Objective To observe the influence of total glucosides of peony (TGP) combined with leflunomide on serum level of TNF-α,IL-8 in the patients with psoriatic arthritis(PsA) ,to evaluate its efficacy and safety and to preliminarily study its action mechanism .Methods The open clinical study was adopted .36 patients with PsA were treated by TGP combined with leflunomide for 12 weeks .at the same time 20 healthy control were selected .The double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was adopted to detect the level of serum TNF-α and IL-8 before treatment and in 12 weeks after treatmention the two groups .The Psoriasis Area And Severity Index (PASI) was adopted as the main effective index and the Health Assessment Ques-tionaire(HAQ) was taken as the secondary effective index .The level of CRP ,ESR ,TNF-α,IL-8 before and after treatment were an-alysed .Results The serum TNF-α,IL-8 levels before therapy in the poriatic arthritis group were significantly higher than those in the normal control group(P<0 .05);after 12 weeks ,PASI ,HAQ ,serum TNF-αand IL-8 levels in the treatment group were signifi-cantly improved than those before treatment ,the difference had statistical significance(P<0 .01) ,and the serum TNF-α,IL-8 levels were similar to those in the healthy control group without statistical difference (P>0 .05) .Conclusion TGP combined leflunomide for treating PsA has better effect and better safety ,which could play the role by influencing serum TNF-α,IL-8 levels .

Objective To compare the positive rate of anti-mutant citrulline vimentin (MCV) antibody and anti-cyclic citrullinated peptide (CCP) antibody in serum of patients with rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA).To investigate the diagnostic value and significance of anti-MCV and antiCCP antibody in these two diseases.Methods Anti-CCP and anti-MCV antibodies were detected by enzymelinked immunosorbent assay (ELISA).The serum samples were from 113 patients with JIA,632 patients with RA,102 adult without RA and 56 children without RA.Chi-square test and multiple comparisons were used for statistical analysis.Results ① In RA patients,the sensitivity,specificity and area under the receiver operating characteristic curve (ROC curve) of anti-MCV antibody was 90.2％,91.2％,0.919;the sensitivity,specificity and area under the ROC curve of anti-CCP antibody was 92.6％,93.1％ and 0.934.In JIA,the specificity of antibodies was 98.2％,the sensitivity was low.Area under the ROC curve of anti-MCV antibody was 0.579.Area under the ROC curve of anti-CCP antibody was 0.561.② The positive rate of anti-MCV antibody in RA was 90.2％,which was higher than that of JIA (16.8％) (P＜0.01).The positive rate of anti-CCP antibody in RA was 92.2％,which was higher than that of JIA (14.2％) (P＜0.01).The positive rates of antiMCV antibody in JIA with RF-negative polyarthrosis,RF-positive polyarthrosis,systemic type,oligo-joint type,attachment points,unclassified was 11.8％,69.2％,14.3％,17.4％,3.6％,0.The positive rate of anti-CCP was 11.8％,61.5％,14.3％,13.0％,0 and 0 prespectively.For anti-MCV antibody,the chi-square values in patients with RA between RF-negative polyarthrosis,RF-positive olyarthrosis,systemic type,oligo-joint type,attachment points,unclassified arthritis were 160.2,4.02,34.4,102.0,165.1 and 57.0 respectively.There were significant differences between RA and all types of JIA (P＜0.05).The positive rate of anti-CCP antibody in patients with RA between RF-negative polyarthrosis,RF-positive polyarthrosis,systemic type,iligo-joint type,attachment points,unclassified arthritis were 192.3,11.9,44.0,139.4,212.5 and 71.9.There were significant differences between RA and all types of JIA (P＜0.05).Conclusion The diagnostic value of anti-MCV and anti-CCP antibodies is high in RA.Anti-MCV and anti-CCP antibody have certain diagnostic value of JIA.The positive rates of anti-MCV and anti-CCP antibody in the types in JIA are lower than those of RA patients.