As one of active immune effector molecules,immunoglobulins play an important role in the pathogenesis,diagnosis and treatment of autoimmune bullous diseases.Human immunoglobulins can be divided into 5 categories,including IgG,IgA,IgM,IgD and IgE,and all of them participate in and play different roles in the pathogenesis of autoimmune bullous diseases except IgD.IgG can induce the formation of blisters by activating complements and leukocytes as well as by releasing proteolytic enzymes,and different subtypes of IgG differ in biological activities.IgA can cause granulocyte migration and lead to the formation of blisters and pustules.IgE is associated with urticaria-like erythema and eosinophil infiltration.IgM is usually seen in Brazilian pemphigus foliaceus.These findings may provide new ideas for the diagnosis and treatment of autoimmune bullous diseases.

Inherited epidermolysis bullosa (EB) is a group of hereditary skin diseases characterized by increases in skin brittleness and being prone to skin blisters or erosions when the skin is exposed to slight friction or injury. At present, it is classified into four types, namely EB simplex, junctional EB, dystrophic EB and Kindler syndrome. An onion skinning approach is recommended for the diagnosis of inherited epedermolysis bullosa, in which, immunofluorescence mapping is performed firstly, and causative genetic loci are then determined through detection of relevant genes. In its treatment, skin care should be intensified, and medical or surgical treatment may be used to alleviate symptoms. Further development of cell?, protein?and gene?based therapies is expected to bring hope to patients via realization of timely prenatal diagnosis and avoidance of adverse consequences.

Objective To assess the changes of serum levels of interleukin-6(IL-6) and interleukin-8 (IL-8) in pregnant women with stationary phase systemic lupus erythematosus (SLE). Methods Enzyme-linked immunosorbent assay (ELISA) was used to measure serum IL-6 and IL-8 from 14 pregnant women with stationary phase SLE (SLE group), 12 normal pregnant women (normal pregnant group) and 12 normal non-pregnant women (group normal non-pregnant). The later two groups are set as controls. Results The IL-6, IL-8 levels in group SLE patients are (20.31?5.70) ng/L and (48.80?9.17) ng/L, significantly higher than those in normal pregnant group [IL-6, IL-8 levels are (8.40?2.49) ng/L and (21.15?5.21) ng/L, respectively, P 0.05). Conclusion Serum levels of IL-6, IL-8 may be helpful to monitor the progress of SLE during pregnancy.

Objective To investigate the potential relationship between the characteristics of atherosclerotic plaque of carotid artery and cardiovascular events in a senior cohort of Renqiu region,Hebei.Methods A random cluster sampling method was used to identify study population among 60 -70 years old residence in Renqiu region, Hebei.In the face of health questionnaire survey,neck vascular ultrasound examination,a total of 4 413 cases,inclu-ding 1 876 males and 2 537 females,the occurrence of carotid artery plaque and stenosis were detected by ultrasound. Carotid ultrasound was used to identify the characteristic of atherosclerotic plaque of bilateral carotid arteries,which were categorized as with and without plaque,single and multiple plaque,homogenous and heterogeneous plaque,and with and without stenosis.Cardiovascular events were defined as composite events of myocardial infarction,cardiovas-cular death,fatal or non -fatal stroke during the subsequent 2 years follow -up after initial evaluation.Multiple Logis-tic regression was performed to identify the association between the characteristics of bilateral carotid arteries and cardiovascular events.Results A total of 4 413 case enrolled in the study.With carotid ultrasound,2 438 cases (55.2%)were found to be with atherosclerotic plaque formation and 235(5.3%)were with carotid artery stenosis. The proportion of single,multiple,homogeneous and heterogeneous plaques were 1 024cases(23.2%),1 114cases (32.0%),1 106cases(25.1%)and 1 333cases(30.2%),respectively.Among them,the single plaque and new cardiovascular and cerebrovascular events occured in 83 cases(P =0.168),the multiple plaques and new cardiovascular and cerebrovascular events occured in 161 cases(P <0.001 ),the homogeneous patch and new cerebral vascular events occured in 98 cases(P =0.032),the non -homogeneous patch and new cerebral vascular events occured in 146 cases(P <0.001),the stenosis and cerebral vascular events occured in 42 cases(P <0.001).Taken the new onset cardiovascular and cerebrovascular events as dependent variable,the single factor analysis showed that the carotid plaques(χ2 =14.969,P <0.001 ),and the multiple plaque(χ2 =22.509,P <0.001 ),the carotid artery stenosis (χ2 =27.561,P <0.001),the homogeneous plaque(χ2 =4.606,P <0.050),the non -homogeneous plaque(χ2 =18.301,P <0.001),the history of hypertension(χ2 =33.709,P <0.001),the high blood fat disease(χ2 =11.262, P <0.001),and the history of diabetes(χ2 =5.525,P <0.050),the coronary heart disease history(χ2 =10.440, P <0.001),the gender(χ2 =5.606,P <0.050),the smoking(χ2 =4.823,P <0.050)and the systolic blood pressure value,were all associated with the new cardio cerebral vascular events.Multivariate analysis showed that,the heterogeneous plaque(β=0.371,P <0.050),the carotid artery stenosis(β=0.621,P <0.050),the history of hypertension(β=0.517,P <0.001)and smoking(β=0.264,P <0.050)were shown to be significantly associates with new onset cardiovascular events.Conclusion The characteristics of atherosclerotic plaque of carotid artery were significantly associated with the subsequent cardiovascular events among 60 -70 years old residence in Renqiu region,Hebei.Routine carotid ultrasound screening might be useful for identify those people with high risk of develo-ping cardiovascular events.

Objective To investigate the clinical diagnosis value of interferon gamma release assay (IGRA ) for pleural effusion in patients with tuberculous pleurisy .Methods 68 patients with tuberculous pleurisy (tu-berculous group) were included as object of study in Ganzi state people′s hospital ,and selected 70 patients with pneumonic pleurisy(pneumonia group) and 70 patients with malignancy (malignant group) as controls . Enzyme linked immunosorbent assay (ELISA) was used to detect interferon gamma release assay for tubercu-losis infected T cells (TB-IGRA ) in pleural effusion ,and were in progress blood TB-IGRA for tuberculous group .Results The IFN-γ level of patients in tuberculous group[179 .3(158 .1 -276 .2)ng/L] was higher than that those in pneumonia group[86 .7(55 .1 -162 .2)ng/L] and malignant group[92 .7(48 .1 -178 .3) ng/L] ,the difference was statistically significant (P＜0 .05) .The IFN-γ level of TB-IGRA for blood was low-er than that TB-IGRA for pleural effusion ,the difference was statistically significant (P＝0 .012) .The sensi-tivity ,specificity ,positive predictive value ,and negative predictive value of TB-IGRA for pleural effusion high-er than that blood TB-IGRA ,the difference was statistically significant (P＜0 .05) .The AUC of TB-IGRA for pleural effusion was higher than that blood TB-IGRA .Conclusion TB-IGRA for pleural effusion is an impor-tant laboratory index for the diagnosis of tuberculous pleurisy ,and its diagnostic efficiency is higher than that of blood TB-IGRA .

Objective To study the relationship between metabolic syndrome (MS) and anterior circulation infarction (ACI). Methods 271 ACI patients (166 men and 105 women) who fulfilled the diagnostic criteria of China Guideline for Cerebrovascular Disease Prevention and Treatment were enrolled. 147 control subjects (67 men and 80 women) without the clinical signs of cerebral infarction but with detailed case history, physical examination and CT or MRI were also selected. The prevalence and risk of MS were observed in the ACI and control group. MS was defined with the modified criteria in Chinese. Results The prevalence of MS in the ACI group and control subjects was respectively 43.17% and 19.05%. The prevalence of MS was significantly higher in the ACI group as compared with the control subjects (P<0.01). The component level of MS were significandy different between the two groups (P< 0.05). MS was associated with a 3.7 fold higher risk of ACI (P<0.01). Conclusions There is a close relationship between MS and ACI. MS is an important risk factor of ACI.

Objective To investigate the hyperuricemia(HUA)and the correlation of blood lipids of the 60 -70years peple in Renqiu area,and to provide the basis for guiding prevention and treatment of the elderly disease the region.Methods According to the cluster random sampling method,Renqiu permanent residents with the age of 60 to 70 years were selected as a screening object.In the total 5 010 cases screened object,2 163 were male(43.2%),2 847 were female(56.8%),with an average age of(64.29 ±3.05)years.The data of blood uric acid and total cholesterol(TC), triglyceride(TG),high -density lipoprotein(HDL -C),low -density lipoprotein(LDL -C)were collected.The rela-tionship between blood uric acid and blood lipids were analyzed.Logistic regression method was used to analysis the relationship between the hyperuricemia and lipids components.Results The overall prevalence of hyperuricemia in Renqiu was 6.1%(9.8% in male,3.2% in female).In men HUA group,the levels of blood uric acid,TG and LDL-L were 464.10(438.00 -508.65)μmol/L,1.54(1.00 -2.19)mmol/Land 2.66(2.25 -3.22)mmol/L,which were higher than those of normal uric acid group of 294.00(249.90 -338.08)μmol/L,1.13(0.84 -1.65)mmol/L and 2.57(2.12 -3.01)mmol/L(P <0.05).In women HUA group,the levels of blood uric acid,TG and LDL -L were 454.15(434.15 -480.78)μmol/L,2.14(1.47 -3.18)mmol/L and 2.96(2.52 -3.76)mmol/L,which were higher than those of normal uric acid group of 250.80(209.00 -299.80)μmol/L,1.53(1.10 -2.20)mmol/L and 2.87(2.40 -3.33)mmol/L(P <0.05).Logistic multi -factor regression analysis showed that TG was an independ-ent risk factor for hyperuricemia,and that HDL -L and gender were protective factors.Conclusion Hyperuricemia is closely associated with blood lipid,especially with TG and HDL -L,so we could screening HUA by blood lipid,which can reduce the occurrence of cardiovascular disease effectively.

Objective To investigate the relationship of resting heart rate (RHR)and dyslipidemia in the elderly.Methods 3 919 cases of cerebrovascular disease risk factor screening in Renqiu permanent residents aged 60 -70 years were selected,excepted cases of atrial fibrillation and hyperthyreosis and received lipid -lowering and slowing the heart rate drugs as the research subjects,mean age 64(62,67)years,the rates of male and femal were 44.0% and 56.0% respectively.They underwent face -to -face health questionnaire,blood pressure and RHR meas-urement,anthropometric and laboratory tests.According to the RHR,they were divided into four groups:RHR1:<60 times/min,RHR2:>60 times/min and <70 times/min,RHR3:>70 times/min and <80 times/min,RHR4:>80 times/min.The effect of RHR on dyslipidemia was analyzed by multivariate logistic regression analysis.Results The high TC,TG,and the prevalence of high LDL -C increased gradually with heart rate,the differences were statisti-cally significant (all P <0.001).The prevalence low HDL -C and HDL -C levels had no obvious statistically differ-ences.TC,TG,and LDL -C and RHR were positively correlated.RHR1:<60 times/min was set as control group,the correction of gender,age,smoking,drinking,lack of physical activities,hypertension,diabetes,coronary heart disease, stroke or TIA,overweight,abdominal obesity,systolic pressure,diastolic blood pressure,fasting plasma glucose,insu-lin,uric acid,high TC in 60 -70 times/min,70 -80 times/min,and the risk of more than 80 times/min,respectively (OR =1.304,95%CI:0.983 -1.73),(OR =1.579,95%CI:1.195 -2.088),(OR =1.677,95%CI:1.258 -2.237).Conclusion The RHR and the prevalence of dyslipidemia is related,medical workers need to know the rela-tionship between RHR and dyslipidemia,increase the focus on RHR and intervention,in order to effectively control the occurrence of dyslipidemia and cardio -cerebrovascular disease,especially cholesterol heighten.

Objective The population -based study was conducted in Hebei Renqiu 60 -70 years old resi-dents to evaluate cardiovascular disease morbidity risk in next 10 years,to analyze the related risk factors and provide an objective basis for the prevention and control of cardiovascular diseases in the local areas.Methods Cluster sam-pling method was used to select elderly residents (aged from 60 to 70 years)in Renqiu city as the research subjects. A total of 5 010 cases,2 163 males,2 847 females were included in this study.Investigation contents included health questionnaire,anthropometric and laboratory detection.According to the Framingham Risk Score (FRS),10 -year risk probability of cardiovascular disease was calculated.Research subjects were divided into low risk group (<10%),medium risk group (≥10% and <20%),high -risk group (≥20%),and logistic regression was used to analyze the risk degree of the related risk factors.Results The 10 -year cardiovascular risk median value of 60 -70 years elderly residents was 8.0 (4.0 -16.0),among them male was 16.0 (12.0 -20.0),female was 4.0 (2.0 -6.0).Low risk group had 2 784 cases,accounted for 55.7%;medium risk group had 1 452 cases,accounted for 29.0%,high-risk group had 774 cases,accounted for 15.3%.The most important risk factors were smoking and cholesterol increasing,who contributes elderly residents aged 60 to 70 years in Renqiu cardiovascular 10 -year risk.The history of stroke,excessive drinking,waist circumference,diastolic blood pressure,elevated uric acid level and HOMA -IR were the independent risk factors in moderately high risk 10 -year probability of cardiovascular.Conclusion The elderly residents aged 60 to 70 years in Renqiu has higher cardiovascular risk of 10 years.Quitting smoking,limitting alcohol,controlling of blood pressure,blood lipids,uric acid,waist circumference and HOMA -IR are important to improve cardiovascular 10 -year risk.Among them,quit smoking and alcohol limit are the most effective measures.

Objective: To investigate the changes of ambient dose equivalent rate in 99mTcO4- single photon emission computed tomography (SPECT) of the thyroid among patients with hyperthyroidism, so as to provide insights into radiation protection guidance. Methods: Patients with hyperthyroidism who underwent 99mTcO4- SPECT of the thyroid in a tertiary hospital were enrolled. The ambient dose equivalent rate was measured at different time points following 99mTcO4- infection and at sites with different distances from patients' neck, and the effects of time post-injection, distance from patients' neck, 24-hour thyroidal radioiodine uptake and thyroid weight on the ambient dose equivalent rate were examined using a generalized linear mixed model. Results: Totally 100 patients with hyperthyroidism were enrolled, including 24 men and 76 women and with a mean age of (38.5±14.0) years. The generalized linear mixed model was statistically significant (F=6 610.165, P<0.001), and patients' thyroid weight, time post-injection and distance from patients' neck significantly affected the ambient dose equivalent rate (F=57.967, 15 988.574, 11 200.645, all P<0.001), and the ambient dose equivalent rate positively correlated with patients' thyroid weight and negatively correlated with time post-injection and distance from patients' neck. Conclusions The ambient dose equivalent rate is affected by patients' thyroid weight, time post-injection and distance from patients' neck among patients with hyperthyroidism undergoing 99mTcO4- SPECT of the thyroid. Delay in contact with patients or keeping distance from patients may be effective for radiation protection.