Biyu Shen

Sjögren’s syndrome is associated with negatively variable impacts on domains of health-related quality of life: evidence from Short Form 36 questionnaire and a meta-analysis

Purpose The purpose of this article was to systematically review the literature to identify the impact of primary Sjögren’s syndrome (pSS) on specific health-related quality of life (HRQoL) domains. Methods A meta-analysis was performed, and the related articles were searched in Medline, Embase, Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine, and Web of Science databases and in reference lists of articles and systematic reviews. Score of the Short Form 36 (SF-36) questionnaire was used as the outcome measurement, and mean differences (MD) with 95% confidence intervals (CIs) were calculated. Results Seven studies were included, comprising 521 patients with pSS and 9,916 healthy controls. The SF-36 questionnaire score of each domain (physical function, role physical [RP] function, emotional role function, vitality, mental health, social function, body pain, general health, physical component scale, mental component scale) was lower in patients with pSS than in healthy controls, especially the score in the dimension of RP function. Conclusion This meta-analysis showed that patients had lower pSS score in each dimension of the SF-36, mostly in the RP function. This demonstrated that targeted interventions should be carried out to improve the HRQoL of pSS patients.

Depression in primary Sjögren’s syndrome: a systematic review and meta-analysis

Abstract There is substantial uncertainty regarding the prevalence of depression in Primary Sjögren’s syndrome (pSS). We conducted a systematic review aiming to evaluate the association of pSS with depression. PubMed, Web of Science, VIP, CNKI and Wanfang database were searched to find the published literatures (from these databases established to October 2016). Studies were screened according to inclusion and exclusion criteria and the qualities of included studies were evaluated. The data was analyzed using Revman5.2 software. A total of 12 studies including 1917 patients were eligible for inclusion in the systematic review and meta-analysis. In this meta-analysis, Severity of depression was assessed using psychometric measures, such as PHQ-9; HADS; CES-D; Zung depression scale and BDI. The result revealed that pSS was associated with an increased prevalence of depression (summary odds ratio (OR) = 5.36, 95% CI: 4.05–7.09, P < 0.01). The depression score in pSS patients (standardized mean difference (SMD) = 1.47, 95% CI: 0.81–2.12, P < 0.01) were higher than in the control group. Depression is highly prevalent in pSS than in healthy controls. Early recognition and appropriate intervention are therefore essential to reduce the negative impact of depression on the patient’s quality of life and outcome of their disease.

The impact of systemic lupus erythematosus on women's sexual functioning: A systematic review and meta-analysis

Background: A number of studies have reported the relationship between womens sexual problems and systemic lupus erythematosus (SLE). However, the results are contradictory. The objective of this paper was to explore the impact of SLE on womens sexual function. Methods: PubMed, Web of Science, CNKI Scholar, VIP and WanFang databases were searched up to April 2017. Studies evaluating the impact of SLE on womens sexual function with the use of Female Sexual Function Index (FSFI) scoring system were included. Statistical analyses were executed using version 5.0 Review Manager statistical software. Data were pooled using a fixed or random effects model according to heterogeneity. Results: A total of 2 identified studies matched the inclusion criteria, reporting on a total of 236 patients with SLE. No significant difference was observed between SLE patients and healthy controls on desire (P = .24; MD = −0.44 [−1.17, 0.29]), arousal (P = .12; MD = −0.39 [−0.89, 0.11]), lubrication (P = .17; MD = −0.53 [−1.28, 0.23]), orgasm (P = .27; MD = −0.27 [−0.75, 0.21]), satisfaction (P = .25; MD = −0.10 [−0.27, 0.07]) and pain (P = .17; MD = −0.50 [−1.22, 0.22]), except for total FSFI (P = .001; MD = −1.24 [−1.97, −0.50]). Conclusion: SLE has some influence on women’ sexual function. However, further studies of a larger population of female patients are required to further evaluate the mechanism by which SLE affects sexual function.

Rheumatoid arthritis is associated with negatively variable impacts on domains of female sexual function: evidence from a systematic review and meta-analysis

Abstract To systematically review the literature to identify the impact of rheumatoid arthritis (RA) on specific female sexual function domains. A meta-analysis was performed and the related literature were searched in MEDLINE, EMBASE, Cochrane Library, CNKI, CBM and Web of Science databases, and in reference lists of articles and systematic reviews. Score of the Female Sexual Function Index (FSFI) was used as the outcome measurement, and mean differences (MD) with 95% confidence intervals (CI) were calculated. Five studies were included, including 346 women with RA and 237 healthy female controls. Each domain of the FSFI score: lubrication (MD, −2.48; 95% CI, −3.69, −1.28), orgasm-1.71 (−2.09, −1.33), sexual desire-1.27 (−1.59, −0.95), satisfaction-1.67 (−2.18, −1.16), arousal-1.83 (−2.85, −0.82), pain-1.57 (−2.43, −0.70) and the total score −8.84 (−11.88, −5.79) were lower in RA women than healthy controls. Furthermore, lubrication dimension was most severely affected especially. This meta-analysis showed that female RA patients scored lower in each dimension of FSFI, mostly in the lubrication domain. It demonstrated that targeted interventions should be done to improve their sexual function. Future well-designed researches with larger sample sizes are necessary to evaluate the potential risk factors which determine female sexual dysfunction.

Medication adherence has an impact on disease activity in rheumatoid arthritis: a systematic review and meta-analysis

Objective Disease activity of rheumatoid arthritis (RA) patients was often measured by the 28-joint count disease activity score (DAS-28), which consists of 28 swollen and tender joint counts, patient’s assessment of disease activity (visual analog scale [VAS]) and erythrocyte sedimentation rate. C-reactive protein was also used to measure disease activity in RA patients. The aim was to explore the impact of medication adherence on disease activity in patients with RA. Methods A systematic search was performed in major electronic databases (PubMed, Web of Science, the Cochrane Library, CNKI, VIP and Wan fang) to identify studies reporting medication adherence and disease activity in RA patients. Results were expressed as mean difference (MD) and 95% CI. Results A total of seven identified studies matched the inclusion criteria, reporting on a total of 1,963 adult RA patients in the analysis. The total score of DAS-28 was significantly lower in adherent patients than in nonadherent subjects (MD =−0.42, 95% CI [−0.80, −0.03], P=0.03). Similarly, a significant difference was observed between medication adherent and nonadherent groups in erythrocyte sedimentation rate (MD =−7.39, 95% CI [−11.69, −3.08], P<0.01) and tender joint count (MD =−1.29, 95% CI [−2.51, −0.06], P=0.04). Interestingly, the results of the meta-analysis showed no significant difference between medication adherent and nonadherent patients in swollen joint count (MD =−0.16, 95% CI [−2.13, 1.80], P=0.87), visual analog scale (MD =1.41, 95% CI [−3.68, 6.50], P=0.59) and C-reactive protein (MD =0.35, 95% CI [−0.64, 1.34], P=0.49). Conclusion The study suggests that RA patients with higher medication adherence tended to have lower disease activity.

The correlations of psychological status, quality of life, self-esteem, social support and body image disturbance in Chinese patients with Systemic Lupus Erythematosus

Abstract This study aimed (i) to complement existing research by focusing on body image disturbance issues in Chinese Systemic Lupus Erythematosus (SLE) patients; (ii) to investigate how Chinese patients make sense of disease diagnosis and perceived cultural influences within the context of their SLE. A total of 118 SLE patients underwent standardized laboratory examinations and completed several questionnaires. Independent sample t-test, Mann–Whitney U-test, Chi-square test, and multivariate analysis using backward stepwise logistic regression model were used to analyze these data. We found 18.3% SLE patients had BID, which were significantly higher than the control group (.8%). SLE patients are more concerned about their physical changes caused by disease. There were significant correlations among personal health insurance, complication of diabetes, appearance of new rash, depression, anxiety, self-esteem and BID in patients with SLE. Meanwhile, logistic regression analysis revealed that appearance of new rash and high anxiety were significantly associated with BID in SLE patients. In conclusion, it is beneficial to pay attention to the physical and mental health of patients with rheumatic disease from the perspective of body image, to understand their needs and to provide effective and effective service for them.

Fatigue of systemic lupus erythematosus in China: contributors and effects on the quality of life

Objective Fatigue is a very common symptom of systemic lupus erythematosus (SLE), which significantly impairs patients’ quality of life. The purpose of this study is to evaluate contributors of fatigue and effects of fatigue on the quality of life in Chinese SLE patients. Methods A survey of 119 SLE patients using the Fatigue Severity Scale (FSS) to assess the severity of fatigue was carried out. SLE patients completed the Systemic Lupus Erythematosus Disease Activity Index, the Hospital Anxiety and Depression Scale, the Short Form 36 health survey and the Pittsburgh Sleep Quality Index. Meanwhile, 105 healthy individuals completed FSS, the Hospital Anxiety and Depression Scale and Short Form 36 health survey. We used chi-squared analysis, independent samples t-tests and logistic regression models to analyze data. Results Our results found that the FSS score of patients with SLE was higher than that of healthy controls. The disease duration, anxiety, depression, subjective sleep quality and sleep disorders significantly correlated with fatigue in SLE patients. Moreover, logistic regression models showed depression and sleep disorders as predictors of fatigue. In SLE patients, fatigued patients had lower quality of life than those who were non-fatigued. Conclusion This is the first time to explore contributors of fatigue and the influence of fatigue on SLE patients’ quality of life in China. Our study showed that depression and sleep disorders were predictors of fatigue, and fatigue seriously damaged SLE patients’ quality of life. The results indicate that it is necessary to conduct holistic assessment and effective intervention, such as systemic psychiatric screening, psychological care and practical sleep guidance, to relieve symptoms of fatigue and finally improve their quality of life in SLE patients.

THU0382 Fatigue in chinese patients with systemic lupus erythematosus: contributing factors and effects on the quality of life

Background Fatigue is a very common symptom in Systemic Lupus Erythematosus (SLE), affecting more than 90% of patients[1]. Fatigue can lead to a decline in the quality of life[2]. Fatigue in SLE patients is associated with adverse demographic, clinical, and psychological characteristics[3,4]. However, there is no systematic study of SLE fatigue in China. Objectives This cross-sectional study aims to evaluate the contributors of fatigue and the effects of fatigue on the quality of life in Chinese SLE patients. Methods A self-report survey was administered to 119 SLE patients and 105 healthy individuals using the Fatigue Severity Scale(FSS) to assess the severity of fatigue. SLE patients completed the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) for disease activity, the Hospital Anxiety and Depression Scale(HADS) for anxiety and depression, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality and the Short Form 36 health survey for the quality of life. Meanwhile, healthy individuals completed the Hospital Anxiety and Depression Scale(HADS) and the Pittsburgh Sleep Quality Index (PSQI). We used Independent samples t-tests, Chi square analysis and logistic regression modelling to analyse these data. Results Our results found that the FSS score of patients with SLE was higher than that of the controls (4.33 ± 1.66 versus 3.41 ± 1.39; p < 0.001). The SLE patients were significantly different from the control group in terms of anxiety, depression and quality of life. There were significant correlations among course of disease, anxiety, depression, subjective sleep quality, sleep disorders and fatigue in SLE patients. Meanwhile, logistic regression models identified depression and sleep disorders as predictors of fatigue. In SLE patients, fatigued patients had lower quality of life than those who were non-fatigued. Conclusions This is the first known evaluation of the contributors of fatigue and the effects of fatigue on SLE patients’ quality of life in China. The majority of Chinese SLE patients suffer from fatigue, which significantly impairs their quality of life. The results emphasise the need for holistic assessment and targeted intervention/management of SLE patients to relieve the symptoms of fatigue and finally improve their quality of life. References [1] O’Riordan R1, Doran M2, Connolly D3. Fatigue and Activity Management Education for Individuals with Systemic Lupus Erythematosus[J]. Occup Ther Int2017Jan 11;:4530104. doi:10.1155/2017/4530104 [2] Finlayson M, Preissner K, Cho C. Outcome moderators of a fatigue management program for people with multiple sclerosis[J]. American Journal of Occupational Therapy2012;66(2):187–197. doi:10.5014/ajot.2012.003160 [3] 3 Özel F, Argon G. The effects of fatigue and pain on daily life activities in systemic lupus erythematosus[J]. Agri 2015;27(4):181–9. doi:10.5505/agri [4] 4 Yilmaz-Oner S, Ilhan B, Can M, Alibaz-Oner F, Polat-Korkmaz O, Ozen G, Mumcu G, Kremers HM, Tuglular S, Direskeneli H. Fatigue in systemic lupus erythematosus: Association with disease activity, quality of life and psychosocial factors[J].Z Rheumatol 2017 Dec;76(10):913–919. doi:10.1007/s00393-016-0185-0 Disclosure of Interest None declared

CDK11p58 Promotes Microglia Activation via Inducing Cyclin D3 Nuclear Localization

Microglia activation has been implicated in the pathogenesis of many neurological diseases. These reactive microglia are capable of producing a variety of proinflammatory mediators and potentially neurotoxic compounds. The increase of cell number and expression of CD11b are the main features of activated microglia. In this study, we examined the suppressive effects of CDK11p58 on microglia activation induced by lipopolysaccharide (LPS) in vitro. We found that in the activated microglia, the expression of CDK11p58 increased and the overexpression of CDK11p58 could reduce the increased proliferation and CD11b expression in LPS-activated microglia. Such suppressive effects might be resulted from the interaction with cyclin D3 which promoted CDK11p58 nuclear localization. Our results suggested that CDK11p58 acted to regulate microglia activation through CDK11p58 and cyclin D3 interaction.