Novel potential lncRNA biomarker in B cells indicates essential pathogenic pathway activation in patients with SLE.

OBJECTIVES: Systemic lupus erythematosus (SLE) is a highly heterogeneous disease, and B cell abnormalities play a central role in the pathogenesis of SLE. Long non-coding RNAs (lncRNAs) have also been implicated in the pathogenesis of SLE. The expression of lncRNAs is finely regulated and cell-type dependent, so we aimed to identify B cell-expressing lncRNAs as biomarkers for SLE, and to explore their ability to reflect the status of SLE critical pathway and disease activity. METHODS: Weighted gene coexpression network analysis (WGCNA) was used to cluster B cell-expressing genes of patients with SLE into different gene modules and relate them to clinical features. Based on the results of WGCNA, candidate lncRNA levels were further explored in public bulk and single-cell RNA-sequencing data. In another independent cohort, the levels of the candidate were detected by RT-qPCR and the correlation with disease activity was analysed. RESULTS: WGCNA analysis revealed one gene module significantly correlated with clinical features, which was enriched in type I interferon (IFN) pathway. Among non-coding genes in this module, lncRNA RP11-273G15.2 was differentially expressed in all five subsets of B cells from patients with SLE compared with healthy controls and other autoimmune diseases. RT-qPCR validated that RP11-273G15.2 was highly expressed in SLE B cells and positively correlated with IFN scores (r=0.7329, p<0.0001) and disease activity (r=0.4710, p=0.0005). CONCLUSION: RP11-273G15.2 could act as a diagnostic and disease activity monitoring biomarker for SLE, which might have the potential to guide clinical management.

The integrated effects of leader-member exchange social comparison on job performance and OCB in the Chinese context.

Although it has been long recognized that leader-member exchange social comparison (LMXSC) has critical implications for employee productivity, little attention has been given to systematically exploring the effects of LMXSC on employee performance in a specific cultural context. Integrating social exchange theory with social comparison theory, we examine a dual process model to explain how and when LMXSC affects employee performance outcomes in the Chinese context. Results based on multiphase, multisource data from China revealed that the mediating roles of employees' perceived obligation toward the leader and self-esteem are examined simultaneously in the relationship between LMXSC and job performance and organizational citizenship behavior (OCB). Additionally, guanxi strengthens the connection between LMXSC and perceived obligation, while Zhongyong thinking erodes the connection between LMXSC and self-esteem. Taken together, these findings enhance our understanding of LMXSC in China.

Integrative Functional Genomics Identifies Systemic Lupus Erythematosus Causal Genetic Variant in the IRF5 Risk Locus.

OBJECTIVE: IRF5 plays a crucial role in the development of lupus. Genome-wide association studies have identified several systemic lupus erythematosus (SLE) risk single-nucleotide polymorphisms (SNPs) enriched in the IRF5 locus. However, no comprehensive genome editing-based functional analysis exists to establish a direct link between these variants and altered IRF5 expression, particularly for enhancer variants. This study was undertaken to dissect the regulatory function and mechanisms of SLE IRF5 enhancer risk variants and to explore the utilization of clustered regularly interspaced short palindromic repeat interference (CRISPRi) to regulate the expression of disease risk gene to intervene in the disease. METHODS: Epigenomic profiles and expression quantitative trait locus analysis were applied to prioritize putative functional variants in the IRF5 locus. CRISPR-mediated deletion, activation, and interference were performed to investigate the genetic function of rs4728142. Allele-specific chromatin immunoprecipitation-quantitative polymerase chain reaction and allele-specific formaldehyde-assisted isolation of regulatory element-quantitative polymerase chain reaction were used to decipher the mechanism of alleles differentially regulating IRF5 expression. The CRISPRi approach was used to evaluate the intervention effect in monocytes from SLE patients. RESULTS: SLE risk SNP rs4728142 was located in an enhancer region, indicating a disease-related regulatory function, and risk allele rs4728142-A was closely associated with increased IRF5 expression. We demonstrated that an rs4728142-containing region could act as an enhancer to regulate the expression of IRF5. Moreover, rs4728142 affected the binding affinity of zinc finger and BTB domain-containing protein 3 (ZBTB3), a transcription factor involved in regulation. Furthermore, in monocytes from SLE patients, CRISPR-based interference with the regulation of this enhancer attenuated the production of disease-associated cytokines. CONCLUSION: These results demonstrate that the rs4728142-A allele increases the SLE risk by affecting ZBTB3 binding, chromatin status, and regulating IRF5 expression, establishing a biologic link between genetic variation and lupus pathogenesis.

Understanding the Attitudes and Willingness of Adult Chinese Patients with Rheumatic Diseases Towards COVID-19 Vaccination.

Background: The SARS-CoV-2 pandemic has imposed substantial health and economic burdens on the societies. COVID-19 vaccination is the most effective method of controlling the epidemic. This study assessed the attitude, willingness, and related factors of adult patients with rheumatic diseases (RDs) in China towards COVID-19 vaccination and identified their reasons for being vaccinated. Methods:  A cross-sectional survey was administered to patients with rheumatic diseases from July 18 to August 18, 2021, using an online questionnaire. Logistic regression analysis was performed to examine the data. Results: We analyzed data drawn from 464 participants who provided valid responses. A total of 324 (69.83%) RD patients were not willing to be vaccinated, of which 76.97% believed that COVID-19 vaccination might exacerbate the diseases symptoms. Logistic regression analysis showed that a combination of experiencing systemic damage, being in the acute attack stage of the disease, and fear of the adverse impact of vaccination on rheumatism, etc., were the predominant factors affecting the intentional vaccination rate in adult patients with rheumatic diseases (p < 0.05). Conclusion: The COVID-19 intentional vaccination rate was relatively low in adult Chinese patients with RD. Public health education and the dissemination of government scientific data for patients with RD should be enhanced to increase COVID-19 vaccination rates.

Safety and immunogenicity of inactivated COVID-19 vaccination in adult rheumatic patients in South China: a prospective study.

Patients with rheumatic diseases (RD) are considered to be a high-risk population for infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The effectiveness of inactivated COVID-19 vaccinations (ICVs) was described as more effective than 95%. Despite this, no data on the immunogenicity and safety of the ICV in Han race stable RD patients in China. In this study, we sought to assess the safety and immunogenicity of the ICVs in RD patients in South China. A total of 80 adult stable RD patients were recruited. Following 14-35 days of immunization, cheiluminescence immunoassays (CLIA) were utilized to detect antibodies titers. An investigation into the relative parameters on the immunogenicity response to vaccination was carried out using logistic regression analysis. Compared to the HC group, the positive response of IgG and Nab in RD patients were lower than those in healthy control (HC) (P = .040 and P < .0001, respectively) after two doses of ICV were inoculated. The use of methotrexate (P = .016) and prednisolone (P = .018), and the level of red blood cell distribution width-C (RDW-C) (P = .035) and C-reactive protein (P = .015) were independently associated with lower rises in the magnitude of COVID-19 vaccine antibodies. No vaccine-related serious adverse reactions were observed in either group. After receiving two doses of ICVs, the production of protective antibodies in stable RD patients treated with immunosuppressive agents may decrease. It was discovered that ICVs were safe and well tolerated by RD patients.

What is the context?There are currently no accessible data on the efficacy and safety of inactivated COVID-19 vaccinations in South China RD patients who are receiving immunosuppressive medications.What is new?Inactivated COVID-19 vaccinations were immunogenic in stable RD patients in our investigation. No significant adverse reactions to the vaccination were seen in either group. No disease flares were observed in our study.What is the impact?Inactivated COVID-19 vaccinations are immunogenic and safe in stable RD patients in China, according to the findings of this study. The use of methotrexate or prednisolone, the RDW-C level, and the CRP level may all have an effect on the development of protective antibodies following vaccination.

College students' stress and health in the COVID-19 pandemic: The role of academic workload, separation from school, and fears of contagion.

The COVID-19 pandemic has unhinged the lives of people across the globe. In particular, more than 30 million Chinese college students are home-schooling, yet there is little understanding of how academic workload, separation from school, and fears of contagion lead to a decrease in their health. This study examined the relationships between Chinese college students' three critical stressors and two types of health in the COVID-19 pandemic context. We used a three-wave lagged design with a one-week interval. All the constructs were assessed by self-report in anonymous surveys during the COVID-19 pandemic. College students were asked to report their demographic information, academic workload, separation from school, fears of contagion, perceived stress, and health. The results of this study showed that academic workload, separation from school, and fears of contagion had negative effects on college students' health via perceived stress. In the COVID-19 crisis, multiple prevention and control measures focusing on college students may lead them to have different degrees of stress and health problems. Our results enrich the literature on stress and health and offer novel practical implications for all circles of the society to ensure students' health under the context of the COVID-19 epidemic.

Examining the Effects of Overtime Work on Subjective Social Status and Social Inclusion in the Chinese Context.

Although researchers have argued that long work hours have been shown to threaten individual health, lead to work-family conflict, and reduce job performance, the effect of overtime work on social-related outcomes has received little attention. Based on the framework of relative deprivation, we attempt to address this important issue by exploring whether, why, and when individuals' overtime work influences their social attitudes. By using the data of 400 Chinese employees from the China Labor-Force Dynamics Survey (CLD), we found that overtime work was associated with a low level of subjective social status and social inclusion. In addition, we found that the time type of overtime work (work overtime on weekdays or on weekends and holidays) has a moderating effect on the relationship between overtime work and social inclusion. That is, employees who work overtime on weekdays are unlikely to have a sense of social inclusion. Furthermore, the negative relationship between overtime work and subjective social status was stronger at a low level of fairness rather than a high level of fairness. In contrast, the negative relationship between overtime work and social inclusion was stronger at a high level of fairness rather than a low level of fairness. These findings highlight the critical role of overtime work in social life and also provide novel insights into social intervention aimed at the happiness and harmony of a society.

Emotional Labor: Scale Development and Validation in the Chinese Context.

Based on the specific cultural context to add greater theoretical precision to emotional labor, we developed the Chinese version scale of emotional labor. For a comprehensive construct development and validation of the new scale, we carried out five studies. First, we used grounded theory methodologies, performed analysis of data from field observations of 15 frontline employees through insider's angle (Study 1) and in-depth interviews with 35 employees (Study 2), and preliminarily glimpsed the main content of emotional labor in China. Second, combined with existing literature and open-ended questionnaires with 110 employees (Study 3), we identified four dimensions labeled as surface acting, deep acting, expression of naturally felt emotions and emotion termination, and established the initial items. Third, Study 4 with 166 service workers from China was performed to demonstrate the validity, reliability, and acceptable psychometric properties of the scale and thus formed the formal scale. Finally, multi-wave data with 403 Chinese samples (Study 5) were collected for validating the formal scale. Future researchers can employ this validated scale to investigate emotional labor in Chinese service settings. We expect the emotional labor phenomena in the Chinese context can add valuable and novel insight into the stock of emotional labor knowledge in numerous geographical and cultural contexts.

The Effect of Social Communication on Life Satisfaction among the Rural Elderly: A Moderated Mediation Model.

Life satisfaction of the rural elderly has increasingly become an important issue for society. Based on the social support theory and Cha Xu Ge Ju (pattern of difference sequence), this study investigates the underlying mechanisms and boundary conditions that explain the relationship between social communication and life satisfaction among the rural elderly. Specifically, it explores the mediating role of psychological well-being in the relationship between social communication and life satisfaction. In addition, it examines whether emotional support moderates the effect of social communication on psychological well-being. Data from 658 rural elderly in China were analyzed using structural equation modeling. Results show that psychological well-being mediates the relationship between social communication and life satisfaction. Additionally, the relationship between social communication on psychological well-being was negatively moderated by emotional support. Finally, implications for management theory and practice are discussed.

[Etanercept combined with Tripterygium wilfordii polyglycoside for treatment of rheumatoid arthritis in the elderly: a clinical study].

OBJECTIVE: To evaluate the efficacy and safety of etanercept plus Tripterygium wilfordii polyglycoside (TWP) in elderly patients with active rheumatoid arthritis (RA). METHODS: Totally 46 elderly patients with active RA were randomly assigned to the treatment group (22 cases) and the control group (24 cases). All patients received subcutaneous injection of etanercept, 25 mg each time, twice per week. The dosage was reduced to once per week 3 months later. Patients in the treatment group took TWP Tablet (10 mg each time, three times per day), while those in the control group took methotrexate (MTX), 10 mg each time, once per week. The whole course lasted for 24 weeks. Patients' rest pain, tender joint number, swollen joint number, health assessment questionnaire (HAQ), patients' global assessment, physicians' global assessment, erythrocyte sediment rate (ESR), C reactive protein (CRP), rheumatic factor were assessed at week 0, 4, 8, 12, and 24. The curative effect was statistically evaluated by the United States Institute of Rheumatology ACR20, ACR50, and ACR70 improvement criteria. Meanwhile, any adverse event was recorded and evaluated. RESULTS: Totally 41 completed the trial, and 5 dropped off (3 in the treatment group and 2 in the control group). Compared with the control group, there was no statistical difference in ACR20, ACR50, or ACR70 in the treatment group (P > 0.05). Compared with before treatment in the same group, there was some improvement in tender joint number, swollen joint number, visual analogue scale (VAS) for patients' global assessment, VAS for physicians' global assessment, ESR, CRP, and HAQ between the two groups, showing statistical difference (P < 0.05). Compared with the control group in the same phase, there was no statistical difference in the treatment group (P > 0.05). There was no statistical difference in the occurrence of adverse events between the two groups. CONCLUSIONS: Etanercept plus TWP could achieve equivalent therapeutic effect to that of Etanercept plus MTX. The two regimens could improve clinical signs, symptoms, and QOL related to RA. They were well tolerated in the treatment of elderly patients with active RA.

[Clinical analysis of bronchopulmonary infection with hypermastigotes: a report of two cases and review of the Chinese literature].

OBJECTIVE: To describe the clinical features of bronchopulmonary infection with hypermastigotes. METHODS: Two cases of bronchopulmonary infection with hypermastigotes were reported. The clinical features of another six cases from the Chinese literature were reviewed. RESULTS: Bronchopulmonary infection with hypermastigotes mostly occurs in the hot and humid southern area. The symptoms are severe, with different manifestations such as chronic cough, asthma, pneumonia, and even lung abscess. Final diagnosis is made by the presence of hypermastigotes in smears of secretions from the respiratory tract. An antiprotozoal such as metronidazole is always effective. CONCLUSION: In patients with unexplained cough, asthma, and pneumonia or lung abscess which do not respond to ordinary therapy, rare pathogens such as hypermastigotes need to be considered.