Objective To explore the therapeutic effect of precise disconnection of pargastric varices guided by endoscopic ultrasound in the treatment of esophagogastric variceal bleeding.Method A retrospective analysis was conducted on 20 patients with cirrhosis esophagogastric variceal bleeding treated with endoscopic ultrasound-guided precise disconnection of pargastric varices from January 1,2024 to December 31,2024.The efficacy was analyzed.Result All 20 patients successfully completed the precise disconnection of pargastric varices under the guidance of endoscopic ultrasound.The injection of tissue gel combined with the placement of spring coils(14 cases)and the injection of tissue gel alone(4 cases)successfully blocked the pargastric varices.All patients did not experience perforation,esophageal and cardia stenosis,massive bleeding,septicemia,or ectopic embolization.One patient who received tissue gel alone had slight bleeding from the pargastric varices after surgery and improved after 3 days of treatment to reduce portal vein pressure.Another one patient who received tissue gel alone had a low-grade fever and normal body temperature after 3 days of anti-infection treatment.Conclusion Precise disconnection of pargastric varices under the guidance of endoscopic ultrasound has a good therapeutic effect on esophagogastric variceal bleeding,with fewer complications such as ectopic embolization,massive bleeding,infection,and perforation.However,close follow-up observation is still needed to address the issue of pargastric varices.

Objective To investigate the expression and clinical significance of serum microRNA-144-3p(miR-144-3p)and microRNA-126-3p(miR-126-3p)in patients with intracerebral hemorrhage(ICH).Methods From February 2022 to April 2023,120 ICH patients who underwent treatment at our hospital were recruited as the ICH group.They were separated into a good prognosis group and a poor prognosis group based on the modified Rankin Scale(mRS)score After 6 months treatment Additionally,110 healthy individuals who underwent physical examination at our hospital were included as the control group.Clinical data of patients were collected and analyzed.Enzyme linked immunosorbent assay(ELISA)was applied to detect serum levels of tumor necrosis factor-α(TNF-α)and vascular endothelial growth factor(VEGF)indicators.Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was applied to detect the expression levels of serum miR-144-3p and miR-126-3p.Pearson method was applied to analyze the correlation between serum miR-144-3p,miR-126-3p,TNF-α,and VEGF levels in ICH patients.Multivariate Logistic regression was applied to analyze the factors affecting the prognosis of ICH patients.ROC curve was applied to analyze the predictive value of serum miR-144-3p and miR-126-3p for the prognosis of ICH patients.Results In the control group,the serum miR-144-3p was 1.02±0.02,the TNF-α was(19.15±6.79)pg/ml,the VEGF level was(1.05±0.18)ng/ml,and the serum miR-126-3p level was 1.04±0.05.The values in the ICH group were 2.12±0.23,(48.32±8.43)pg/ml,(6.56±1.49)ng/ml,and(0.53±0.12),respectively.There was a statistically significant difference between the two groups(P＜0.05).Pearson analysis results showed that serum miR-144-3p was positively correlated with TNF-α and VEGF levels in ICH patients(r=0.496,0.542,P＜0.05),while serum miR-126-3p was negatively correlated with TNF-α and VEGF levels(r=-0.493,-0.526,P＜0.05).There were significant differences in the serum levels of miR-144-3p,miR-126-3p,TNF-α,VEGF,and NIHSS score between different prognostic groups(P＜0.05).Multivariate logistic analysis revealed that serum miR-144-3p,miR-126-3p,TNF-α,and VEGF were all factors affecting the poor prognosis of ICH patients(P＜0.05).The area under the curve(AUC)of serum miR-144-3p,miR-126-3p,and combined prediction of prognosis in ICH patients was 0.851,0.886,and 0.952,respectively,the combined prediction of the two was more valuable(Zcombination-miR-144-3p=3.371,Zcombination-miR-126-3p=2.791,P＜0.05).Conclusion The expression of miR-144-3p in the serum of ICH patients increases,while the expression of miR-126-3p decreases.The two may serve as biological markers for predicting the prognosis of ICH patients,and the combination of the two is more valuable in predicting the prognosis of ICH patients.

Objective To investigate the expression and clinical significance of serum microRNA-144-3p(miR-144-3p)and microRNA-126-3p(miR-126-3p)in patients with intracerebral hemorrhage(ICH).Methods From February 2022 to April 2023,120 ICH patients who underwent treatment at our hospital were recruited as the ICH group.They were separated into a good prognosis group and a poor prognosis group based on the modified Rankin Scale(mRS)score After 6 months treatment Additionally,110 healthy individuals who underwent physical examination at our hospital were included as the control group.Clinical data of patients were collected and analyzed.Enzyme linked immunosorbent assay(ELISA)was applied to detect serum levels of tumor necrosis factor-α(TNF-α)and vascular endothelial growth factor(VEGF)indicators.Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was applied to detect the expression levels of serum miR-144-3p and miR-126-3p.Pearson method was applied to analyze the correlation between serum miR-144-3p,miR-126-3p,TNF-α,and VEGF levels in ICH patients.Multivariate Logistic regression was applied to analyze the factors affecting the prognosis of ICH patients.ROC curve was applied to analyze the predictive value of serum miR-144-3p and miR-126-3p for the prognosis of ICH patients.Results In the control group,the serum miR-144-3p was 1.02±0.02,the TNF-α was(19.15±6.79)pg/ml,the VEGF level was(1.05±0.18)ng/ml,and the serum miR-126-3p level was 1.04±0.05.The values in the ICH group were 2.12±0.23,(48.32±8.43)pg/ml,(6.56±1.49)ng/ml,and(0.53±0.12),respectively.There was a statistically significant difference between the two groups(P＜0.05).Pearson analysis results showed that serum miR-144-3p was positively correlated with TNF-α and VEGF levels in ICH patients(r=0.496,0.542,P＜0.05),while serum miR-126-3p was negatively correlated with TNF-α and VEGF levels(r=-0.493,-0.526,P＜0.05).There were significant differences in the serum levels of miR-144-3p,miR-126-3p,TNF-α,VEGF,and NIHSS score between different prognostic groups(P＜0.05).Multivariate logistic analysis revealed that serum miR-144-3p,miR-126-3p,TNF-α,and VEGF were all factors affecting the poor prognosis of ICH patients(P＜0.05).The area under the curve(AUC)of serum miR-144-3p,miR-126-3p,and combined prediction of prognosis in ICH patients was 0.851,0.886,and 0.952,respectively,the combined prediction of the two was more valuable(Zcombination-miR-144-3p=3.371,Zcombination-miR-126-3p=2.791,P＜0.05).Conclusion The expression of miR-144-3p in the serum of ICH patients increases,while the expression of miR-126-3p decreases.The two may serve as biological markers for predicting the prognosis of ICH patients,and the combination of the two is more valuable in predicting the prognosis of ICH patients.

Objective To explore the therapeutic effect of precise disconnection of pargastric varices guided by endoscopic ultrasound in the treatment of esophagogastric variceal bleeding.Method A retrospective analysis was conducted on 20 patients with cirrhosis esophagogastric variceal bleeding treated with endoscopic ultrasound-guided precise disconnection of pargastric varices from January 1,2024 to December 31,2024.The efficacy was analyzed.Result All 20 patients successfully completed the precise disconnection of pargastric varices under the guidance of endoscopic ultrasound.The injection of tissue gel combined with the placement of spring coils(14 cases)and the injection of tissue gel alone(4 cases)successfully blocked the pargastric varices.All patients did not experience perforation,esophageal and cardia stenosis,massive bleeding,septicemia,or ectopic embolization.One patient who received tissue gel alone had slight bleeding from the pargastric varices after surgery and improved after 3 days of treatment to reduce portal vein pressure.Another one patient who received tissue gel alone had a low-grade fever and normal body temperature after 3 days of anti-infection treatment.Conclusion Precise disconnection of pargastric varices under the guidance of endoscopic ultrasound has a good therapeutic effect on esophagogastric variceal bleeding,with fewer complications such as ectopic embolization,massive bleeding,infection,and perforation.However,close follow-up observation is still needed to address the issue of pargastric varices.

Humans ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome/drug therapy*

To investigate the distribution and clinical significance of nuclear dense fine speckled (DFS) pattern in various diseases. A total of 95 289 patients who received DFS tests at Peking Union Medical College Hospital from January 2019 to December 2020 were included in this study. The results of indirect immunofluorescence assay (IIF) for detection of antinuclear antibody (ANA) were evaluated. The positive rates of ANA and DFS were 39.60% (37 733/95 289) and 1.19% (1 139/95 289) respectively. The positive rate of DFS in ANA-positive patients was 3.02% (1 139/37 733). DFS and ANA positivity were significantly different among different age groups rather than gender. The positivity rate of DFS reached the peak (55.57%, 633/1 139) in young patients between 21-40 years, while positive ANA with negative DFS was mainly observed in patients between 41-60 years (37.26%, 13 636/36 594). Additionally, single ANA-positivity were mainly detected in rheumatology department (59.23%, 18 402/31 066), whereas positive DFS was more common in obstetrics and gynecology department (3.08%, 49/1 593). There were 82.88% (944/1 139) patients with positive DFS diagnosed with non-autoimmune disease (non-AID), and 19.49%(222/1 139) with dermatosis. Positive DFS with higher titer (≥1∶320) was detected more frequently in autoimmune disease (AID) patients (5.13%, 10/195) than in non-AID patients (1.69%, 16/944) ( P<0.05). The DFS pattern is rare in ANA positive patients, which is mainly observed in women between 21-49 years. High titer of DFS is prevalent in AID patients, but positive DFS is detected more in non-AID patients, especially those with dermatosis.

Glycosylation is one of the most important post-translational modification in protein biosynthesis. Immunoglobulin glycosylation can exert anti-inflammatory or pro-inflammatory activity by regulating antibody stability and affecting its interaction with different FcγRs. In recent years, a large number of studies have confirmed that abnormal glycosylation of immunoglobulin plays a key role in the pathogenesis of autoimmune diseases. Its products, such as sugar chain structure or/and glycosylated proteins, can be detected by lectin microarray and other technologies, are expected to become new serum markers of autoimmune diseases. It has a broad application prospect in disease diagnosis, condition monitoring, prognosis evaluation and treatment.

Objective This study aimed to assess the diagnostic value of anti-mutated citrullinated vimentin (MCV) antibodies in rheumatoid arthritis (RA) and its correlation with disease progression, extra-articular manifestations and overlap syndrome. Methods Retrospective Studies. Clinical data of 837 patients in PekingUnionMedicalCollegeHospitalfrom June to August 2017 were collected, including the result of anti-MCV, anti-cyclic citrullinated peptide (anti-CCP) antibodies, rheumatoid factor (RF), erythrocyte sedimentation rate (ESR) and High-sensitivity-C-reactive protein (CRP). According to the 1987 American College of Rheumatology classification criteria for rheumatoid arthritis, there were 323 patients diagnosed with RA, including 59 males and 264 females with the average age of 51 years. According to whether the RA patients have overlap syndrome with other autoimmune disease (AID) or have extra-articular manifestations, 258 cases were categorized into RA group, including 47 males and 211 females with the average age of 50 years; 14 cases were categorized into the group of overlap syndrome, including 1 male and 13 females with the average age of 36 years;51 cases were categorized into the group of extra-articular manifestations, including 11 males and 40 females with the average age of 59 years.According to 2010 rheumatoid arthritis classification criteria for destruction in joints, the radiographic changes were divided into 4 stages. There were 203 casesenrolled in our study, 88 caseswere fitted into early stage group (stage I)including 21 males and 67 females with the average age of 48 years; 115 caseswere fitted into progressive stage group, which compromisedstageⅡ (interim stage), stage Ⅲ (severe stage) and stage Ⅳ(final stage) cases, including 19 males and 96 females with the average age of 53 years. Mann-Whitney U test, x2 test, Receiver operating characteristic (ROC) curves and Spearmancorrelation coefficientwere used in Statistical analysis. Results Ⅰ Amongdiagnosed RA patients, 199 (61.6％) cases were positive for anti-MCV, anti-CCP and RFsimultaneously, 42 (13％) cases were positive for anti-MCV, which was higher than anti-CCP positive (1 cases, 0.3％) or RF positive (7cases, 2.2％). The difference was statistically significant(P<0.001, P<0.001). ⅡROC was calculated and MCV=35.95 U/ml was used as best-fit cut-off value. The AUC for anti-MCV was 0.867, while the sensitivity was 80.5％and specificity was 80.9％.ⅢThe detection levels of anti-MCV (682.8 (106.4-1000.0)), anti-CCP (407 (4.0-1536.0)) and RF (82.8 (21.1-244.9)) in the group of progressive stage were higher than those in the group of early stage (114.5 (28.5-1000.0), 62.5 (5.0-1020.7), 50.1 (6.7-127.1)), which showed a significant difference(P<0.05, P<0.05, P<0.05). The anti-MCV, anti-CCP and RF were positively related to the degree of joint destruction (r=0.229, P<0.05;r=0.187, P<0.05;r=0.167, P<0.05);anti-MCV and anti-CCP were positively related to extra-articular manifestation (r=0.152, P<0.05;r=0.136, P<0.05). Conclusion Anti-MCV antibodies are more sensitive in patients with RA, and have complementary diagnostic value for anti-CCP and RF-negative patients; high levels of anti-MCV and anti-CCP in RA patients are associated with RA progression and extra-articular involvement.

Objective To explore the influence of prozone effect on anti-nuclear antibodies (ANA) testing by indirect immunofluorescence assay (IIFA).Methods The samples with high titer of ANA (≥1∶1 000) were selected from 880fresh serum samples, and were subsequently diluted in 1∶100, 1∶1 000and 1∶10 000ratio.Prozone effect was defined as fluorescence intensity from 1∶1 000dilution was stronger than that from1∶100dilution.The samples with prozone effect were determined manually or by Sprinter XL and EUROPattern.The samples with prozone effect were further characterized by combinations of fluorescence patterns, fluorescence intensities and autoantibody specificities.Results A total of 880samples were tested.Importantly, 34samples displayed prozone effect (3.86％in total and 29.57％in samples with ANA≥1∶1 000).Interestingly, prozone effect was identified by manual detection as well as by Sprinter XL with similar fluorescence patterns and fluorescence intensities.Notably, EUROPattern can only select the central area for identification.Among all samples with prozone effect, 74.42％samples exhibited fluorescence intensities of≥1∶10 000.Speckled pattern was the most prevalent fluorescence patterns in samples with prozone effect (46.51％).In addition, anti-RNP antibodies (62.79％) were the most popular autoantibodies in samples with prozone effect, followed by anti-dsDNA antibodies (51.16％) and anti-SSA antibodies (51.16％).Conclusion Prozone effect was present in ANA testing, especially in samples with high titers, resulting in underestimating the titers.The study highlighted that special attention should be paid to the prozone effect in clinical practice.

Along with the rapid development of biomedical technology and the clinical application of anti-neutrophil cytoplasmic antibody ( ANCA ) , the detection of ANCA by indirect immunofluorescence ( IIF) and the detection of specific autoantibodies of ANCA by various immunological methods have also been developed , which promoted the standardization of ANCA′s laboratory testing procedures .These advances have brought new opportunities and challenges to ANCA′s laboratory testing technology and its clinical application.