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Objective:To evaluate the relationship between gluten-free diet and rheumatoid arthritis (RA).Methods:Data were obtained from large-scale genome-wide association studies (GWAS), and genetic loci that are independent of gluten-free diet and RA of people of Europe2 were selected as instrumental variables. The gluten-free diet GWAS data included 64 949 individuals and 9 851 867 controls. Data were obtained from GWAS of 58 284 RA patients and 13 108 512 controls. The inverse variance weighted (IVW), MR Egger, weighted median method and weighted model were used to conduct two sample Mendelian randomization (MR) analysis. Cochran Q test and mendelian randomness pleiotropy residual sum and outlier (MR-PRESSO) were used to assess SNP heterogeneity. Applying the MR Egger intercept to test the level pleiotropy of SNP. The sensitivity analysis of the "leave one method" that evaluates whether MR studies were influenced by a single SNP. Results:After matching GFD and RA data, three SNPs were included as instrumental variables in the study. IVW showed that GFD could significantly reduce the risk of RA ( β=-60.83, s x=3.82, P<0.001). The weighted median method and weighted pattern also showed that the gluten free diet could reduce the risk of RA ( β=-57.97, s x=4.41, P<0.001; β=-55.81, s x=5.10, P=0.008). Sensitivity analysis of the correlation between GFD and RA showed that there might be heterogeneity between SNPs (Cochran Q test, Q=12.80, P=0.002). The MR-PRESSO results showed that no abnormal SNP was detected ( P=0.174). The forest map showed that SNPs was closely related to GFD and RA stability. The method comparison chart showed that the results of multiple testing methods were basically consistent. The funnel plot showed that SNPs were basically symmetrical, indicating that there was no pleiotropy in MR analysis. The MR Egger intercept test showed no horizontal pleiotropy in MR analysis (intercept value was-0.24, P=0.174). The sensitivity analysis of the "leave one method" is suggested that no single SNP had a significant impact on the overall results. Conclusion:Gluten free diet is related to the risk reduction of RA.
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Objective This study aims to investigate the variation of neutrophil extracellular traps (NETs) in animal model of staphylococcus aureus (SA) infected systemic lupus erythematosus (SLE) MRL/Lpr mouse.Methods The infection model was developed by injecting the Staphylococcus Aureus in the mouse tail vein.The Staphylococcus Aureus load of the serum and kidney was detected by enzyme-linked immuno sorbent assay (ELISA).The level of NETs complex in the serum was detected by Cell-Death-Elisa-Plus-Kit and anti-myeloperoxidase (MPO) antibody.The kidney NETs formation was tested with the immunofluorescence.Statistical program for social sciences (SPSS) 17.0 software and Image Pro Plus statistical software were used for analysis.Comparisons between groups were made using unpaired t test for normally distributed numerical data,nonparametric test for non-normally distributed numerical data,and single factor analysis (ANOVA) for variance.Results The incidence of walking instability,purulent exudate in eyes and death was 2/6,1/6,1/6 respectively in Staphylococcus Aureus-infected MRL/Lpr mice,However,The control group had no death and related symptoms.The Staphylococcus Aureus load of the serum was higher in MRl/lpr mice when compared to the control group [(106.79±23.39) ng/ml vs (48.82±11.49) ng/ml,U=2.739,P<0.05] after Staphylococcus Aureus infection.The control group had a higher NETs level [(2.24±0.15) vs (1.64±0.08),U=2.882,P<0.05],however,all the MRL/Lpr mice had no significant change of the NETs level [(2.63±0.61) vs (2.65 ±0.260),U=0.548,P>0.05] after Staphylococcus Aureus infection.Conclusion After infected by the Staphylococcus Aureus,more symptoms,higher death rate and higher Staphylococcus Aureus load of the serum present in the MRlL/lpr mice than the control group.While,there's none significant change of the NETs level in Staphylococcus Aureus-infected MRLL/lpr mice.This suggests that the dyspoiesis of NETs is present in Staphylococcus Aureus-infected MRL/lpr mice.
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Objective:To analyze the trend relevant factors leading to death and their patterns over a 10-year period in inpatients with connective tissue diseases (CTDs).Methods:All clinical data about death in inpatients with CTDs were retrospectively reviewed between 2005 and 2014 at the Department of Rheumatology and Immunology in Xiangya Hospital of Central South University.Results:In the 10-year time period,the overall hospital mortality was 15.689‰.The disease itself accounted for 44.71% of the total causes of death,infection accounted for 42.94%,and comorbidities accounted for 12.35%.The constituent ratio of deaths and the average hospital mortality caused by the disease itself declined gradually year by year,and the constituent ratio of deaths caused by infection and comorbidities increased gradually year by year (P<0.05).In 2013-2014,infection was the leading cause of death,which accounted for 51.06%.The survival time for CTDs inpatients with interstitial lung disease (ILD) was shorter than that of CTDs inpatients without ILD,and even the risk of death was 1.722 times of the latter.The proportion of deaths caused by the disease itself was the highest in systemic sclerosis and systemic lupus erythematosus,that by infection was the highest in idiopathic inflammatory myopathy (IIM),and that by comorbidities was the highest in rheumatoid arthritis.Conclusion:The proportion of deaths and the hospital mortality in CTDs inpatients caused by the disease itself show a declining trend,while the proportion of deaths caused by infection and comorbidities increase.CTDs patients with ILD have shorter survival time and an increase in risk of death.
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Objective To investigate the expression and antibacterial function of Neutrophil extracellular traps (NETs) in systemic lupus erythematosus (SLE) patients.Methods Thirty stable SLE patients and thirty normal controls (NC) were recruited to this study.The acitivity of SLE was assessed by SLE Disease Activity Index (SLEDAI).Density gradient centrifugation was uesd to isolate neutrophilic granulocytes.Picogreen assay was used to quantify NETs formation.Colony counting method was used to compare the antibacterial rate of NETs between two groups.Variation of quantity and activities of neutrophil elastase (NE) and myeloperoxidase (MPO) on induced NETs was tested by enzyme linked immunosorbent assay (ELISA).Results There was no significant difference in the number of NETs between SLE and NC.Compared to the control group,more NETs were induced from neutrophils in SLE,the antibacterial rate of induced NETs was significantly lower,with the activities of antibacterial protein MPO decreased.Conclusions Stable SLE patients are more easily to induce NETs,and the antibacterial function of induced NETs are truly defective,may be related to the decreased activity of the antibacterial protein MPO.
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OBJECTIVE@#To study the clinical characteristics of invasive fungal infection secondary to systemic lupus erythematosus (SLE).@*METHODS@#We observed the clinical features and experimental examination in 91 patients treated in Xiangya Hospital in recent years, of which 48 patients with invasive fungal infection and 41 patients without invasive fungal infection.@*RESULTS@#The invasive fungal infection secondary to SLE mainly occurred in the lungs, nervous system, and urinary system. The fungi were mainly Candida albins and Aspergillus. The rate of invasive fungal infection in SLE patients and the level of CRP and TNF-α in these patients were significantly increased. The occurrence of invasive fungal infection was positively correlated with the prolonged course of disease, long-term use of immunosuppressants and antibiotics, and occurrence of complications, such as hypoproteinemia, leukocytopenia, and so on. The levels of C-reactive protein (CRP) and tumor necrosis factor-α(TNF-α) were increased in SLE patients with invasive fungal infection.@*CONCLUSION@#The clinical features of SLE patients with invasive fungal infections are long course of disease, long-time use of immunosuppressants or antibiotics, and occurrence of complications, such as hypoproteinemia or leukopenia. The level of CRP and TNF-α can be used as an important reference index for diagnosing invasive fungal infections.
Sujets)
Adolescent , Adulte , Enfant , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Aspergillus , Protéine C-réactive , Métabolisme , Candida albicans , Infections fongiques du système nerveux central , Épidémiologie , Chine , Mycoses pulmonaires , Épidémiologie , Lupus érythémateux disséminé , Microbiologie , Mycoses , Facteur de nécrose tumorale alpha , SangRésumé
Objective To investigate the efficacy and safety of low-dose prednisone combined with methotrexate (MTX) and hydroxychloroquine (HCQ) in the treatment of rheumatoid arthritis (RA).Methods In this 12-week study,150 patients with active rheumatoid arthritis were randomly divided into two groups:prednisone group (70 cases who were received prednisone 5 ~ 10 mg/d + MTX 10 mg/w +HCQ 0.2 g/d) and control group (80 cases who were treated by Meloxicam 7.5 mg/d + MTX 10 mg/w +Leflunomide (LEF) 20 mg/d).The primary end-points were tender and swollen joint counts,visual analogue scales (VAS),and global physician and patients assessments of disease.The secondary end-points were morning stiffness time,C-reactive protein,erythrocyte sedimentation rate,the Health Assessment Questionnaire (HAQ),DAS28 and ACR20,ACR50.Results After 12 weeks,in terms of primary endpoints,tender and swollen joint counts,VAS and global physician assessments in the prednisone group were improved significantly [(4.5 ± 2.5),(3.2 ± 3.36),(21 ± 15),(24.2 ± 16.4),(20.2 ± 10.4) vs (6.4 ±5.84),(6.6±5.5),(46±14),(37.9±19.7),(34.1±12.4),P <0.05orP <0.01].In terms of secondary end-points,the prednisone group produced higher response rates [HAQ score (0.93 ± 0.52),CRP(10.2 ± 5.8) mg/L,ESR(30 ± 14) mm/h,morning stiffness time (32.0 ± 32.3) min,DAS 28 score (3.1±0.9) vs (1.22 ±0.81),(16.3±10.1)mg/L,(33±29)mm/h,(54.7±45.4)min,(4.9±1.9),P <0.05 orP <0.01].The incidence of adverse events was similar between two groups (43% vs 49%,P > 0.05).Conclusions Low-dose prednisone combined with MTX and HCQ produced rapid and relevant improvements in RA signs and symptoms.
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Objective To investigate the feedback of eight-year program students to problem-based learning ( PBL ),and find out the existing problems and solutions.MethodsThe questionnaire survey was made in the eight-year program students.ResultsApplication of PBL could achieve good feedback.It helped to enhance the self-directed learning,expressing ability,accessing resource skill,and team spirit.ConclusionAlthough there are some problems in the practice of PBL,PBL is a good teaching method in eight-year program education.
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OBJECTIVE@#To explore the effect of unmethylated CpG motif containing oligodeoxynucleotides (CpG ODN) on the function of dendritic cells (DCs) in patients with chronic hepatitis B (CHB).@*METHODS@#DCs were obtained from peripheral blood mononuclear cells (PBMCs) of 15 CHB patients, 12 hepatitis B virus (HBV) carriers, and 10 healthy controls. The expressions of HLA-DR, CD80, and CD86 on DCs were determined by fluorescence activated cell sorting (FACS). The IL-12 level in supernatant of the culture medium was measured by ELISA, and the morphological changes of DCs were observed under transmission electron microscope.@*RESULTS@#Compared with the controls, DCs stimulated with CpG ODN represented enrichment in cell surface protrusions and rough endoplasmic reticulum, decreased or disappeared vacuole. The expressions of HLA-DR, CD86, and CD80 were much higher in DCs stimulated with CpG ODN than those in complete medium control (P<0.05). When culturing in complete medium, the expressions of HLA-DR, CD86, and CD80 were much lower in CHB patients and HBV carriers than healthy controls (P<0.05). The expressions of HLA-DR and CD86 stimulated with CpG ODN were much lower in CHB patients than HBV carriers and healthy controls (P<0.05). The expressions of CD80 were much lower in CHB patients and HBV carriers than healthy controls (P<0.05). The levels of IL-12 were much higher in DCs stimulated with CpG ODN than that in complete medium controls (P<0.05). The levels of IL-12 in complete medium or medium added with CpG ODN were much lower in CHB patients and HBV carriers than in healthy controls (P<0.05).@*CONCLUSION@#CpG ODN could significantly promote the maturation of dendritic cells in peripheral blood in CHB patients.