OBJECTIVE: To stratify systemic lupus erythematosus (SLE) patients clinically, to analyze the clinical characteristics of patients with and without disease activity, and to explore the application va-lue of key clinical indicators in assessing disease activity, as well as to construct an evaluation model. METHODS: A retrospective analysis was conducted on clinical data of the SLE patients diagnosed at Peking University People' s Hospital from May 1995 to April 2014. Demographic information, clinical manifestations, laboratory tests, and antibody detection results were collected. The patients were divided into active and inactive groups based on systemic lupus erythematosus disease activity index 2000(SLEDAI-2000)scores. t-tests, Mann-Whitney U tests, and χ² tests were used to compare the differences between the groups. Spearman correlation analysis was used to evaluate the relevant clinical indicators associated with SLE activity in the active disease group. Based on the results of statistical analysis, a Logistic regression model was constructed, and the performance of the model was evaluated. RESULTS: No significant differences were found in demographic characteristics between the two groups. In the active disease group, positive rates of antinuclear antibodies (ANA) and anti-double-stranded DNA antibodies (anti-dsDNA) were increased; white blood cell count (WBC), red blood cell count (RBC), hemoglobin (HGB), lymphocytes (LY), total protein (TP), albumin (ALB), and complement 3(C3) levels were significantly decreased; while immunoglobulin A and G levels were markedly elevated. The correlation analysis results showed that hemoglobin, albumin, C3, and complement 4(C4) had higher correlation indices compared with other clinical indicators. Among these, C3 exhibited a certain negative correlation with disease activity. The Logistic regression model based on 12 significantly different indicators (P < 0.05) achieved an accuracy of 91.4%, sensitivity of 94.4%, specificity of 81.0%, and the area under curve (AUC) of the receiver operating characteristic (ROC) was 0.944. CONCLUSION This study comprehensively evaluated a range of clinical indicators related to SLE disease activity, providing a thorough understanding of both laboratory and clinical markers. The Logistic regression model, which was primarily constructed using laboratory test indicators, such as inflammatory markers, immune response parameters, and organ involvement metrics, demonstrated a high degree of accuracy in assessing the disease activity in SLE patients. Consequently, this model might provide a new basis for the diagnosis and treatment of SLE patients, offering significant clinical diagnostic value.
Humans ; Lupus Erythematosus, Systemic/diagnosis* ; Retrospective Studies ; Antibodies, Antinuclear/blood* ; Complement C3/metabolism* ; Complement C4/metabolism* ; Logistic Models ; Severity of Illness Index ; Leukocyte Count ; Female ; Male ; Serum Albumin/analysis*

Objective: To explore the application of interactive nursing model in children with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: From July 2015 to August 2017, 110 children with OSAHS admitted to our hospital were enrolled in this study. The patients were divided into two groups (55 cases) according to the digital random table method. Control group routine care, observation group interactive nursing model. Anxiety, pain, treatment compliance and nursing satisfaction were compared between the two groups before and after treatment. Results: The scores of anxiety before operation and at 24h after operation in observation group were (45.01±5.22) points, (50.26±5.44) points and (48.37±5.21) points respectively before operation and (48.87±5.79) points, (56.28±6.03) points and (51.46±5.28) points respectively, the difference was statistically significant (t= 3.672, 5.497, 3.089, P <0.05). The VAS scores of the observation group at 6h and 24h after operation were (4.65±0.78), (2.82±0.51) points in the control group and (5.14±0.73) points and (3.43±0.57) points in the control group (t= 3.402, 5.915, P<0.05) The treatment compliance and nursing satisfaction were 94.55%(52/55) and 96.36%(53/55) respectively, while those in the control group were 74.55%(41/55) and 72.73%(40/55), respectively. The difference was statistically significant (χ²=8.419, 11.758, P<0.05). Conclusions The interactive nursing model applied to children with OSAHS surgery can relieve anxiety, relieve postoperative pain, improve treatment compliance and satisfaction with nursing, which is worthy of popularization.

Objective To explore the expression and clinical significance of soluble Axl and Tyro3 receptor tyrosine kinase in systemic lupus erythematosus (SLE).Methods Sandwich enzyme linked immunosorbent assay (ELISA) was used to detect sAxlTK and sTyro3TK in the serum of 140 SLE patients,150 disease controls and 100 healthy controls (HC).The relationships between the serum levels of sAxlTK/sTyro3TK and clinical manifestations,laboratory parameters,disease activity were analyzed in SLE patients.Analysis of variance,Dunnett's t-test,chi-square test and spearman's test were used for statistical analysis.Results The concentrations of sAxlTK [(56±18) ng/ml] and sTyro3TK [(3.9±1.6) ng/ml] were both elevated in serum of SLE patients,which were significantly higher than disease controls [sAxlTK:(41±17) ng/ml;sTyro3TK:(2.6± 1.2) ng/ml] and healthy controls [sAxlTK:(37±10) ng/ml;sTyro3TK:(2.1±0.7) ng/ml].The SLE sAxlTK levels were negatively correlated with lymphocyte count (r=-0.266,P=0.002),hemoglobin (r=-0.480,P＜0.01),platelet count (r=-0.374,P＜0.01),albumin (r=-0.465,P＜0.01),estimated glomerular filtration rate (eGFR,r=-0.230,P=0.006),complement C3 (r=-0.399,P＜0.01) and complement C4 (r=-0.374,P＜0.01).However,the levels of sAxlTK in SLE patients were positively correlated with D-dimer (r=0.371,P＜0.01),creatinine (r=0.278,P＜0.01),24-hour urinary protein quantification (r=0.383,P＜0.01),erythrocyte sedimentation rate (r=0.422,P＜0.01),titre of anti-nuclear antibodies (r=0.271,P=0.002),anti-dsDNA antibody (r=0.299,P＜0.01),anti-nucleosome antibody (r=0.263,P=0.013) and anti-cardiolipin antibody (r=0.309,P＜0.01).In addition,the levels of serum sAxlTK in SLE patients showed positive correlation with the scores of SLEDAI (r=0.307,P＜0.01).Comparisons of sAxlTK levels between patients with high and low disease activity demonstrated a higher level of sAxlTK in the former [(64±17) ng/ml vs (52±16) ng/ml;t=-3.939,P＜0.01].Conclusion The levels of sAxlTK and sTyro3TK are elevated in the serum of SLE patients.The concentration of sAxlTK is correlated with autoantibodies production,hematological and renal involvement in SLE,which may be a serolgical marker for disease activity.

Objective To evaluate the value and the expression of Axl receptor tyrosine kinase (AxlTK) in renal pathology of lupus nephritis (LN) patients. Methods The expression of AxlTK were detected in 29 LN and 10 primary nephritic syndrome (NS) patients using immunohistochemistry in renal tissue. The correlations between the levels of AxlTK on glomeruli and clinical manifestations, laboratory parameters, disease activity, and renal pathology in LN patients were investigated. T test and single factor analysis of variance were used tp compare between groups, and Pearson or Spearman test was used for correlation analysis. Results AxlTK was extensively expressed on surface of mesangial cells, endothelial cells in glomeruli. There was more expression of AxlTK on mesangial cells in LN patients [(7.0 ±2.2)×10-2] than that in primary NS patients [(3.1 ±1.2) ×10-2] (t=5.382, P<0.01). The expression of AxlTK in the glomeruli of LN patients with oral ulcers is higher than that in patients without of ulcers (t=2.259, P=0.032), and it was positively correlated with the anti-nucleosome antibody (AnuA) level in patients (r=0.488, P=0.017). The expression of AxlTK on glomeruli were higher in class Ⅳ and classⅢ of LN patients than that of class Ⅴ, but there was no statistically significant difference between them (P>0.05). Conclusion The expression of Axl TK in glomerular is significantly increased in glomeruli in LN patients. The expression level of AxlTK on glomeruli is correlated with the occurrence of oral ulcers and AnuA. The level of AxlTK expression is related to pathological categories of kidney in LN patients. The results of this study suggest that AxlTK might participate in the pathogenesis of LN.

Objective To explore changes humoral immune factors and MDA in DEACMP patients.Methods 40 cases with carbon monoxide poisoning delayed brain were selected to be experiment group.40 cases of healthy people were selected to be control group.IL-2,IL-6,IL-10 and MDA were before and after treatment.Results IL-2,IL-6 of the experiment group were lower,IL-10,MDA were higher than the control group before treatment (P<0.05),both of IL-2,IL-6,IL-10 and MDA were recovery after the treatment (P<0.05).IL-6 of the experiment before treatment was significantly correlated with MMSE score(r =0.34,P <0.05).More severe cognitive impairment, the higher the level of concentration of IL-6(P<0.05). Conclusion The immune inflammatory cytokines and MDA play an important role in acute carbon monoxide poisoning delayed encephalopathy pathogenesis.Detection of the levels for judging the severity of the patient’s condition and prognosis has important significance.

BACKGROUND:Studies have shown that percutaneous vertebroplasty is a better method to repair osteoporotic vertebral compression fractures, but there are stil less specific schemes of transpedicular approach. Whether unipedicular or bipedicular approach is preferred is stil controversial. OBJECTIVE:To compare the clinical efficacy of percutaneous verterbroplastyviaunipedicular and bipedicular approach on osteoporotic vertebral compression fractures. METHODS:Totaly 118 patients with osteoporotic vertebral compression fractures who had been admitted at the Department of Orthopedics, the First People's Hospital of Kashi from June 2010 to June 2013 and folowed up over 1 year were enroled and randomly divided into unipedicular and bipedicular groups, with 59 in each group. These two groups were compared in terms of bone cement volume, bone cement leakage, kyphosis correction, vertebral height restoration, visual analog scale score, Oswestry disability index, activity of daily living scale score, SF-36 score, and postoperative complications. RESULTS AND CONCLUSION: The cement leakage rate was lower in the unipedicular group (34%) than the bipedicular group (37.3%), but there was no significant difference (P=0.701 > 0.05). The kyphosis correction and scoliosis correction had no statistical significance between the two groups (P > 0.05). The mean vertebral height was improved significantly in both two groups at 1 year after operation (P < 0.05), but there was no difference between the two groups before and after operation (P > 0.05). There were also no significant differences between the two groups in terms of visual analog scale score, Oswestry disability index, activity of daily living scale score, SF-36 score before and after operation, but these indexes were al improved significantly in each group at 1 year after operation than before operation (P < 0.05). The bone cement amount of the unipedicular group was lower than that of the bipedicular group (P=0.001 < 0.05), and the operation time was also shorter in the unipedicular group than the bipedicular group (P=0.000 < 0.05). No serious complications occurred in the two groups. These findings indicate that percutaneous verterbroplasty via unipedicular and bipedicular approach has good analgesic and repair outcomes in patients with osteoporotic vertebral compression fractures, and the unipedicular approach is better than the bipedicular approach in the folowing aspects: less bone cement volume, lower cement leakage and shorter operation time.

Objective To investigate the clinical significance of soluble Mer receptor tyrosine kinase (sMerTK) in patients of systemic lupus erythematosus.Methods sMerTK was detected in the serum of 101 SLE patients,96 disease controls and 62 healthy controls (HC) by sandwich enzyme-linked immunosorbent assay (ELISA).The relationships between the serum levels of sMerTK and clinical manifestations,laboratory parameters,disease activity were investigated in SLE patients.Comparisons between groups were tested by t-test and x2 test,Correlation of parameters were analyzed by Spearman method.Results sMerTK levels in SLE patients [(10.6±6.0) ng/ml] was significantly higher than disease controls [(4.4±2.0) ng/ml] (t=9.704,P＜0.01) and healthy controls [(2.8±2.5) ng/ml] (t=11.505,P＜0.01).The concentrations in SLE patients were independent of gender,age and disease duration.The levels of sMerTK were negatively correlated with white blood cell (r=-0.236,P=0.017),hemaglobin(r=-0.354,P＜0.01),platelet values (r=-0.310,P=0.002).Compared with the patients without lupus nephritis (LN)[(9±6) ng/ml],patients with LN had higher concentrations in serum [(11±6) ng/ml],and the difference was statistically significant (t =2.071,P=0.041).In addition,sMerTK levels were also correlated with 24 h-urinary protein level (r=0.293,P=0.013),serum creatinine (r=0.250,P=0.035) and e-GFR (r=-0.201,P=0.045).Furthermore this study indicated that sMerTK was negatively correlated with C3 (r=-0.447,P＜0.01) and C4 (r=-0.357,P＜0.01)level,but positively correlated with anti-dsDNA antibody titers (r=0.360,P＜0.01),anti nucleosome antibody (AnuA) (r=0.264,P=0.016) and SLEDAI (r=0.473,P＜0.01).Conclusion sMerTK level is increased in SLE patients.The concentration may associate with hematology changes and lupus nephritis.It may be an indicator of disease activity.

Objective To investigate the significance of plasma protein S and growth-arrest specific protein 6 (Gas6) in systemic lupus erythematosus (SLE).Methods Sandwich enzyme-linked immunosorbent assay (ELISA) was used to measure the protein S and Gas6 in the plasma of 103 SLE patients and 40 healthy controls.Mann-Whitney U-test,x2-test and Spearman's rank correlation were used for statistical analysis.Results The plasma concentrations of protein S and Gas6 were both significantly [protein S:30.6 (27.2,33.6) μg/ml,37.8(35.4,46.7) μg/ml,Z=6.04,P＜0.01; Gas6:402.6(239.2,757.8) pg/ml,913.6(765.0,1 290.6) pg/ml,Z=4.26,P＜0.01] decreased in plasma of SLE patients than that in healthy controls.There was a positive correlation between levels of protein S and Gas6 (r=0.312,P=0.001).The level of protein S in SLE patients was positively correlated with hemoglobin (Hb),WBC,platelet blood platelet (PLT),C3 and C4 (r=0.209,0.264,0.264,0.362,0.280,P＜0.01 or P＜0.05).Plasma protein S level was also found to be negatively correlated with auto-antibodies such as anti-double strand DNA (anti-dsDNA) antibody,anticardiolipin (ACL),anti-nucleosome antibody (AnuA) or IgG (r=-0.197,-0.264,-0.226,-0.229,P＜0.01or P＜0.05).The plasma Gas6 level was positively associated with age,disease duration and C-reaction protein (CRP) (r=0.229,0.198,0.263,P＜0.01 or P＜0.05).Patients with decreased Gas6 level showed higher incidence of fever,rash and serositis.Patients with decreased WBC or positive for proteinuria also showed decreased Gas6 (P＜0.05).Conclusion Protein S levels are significantly decreased in plasma of SLE patients and is associated with a series of severe disease manifestations such as hematological involvement,decreased complements and the presence of auto-antibodies.Decreased Gas6 levels in SLE patients are observed and they are correlated with age,disease duration and certain clinical characteristics such as rash,renal involvement and inflammatory response.

Ras is best known for its ability to regulate cell growth, proliferation and differentiation. Mutations in Ras are associated with the abnormal cell proliferation which can result in incidence of all human cancers. Extracellular signal-regulated kinase (ERK) is a downstream effector of Ras and plays important roles in prognosis of tumors. Recently, evidence has gradually accumulated to demonstrate that there are other effectors between Ras and ERK, these proteins interact each other and constitute the thorough Ras/Raf/MEK/ERK signaling pathway. The pathway has profound effects on incidence of esophageal carcinoma and clinical applications of some chemotherapeutic drugs targeting the pathway. Further understanding of the relevant molecular mechanisms of Ras/Raf/MEK/ERK signaling pathway can be helpful for the development of efficient targeting therapeutic approaches which contribute to the treatment of esophageal cancer. In this article, roles of Ras/Raf/MEK/ERK signaling pathway in esophageal carcinoma as well as pharmacological targeting point in the pathway are reviewed.

AIM: To investigate the role of mild heat stress towards the immunological function of splenic macrophages and significance of BiP protein expression. METHODS: Primary cultured splenic macrophages were prepared and placed in 41 ℃ thermostat for thermal stress and restored to 37 ℃ after an hour. Heat stressed macrophages were separated into groups at time points of 0 min, 30 min, 60 min, 120 min and 180 min, and their BiP mRNA and BiP protein expressions were detected. At the same time, the phagocytic function, cytotoxicity and chemotaxis of the macrophages were detected. RESULTS: After heat stress, the expressions of BiP mRNA and BiP protein in splenic macrophages remarkably increased, and reached to peak after 30-60 min, still remained higher than control group after 120 min and restored to normal level after 180 min. At the same time, mild heat stress enhanced the phagocytotic, cytotoxicity and chemotactic activities of splenic macrophages, and reached to peak after 60 min then gradually decreased. CONCLUSION: The expression of BiP protein is enhanced after mild heat stress, synchronous changes happen both in BiP protein expression and cellular function. There is close relation between BiP protein expression and increased functions of splenic macrophages induced by mild heat stress.