To investigate the influence of the S447X variant in lipoprotein lipase (LPL) gene on the response rate to therapy with the thiazolidinedione pioglitazone. A total of 113 diabetic patients were treated with pioglitazone 30 mg for 10 weeks. Response to the pioglitazone treatment was defined by either a >10% relative reduction in fasting blood glucose (FBG) or a more than 1% decrease in glycosylated haemoglobin (HbA1c) values after 10 weeks of pioglitazone treatment. The genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism method. Using the criteria >10% relative reduction in FBG after 10 weeks of pioglitaone treatment, responder frequency to pioglitazone treatment in S447S genotype group is significantly higher than S447X genotype group. Meanwhile, the S447X genotype conferred a statistically significant 0.538-fold reduction in response rate to pioglitazone treatment relative to the S447S genotype. Moreover, pioglitazone treatment has significantly beneficial effects on serum lipid profile and blood pressure in S447S genotype carriers. The S447X variant in LPL gene may be a cause for therapy modification by pioglitazone.

Objectives To summarize our experience in the application of radiofrequency ablation (RFA) and microwave ablation (MWA) for selective fetal reduction in complicated monochorionic pregnancies and compare the perinatal outcome of the two techniques. Methods This was a retrospective study of data from a consecutive cohort of all monochorionic twin pregnancies that underwent selective fetal reduction with RFA or MWA at Peking University Third Hospital, Beijing, China from January 2012 to December 2018. All surviving cotwins were followed up to assess their neurodevelopment using the Age & Stage Questionnaire, Chinese version. Perinatal and neurodevelopmental outcomes were compared between the RFA and MWA groups. We also fitted multivariable models to test the association between procedure‐related factors and the main perinatal outcomes, including preterm birth (PTB) < 37 weeks' gestation, intrauterine fetal death (IUFD) of the cotwin, adverse outcome (defined as occurrence of IUFD of the cotwin, termination of pregnancy or PTB < 28 weeks) and overall survival. Results In total, 45 cases (42 twin and three triplet pregnancies) underwent RFA and 126 cases (105 twin and 21 triplet pregnancies) underwent MWA. The overall survival rates in monochorionic diamniotic twin pregnancies were similar between the RFA and MWA groups (61.0% vs 67.0%; P = 0.494). However, pregnancies whose indication for fetal reduction was selective intrauterine growth restriction or twin reversed arterial perfusion had higher overall survival rates (75.5% and 82.6%, respectively) compared with those in other indication groups. A total of 104 children were followed up (20 in the RFA group and 84 in the MWA group); four (20.0%) and eight (9.5%) children were assessed as having overall developmental delay in the RFA and MWA groups, respectively, with no significant difference between the two groups. Multivariable analyses showed that procedure indication, number of ablation cycles and gestational age at procedure were associated significantly with the main perinatal outcomes. Conclusions RFA and MWA for selective fetal reduction in complicated monochorionic pregnancies can achieve similar overall survival rate and neurodevelopmental outcome, but MWA is associated with a lower risk of preterm birth. Moreover, procedure‐related factors are associated significantly with perinatal outcome. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

No abstract

No abstract

Background:Many autoantibodies are found in the serum of rheumatoid arthritis (RA) patients, including RF, ACPA and so on, which are essential for the disease diagnosis and prognosis judgment. However, 20-30% of patients are still seronegative, so more investigations are needed to find new biomarkers in RA.Objectives:To investigate the prevalence of serum connective tissue growth factor (CTGF) and the association with the clinical features in RA patients.Methods:Serum samples were obtained from 180 patients with RA, 168 patients with other rheumatic diseases, including 43 systemic lupus erythematosus (SLE), 34 osteoarthritis (OA), 17 primary Sjögren’s syndrome (pSS), 20 ankylosing spondylitis (AS), 23 psoriatic arthritis (PsA), 6 reactive arthritis (ReA), 20 systemic sclerosis (SSc), and 5 systemic vasculitis (SV), and 64 healthy individuals in Peking University Third Hospital. The clinical and laboratory data of patients with RA were collected. Levels of CTGF in serum were measured by ELISA. The cut-off value of CTGF was determined by 95 percent of the concentration of the healthy controls. Statistical analyses were performed using the SPSS 24.0 software. Associations between CTGF and the clinical features of RA were evaluated.Results:The prevalence of serum CTGF among RA patients (33.89%) was significantly higher than those of SLE (9.3%), OA (0%), AS (0%), pSS (0%), PsA (0%), ReA (0%), SSc(5%), SV(0%) and healthy controls (4.69%) (p<0.0001). The mean titer of serum CTGF in RA was also significantly higher than those in other rheumatic diseases and healthy controls (p<0.001). At the cutoff value of 264.30 pg/ml, the sensitivity, specificity, positive predictive value and negative predictive value of serum CTGF for RA were 33.89%, 96.55%, 88.41% and 55.45% respectively. Anti-cyclic citrullinated peptide (CCP) antibody (p<0.001), rheumatoid factor (p<0.001), IgG (p=0.025) and IgM (p=0.004) in CTGF-positive patients were higher than those in CTGF-negative patients. Besides, more patients with interstitial lung disease (ILD) were found in CTGF-positive RA.Conclusion:Serum CTGF, as a novel biomarker, has certain diagnostic value for RA. Further studies are necessary to get more knowledge for the diagnostic performance of CTGF in RA.References:[1] Ramazani Y, et al. (2018) Connective tissue growth factor (CTGF) from basics to clinics. Matrix Biol 68-69:44-66.[2] Nozawa K, F et al. (2009) Connective tissue growth factor promotes articular damage by increased osteoclastogenesis in patients with rheumatoid arthritis. Arthritis research & therapy 11 (6):R174.[3] Yang X, et al. (2017) Serum connective tissue growth factor is a highly discriminatory biomarker for the diagnosis of rheumatoid arthritis. Arthritis research & therapy 19 (1):257.[4] Wei JL, et al. (2018) Role of ADAMTS-12 in Protecting Against Inflammatory Arthritis in Mice By Interacting With and Inactivating Proinflammatory Connective Tissue Growth Factor. Arthritis & rheumatology (Hoboken, NJ) 70 (11):1745-1756.[5] Tang X, et al. (2018) Connective tissue growth factor contributes to joint homeostasis and osteoarthritis severity by controlling the matrix sequestration and activation of latent TGFbeta. Ann Rheum Dis 77 (9):1372-1380.Fig 1.Distribution of serum CTGF in RA, other rheumatic diseases and healthy control. Serum sample were from 180 patients with rheumatoid arthritis (RA), 168 patients with other rheumatic diseases and 64 healthy individuals (HC). Levels of serum CTGF were measured by CTGF ELISA kit. The cut-off value was 263.30 pg/mL (black horizontal dotted line); ***p <0.001Table 1. Demographic, clinical and laboratory features of total RA patients and grouped with serum CTGF.Abbreviations: RA=rheumatoid arthritis; SJC=swollen joint count; TJC=tender joint count; ESR=erythrocyte sedimentation rate; CRP=C-reactive protein; DAS=disease activity score; CCP=cyclic citrullinated peptid; RF=rheumatoid factor. CTGF=connective tissue growth factor; ILD= interstitial lung diseaseDisclosure of Interests:None declared