Objective To explore the positive distribution of antinuclear antibody(ANA)and antinuclear antibody spectrum(ANAs)specific antibody detection in patients with chronic kidney disease(CKD)and its clinical application.Methods Indirect immunofluorescence(IIF)and line immunoassay(LIA)were used to detect ANA and ANAs in the sera of 3 968 CKD patients.Results The positive rate of IIF-ANA was 14.34％,that of LIA-ANAs was 26.84％,and the coincidence rate of the two detection results was 74.65％.In IIF-ANA,the distribution of nuclear patterns showed that the highest proportion was the nuclear speckled type(38.87％),followed by the cytoplasmic speckled type(20.06％).In LIA-ANAs,anti-SSB antibody showed the highest positive rate(13.40％),followed by anti-SSA antibody(13.33％).Additionally,the positive rates of IIF-ANA and LIA-ANAs were 20.44％and 30.35％respectively in females,significantly higher than those of males at 9.98％and 24.33％(P＜0.05),and also showed a relatively high positive rate in patients under 20 years old at 46.15％and 38.46％(P＜0.05).Among patients with stage 5 CKD(CKD5),the positive detection rate of ANA was the highest at 15.30％,and the specific antibody indicators with relatively high detection rates in stages 1 to 5 mainly included anti-SSB antibody(average 5.12％)and anti-SSA antibody(average 5.09％).Conclusion The positive detection rates and consistent coincidence rates of autoantibodies in CKD patients,detected by IIF and LIA,are relatively high,especially in young women,middle-aged and elderly women,and patients who have progressed to stage 5.The positive rate of IIF-ANA increases with the progression of the disease.Therefore,routine detection of autoantibodies in patients is of great value and significance for the early identification of autoimmune diseases and can provide assistance for the treatment and prevention of CKD.

Objective To explore the positive distribution of antinuclear antibody(ANA)and antinuclear antibody spectrum(ANAs)specific antibody detection in patients with chronic kidney disease(CKD)and its clinical application.Methods Indirect immunofluorescence(IIF)and line immunoassay(LIA)were used to detect ANA and ANAs in the sera of 3 968 CKD patients.Results The positive rate of IIF-ANA was 14.34％,that of LIA-ANAs was 26.84％,and the coincidence rate of the two detection results was 74.65％.In IIF-ANA,the distribution of nuclear patterns showed that the highest proportion was the nuclear speckled type(38.87％),followed by the cytoplasmic speckled type(20.06％).In LIA-ANAs,anti-SSB antibody showed the highest positive rate(13.40％),followed by anti-SSA antibody(13.33％).Additionally,the positive rates of IIF-ANA and LIA-ANAs were 20.44％and 30.35％respectively in females,significantly higher than those of males at 9.98％and 24.33％(P＜0.05),and also showed a relatively high positive rate in patients under 20 years old at 46.15％and 38.46％(P＜0.05).Among patients with stage 5 CKD(CKD5),the positive detection rate of ANA was the highest at 15.30％,and the specific antibody indicators with relatively high detection rates in stages 1 to 5 mainly included anti-SSB antibody(average 5.12％)and anti-SSA antibody(average 5.09％).Conclusion The positive detection rates and consistent coincidence rates of autoantibodies in CKD patients,detected by IIF and LIA,are relatively high,especially in young women,middle-aged and elderly women,and patients who have progressed to stage 5.The positive rate of IIF-ANA increases with the progression of the disease.Therefore,routine detection of autoantibodies in patients is of great value and significance for the early identification of autoimmune diseases and can provide assistance for the treatment and prevention of CKD.

Tumor immunotherapy includes immune checkpoint inhibitor (ICI), tumor vaccines, and adoptive cell therapy. Immunotherapy, as the main systemic treatment for advanced malignant tumors, kills tumor cells by activating the immune system and prolongs the survival of patients. However, excessive immune responses can cause immune-related adverse events (irAE), causing damage to systemic tissues. ICI are the main tumor immunotherapy drugs that cause optic nerve irAE. The most common optic nerve irAE are optic neuritis, only a few patients appeared arteritic anterior ischemic optic neuropathy. Sudden painless loss of bilateral vision is the most common clinical manifestation. In severe cases, the vision decrease to no light perception. Early diagnosis and early adequate glucocorticoid treatment can improve the symptoms. Therefore, neuro-ophthalmologists and oncologists should know the clinical characteristics of optic nerve irAE, in order to diagnose and treat early and improve the prognosis.

Objective:To examine the correlation factors of acute appendicitis associated with appendiceal neoplasms.Methods:Consecutive 712 patients with acute appendicitis who treated at Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University from January 2002 to December 2016 were analyzed retrospectively. There were 314 females and 398 males, aging (42.5±16.2) years (range: 14 to 94 years). Among the 712 cases, 36 patients were diagnosed with acute appendicitis associated with appendiceal neoplasms, the other 676 patients had no appendiceal neoplasm. The patients ′ clinical baseline characteristics and clinical parameters were compared between the two groups. The correlation factors of acute appendicitis associated with appendiceal neoplasms were evaluated by using the univariate (χ 2 test or t test) and multivariate Logistic regression analysis. The area under curve of receiver operating characteristic curves was utilized to evaluate the discriminatory power of the predictive models. Results:According to the univariate analysis, gender, age, body mass index, the duration of chronic right low abdominal pains≥3 months, the frequency of recurrently acute right lower abdominal pain≥2, the frequency of acute right lower abdominal pain, past history of diabetes, hypertension or coronary heart disease, the level of neutrophils and leukocytes preoperatively, stercolith and periappendiceal effusion, and modified Alvarado score were positively correlated with appendiceal neoplasms (all P<0.05). Then four variables were incorporated into the model eventually by multivariate Logistic regression analysis, which were as follows: age (increased per decade) ( OR=2.23, 95% CI: 1.68 to 2.95, P<0.01), gender (female) ( OR=4.21, 95% CI: 1.74 to 10.19, P=0.001), the duration of chronic right low abdominal pains (more than 3 months) ( OR=2.53, 95% CI: 1.01 to 3.37, P=0.048), and modified Alvarado score (decreased per 1 score) ( OR=2.54, 95% CI: 1.87 to 3.34, P<0.01). The area of curve was 0.93 (95% CI: 0.88 to 0.97), which indicated that the model exhibits an excellent ability to discriminate between appendiceal neoplasms and acute appendicitis. Conclusions:The older age, female, the duration of chronic right low abdominal pains, and lower modified Alvarado score are independent correlation factors for acute appendicitis associated with appendiceal neoplasms. Clinicians should be alert for the above clinical characteristics and choose optimal treatment for acute appendicitis associated with appendiceal neoplasms.

Objective:To examine the correlation factors of acute appendicitis associated with appendiceal neoplasms.Methods:Consecutive 712 patients with acute appendicitis who treated at Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University from January 2002 to December 2016 were analyzed retrospectively. There were 314 females and 398 males, aging (42.5±16.2) years (range: 14 to 94 years). Among the 712 cases, 36 patients were diagnosed with acute appendicitis associated with appendiceal neoplasms, the other 676 patients had no appendiceal neoplasm. The patients ′ clinical baseline characteristics and clinical parameters were compared between the two groups. The correlation factors of acute appendicitis associated with appendiceal neoplasms were evaluated by using the univariate (χ 2 test or t test) and multivariate Logistic regression analysis. The area under curve of receiver operating characteristic curves was utilized to evaluate the discriminatory power of the predictive models. Results:According to the univariate analysis, gender, age, body mass index, the duration of chronic right low abdominal pains≥3 months, the frequency of recurrently acute right lower abdominal pain≥2, the frequency of acute right lower abdominal pain, past history of diabetes, hypertension or coronary heart disease, the level of neutrophils and leukocytes preoperatively, stercolith and periappendiceal effusion, and modified Alvarado score were positively correlated with appendiceal neoplasms (all P<0.05). Then four variables were incorporated into the model eventually by multivariate Logistic regression analysis, which were as follows: age (increased per decade) ( OR=2.23, 95% CI: 1.68 to 2.95, P<0.01), gender (female) ( OR=4.21, 95% CI: 1.74 to 10.19, P=0.001), the duration of chronic right low abdominal pains (more than 3 months) ( OR=2.53, 95% CI: 1.01 to 3.37, P=0.048), and modified Alvarado score (decreased per 1 score) ( OR=2.54, 95% CI: 1.87 to 3.34, P<0.01). The area of curve was 0.93 (95% CI: 0.88 to 0.97), which indicated that the model exhibits an excellent ability to discriminate between appendiceal neoplasms and acute appendicitis. Conclusions:The older age, female, the duration of chronic right low abdominal pains, and lower modified Alvarado score are independent correlation factors for acute appendicitis associated with appendiceal neoplasms. Clinicians should be alert for the above clinical characteristics and choose optimal treatment for acute appendicitis associated with appendiceal neoplasms.