Objective To investigate the clinical significance of serum anti-Saccharomyces cerevisias antibody (ASCA),anti-outer membrane porin C (anti-OmpC),antibody to Pseudomonas fluorescens-associated sequence I2 (anti-I2 )and antibody to bacterial flagellin (anti-CBirl )in the diagnosis and treatment of inflammatory bowel disease (IBD).Methods From 2011 to 2013,87 patients with IBD were enrolled and divided into Crohn′s disease (CD)group (66 cases)and ulcerative colitis (UC)group (21 cases).A total of 62 age and gender matched healthy individuals were enrolled as the control group. Fasting blood samples (2 mL)of the subjects were collected.The expression of ASCA,anti-OmpC,anti-I2 and anti-Cbirl antibodies was detected with enzyme-linked immunosorbent assay (ELISA)kits.The diagnosis value of each antibody in IBD and the differential diagnostic value of in UC and CD were compared by receiver operating characteristic (ROC)curve.Results The area under the curve (AUC)of ASCA between IBD and the healthy control group,between CD group and UC group was 0.580 and 0.512, respectively;the accuracy in diagnosis was low.The AUC of anti-CBirl between IBD and the healthy control group was 0.617.There was no differential diagnosis significance of the other antibodies.The positive rate of ASCA in IBD group was 62.1 % (54/87),which was significantly higher than that in the control group (38.7%,24/62).The positive rates of anti-OmpC and anti-I2 in IBD group was significantly lower than those in the control group and the differences were statistically significant (both P <0.05).No difference was observed in positive rates of serum antibodies among the others groups (all P >0.05).The specificity,sensitivity,positive predictive value (PPV)and negative predictive value (NPV)of ASCA in differential diagnosis of CD and UC was 52.4%,66.7%,81 .48% and 33.33%,respectively.The specificity and sensitivity of anti-OmpC,anti-I2 and anti-CBirl in differential diagnosis of CD and UC was 81 .0% to 100.0% and 9.1 % to 37.9%,respectively.The specificity,sensitivity,PPV and NPV of double-positive ASCA and anti-I2 in the diagnosis of CD was 57.1 %,86.4%,82.6% and 50.0%, respectively.The positive rate of ASCA and anti-I2 in CD group was significantly higher than that in UC group (84.8%(56/66)vs 57.1 % (12/21 );χ2 =5 .633,P =0.018 ).Conclusions Positive ASCA has some significance in the diagnosis of patients with IBD in our country.The detection of anti-I2 can help to diagnose ASCA negative CD.Because of low sensitivity and positive rate,anti-OmpC and anti-CBirl have limited value in the diagnosis of IBD and the differential diagnosis of UC and CD in our country.

Objective To investigate the predictive value of Rho-associated coiled-coil contai-ning kinase1(ROCK1)and ROCK2 for no reflow in patients with acute ST segment elevation myocar-dial infarction(STEMI)undergoing percutaneous coronary intervention(PCI).Methods A total of 168 STEMI patients who received PCI were selected as study objects,and were divided into no reflow group and normal blood flow group based on whether no reflow occurred,were divided into high ex-pression group and low expression group based on the expression of ROCK1 and ROCK2.Enzyme linked immunosorbent assay was used to detect the levels of serum ROCK1 and ROCK2.The differ-ences in serum levels of ROCK1 and ROCK2 between the no reflow group and the normal blood flow group were analyzed,and the risk factors for no reflow in STEMI patients undergoing PCI treatment were analyzed,the predictive value of ROCK1 and ROCK2 for no reflow in STEMI patients undergoing PCI treatment were analyzed.Results Of 168 STEMI patients,no reflow occurred in 46 cases(27.38％).The Killip grade,time from onset to hospital admission,proportion of patients who did not use proph-ylactic no reflow,serum ROCK1 level and serum ROCK2 level in the no reflow group were higher or longer than those in the normal blood flow group(P＜0.05).The incidence of no reflow in ROCK1 high expression group was higher than that in ROCK1 low expression group,and the incidence of no reflow in ROCK2 high expression group was higher than that in ROCK2 low expression group,the differences were statistically significant(P＜0.05).The incidence rates of no reflow in the ROCK1 high expression group and ROCK2 high expression group were higher than that in the ROCK1 low expression group and ROCK2 low expression group(P＜0.05).Multiple Logistic regression analy-sis showed that Killip grade of Ⅲ to Ⅳ,longer onset to admission time,no using prophylactic no re-flow drugs,and higher serum levels of ROCK1 and ROCK2 were all risk factors for no reflow in STEMI patients undergoing PCI(P＜0.05).Receiver operating characteristic curve showed that ROCK1 and ROCK2 had high predictive value for PCI in STEMI patients without reflow,and the predictive value was increased after the combination of ROCK1 and ROCK2.The area under the curve was 0.789(95％CI,0.711 to 0.867).Conclusion High serum levels of ROCK1 and ROCK2 are both risk factors for no reflow in STEMI patients undergoing PCI,and their combination has high predictive value for no reflow.

Objective To investigate the predictive value of Rho-associated coiled-coil contai-ning kinase1(ROCK1)and ROCK2 for no reflow in patients with acute ST segment elevation myocar-dial infarction(STEMI)undergoing percutaneous coronary intervention(PCI).Methods A total of 168 STEMI patients who received PCI were selected as study objects,and were divided into no reflow group and normal blood flow group based on whether no reflow occurred,were divided into high ex-pression group and low expression group based on the expression of ROCK1 and ROCK2.Enzyme linked immunosorbent assay was used to detect the levels of serum ROCK1 and ROCK2.The differ-ences in serum levels of ROCK1 and ROCK2 between the no reflow group and the normal blood flow group were analyzed,and the risk factors for no reflow in STEMI patients undergoing PCI treatment were analyzed,the predictive value of ROCK1 and ROCK2 for no reflow in STEMI patients undergoing PCI treatment were analyzed.Results Of 168 STEMI patients,no reflow occurred in 46 cases(27.38％).The Killip grade,time from onset to hospital admission,proportion of patients who did not use proph-ylactic no reflow,serum ROCK1 level and serum ROCK2 level in the no reflow group were higher or longer than those in the normal blood flow group(P＜0.05).The incidence of no reflow in ROCK1 high expression group was higher than that in ROCK1 low expression group,and the incidence of no reflow in ROCK2 high expression group was higher than that in ROCK2 low expression group,the differences were statistically significant(P＜0.05).The incidence rates of no reflow in the ROCK1 high expression group and ROCK2 high expression group were higher than that in the ROCK1 low expression group and ROCK2 low expression group(P＜0.05).Multiple Logistic regression analy-sis showed that Killip grade of Ⅲ to Ⅳ,longer onset to admission time,no using prophylactic no re-flow drugs,and higher serum levels of ROCK1 and ROCK2 were all risk factors for no reflow in STEMI patients undergoing PCI(P＜0.05).Receiver operating characteristic curve showed that ROCK1 and ROCK2 had high predictive value for PCI in STEMI patients without reflow,and the predictive value was increased after the combination of ROCK1 and ROCK2.The area under the curve was 0.789(95％CI,0.711 to 0.867).Conclusion High serum levels of ROCK1 and ROCK2 are both risk factors for no reflow in STEMI patients undergoing PCI,and their combination has high predictive value for no reflow.

Objective:To analyze the prognostic factors for survival in elderly patients with glioma.Methods:We performed a retrospective analysis of prognostic factors for elderly patients with glioma,who were treated by the same attending doctor during June 2014 and June 2016,to investigate the correlations of the age,dimension of pathology,histological grade,extent of resection,adjuvant therapy,preoperative Karnofsky Performance Scale (KPS) score,postoperative KPS score,molecular markers [isocitrate dehydrogenase-1 (IDHH-1),O6-methylguanine DNA-transferase (MGMT),epidermal growth factor receptor (EGFR),Ki-67] with the prognosis.Results:A total of 45 patients were included in the study.The median overall survival (OS) was 11 months.The median progression-free survival (PFS) was 6 months.Univariate analysis revealed that the age,gender,dimension ofpathology,histological grade and preoperative KPS score had no significant correlation with survival (P＞0.05).The gross total resection,higher postoperative KPS score,adjuvant therapy,lower Ki-67 index were significantly correlated with survival.The expressions of MGMT and EGFR were significant factors for survival.High postoperative KPS score (P=0.019),adjuvant therapy (P=0.024),and the expression of MGMT (P=0.026) were independent predictors for increased median OS in a multivariate regression model.Conclusion:The extent of resection,adjuvant therapy,postoperative KPS score and molecular markers are the influential factors for survival.Larger prospective studies are needed to confirm these findings.

Narcolepsy is the most common cause of excessive daytime sleepiness (EDS) following obstructive sleep apnea. Its treatment aims to reduce EDS and cataplexy, improve nighttime sleep disturbance, sleep paralysis and sleep-related hallucinations. Pitolisant (a histamine H3 receptor antagonist) and solriamfetol (a norepinephrine reuptake inhibitor) have recently been approved effective for narcolepsy in the United States and the European Union. Pitolisant has proved to be effective for both EDS and cataplexy. Besides being effective on EDS, solriamfetol seems to have advantages in abuse potential and withdrawal syndrome. As potential treatments for EDS and cataplexy associated with narcolepsy, several new drugs are being developed and tested. These new drugs include new hydroxybutyrate preparations (controlled release sodium hydroxybutyrate FT218, low sodium hydroxybutyrate JZP-258), selective norepinephrine reuptake inhibitor (AXS-12), and modafinil combined with astroglial junction protein inhibitor (THN102). This paper reviews the recently approved drugs and potential treatments for narcolepsy.