OBJECTIVETo investigate the clinical significance of serum midkine (MK) in children with henoch-schnlein purpura(HSP).

METHODSOne hundred and six children with HSP admitted in our hospital from March 2013 to March 2016 were enrolled in HSP group, but then 80 healthy volunteers were used as control. MK, interleukin-2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor (TNF), interferon γ (IFN-γ) and IL-17 in peripheral blood were measured by ELISA, biochemical indicators including white blood cell count (WBC), platelet (Plt), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), D-dimer, immunoglobulin A (IgA), IgE, IgG, IgM and other clinical data were recorded and analyzed.

RESULTSAmong 106 cases of henoch-schonlein purpura, 42 patients combined with renal failure (isolated hematuria in 4 cases, 17 cases of isolated proteinuria, hematuria and proteinuria in 21 cases). Midkine level in children with HSP was significantly higher than that in the control group [291.70(248.50-396.41) pg/ml vs 217.30(198.98-243.65) pg/ml)](P<0.05); the MK level in group of HSP with nephritis was higher than that in group of HSP without nephritis [326.58(266.58-459.25) pg/ml vs 280.72(233.67-384.36) pg/ml] (P<0.05). IL-4, IL-6, IL-17, TNF and IFN-γ levels in children with HSP were higher than those in the control group(P<0.05), but IL-10 level was lower than that in control group. IL-2 level was not significantly different between 2 groups. Cytokines levels in HSP nephritis group and HSP without renal involvement were not significantly different. Pearson correlation analysis showed that midkine level positively correlated with IL-4, IL-6, IL-17, IgA and IgE (P<0.05). By ROC curve analysis, the AUC of midkine was 0.902, 95% CI 0.841-0.963 (P<0.001), threshold 295.50 pg/ml. The sensitivity and specificity of midkine for predicting Henoch-Schonlein purpura nephritis were 80.60% and 88.30% respecitvely.

CONCLUSIONPlasma MK plays an important role in the development of Henoch-Schonlein purpura and Henoch-Schonlein purpura nephritis. Plasma MK can be used as an effective indicator for early diagnosis and prediction of HSP and renal damage.

Objective To investigate the correlation between levels of Annexin A1,Bax and lipoprotein-associated phospholipase A2 (Lp-PLA2) and both formation and stability of human carotid atherosclerotic plaques.Methods Forty-five specimens from patients with carotid atherosclerotic plaques (test group,group A),admitted to our hospital from May 2010 to June 2011 and performed carotid endarterectomy (CEA),and 20 specimens from patients with mesenteric artery and 20 healthy subjects (control groups,group B and group C,respectively) were collected in our study.The carotid atherosclerotic plaque specimens were divided into soft plaque group A1 (n=15),mixed plaque group A2 (n=15) and hard plaque group A3 (n=15) according to the results of carotid artery ultrasound.The Lp-PLA2 level in group A and group C was measured by enzyme linked immunosorbent assay (ELISA),and the mRNA and protein expressions of Annexin A1 and Bax in group A and group B were determined by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting.Results The level of Lp-PLA2 in all patients with carotid atherosclerotic plaques was significantly increased as compared with that in group C (P＜0.05); that in group A1 was significantly higher than that in group A3 (P＜0.05).The mRNA and protein expressions of Annexin A1 and Bax in all patients with carotid atherosclerotic plaques were significantly increased as compared with those in group B (P＜0.05); group A1 exhibited lower mRNA and protein expressions of Annexin A1 than group A3 (P＜0.05),while group A1 exhibited higher mRNA and protein expressions of Bax than group A3 (P＜0.05).Conclusion Annexin A1,Lp-PLA2 and Bax participate in the formation and stability of human carotid atherosclerotic plaques.