ABSTRACT
Objective To evaluate the value of 2012 classification criteria for early rheumatoid arthritis (ERA),2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria,and 1987 ACR classification criteria in the diagnosis of early rheumatoid arthritis (RA).Methods Patients who had at least one swollen and tender joint with disease duration no more than 2 years,and age more than 16 years were enrolled.The patients were diagnosed as RA or other non-RA by 2 experienced rheumatologists.The clinical and laboratory parameters were recorded.The sensitivity and specificity of three RA classification criteria were compared by McNemar test,The areas under the receiver operating characteristic curve (ROC) curve (AUC) of each RA classification criteria were analyzed using MedCalc software.Results Atotal of 310 patients were enrolled in this study,including 182ERA and 128 non-RA.The sensitivity(88.5％) of ERA criteria was much higher than that of the 1987 ACR criteria (45.6％,x2=75.013,P＜0.05),and not significantly different with the 2010 ACR/EULAR criteria (91.8％,X2=1.042,P＞0.05).The specificity of ERA criteria (91.4％) of 2010 ACR/EULAR criteria (87.5％,x2=1.8,P＞0.05) was similar to that of the 1987 ACR criteria (96.1％,x2=3.1,P＞0.05).The AUC of ERA criteria was 0.962 [95％CI(0.934,0.980)],which was slightly better than that of the 2010 ACR/EULAR criteria 0.959 [95％CI(0.931,0.978)],Z=0.380,P=0.7038,and much higher than that of the 1987 ACR criteria 0.885 [95％CI (0.845,0.919)],Z=4.517,P＜0.01.Conclusion Overall evaluation,the diagnostic value of ERA criteria is better than 1987 ACR and 2010 ACR/EULAR criteria in early rheumatoid arthritis.Compared to 2010 ACR/EULAR classification criteria,ERA criteria is more simple and practical.
ABSTRACT
Objective To induce the formation of hair follicles in vivo and in vitro with primary human hair follicle outer root sheath cells (ORSCs),human hair dermal papilla cells (DPCs) and fibroblasts seeded on three-dimensional alginate scaffolds at different sequences.Methods Second-passage ORSCs,DPCs and mitomycin-c-treated human fibroblasts were seeded into three-dimensional alginate scaffolds at different sequences and a certain ratio to reconstruct hair follicles in vitro.After 8 weeks of culture,some of the substitutes were subjected to hematoxylin and eosin (HE) staining,and some were transplanted into the subcutaneous tissue of bal/bcl nude mice followed by additional culture for 8 weeks.Then,the mice were sarcrificed and transplants were harvested and subjected to HE staining,immunohistochemical staining and transmission electron microscopy for the observation of hair follicle formation.Results After 8 weeks of culture in vitro,hair follicle cells were evenly scattered in three-dimensional scaffolds,with no keratinized material or hair follicle formation.When the substitutes were cultured in vivo for 8 weeks,DPCs and ORSCs gathered together to form cell aggregates,with the visualization of hair follicle-like structure in circular arrangement,which was positive for cytokeratin (CK) 14,CK15,β1-integrin and vimentin.Electron microscopy showed hair follicle cells and erythrocytes adhering to the scaffolds.One-week preculture of mitomycin-c-trcatcd human fibroblasts in the scaffolds followed by the seeding of the suspension of ORSCs and DPCs at a ratio of 1∶5 resulted in increased follicular like structures with more typical appearance in mice compared with the other strategies for cell inoculation and culture.Conclusions In the reconstructed hair follicle models,DPCs keep the capability to induce the formation of hair follicles,and ORSCs keep the characteristics of hair follicle stem cells.The optimal cell density,ratio and process were determined in the experiment,which may lay a methodological and theoretical basis for hair follicle reconstruction.