Objective To explore the value of human leucocyte antigen-DR53 (HLA-DR53),anti-Sa antibody and anti-cyclic citrullinated peptide antibody(anti-CCP) factors combination in rheumatoid arthritis.Methods 170 patients with rheumatoid arthritis and 50 healthy individuals in the hospital were chosen.The levels of HLA-DR53 by PCR-SSP,the levels of anti-Sa and anti-CCP by ELISA,compared their diagnostic value by consistency analysis and joint detection analysis.Results The sensibility of anti-Sa,HLA-DR53 and anti-CCP in RA were 44.07％ (P =0.00,x2 =165.214),68.65 ％ (P =0.00,x2 =9.837) and 79.45 ％ (P=0.00,x2=48.028).Consistency analysis in RA,HLA DR53,anti-CCP and anti-Sa highly consistent,OR were 3.94,38.6 and 184.52.The sensitivity and Youden index of anti-CCP were the highest.The sensitivity of anti Sa and anti-CCP parallelled was 88.51 ％.The sensitivity of HLA-DR53 and anti-CCP parallelled was 93.56％,and the spe cificity of anti-Sa and anti-CCP of RA were 100％.Conclusion There is a certain correlation between HLA-DR53,anti-Sa and anti-CCP antibody,which are related risk factors of RA,co-detection will improve the diagnosis of RA.

Objective To study the significance of plasma homocysteine(Hcy),high sensitivity C-reactive protein(hs-CRP)and cardiac treponin T(cTnT)changes in the patients with coronary heart diseases(CHD).Methods From August 2012 to November 2013,240 patients with CHD in our hospital were collected as the CHD group and 250 individuals of healthy physical examination served as the control group.Serum Hcy,hs-CRP and cTnT were detected by using the enzymatic cycle assay,immune scatter turbi-dimetry and electrochemiluminescence assay respectively.The data were statistically analyzed by the SPSS software.Results The serum levels of Hcy,hs-CRP and cTnT in the CHD group were (24.89±17.78)μmol/L,(17.43±35.89)mg/L and (0.76±2.36) ng/mL respectively,which were significantly higher than those in the control group(P <0.001).Moreover,the positive rate of Hcy in the CHD group was the highest (81 .25%),followed by hs-CRP(64.58%)and cTnT (58.75%).Conclusion Hcy,hs-CRP and cTnT played important roles in the development and progression of CHD,so reducing Hcy level may be an important pathway for preventing and treating CHD.

Objective To investigate the clinical value of combined test of prealbumin (PA),total bile acid(TBA)and liver bi-opsy in chronic hepatitis.Methods 172 patients hospitalized with chronic hepatitis in the Affiliated Hospital of Yan’an Uni-versity Medical College from October,2013 to March,2014 was collected as the chronic hepatitis group;and 45 cases of nor-mal healthy control of the corresponding period was collected as the control group.Prealbumin,TBA was detected respec-tively in the two groups.Immunoturbidimetry was adopted in PA,Enzymatic cycling assay was employed in TBA,and at the same time percutaneous puncture of liver histology was detected in the chronic hepatitis group.Results The PA in the chro-nic hepatitis group (179.12±8.46 mg/L)was lower than the control group (257.34±6.38 mg/L),and the difference was statistically significant (P <0.05).The TBA in the chronic hepatitis group (30.58±9.37 μmol/L)was higher than the con-trol group (8.16±1.59 μmol/L)and also the difference was statistically significant (P <0.05).PA was negatively correla-ted with the pathological grades (rs =-0.617,P <0.05),and TBA was positively correlated with pathological grades (rs =0.724,P <0.05).The separate diagnostic positive rate of PA was 58.7% (101/172),while the TBA was 93.6% (161/172).The combined diagnostic positive rate of the two was 93.6% (161/172),it was higher than the separate rate and was statistically significant (P <0.05).Conclusion The serum levels of PA and TBA can reflect the extent and degree of hypo-hepatia and hepatic inflammation,and the combined detection of the two will be much sensitive to the diagnosis of chronic hepatitis,and compared with histological detection,it is convenient,simple,and easy to operate.

Objective To investigate the change of homocysteine (Hcy),high sensitive C-reactive protein (hs-CRP)and Inter-leukin 6 (IL-6)in patients with Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS)complicated by Cerebral Infarction (CI).Methods Chose 55 patients with OSAHS and 56 patients with CI.All patients with OSAHS were divided into mild group,moderate group and severe group by polysomnography,and all patients were divided into simple OSAHS group,sim-ple CI group and OSAHS complicated by CI group.All the patients’sleep apnea hypoventilation index (AHI),the lowest oxygen saturation (LSpO2 ),average blood oxygen saturation (MSpO2 ),sleep apnea the longest (LAT)and the level of Hcy,hs-CRP,IL-6 were determined,and compared with 30 cases of control group.Results The AHI,LAT,Hcy,hs-CRP and IL-6 of simple OSAHS group and simple CI group were obviously higher than that in control group,LSpO2 ,MSpO2 were obviously lower,the differences were statistical significant (P<0.05).The AHI,LAT,Hcy,hs-CRP and IL-6 of OS-AHS complicated by CI group were obviously higher than that in simple groups,but LSpO2 and MSpO2 were obviously low-er,and the differences were statistical significant (P<0.05).With the aggravation of OSAHS,Hcy,hs-CRP and IL-6 were gradually increased.Hcy,hs-CRP and IL-6 were positively correlated with AHI in patients with OSAHS,correlation coeffi-cient were 0.751,0.678 and 0.635,respectively (P<0.001).Conclusion OSAHS was closely related to the occurrence and development of CI,the dynamic monitoring of Hcy,hs-CRP and IL-6 levels has a certain reference value for evaluation of therapeutic effect.

Objective To study the relationship between homocysteine (Hcy)and carotid atherosclerosis in patients with cer-ebral infarction.Methods During January and November 2013,281 patients with cerebral infarction from Affiliated Hospital of Yan’an University were provided the blood samples as cerebral infarction group,140 healthy volunteers served as control group.Serum Hcy was detected by enzymatic cycle assay.According to the results of carotid artery ultrasonography,cerebral infarction group was divided into five groups:artery normal group,intimal thickening group,soft plaque group,mixed plaque group and hard plaque group.The statistically significance was analyzed by SPSS 19.0.Results The serum Hcy level of cer-ebral infarction group was 19.78 ± 5.21 μmol/L,significantly higher than the control group 10.24 ± 3.33 μmol/L (P <0.001).The serum Hcy levels of control group,artery normal group,intimal thickening group,soft plaque group,mixed plaque group and hard plaque group were 10.24±3.33,15.20±2.99,17.03±1.85,25.44±4.24,19.65±4.74 and 18.31 ±3.67 μmol/L respectively.The differences between groups were statistically significant in addition to intimal thickening group and hard plaque group (P =1.106).The positive rates were 16.4%,53.7%,87.1%,95.7%,83.1% and 77.3% re-spectively,the groups which in cerebral infarction group compared with control group,the differences were statistically sig-nificant (P <0.001).Conclusion Hcy played an important role in the occurrence and development of cerebral infarction. Lower serum Hcy concentration,may be an effective way to prevent carotid atherosclerosis and cerebral infarction.

Extrarenal Wilms′ tumor is extremely rare and has no characteristic clinical manifestations. Diagnosis is difficult before surgery, and is often confirmed by histopathology. Comprehensive treatment by surgery, chemotherapy and radiotherapy is currently adopted for such patients, and the overall survival rate can reach about 90%. Here we report a 2-year-old child with Wilms′ tumor in the left scrotum.