Abstract Aim: The c‐myc proto‐oncogene is over‐expressed in synoviocytes from patients with rheumatoid arthritis (RA). For improving the inhibition of c‐myc antisense oligodeoxynucleotides (AS ODN) on RA synoviocytes proliferation, we used two antisense sequences: one (antimyc‐AUG AS ODN) targeting the initiation codon (AUG) and the next four codons on c‐myc mRNA; another (antimyc‐CRD AS ODN) targeting the coding region determinant (CRD) on c‐myc mRNA to investigate if there was a difference on inhibiting synoviocytes proliferation. Methods: Cultured human synoviocytes from patients with RA. The sequences were modified by phosphorothioates. Lipofectin was used as carrier. MTT assay was used to examine the inhibition of cell proliferation. Results: Antimyc‐AUG AS ODN and antimyc‐CRD AS ODN both can inhibit synoviocytes proliferation dose‐dependently. The maximum decrement of cell number was 40% at 2.5 µM and 48 h, 41.4% at 5 µM and 48 h, respectively. The action time of antimyc‐AUG AS ODN inhibiting synoviocytes proliferation was earlier than that of antimyc‐CRD AS ODN. ODN at high levels had non‐sequence‐specific cytotoxicity. Conclusions: Both c‐myc AS ODN are useful in inhibiting synoviocytes proliferation.
Abstract: Osteoarthritis (OA) is a degenerative disease of middle-aged and elderly people, contributed a higher burden of disease in China and the world. In 2017, under the support of the Rheumatology and Immunology Expert Committee of the Cross-Strait Medical and Health Exchange Association. The objective was to develop an evidence-based diagnosis and treatment guideline for OA in China based on emerging new evidence. The guideline was registered at International Practice Guidelines Registry Platform (IPGRP-2018CN028). The grading of recommendations assessment, development and evaluation (GRADE) approach was used to rate the quality of evidence and the strength of recommendations, and the RIGHT (Reporting Items for Practice Guidelines in Healthcare) checklist was followed to report the guideline. The guideline provides recommendations for the OA diagnosis, disease risks monitoring and evaluate, treatment purpose and physical, medical and surgical interventions. This guideline is intended to serve as a tool for Chinese clinicians for the best decisions-making on diagnosis and treatment of OA.
To explore the correlation between cerebrovascular hemodynamic index (CVHI)accumulative score and subclinical arteriosclerosis indicators. Methods: A total of 27 184 cases were collected from the Health Management Center, the Third Xiangya Hospital, Central South University. Linear regression analysis was carried out to confirm the correlations between CVHI accumulative score and the modified Framingham stroke profile (FSP), as well as between CVHI accumulative score and cerebrovascular diseases (ICVD) scale. The correlation between CVHI accumulative score and brachial-ankle pulse wave velocity (baPWV), carotid plaque orcarotid intima-media thickness (CIMT) was analyzed by multifactor logistic regression model in 11 580 cases. Moreover, the correlation between CVHI accumulative score and microalbuminuria or serum cystatin C was performed by multifactor logistic regression model in 9 860 cases. Results: In this study, the people whose CVHI accumulative score was less than 75 accounted for 12.98%. The CVHI accumulative score was negatively related with the modified FSP score (r=-0.484, P<0.01) or ICVD score (r=-0.455, P<0.01). The multifactor logistic regression model found that the baPWV, carotid plaque, microalbuminuria and serum cystatin C were independent predictors for CVHI accumulative score. Conclusion: The CVHI accumulative score is correlated with the modified FSP score, ICVD score and indexes of subclinical arteriosclerosis (baPWV, carotid plaque, microalbuminuria and serum cystatin C). The CVHI accumulative score could be used as a tool for zero-level and primary prevention of cerebral stroke.目的：探讨脑血管血流动力学指标(cerebrovascular hemodynamic index，CVHI)积分值与亚临床动脉硬化指标的相关性。方法：以中南大学湘雅三医院健康管理中心的27 184名体检人群为研究对象，采用线性回归分析CVHI积分值、改良版弗莱明翰评分量表(framingham stroke profile，FSP)和国人心脑血管缺血疾病(ischemic cardiovascular diseases，ICVD)量表的相关性；对其中11 580名受检对象采用多因素logistic回归模型进行CVHI积分值与臂踝脉搏波传导速度(brachial ankle pulse wave velocity，baPWV)、颈动脉斑块及颈动脉内膜中层厚度(carotid intima-media thickness，CIMT)的相关性分析；对其中9 860名受检对象采用多因素logistic回归模型进行CVHI积分值与尿微量白蛋白及胱抑素C的相关性分析。结果：本研究中CVHI积分值<75分的人数占总体检人数的12.98%；CVHI积分值与改良版FSP分值呈负相关(r=–0.484，P<0.01)，与ICVD量表分值亦呈负相关(r=–0.455，P<0.01)；多因素logistic回归模型发现baPWV，颈动脉斑块，尿微量白蛋白及胱抑素C是CVHI积分值的独立影响因素。结论：CVHI积分值与改良版FSP和ICVD量表、亚临床动脉硬化相关指标(baPWV，颈动脉斑块，尿微量白蛋白及胱抑素C)均具有良好的相关性，推荐将其作为脑卒中零级预防和一级预防的筛查手段。.
Objectives: To determine whether healthy lifestyle decreases the risk of developing hypertension in pre-hypertensive patients.Study design: A longitudinal study.Setting & participants: Randomly selected pre-hypertensive young adults 20-45 years old without any vascular disease such as stroke or diabetes.Predictors: Four lifestyle factors (a body mass index [BMI] of 18.5-24.9kg/m 2 , regular physical activity, no alcohol use and 6-8 h of sleep per day), individually and in combination.Outcomes: Hypertension was defined as a systolic blood pressure (SBP) ≥ 140 mmHg, or a diastolic BP (DBP) ≥ 90 mmHg or self-reported hypertension.Measurements: Multivariate adjusted Cox proportional hazards.Results: During a median follow-up of 4.7 years, 1009 patients were enrolled in our study, and 182 patients developed hypertension.Compared with a BMI of 18.5-24.9kg/m 2 , a BMI of 25-30 kg/m 2 and a BMI of >30 kg/m 2 were associated with an increased risk of hypertension occurrence (hazard ratio [HR], 1.83; 95% confidence interval [CI], 2.62; 95% CI, respectively).Compared with sleep duration of >8 h/day, 6-8 h/day of sleep was associated with a lower risk of hypertension occurrence (HR, 0.40; 95% CI, 0.18-0.86).There were no statistically significant associations between physical activity or alcohol use and hypertension occurrence (P>0.05).Limitation: All lifestyle factors were measured only once.Conclusion: Healthy BMI (18.5-24.9kg/m 2 ) and sleep duration (6-8 h/day) were associated with a lower risk of the occurrence of hypertension in pre-hypertension patients.
The classification criteria of osteoarthritis (OA) is lack of the support of relevant research evidence and there is no standardized protocol for detailed steps of the development or clinical verification of classification criteria has yet been established. This study aims to describe the development process of the Categorization of Osteoarthritis CHecklist (COACH), which is designed to choose the precise treatment option for patients with OA.A multidisciplinary panel was established to gather opinions. We conducted questionnaire survey and literature review to generate and COACH Panel members were invited to review the drafted classification criteria and optimize classification criteria. The final list of items was discussed and reached the agreement by the core group of the panel.Thirty-six experts participated in COACH Panel including rheumatologist (80.6%; 29/36), orthopedist (13.9%; 5/36), methodologist (2.8%; 1/36) and rehabilitation physician (2.8%; 1/36) for classification factors generating and optimizing. The main body of the final classification criteria consists of six types of OA pathogenesis, eight types of medical findings (which can be grouped into two categories), and six types of the location. The final criteria include load-based type, structure-based type, inflammation-based type, metabolic-based type, systemic factor based type and mixed type.COACH can better help clinicians quickly classify OA patients and help to choose the best treatment option from the aspects of types, findings and locations. What's more, the classification criteria are also helpful to promote the basic medical research and targeted prevention of OA.
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