Objective To investigate the clinical value of perinuclear antineutrophil cytoplasmic antibody (p-ANCA) and fecal calprotectin in predicting the severity of ulcerative colitis (UC) in children.Methods One hundred children with UC from March 2014 to March 2019 in Affiliated Dongfeng Hospital,Hubei University of Medicine were selected.According to the endoscopic severity index of ulcerative colitis (UCEIS),the children were divided into remission stage (29 cases);active stage (71cases),among whom 43 cases were mild-moderate,and 28 cases were severe.The serum levels of interleukin-6 (IL-6),procalcitonin (PCT),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),albumin,platelet,hemoglobin,white blood cell and p-ANCA were detected,and the fecal calprotectin was detected.The clinical value of each index in predicting the severity of UC was determined by receiver operating characteristic (ROC) curve.Results The course of disease,IL-6,PCT,CRP,ESR,p-ANCA and calprotectin in remission stage children were significantly lower than those in active stage children:(3.14 ± 1.25) years vs.(3.73 ± 0.89) years,(10.08 ± 4.40)/μg/L vs.(15.84 ± 3.22) μg/L,(1.02 ± 0.38) μg/Lvs.(1.38 ± 0.43) μg/L,(15.92 ± 6.13) mg/L vs.(24.30 ± 6.06) mg/L,(14.75 ± 6.42) mm/1 h vs.(25.31 ± 6.98) mm/1 h,(17.19 ± 4.76) U vs.(28.01 ± 6.12) U and (504.82 ± 127.46) μg/g vs.(717.04 ± 142.30) μg/g,and there were statistical differences (P＜0.05 or ＜0.01).The IL-6,CRP,ESR,white blood cell,p-ANCA and calprotectin in mild-moderate children were significantly lower than those in sever children:(14.56 ± 2.72) μg/L vs.(17.82 ± 2.93) μg/L,(22.01 ± 5.32) mg/L vs.(27.83 ± 5.46) mg/L,(22.31 ± 4.46) mm/1 h vs.(29.91 ± 7.70) mm/1 h,(7.33 ± 1.33) × 109/L vs.(8.38 ± 1.90) × 109/L,(25.52 ± 5.22) U vs.(31.83 ± 5.44) U and (632.80 ± 82.51) μg/g vs.(846.42 ± 11.10) μg/g,and there were statistical differences (P＜0.01 or ＜:0.05).Pearson correlation analysis result showed that,in active children,the UCEIS had high positive correlation with fecal calprotectin (r =0.707,P＜0.01),mild positive correlation with p-ANCA,ESR,IL-6,CRP and albumin (r =0.660,0.650,0.626,0.592 and 0.486;P＜0.01),and low positive correlation with PCT and white blood cell (r =0.362 and 0.245,P＜0.01 or ＜0.05).ROC curve analysis result showed that the optimal cut-off value of p-ANCA was 23.40 U,and the area under curve (AUC) in diagnosis of active stage UC was maximum (0.923),with a specificity of 93.1％ and a sensitivity of 78.9％;the optimal cut-off value of fecal calprotectin was 732.69 μg/g,and the AUC in diagnosis of active stage UC was maximum (0.937),with a specificity of 93.0％ and a sensitivity of 92.9％.Conclusions Serum p-ANCA is useful for UC disease activity diagnosis in children,while fecal calprotectin is independent predictor of the severe of UC.

Objective: To investigate the diagnostic and predictable value of the levels of serum Trx (S-Trx), urinary Trx (U-Trx) and S-Trx/U-Trx ratio in acute pyelonephritis of children. Methods: A total of 120 children with urinary tract infection were divided into APN group (67 cases) and non-APN group (53 cases).In addition, 67 children with APN were assigned to severe group (23 cases)and non-severe group (44 cases). The leves of serum C-reactive protein(CRP), precalcitonin(PCT), cystatin C (CysC), Trx (S-Trx) and urinary β₂-microglobulin(β₂-MG), neutrophill gelatinase-related apolipoprotein (NGAL), Trx (U-Trx) were collected. Besides, the ratio of S-Trx/U-Trx was also counted. The diagnostic and predictable value of each index were determined by receiver operating characteristic (ROC). Results: Serum PCT, S-Trx, urinary β₂-MG, NGAL, U-Trx was markedly increased and S-Trx/U-Trx ratio was obviously decreased in the APN group compared to that of the non-APN group (P<0.05). Moreover, S-Trx, urinary NGAL, U-Trx was significantly increased and S-Trx/U-Trx ratio was significantly decreased in the severe group compared to that of the non-severe group (P<0.05). Both in APN group or severe APN group, S-Trx and U-Trx displayed significantly positive correlation (P<0.05). The results from ROC demonstrated that AUC were 0.960, and optimal cut-off value were 16.17 μg/L of U-Trx diagnostic APN in children, with a specificity and sensitivity of 94.34% and 92.54%, respectively. The optimal cut-off value was 1.29.AUC of S-Trx/U-Trx 0.960 predicted the severe of APN in children, with a specificity and sensitivity of 81.82% and 82.61%, respectively. Conclusions U-Trx is useful for diagnostic APN in children, S-Trx/U-Trx is an independent predictor of the severe APN.