Objective To evaluate the clinical application of serum pyridinoline cross-linked carboxy-terminal telopeptide of type Ⅰ collagen(ⅠCTP),anti-cyclic citrullinated peptide(CCP)antibody,rheumatoid factor(RF)and C-reative protein(CRP)detection to the diagnosis and disease monitor of rheumatoid arthritis.Methods Serum ⅠCTP and anti-CCP antibody were measured by ELISA,RF and CRP by immunonephelometry assay in 57 patients with RA and 25 with non-RA as well as 30 normal controls.Results Serum ⅠCTP concentration was positively correlated with that of anti-CCP antibody,RF and CRP(rs=0.474,0.366,0.645,P0.05).Serum ⅠCTP in the patients with active RA was significantly higher than in those with stable RA and normal controls(P0.05).The combined sensitivity of RF and anti-CCP antibody was 87.5%.Conclusion Serum ⅠCTP is a sensitive serum marker to monitor the early damage of arthrosis.Missed diagnosis rate of RA is reduced by detecting anti-CCP antibody and RF together.Combinational monitoring the variance of serum ⅠCTP,anti-CCP antibody,RF and CRP could effectively monitor the disease development in time,which exhibits great sense on impede arthrosis damage.

Objective To investigate the expression of T cell immunoreceptor with Ig and immunoreceptor tyrosine-based inhibitory domains (TIGIT) on peripheral CD4+ T and CD8+ T cells from patients with rheumatoid arthritis (RA) and its significance in order to clarify its role in the development of RA.Methods Peripheral blood samples were collected from 81 patients with RA and 33 healthy controls (HC).Expression of TIGIT on the surface of peripheral blood leukocytes was detected by flow cytometry.Differences in TIGIT expression between RA and HC groups were comparatively analyzed.Correlations of TIGIT expression on CD4+ T and CD8+ T cells with several laboratory indexes were analyzed.All data were statistically analyzed.Results (1) The percentage of TIGIT-expressing CD3+ T cells in patients with RA was significantly higher than that in HC (P<0.01).Moreover, the median fluorescence intensity (MFI) of TIGIT on CD3+ T cells was significantly elevated in patients with RA as compared with that in HC (P<0.01).No significant difference in the expression of TIGIT on B cells, monocytes or neutrophils was observed between RA and HC groups.(2) The percentages of TIGIT-expressing CD4+ T and CD8+ T cells were significantly elevated in patients with RA as compared with those in HC (P<0.01).Moreover, the MFI of TIGIT on CD4+ T and CD8+ T cells were significantly elevated in patients with RA as compared with those in HC (P<0.01).(3) The percentages of both TIGIT-expressing CD4+ T cells and TIGIT-expressing CD8+ T cells in patients with RA were positively correlated with erythrocyte sedimentation rate (ESR) (rs=0.355, P<0.01;rs=0.277, P=0.013).(4) The percentages of both TIGIT-expressing CD4+ T cells and TIGIT-expressing CD8+ T cells in patients with RA were positively correlated with rheumatoid factor (RF) (rs=0.265, P=0.017;rs=0.366, P<0.01).The MFI of TIGIT on CD4+ T cells was positively correlated with RF in RA group (rs=0.226, P=0.043).The percentage of TIGIT-expressing CD4+ T cells was positively correlated with anti-cyclic citrullinated peptide (anti-CCP) antibody in patients with RA who were positive for anti-CCP antibody (rs=0.324, P=0.012).(5) The percentage of TIGIT-expressing CD4+ T cells as well as the MFI of TIGIT on CD4+ T cells in patients with RA was positively correlated with Disease Activity Score-28 (DAS28) (r=0.232, P=0.038;r=0.343, P<0.010).Conclusion The expression of TIGIT on T cells is elevated in patients with RA and correlated with inflammatory markers, antibody production and disease activity.

Objective To explore the application effect of "world cafe" mode in the summary of nursing quality.MethodsFrom September 2015 to December 2015,the nursing department discussed the topics of nursing quality summary according to the "world cafe" mode,finally the duration of nursing quality discussion, the structural proportion of participants and the satisfaction of all participants were taken as observation indexes to compare with the traditional nursing quality review meeting held during March to June 2015. According to the "world cafe" mode, the discussion table of nursing summary was established nursing quality,the contents of nursing quality discussion were standardized,and participants of the seminar and the time were made. ResultsAfter the application of "world cafe" mode,the total conference time shortened to 1.5 h from 3 h before the application,and the repeat situation of participants′ statement and the rectification views were obviously improved (χ2=34.737,5.963;P<0.05). After the application of "world cafe" mode,participants were mainly clinical nurses,which accounted for 53.4%,and the structural situation of participants was significantly different (χ2=27.086,P<0.05). There were significant differences in satisfaction before and after the application of "world cafe" mode (χ2=4.706,P=0.03).ConclusionsThe application of "world cafe" mode fully shows the divergent thinking of clinical nurses,and embodies the idea of improving nursing quality of nurses at different levels,which can discover the key problem of nursing quality,provide practical measures for the improvement of nursing quality in next stage,set stage for the implementation of nursing work,shorten the conference time and improve the work efficiency and satisfaction of nurses. This method will have broad research and application prospect as a means to improve the nursing quality.