Clinical and psychological assessment of patients with rheumatoid arthritis and fibromyalgia: a real-world study.

OBJECTIVES: To assess the clinical features and functional and psychological status of patients with rheumatoid arthritis (RA) and those with fibromyalgia (FM) in a real-world setting. METHOD: Between December 2018 and April 2019, 202 inpatients with RA were enrolled from the Rheumatology and Immunology Department at Peking University People's Hospital and assessed for the presence of FM using the 1990 American College of Rheumatology's classification criteria for FM. Disease activity and functional and psychological status were assessed using the Disease Activity Score in 28 joints (DAS-28), Short-Form 36 (SF-36), Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale, and Visual Analog Scale. RESULTS: Among the patients with RA, 42 (20.8%) had concurrent FM. Compared with patients without FM, patients with FM had higher DAS-28 (6.0 vs. 4.4, P = 0.011) and notably higher tender joint counts (16.5 vs. 4.5, P < 0.001). Patients with RA and FM had worse HAQ scores (1.24 vs. 0.66, P < 0.001) and lower SF-36 scores (28.6 vs. 58.2, P < 0.001). Patients with RA and FM experienced more fatigue (88.1% vs. 50.6%, P < 0.001) and had higher anxiety (10 vs. 4, P < 0.001) and depression scores (12 vs. 6, P < 0.001). No significant differences in erythrocyte sedimentation rate, C-reactive protein concentration, morning stiffness period, or swollen joint counts were found between the groups. CONCLUSIONS: Patients with RA and FM had higher disease activity, a worse functional and psychological status, and poorer quality of life. The DAS-28 may have been overestimated in these patients. When patients with RA do not reach remission, FM should be considered. Key Points • Patients with rheumatoid arthritis and fibromyalgia had a worse functional and psychological status compared with those with rheumatoid arthritis alone. • When patients with rheumatoid arthritis do not reach remission, fibromyalgia should be considered. • Physicians should avoid overtreatment and enable these patients to receive the treatment, such as non-drug interventions, that they need.

[Experimental study on effect of hirudin in inhibiting hyperplastic scar fibroblasts].

OBJECTIVE: To study the effect of hirudin on the function of human hyperplastic scar fibroblasts (HSFBs). METHODS: HSFBs were cultured in vitro. Hirudin solution in the concentration of 1, 10, and 50 kU/L was respectively added into DMEM culture medium to form 1, 10, and 50 kU/L hirudin groups, with 9 wells in each group. HSFBs cultured without hirudin were set up as control group. Cell inhibition rate, secretion level of TGF-beta1 from cells, and expression levels of mRNA of type I and III precollagen were determined at 24, 48, and 72 h after culture. RESULTS: Inhibition rates of HSFBs growth was respectively (29.3 +/- 0.9)%, (30.1 +/- 0.3)%, and (45.2 +/- 1.9)% when cultured with 10 kU/L hirudin for 24, 48, and 72 hs, which were higher than those in control group [(0.0 +/- 0.0)%, P < 0.05]. There was statistically significant difference between control group and 1 and 50 kU/L hirudin groups in the inhibition rates of HSFBs at some time points (P < 0.05). Secretion level of TGF-beta1 of HSFBs in 1, 10, 50 kU/L hirudin groups was respectively (228.5 +/- 1.8), (210.5 +/- 11.1), and (168.5 +/- 14.1) pg/mL when cultured for 48 hs, of which the last 2 figures were significantly lower than that of control group [(265.0 +/- 1.5) pg/mL, P < 0.05]. Hirudin in the concentration of 10 and 50 kU/L could inhibit the expression of mRNA of type I and III precollagen in HSFBs. CONCLUSIONS: Hirudin solution in the concentration of 10 and 50 kU/L can inhibit the proliferation of HSFBs and secretion of TGF-beta1 and collagen in certain degree.

Thermodynamics and dynamics of metallic glass formers: their correlation for the investigation on potential energy landscape.

Great progress has been made in basic features of the potential energy landscape (PEL) theoretically. The present work, however, attempts to cast new light on it from experimental aspects. By a survey of experimental data related to thermodynamics or dynamics of metallic glass-forming liquids, it is found that the increased rate of excitation of vibrational entropy at glass transition tends to increase the rate of generation of configurational part. Although for the type of metallic materials a generally positive relationship exists between the density of the energy minima at glass transition and the liquid fragility strength, just as expected, our main attention is paid to the phenomenon of the scattering of the slopes. Analysis shows that the phenomenon results from the different average height of energy barriers between minima near glass transition. Investigation on the PdNiP metallic system indicates that the mismatch entropy is a dominant factor in the barrier height: a large value of it results in low energy barriers. Our previous work on the AlNiCe system gives the support to this finding.