Background: There is no gold standard for the diagnosis and monitoring of inflammatory bowel disease (IBD).As immune system plays crucial role in the pathogenesis of IBD,some immune-specific serum antibodies are considered to be useful tools for the diagnosis and differential diagnosis of the disease.Aims: To investigate the clinical significance of serum antibodies,including anti-Saccharomyces cerevisiae antibody (ASCA) and perinuclear anti-neutrophil cytoplasmic antibody (pANCA) in IBD.Methods: Serum samples were obtained from 91 consecutive IBD patients from Feb.2015 to May 2016 at the First Affiliated Hospital of Soochow University.Of them,52 were Crohn's disease (CD) and 39 were ulcerative colitis (UC).Serum samples of 36 non-IBD patients were served as controls.ASCA-IgG and ASCA-IgA were detected by ELISA,and pANCA by indirect immunofluorescence assay.Using clinical diagnosis as gold standard,crosstabs statistics was performed to measure the diagnostic accuracy of ASCA and pANCA,and ROC curve,Pearson Chi-square test and Fisher's exact test were employed for analyzing the correlations of these two serum antibodies with IBD,CD,UC,and the location of the disease.Results: Both serum ASCA-IgG and IgA were correlated with CD (AUC=0.626 and 0.614),while UC was correlated with ASCA-IgA only (AUC=0.486).Serum pANCA had relevance to IBD (r=0.342),CD (r=-0.262) and UC (r=0.614);its sensitivity and specificity for IBD and UC were superior to those for CD (P＜0.05).In CD patients,ASCA-IgG was associated with terminal ileal disease (P＜0.05),and pANCA was associated with colonic involvement (P＜0.05).In UC patients,both ASCA-IgG and IgA were correlated with terminal ileal disease (P＜0.05).Conclusions: Serum ASCA and pANCA may be helpful for discrimination between CD and UC when the diagnosis of IBD is established.Furthermore,they are closely associated with the disease location,ASCA is related with the terminal ileal disease and pANCA is related with colonic involvement.

Objective To investigate the levels of 14 kinds of food allergic specific IgG antibody in eczema and chronic urticaria patients'serum and the role of food allergens in allergic skin diseases and provide scientific basis for clinical treatment and prophylaxis. Methods We used ELISA method to detect the concentration of 14 kinds of food allergic specific IgG antibody in the serum of 900 eczema and chronic urticaria patients and 18 healthy people. Results The food allergen of positive rate in studied group and control group was 90.2% and 11.1%. The positive rate of 14 kinds of food allergic specific IgG antibody in 900 eczema and chronic urticaria patients' serum from high to low was eggs, wheat, shrimp, milk, soja,crab, rice, corn, tomato, chicken, mushroom, beef, pork and ling. The food allergen positive rate in eczema and chronic urticaria patients'serum was 91.9% and 88. 9% ( P >0. 05). The positive rate of shrimp,mushroom and ling in eczema patients'serum was higher than that in chronic urticaria patients'serum ( P <0. 05 ). The positive rate in children's group was 96. 6%, which was higher than other age groups ( P >0. 05 ). The main allergens were egg, wheat and milk in children's group. The sensitization of crab and shrimp increased as people grew up. In 812 positive patients, who were intolerant of three and more than three foods accounted for 53.7%. In 175 follow-up patients, the effective rate was 50.9% in 20 days and 61.1% in 60 days after they avoided the intolerant food. The patients'diet was adjusted according to the test results.In 325 follow-up patients, the effective rate in eczema group was 59.9% in 20 days and 70. 4% in 60 days ( P <0. 05). Thee effective rate in chronic urticaria group was 65.6% in 20 days and 77. 3% in 60 days ( P <0.05 ). Conclusion The intolerant food can be found by detecting serum food allergen specific IgG.It can be used to adjust the diet and relieve the symptom, which is of great importance for preventing and treating allergic skin diseases.

Objective To observe the effects of lα-hydroxyvitamin D3 on renal tubular function in the patients with IgA ne phropathy(IgAN) accompanied with proteinuria.Methods Forty-eight eligible patients with IgAN were selected as the IgAN group and divided into the treatment group and control group according to the random number table method,meanwhile 30 healthy adults undergoing healthy physical examination were selected as the normal group.On the routine treatment such as maintaining the double dose of renin-angiotensin system(RAS) blocker,the treatment group took oral l α-hydroxyvitamin D3 capsule (0.5 μg,once a day);the control group continued to adopt the original treatment scheme.The treatment course lasted for 12 weeks.The changes of urinary cystatin C(Cys-C),α1-microglobulin(α1-MG),N-acetyl-β-D-glucosaminidase (NAG),24 h urinary total protein (UTP),blood urea nitrogen (BUN),serum creatinine (Scr),serum calcium (Ca),serum phosphorus (P) and intact parathyroid hormone (iPTH) in two groups were respectively compared between before and after treatment.Results Compared with the normal group,urinary Cys-C,αl-MG and NAG levels in the IgAN group were significantly increased (P＜ 0.01).After 12-week treatment,the levels of Cys-C,α1-MG and NAG were obviously declined compared with that before treatment and in the control group,the differences were statistically significant (P＜ 0.05),meanwhile the UTP level had statistical difference between the two groups after treatment and between before and after treatment in the same group (P＜0.05),but the decrease in the treatment group was more significant than that in the control group(P＜0.05).There was no statistically significant difference in BUN,Scr,Ca,P and iPTH between the two groups before and after treatment(P＞0.05).Conclusion There exists tubulointerstitial injury in IgAN with proteinuria.1α-hydroxyvitamin D3 can significantly decrease urine protein and improves the renal tubular function in the patients with IgAN.

Objective To investigate relationships between signal/cutoff (S/CO) ratios of antiHCV recombinant immunoblot assay (RIBA) and their positivity with different chemiluminescence immunoassay(CLIA) reagents.Methods A case-control study was performed.From March 2014 to March 2015,anti-HCV antibody was detected in 2 616 serum of outpatients and inpatients coming from Department of Clinical Laboratory,Qilu Hospital of Shandong University by three kinds of homemade CLIA reagents and one imported CLIA reagents.The positive samples were further tested by RIBA.The correlation between the positivity and the S/CO ratios was analyzed.The difference between different reagents were compared by x2 method.Results The predicted positivities of Shandong Laibo were 97.8％ and 33.3％ with S/CO ratio ≥ 26.8 and 1 to 26.8,respectively;The predicted positivities of Beijing Yuande were 96.7％ and 20％ with S/CO ratio ≥ 16.6 and 1 to 16.6,respectively;The predicted positivities of Beijing Kemei were 97.0％ and 9.8％ with S/CO ratio ≥ 16.7 and 1 to16.7,respectively;The predicted positivities of Abbott were 96.9％ and 12.8％ with S/CO ratio≥5 and 1 to 5,respectively.Conclusions Anti-HCV CLIA S/CO ratio and RIBA confirmatory test results have some relevance.Domestic reagents also can refer to import reagents determine the relationship between the positivity and the S/CO ratio.Different domestic reagent of positivity has different S/CO ratio.Although each reagent S/CO ratio to the same positivity has large difference,suggesting each manufacturer should set their products corresponding values according to the situation,providing reference for the clinical use of unit in result determination of the clinical trials.

Objective To investigate the therapeutic value of enteral nutrition in disease activity, nutritional status and complications of patients with Crohn's disease (CD).Methods From January 2015 to February 2017,64 CD patients with malnutrition in the First Affiliated Hospital of Soochow University were selected and received basic treatment with enteral nutrition.Before enteral nutrition and three months after therapy,white blood cell (WBC),red blood cell (RBC),hemoglobin,platelet,total protein,albumin,erythrocyte sedimentation rate (ESR)and C-reaction protein (CRP)were examined;Crohn's disease activity index (CDAI)was calculated;abdominal and perianorectal lesions of patients were observed by small intestinal computed tomography (CT ), abdominal ultrasound and anus magnetic resonance imaging (MRI).Paired t test and McNemar test were performed for statistical analysis.Results Compared with those before enteral nutrition treatment,who received enteral nutrition for three months, the levels of WBC,platelet,ESR,CRP and CDAI scores of CD patients were lowered ((7.83±3.61)× 109/L vs.(4.82±2.26)×109/L,(272.52±191.79)×109/L vs.(166.17±67.18)×109/L,33.5 mm/1 h vs.5.5 mm/1 h,21.70 mg/L vs.1.97 mg/L,220.75±119.71 vs.33.48 ±20.22),and the differences were statistically significant (t＝13.14 and 10.02;Z＝501.50 and 57.80;t＝25.44,all P＜0.01).The levels of RBC,hemoglobin,total protein,albumin increased ((4.17 ±0.97)×1012/L vs. (4.97±0.98)×1012/L,(115.33±40.38)g/L vs.(133.88±43.87)g/L,(57.82±19.46)g/L vs. (69.68±16.53)g/L,(34.32 ±16.85)g/L vs.(43.29 ±17.57)g/L),and the differences were statistically significant (t＝-10.45,-7.12,-11.44 and -6.87,all P＜0.01).The CDAI scores of patients with remission of abdominal pelvic diseases and intestinal stenosis were both lower than those of patients without remission (214.3±113.54 vs.296.77±60.24,219.31±104.74 vs.221.04±121.47), and the differences were statistically significant (both t＝28.91,both P＜0.05).Three months after enteral nutrition treatment,the remission patients of perianal lesions,abdominal pelvic diseases and intestinal stenosis were 28,14 and 18 cases,respectively.Conclusion CD patients can achieve clinical remission with enteral nutrition treatment,which also prevent and treat CD related malnutrition and may prove to be a safe and first-line therapeutic approach.

Hepatitis C is distributed worldwide and possesses a hidden characteristic. The traditional methods of screening and diagnosis of hepatitis C infection commonly used in clinics are based on anti-HCV antibody and HCV RNA detection. Advances in HCV antigen detection technologies can apparently reduce the window period for anti-HCV antibodies, providing new clinical evidence for the early detection, diagnosis, and treatment of HCV infection. This article is a current review of HCV antigen detection methodologies, clinical applications, and detection strategies.

Objective:To investigate the genetic risk factors and prognosis of 190 patients with myelodysplastic syndrome(MDS). Methods:The clinical data of 190 patients with MDS admitted to the Department of Hematology,The First Affiliated Hospital of Chongqing Medical University from January 2015 to October 2020 were analyzed retrospectively,and the genetic background and survival curve of the patients were also analyzed. Results:MDS patients with higher risk according to International Prognostic Score System(IPSS)stratification at the time of initial diagnosis had more frequent and complex types of gene mutation and chromosomal abnormalities,indicating poor prognosis.The choice of treatment is associated with the prognosis of MDS patients with intermediate risk(IPSS stratification),and the relative risk of the overall survival rate of patients treated with hypomethylating agents is higher than that of patients on concomitant medication. Conclusion:MDS patients with higher-risk(IPSS stratification)have more complex genetic risk factors and lower survival rate than those with lower-risk(IPSS stratification).MDS patients with multiple genetic risk factors have a poor prognosis,and the type of gene mutation is a predictor of prognosis.