Search

Wen-Man Zhao,1,&ast; Rui Shi,1,&ast; Peng Wang,2,&ast; Jun He,3,4,&ast; Yue Chen,5,6 Ya-Ting Feng,5,6 Hai-Feng Pan,5,6 De-Guang Wang1 1Department of Nephrology, The Second Hospital of Anhui Medical University, Hefei, People’s Republic of China; 2Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, People’s Republic of China; 3Anhui Provincial Center for Disease Control and Prevention, Hefei, People’s Republic of China; 4Public Health Research Institute of Anhui Province, Hefei, People’s Republic of China; 5Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People’s Republic of China; 6Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hai-Feng Pan, Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People’s Republic of China, Tel +86 13865972319, Email panhaifeng@ahmu.edu.cn De-Guang Wang, Department of Nephrology, The Second Hospital of Anhui Medical University, Hefei, People’s Republic of China, Tel +86 13865808366, Email wangdeguang@ahmu.edu.cnPurpose: To detect antibody responses to inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in patients undergoing hemodialysis and to investigate vaccine-related adverse events.Patients and Methods: A total of 120 hemodialysis (HD) patients and 24 healthy controls (HCs) who had not been previously infected with SARS-CoV-2 and had received their first dose of the inactivated vaccine (CoronaVac; Sinovac Biotech Ltd) were recruited for this study. All participants were scheduled to receive a second dose of inactivated SARS-CoV-2 vaccine. Serum-specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies against the SARS-CoV-2 were detected at least 14 days after the second dose of vaccine using a commercial kit. Positive and negative results were defined as a sample/cutoff (S/CO) ratio≥ 1.00 and < 1.00, respectively. Vaccination-related adverse events were assessed using a standardized questionnaire.Results: There were no significant differences regarding the seroprevalences of IgG and IgM antibodies against SARS-CoV-2 and the self-reported vaccination-related adverse events between HD patients and HCs. The analysis results for HD patients suggest that 82 (68.3%) and 27 (22.5%) tested positive for IgG and IgM, respectively. The levels of IgG were higher than IgM levels (P< 0.0001). In addition, the IgG-positive group had significantly higher serum albumin levels than the IgG-negative group (P< 0.05). Only mild vaccine-related adverse events were observed in two patients (1.66%) and in one healthy individual (4.2%).Conclusion: The seroprevalences of IgG and IgM antibodies against SARS-CoV-2 and vaccination-related adverse effects are similar between HD and HCs. The inactivated SARS-CoV-2 vaccine is effective and safe in inducing near-term immunity in hemodialysis patients.Keywords: adverse events, COVID-19, inactivated SARS-CoV-2 vaccine, IgM and IgG antibody

BACKGROUND Osteoarthritis (OA) is the most common cause of adult activity limitation and a major cause of deformity in aging people, therefore gradually becomes a global public health issue. OBJECTIVE We here provide a comprehensive evaluation of the trends and cross-country inequalities of global OA burden over the last 30 years. METHODS The estimates and 95% uncertainty interval (UI) for incidence, prevalence, and disability-adjusted life-years (DALYs) of OA were extracted from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 as measures of OA burden. We described OA epidemiology at global, regional, and national levels, analyzed 1990-2019 trends in OA burden from overall, local, and multi-dimension scopes, decomposed OA DALYs, and quantified cross-country inequalities in OA DALYs. RESULTS GBD 2019 estimated 527,811,871 (95% UI: 478,667,549 to 584,793,491) prevalent cases, 41,467,542 (95% UI: 36,875,471 to 46,438,409) incident cases and 18,948,965 (95% UI:9,571,298 to 37,659,660) DALYs of OA occurred worldwide in 2019, with the highest cases in East Asia and highest age-standardized rate (ASR) in high-income North America. The global burden of OA increased overall from 1990 to 2019 with the fastest growth observed in the first decade of the 21st century, although there were variations in incidence, prevalence and DALYs of OA across countries. Decomposition analysis revealed that OA knee (62.78%), women (60.47%), and middle sociodemographic index (SDI) quintile region (32.35%) were responsible for the most significant DALYs, whose changes were primarily driven by population growth and aging. A significant increase in SDI-related inequalities was detected, and the gap in DALYs between the highest SDI countries and the lowest SDI countries increased from 179.5 (95% CI: 149.3 to 209.8) per 100,000 in 1990 to 341.9 (95% CI: 309.5 to 374.4) per 100,000 in 2019. CONCLUSIONS From 1990 to 2019, there was a significant increase in OA burden globally (particularly in OA knee burden), which was primarily driven by population growth and aging. Countries with high SDI shouldered disproportionately high OA burden, and the magnitude of the SDI-related inequalities across countries increased over time.

The high prevalence of dialysis-related symptoms in maintenance hemodialysis (MHD) patients severely affect quality of life. Therefore, in this study, we assessed the dialysis symptom index (DSI) of MHD patients during the second wave of COVID-19, which triggered a health crisis, resulting in many cities in China opting for social isolation. A total of 106 MHD patients from our center were screened. DSI, sleep quality, and fatigue scales were investigated separately before and during lockdown. Demographic and laboratory data of MHD patients were collected. A nomogram was used to predict high DSI by combining multiple indicators. Additionally, internal validation was performed to reduce overfitting bias. The mean age of patients was 56.0 years (SD 13.1). The prevalence and severity of DSI were significantly higher during lockdown than pre-lockdown. Notably, itching, trouble staying asleep, bone or joint pain, muscle cramps, feeling irritability, difficulty concentrating, headache, constipation, and feeling nervous were observed ( P

Objectives: Thrombomodulin (TM) is closely related to the pathogenesis of autoimmune diseases, including systemic lupus erythematosus (SLE). However, current evidence on circulating TM levels in SLE patients is contradictory. We conducted this meta-analysis to more accurately assess circulating TM levels in patients with SLE and lupus nephritis (LN) and to analyze related influencing factors. Methods: Systematic search of relevant documents was conducted in PubMed, Embase, and The Cochrane Library databases (up to 28 February 2021). Studies on the comparison of circulating TM between SLE patients and controls were screened and evaluated for inclusion. Random-effects model analysis was applied to calculate the combined standardized mean difference (SMD) with a 95% confidence interval (CI). Heterogeneity was estimated by Q statistics and I2. Results: A total of 353 articles were identified, 14 provided adequate information for this study finally. The results illustrated that SLE patients had higher TM levels than healthy controls (SMD=0.38, 95% CI: 0.02 to 0.74, p=0.04). Circulating TM levels were increased in patients with active SLE compared to inactive SLE patients (SMD=1.12, 95% CI: 0.03 to 2.20, p=0.04). In addition, circulating TM levels of SLE patients with LN were higher than those without LN (SMD=4.55, 95% CI: 1.97 to 7.12, p=0.001). Conclusions: The circulating TM levels in SLE patients are enhanced. In addition, circulating TM levels may be practical in reflecting the disease activity and nephritis involvement of SLE patients.

Galectins are a highly conserved protein family that binds to β-galactosides. Different members of this family play a variety of biological functions in physiological and pathological processes such as angiogenesis, regulation of immune cell activity, and cell adhesion. Galectins are widely distributed and play a vital role both inside and outside cells. They can regulate homeostasis and immune function in vivo through mechanisms such as apoptosis. Recent studies have indicated that galectins exhibit pleiotropic roles in inflammation. Furthermore, emerging studies have found that galectins are involved in the occurrence and development of autoimmune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), type 1 diabetes (T1D), and systemic sclerosis (SSc) by regulating cell adhesion, apoptosis, and other mechanisms. This review will briefly discuss the biological characteristics of the two most widely expressed and extensively explored members of the galectin family, galectin-1 and galectin-3, as well as their pathogenetic and therapeutic roles in autoimmune diseases. This information may provide a novel and promising therapeutic target for autoimmune diseases.

Progranulin (PGRN), a secretory glycoprotein consisting of 593 amino acid residues, is a key actor and regulator of multiple system functions such as innate immune response and inflammation, as well as tissue regeneration. Recently, there is emerging evidence that PGRN is protective in the development of a variety of immune-mediated diseases, including rheumatoid arthritis (RA), inflammatory bowel disease (IBD), type 1 diabetes mellitus (T1DM) and multiple sclerosis (MS) by regulating signaling pathways known to be critical for immunology, particularly the tumor necrosis factor alpha/TNF receptor (TNF-α/TNFR) signaling pathway. Whereas, the role of PGRN in psoriasis, systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) is controversial. This review summarizes the immunological functions of PGRN and its role in the pathogenesis of several immune-mediated diseases, in order to provide new ideas for developing therapeutic strategies for these diseases., Graphical Abstract

Yi-Sheng He,1,2,&ast; Gui-Hong Wang,3,&ast; Qian Wu,1,2,&ast; Zheng-Dong Wu,1,2 Yue Chen,1,2 Jin-Hui Tao,4 Xin-Yu Fang,1,2 Zhiwei Xu,5 Hai-Feng Pan1,2 1Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China; 2Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, People’s Republic of China; 3Department of Rheumatology, Anqing Hospital Affiliated to Anhui Medical University, Anqing, Anhui, People’s Republic of China; 4Department of Rheumatology and Immunology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People’s Republic of China; 5School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia&ast;These authors contributed equally to this workCorrespondence: Zhiwei Xu; Hai-Feng Pan Email xzw1011@gmail.com; panhaifeng1982@sina.comObjective: Gout is a chronic disease caused by the deposition of sodium urate (MSU) crystals. Available data on the association between environmental hazards and gout are scarce. The present study was present to investigate the relationship between short-term exposure to air pollution and hospitalizations for acute gout from 2016 to 2020 in Anqing City, China.Methods: Daily records of hospital admissions for acute gout in Anqing from 1 January 2016 to 31 December 2020 were retrieved from the tertiary first-class hospitals in Anqing. Air pollutants and meteorological data were obtained from the China Environmental Monitoring Station and China Meteorological Data Service Center respectively. We used a time-series analysis to explore the association between air pollution (NO2, O3, and CO) and hospitalizations for acute gout, and conducted stratified analyses by gender, age and season.Results: We observed an association between NO2 and hospitalizations for gout (lag 0, relative risk (RR):1.022, 95% confidence interval (CI):1.004– 1.041). For every 1 mg/m3 increase in CO concentration, hospitalizations for gout increased by 3.9% (lag 11 days, RR=1.039, 95% CI: 1.004– 1.076). Intriguingly, there was a negative association between O3 and hospitalizations for gout (lag0, RR=0.986, 95% CI: 0.976– 0.996). Stratified analyses showed that exposure to high levels of NO2 was considered to be more vulnerable to gout in cold season.Conclusion: Our study showed that short-term exposure to NO2 and CO has a significant effect on hospitalizations for acute gout.Keywords: gout, air pollutants, carbon monoxide, nitrogen dioxide, ozone

Rosuvastatin therapy might have an effect on the inflammatory and coagulation biomarkers. However, the evidence about the effect of rosuvastatin therapy on the high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and D-dimer levels among people living with human immunodeficiency virus (PLHIV) is still unclear. Therefore, this study investigated the relational effect of rosuvastatin therapy on serum/plasma hsCRP, IL-6 and D-dimer levels in PLHIV. The literature search was done from Embase, PubMed, and Web of Science databases. The review and meta-analysis included studies written in English language up to January 4, 2020. Random effects model was used to evaluate the pooled standard mean difference with 95% confidence interval. A meta-analysis was performed using nine articles with 392 PLHIV. The result revealed that the plasma/serum levels of IL-6 were significantly reduced after the intervention. However, hsCRP and D-dimer levels showed no significant difference (

Exosomes are spherical lipid bilayer vesicles composed of lipids, proteins and nucleic acids that deliver signaling molecules through a vesicular transport system to regulate the function and morphology of target cells, thereby involving in a variety of biological processes, such as cell apoptosis or proliferation, and cytokine production. In the past decades, there are emerging evidence that exosomes play pivotal roles in the pathological mechanisms of several autoimmune diseases (ADs), including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), type 1 diabetes mellitus (T1DM), Sjogren's syndrome (SS), multiple sclerosis (MS), inflammatory bowel disease (IBD). systemic sclerosis (SSc), etc. Several publications have shown that exosomes are involved in the pathogenesis of ADs mainly through intercellular communication and by influencing the response of immune cells. The level of exosomes and the expression of nucleic acids can reflect the degree of disease progression and are excellent biomarkers for ADs. In addition, exosomes have the potential to be used as drug carriers thanks to their biocompatibility and stability. In this review, we briefly summarized the current researches regarding the biological functions of exosomes in ADs, and provided an insight into the potential of exosomes as biomarkers and therapeutic delivery for these diseases.

Objective To investigate the associations of mitochondrial DNA (mtDNA) genetic variants with SLE susceptibility, glucocorticoid (GC) efficacy and prognosis. Methods Our study was done in two stages. First, we performed whole mitochondrial genome sequencing in 100 patients and 100 controls to initially screen potential mtDNA variants associated with disease and GC efficacy. Then, we validated the results in an independent set of samples. In total, 605 SLE patients and 604 normal controls were included in our two-stage study. A two-stage efficacy study was conducted in 512 patients treated with GCs for 12 weeks. We also explored the association between mtDNA variants and SLE prognosis. Results In the combined sample, four mtDNA variants (A4833G, T5108C, G14569A, CA514-515-) were associated with SLE susceptibility (all PBH Conclusion We identified novel mtDNA genetic variants that were associated with SLE susceptibility, GC efficacy, and prognosis. Interactions between mtDNA variants and environmental factors were related to SLE risk and GC efficacy. Our findings provide important information for future understanding of the occurrence and development of SLE.

Sclerostin, a regulator of bone metabolism and vascular calcification involved in regulating the Wnt/β-catenin signaling pathway, has been shown to be involved in the pathogenesis of rheumatoid arthritis (RA). However, current results regarding the circulating sclerostin level of RA patients are debatable. This study aimed to evaluate the circulating level of sclerostin in RA patients and briefly summarize its role.PubMed, EMBASE, and the Cochrane Library databases were systematically searched till May 27, 2021, for eligible articles. Useful data from all qualified papers were systematically extracted and analyzed using Stata 12.0 software (Stata Corp LP, College Station, TX, USA).Overall, 13 qualifying studies including 1030 cases and 561 normal controls were analyzed in this updated meta-analysis. Forest plot of this meta-analysis showed that RA patients had higher circulating sclerostin levels (P 0.001, standardized mean difference [SMD] = 0.916, 95% CI: 0.235-1.597) compared to normal controls. Subgroup analyses implied that age, region, and assay method were associated with sclerostin level in RA patients.RA patients have higher circulating sclerostin levels, and these was influenced by age, region, and assay method.HINTERGRUND: Für Sclerostin, ein Regulator des Knochenstoffwechsels und der Gefäßkalzifizierung, der an der Regulierung des Wnt/β-Catenin-Signalwegs beteiligt ist, wurde nachgewiesen, dass es auch in der Pathogenese der rheumatoiden Arthritis (RA) eine Rolle spielt. Jedoch sind die aktuellen Ergebnisse in Bezug auf die Werte für zirkulierendes Sclerostin bei RA-Patienten umstritten. Ziel der vorliegende Studie war es, die Werte für zirkulierendes Sclerostin bei RA-Patienten zu untersuchen und dessen Rolle kurz zusammenzufassen.Die Datenbanken PubMed, EMBASE und der Cochrane Library wurden systematisch bis 27. Mai 2021 auf infrage kommende Artikel hin durchsucht. Nützliche Daten aus allen geeigneten Arbeiten wurden systematisch erfasst und mittels der Software Stata 12.0 analysiert (Stata Corp LP, College Station, TX, USA).In dieser aktualisierten Metaanalyse wurden 13 geeignete Studien mit 1030 Fällen und 561 normalen Kontrollen ausgewertet. Das Walddiagramm dieser Metaanalyse zeigte, dass RA-Patienten höhere Werte für Werte für zirkulierendes Sclerostin aufwiesen als die normalen Kontrollen (p 0,001; standardisierte mittlere Differenz, SMD: 0,916; 95%-Konfidenzintervall, 95%-KI: 0,235–1,597). Untergruppenanalysen ergaben, dass Alter, Region und Bestimmungsmethode mit dem Sclerostinwert bei RA-Patienten in Zusammenhang standen.Bei RA-Patienten fanden sich höhere Werte für zirkulierendes Sclerostin auf als bei normalen Kontrollen. Dieser Zusammenhang wurde durch die Faktoren Alter, Region und Bestimmungsmethode beeinflusst.

Background: Abnormal expression and function of long non-coding RNAs (lncRNAs) are closely related to the pathogenesis of systemic lupus erythematosus (SLE). In this study, we aimed to investigate the association of lncRNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT-1) gene single-nucleotide polymorphisms (SNPs) with susceptibility and clinical characteristics of SLE patients. Methods: A case-control study including 489 SLE patients and 492 healthy controls was conducted. Four MALAT-1 SNPs (rs4102217, rs591291, rs11227209, and rs619586) were genotyped in all subjects, their correlation with SLE susceptibility and clinical characteristics were also analyzed. Results: Results showed that the rs4102217 locus was associated with the risk of SLE. In recessive models, the GG+CG genotype of rs4102217 was associated with the decreased risk of SLE compared to CC ( p = 0.036, OR = 0.348, 95% CI: 0.124–0.975). In additive models, the GG genotype of rs4102217 was associated with the decreased risk of SLE compared to CC ( p = 0.040, OR = 0.355, 95% CI: 0.127–0.996). However, no association was found between MALAT-1 gene polymorphism and clinical manifestations of SLE (all p > 0.05). Conclusion: In summary, MALAT-1 rs4102217 is associated with susceptibility to SLE, suggesting that MALAT-1 may play a role in SLE.

Background The global pandemic of COVID-19 has brought huge changes to people's lifestyles, college students have also been affected seriously. Evidence about these significant changes indicated that college students were more prone to feel anxious and depressed. To derive a precise assessment of the prevalence of anxiety symptom and depressive symptom among college students worldwide, we conducted this meta-analysis. Methods Based on the guidance of PRISMA, literature was searched in Pubmed, Web of Science, Embase, and PsycArticles (last search November 6, 2020). These articles after the screening were analyzed by a random-effects model to estimate the pooled prevalence of anxiety symptom and depressive symptom. Also, subgroup analysis, sensitivity analysis, and publication bias were performed in this meta-analysis. Results The results showed that the pooled anxiety symptom prevalence was 31% (95% CI: 23-39%), pooled depressive symptom prevalence was 34% (95% CI: 27-41%). Subgroup analysis showed that the prevalence of anxiety symptom and depressive symptom among different countries’ college students were different, and the pooled depressive symptom prevalence of females was higher compared with males. Limitations The prevalence of anxiety symptom and depressive symptom in worldwide college students could be better assessed by a standard and reliable questionnaire. Conclusions The results suggest that the prevalence of anxiety symptom and depressive symptom during the COVID-19 pandemic is relatively high. Except for interventions that should be taken to control the pandemic urgently, mental health services are also needed to decrease the risk of anxiety and depression among college students.

IntroductionSeveral published results have established variations in respect to plasma/serum macrophage migration inhibitory factor (MIF) levels and gene polymorphisms with systemic lupus erythematosus (SLE). This study gave a more concise estimation on the MIF levels for SLE patients and established the association between MIF polymorphisms and SLE.Material and methodsAll articles were searched from PubMed, Embase, Web of Science, Wan-Fang, Chinese Biological Medical Literature, and China National Knowledge Infrastructure up to 6th October 2017, with no language restriction. Pooled standard mean difference with 95% confidence interval was evaluated using random effect model. Thirteen articles were used for this meta-analysis, with 620 SLE patients and 779 healthy controls assessed for MIF levels, and 2,159 SLE patients and 2,574 healthy controls considered for MIF-173 C/G and MIF-794 CATT polymorphisms.ResultsThere was a significant higher MIF levels in SLE patients than in healthy controls (p = 0.004). The subgroup analysis showed Asians and ages < 30 had higher MIF levels in SLE patients than in healthy controls. It was evident that patients with systemic lupus erythematosus diseases activity index scores < 8 and ≥ 8, and disease duration for both year < 5 and ≥ 5 of SLE had higher MIF levels when compared to healthy controls. We found a significant association between SLE and MIF-173 C/G, but not MIF-794 CATT.ConclusionsThis study provided evidence of significant higher MIF levels in SLE patients and supported the association of MIF-173 C/G and SLE. However, we were not able to establish an association between MIF-794 CATT and SLE.

Background The existing evidence suggests that pre-existing diabetes may modify the association between heat and hospitalizations for acute myocardial infarction (AMI). Methods This study included patients who were hospitalized for AMI from 1 January 2005 to 31 December 2013 in Brisbane, Australia, and also included those who died within 2 months after discharge. A time-stratified case-crossover design with conditional logistic regression was used to quantify the associations of heat and cold with hospitalizations and post-discharge deaths due to AMI in patients with and without pre-existing diabetes. Stratified analyses were conducted to explore whether age, sex and suburb-level green space and suburb-level socio-economic status modified the temperature–AMI relationship. Heat and cold were defined as the temperature above/below which the odds of hospitalizations/deaths due to AMI started to increase significantly. Results There were 14 991 hospitalizations for AMI and 1811 died from AMI within 2 months after discharge during the study period. Significant association between heat and hospitalizations for AMI was observed only in those with pre-existing diabetes (odds ratio: 1.19, 95% confidence interval: 1.00–1.41) [heat (26.3°C) vs minimum morbidity temperature (22.2°C)]. Cold was associated with increased odds of hospitalizations for AMI in both diabetes and non-diabetes groups. Significant association between cold and post-discharge deaths from AMI was observed in both diabetes and non-diabetes groups. Conclusions Individuals with diabetes are more susceptible to hospitalizations due to AMI caused by heat and cold.

Xiaohu Wang,1,&ast; Yuqian Hu,2,&ast; Jie Tao,3 Fuyong Hu,4 Peng Li,1 Donghua Shao,5 Hai-Feng Pan,2 Tao Xu6 1The First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China; 2Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People’s Republic of China; 3Anhui Provincial Hospital, Hefei, People’s Republic of China; 4School of Public Health, Bengbu Medical College, Bengbu, People’s Republic of China; 5Public Anhui Provincial Health and Family Planning Commission, Hefei, People’s Republic of China; 6School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hai-Feng PanDepartment of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, People’s Republic of ChinaTel/Fax +86 551 65161165Email panhaifeng@ahmu.edu.cn; panhaifeng1982@sina.comTao XuSchool of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei, People’s Republic of ChinaEmail xutao@ahmu.edu.cnObjective: This study aimed at developing and validating a humanistic care tool in Anhui province that could be used across Chinese public hospitals, and to reflect the humanistic care from patients’ perspective.Participants: A cross-sectional survey was conducted in three public hospitals of Anhui Province, China by adopting simple random sampling, which included 312 outpatients and 323 inpatients.Methods: The dimensions of the tool were set according to “Further Improve Medical Service Action Plan” in China and Patient-Doctor Relationship Questionnaire. Cronbach’s alpha values were calculated and used to evaluate the reliability of this tool. Construct validity was tested by the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The associations between characteristics and humanistic care were analyzed by binary logistic regression.Results: These initial findings showed that about two-thirds of the respondents experienced humanistic care. Both the reliability and construct validity of the humanistic care evaluation tool were suitable Social aspects (location and yearly income), treatment style and having a regular doctor were significantly associated with better humanistic care (all P< 0.05).Conclusion: The humanistic care tool can directly reflect the humanistic care from patients’ perspective, and can be popularized and applied across Chinese public hospitals. These findings have important implications to further improve medical service in Chinese public hospitals.Keywords: humanistic care, hospital, evaluation tool

Objective Our present study intended to examine the associations of RPEL1 and miR-1307 gene polymorphisms (rs4917385 and rs7911488) with susceptibility, glucocorticoids (GCs) efficacy, anxiety, depression, and health-related quality of life (HRQoL) in Chinese systemic lupus erythematosus (SLE) patients. Methods Initially, 1000 participants (500 SLE cases and 500 controls) were recruited for the case–control study. Then, 429 cases who received GCs were followed through 12 weeks to explore GCs efficacy, depression, anxiety, and HRQoL. We selected the iMLDR technique for genotyping: RPEL1: rs4917385 (G/T) and miR-1307: rs7911488 (A/G). Results The minor G allele of rs7911488 reduced the risk of SLE ( p = .024). Four haplotypes consisting of rs4917385 and rs7911488 were associated with SLE susceptibility ( p < .025). Both rs4917385 and rs7911488 were associated with anxiety symptoms and physical function (PF) in SLE patients ( p < .025). The rs4917385 was associated with depression and its improvement. No statistical significance was found between RPEL1 and miR-1307 gene polymorphisms with GCs efficacy. Meanwhile, additive interaction analysis showed a significant association between RPEL1 and miR-1307 gene polymorphisms with tea consumption in anxiety. Conclusion RPEL1 and miR-1307 gene polymorphisms (rs4917385 and rs7911488) might be related to SLE susceptibility in Chinese population. Additionally, the two polymorphisms were possibly associated with depression, anxiety, and HRQoL in Chinese SLE population.

In the context of the coronavirus disease 2019 pandemic, we investigated the epidemiological and clinical characteristics of a young patient infected by avian influenza A (H5N6) virus in Anhui Province, East China, and analyzed genomic features of the pathogen in 2020. Through the cross‐sectional investigation of external environment monitoring (December 29–31, 2020), 1909 samples were collected from Fuyang City. It was found that the positive rate of H5N6 was higher than other areas obviously in Tianma poultry market, where the case appeared. In addition, dual coinfections were detected with a 0.057% polymerase chain reaction positive rate the surveillance years. The virus was the clade 2.3.4.4, which was most likely formed by genetic reassortment between H5N6 and H9N2 viruses. This study found that the evolution rates of the hemagglutinin and neuraminidase genes of the virus were higher than those of common seasonal influenza viruses. The virus was still highly pathogenic to poultry and had a preference for avian receptor binding., Highlights Various avian influenza virus (AIV) subtypes naturally have caused zoonotic infections, but the subtypes H5N1 and H7N9 have caused a prominent impact.At present, the outbreak of novel coronavirus pneumonia (coronavirus disease 2019 [COVID‐19]) has caused a worldwide pandemic.To our knowledge, this is the youngest child infected with H5N6 subtype avian influenza in Anhui Province.Herein, we analyzed the epidemiology of the case and the characteristics of the pathogen genome, to find out the possible evolution of the virus.

Hand, foot and mouth disease (HFMD) caused by enterovirus A71 (EV-A71) is a contagious viral disease, and toll-like receptors (TLRs) play essential roles in resisting the pathogen. The aim of this study was to assess the potential relationship between several TLRs polymorphisms and the HFMD severity in a Chinese children population. A total of 328 Chinese children with HFMD were included in the present study. The polymorphisms of TLR3 (rs3775290, rs3775291, rs3775296, rs1879026, rs5743312, rs5743313, rs5743303, rs13126816 and rs3775292), TLR4 (rs4986790, rs4986791, rs2149356, rs11536889 and rs41426344), TLR7 (rs179009, rs179010, rs179016, rs3853839, rs2302267, rs1634323 and rs5741880) and TLR8 (rs3764880, rs2159377, rs2407992, rs5744080, rs3747414, rs3764879 and rs5744069) genes were selected. The study indicated that individuals with the GG genotype of TLR3 single nucleotide polymorphism (SNP) rs1879026 had a higher risk of developing severe cases (GG vs GT: OR=1.875, 95% CI, 1.183-2.971, P=0.007). Meanwhile, TLR3 rs3775290 CC genotype and C allele were associated with lower disease severity in females (CC vs CT: OR=0.350, 95% CI, 0.163-0.751, P=0.006; C vs T: OR=0.566, 95% CI, 0.332-0.965, P=0.036). TLR3 rs3775291 CC genotype showed 2.537 folds higher risk of developing severe cases in females (CC vs CT: OR=2.537, 95% CI, 1.108-5.806, P=0.026). Moreover, TLR3 rs1879026 GG genotype was found to be related to increased risk of severe cases in males (GG vs GT: OR=2.076, 95% CI, 1.144-3.768, P=0.016). The current findings show that the genetic variants of TLR3 rs1879026, rs3775290 and rs3775291 are associated with the severity of EV-A71-associated HFMD in the Chinese children population. This article is protected by copyright. All rights reserved.

Objectives. The aim of our study was to investigate the association of single-nucleotide polymorphism (SNP) and mRNA expression profile of single immunoglobulin IL-1-related receptor (SIGIRR) in rheumatoid arthritis (RA) in a Chinese population. Methods. SIGIRR rs7396562 polymorphism was genotyped using TaqMan allelic discrimination assay in 517 RA patients and 601 healthy controls. Simultaneously, the SIGIRR mRNA expression levels of 79 RA patients and 76 healthy controls were examined by real-time quantitative polymerase chain reaction (RT-qPCR). Results. The frequency of SIGIRR rs7396562 T allele was significantly higher in RA patients compared with healthy controls (T versus G:OR=1.277,95%CI=1.079−1.511,P=0.004). The TT genotype of SIGIRR rs7396562 was more frequent in RA patients than in healthy controls (OR=1.547,95%CI=1.107−2.163,P=0.011). Moreover, we also found a significant difference in the recessive model (TT versus TG+GG:OR=1.439,95%CI=1.122−1.847,P=0.004). However, no significant evidence was observed for the association of the SIGIRR rs7396562 with RA in dominant model (TT+TG versus GG:OR=1.275,95%CI=0.947−1.717,P=0.109). Further analysis showed no association between SIGIRR rs7396562 polymorphism and laboratory parameters of RA patients (allP>0.05). The mRNA expression of SIGIRR was decreased in PBMCs of patients with RA when compared to healthy controls (Z=−2.459,P=0.014). No significant differences in SIGIRR mRNA expression levels were observed in patients with RA with different genotypes (P=0.280). Conclusions. Our findings demonstrated that the dysregulation of SIGIRR might be associated with the pathogenesis of RA, and SIGIRR rs7396562 polymorphism might contribute to RA susceptibility in the Chinese population.

Exposure to air pollutants has been associated with respiratory viral infections. Epidemiological studies have shown that air pollution exposure is related to increased cases of SARS‐COV‐2 infection and COVID‐19‐associated mortality. In addition, the changes of meteorological parameters have also been implicated in the occurrence and development of COVID‐19. However, the molecular mechanisms by which pollutant exposure and changes of meteorological parameters affects COVID‐19 remains unknown. This review summarizes the biology of COVID‐19 and the route of viral transmission, and elaborates on the relationship between air pollution and climate indicators and COVID‐19. Finally, we envisaged the potential roles of air pollution and meteorological parameters in COVID‐19.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause coronavirus disease 2019 (COVID-19), an acute respiratory inflammation that has emerged worldwide since December 2019, and it quickly became a global epidemic. Inflammatory bowel disease (IBD) is a group of chronic nonspecific intestinal inflammatory diseases whose etiology has not been elucidated. The two have many overlapping symptoms in clinical presentation, such as abdominal pain, diarrhea, pneumonia, etc. Imbalance of the autoimmune system in IBD patients and long-term use of immunosuppressive drugs may increase the risk of infection; and systemic symptoms caused by COVID-19 may also induce or exacerbate intestinal inflammation. It has been found that the SARS-CoV-2 receptor angiotensin converting enzyme 2, which is highly expressed in the lung and intestine, is an inflammatory protective factor, and is downregulated and upregulated in COVID-19 and IBD, respectively, suggesting that there may be a coregulatory pathway. In addition, the immune activation pattern of COVID-19 and the cytokine storm in the inflammatory response have similar roles in IBD, indicating that the two diseases may influence each other. Therefore, this review aimed to address the following research questions: whether SARS-CoV-2 infection leads to the progression of IBD; whether IBD increases the risk of COVID-19 infection and poor prognosis; possible common mechanisms and genetic cross-linking between the two diseases; new treatment and care strategies for IBD patients, and the feasibility and risk of vaccination in the context of the COVID-19 epidemic.

The coexistence of arthritis and pulmonary abnormalities has long been observed, but the causal inter-relationships among them are still uncertain especially in elderly adults.We extracted data from The China Health and Retirement Longitudinal Study (CHARLS). A total of 7534 participants without chronic lung diseases or/and asthma at the baseline and have complete follow-up information were included. Multivariate Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) for developing chronic lung diseases or asthma. We also utilized generalized linear models to examine the association between arthritis and baseline peak expiratory flow (PEF).During 50,615 and 51,975 person-years of follow-up, 629 and 188 participants incident chronic lung diseases and asthma, respectively. Compared to those without arthritis, participants with arthritis had a higher risk of chronic lung diseases (HR = 1.54, 95%CI = 1.31-1.81, P = 1.23 × 10Arthritis increased the risk of pulmonary diseases among middle-aged and elderly Chinese. Early detection and treatment of pulmonary abnormalities among arthritis patients could help decrease the mortality and reduce the global burden of arthritis. Key Points • The coexistence of arthritis and pulmonary abnormalities has long been observed, but whether arthritis status can trigger pulmonary disorders is still uncertain. • Arthritis status are associated with increased risk of pulmonary diseases (chronic lung diseases/asthma) among middle-aged and elderly Chinese. • Early detection and treatment of pulmonary abnormalities among arthritis patients could help decrease the mortality and reduce the global burden of arthritis.

This study aimed to explore the role of mitochondrial DNA copy number (mtDNAcn) in the risk, glucocorticoid (GC) effectiveness, and prognosis of systemic lupus erythematosus (SLE) and its interactions with environmental factors and tumor necrosis factor receptor-associated protein 1 (TRAP1) genetic polymorphisms. We first conducted a case-control study of 1198 subjects (595 SLE patients and 603 healthy controls). Subsequently, we followed up with patients to assess the effectiveness of GC treatment and the prognosis of SLE. Real-time fluorescent quantitative PCR (qPCR) was used to quantify mtDNAcn. Associations were estimated using logistic regression, and prognosis analysis was performed using Kaplan-Meier analysis and Cox proportional hazards models. Interactions on multiplicative and additive scales were also evaluated. Individuals with low mtDNAcn had an increased risk of SLE (P lt; 0.001). Low mtDNAcn was associated with poor GC effectiveness in patients with spicy food consumption or with arthritis (P lt; 0.05). mtDNAcn was significantly related to the prognosis of SLE in the drinking subgroup (P = 0.018). Furthermore, we found significant interactions between mtDNAcn and environmental factors/TRAP1 genetic polymorphisms on the risk, GC effectiveness, and prognosis of SLE. Our data suggest that low mtDNAcn is associated with an increased risk of SLE. Alteration of mtDNAcn may be associated with GC effectiveness and prognosis in certain subgroups of SLE. The interactions between mtDNAcn, environmental factors, and TRAP1 gene polymorphisms may jointly affect the risk, GC effectiveness, and prognosis of SLE.

Hong-Miao Li,1,2,&ast; Li-Jun Wang,2,&ast; Fei Tang,3 Hai-Feng Pan,1 Tian-Ping Zhang4 1Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People’s Republic of China; 2Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China; 3Anhui Chest Hospital (Anhui Provincial TB Institute), Hefei, Anhui, People’s Republic of China; 4The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Tian-Ping Zhang, The First Affiliated Hospital of USTC, 17 Lujiang Road, Hefei, Anhui, 230001, People’s Republic of China, Email zhangtianping@ustc.edu.cn Hai-Feng Pan, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, People’s Republic of China, Email panhaifeng@ahmu.edu.cnBackground: Recent studies have shown that abnormal expression of lncRNA NEAT1 is associated with the progression of pulmonary tuberculosis (PTB). The aim of our study was to analyze the relationship between single nucleotide polymorphisms (SNPs) of NEAT1 gene and susceptibility to PTB.Methods: Four SNPs (rs2239895, rs3741384, rs3825071, rs512715) in NEAT1 gene were genotyped in 479 patients with PTB and 476 controls by improved multiple ligase detection reaction (iMLDR) in a Chinese population.Results: We found no significant differences in allele and genotype frequencies of NEAT1 gene rs2239895, rs3741384, rs3825071, rs512715 between PTB patients and controls (all P > 0.05). There was no statistically significant association between genotype frequency distribution of dominant model, as well as recessive model, and genetic susceptibility to PTB patients (all P > 0.05). The TT genotype, T allele frequencies of rs3825071 were significantly increased in sputum smear-positive PTB patients when compared to sputum smear-negative PTB patients (P = 0.010, P = 0.003, respectively). Haplotype analysis shown that NEAT1 haplotype frequency was not associated with PTB susceptibility.Conclusion: NEAT1 gene polymorphisms were not associated with the risk of PTB in Chinese population, and rs3825071 polymorphism might be related to sputum smear-positive in PTB patients.Keywords: long non-coding RNA, NEAT1, pulmonary tuberculosis, single nucleotide polymorphisms

Background: Abnormal expression and function of long non-coding RNAs (lncRNAs) are closely related to the pathogenesis of systemic lupus erythematosus (SLE). In this study, we aimed to investigate the association of lncRNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT-1) gene single-nucleotide polymorphisms (SNPs) with susceptibility and clinical characteristics of SLE patients. Methods: A case-control study including 489 SLE patients and 492 healthy controls was conducted. Four MALAT-1 SNPs (rs4102217, rs591291, rs11227209, and rs619586) were genotyped in all subjects, their correlation with SLE susceptibility and clinical characteristics were also analyzed. Results: Results showed that the rs4102217 locus was associated with the risk of SLE. In recessive models, the GG+CG genotype of rs4102217 was associated with the decreased risk of SLE compared to CC (p = 0.036, OR = 0.348, 95% CI: 0.124-0.975). In additive models, the GG genotype of rs4102217 was associated with the decreased risk of SLE compared to CC (p = 0.040, OR = 0.355, 95% CI: 0.127-0.996). However, no association was found between MALAT-1 gene polymorphism and clinical manifestations of SLE (all p > 0.05). Conclusion: In summary, MALAT-1 rs4102217 is associated with susceptibility to SLE, suggesting that MALAT-1 may play a role in SLE.

Objective: Due to the inconsistent results of current studies on the association between urinary and blood vascular cell adhesion molecule-1 (VCAM-1) and systemic lupus erythematosus (SLE) disease activity, we conducted this study and analyzed its influencing factors. Methods: A literature search was conducted in PubMed, EMBASE, Web of Science, and Cochrane Library. Data were extracted from eligible studies to calculate standardized mean differences (SMD) with 95% confidence intervals (CI). Cochrane Q test and I2 statistics were used to examine heterogeneity. The sources of heterogeneity were assessed through sensitivity analysis and subgroup analysis. Publication bias was evaluated by funnel plots and Egger's test. Results: A total of 15 studies met the inclusion criteria, including 473 active SLE patients and 674 inactive SLE patients. The random effects model was used for data analysis. In both urine and blood samples, VCAM- 1 level in active SLE patients was significantly higher than those in inactive SLE patients (urine: SMD: 0.769; 95% CI: 0.260-1.278; blood: SMD=0.655, 95% CI: 0.084-1.226). No publication bias was found in this study. Conclusion: Compared with inactive SLE patients, patients with active SLE have higher levels of VCAM-1 in both urine and blood. VCAM-1 may be a potential indicator of SLE disease activity.

BACKGROUND This study aimed to investigate the factors associated with non-adherence of prescribed treatment in patients with multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) in Anhui Province, China. MATERIAL AND METHODS A cross-sectional survey was conducted in each designated hospital between March 2020 and May 2021. A structured questionnaire was designed to collect categorical characteristics and the historical data of the study participants. Non-adherence was determined from patient medical records and face-to-face interviews using the questionnaire at each designated hospital for MDR/RR-TB. RESULTS A total of 201 patients with confirmed sputum cultures positive for MDR/RR-TB were enrolled, 27.4% of whom were non-adherent to MDR/RR-TB treatment. In Anhui, MDR patients had a high incidence of adverse events, of which gastrointestinal reactions accounted for the majority. Absence of other chronic diseases (odds ratio (OR) 0.401; 95% confidence interval (CI) 0.203-0.791) and having no drug discontinuation (OR 0.040; 95% CI 0.018-0.091) were protective predictors of adherence. Patients with MDR/RR-TB with secondary education level and above and monthly family income of $309.4 USD or higher were more likely to follow the guidelines. Those who received anti-tuberculosis treatment and those who lived in suburban areas were less likely to adhere to the treatment. Binary-logistic regression indicated that the risk factor of non-adherence was drug discontinuation. CONCLUSIONS Low education level, place of residence, poor financial conditions, presence of other chronic diseases, discontinuation of medication, and frequency of anti-tuberculosis treatments were influential factors of adherence to MDR/RR-TB treatment.

Objectives Since the outbreak of coronavirus disease 2019 (COVID-19), it has caused serious casualties worldwide. In recent months, the virus has mutated into an increasingly infectious form (Delta variant) and spread rapidly. Methods In the current study, we analyzed the clinical, epidemiological and viral genetic characteristics of the first four imported Delta cases in Anhui Province, China. Results The four imported Delta cases developed chest inflammation, tissue damage and recovered after admission, the serum high-sensitivity C-reactive protein (hs-CRP) and CRP levels showed a first increasing and then decreasing trend. The changes of hs-CRP /CRP and serum neutralizing antibodies (Nab) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) levels were associated with the regression of chest lesions. The combination of genetic sequencing and epidemiological analysis suggested that the SARS-CoV-2 delta variant infection of these four patients may originate from Russia. Conclusions Our study found the certain correlations of serum hs-CRP/CRP and Nab levels with the occurrence, development and outcome of COVID-19 delta variant, suggesting that monitoring hs-CRP/CRP and Nab levels of COVID-19 delta variant patients at hospital admission may be useful for understanding the severity of patients’ current conditions.

The ongoing global pandemic of novel coronavirus pneumonia (COVID-19) caused by the SARS-CoV-2 has a significant impact on global health and economy system. In this context, there have been some landmark advances in vaccine development. Over 100 new coronavirus vaccine candidates have been approved for clinical trials, with ten WHO-approved vaccines including four inactivated virus vaccines, two mRNA vaccines, three recombinant viral vectored vaccines and one protein subunit vaccine on the "Emergency Use Listing". Although the SARS-CoV-2 has an internal proofreading mechanism, there have been a number of mutations emerged in the pandemic affecting its transmissibility, pathogenicity and immunogenicity. Of these, mutations in the spike (S) protein and the resultant mutant variants have posed new challenges for vaccine development and application. In this review article, we present an overview of vaccine development, the prevalence of new coronavirus variants and their impact on protective efficacy of existing vaccines and possible immunization strategies coping with the viral mutation and diversity.

Objectives Several studies have reported increased serum/plasma adiponectin levels in SLE patients. This study was performed to estimate the causal effects of circulating adiponectin levels on SLE. Methods We selected nine independent single-nucleotide polymorphisms that were associated with circulating adiponectin levels (P Results The results of inverse-variance weighted methods showed no significantly causal associations of genetically predicted circulating adiponectin levels and the risk for SLE, with an odds ratio (OR) of 1.38 (95% CI 0.91, 1.35; P = 0.130). MR-Egger [OR 1.62 (95% CI 0.85, 1.54), P = 0.195], weighted median [OR 1.37 (95% CI 0.82, 1.35), P = 0.235) and weighted mode methods [OR 1.39 (95% CI 0.86, 1.38), P = 0.219] also supported no significant associations of circulating adiponectin levels and the risk for SLE. Furthermore, MR analyses in using SLE-associated single-nucleotide polymorphisms as an instrumental variable showed no associations of genetically predicted risk of SLE with circulating adiponectin levels. Conclusion Our study did not find evidence for a causal relationship between circulating adiponectin levels and the risk of SLE or of a causal effect of SLE on circulating adiponectin levels.

ObjectivesThe present study aimed to discover novel susceptibility loci associated with risk of rheumatoid arthritis (RA).MethodsWe performed a new genome-wide association study (GWAS) in Chinese subjects (1027 RA cases and 2879 controls) and further conducted an expanded meta-analysis with previous GWAS summary data and replication studies. The functional roles of the associated loci were interrogated using publicly available databases. Dual-luciferase reporter and cytokine assay were also used for exploring variant function.ResultsWe identified five new susceptibility loci (IL12RB2, BOLL-PLCL1, CCR2, TCF7 and IQGAP1; pmeta IQGAP1 have significantly increased reporter activity in HEK293T cells. In addition, the cytokine assay found that the risk allele of rs244672 in TCF7 was most significantly associated with increased plasma IL-17A levels in healthy controls. Finally, identified likely causal genes in these loci significantly interacted with RA drug targets.ConclusionThis study identified novel RA risk loci and highlighted that comprehensive genetic study can provide important information for RA pathogenesis and drug therapy.

Human immunodeficiency virus (HIV) infection results in gut microbiota alteration and this is associated with immune activation and chronic inflammation. The gastrointestinal tract is a primary site of viral replication and thus HIV-induced loss of T-helper (Th) cells in the gut causes impairments in intestinal barriers, resulting in disruptions in intestinal immunity and precipitating into gut dysbiosis. Here, we show that late HIV diagnosis can negatively affect the immunological, virological, and clinical prognosis of the patients with its higher implication at an older age. Further, the review indicates that antiretroviral therapy affects the gut microbiota. We discussed the use of probiotics and prebiotics that have been indicated to play a promising role in reversing gut microbiota alteration in HIV patients. Though there are several studies reported with regard to such alterations in gut microbiota regarding HIV infection, there is a need to provide comprehensive updates. It is, therefore, the objective of this review to present most recently available evidence on the alteration of gut microbiota among HIV patients.

Objectives : To explore the associations of FKBP4 and FKBP5 gene polymorphisms with disease susceptibility, glucocorticoid (GC) efficacy, anxiety, depression, and health-related quality of life (HRQOL) in systemic lupus erythematosus (SLE) patients. Methods : All subjects were collected from the First and the Second Affiliated Hospital of Anhui Medical University in Hefei, China, during 2011 to 2015. In the case–control study, 541 SLE patients and 543 controls were recruited. In the follow-up study, 466 patients completed the 12-week follow-up and then were divided into GC-sensitive and GC-insensitive groups. Genotyping was determined using Multiplex SNaPshot technique. Data were analyzed using chi-square test and univariate and multivariate logistic regression analyses. Results : rs4713904, rs9368878, and rs7757037 of FKBP5 were associated with depression in SLE patients (rs4713904, PBH = 0.037; rs9368878, PBH = 0.001; rs7757037, PBH = 0.003). Moreover, rs4713904 was associated with GC efficacy in males with SLE (PBH = 0.011). The rs755658 of FKBP5 was associated with improvement in social function (PBH = 0.022) and mental component summary (PBH = 0.028). The rs4713907 of FKBP5 was related to improvement in total score of SF-36, bodily pain, and mental component summary score (all PBH = 0.018). Furthermore, the rs12582595 of FKBP4 was correlated with general health improvement (PBH = 0.033). No associations were seen between FKBP4/FKBP5 gene polymorphisms and SLE susceptibility and anxiety. Conclusions : FKBP5 gene polymorphisms may be associated with depression and GC efficacy of SLE patients. Meanwhile, the genetic polymorphisms of FKBP4 and FKBP5 genes may be associated with HRQOL improvement in SLE patients.Key Points• FKBP5 gene polymorphisms were associated with depression of SLE patients.• FKBP5 gene polymorphisms were associated with GC efficacy of SLE patients.• FKBP5 gene polymorphisms were associated with HRQOL improvement in SLE patients.• FKBP4 gene polymorphisms were associated with HRQOL improvement in SLE patients.

Plasmodium falciparum and P. vivax are prevalent in Pakistan. Data on the epidemiology of Plasmodium infections in Khyber Pakhtunkhwa province are lacking.This study aimed to: 1) determine the malaria prevalence in three districts of Khyber Pakhtunkhwa province with endemic malaria (Bannu, Dera Ismail Khan and Lakki Marwat); 2) determine household ownership of long-lasing insecticidal bed nets in the districts; and 3) assess malaria services in health facilities in the districts, in order to provide baseline information for malaria control in these areas.A cross-sectional study was conducted. In total, 31 041 individuals were selected for the malaria prevalence survey, 864 households for the insecticidal net ownership survey and 98 health facilities for malaria services. Rapid diagnostic tests were used to test for malaria.Overall, 4297 (13.8%) people tested positive for malaria. The prevalence of P. vivax, P. falciparum and mixed infection was 92.4%, 4.7% and 2.9%, respectively. The prevalence of malaria infection differed significantly between districts (P0.05). Prevalence was higher in people over 14 years and in women for P. vivax and P. falciparum malaria (P0.05). Only 44.1% of households owned one or more insecticidal nets. The most common drugs used to treat malaria were primaquine (62.5% of cases) and chloroquine (36.1%).The prevalence of malaria infection was high in the three districts. Malaria services in the health facilities were weak. Household ownership of long-lasing insecticidal nets was low. Malaria control or elimination strategies should be strengthened in these districts.مسح مرجعي لمعدل انتشار الملاريا في إقليم خيبر باختونخوا، باكستان.حميرا قورشي، محمد عُمران خان، هينوك أمباتشو، هاي فينج بان، دونج كينج يي.تنتشر كل من المتصورة المنجلية والمتصورة النشيطة في باكستان. ويتعذر الحصول على بيانات السمات الوبائية لحالات العدوى التي تسببها المتصورة في إقليم خيبر باختونخوا.هدفت هذه الدراسة إلى تحديد معدل انتشار الملاريا ومعدل امتلاك الأسر للناموسيات المتينة المعالجة بمبيد الحشرات وتقييم خدمات الملاريا في المرافق الصحية في ثلاث مناطق بالإقليم مستوطنة بالملاريا (وهي بانو، وديرا إسماعيل خان، ولاكي مروات) من أجل توفير المعلومات الأساسية لمكافحة الملاريا في تلك المناطق.أُجريت دراسة مقطعية باستخدام أسلوب المعاينة العنقودية. وإجمالا، فقد اختير 31041 فردا لمسح معدل انتشار الملاريا، و 864 أسرة لمسح امتلاك الناموسيات، و 98 مرفقا صحيا لمسح خدمات الملاريا. واستخدمت الاختبارات التشخيصية السريعة لاختبار الملاريا.من بين الأفراد الخاضعين للاختبار والبالغ عددهم 31041 فردا، جاءت نتيجة اختبار الملاريا إيجابية لدى 4297 فردا (%13.8). وبلغ معدل انتشار العدوى بالمتصورة النشيطة، والمتصورة المنجلية، والعدوى المشتركة بينهما %92.4، و %4.7، و %2.9 على التوالي. وكانت هناك اختلافات جوهرية بين معدل انتشار العدوى بالملاريا بين المناطق الثلاثة (0.05P). وكان معدل الانتشار أعلى في تلك المناطق دون سواها على امتداد 14 عاما (0.05P)، وفي صفوف النساء بالنسبة للعدوى بالمتصورة النشيطة والمتصورة المنجلية (0.05P). ولم يمتلك ناموسية واحدة أو أكثر معالجة بمبيدات الحشرات سوى %44.1 من الأسر. وكانت الأدوية الأكثر شيوعا المستخدمة في علاج الملاريا البريماكين (في %62.5 من الحالات) والكلوروكين (%36.1).كان معدل انتشار الملاريا مرتفعا في المناطق الثلاثة المستوطنة بالمرض في إقليم خيبر باختونخوا. واتسمت خدمات الملاريا في المرافق الصحية بالضعف. وكان معدل امتلاك الأسر لناموسيات متينة معالجة بمبيدات الحشرات منخفضا. لذا، ينبغي تعزيز استراتيجيات مكافحة الملاريا أو القضاء عليها في تلك المناطق.Enquête initiale sur la prévalence du paludisme dans la province de Khyber Pakhtunkhwa au Pakistan.Le Plasmodium falciparum ainsi que le P. vivax sont prévalents au Pakistan. Il n’existe pas de données disponibles sur l’épidémiologie des infections à Plasmodium dans la province de Khyber Pakhtunkhwa.La présente étude avait pour objectifs i) de déterminer la prévalence du paludisme dans trois districts de la province de Khyber Pakhtunkhwa touchés par le paludisme endémique (Bannu, Dera Ismail Khan et Lakki Marwat) ; ii) de déterminer la proportion de ménages disposant de moustiquaires impregnées d’insectiside à effet rémanent dans les districts ; et iii) d’évaluer les services de lutte antipaludique dans les établissements de santé de ces districts afin de fournir des informations de base permettant de lutter contre cette maladie dans ces zones.Une étude transversale a été menée. Au total, 31 041 individus ont été sélectionnés pour l’enquête sur la prévalence du paludisme, 864 ménages pour l’enquête sur la possession de moustiquaires et 98 établissements de santé pour les services de lutte antipaludique. Des tests diagnostiques rapides ont été utilisés pour le dépistage du paludisme.Au total, 4297 personnes (13,8 %) ont été testées positives pour le paludisme. La prévalence de l’infection à P. vivax, à P. falciparum ou par les deux espèces était respectivement de 92,4 %, 4,7 % et 2,9 %. On a observé des différences importantes en ce qui concerne la prévalence de l’infection palustre entre les districts (p0,05). La prévalence de l’infection à P. vivax et à P. Falciparum était plus élevée chez les personnes de plus de 14 ans et chez les femmes (p0,05). Seulement 44,1 % des ménages possédaient une ou plusieurs moustiquaires imprégnées d’insecticide. Les médicaments antipaludiques les plus couramment utilisés étaient la primaquine (62,5 % des cas) et la chloroquine (36,1 %).La prévalence de l’infection palustre était élevée dans les trois districts endémiques du Khyber Pakhtunkhwa. Les services de lutte antipaludique des établissements de santé étaient déficients. Le taux de possession par les ménages de moustiquaires imprégnées d’insecticide à effet rémanent était bas. Les stratégies de lutte antipaludique ou d’élimination de cette maladie doivent être renforcées dans ces districts.

Published studies have shown contradictory results in the association of serum/plasma levels of homocysteine (HCY) with systemic lupus erythematosus (SLE). This study is to systematically evaluate the association of serum/plasma HCY levels in SLE. A search was done using PubMed, Embase, Web of Science, and ScienceDirect databases up to 7 April 2019. Thirty-six articles including 2919 SLE patients and 3120 healthy controls were finally included in this meta-analysis. The HCY levels were significantly higher in SLE patients than in healthy controls (P 0.001). The subgroup analysis revealed that Asian, African, Arab, Mixed, White and others as well as ages ( 35 and ≥ 35) had significant higher HCY levels in SLE patients than in the healthy controls. The study indicated that patients with disease activity index scores 8 (P 0.001) and ≥ 8 (P = 0.003) of SLE had significant higher HCY levels as compared with the healthy controls. It was also revealed that disease duration in SLE patients for 10 and ≥ 10 years (P 0.001) had significant higher HCY levels as compared with the healthy controls. A significant higher HCY level for body mass index ( 23 and ≥ 23) was found as well as measurement type in SLE patients than healthy controls. This meta-analysis demonstrated higher HCY levels in patients with SLE than healthy controls, suggesting a possible role of HCY in the disease.Key Points• Homocysteine (HCY) is closely related to the mechanisms of systemic lupus erythematosus (SLE).• This study reveals a significant correlation between HCY levels and the various indexes of disease activity.• This study reveals that medication may influence HCY levels in SLE.• This study also discovers that the subgroup analysis of all the factors influences the HCY levels in SLE patients.

Purpose. Intratumor metabolic heterogeneity parameters on 18F-2-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) have been proven to be predictors of the clinical prognosis of cancer patients. The study aimed to examine the correlation between 18F-FDG PET-CT-defined heterogeneity parameters and the prognostic significance in patients with colorectal cancer. Methods. The study included 188 patients with colorectal cancer who received surgery and 18F-FDG PET/CT examinations. Preoperative 18F-FDG PET/CT conventional and metabolic heterogeneity parameters were collected, including maximum, peak, and mean standardized uptake value (SUVmax, SUVpeak, and SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), heterogeneity index-1 (HI-1) and heterogeneity index-2 (HI-2), and clinicopathological information. Correlations between these parameters and patient survival outcomes were inferred. Results. The associations between 18F-FDG PET/CT parameters and clinical outcomes were analyzed. Tumor thrombus ( P < 0.001 ), tumor stage ( P = 0.001 ), MTV ( P = 0.003 ), HI-1 ( P = 0.032 ), and HI-2 ( P = 0.001 ) differed between the two groups with and without recurrence. Multivariate analysis showed that, in the radical surgery group, HI-2 (HR = 1.10, 95% CI: 1.04–1.17, P = 0.001 ), tumor stage (HR = 20.65, 95% CI: 4.81–88.62, P < 0.001 ), and regional lymph nodes status (HR = 0.16, 95% CI: 0.04–0.57, P = 0.005 ) were independent variables significantly correlated with progression-free survival (PFS) and HI-2 (HR = 1.16, 95% CI: 1.07–1.26, P < 0.001 ) was an independent variable affecting overall survival (OS). In the palliative surgery group, HI-2 (HR = 1.03, 95% CI: 1.01–1.06, P = 0.020 ) was an independent variable affecting PFS, and all the parameters were not statistically significant for OS. Conclusion. HI-2, tumor stage, and regional lymph nodes status might predict the outcomes of colorectal cancer more effectively than other 18F-FDG PET/CT defined parameters.

BackgroundAlthough genome-wide association studies (GWASs) have identified more than 100 loci associated with rheumatoid arthritis (RA) susceptibility, the causal genes and biological mechanisms remain largely unknown.MethodsA cross-tissue transcriptome-wide association study (TWAS) using the unified test for molecular signaturestool was performed to integrate GWAS summary statistics from 58 284 individuals (14 361 RA cases and 43 923 controls) with gene-expression matrix in the Genotype-Tissue Expression project. Subsequently, a single tissue by using FUSION software was conducted to validate the significant associations. We also compared the TWAS with different gene-based methodologies, including Summary Data Based Mendelian Randomization (SMR) and Multimarker Analysis of Genomic Annotation (MAGMA). Further in silico analyses (conditional and joint analysis, differential expression analysis and gene-set enrichment analysis) were used to deepen our understanding of genetic architecture and comorbidity aetiology of RA.ResultsWe identified a total of 47 significant candidate genes for RA in both cross-tissue and single-tissue test after multiple testing correction, of which 40 TWAS-identified genes were verified by SMR or MAGMA. Among them, 13 genes were situated outside of previously reported significant loci by RA GWAS. Both TWAS-based and MAGMA-based enrichment analyses illustrated the shared genetic determinants among autoimmune thyroid disease, asthma, type I diabetes mellitus and RA.ConclusionOur study unveils 13 new candidate genes whose predicted expression is associated with risk of RA, providing new insights into the underlying genetic architecture of RA.

Previous studies concerning the circulating interleukin-17 (IL-17) in systemic lupus erythematosus (SLE) were contradictory.To further precisely investigate circulating IL-17 in SLE and evaluate its influential factors by meta-analysis.EMBASE, PubMed and Cochrane Library were comprehensively searched to obtain studies on circulating IL-17 in SLE patients by November 22, 2018. The results were illustrated by pooled standard mean difference (SMD) with corresponding 95% confidence interval (CI) using random-effects model as there was significant heterogeneity, which was estimated using CochranOverall, 1872 articles were reviewed and 20 studies involving 1067 subjects with SLE and 721 healthy controls (HCs) were enrolled in the final analysis according to inclusion criteria. Compared with HCs, circulating IL-17 levels in SLE patients were elevated (SMD: 1.183, 95% CI: 0.763-1.603;SLE patients have higher circulating IL-17 levels, which is influenced by ethnic, age and disease duration, literature quality and measurements.