Objective To explore the diagnostic significance of anti-cyclic citrullinated peptide antibody(anti-CCP)and the role it plays in the articular erosion in patients with rheumatoid arthritis(RA).Methods The diagnostic significance of anti-CCP?AKA and RF were evaluated respectively.Seventy-five RA patients were devided into group1(limited radiographic damage group)and group2(severe radiographic damage group).The distribution of anti-CCP,AKA and RF in patients of the two groups were investigated.A univariate analysis was used to determine whether anti-CCP?AKA?RF?ANA?ESR?CRP or cutaneous nodules plays a role on articular erosion in RA.To determine which has the best predictive value for severe radiographic da-mage,all variables were entered into a logistic regression model.Results The sensitivity and specificity of an-ti-CCP?AKA and RF were49%,94%;50%,93%;79%,67%respectively.When any two markers were combined,the specificity would be raised.The positive rate of these three markers were much higher in group2than that in group1.Anti-CCP had the highest OR(6.71)for articular erosion in RA.Logistic regression analysis showed a strong correlation between anti-CCP,AKA,CRP or cutaneous nodules and less favourable disease outcomes.Cut.aneous nodules had the strongest correlation with severe radiographic damage.Conclusion Anti-CCP is a satisfactory marker for RA.Diagnostic accuracy appears to be raised when anti-CCP combined with AKA and RF.Anti-CCP has a strong correlation with severe radiographic damage.To investigate multiple risk factors of articular erosion will be helpful to pridict the outcome of RA.

Objective:Analysis the relationship between antiribosomal antibodies with molecular weight 38 kD and/or 15/16.5 kD protein and SLE,then to discuss the positive standard of anti ribosomal antibodies and its prevalent rate in SLE patients.Methods:262 sera from 115 SLE, 57 RA,20 SSc,39 MCTD and 31 other immune diseases were detected anti ENA antibodies by Western blot method.Results:Respectively, use 38 kD and 15/16.5 kD protein bands appear simultaneously and 38 kD protein bands appear as anti ribosomal antibodies’ positive standard, the sensitivity and specificity of anti ribosomal antibodies to SLE were 17.4%,97.3% and 28.7%,96.6% respectively.The sensitivity had significant difference (P0 05).SLE patients were dramatically dominated in 14 anti ribosomal 38 kD antibody positive patients(71.4% vs. 28.6%,P0 05).Conclusion:Anti ribosomal 38 kD antibody was closely associated with SLE but not with anti Sm antibody. Use 38 kD protein as the primary standard to verdict anti ribosomal antibody,not only can improve the positive rate of anti ribosomal antibody, but also do not depress its diagnostic specificity for SLE.So it’s worthy to spread this method. [

0 05)and the consistence rate of 3 000 sera tested by two methods were 99 4% totally, including 99 8%(mixture of speckled and homogeneous), 99 5%( homogeneous) and 99 0%( speckled), respectively Conclusion The difference of ANA results between laboratory caused by test condition such as fluorescence microscopy could be eliminated by using quality control with known fluorescence density So the ANA results may be more precise, reliable and comparable We could, thereby, holisticly improve the quality of ANA detection

Objective To investigate the level of five auto-antibodies including MCV and GPI in the serum of RA patients and assess the application value of five auto-antibodies in RA diagnosis.Methods The five auto-antibodies were detected by ELISA in serum samples of 150 patients with RA and 40 healthy controls,32 patients of SLE,30 patients of OA,20 patients of AS,20 patients of SS,20 patients of CTD.Results The positive rates of these five auto-antibodies in RA patients were significantly higher than in other group(X2=88.5,76.0,279.2,88.2,94.8,P＜0.05).Except anti-AKA,there was no the differences in the level of other antibodies among groups(X2=21.9,9.4,20.2,43.2,41.6,P＞0.05).Anti-MCV and anti-GPI has the highest sensitivity(78.0% and 83.3%),while anti-CCP has the highest specificity(97.1%)and anti-AKA has good specificity(96.1%)and lowest sensitivity(49.4%).When two antibodies were detected together,the sensitivity and specificity of MCV/CCP were highest(92.7% and 96.9%).When RF/GPI/CCP were detected together,the sensitivity and specificity were 90.7% and 96.9%,respectively.When RF/MCv/CCP were detected together,the sensitivity and specificity were 94.0% and 96.9%.Conclusions Anti-MCV and anti-GPI has the hishest sensitivity in laboratory diagnosis of RA,while anti-CCP has the highest specificity and anti-AKA have good specificity and lowest sensitivity.The combination detection can decrease the amount of missed diagnosis caused by single test. The combination detection of RF/GPI/CCP and RF/MCV/CCP will improve sensitivity and specificity for diagnosis to the RA patients.

Objective To investigate the expression and the possible clinical significance of serum Golgi protein(GP73)in infantile hepatitis syndrome(IHS)by different causes.Methods Totally 79 patients with IHS in Guangzhou Women and Children's Medical Center from February 2012 to December 2012 were enrolled in this study,including 15 cases with biliary atresia(BA)group,29 cases with infection(infection group),5 cases with neonatal intrahepatic cholestasis caused by citrin deficiency(NICCD group),and 30 cases with unknown etiology(idiopathic infantile hepatitis group).At the same time,30 healthy infants were enrolled as healthy control group.The serum levels of GP73 were determined by quantitative enzyme-linked immunosorbent assay(ELISA),and the children's liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),direct bilirubin(DBIL),alkaline phosphatase(ALP),γ-glutamyl trans-peptidase(γ-GT),total bile acid(TBA)and albumin(ALB)] were measured by turbidimetric inhibition immuno assay.Then,the corresponding data were statistically analyzed.Results Serum GP73 in BA group,infection group,NICCD group,idiopathic infantile hepatitis group and the healthy control group were(296.6±67.5)μg/L,(185.1±66.4)μg/L,(199.2±87.1)μg/L,(181.7±74.2)μg/L and(65.3±17.0)μg/L,respectively.Serum γ-GT levels in BA group,infection group,NICCD group,idiopathic infantile hepatitis group and healthy control group were(764.7±775.8)U/L,(448.2±352.7)U/L,(239.4±88.7)U/L,(283.3±377.2)U/L and(54.0±72.6)U/L,respectively.The levels of GP73 and γ-GT were significantly higher in infants with IHS,and the levels of GP73 and γ-GT in infants with BA were the highest(F=46.775,9.238,all P<0.05).There was a positive correlation between serum levels of GP73 and γ-GT(r=0.280,P<0.05),and there was no correlation between GP73 and ALT,AST,TBIL,DBIL,ALP,TBA,ALB(r=-0.061,-0.071,0.164,0.123,0.137,0.008,-0.047,respectively,all P>0.05).The receiver operating characteristic curve(ROC)constructed with GP73 showed a sensitivity of 80.0％and specificity of 82.8％with an area under the receiver(AUC)of 0.872 for diagnosis of BA,comparatively,a sensitivity of 66.7％and specificity of 71.9％were showed with a AUC of 0.731 when performed with γ-GT.Conclusions Serum GP73 concentration significantly increased in all liver disease groups,regardless of the etiology.Serum GP73 expression is significantly higher in infants with BA.Serum GP73 shows a superior sensitivity and specificity to γ-GT for diagnosis of BA,which might be useful for early diagnosis of BA and IHS with different causes.

This study was firstly conducted to detect antinuclear antibody(ANA) titer by using number influorescence density analysis assay instead of serum diluted assay. The best camera explore time was selected. Then 4,140 ANA positive sera were detected to determine the relationship between number influorescence density (detected by number camera system Spot 32 and computer analysis software ipwin32) and serum diluted titer. The consistent rates in different ANA patterns used by the two methods were compared. 4 seconds was found to be the best explore time and the relationship between number influorescence density and serum diluted titer was 29-50 vs 1:100, 51-85 vs 1:320, 86-175 vs 1:1000, 176-215 vs 1:3200, 216-237 vs 1:10,000. According to this standard we detected 3140 ANA positive sera by use of the two methods and observed a total consistency rate of 89.4%. The consistency rates of three ANA patterns including speckled, homogenous, mixture of speckled and homogenous were as high as 98.9%, 99.5%, 99.8% respectively. The lower consistency rate patterns included nucleolar (5.3%), centromere (1.8%), ribosome(12.6%) and other special patterns(0%). For practical purpose, number influorescence density analysis assay can be used in detecting the three main ANA patterns (speckled, homogeneous, mixture of speckled and homogenous) titer instead of serum diluted assay. The number influorescence density analysis assay is more objective, economical and simple than the serum diluted assay.
Antibodies, Antinuclear ; analysis ; Fluorescence ; Fluoroimmunoassay ; methods ; Software

Objective to explore the value of scenario simulation combined with PDCA cycle in the training of newly recruited staff of the radiology department. Methods thirty newly recruited members of the radiology department were selected as research subjects and received three months of training using scenario simulation combined with PDCA cycle teaching. The subjects took examinations before and after the training to estimate its effect on the their first-aid related knowledge and skills, as well as the apprehension of professional knowledge; questionnaires were used to collect the subjects' self-evaluation and their feedbacks for the training. T test was conducted using SPSS 20.0. Results the scores of first aid related knowledge, first aid instrument use, first aid skills and first aid ability after training were significantly higher, and the differences were statistically significant. After the training, the staff's performance in terms of noun explanation, problem solving and essay questions was significantly higher than that before the training, and the overall performance was significantly improved. More than 90％of the new recruits believed that scenario simulation combined with PDCA had practical effects on improving clinical practice ability , knowledge understanding, comprehensive analysis, problem solving ability and cooperative ability. More than 85％ of the subjects considered it helpful for mastering the teaching content , improving learning efficiency , developing independent learning ability and stimulating learning interest. Conclusion scenario simulation teaching combined with PDCA can improve new employee's learning interest and teaching satisfaction, and further improve doctor-patient communication ability and training effect.

Objective:To observe the effects of rolling method massager on local tissue morphology, tissue and serum TNF-α and IL-1β in rabbits with skeletal muscle injury at different time points; To investigate the mechanism of temporal effect of rolling method action on skeletal muscle injury.Methods:Totally 72 New Zealand rabbits were divided into blank group, model group and rolling method treatment group according to random number table method, with 24 rabbits in each group. Rabbits in each group were divided into 1 d, 3 d, 5 d, 7 d, 9 d and 11 d subgroups according to the time point of injury, with 4 rabbits in each group. Blunt contusion was used to model the model group and the rolling method treatment group. Each subgroup of the rolling method treatment group was subjected to rolling method intervention for 3 d, using a homemade rolling method massager, 2 times/d, 3 min/time. At 24 h after the completion of the intervention, the histomorphological changes were observed by HE staining, and the TNF-α and IL-1β contents in serum and damaged skeletal muscle tissues were detected by ELISA.Results:Compared with the blank group, the inflammatory cell infiltration in the model group was obvious, edema was severe, and myofibers were broken; the inflammatory cell infiltration in the 1 d rolling method treatment group was intensified, myocytes were apoptotic, and myofibers were broken and necrosed more seriously; the inflammation in the 7 d rolling method treatment group was obviously improved with the best effect, and the difference with normal healthy muscle tissue was smaller. After modeling, TNF-α and IL-1β levels in skeletal muscle tissues and serum TNF-α levels were higher in the 3 d model group than in the 1 d model group ( P<0.05). Compared with the blank group, TNF-α and IL-1β levels in skeletal muscle tissues and serum increased in each subgroup of the model group and each subgroup of the rolling method treatment group ( P<0.01); Compared with the 1 d model group, TNF-α and IL-1β levels in skeletal muscle tissues and serum TNF-α levels increased in the 1 d rolling method treatment group. The levels of TNF-α and IL-1β in the 3 d, 5 d, 7 d, 9 d and 11 d rolling method treatment group were lower than those in the model group subgroup ( P<0.05). TNF-α and IL-1β levels in skeletal muscle tissues and serum TNF-α levels were higher in the 1 d, 3 d and 5 d rolling method treatment group than in the 7 d rolling method treatment group ( P<0.05). TNF-α levels in skeletal muscle tissues were higher in the 1 d and 3 d rolling method treatment group than in the 7 d rolling method treatment group ( P<0.05). Conclusion:The inflammatory factors in the rolling treated group were significantly higher at 1 d after skeletal muscle injury, indicating that treatment with the rolling method was inappropriate at this time; seven days after injury, the application of rolling method can reduce the inflammatory effect, accelerate the repair of skeletal muscle, and improve the quality of functional recovery.

Background: Studies have shown that transient receptor potential (TRP) channels play important roles in gastroesophageal reflux disease (GERD), however, the relationship between TRPV1 and TRPM8 in reflux esophagitis (RE) remains unclear. Aims: To investigate the expressions of TRPV1, TRPM8 and their correlation in guinea pigs with RE. Methods: Thirty male guinea pigs aged 3⁃4 weeks were randomly divided into 3 groups: blank control group, negative control group and model group, with 10 animals in each group. Guinea pigs in model group and negative control group were given esophageal perfusion with 0.1 mol/L HCl containing 0.5% pepsin and normal saline, respectively, once a day for 14 days; guinea pigs in blank control group were free to drink sterile water for 14 days. On day 15, the esophagus was dissected for macroscopic and histopathological examination, and Western blotting and/or real⁃time PCR were used to detect the expression levels of TRPV1, TRPM8, GNAQ (an isoform of G protein), and the tight junction proteins and proinflammatory cytokines in esophageal tissue. The co⁃localization of TRPV1 and TRPM8 was assessed by immunofluorescence. Results: Esophageal mucosal congestion, hyperplasia of esophageal epithelial cells, infiltration of inflammatory cells, as well as up⁃regulation of proinflammatory cytokines and down⁃regulation of tight junction proteins were observed in esophageal tissue of guinea pigs in model group, which indicated the successful RE model construction. As compared with the negative control group, expression levels of TRPV1 and GNAQ mRNA and protein were significantly increased, while expression levels of TRPM8 mRNA and protein were significantly reduced in esophageal tissue of guinea pigs in model group (all P<0.05). TRPV1 and TRPM8 channels were co ⁃ localized in the lamina propria of esophageal mucosa. Conclusions: There is a certain equilibrium mechanism between TRPV1 and TRPM8 channels in RE models. G protein⁃coupled receptor signaling pathway and the downstream TRPV1/TRPM8 might be involved in the occurrence and development of GERD.

Objective:To explore the feasibility and effectiveness of 3D printing aortic model for preoperative evaluation and surgical simulation, and to assist interventional treatment of coarctation of the aorta(CoA).Methods:From December 2017 to January 2019, 8 patients with congenital coarctation of the aorta who underwent percutaneous balloon dilatation and covered stent placement in Xijing Hospital of Air Force Military Medical University were analyzed retrospectively. Among them, 7 cases were male and 1 case was female. The age was(32.00±14.93) years old. Before operation, CT data of patients' heart and aorta were collected, reconstructed with Mimics software, and 3D printing technology was used to make the model of patients' aortic lesions. Before operation, the operation simulation was carried out to determine the best operation scheme and estimate the possible situation, and the relevant clinical data of patients during hospitalization and follow-up were collected.Results:One stent graft was successfully implanted into CoA through femoral artery in all 8 patients. The mean diameter of CoA increased from(3.70±2.94) mm before operation to(18.01±1.51) mm immediately after operation( P<0.05), and the mean systolic pressure difference decreased from(83.75±25.44) mmHg before operation to(14.63±8.09) mmHg after operation( P<0.05). The mean systolic blood pressure of the right upper extremity decreased from(204.13±22.31) mmHg before operation to(145.63±32.08) mmHg after operation( P<0.05), and there was no significant difference between the two groups. During the period of hospitalization and follow-up, no corresponding cardiovascular complications were found. Conclusion:The short-term effect of percutaneous balloon dilatation covered stent implantation on CoA in adolescents and adults is obvious. 3D printing model can reproduce the anatomical model of CoA site of patients individually, which is feasible and effective for the preoperative evaluation of CoA and the preparation of operation plan.