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Analysis of mechanotransduction among ensembles of sensory hair cells in vivo is challenging in many species. To overcome this challenge, we used optical indicators to investigate mechanotransduction among collections of hair cells in intact zebrafish. Our imaging reveals a previously undiscovered disconnect between hair-cell mechanosensation and synaptic transmission. We show that saturating mechanical stimuli able to open mechanically gated channels are unexpectedly insufficient to evoke vesicle fusion in the majority of hair cells. Although synaptically silent, latent hair cells can be rapidly recruited after damage, demonstrating that they are synaptically competent. Therefore synaptically silent hair cells may be an important reserve that acts to maintain sensory function. Our results demonstrate a previously unidentified level of complexity in sculpting sensory transmission from the periphery., Hair cells of the inner ear are mechanosensors that detect sound, and synapse onto afferent neurons. Here, the authors used calcium imaging to find that not all hair cells are synaptically engaged, but after damage these silent cells are synaptically engaged.

Lactiplantibacillus plantarum CCFM8724 is a probiotic with the potential to prevent dental caries in vitro and in vivo. To explore the effects of this probiotic at inhibiting Streptococcus mutans-Candida albicans mixed-species biofilm and preventing dental caries, multi-omics, including metabolomics and transcriptomics, was used to investigate the regulation of small-molecule metabolism during biofilm formation and the gene expression in the mixed-species biofilm. Metabolomic analysis revealed that some carbohydrates related to biofilm formation, such as sucrose, was detected at lower levels due to the treatment with the L. plantarum supernatant. Some sugar alcohols, such as xylitol and sorbitol, were detected at higher levels, which may have inhibited the growth of S. mutans. In transcriptomic analysis, the expression of the virulence genes of C. albicans, such as those that code agglutinin-like sequence (Als) proteins, was affected. In addition, metabolomics coupled with a Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis and RNA-seq revealed that the L. plantarum supernatant had an active role in sugar metabolism during the formation of the S. mutans-C. albicans mixed-species biofilm, and the L. plantarum supernatant was also related to carbohydrate utilization, glucan biosynthesis, and mycelium formation. Hence, L. plantarum CCFM8724 decreased the mixed-species biofilm mass from the perspective of gene expression and metabolic reprogramming. Our results provide a rationale for evaluating L. plantarum CCFM8724 as a potential oral probiotic for inhibiting cariogenic pathogen biofilm formation and improving dental caries.

Background:Systemic lupus erythematosus (SLE) is an autoimmune disease, the immune system of patients to be disordered, especially in T cell subsets1. They were prone to mental diseases, anxiety particularly, which lead to suicide2. The recent study had reported that CD4+ T cells in the peripheral blood played the key role in like anxiety behavior of mice3. Although there showed that the level of serum TNF-α in SLE patients with anxiety was higher than without anxiety4, finding the important special mediators especially in T cell subsets was still necessary for the prevention of anxiety in SLE patients.Objectives:In total, 108 SLE patients, which met the diagnostic criteria of the American Society of rheumatology (v1997), were enrolled in this study from Affilliated Hospital of Nantong University, China. Exclusion criteria included other autoimmune diseases and active infection (including hepatitis B or C virus, Epstein-Barr virus, human immunodeficiency virus or Mycobacterium tuberculosis infection).Methods:We surveyed the abundance of 74 immune cell subpopulations from 108 SLE patients using flow cytometry, and investigated their differences between patients with and without anxiety (24 versus 84). Moreover, machine learning including Lasso regression, Random forest (RF) and Sparsity partial least squares discriminant analysis (sPLS-DA) was employed to build models and futher selected important features for the classification of SLE patients with anxiety.Results:SLE patients with anxiety showed higher body mass index (BMI) and lower quality of life. In their peripheral blood, the proportion of internal cell subsets composition of Th cell and Treg cells changed. By machine learning, we finally found that BMI and PD1-CD28- Treg played important rules to developing lupus anxiety.Conclusion:In this study, machine learning was applied to build models to select the most important T cell subset in SLE patients with anxiety. These findings suggested that BMI and imbalance of PD1-CD28- Treg containing effector memory Treg cells and effector Treg cells mostly played important roles in the development of SLE anxiety.Disclosure of Interests:None declared

The aim of this study was to assess adherence rate and predictors of non-adherence with urate-lowering therapy (ULT) in Chinese gout patients. A cross-sectional study was administered to 125 gout patients using the Compliance Questionnaire on Rheumatology (CQR) for adherence to ULT. Patients were asked to complete the Treatment Satisfaction Questionnaire for Medication version II, Health Assessment Questionnaire, Confidence in Gout Treatment Questionnaire, Gout Knowledge Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and 36-Item Short Form Health Survey. Data were analyzed by independent sample t test, rank sum test, Chi-square analysis as well as binary stepwise logistic regression modeling. The data showed that the rate of adherence (CQR ≥80%) to ULT was 9.6% in our investigated gout patients. Adherence was associated with functional capacity, gout-related knowledge, satisfaction with medication, confidence in gout treatment and mental components summary. Multivariable analysis of binary stepwise logistic regression identified gout-related knowledge and satisfaction of effectiveness with medication was the independent risk factors of medication non-adherence. Patients unaware of gout-related knowledge, or with low satisfaction of effectiveness with medication, were more likely not to adhere to ULT. Non-adherence to ULT among gout patients is exceedingly common, particularly in patients unaware of gout-related knowledge, or with low satisfaction of effectiveness with medication. These findings could help medical personnel develop useful interventions to improve gout patients' medication adherence.

In sensory hair cells of auditory and vestibular organs, the ribbon synapse is required for the precise encoding of a wide range of complex stimuli. Hair cells have a unique presynaptic structure, the synaptic ribbon, which organizes both synaptic vesicles and calcium channels at the active zone. Previous work has shown that hair-cell ribbon size is correlated with differences in postsynaptic activity. However, additional variability in postsynapse size presents a challenge to determining the specific role of ribbon size in sensory encoding. To selectively assess the impact of ribbon size on synapse function, we examined hair cells in transgenic zebrafish that have enlarged ribbons, without postsynaptic alterations. Morphologically, we found that enlarged ribbons had more associated vesicles and reduced presynaptic calcium-channel clustering. Functionally, hair cells with enlarged ribbons had larger global and ribbon-localized calcium currents. Afferent neuron recordings revealed that hair cells with enlarged ribbons resulted in reduced spontaneous spike rates. Additionally, despite larger presynaptic calcium signals, we observed fewer evoked spikes with longer latencies from stimulus onset. Together, our work indicates that hair-cell ribbon size influences the spontaneous spiking and the precise encoding of stimulus onset in afferent neurons. SIGNIFICANCE STATEMENT Numerous studies support that hair-cell ribbon size corresponds with functional sensitivity differences in afferent neurons and, in the case of inner hair cells of the cochlea, vulnerability to damage from noise trauma. Yet it is unclear whether ribbon size directly influences sensory encoding. Our study reveals that ribbon enlargement results in increased ribbon-localized calcium signals, yet reduces afferent spontaneous activity and disrupts the timing of stimulus onset, a distinct aspect of auditory and vestibular encoding. These observations suggest that varying ribbon size alone can influence sensory encoding, and give further insight into how hair cells transduce signals that cover a wide dynamic range of stimuli.

Background There have been no previous report of hand joint destruction prevalence in Chinese rheumatoid arthritis (RA) patients. Therefore, the aim of this study was to investigate the prevalence and potential factors of hand joint destruction among RA patients from Nantong China. In addition, we wanted to examine the differences between functional capacity, psychological status, and quality of life in patients with hand joint destruction compared to those without hand joint destruction. Methods A cross-sectional study was conducted from the Affiliated Hospital of Nantong University between July 2015 and June 2016. RA patients completed questionnaires for demographic or clinical variables, the 10-cm Visual Analog Scale for pain, the 28-joint Disease Activity Score-erythrocyte sedimentation rate for disease activity, the Health Assessment Questionnaire-disability index for physical function, the Hospital Anxiety and Depression Scale for anxiety and depression, and the Short Form 36 health survey for quality of life. Laboratory examinations were taken to obtain some biochemical indicators (e.g., rheumatoid factor, anti-cyclic citrullinated peptide antibody). X-ray assessment of hand was performed and hand joint destruction was defined as Sharp score > 0. 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. Results One hundred and sixty-one RA patients were included in this study. Radiographic findings revealed that almost 47.2% (n = 76) of patients had hand joint destruction. Multivariate analysis found that education ≤ 9 years (p = 0.041), anti-cyclic citrullinated peptide antibody positive (p = 0.021), high disease activity (p = 0.020), and long disease duration (p

Purpose The purpose of this article was to systematically review the literature to identify the impact of primary Sjogren'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.

Background As an important outcome measure among rheumatoid arthritis (RA) patients, functional disability may contribute to unemployment, loss of work productivity, and impaired quality of life. However, little is known about the risk factors of functional disability in Chinese RA patients. This study aimed (1) to examine the prevalence of functional disability in Chinese RA patients; (2) to explore factors associated with the health assessment questionnaire-disability index (HAQ-DI). Methods A total of 101 RA patients in this cross-sectional study underwent standardized laboratory examinations and responded to the questionnaire for demographic data, the HAQ-DI for functional disability, the Compliance Questionnaire on Rheumatology (CQR) for medication adherence, the Hospital Anxiety and Depression Scale (HADS) for psychological status, and the Short Form 36 health survey (SF-36) for quality of life. Pain, grip/pinch strength, disease activity, and large joint mobility were recorded. Independent samples t-tests, chi-square analyses, and logistic regression modeling were used to analyze the data. Results The mean ± SD age of RA patients was 54.9 ± 11.9 years. Approximately 15.8% RA patients in mainland China experience functional disability (defined as a HAQ-DI score ≥ 1). Long disease duration, pain, high disease activity, a larger number of tender and swollen joints, high C-reactive protein (CRP) level, decreased grip strength, and limitation of shoulder, elbow, wrist, knee, and ankle motion were associated with the HAQ-DI. Participants with functional disability tended to have more severe depressive symptoms and a lower quality of life compared with individuals without functional disability. Stepwise logistic regression analyses found that limitation of wrist extension (P = 0.001) and lower body pain (BP) score (P = 0.001) explained higher HAQ-DI score. Conclusions The present study reported that functional disability was common in Chinese RA patients. A low quality of life and limitation of joint mobility had great impacts on functional disability in Chinese RA patients. Targeted and culturally sensitive interventions should be strengthened to delay the onset of disabilities of this population.

The aim of this study was to determine the effects of psychological interventions (e.g. cognitive restructuring, relaxation) on physiological and psychological health in osteoarthritis patients. A systematic literature search was done using PubMed, Embase, PsycINFO, Web of Science, China National Knowledge Infrastructure, and Wanfang Database through November 2016. Studies were included if they used a randomized controlled trial designed to explore the effects of psychological interventions in osteoarthritis patients. Two independent authors assessed the methodological quality of the trials using criteria outlined by Jadad et al. Meta-analysis was done with the Revman5.0. Twelve randomized controlled trials, including 1307 osteoarthritis patients, met the study inclusion criteria. Meta-analysis showed that psychological interventions could reduce the levels of pain [standard mean difference (SMD) -0.28, 95% CI -0.48, -0.08, P-value 0.005)] and fatigue (SMD -0.18, 95% CI -0.34, -0.01, P-value 0.04). In addition, psychological interventions significantly improved osteoarthritis patients' self-efficacy (SMD 0.58, 95% CI 0.40, 0.75, P-value 0.00) and pain coping (MD 1.64, 95% CI 0.03, 3.25, P-value 0.05). Although the effects on physical function, anxiety, depression, psychological disability were in the expected direction, they were not statistically significant. In conclusion, the role of psychological interventions in the management of osteoarthritis remains equivocal. Some encouraging results were seen with regard to pain, pain coping, self-efficacy, and fatigue. We believe that more methodologically rigorous large-scale randomized controlled trials are necessary to answer this study question.

Ethyl esters are often detected at trace levels in Camembert cheese. This study investigated how the addition of ethanol prior to cheesemaking influenced the composition, texture and flavour profile of Camembert compared to a control cheese manufactured under identical conditions without ethanol. No statistical differences were observed in the composition, microbes or textures of the experimental and control cheeses. However, more ethyl esters and a significantly enhanced fruity flavour perception were reported for the experimental cheeses compared to the control. The addition of 400–1200 μg/g of ethanol may be applied in the production of Camembert cheese to enhance fruity flavour.

Employing NH4BF4 as a fluoride source, novel hierarchical cake-like ZnO microstructures have been fabricated by a simple, template-free, environmentally-friendly DMF (N,N-dimethylformamide)-mediated solvothermal route. The products were characterized by XRD, SEM, TEM and nitrogen adsorption–desorption and PL. The SEM and TEM results indicated that the hierarchical cake-like ZnO were assembled from numerous tiny nanoplates. DMF acted as solvent and structure-directing agent to guide the formation of ZnO nuclei and the self-assembled preferential growth from smaller building units (nanoplates) to larger cake-like ZnO microstructures. The as-prepared samples, ZnO or ZnOHF could be regulated by altering the two major reaction parameters (the amount of DMF and fluoride source). Time-dependent morphological evolution results revealed that self-assembly and Ostwald ripening were the main formation mechanism for the hierarchical ZnO microstructure. Furthermore, the photocatalytic activity of the as-prepared ZnO samples was evaluated by the degradation of Rhodamine B (RhB) under UV light irradiation. Such hierarchical cake-like ZnO microstructures showed an excellent photocatalytic activity. Additionally, the cake-like ZnO microstructures were chemically stable, and the efficiency remained almost the same after being recycled five times.

To analyze the response mechanisms of Lactobacillus plantarum against manganese starvation stress, different metabolisms from physiology, proteomics and transporters aspects in L. plantarum CCFM 436 were systematically investigated. The kinetics of cell growth (μmax) decreased from 0.310 to 0.256 h−1, while thinner cell morphology was observed by transmission electron microscopy under Mn-starvation conditions. Gas chromatography-mass spectrometry analysis indicated that membrane mobility and compactness increased, with a higher proportion of unsaturated fatty acids and cyclopropane fatty acids. High-performance liquid chromatography analysis showed that intracellular Asp, Glu, and Arg contents, closely related to energy metabolism, were significantly increased. Fourier transform infrared spectroscopy proved that some functional groups (N–H and OC–OH) were significantly affected by Mn starvation. Comparative two-dimensional proteomic analysis identified 73 proteins that differed significantly under Mn starvation conditions. These differentially expressed proteins involved in carbohydrate, amino acid and transcription/translation metabolisms and stress response were categorized as crucial components required to resist manganese starvation stress. Moreover, qRT-PCR analysis proved that MntH 1–5, negatively regulated by MntR, acted as potential Mn importers under Mn starvation conditions. The proposed coordinated mechanism model provides a reference for, and insight into, the intracellular metabolism of LAB strains.

A surface-layer protein (Slp) derived from Lactobacillus acidophilus NCFM has been reported to possess multiple biological properties, including anti-inflammatory, inhibition of apoptosis in pathogen-invaded HT-29 cells and oxidative stress relief. However, its anti-tumor ability and underlying molecular mechanism are unknown. Here, we report that Slp suppresses cell proliferation and induces autophagic cell death in HCT116 cells. Accumulation of Beclin-1 and microtubule-associated protein 1 light chain 3 from II (LC3-II), and the degradation of p62 were observed when cells were treated with various concentrations of Slp (25, 50, 100 μg mL-1) for 24 h. We also found that the mammalian targets of rapamycin (mTOR) and c-Jun N-terminal kinase (JNK) signaling pathways were crucial mediators regulating Slp-induced autophagic cell death. Additionally, treatment with Slp resulted in the obvious formation of reactive oxygen species (ROS). SP600125, a JNK inhibitor, and N-acetylcysteine (NAC), a ROS inhibitor, attenuated Slp-induced autophagic cell death in HCT116 cells. Furthermore, NAC was found to prevent Slp-induced p70 and JNK phosphorylation. Taken together, our results suggest a novel mechanism of action of Slp induced autophagy, acting simultaneously through the ROS-mediated mTOR and JNK signaling pathways in HCT116 colon cancer cells.

SummarySensory hair cells in the ear utilize specialized ribbon synapses. These synapses are defined by electron-dense presynaptic structures called ribbons, composed primarily of the structural protein Ribeye. Previous work has shown that voltage-gated influx of Ca2+through CaV1.3 channels is critical for hair-cell synapse function and can impede ribbon formation. We show that in mature zebrafish hair cells, evoked presynaptic-Ca2+influx through CaV1.3 channels initiates mitochondrial-Ca2+(mito-Ca2+) uptake adjacent to ribbons. Block of mito-Ca2+uptake in mature cells depresses presynaptic Ca2+influx and impacts synapse integrity. In developing zebrafish hair cells, mito-Ca2+uptake coincides with spontaneous rises in presynaptic Ca2+influx. Spontaneous mito-Ca2+loading lowers cellular NAD+/NADH redox and downregulates ribbon formation. Direct application of NAD+or NADH increases or decreases ribbon formation respectively, possibly acting through the NAD(H)-binding domain on Ribeye. Our results present a mechanism where presynaptic- and mito-Ca2+couple to confer proper presynaptic function and formation.

SCOPE: Mucus produced by goblet cells contributes to gut barrier function. Lactic acid bacteria (LAB) have been shown to impact mucus production. It is not completely known whether mucus production is influenced by the abundantly present fibroblasts in the intestine.METHODS AND RESULTS: The influence of fibroblasts on mucus-related genes including mucin-2 (MUC2), trefoil factor 3 (TFF3), resistin-like molecule β (RETNLB), carbohydrate sulfotransferase 5 (CHST5), and galactose-3-O-sulfotransferase 2 (GAL3ST2) is examined after co-culture of LS174T-goblet cells and CCD-18Co colonic fibroblasts in the presence and absence of LAB-strains known to impact mucus function. This is also tested after exposure to TNF-α, IL-13, or the mucin synthesis inhibitor tunicamycin (Tm). Effects of fibroblasts are treatment duration- and bacterial species-dependent under homeostatic conditions. During TNF-α challenge, fibroblasts reverse Lactobacillus (L.) rhamnosus CCFM237-elicited declined TFF3 expression. After IL-13 exposure, L. rhamnosus CCFM237 and L. fermentum CCFM787 attenuate enhanced TFF3 and RETNLB expression, respectively, only in the presence of fibroblasts. LAB has no effects on Tm-induced decreased expression of goblet cell-related genes regardless of the presence of fibroblasts.CONCLUSION: It is demonstrated that goblet cell-fibroblast crosstalk impacts mucus synthesis and influences the effects of LAB on goblet cell-related genes. Effects are LAB-species and stressor dependent.

Table S1. Primers for the PCR detection of antimicrobial-resistance determinants used in this study. (PDF 165 kb)

The static magnetic field model of the magnetic grease seal was established by the nonlinear magnetic field finite element method. The influence of three typical pole teeth with different seal gaps, namely rectangular teeth, single-side trapezoid, and symmetrical teeth, on pressure bearing capacity was analyzed. The results show that the maximum pressure bearing capacity of the optimized structure is from large to small: symmetric trapezoid teeth, single-sided trapezoid teeth, rectangular teeth. The seal gap increased by 0.1 mm and pressure bearing capacity decreased by 12 %. If the teeth width was doubled, the pressure bearing capacity can be increased by 17.8%, with an optimum range of 1.8 mm to 2.2 mm. The interval length of the teeth doubled, the pressure bearing capacity increased by 30.65 %, and the optimum range for the interval length of the teeth was 1.8 mm to 2.0 mm. There was no significant correlation between teeth height and pressure bearing capacity. The study on the optimization of the teeth structure based on pressure bearing capacity could provide a reference for technical personnel to improve the efficiency and rationality of the design of the teeth for the sealing of the magnetic grease.

Purpose – This paper aims to introduce a new type of analysis method to seek the actual working performance of the regulatable dry gas seal, including equilibrium film thickness, stiffness-leakage ratio and so on. Additionally, a parametric optimization of the hydrostatic structure is completed for this kind of seal. Design/methodology/approach – From the point of axial force balance based on gas lubrication theory, a new analysis method, the Gas Film Divided Method, has been introduced. A four-factor and three-level hydrostatic structural parameters test scheme is designed by means of Central Composite Design test and then the hydrostatic structural parameters of regulatable dry gas seal were optimized. Three types of regulatable dry gas seal have been designed and manufactured to verify the theoretical analysis by measuring the equilibrium film thickness and inward leakage. Findings – The results indicate that the numerical values of the Gas Film Divided (GFD) method agree well with the experimental ones. Test proves that the Central Composite Design test could achieve optimized hydrostatic structural parameters of regulatable dry gas seal effectively. Research limitations/implications – For validating the correctness of the GFD method, an experiment study of the regulatable dry gas seal is being carried out where atmosphere is selected as the lubricant for the sake of safety. Soon after, the author will discuss the application in the new paper. Originality/value – The introduction of the GFD method proffers important insights to seek the performances of regulatable dry gas seal under the actual working conditions. The detailed optimal values of the hydrostatic structural parameters were given by the theoretical research which may be helpful for the design of regulatable dry gas seal.

Manganese (Mn) is a toxic heavy metal that has a variety of adverse effects on human health under excess exposure. Here, we screened the lactic acid bacteria Lactobacillus plantarum CCFM436, which displayed a good potential Mn adsorption capacity, from 34 isolates via the Mn binding ability, antioxidative activity and tolerance in simulated gastrointestinal solution. The Mn adsorption of L. plantarum CCFM436 was mainly accomplished by extracellular components (extracellular polysaccharides 6.50–7.22%, cell wall 26.87–43.90%, wall-membrane space, and membrane 41.48–47.51%), whereas only 8.12–18.40% of Mn was transferred into intracellular protoplast. Transmission electron microscope observation indicated that more EPS was secreted with higher levels of Mn stress. Fourier transform infrared spectroscopy showed that the carboxyl and amino groups of L. plantarum CCFM436 made the greatest contribution to the Mn adsorption ability. High performance liquid chromatography analysis indicated that the levels of amino acids (aspartic, glutamic, arginine and lysine) rich in amino/carboxyl groups decreased and cysteine increased, further favorable to tolerance the intracellular Mn stress. The manganese transport operon (mntr) and manganese transporters (mnth1/mnt2/mnt3) were identified by PCR-sequencing. Moreover, qRT-PCR analysis proved that MntH 1–3 were the potential Mn importers and negatively regulated by MntR. This study contributes our scientific understanding of the health-benefits of probiotics and provides a new potential reference in food applications against Mn toxicity.

Lactobacillus rhamnosus CCFM1107 was screened for high antioxidative activity from 55 lactobacilli. The present study attempted to explore the protective properties of L. rhamnosus CCFM1107 in alcoholic liver injury. A mouse model was induced by orally feeding alcohol when simultaneously treated with L. rhamnosus CCFM1107, the drug Hu-Gan- Pian (HGP), L. rhamnosus GG (LGG), and L. plantarum CCFM1112 for 3 months. Biochemical analysis was performed for both serum and liver homogenate. Detailed intestinal flora and histological analyses were also carried out. Our results indicated that the administration of L. rhamnosus CCFM1107 significantly inhibited the increase in the levels of serum aminotransferase and endotoxin, as well as the levels of triglyceride (TG) and cholesterol (CHO) in the serum and in the liver. Glutathione (GSH), glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) were elevated while the levels of malondialdehyde (MDA) were decreased. The enteric dysbiosis caused by alcohol was restored by increasing the numbers of both lactobacilli and bifidobacteria and decreasing the numbers of both enterococci and enterobacter. Histological analysis confirmed the protective effect of L. rhamnosus CCFM1107. Compared with the other lactobacilli and to the drug Hu-Gan-Pian, there is a high chance that L. rhamnosus CCFM1107 provides protective effects on alcoholic liver injury by reducing oxidative stress and restoring the intestinal flora.

Allergen-specific immunotherapy (SIT) is considered to be the only curative treatment of allergy, but its safety is always affected by immunologic properties and quality of allergen. Recombinant allergen derivative could be a potential therapeutic strategy, but clinical studies showed that macromolecular derivatives could not avoid T cell-mediated side effects. In this study, five Der p2-derived peptides (DPs) containing major T cell epitopes of Der p2 were first artificially synthesized. Compared with Der p2 macromolecular derivative DM, these DPs not only fully eliminated IgE-binding capacity but also reduced T cells reactivity, suggesting these DPs could be better therapeutic molecules. For their application in vivo, Lactococcus lactis was engineered to express these DPs, and their protective effects were evaluated in BALB/c mice models. Western blot showed that all DPs could be produced in the recombinant strains. Mucosal delivery of these strains could inhibit Der p2-induced allergic responses in Der p2-sensitized mice, characterized by a reduction in specific IgE antibody and lung inflammatory responses. These protective effects were associated with an increase of specific IgG2a in serum and regulatory T cells in the mesenteric lymph nodes. On the whole, the suppressive effect induced by the DP mixture could be better than single DP, but a bit weaker than DM. These DPs could be promising candidate molecules for active vaccination and induction of tolerance, and thus promote the development of non-allergenic peptide in the treatment and prevention of allergy.

Among the beneficial effects of Lactobacillus spp., the common mechanism underlying health protection is believed to be related to antioxidant activity. The antioxidant activities of cell-free suspension (CFS) and strain suspension (SS) of 13 Lactobacillus strains derived from 4 species (L. rhamnosus, L. acidophilus, L. casei, and L. fermenti) were determined. The correlation of CFSs and SSs in different cell lines, as well as the correlation among the three cell models (RAW264.7, Caco-2, and EA.hy926 cell lines), were compared. All CFSs and SSs of lactobacilli showed that they significantly inhibited the production of intracellular reactive oxygen species without creating obvious cytotoxic effects in the three mammal cell lines. These results suggested that RAW264.7, Caco-2, and EA.hy926 cell lines could be used as cell models to assay the cellular antioxidant activity of CFS and SS of lactobacilli. Thus, lactobacilli and by-products are a potential source of natural antioxidants and to reduce oxidative stress.

Aluminium (Al) is the most abundant metal in the earth's crust. Al exposure can cause a variety of adverse physiological effects in humans and animals. Our aim was to demonstrate that specific probiotic bacteria can play a special physiologically functional role in protection against Al toxicity in mice. Thirty strains of lactic acid bacteria (LAB) were tested for their aluminium-binding ability, aluminium tolerance, their antioxidative capacity, and their ability to survive the exposure to artificial gastrointestinal (GI) juices. Lactobacillus plantarum CCFM639 was selected for animal experiments because of its excellent performance in vitro. Forty mice were divided into four groups: control, Al only, Al plus CCFM639, and Al plus deferiprone (DFP). CCFM639 was administered at 10(9) CFU once daily for 10 days, followed by a single oral dose of aluminium chloride hexahydrate at 5.14 mg aluminium (LD50) for each mouse. The results showed that CCFM639 treatment led to a significant reduction in the mortality rates with corresponding decrease in intestinal aluminium absorption and in accumulation of aluminium in the tissues and amelioration of hepatic histopathological damage. This probiotic treatment also resulted in alleviation of hepatic, renal, and cerebral oxidative stress. The treatment of L. plantarum CCFM639 has potential as a therapeutic dietary strategy against acute aluminium toxicity.

Lactobacillus crispatus colonizes the human feces, human vagina, and the crops and ceca of chicken. To explore the genetic characteristics and evolutionary relationships of L. crispatus isolated from different niches, we selected 37 strains isolated from the human vagina (n = 17), human feces (n = 11), and chicken feces (n = 9), and used comparative genomics to explore the genetic information of L. crispatus from the feces and vagina. No significant difference was found in the three sources of genomic features such as genome size, GC content, and number of protein coding sequences (CDS). However, in a phylogenetic tree constructed based on core genes, vagina-derived L. crispatus and feces-derived strains were each clustered separately. Therefore, the niche exerted an important impact on the evolution of L. crispatus. According to gene annotation, the L. crispatus derived from the vagina possessed a high abundance of genes related to acid tolerance, redox reactions, pullulanase, and carbohydrate-binding modules (CBMs). These genes helped L. crispatus to better adapt to the acidic environment of the vagina and obtain more nutrients, maintaining its dominance in the vagina in competition with other strains. In feces-derived bacteria, more genes encoding CRISPR/Cas system, glycoside hydrolases (GHs) family, and tetracycline/lincomycin resistance genes were found to adapt to the complex intestinal environment. This study highlights the evolutionary relationship of L. crispatus strains isolated from the vagina and feces, and the adaptation of L. crispatus to the host environment.

Background The wrist is often severely affected in rheumatoid arthritis (RA) patients; however, little is known about the potential risk factors of the reduced wrist range of motion. In this study, we explored a broad range of possible risk factors of wrist range of motion in RA patients. We also determined whether measurements of wrist range of motion reflect Sharp score for the wrists. Methods Active wrist volar flexion, dorsal flexion, radial deviation and ulnar deviation were assessed using a goniometer. RA patients underwent standardized laboratory and radiographic examinations and completed several questionnaires. A linear regression model was used to study association between the wrist range of motion and independent variables. In addition, Spearman and Pearson correlation analysis were used to compare influence factors and outcome measurements between the measurements of wrist range of motion and Sharp score for the wrists. Results In this study, lower socioeconomic status, longer disease duration, severe pain, higher disease activity and drug treatments were associated with reduced wrist range of motion in RA patients (n = 102, 86.3% female, mean ± SD age, 55.0 ± 11.7 years, and mean ± SD disease duration, 8.4 ± 8.7 years). Furthermore, wrist range of motion was highly correlated with Sharp score for the wrists (P

The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of mindfulness-based stress reduction (MBSR) in breast cancer patients. A systematic search of Cochrane Library, Cochrane Central Register of Controlled Trials, PsycINFO database, Web of science, Medline, EMBASE, CNKI, and CBM database was carried out from February to May 2018, with no language restrictions. Trials examining the effects of MBSR versus control group on symptom variables and health-related quality of life were included. Data concerning studies, patient characteristics, and outcomes were extracted. Methodological quality of each included randomized controlled trials were assessed individually by two reviewers independently using criteria recommended in the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Meanwhile, Newcastle-Ottawa Quality Assessment Scale (NOS) was used to evaluate methodological quality of non-randomized studies. In all, 14 studies involving 1505 participants were included. Due to the effect of MBSR, statistically significant results were found on physiological function (SMD = 0.28, 95% CI [0.07, 0.049], P = 0.008), cognitive function (SMD = 1.48, 95% CI [0.34, 2.61], P = 0.01), fatigue (SMD = − 0.66, 95% CI [− 1.11, − 0.20], P = 0.004), emotional wellbeing (SMD = 1.01, 95% CI [0.35, 1.67], P = 0.003), anxiety (SMD = − 0.54, 95% CI [− 1.01, − 0.07], P = 0.02), depression (SMD = − 0.61, 95% CI [− 1.11, − 0.11], P = 0.02), stress (SMD = − 0.48, 95% CI [− 0.81, − 0.15], P = 0.004), distress (SMD = − 0.56, 95% CI [− 0.85, − 0.26], P = 0.0002) and mindfulness (SMD = 0.94, 95% CI [0.10, 1.79], P = 0.03). Although the effects on pain, sleep quality, and global QoL were in the expected direction, they were not statistically significant (P > 0.05) based on insufficient evidence. MBSR is worthy of being recommended to breast cancer patients as a complementary treatment or adjunctive therapy.

Background Brucellosis is a worldwide zoonotic disease caused by Brucella spp. Brucella invades the body through the skin mucosa, digestive tract, and respiratory tract. However, only a few studies on human spontaneous abortion attributable to Brucella have been reported. In this work, the patient living in Shanxi Province in China who had suffered a spontaneous abortion was underwent pathogen detection and Brucella melitensis biovar 3 was identified. Case presentation The patient in this study was 22 years old. On July 16, 2015, she was admitted to Shanxi Grand Hospital, Shanxi Province, China because of one day of vaginal bleeding and three days of abdominal distension accompanied by fever after five months of amenorrhea. A serum tube agglutination test for brucellosis and blood culture were positive. At the time of discharge, she was prescribed oral doxycycline (100 mg/dose, twice a day) and rifampicin (600 mg/dose, once daily) for 6 weeks as recommended by the World Health Organization (WHO). No recurrence was observed during the six months of follow-up after the cessation of antibiotic treatment. Conclusions This is the first reported case of miscarriage resulting from Brucella melitensis biovar 3 isolated from a pregnant woman who was infected through unpasteurized milk in China. Brucellosis infection was overlooked in the Maternity Hospital because of physician unawareness. Early recognition and prompt treatment of brucellosis infection are crucial for a successful outcome in pregnancy. Electronic supplementary material The online version of this article (10.1186/s40249-018-0411-x) contains supplementary material, which is available to authorized users.

SCOPE: Lactic acid bacteria (LAB) are recognized to promote gastrointestinal health by mechanisms that are not fully understood. LABs might modulate the mucus and thereby enhance intestinal barrier function. Herein, we investigated effects of different LAB strains and species on goblet cell genes involved in mucus synthesis.METHODS AND RESULTS: Gene expression profiles of goblet cell-associated products (mucin MUC2, trefoil factor 3, resistin-like molecule β, carbohydrate sulfotransferase 5, and galactose-3-O-sulfotransferase 2) induced by LAB or their derived conditioned medium in human goblet cell line LS174T were studied. Effects of LAB on gene transcription were assessed with or without exposure to TNF-α, IL-13 or the mucus damaging agent tunicamycin. LAB did impact the related genes in a species and strain specific fashion and their effects were different in the presence of the cytokines and tunicamycin. Bioactive factors secreted by some strains were also found to regulate goblet cell-related genes.CONCLUSION: Our findings provide novel insights in differences in modulatory efficacy on mucus genes between LAB species and strains. This study further unravels direct interactions between LAB and intestinal goblet cells, and highlights the importance of rationally selecting appropriate LAB candidates to achieve specific benefits in the gut. This article is protected by copyright. All rights reserved.

Food allergy is an abnormal immune response to food. The symptoms and signs may range from mild to severe. The prevalence of food allergy is increasing, and consumers are now more aware of allergy and intolerance than ever. This chapter introduces the symptoms and mechanisms of food allergy and the method to prevent food allergy. Lactic acid bacteria, which are widely used in the food industry, have positive effects either on cellular immunity or humoral immunity. This chapter also introduces how mucosal vaccines for food allergy are constructed based on lactic acid bacteria.

Background Gout is a painful, inflammatory disease that may cause decreased function and health-related quality of life (HRQoL). Limited study did not take the influence of gout characteristics and anxiety on HRQoL into consideration and there are no studies associated with functional disability in individuals with gout from China. This study aims to investigate the related factors of functional disability and HRQoL in gout patients recruited from China. Methods A total of 226 consecutive gout patients and 232 age- and gender-matched healthy individuals were involved in the study. A series of questionnaires (the Short Form 36 health survey, the Patient Health Questionnaire, the Generalized Anxiety Disorder questionnaire, the 10 cm Visual Analog Scale, and the Health Assessment Questionnaire-Disability Index) were applied. Blood samples were taken to examine the level of serum uric acid. Independent samples t-tests, Chi square tests, U test, Spearman rank correlation, logistic regression modeling, and linear regression were used to analyze the data. Results After adjusted demographic variables, individuals with gout have poorer HRQoL compared to healthy controls. Univariate tests presented that patients with functional disability had longer disease duration, more frequent flares/last year, more severe total pain, more number of tophi, higher degree of depression and anxiety, with a trend toward diabetes, the treatment of colchicine and corticosteroids use, compared to patients without functional disability. Meanwhile, place of residence, hypertension, DM, disease duration, cardiovascular disease, number of flares/last year, total pain, more number of tophi, presence of tender joints, depression, anxiety, currently using colchicine and corticosteroids were correlated significantly with HRQoL. Additionally, multiple regression analysis identified severe pain, depression, and colchicine use as predictors of functional disability. Cardiovascular disease, total pain, number of flares/last year, presence of tender joints, depression, anxiety, colchicine and corticosteroids use contributed to low HRQoL. Conclusions After adjusted demographic variables, gout subjects have poorer HRQoL compared to healthy controls. Chinese gout population experiencing poor HRQoL and functional disability were likely to suffer from gout-related features and psychological problems. The results underscore the need of effective interventions including psychological nursing and appropriate treatment approaches to reduce their functional disability and improve their HRQoL.

House dust mite allergy accounts for a majority of severe allergic asthma cases, and there is a need for new prevention and treatment strategies. Specific probiotics have shown beneficial effects in the treatment of allergic diseases, owning to their inherent immunomodulatory properties. To obtain new and effective anti-allergy probiotics, cytokine profiles of 25 lactic acid bacteria strains were measured by in vitro co-culture with mice spleen cells. Of the various strains, strong IL-10-inducing Streptococcus thermophilus CCFM218 (ST218) significantly suppressed IL-4 secretion in vitro and was postulated to have a better anti-allergy effect in vivo . To determine the anti-allergy property of ST218, its protective effect on allergic response was evaluated in a mouse allergy model together with Lactobacillus rhamnosus GG. In contrast to LGG, ST218 had a better suppressive effect on allergic response in vivo , characterized by increased specific IgG2a and IL-10 levels in serum, regulatory T cells in the mesenteric lymph nodes and a reduction in serum Th2 cytokine IL-4. It indicated that ST218 was an excellent anti-allergy strain that can be favorable to use in the treatment or prevention of allergic diseases.

Lactobacilli are associated with multiple health-protective effects. One beneficial effect is their antioxidant activity, which needs to be measured using efficient biologically relevant assays. In this study, a cellular antioxidant assay (CAA) was used to determine the cellular anti-oxidative properties of 10 Lactobacillus strains from 5 species (L. rhamnosus, L. plantarum, L. acidophilus, L. casei, L. fermenti) in hepatocellular carcinoma (HepG2) cells and the results were compared with those obtained with the traditional 2,2-diphenylpicrylhydrazyl (DPPH) radical scavenging assay. The results from these two methods showed no obvious correlation at three concentrations (107–109 colony-forming units per mL). A further study was performed to evaluate the protective effects of the strains against H2O2-induced oxidative stress in HepG2 cells and the results showed greater consistency in the data obtained with CAA assay than in those from the DPPH radical scavenging assay. The findings indicate that CAA may be a better choice for the detection of the antioxidant activity of Lactobacillus strains.

Glycine betaine (GB) is one of the most universal osmoprotectants, which is commonly distributed in plant tissues. In natural habitats, GB can be accumulated by some bacteria to against salt stress, but the mechanism of this protective process is still not fully understood. In this study, RNA-seq approach was used to investigate the role of GB in resistance of Lactobacillus plantarum ST-III to salt stress. When L. plantarum ST-III was cultured in a chemically defined medium with 6% NaCl, cell growth was significantly improved by GB. Transcriptomic analyses indicated that, in the presence of GB, the expression level of genes involved in carbohydrate transport and metabolism and ribosomal associated proteins was significantly up-regulated, which might be closely associated with salt stress resistance of L. plantarum ST-III. Fifteen genes were randomly selected and the results showed that the transcription levels of these genes exhibited the same trend with transcriptomic results by RT-qPCR analysis. This study provided a global view of the effect of GB on the ability of L. plantarum ST-III to resist salt stress, and may help us to develop strategies to improve the robustness of industrial production.

In the present study, 78 lactic acid bacteria (LAB) strains were screened for the antagonistic activity against Campylobacter jejuni and 15 LAB strains with high bactericidal capacity were selected for further study through the analysis of the inhibition zone of LAB spent culture supernatant on the growth of C. jejuni. Among these strains, four isolates, Lactobacillus plantarum N8, N9, ZL5 and Lactobacillus casei ZL4 exhibited high adhesion ability to HT-29 cells. All the cell free supernatant (CFS) of these four strains contained high concentration of organic acid and their inhibition effects against C. jejuni were pH sensitive. Furthermore, these four strains could strongly antagonize the adhesion and invasion of C. jejuni to HT-29 cells and showed good tolerance to artificial gastric and small intestinal juices. This study suggests that Lactobacillus strains N8, N9, ZL4 and ZL5 could be used as potential probiotics in food applications against C. jejuni infection.

This study aims to evaluate the prevalence of depression and anxiety and investigate the potential risk factors for depression and anxiety in Chinese gout patients. A self-report survey was administered to 226 gout patients and 232 age- and gender-matched healthy individuals. Patients were asked to complete a set of standardized self-report questionnaires. Univariate and mutiple regression were used to analyze the data. We found 15.0% of gout patients had depression, and 5.3% had anxiety. After adjusted demographic variables, the prevalence of depression was significantly higher than the healthy controls (6.0%). There were significant correlations among education, total pain, disease duration, stage of gout, functional disability, number of tophi, number of flares/last year, presence of tender joints, nephropathy comorbidity, health-related quality of life (HRQoL), and psychological status. Meanwhile, logistic regression analysis identified number of tophi, functional disability, and mental component summary (MCS) as predictors of depression in gout patients. Education and MCS were significantly accounted for anxiety. In summary, the prevalence of depressive symptoms among gout patients was higher than healthy individuals. Education, disability, tophi and HRQoL were important risk factors linked to depression/anxiety in Chinese gout population.

High salt intake has been recognised as a risk factor that contributes to a poor outcome in patients with end stage kidney disease (ESKD). This study examined health beliefs about salt intake among patients undergoing haemodialysis.This was a cross-sectional study using a convenience sample. 307 outpatients completed the health beliefs of sodium intake scale (HBSIS).In this cohort, the score for the perceived self-efficacy subscale (3.59 ± 0.76) was highest, while the score for perceived barriers (2.52 ± 0.67) subscale was lowest. These perceived benefits, susceptibility for the reduction, and no reduction of sodium intake subscale scores were significantly higher in female than in male patients (p 0.05). The scores for the subscale of perceived barriers, and the seriousness for the reduction and no reduction of sodium intake were significantly higher in haemodialysis patients who had been educated above high school compared with patients with middle school education and below (p 0.05). The scores for the subscale of perceived benefits, susceptibility, and self-efficacy for reduction or no reduction of sodium intake were also significantly higher in haemodialysis patients with higher income compared to those with lower income (p 0.05 to p 0.001). The score for the subscale of perceived seriousness for no reduction of sodium intake was significantly higher in patients who had received transplants than in patients who had not received a transplant (p 0.01).Patients undergoing haemodialysis have a low level of health belief about salt intake.

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.

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.

Background Gout is a chronic rheumatic disease caused by deposition of monosodium urate crystals in and around the joint, with a reported prevalence of 1.1% in mainland China and 6.24% in Taiwan, making it the most common form of inflammatory arthritis. With the disease progression, gout can cause permanent joint destruction, bone erosion, and organ damage. Urate-lowering therapy (ULT) is necessary to lower and maintain serum urate (sUA) levels at a therapeutic target of Objectives The current study aimed to investigate knowledge related to gout and it9s risk factors, and the relationship with adherence to urate-lowering therapy in patients with gout in east China. Methods A cross-sectional study of 229 gout patients recruited from the Affiliated Hospital of Nantong University between August 2015 and November 2016 was conducted with two questionnaire, Gout Knowledge Questionnaire (GKQ) and Compliance Questionnaire on Rheumatology (CQR). Chi-square analysis, t-test, rank sum test, as well as logistic regression analysis were used to analyze data. Results 21.5% (49/228) of gout patients in east China had knowledge of gout, and 9.1% (13/143) adhered to ULT. Age, employment, income, alcohol use, family history, acute flares in preceding 1 year, and colchicine use were associated with awareness of gout-related knowledge, and age, income, alcohol use, and colchicine use were the predictors. Among patients with ULT, patients adherent to ULT tended to have gout-related knowledge, compared with non-adherent patients. Awareness of the cause of gout attack, flare prevention induced by ULT and comorbidity were correlated with medication adherence, and the cause of gout attack as well as flare prevention induced by ULT were predictors of adherence to ULT in gout patients in east China. Conclusions In this study, 78.5% of patients in east China didn9t have gout-related knowledge. Patients9 knowledge on gout is a significant independent determinant of adherence to ULT. Acknowledgements This study was supported by grants from the Cultivative Distinguished Young Scholars Project of Nantong University (2nd);the 2015 Graduate Innovation Project of Nantong University (YKC15075); and College graduate research and innovation of Jiangsu Province (KYZZ15–0353). Disclosure of Interest None declared

Background Poor sleep quality is common in patients with chronic diseases and may lead to disease aggravation and decreased quality of life. The increasing prevalence of poor sleep in individuals with chronic medical conditions is associated with adverse demographic, clinical, and psychological characteristics. However, there are currently no known reported studies related to the sleep quality of gout patients. Objectives This study aims to evaluate the prevalence of poor sleep quality and investigate the contributors of poor sleep in Chinese gout patients. Methods A self-report survey was administered to 226 gout patients and 232 healthy individuals using the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the Patient Health Questionnaire (PHQ-9) for depression, and the Generalized Anxiety Disorder (GAD-7) questionnaire for anxiety. Gout patients completed the 10 cm Visual Analog Scale (VAS) for total pain, and the Health Assessment Questionnaire-Disability Index (HAQ-DI) for functional capacity. Blood samples were taken to examine the level of uric acid (UA). Independent samples t-tests, Chi square analyses, and logistic regression were used to analyze the data. Results Our results found that the prevalence of poor sleep (PSQI≥5) was 55.3% and the mean global score of PSQI was 6.69 (SD 3.48) in patients, which were significantly higher than the controls (17.7% and 3.83 (SD 1.88), respectively). There were significant correlations among alcohol use, HAQ-DI, PHQ-9, GAD-7 and sleep quality in gout patients. Patients with yellow rice wine and wine use preferred to have better sleep quality. While, disease stage was associated with hypertension, total pain, number of tophi, presence of tender joints and swollen joints. Meanwhile, logistic regression models identified alcohol use and depression as predictors of poor sleep quality. Conclusions More than half of Chinese gout population suffered from poor sleep, which significantly higher than healthy individuals. These findings suggested medical personnel should pay more attention to the sleep quality of gout patients, especially those with depression. Additionally, it is beneficial for the patients with normal UA level to take moderate yellow rice wine and wine to improve their sleep quality. Acknowledgements This study was supported by Grants from the Chinese National Natural Science Foundation (no. 81671616 and 81471603). Disclosure of Interest None declared

Background Depression and anxiety are common worldwide and may lead to disease aggravation and decreased health-related quality of life (HRQoL). The increasing prevalence of depression and anxiety in gout patients is associated with demographic and gout characteristics. However, there are currently no known reported studies related to the association between HRQoL and depression/anxiety. Objectives This cross-sectional study aims to evaluate the prevalence of depression and anxiety and investigate the potential risk factors for depression and anxiety in Chinese gout patients. Methods A self-report survey was administered to 193 gout patients and 208 healthy individuals from September 2015 to September 2016. Patients were asked to complete a set of standardized self-report questionnaires [Visual Analog Scale (VAS), Health Assessment Questionnaire-Disability Index (HAQ-DI), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7) questionnaire, Short Form 36 health survey (SF-36)]. Independent samples t-tests, χ2 analyses, and logistic regression were used to analyze the data. Results We found 15% of gout patients had depression, and 5.2% had anxiety, which were significantly higher than the healthy controls (1.4 and 1.0%, respectively). There were significant correlations among education, pain, disease duration, stage of gout, disability, number of tophi, presence of tender joints, HRQoL, and psychological status. Meanwhile, logistic regression analysis identified number of tophi, HAQ-DI, and MH scale as predictors of depression in gout patients. Education, GH, and VT domains were significantly accounted for anxiety. Conclusions The prevalence of depressive and anxious symptoms among gout patients was higher than healthy individuals. Education, disability, tophi and HRQoL were important risk factors linked to this disorder in Chinese gout population. These findings suggested medical personnel should pay more attention to the psychological health of gout patients and make objective interventions to relieve their depression and anxiety, especially those with low education level, more than two tophi, severe disability, and poor HRQoL. Acknowledgements This study was supported by Grants from the Chinese National Natural Science Foundation (no. 81671616 and 81471603). Disclosure of Interest None declared

Background As the most common arthritis in adults, gout is a painful, inflammatory disease that may cause functional disability and decreased health-related quality of life (HRQoL). However, there are currently no known reported studies related to functional disability and HRQoL of gout patients from China. Objectives This cross-sectional study aims to investigate the effect of demographic variables, disease parameters, and psychological status on functional disability and HRQoL of Chinese gout patients. Methods A self-report survey was administered to 226 gout patients and 232 healthy individuals using the Short Form 36 health survey (SF-36) for HRQoL and the Health Assessment Questionnaire-Disability Index (HAQ-DI) for functional disability. Gout patients were asked to complete the 10 cm Visual Analog Scale (VAS) for total pain, the Patient Health Questionnaire (PHQ-9) for depression, and the Generalized Anxiety Disorder (GAD-7) questionnaire for anxiety. Blood samples were taken to examine the level of uric acid (UA). Independent samples t-tests, Chi square tests, spearman and/or pearson correlation and multiple linear regression were used to analyze the data. Results Our results found that individuals with gout have poorer HRQoL compared to healthy controls and the mean disability score was 0.32 (SD 0.54), representing mild disability. SF-36 and almost all components of the SF-36 score were associated with place of residence, hypertension, DM, cardiovascular disease, disease duration, number of flares/last year, total pain, number of tophi, presence of tender joints, colchicines use, corticosteroids use, depression, and anxiety (p Conclusions Chinese gout patients experienced mild disability and poor HRQoL. Disease status and psychological status were important risk factors linked to functional disability and HRQoL in Chinese gout population. These data suggest medical personnel should pay more attention to functional disability and HRQoL of gout patients and make suitable interventions to relieve their psychological disorders and finally to reduce their functional ability and improve their HRQoL. Acknowledgements This study was supported by Grants from the Chinese National Natural Science Foundation (no. 81671616 and 81471603). Disclosure of Interest None declared

Background Gout, which is characterised by deposition of monosodium urate monohydrate (MSU) in synovial fluid and other tissues, is the most common form of inflammatory arthritis in man and older women. In addition to recurrent acute arthritis, subcutaneous tophi and chronic painful arthritis, gout also affects morbidity and premature mortality. Previous studies have reported that effective ULT can decrease sUA levels enough to prevent further crystal formation, dissolve existing urate crystals and eliminate the causative agent, thus reducing the frequency of acute gout attacks and preventing urate nephropathy, uric acid nephrolithiasis, and the deposition of tophi: a common cause of progressive joint damage, deformity and functional impairment, making gout the only chronic arthritis that can be “cured”. However, gout patents9 adherence rate to ULT is low, ranged from 10 to 46%. Emerging data suggest that poor adherence to long-term ULT use may be an important contributor to the suboptimal outcomes seen in gout and nonadherence may be worse in gout than in any other chronic disease. This suggests that there is a strong need to make a further study on drug adherence and its risk factors. Objectives Non-adherence in gout patients using urate-lowering therapy (ULT) may lead to joint destruction and permanent disability. Purpose of this cross-section survey was to explore Chinese gout patients9 adherence rates and investigate potential risk factors for medication non-adherence. Methods A total of 129 gout patients were recruited from the Affiliated Hospital of Nantong University from August 2015 to September 2016. Patients were asked to complete a standardized self-report questionnaires (Compliance Questionnaire on Rheumatology, Treatment Satisfaction Questionnaire for Medication version II, Health Assessment Questionnaire, Confidence in gout treatment questionnaire, Gout Knowledge Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and 36-Item Short Form Health Survey). Data was analyzed by independent sample t-test, rank sum test, chi-square analysis as well as logistic regression modeling. Results Based on CQR, 9.6% of gout patients were adherent to ULT. Adherence was associated with HAQ, GKQ, treatment satisfaction for medication, confidence in gout treatment and MCS. Other demographic, clinical and psychological characteristics were not related to adherence. Logistic regression models identified HAQ, GKQ and MCS as predictors of medication non-adherence. Conclusions In the current study, 90.4% of gout patients didn9t adhere to their ULT prescription. HAQ, GKQ, treatment satisfaction for medication, confidence in gout treatment and MCS were relevant to medication adherence, and HAQ, GKQ and MCS were independent predictors of medication non-adherence in patients with gout. These findings could help medical personnel develop useful interventions to improve gout patients9 medication adherence and quality of life. Acknowledgements This study was supported by grants from the Cultivative Distinguished Young Scholars Project of Nantong University (2nd); the 2015 Graduate Innovation Project of Nantong University (YKC15075); and College graduate research and innovation of Jiangsu Province (KYZZ15–0353). Disclosure of Interest None declared

Background There have been no previous report of hand joint destruction prevalence in Chinese rheumatoid arthritis (RA) patients. Therefore, the aim of this study was to investigate the prevalence and potential factors of hand joint destruction among RA patients from Nantong China. In addition, we wanted to examine the differences between functional capacity, psychological status, and quality of life in patients with hand joint destruction compared to those without hand joint destruction. Methods A cross-sectional study was conducted from the Affiliated Hospital of Nantong University between July 2015 and June 2016. RA patients completed questionnaires for demographic or clinical variables, the 10-cm Visual Analog Scale for pain, the 28-joint Disease Activity Score-erythrocyte sedimentation rate for disease activity, the Health Assessment Questionnaire-disability index for physical function, the Hospital Anxiety and Depression Scale for anxiety and depression, and the Short Form 36 health survey for quality of life. Laboratory examinations were taken to obtain some biochemical indicators (e.g., rheumatoid factor, anti-cyclic citrullinated peptide antibody). X-ray assessment of hand was performed and hand joint destruction was defined as Sharp score > 0. 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. Results One hundred and sixty-one RA patients were included in this study. Radiographic findings revealed that almost 47.2% (n = 76) of patients had hand joint destruction. Multivariate analysis found that education ≤ 9 years (p = 0.041), anti-cyclic citrullinated peptide antibody positive (p = 0.021), high disease activity (p = 0.020), and long disease duration (p

Summaries of symptom thresholds required for diagnosis of depression/anxiety. (DOCX 19 kb)

The list of 59 studies included in the meta-analysis. (DOCX 19 kb)

Quality Assessment. (DOCX 19 kb)

Assessment of Publication Bias. (DOCX 56 kb)

The aim of this study was to evaluate the antidiabetic effects of Lactobacillus casei CCFM0412 on mice with type 2 diabetes induced by a high-fat diet and streptozotocin.Thirty-two male C57 BL/6 J mice were assigned to four groups in this study. Type 2 diabetes was induced by feeding of a high-fat diet and injection of streptozotocin. L. casei CCFM0412 was administered to mice at a dose of 10(9) cfu/d per mouse for 12 wk. Body weight, fasting and postprandial 2-h blood glucose, oral glucose tolerance, glycosylated hemoglobin, insulin, and glycogen in liver were measured. Endotoxin, tumor necrosis factor-α, and interleukin-10 levels were determined. Lipid metabolic parameters including triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were also measured. The activities of glutathione peroxides, reactive oxygen species, and superoxide dismutase, and the levels of glutathione and malondialdehyde in the liver also were determined. Pancreas injury was evaluated by histologic analysis.At 13 wk, L. casei CCFM0412 significantly decreased fasting and postprandial 2-h blood glucose, glycosylated hemoglobin, endotoxin, tumor necrosis factor-α, triglycerides, total cholesterol, low-density lipoprotein cholesterol, reactive oxygen species, and malondialdehyde levels compared with the control group (P 0.05). The values for insulin, interleukin-10, high-density lipoprotein cholesterol, glutathione peroxides, superoxide dismutase, glutathione, and glycogen were significantly increased at 13 wk (P 0.05). Islets of Langerhans in the L. casei CCFM0412 group were substantially protected from destruction compared with those in the control group.L. casei CCFM0412 significantly improved glucose intolerance, dyslipidemia, immune-regulatory properties, and oxidative stress in mice with type 2 diabetes induced by a high-fat diet and streptozotocin. The results provide a sound rationale for future clinical trials of oral administration of L. casei CCFM0412 for the primary prevention of type 2 diabetes.