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Xiu-Ping Cheng,1,2,* Xiao-Wan Wang,3,* Han-Fei Sun,4,* Liang Xu,3 Opeyemi Joshua Olatunji,5 Yan Li,1,2,6 Jia-Ting Lin,2,7 Jian Zuo1,2,6 1Xin’an Medicine Research Center, the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, 241000, People’s Republic of China; 2Research Center of Integration of Traditional Chinese and Western Medicine, Wannan Medical College, Wuhu, 241000, People’s Republic of China; 3Department of Rheumatology, the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, 241000, People’s Republic of China; 4Department of Pharmacy, the Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, People’s Republic of China; 5African Genome Center, Mohammed VI Polytechnic University, Ben Guerir, 43150, Morocco; 6Center for Xin’an Medicine and Modernization of Traditional Chinese Medicine, Institution of Health and Medicine, Hefei Comprehensive National Science Center, Hefei, 230000, People’s Republic of China; 7Department of Stomatology, the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, 241000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jia-Ting Lin; Jian Zuo, Email 20141247@wnmc.edu.cn; zuojian8178@163.comBackground: Rheumatoid arthritis (RA) patients are prone to developing different metabolic complications. Traditional Chinese Medicine attributes this uncertainty to varied syndrome types.Methods and Results: We retrospectively analyzed some serological indicators of active RA patients and healthy individuals. Randomly selected RA patients were divided into three groups according to NAMPT and SIRT1 expression levels in white blood cells (WBCs). Their disease severity and metabolic status were compared. Representative blood samples were subjected to a UPLC-MS/MS-based metabolomics analysis. Different human WBCs were treated with oleic acid and palmitic acid in vitro. The results indicated that blood glucose and lipid levels were decreased in RA patients, but their decrease was not in accordance with disease severity. Nutrients in the patients highly expressing SIRT1 were well preserved, with the lowest levels of RF and β-CTX and the highest levels of adiponectin and resistin. Most of them exhibited cold symptoms. When SIRT1 deficiency was obvious, lipid depletion became evident, irrespective of expression levels of NAMPT. Simultaneous high-expression of SIRT1 and NAMPT coincided with the increase in production of lactic acid and the prevalence of hot symptoms. Despite the low levels of IL-6, joint injuries were severe. The corresponding WBCs were especially sensitive to fatty acids anti-inflammatory treatments. The levels of CCL27, CCL11, CCL5, AKP, CRP and ESR were similar among all the groups.Conclusion: NAMPT overexpression is a risk factor for joint injuries and nutrient depletion in RA. Supplementation with lipids would exert beneficial effects on these RA patients. Its aftermath would cause even severe inflammation. Contrarily, SIRT1 up-regulation restrains inflammation and lipid depletion.Keywords: rheumatoid arthritis, inflammation, energy metabolism, blood glucose, lipids, joint damage

David Price,1,2 Aileen David-Wang,3 Sang-Heon Cho,4 James Chung-Man Ho,5 Jae-Won Jeong,6 Chong-Kin Liam,7 Jiangtao Lin,8 Abdul Razak Muttalif,9 Diahn-Warng Perng,10,11 Tze-Lee Tan,12 Faisal Yunus,13 Glenn Neira14 On behalf of the REcognise Asthma and LInk to Symptoms and Experience (REALISE) Asia Working Group 1Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK; 2Research in Real Life, Singapore; 3University of the Philippines-Philippine General Hospital, Manila, Philippines; 4College of Medicine, Seoul National University, Seoul, Republic of Korea; 5Department of Medicine, University of Hong Kong, Hong Kong, Special Administrative Region of the People's Republic of China; 6College of Medicine, Inje University, Goyang, Republic of Korea; 7Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 8China-Japan Friendship Hospital, Beijing, People's Republic of China; 9Institute of Respiratory Medicine, Kuala Lumpur, Malaysia; 10School of Medicine, National Yang-Ming University, 11Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; 12National University Hospital, Singapore; 13Persahabatan Hospital, University of Indonesia, Jakarta, Indonesia; 14Medical Affairs Department, Mundipharma Pte Ltd, Singapore Purpose: Asthma is a global health problem, and asthma prevalence in Asia is increasing. The REcognise Asthma and LInk to Symptoms and Experience Asia study assessed patients' perception of asthma control and attitudes toward treatment in an accessible, real-life adult Asian population. Patients and methods: An online survey of 2,467 patients with asthma from eight Asian countries/regions, aged 18–50 years, showed greater than or equal to two prescriptions in previous 2 years and access to social media. Patients were asked about their asthma symptoms, exacerbations and treatment type, views and perceptions of asthma control, attitudes toward asthma management, and sources of asthma information. Results: Patients had a mean age of 34.2 (±7.4) years and were diagnosed with asthma for 12.5 (±9.7) years. Half had the Global Initiative for Asthma-defined uncontrolled asthma. During the previous year, 38% of patients visited the emergency department, 33% were hospitalized, and 73% had greater than or equal to one course of oral corticosteroids. About 90% of patients felt that their asthma was under control, 82% considered their condition as not serious, and 59% were concerned about their condition. In all, 66% of patients viewed asthma control as managing attacks and 24% saw it as an absence of or minimal symptoms. About 14% of patients who correctly identified their controller inhalers had controlled asthma compared to 6% who could not. Conclusion: Patients consistently overestimated their level of asthma control contrary to what their symptoms suggest. They perceived control as management of exacerbations, reflective of a crisis-oriented mind-set. Interventions can leverage on patients' trust in health care providers and desire for self-management via a new language to generate a paradigm shift toward symptom control and preventive care. Keywords: asthma control, attitudes, perception

Substantial anthropogenic emissions from China have resulted in serious air pollution, and this has generated considerable academic and public concern. The physical transport of air pollutants in the atmosphere has been extensively investigated; however, understanding the mechanisms how the pollutant was transferred through economic and trade activities remains a challenge. For the first time, we quantified and tracked China's air pollutant emission flows embodied in interprovincial trade, using a multiregional input - output model framework. Trade relative emissions for four key air pollutants (primary fine particle matter, sulfur dioxide, nitrogen oxides and non-methane volatile organic compounds) were assessed for 2007 in each Chinese province. We found that emissions were significantly redistributed among provinces owing to interprovincial trade. Large amounts of emissions were embodied in the imports of eastern regions from northern and central regions, and these were determined by differences in regional economic status and environmental policy. It is suggested that measures should be introduced to reduce air pollution by integrating cross-regional consumers and producers within national agreements to encourage efficiency improvement in the supply chain and optimize consumption structure internationally. The consumption-based air pollutant emission inventory developed in this work can be further used to attribute pollution to various economic activities and final demand types with the aid of air quality models.

A preliminary investigation was carried out by the US Environmental Protection Agency (EPA) on the impact of regional ozone concentrations on climate change in the country. The main objective of the investigation was to enhance the ability of air quality managers to consider global change in their decisions through improved characterization of the potential effects of global change on air quality, including O3, PM, and Hg. An integrated assessment framework was designed that supported the research and development efforts within the EPA and the academic research professionals. This design recognized the challenges of bridging spatial scales, temporal scales, and disciplines that characterize the global change and regional air quality problem. A major component of the assessment approach involved the development and application of global to regional climate and air quality modeling systems.