, CCL21, ZNF662, TDRD5 and GSDMB) were screened. Patients in high-risk group (Risk Score > - 0.684511507) had worse prognosis compared to the low-risk group (Risk Score < - 0.684511507). Survival rates of patients in the high-risk group were lower in the gender, age and degrees of differentiation subgroups compared to the low-risk group. CONCLUSIONS: The Risk Score model constructed by 7 TMB-related genes may be a reliable biomarker for predicting the prognosis of OSCC patients.

Prevalence of signs and symptoms suggestive of obstructive sleep apnea syndrome in Guangxi, China.

BACKGROUND: The prevalence, profiles, and potential risk factors of snoring and obstructive sleep apnea-hypopnea syndrome (OSAHS) in China are largely unknown. OBJECTIVES: This study aims to investigate the prevalence, profiles, and potential risk factors for snoring and OSAHS in Guangxi, China, and the association between OSAHS and ethnicity. METHODS: Urban and rural population-based cluster samples were randomly selected in each of eight counties/cities. All residents aged 14 years or older in the selected clusters were interviewed using a standardized questionnaire. A subject was considered to have clinically diagnosed OSAHS if snoring was loud and habitual, breathing pauses were observed, and the subject experienced excessive daytime sleepiness. RESULTS: Among 12,742 sampled subjects, 10,819 completed the questionnaire (response rate = 84.9%). The overall OSAHS prevalence was 4.1% (men, 5.7% (5.1-6.3%); women, 2.4% (2.0-2.9%); Zhuang people, 3.2% (2.8-3.7%); Han people 6.0% (5.2-6.8%).The overall rate of habitual snoring was 11.5 % (men, 17.1% (16.1-18.1%); women, 5.6% (5.0-6.2%)). Univariate analysis showed that the OSAHS prevalence was significantly higher among the following groups: urban residents, elderly individuals, smokers, drinkers, those with higher body mass indexes (BMI), those with more years of schooling, those with nasal problems, those whose parents are Han, and those who usually sleep in prone position. However, multiple logistic regression analysis revealed that only urban residency, age, smoking status, drinking status, and BMI were the risk factors for OSAHS. CONCLUSIONS: OSAHS is prevalent in individuals aged 14 years or older in Guangxi, China. Han and Zhuang people differ significantly in their obstructive sleep apnea (OSA) prevalence, but this difference is explained by the combination of classic OSA risk factors.

SAPHO syndrome complicated by multiple venous thrombosis of left lower limb: A case report and literature review.

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is an uncommon clinical syndrome with the signs of skin problems and osteoarthropathy as its main features. The pathogenesis of SAPHO syndrome has not been fully elucidated, and multiple complications may be present, including thrombosis. A 39-year-old male patient was diagnosed with SAPHO syndrome, complicated by multiple venous thrombosis of the left lower limb. We conducted a brief review of the current available literature on thrombosis in patients with SAPHO syndrome and speculated that the presence of lower extremity thrombosis in this patient with SAPHO syndrome may be related to physiological structure or antiphospholipid syndrome. Whether positive lupus anticoagulant has an effect on thrombosis in patients with SAPHO syndrome remains to be investigated.

Prevalence and treatment rate of gout by depressive symptom severity: A cross-sectional analysis of NHANES 2007-2018.

BACKGROUND: The co-disease of depression and gout is becoming more common in the modern era. However, the relationship between the severity of depressive symptoms and gout prevalence and treatment rate was still unclear. OBJECTIVE: This study aimed to determine the relationship between the prevalence, treatment rate of gout, and the severity of depression in the United States. METHOD: The cross-sectional analysis of the 2007-2018 National Health and Nutrition Examination Survey (NHANES) for participants with depression was performed. According to their Patient Health Questionnaire-9 (PHQ-9) scores, participants were categorized as none, mild, moderate, moderately severe, and severe. To learn the correlation between the severity of depressive symptoms and the prevalence and treatment rate of gout using multivariate logistic regression to control for confounder interference. RESULTS: A total of 25 022 patients were included in this study. As the severity of the depressive symptoms worsened (Mild, Moderate and Moderately severe), the risk of gout increased in non-adjusted model and model 1,2,3 (p-value for trend =.01 in non-adjusted model, <.0001 in model 1, <.01 in models 2 and 3; prevalence group in Model 1, aOR1.71, 95% CI (1.40, 2.08) in the mild group, aOR1.68, 95% CI (1.19, 2.39) in the moderate group, aOR1.31,95% CI (0.82, 2.11) in the moderately severe group, aOR1.21, 95% CI (0.62, 2.38) in the severe group). However, the lower gout prevalence trend has no statistical significance after adjusting all factors in Model 4(p-value for trend =.98). Compared with patients without depression, only a few patients received treatment, especially patients with severe depression (none, 80.1%; severe, 0.2%). The more severe the depression, the lower the treatment rate (p-value for trend: non-adjusted model, p < .001; model 1, p = .05; model 2, p = .02; model 3, p = .03). CONCLUSION: Compared with patients without depression, the patients with depression had a higher risk of gout. With the aggravation of depression, the prevalence of gout and the rate of treatment both were decreased. Patients with gout and depression need to receive multidisciplinary care after diagnosis. However, currently, treatment cannot meet the needs of the current patients.

Association between serum uric acid levels and lung function in the NHANES cohort (2007-2012): A cross-sectional analysis of a diverse American population.

BACKGROUND: Hyperuricemia has been linked to various health conditions. However, the relationship between uric acid (UA) levels and lung function remains debated. METHODS: In a cross-sectional study of 6750 participants aged 20-69 from NHANES, we assessed UA levels and lung function (FVC and FEV1). We conducted regression analyses while adjusting for potential confounders. RESULTS: After accounting for factors like age, sex, BMI, smoking, and more, we found a negative association between UA FVC and FEV1. Specifically, for every 0.1 mg/dL increase in UA, FEV1 decreased by 15.265 mL, and FVC decreased by 24.46 mL. No association was observed with FEV1/FVC. Subgroup analyses revealed similar negative correlations among various groups, particularly in non-Hispanic Black females under 60. CONCLUSION: Serum UA levels are inversely associated with FEV1 and FVC in the American population, with a notable impact on non-Hispanic Black females under 60.

Different gender of oxidative balance score on the risk of rheumatoid arthritis in the US population from NHANES.

BACKGROUND: Oxidative stress is associated with risk of pathogenesis between rheumatoid arthritis. The Oxidative Balance Score (OBS) is a systematic tool to assess the effects of diet and lifestyle in relation to oxidative stress. However, the association between OBS and rheumatoid arthritis has not been reported previously. We conducted a cross-sectional study to investigate the complex association between OBS and rheumatoid arthritis in US adults. METHODS: Overall, 9747 participants were included in this cross-sectional study. The exposure variable was OBS, which was scored by 16 dietary and four lifestyle factors. Multivariate logistic regression, subgroup analysis, and restricted cubic spline (RCS) regression were used to analyze the association between OBS and rheumatoid arthritis. RESULTS: Compared to the lowest OBS quartile group (Q1), the multivariate corrected odds ratio (OR) (95% confidence interval [CI]) for the highest quartile of OBS (Q4) was 0.69 (0.52-0.90) (p = .013 for trend); furthermore, the RCS showed a negative linear relationship between OBS and rheumatoid arthritis. According to subgroup and RCS analyses, there was a significant difference between the association of OBS and with rheumatoid arthritis in terms of gender (p = .049). CONCLUSION: In conclusion, high OBS was negatively associated with the risk of rheumatoid arthritis. Gender has an effect on OBS in RA. Our results suggest that OBS can be used as a biomarker to predict rheumatoid arthritis.

Identification of a prognosis-related gene signature and ceRNA regulatory networks in lung adenocarcinoma.

The ceRNA network, consisting of both noncoding RNA and protein-coding RNA, governs the occurrence, progression, metastasis, and infiltration of lung adenocarcinoma. Signatures comprising multiple genes can effectively determine survival stratification and prognosis of patients with lung adenocarcinoma. To explore the mechanisms of lung adenocarcinoma progression and identify potential biological targets, we carried out systematic bioinformatics analyses of the genetic profiles of lung adenocarcinoma, such as weighted gene co-expression network analysis (WGCNA), differential expression (DE) assessment, univariate and multivariate Cox proportional hazard regression models, ceRNA modulatory networks generated using the ENCORI and miRcode databases, nomogram models, ROC curve assessment, and Kaplan-Meier survival curve analysis. The ceRNA network encompassed 37 nodes, comprising 12 mRNAs, 22 lncRNAs, and three miRNAs. Simultaneously, we performed integration analysis using the 12 genes from the ceRNA network. Our findings revealed that the signature established by these 12 genes serves as an adverse element in lung adenocarcinoma, contributing to unfavorable patient prognosis. To ensure the credibility of our results, we used in vitro experiments for further verification. In conclusion, our study delved into the potential mechanisms underlying lung adenocarcinoma via the ceRNA regulatory network, specifically focusing on the PIF1 and has-miR-125a-5p axis. Additionally, a signature comprising 12 genes was identified as a biomarker related to the prognosis of lung adenocarcinoma.

A nomogram based on multimodal ultrasound and clinical features for the prediction of central lymph node metastasis in unifocal papillary thyroid carcinoma.

OBJECTIVES: To build a predictive model for central lymph node metastasis (CLNM) in unifocal papillary thyroid carcinoma (UPTC) using a combination of clinical features and multimodal ultrasound (MUS). METHODS: This retrospective study, included 390 UPTC patients who underwent MUS between January 2017 and October 2022 and were divided into a training cohort (n = 300) and a validation cohort (n = 90) based on a cut-off date of June 2022. Independent indicators for constructing the predictive nomogram models were identified using multivariate regression analysis. The diagnostic yield of the 3 predictive models was also assessed using the area under the receiver operating characteristic curve (AUC). RESULTS: Both clinical factors (age, diameter) and MUS findings (microcalcification, virtual touch imaging score, maximal value of virtual touch tissue imaging and quantification) were significantly associated with the presence of CLNM in the training cohort (all P < .05). A predictive model (MUS + Clin), incorporating both clinical and MUS characteristics, demonstrated favourable diagnostic accuracy in both the training cohort (AUC = 0.80) and the validation cohort (AUC = 0.77). The MUS + Clin model exhibited superior predictive performance in terms of AUCs over the other models (training cohort 0.80 vs 0.72, validation cohort 0.77 vs 0.65, P < .01). In the validation cohort, the MUS + Clin model exhibited higher sensitivity compared to the CLNM model for ultrasound diagnosis (81.2% vs 21.6%, P < .001), while maintaining comparable specificity to the Clin model alone (62.3% vs 47.2%, P = .06). The MUS + Clin model demonstrated good calibration and clinical utility across both cohorts. CONCLUSION: Our nomogram combining non-invasive features, including MUS and clinical characteristics, could be a reliable preoperative tool to predict CLNM treatment of UPTC. ADVANCES IN KNOWLEDGE: Our study established a nomogram based on MUS and clinical features for predicting CLNM in UPTC, facilitating informed preoperative clinical management and diagnosis.

Hydroxychloroquine had neutral effect on long-term risk of malignancy in rheumatoid arthritis patients: A population-based retrospective cohort study.

BACKGROUND: The cancer risk in rheumatoid arthritis (RA) patients has been discussed. Hydroxychloroquine (HCQ) may exert protective effects against malignancy. The study investigated the association between HCQ use and the risk of subsequent malignancy in RA patients. METHODS: Catastrophic illness certificated RA patients were extracted from the National Health Insurance Research Database. The index date was set 180 days after the RA diagnosis date to avoid immortal time bias. Two groups were matched in a 1-to-1 ratio by propensity score regarding age, gender, index date, relevant comorbidities, and comedication. HCQ users prior to the diagnosis of RA were exempted to ensure compliance with the new-user design. Cancers diagnosed before or less than 180 days after the index date were excluded to mitigate protopathic bias. The study adopted the Kaplan-Meier curve and Cox proportional hazards model to examine the association between HCQ use and cancer risk. The assumption of proportional hazard was also tested. RESULTS: Based on strict criteria, we included 492 eligible RA patients and divided them into study and control groups (N = 246 in each group). HCQ users exhibited a neutral risk of cancer relative to the controls (adjusted hazard ratio, 0.99; 95% CI, 0.44-2.21, p > .05). The assumption of proportional hazard was not violated. CONCLUSION: This study does not observe the effect of using HCQ as a primary regimen to prevent cancer in RA patients. We are assured that HCQ is not associated with an increased risk of subsequent malignancy in RA patients. Further mechanistic research is needed.

Association between oxidative balance score and risk of gout: The NHANES cross-sectional study, 2007-2018.

BACKGROUND: The Oxidative Balance Score (OBS) is a systematic tool to assess the effects of diet and lifestyle in relation to oxidative stress. The association between OBS and gout has not been reported previously. We conducted a cross-sectional study to investigate the complex association between OBS and gout in US adults. METHODS: In all, 10 492 participants were included in this study. The exposure variable was OBS, which was scored by 16 dietary and four lifestyle factors. Multivariate logistic regression, subgroup analysis, and restricted cubic spline (RCS) regression were used to analyze the association between OBS and gout. RESULTS: Compared with the lowest OBS quartile group (Q1), the multivariate corrected odds ratio (OR) (95% confidence interval [C]) for the highest quartile of OBS (Q4) was 0.72 (0.52-1.00) (p = .13 for trend); furthermore, the RCS showed a negative linear relationship between OBS and gout (p-nonlinear = .606). CONCLUSION: In conclusion, the risk of gout is higher with high OBS. The prevalence of gout decreased with higher OBS. Diabetes may alter this negative correlation.

Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis (SAPHO) Syndrome with Henoch-Schönlein Purpura: A Case Report.

Introduction: SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome is a rare disease clinically characterized by a wide range of cutaneous and osteoarticular manifestations, involving multiple system impairments. Vasculitis is a rare comorbidity of SAPHO. Henoch-Schönlein purpura (HSP) is a vasculitis involving the capillaries and arterioles mediated by IgA immune complex. No case report of SAPHO syndrome with HSP was ever found. Case: Here we reported a case of SAPHO syndrome complicated with HSP and was successfully treated by methylprednisolone and tofacitinib. Discussion: Although the treat-to-target management of HSP and the first-line clinical medication have given some advices on the treatment. A precise treatment was still needed based on the pathogenesis of the comorbidity. The mechanism of the co-occurrence includes innate immunity and adapted immunity. Considering the active inflammatory reaction and the rapid disease progression, methylprednisolone and tofacitinib were prescribed. Conclusion: HSP is a new comorbidity of SAPHO. The spectrum of cutaneous small-vessel vasculitis in SAPHO syndrome was enriched. A new treatment approach for SAPHO with HSP was provided.

Secukinumab-Induced Alopecia Areata Successfully Treated with Tofacitinib in a Patient with Palmoplantar Pustulosis.

Secukinumab, a monoclonal antibody targeting interleukin-17 (IL-17), has exhibited encouraging results in the therapeutic management of palmoplantar pustulosis (PPP). The development of alopecia areata (AA) is closely related to IL-17, and IL-17A inhibitors were considered as a potential treatment modality. Therefore, the development of AA during secukinumab treatment for PPP is a rare adverse event that has been rarely reported worldwide. Here we report a 35-year-old female patient with PPP who developed AA after completing the induction period of secukinumab treatment. Discontinuing secukinumab and initiating treatment with tofacitinib resulted in a significant improvement in both PPP and AA. The emergence of AA in this patient can be attributed to paradoxical skin reactions associated with IL-17 inhibitors. Tofacitinib appears to alleviate biologic-induced AA during PPP syndrome treatment.

Effectiveness of traditional Chinese exercise in patients with fibromyalgia syndrome: A systematic review and meta-analysis of randomized clinical trials.

BACKGROUND AND OBJECTIVE: Fibromyalgia syndrome (FMS) is a common disorder characterized by heterogeneous symptoms that leads to decreased functioning, work productivity, and quality of life. Exercise has been recommended for fibromyalgia treatment. Traditional Chinese exercise (TCE), including Taichi, Qigong, Badunjin, Wuqinxi, etc., as a kind of mind-body exercise, plays an important role in alleviating symptoms of FMS. The objective of this study is to summarize the available evidence, through meta-analysis, on the pain relief, quality of life, sleep improvement, and emotion regulation of FMS in TCE. METHODS: Databases of PubMed, EMBASE, Cochrane library, Google scholar, CNKI, WANFANG DATA, VIP, etc. were used to search eligible studies that were published from the time of their inception to February 11, 2022, in English and Chinese. The included studies were divided into two groups: TCE group (experimental group) and control group. The Cochrane collaboration's tool was used to assess the risk of bias, and Revman5.4.1 software was used to synthesize and analyze the data. RESULTS: A total of 12 literatures were included in this study, which contained 781 patients, and 448 of them were included in the treatment group, 333 of others in control group. TCE significantly alleviated pain [SMD = -0.83, 95% CI (-1.15, -0.51), p < .00001], improved quality of life [SMD = -0.53, 95% CI (-0.86, -0.19), p = .002] and improved qualities of sleep [SMD = -0.41, 95% CI (-0.57, -0.24), p < .00001] and relieved depression [SMD = -0.40, 95% CI (-0.69, -0.10), p < .008]. CONCLUSION: TCE may be a way to reduce pain, improve the quality of life and sleep, and relieve depression for FMS, and it could be part of the FMS treatment.

Synovitis, acne, pustulosis, hyperostosis, osteitis syndrome with invisible organizing pneumonia: A case report.

We report the case of a 59-year-old female patient, presenting with pustular rash on both hands and pain in the lumbosacral part and left lower limb. A magnetic resonance imaging examination of the left leg was undertaken and the result showed that a malignant lesion with bone destruction of the left femoral shaft could not be excluded. Subsequently, bone tumor was excluded by pathological examination. Lung computed tomography scan showed patchy consolidation and cord shadow in the middle left lung. Subsequently, lung cancer was excluded by pathological examination, and the histopathological changes of lung were consistent with those of organized pneumonia. Blood tests revealed elevated C-reactive protein and erythrocyte sedimentation rate. Antinuclear antibody, rheumatoid factor, and human leukocyte antigen-B27 were unremarkable. Whole body bone scintigraphy via technetium 99m-methyl diphosphonate showed increased radionuclide uptake in the left middle femur. Based on her clinical manifestations, imaging results and bone scintigraphy, the patient was diagnosed as having synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome. Loxoprofen and Tripterygium wilfordii Hook F led to impressive clinical and radiologic improvement.