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Additional file 1:Table S1. Deaths of NASH-related liver cancer attributable to HFPG in 1990 and 2019, and its temporal trends from 1990 to 2019. Table S2. YLDs of NASH-related liver cancer attributable to HFPG in 1990 and 2019, and its temporal trends from 1990 to 2019. Table S3. YLLs of NASH-related liver cancer attributable to HFPG in 1990 and 2019, and its temporal trends from 1990 to 2019. Table S4. Deaths and DALYs of NASH-related liver cancer attributable to HFPG in countries and territories. Table S5. EAPC of NASH-related liver cancer deaths and DALYs attributable to HPFG in countries and territories. Figure. S1. The deaths of NASH-related liver cancer attributable to HFPG in countries and territories. (A) The ASR of NASH-related liver cancer deaths attributable to HFPG in 2019; (B) The relative change in percentage of NASH-related liver cancer deaths attributable to HFPG between 1990 and 2016. ASR, age-standardized rate. Figure. S2. The DALYs of NASH-related liver cancer attribute to HFPG in countries and territories. (A) The ASR of DALYs of NASH-related liver cancer attributable to HFPG in 2019; (B) The relative change in percentage of NASH-related liver cancer DALYs attributable to HFPG between 1990 and 2016. ASR, age-standardized rate. DALYs, disability adjusted life years. Figure. S3. The clusters of countries and territories in terms of the temporal trends of the NASH-related liver cancer burden attributable to HFPG. Figure. S4: Temporal trend of deaths rate of NASH-related liver cancer attributable to HFPG for different age group, 1990–2019.

Additional file 1: Figure S1. Rapid causes of cancer mortality worldwide for females and males, 1990–2019. Figure S2. Tracheal, bronchus, and lung cancer age-standardized mortality rates in 2019 (A) and percent change (%) in age-standardized rates during 1990–2019 (B) for 204 countries and territories by sociodemographic index. Figure S3. The colon and rectal cancer age-standardized mortality rates in 2019 (A) and percent change (%) in the age-standardized rate during 1990–2019 (B) for 204 countries and territories by sociodemographic index. Figure S4. Breast cancer age-standardized mortality rates in 2019 (A) and percent change (%) in age-standardized rates during 1990–2019 (B) for 204 countries and territories by sociodemographic index. Figure S5. Pancreatic cancer age-standardized mortality rates in 2019 (A) and percent change (%) in age-standardized rates during 1990–2019 (B) for 204 countries and territories by sociodemographic index. Figure S6. Local drifts of tracheal, bronchus, and lung cancer mortality attributable to HFPG by SDI quintiles, 1990–2019. Figure S7. Local drifts of colon and rectal cancer mortality attributable to HFPG by SDI quintiles, 1990–2019. Figure S8. Local drifts of breast cancer mortality attributable to HFPG by SDI quintiles, 1990–2019. Figure S9. Local drifts of pancreatic cancer mortality attributable to HFPG by SDI quintiles, 1990–2019. Figure S10. Age distribution of tracheal, bronchus, and lung cancer mortality attributable to HFPG by SDI quintiles, 1990–2019. Figure S11. Age distribution of colon and rectal cancer mortality attributable to HFPG by SDI quintiles, 1990–2019. Figure S12. Age distribution of breast cancer mortality attributable to HFPG by SDI quintiles, 1990–2019. Figure S13. Age distribution of pancreatic cancer mortality attributable to HFPG by SDI quintiles, 1990–2019. Figure S14. Age, period and cohort effects on tracheal, bronchus, and lung cancer mortality attributable to HFPG by SDI quintiles. Figure S15. Age, period and cohort effects on colon and rectal cancer mortality attributable to HFPG by SDI quintiles. Figure S16. Age, period and cohort effects on breast cancer mortality attributable to HFPG by SDI quintiles. Figure S17. Age, period and cohort effects on pancreatic cancer mortality attributable to HFPG by SDI quintiles. Figure S18. Age, period and cohort effects on tracheal, bronchus, and lung cancer mortality attributable to HFPG for representative countries. Figure S19. Age, period and cohort effects on colon and rectal cancer mortality attributable to HFPG for representative countries. Figure S20. Age, period and cohort effects on breast cancer mortality attributable to HFPG for representative countries. Figure S21. Age, period and cohort effects on pancreatic cancer mortality attributable to HFPG for representative countries. Table S1. Percent changes (%) in the age-standardized mortality rate 1990–2019 for all risk factors. Table S2. Trends in cancer mortality attributable to HPFG for females and males across SDI quintiles, 1990 − 2019. Table S3. Trends in tracheal, bronchus, and lung cancer mortality attributable to HPFG for both females and males across SDI quintiles, 1990 − 2019. Table S4. Trends in colon and rectal cancer mortality attributable to HPFG for both females and males across SDI quintiles, 1990 − 2019. Table S5. Trends in breast cancer mortality attributable to HPFG for female across SDI quintiles, 1990 − 2019. Table S6. Trends in pancreatic cancer mortality attributable to HPFG for both females and males across SDI quintiles, 1990 − 2019. Table S7. Trends in cancer mortality attributable to HPFG for both genders in 204 countries and regions, 1990–2019. Table S8. Trends in cancer mortality attributable to HPFG for both females and males in representative countries, 1990–2019. Table S9. Trends in tracheal, bronchus, and lung cancer mortality attributable to HPFG for both females and males in representative countries, 1990–2019. Table S10. Trends in colon and rectal cancer mortality attributable to HPFG for both females and males in representative countries, 1990–2019. Table S11. Trends in breast cancer mortality attributable to HPFG for both females in representative countries, 1990–2019. Table S12. Trends in pancreatic cancer mortality attributable to HPFG for both females and males in representative countries, 1990–2019.

The acupuncture case registry study is focusing on acupuncture therapy data from patient cases. The main objective is to collect real-world data and integrate clinically meaningful outcome evaluation indicators to uncover and evaluate real-world acupuncture efficacy and safety, explore factors affecting acupuncture efficacy, and provide real-world evidence to complement RCTs. Since the International Acupuncture Case Registry data collection system’s establishment in 2017, 16 projects have been underway, including two acupuncture specialty therapies and 15 diseases. Data from 3404 patients included extensive information on the diagnosis and treatment of acupuncture and the evaluation of its efficacy. In order to serve as a guide for future studies, this article discusses the value of and rationale for establishing acupuncture case registry studies, how to distinguish them from patient registries, and crucial techniques for implementing registry studies in terms of applications, patient recruitment, costakeholder collaboration, data collection and management, study quality control, and ethics.

Objective: To explore the effect of individualized nursing intervention on autologous arteriovenous fistula (AVF) dysfunction and the risk factors leading to failures in maintenance hemodialysis (MHD) patients. Methods: A total of 196 patients undergoing MHD in our hospital from March 2017 to May 2019 were recruited as the study cohort and divided into two groups according to the nursing method each patient underwent. The patients who underwent individualized nursing intervention were placed in the research group (RG, n = 107), and the patients who underwent routine nursing intervention were placed in the control group (CG, n = 89). The proportion of patients with primary dysfunction in the use of AVF was recorded, and the patients’ psychological states, treatment compliance, and self-nursing abilities in the two groups before and after the nursing intervention were observed. The complications, the life treatment scores, and the patients’ nursing satisfaction were recorded after the nursing intervention. A logistic regression analysis was performed for the patients with initial AVF dysfunction. Results: Compared with the CG, the patients in the RG after the nursing intervention had statistically lower AVF dysfunction rates, notably lower SAS and SDS scores, remarkably higher total compliance rates and ESCA scores, and a dramatically lower total incidence of complications. AVF dysfunction occurred in 26 of 196 patients (13.4%) during the follow-up, with an increased risk of AVF loss in patients over 60 years old, lower blood pressure, higher hemoglobin concentrations, lower treatment compliance, self-care inability, and routine nursing interventions. After the nursing, the WHOQOL-BREF and nursing satisfaction scores in the RG were noticeably higher than they were in the CG. Conclusion: Autologous AVF dysfunction is the result of multiple risk factors, and personalized nursing can reduce the incidence of complications, improve patients’ treatment compliance and self-care abilities, and ameliorate their quality of life.

Liyun He, Na Yang, Fan Ping, Lingling Xu, Wei Li, Yuxiu Li, Huabing Zhang Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of ChinaCorrespondence: Huabing ZhangAddress: Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of ChinaTel/Fax +86-010-69155073Email huabingzhangchn@163.comPurpose: High-sensitivity C-reactive protein (hs-CRP) has been shown as an important predictor of cardiovascular risk, and sleep duration is an important factor influencing health outcomes. However, the association between hs-CRP and sleep duration among Chinese adults remained unknown and controversial. We aimed to explore the associations between sleep duration and hs-CRP levels among Chinese adults, and the differences in sex and geographical regions.Methods: This cross-sectional study was based on nationally representative Chinese samples from the 2009 China Health and Nutrition Survey, which employed multistage, random cluster designs. Habitual sleep duration was self-reported with short and long sleep duration defined as ≤ 6h and ≥ 9h per day, respectively. Participants were divided into 4 groups based on the categories of self-reported sleep duration (≤ 6h, 7h, 8h, ≥ 9h per day), excluding hs-CRP levels ≥ 10 mg/L. Subset samples were stratified by sex and geographical regions.Results: A total of 8170 Chinese adults with a mean age of 50.0± 14.9 years and 4369 (53.5%) men were included. Participants sleeping eight hours had the lowest hs-CRP levels. Long sleep duration (≥ 9h) was significantly associated with elevated hs-CRP levels after adjusting for multiple covariates in full samples (β=0.0356; 95% CI: 0.0050– 0.0663; P=0.0228), but the associations of short sleep duration (≤ 6h) were limited to the unadjusted model. Long sleep duration was associated with elevated hs-CRP levels in women (β= 0.0512; 95% CI: 0.0097– 0.0927; P=0.0155) and in the northern region of China (β=0.0699; 95% CI: 0.0210– 0.1187; P=0.0051), but not in men or the southern region.Conclusion: Long but not short sleep duration was positively associated with elevated hs-CRP levels, independent from traditional risk factors among Chinese adults, and sex and geographical differences were observed. Our findings imply that modifications of long sleep duration might be added to behavioral therapy to reduce cardiovascular risk in Chinese adults.Keywords: high-sensitivity C-reactive protein, sleep duration, cardiovascular risk, Chinese population

To evaluate the clinical effects of Xiyanping injection intervention in pediatric patients with mild hand foot and mouth disease (HFMD).A total of 329 patients were stratified and block-randomized for symptomatic treatment of HFMD and assigned to one of the following groups: Western Medicine (group A, n = 103), Xiyanping injection (group B, n = 109), or Xiyanping injection and symptomatic treatment using Western Medicine (group C, n = 117). During the trial, fever, rash, ulcers of the mouth were observed among participants in each group before and after treatment, and conversion rates from mild to severe HFMD were measured.After 3-7 days' treatment, no significant differences in the conversion rates from mild to severe HFMD were observed among the three groups (P0.05). There was a significantly low number of patients with the onset time of antifebrile effect, vanished time of hand and foot rashes and cumulative time for the ulcers in the mouth vanished, among the three groups (P0.05, P0.01). The onset time of antifebrile effect of patients in groups B and C were markedly shorter compared with those in group A (P0.05, P0.01); there was no statically significant difference observed between groups B and C (P0.05). No significant differences were observed in the time for body temperature recovery among the three groups (P0.05). There were no significant differences in adverse effects among the three groups (P0.05).Xiyanping injection together with use of Western Medicine is most effective for symptomatic treatment of mild HFMD. No severe adverse reactions were observed.

Premature ovarian insufficiency (POI) affects seriously physical and mental health of the patients. Studies show that acupuncture may be promising in treating POI, yet evidence is insufficient. International patient registry, one form of observational study, is designed for evaluating effectiveness and safety of acupuncture in real-world clinical settings. We will face a series of opportunities and challenges. The opportunities are as follows: (1) Interdisciplinary cooperation can improve the effect of acupuncture for POI. (2) The protocol for acupuncture to treat POI has room for improvement. (3) The patient registry study can make up the shortcomings of randomized controlled trials. (4) The patient registry study can collect real-world data and explore responses of different populations to acupuncture and can be the foundation for the successive studies. International patient registry may face technological, ethical and financial challenges, while the established International Patient Registry Platform of Acupuncture-Moxibustion ( www.amreg.org:8082/v3 ) is actively responding to these challenges. Till now there have been more than 300 patients of POI enrolled on this platform.

In recent years, a growing number of dynamic, double-blind and randomized trials for traditional Chinese medicine (TCM) have been designed with adaptive treatment regimens. The blind envelope or current randomization and trial supply management (RTSM) system have not met this requirement. Therefore, a more efficient platform for subject randomization and medicine dispensation was required. After we had done much research on dynamic TCM treatment trials’ protocols, a new RTSM was designed and developed, which is suitable for TCM clinical trial during randomizing the groups for subject and medicine allocation in China. In a recurrent tuberculosis study of TCM, this RTSM system was involved in the management of subjects and medicines. By this system, a suit of TCM formulas or placeboes were assigned to patients based on their TCM syndrome diagnosis results by investigators at different visit points. The new RTSM system was convenient to operate, reduced operational errors, enhanced the management efficiency, and improved the data quality.

Background. Daodi medicinal material is widely used in Chinese herb medication. However, there is a lack of systematic methodology for identifying characteristics associated with good quality and reliable efficacy of Daodi med-material. Purpose. The purpose of this study is to provide some evidence to further substantiate the use of Daodi medicinal materials. Methods. Seven relevant databases were searched before July 2014. Two evaluators were responsible for screening and categorizing the results. The data was analyzed with Microsoft Excel 2007 and SPSS 21.0 statistical software. Results. Overall, 107 articles were systematically analyzed. Of these studies, 55.1% (59/107) focused on the methodology to assess Daodi med-material, and 38.3% (41/107) were interested in med-material ingredients, soil physical and chemical properties, and the geological background system (GBS). Only 6.5% (7/107) of studies were mainly conducted as clinical trials and animal experiments. Conclusion. Comparisons between Daodi and non-Daodi materials have been studied mainly in terms of the ingredients or composition of medical materials, soil physics and chemistry, and the GBS, and some identifying methodologies have been created to identify Daodi attributes. Until now, there is still no consensus of comparison criteria between Daodi and non-Daodi medicinal material. Only a few studies were conducted through animal experiments and clinical trials to determine Daodi superiority.

Purpose. To analyze and compare the clinical registration information about acupuncture and moxibustion for intervention characteristics. Methods. Clinical trials from the International Clinical Trials Registry Platform of the World Health Organization in acupuncture and moxibustion were comprehensively collected from 2013 to 2015; data were independently screened and extracted by two retrievers, and relevant data involving either basic descriptions or intervention characteristics were analyzed. Results. 425 acupuncture and moxibustion registered clinical trials were included; 88.00% (374/425) were designed as controlled studies, among which 38.59% (164/425) had sham acupuncture as the control group. The most common diseases were pain-related at approximately 19.29% (82/425) of trials. Reports on the intervention information in these acupuncture and moxibustion clinical studies were not sufficiently presented; these reports included the reporting of names of points (39.8%), the method of needle stimulation (32.5%), needle type (29.6%), needle retention time (34.1%), the number of treatment sessions (22.4%), and the frequency and duration of treatment sessions (38.1%). Conclusion. The registration information for the clinical trials of acupuncture and moxibustion was quite low according to this investigational study. Steps should be taken to improve the quality of acupuncture and moxibustion registration information.

Objective To preliminarily analyze key factors influencing curative effect through clinical observations of acupoint application for “treatment of winter disease in summer” used to prevent and treat bronchial asthma in children. Methods In an observational study and prospective cohort study, we observed children in remission of asthma at three class III grade A TCM hospitals in Liaoning, Hubei, and Chengdu. Results A total of 609 children conformed to diagnostic and inclusive standards for remission of bronchial asthma. Through follow-up visits, we observed their skin reactions and the time and chance of treatment with different therapies in the three hospitals; we also compared and analyzed different drugs, acupoints, and preparations. We found that the key Chinese drugs were Bai Jie Zi (Semen Sinapis Albae) and Yian Hu Suo (Rhizoma Corydalis); the key acupoints were Feishu (BL 13), Gaohuang (BL 43), Dingchuan (EX-B1), Tiantu (CV 22), and Shanzhong (CV 17); and the best preparation was a mixture of drugs, ginger juice, and musk. Acupoint application was practiced on the hottest days of summer and the coldest days of winter for 0.5 to 2 h with the lowest rate of asthma relapse. Conclusions The present data analysis shows that the curative effect of acupoint application for “treatment of winter disease in summer” may be influenced by recipes of Chinese drugs, preparations, prescriptions of acupoints, chance, time, and skin reactions. A curative effect is the result of the comprehensive action of these factors.

Patient-reported outcome (PRO), which is directly obtained from patients, is a multidimensional measure to evaluate the health condition of a patient. The obtained data give evidence of effectiveness from patients' point of view. This article reviews the application of PRO in the study of cancer. The application of PRO is studied from aspects, such as evaluating cancer clinical trials, formulating health policies, evaluating adverse events, evaluating compliance, approving new drugs, and studying the relation between health-related quality of life and PRO.

Magnaporthe oryzae (Mo) is the causative pathogen of the damaging disease rice blast. The effector gene AvrPib, which confers avirulence to host carrying resistance gene Pib, was isolated via map-based cloning. The gene encodes a 75-residue protein, which includes a signal peptide. Phenotyping and genotyping of 60 isolates from each of five geographically distinct Mo populations revealed that the frequency of virulent isolates, as well as the sequence diversity within the AvrPib gene increased from a low level in the far northeastern region of China to a much higher one in the southern region, indicating a process of host-driven selection. Resequencing of the AvrPiballele harbored by a set of 108 diverse isolates revealed that there were four pathoways, transposable element (TE) insertion (frequency 81.7%), segmental deletion (11.1%), complete absence (6.7%) and point mutation (0.6%), leading to loss of the avirulence function. The lack of any TE insertion in a sample of non-rice infecting Moisolates suggested that it occurred after the host specialization of Mo. Both the deletions and the functional point mutation were confined to the signal peptide. The reconstruction of 16 alleles confirmed seven functional nucleotide polymorphisms for the AvrPiballeles, which generated three distinct expression profiles.

Objective: To evaluate the effects of treatment of integrative Chinese and Western medicine (ICWM) on arterial oxygen saturation (SaO2) in patients with severe acute respiratory syndrome (SARS).Methods:The non-randomized, controlled trial was conducted on 447 SARS patients treated synchronously with western conventional treatment (WM group,n = 171) alone and ICWM (ICWM group,n = 276). The changes of the cases with normal level (≥95%) or abnormal level (0.05).Conclusion: ICWM treatment, particularly when it is used for intervention in the early stage, is beneficial for maintaining normal SaO2 in SARS patients.

The light extraction has an important effect on LED encapsulation to obtain a high efficiency. The influence of packaging structure on LED light extraction was investigated in TracePro. Four kinds of high-power LED packaging methods based on the structure and the character of flip chip were presented, flip chip on board (1 reflective-cup), flip chip to substrate (1 reflective-cup), flip chip on board (100 reflective-cups) and flip chip to substrate (100 reflective-cups). Flip chip on board was that the LED chip was directly bonded to the aluminum substrate, flip chip to substrate was the LED chip bonded to the Si-Substrate before bonded to the aluminum. Two different structures of aluminum substrate were analyzed, 1 substrate with only 1 reflective cup and 1 substrate with 100 reflective cups. The final result shows that the luminous efficiency of flip chip on board (100 reflective-cups) is 0.03% higher than flip chip to substrate (100 reflective-cups); luminous efficiency of flip chip on board (1 reflective-cup1) is 0.04% lower than flip chip to substrate(1 reflective-cup). Luminous efficiency of flip chip on board (100 reflective-cups) is 10% higher than flip chip on board(1 reflective-cups); luminous efficiency of flip chip to substrate (100 reflective-cups) is 6.3% higher than flip chip to substrate(1 reflective-cup).

International audience; This paper presents the simulation results of a hybrid positioning system based on a pedestrian navigation system that takes advantage of very few measurements of different types as well as map constraints. The data fusion is achieved at infrastructure and user level. Particle and extended Kalman filters are implemented and tested against different beacon density scenarios. Results show that metric accuracy (below 3 meters) is achievable in structured areas of low beacons and WiFi AP density.

International audience; This paper describes a fusion approach to the problem of indoor localization of a pedestrian user, in which PNS measurements, cartographic constraints and ranging or proximity beacon measurements are combined in a particle filter approximation of the Bayesian filter. Some critical issues are also addressed, such as taking the constraints into account, monitoring the degeneracy of the weights and the sample depletion in terms of the effective sample size, detecting track loss, and recovering from a detected loss.

Rough set based rule generation methods need discretization of the continuous values. However, most existing discretization methods cause inconsistencies. In this paper, we propose an algorithm that can eliminate the inconsistencies caused during the course of discretization. The algorithm can be integrated into the discaretization algorithms that cannot avoid causing inconsistencies to eliminate the inconsistencies. Three data experimental results show that the algorithm is available.

Rough set discernibility matrix method is a valid method to attribute reduction. However, it is a NP-hard problem. Up until now, though some methods have been proposed to improve this problem, the case is not improved well. We find that the idea of discernibility matrix can be used to not only the whole data but also partial data. So we present a new algorithm to reduce the computational complexity. Firstly, select a condition attribute C that holds the largest measure of γ(C, D) in which the decision attribute D depends on C. Secondly, with the examples in the non-positive region, build a discernibility matrix to create attribute reduction. Thirdly, combine the attributes generated in the above two steps into the attribute reduction set. Additionally, we give a proof of the rationality of our method. The larger the positive region is; the more the complexity is reduced. Four Experimental results indicate that the computational complexity is reduced by 67%, 83%, 41%, and 30% respectively and the reduced attribute sets are the same as the standard discernibility matrix method.

Most of the existing discretization methods such as k-interval discretization, equal width and equal frequency methods do not take the dependencies of decision attributes on condition attributes into account. In this paper, we propose a discretization algorithm that can keep the dependencies of the decision attribute on condition attributes, or keep the positive regions of the partition of the decision attribute. In the course of inducing classification rules from a data set, keeping these dependencies can achieve getting the set of the least condition attributes and the highest classification precision.

In a real world data set there are usually four kinds of mistaken values, the first one is the mistake in unit; the second one is the mistake of putting the radix points in wrong place, the third one is a scribal error, and the fourth one is a computational mistake. In this paper, we propose two algorithms for finding these four kinds of mistaken data. SARS and coronary heart disease data sets experimental results show that the two algorithms are available, that is, using the two algorithms we find some mistakes in the SARS and coronary heart disease data sets, and the results correspond to that found manually by medical experts.

In fault diagnosis and medical diagnosis fields, often there is more than one fault or disease that occur together. In order to obtain the factors that cause a single fault to change to multi-faults, the standard rough set based methods should be rebuilt. In this paper, we propose a decernibilty matrix based algorithm with which the cause of every single fault to change to multi-faults can be revealed. Additionally, we propose another rough set based algorithm to induce the common causes of all the single faults to change to their corresponding multi-faults, which is a process of knowledge discovery in rule base, i.e., not the usual database. Inducing more abstract rules in knowledge base is a very challenging problem that has not been resolved well.

Because of the amount of missing values in our SARS data set is very large, to fill in them wholly with the existing methods is impossible or the results of being filled in are not reliable. Only taking two attributes into account can avoid using the large amount of missing values, which is the feature of rough set that other machine learning method cannot hold. In this paper, we induced some rules based on rough set from the SARS data set that have not been detected by medical experts in clinic practice.

Objective To evaluate the efficacy and safety of Xinfeng capsule in patients suffering rheumatoid arthritis (RA). Methods A multi-center parallel-group designed, double-blind, randomized, controlled trial was conducted. Totally 304 RA patients were assigned to two groups: one group was administered Xinfeng capsule (XFC) plus the placebo of leflunomide and the other given leflunomide (LEF) plus the placebo of XFC for twelve weeks. The clinical and laboratory parameters were compared at baseline and fourth, eighth, and twelfth weeks. Results After twelve-week treatment, patients in two groups all showed some trend of effectiveness when compared in terms of American Rheumatism Association (ACR) recommended 20%, 50%, 70% improvement criteria, but it was insignificant. The validity in ameliorate modified disease activity score (DAS28) and laboratory indexes as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) were also found no difference. The score of health assessment questionnaire (HAQ), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and quality of life questionnaire with rheumatoid arthritis (RAQOL) both lower than the first week and the changes showed no difference. However, the score of SDS dropped more in XFC group than in the other. A total of 147 adverse reaction cases were reported, which shows no difference between the two groups. The most common adverse reactions were hepatic impairment, anemia, leukocytopenia, epigastric discomfort and phalacrosis. Conclusion XFC demonstrated better improvement in the scores of SDS and compared with those of LEF group.

ObjectiveWe sought to test the hypothesis that Polygenic Risk Scores (PRSs) have strong capacity to discriminate cases of ankylosing spondylitis (AS) from healthy controls and individuals in the community with chronic back pain.MethodsPRSs were developed and validated in individuals of European and East Asian ethnicity, using data from genome-wide association studies in 15 585 AS cases and 20 452 controls. The discriminatory values of PRSs in these populations were compared with other widely used diagnostic tests, including C-reactive protein (CRP), HLA-B27 and sacroiliac MRI.ResultsIn people of European descent, PRS had high discriminatory capacity with area under the curve (AUC) in receiver operator characteristic analysis of 0.924. This was significantly better than for HLA-B27 testing alone (AUC=0.869), MRI (AUC=0.885) or C-reactive protein (AUC=0.700). PRS developed and validated in individuals of East Asian descent performed similarly (AUC=0.948). Assuming a prior probability of AS of 10% such as in patients with chronic back pain under 45 years of age, compared with HLA-B27 testing alone, PRS provides higher positive values for 35% of patients and negative predictive values for 67.5% of patients. For PRS, in people of European descent, the maximum positive predictive value was 78.2% and negative predictive value was 100%, whereas for HLA-B27, these values were 51.9% and 97.9%, respectively.ConclusionsPRS have higher discriminatory capacity for AS than CRP, sacroiliac MRI or HLA-B27 status alone. For optimal performance, PRS should be developed for use in the specific ethnic groups to which they are to be applied.