Total glucosides of paeony for rheumatoid arthritis : a protocol for a systematic review

Introduction: Total glucosides of paeony (TGP) is a natural plant extract, which is widely used in China for treating rheumatoid arthritis (RA). Many relevant randomised controlled trials (RCTs) of TGP for RA are available, but they have not been systematically reviewed. This systematic review aims to examine the effectiveness and safety of TGP in patients with RA. Methods and analyses: We will search for RCTs of TGP in the treatment of RA, performed up until February 2016, in PubMed, Embase, Cochrane Central Register of Controlled Trials, and four Chinese databases (Chinese Biomedical Database, China National Knowledge Infrastructure, Wanfang Database and Chinese Scientific Journal Database). Trial registers and reference lists of retrieved articles will also be searched to identify potential articles. RCTs comparing TGP with placebo, no treatment, or disease-modifying antirheumatic drugs for patients with RA will be retrieved. The primary outcomes will be disease improvement and disease remission. The secondary outcomes will be surrogate outcomes, symptoms, adverse effects, and quality of life. Two reviewers will independently extract data on participants, interventions, comparisons, outcomes, etc. The methodological quality of each included study will be evaluated using the Cochrane risk of bias tool, and the strength of evidence on prespecified outcomes will be assessed in accordance with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Review Manager 5.3 software will be used for data analyses. Meta-analyses will be performed if the data are sufficiently homogeneous, both statistically and clinically. Possible publication bias will also be checked using funnel plots once the number of included studies is sufficient

Time-Dependent Reliability Assessment Method for RC Simply Supported T-Beam Bridges Based on Lateral Load Distribution Influenced by Reinforcement Corrosion

The safety and reliability of bridges gradually decrease over time under the influence of disadvantageous environmental factors, primarily due to reinforcement corrosion caused by chloride ingress. The traditional lateral load distribution (LLD) theory does not consider the influence of corrosion, which degrades the accuracy of bridge performance and reliability calculation. A time-dependent reliability assessment method for simply supported T-beam bridges is proposed in this paper, which considers the influence of reinforcement corrosion on LLD. Firstly, the steel corrosion process and degree are predicted based on the chloride ingress model, into which the water/cement ratio and concrete strength are innovatively introduced in order to improve the prediction accuracy. Secondly, the effective stiffness calculation method for corroded reinforcement bridges is established with the moment of inertia and section crack condition employed. Thirdly, the modified eccentric compression method is improved by the effective stiffness and iterative algorithm, which is suitable for the LLD calculation of corroded reinforcement bridges. The time-dependent vehicle load effect can be computed combined with the probability distribution of live load. Finally, the time-dependent reliability of the flexural bearing capacity is obtained by the Monte Carlo method and Bayesian theory without prior information. A simply supported bridge with five T-beams is taken as an example for analysis. It is indicated that the results calculated by the traditional reliability method are conservative, which cannot make a true and accurate evaluation. The method proposed in this paper can effectively reduce the assessment error caused by model uncertainty while considering the interaction between reinforcement corrosion and vehicle live load effect

Total glucosides of paeony for rheumatoid arthritis : a systematic review of randomized controlled trials

Background: Total glucosides of paeony (TGP) is commonly used to treat rheumatoid arthritis (RA) in China. However, clinical practice hasn't been well informed by evidence from appropriately conducted systematic reviews. This PRISMA-compliant systematic review aims at examining the effectiveness and safety of TGP for RA. Methods: Randomized controlled trials (RCTs) comparing TGP with placebo, no treatment, or disease-modifying antirheumatic drugs (DMARDs) for patients with RA were retrieved by searching seven databases. Primary outcomes included disease improvement and disease remission. Secondary outcomes included adverse effects, pain, health-related quality of life, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Data extraction and analyses were conducted according to the Cochrane standards. We assessed risk of bias for each included studies and quality of evidence on pre-specified outcomes. Results: Eight studies enrolling 1209 patients with active RA were included in this systematic review. On the basis of traditional DMARD(s), TGP might be beneficial for patients with RA in improvement of American College of Rheumatology (ACR) 20 response rate, ACR 50 response rate, ACR70 response rate, and in reduction of adverse effects, compared with no treatment. The overall methodological quality of included studies and the quality of evidence for each outcome were limited. Conclusions: Current trials suggested potential benefits of TGP for RA on the basis of traditional DMARD(s). Therefore, TGP may be a good choice for RA as an adjuvant therapy. However, considering the limited methodological quality and strength of evidence, high-quality RCTs are warranted to support the use of TGP for RA

A Novel Graphic-Aided Algorithm (gNIPT) Improves the Accuracy of Noninvasive Prenatal Testing

Noninvasive Prenatal Testing (NIPT) has advanced the detection of fetal chromosomal aneuploidy by analyzing cell-free DNA in peripheral maternal blood. The statistic Z-test that it utilizes, which measures the deviation of each chromosome dosage from its negative control, is now widely accepted in clinical practice. However, when a chromosome has loss and gain regions which offset each other in the z-score calculation, merely using the Z-test for the result tends to be erroneous. To improve the performance of NIPT in this aspect, a novel graphic-aided algorithm (gNIPT) that requires no extra experiment procedures is reported in this study. In addition to the Z-test, this method provides a detailed analysis of each chromosome by dividing each chromosome into multiple 2 Mb size windows, calculating the z-score and copy number variation of each window, and visualizing the z-scores for each chromosome in a line chart. Data from 13537 singleton pregnancy women were analyzed and compared using both the normal NIPT (nNIPT) analysis and the gNIPT method. The gNIPT method had significantly improved the overall positive predictive value (PPV) of nNIPT (88.14% vs. 68.00%, p=0.0041) and the PPV for trisomy 21 (T21) detection (93.02% vs. 71.43%, p=0.0037). There were no significant differences between gNIPT and nNIPT in PPV for trisomy 18 (T18) detection (88.89% vs. 63.64%, p=0.1974) and in PPV for trisomy 13 (T13) detection (57.14% vs. 50.00%, p=0.8004). One false-negative T18 case in nNIPT was detected by gNIPT, which demonstrates the potency of gNIPT in discerning chromosomes that have variation in multiple regions with an offsetting effect in z-score calculation. The gNIPT was also able to detect copy number variation (CNV) in chromosomes, and one case with pathogenic CNV was detected during the study. With no additional test requirement, gNIPT presents a reasonable solution in improving the accuracy of normal NIPT

Predisposition of six well-characterized microRNAs to syndesmophytes among Chinese patients with ankylosing spondylitis

<p><b>Objectives:</b> We quantified the expression of six well-characterized microRNAs (miRNAs) in peripheral blood mononuclear cells to see whether they can predispose to syndesmophytes in ankylosing spondylitis (AS) patients.</p> <p><b>Methods:</b> This is a cross-sectional study involving 46 AS patients (23/23 with/without syndesmophytes) and 22 healthy controls. miRNAs expression was quantified by real-time PCR.</p> <p><b>Results:</b> Six examined miRNAs were comparably expressed between AS patients without syndesmophytes and healthy controls (<i>p</i> > .05). Relative to AS patients without syndesmophytes, patients with syndesmophytes had significantly higher levels of miR-29a, miR-335-5p, miR-27a and let-7i (<i>p</i> = .001, .002, .013 and .029, respectively). Nine significant contributors associated with syndesmophytes in AS, including smoking, AS duration, human leukocyte antigen B27, erythrocyte sedimentation rate, C-reactive protein, miR-335-5p, miR-27a, miR-218 and sacroiliitis, were identified. The addition of miR-335-5p, miR-27a and miR-218 can significantly improve the accuracy of baseline risk factors. Based on the nine significant contributors, a nomogram was constructed, with good prediction accuracy (C-index: 0.86, <i>p</i> < .001).</p> <p><b>Conclusion:</b> We provide evidence for the predisposition of miR-335-5p, miR-27a and miR-218 to syndesmophytes in AS patients, indicating a contributory role of miRNAs in the pathogenesis of syndesmophytes. Further validation is warranted.</p

Interaction effects of significant risk factors on low bone mineral density in ankylosing spondylitis

Background To analyze individually and interactively critical risk factors, which are closely related to low bone mineral density (BMD) in patient with ankylosing spondylitis (AS). Methods A total of 249 AS patients who visited China-Japan Friendship Hospital were included in this training set. Patients with questionnaire data, blood samples, X-rays, and BMD were collected. Logistic regression analysis was employed to identify key risk factors for low BMD in different sites, and predictive accuracy was improved by incorporating the selected significant risk factors into the baseline model, which was then validated using a validation set. The interaction between risk factors was analyzed, and predictive nomograms for low BMD in different sites were established. Results There were 113 patients with normal BMD, and 136 patients with low BMD. AS patients with hip involvement are more likely to have low BMD in the total hip, whereas those without hip involvement are more prone to low BMD in the lumbar spine. Chest expansion, mSASSS, radiographic average grade of the sacroiliac joint, and hip involvement were significantly associated with low BMD of the femoral neck and total hip. Syndesmophytes, hip involvement and higher radiographic average grade of the sacroiliac joint increases the risk of low BMD of the femoral neck and total hip in an additive manner. Finally, a prediction model was constructed to predict the risk of low BMD in total hip and femoral neck. Conclusions This study identified hip involvement was strongly associated with low BMD of the total hip in AS patients. Furthermore, the risk of low BMD of the femoral neck and total hip was found to increase in an additive manner with the presence of syndesmophytes, hip involvement, and severe sacroiliitis. This finding may help rheumatologists to identify AS patients who are at a high risk of developing low BMD and prompt early intervention to prevent fractures

Tuning the Se Content in Cu₂ZnSn(S, Se)₄ Absorber to Achieve 9.7% Solar Cell Efficiency from a Thiol/Amine-Based Solution Process

The Se content in a Cu₂ZnSn­(S, Se)₄ absorber layer has a significant impact on the electronic properties, but it is rather challenging to control the Se/(S + Se) ratio due to a complicated selenization process. Here, a low-toxicity thiol/amine-based solution process was developed to tune the Se content in a Cu₂ZnSn­(S, Se)₄ absorber layer to an optimal value by ingeniously controlling the SeO₂ in the precursor solution. We demonstrated that the crystal growth and the band gap of Cu₂ZnSn­(S, Se)₄ thin films are affected by the Se/(S + Se) ratio. By this approach, the open-circuit voltage deficit (<i>V</i>_oc,def) of the device was effectively decreased, and the short-circuit density (<i>J</i>_sc) and fill factor (FF) were remarkably improved; thus, the power conversion efficiency of the Cu₂ZnSn­(S, Se)₄ solar cells was successfully increased from 5.6% to 9.7% for the optimal band gap (<i>E</i>_g = 1.13 eV)