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Objective:To evaluate the clinical performance of anti-peptidylarginine deiminase 2 (PAD2) and anti-PAD4 antibodies combined testing in a Chinese rheumatoid arthritis (RA) cohort.Methods:A total of 148 RA inpatients and 35 patients with non-RA arthritis as controls (DC) were recruited from November, 2018 to November, 2019 in Peking University People′s Hospital. In addition, a total of 44 healthy controls (HC) who went to Peking University People′s Hospital for annual physical examination were collected from June 2019 to July 2019. The α-PAD2 and α-PAD4 level in clinical specimens were determined by ELISA. Statistical analysis was performed by the Mann-Whitney U test, the Kruskal-Wallis (KW) test, the χ 2 test or the Fisher′s Exact Test, as necessary. Correlation analysis were performed by logistic regression. Results:α-PAD2 and α-PAD4 were present in 26.4% (39/148) and 20.9% (31/148) patients with RA, 5.7% (2/35) and 5.7% DC (2/35) and 4.5% (2/44) and 2.3% HC (2/44), respectively. α-PAD4-positive RA patients displayed significantly longer disease duration compared to α-PAD4-negative RA patients (17.3±13.2 years vs 8.6±10.2 years, P<0.001). α-PAD4-positive RA patients showed a significantly higher incidence of interstitial lung disease (ILD) compared to those without α-PAD4 (54.8% vs 25.6%, P=0.002). No associations between α-PAD2 and ILD were found ( OR: 0.797, P=0.579). In contrast, significant associations between α-PAD4 and ILD were found ( OR: 3.521, P=0.002). In seropositive RA, α-PAD4 displayed a weak correlation with ILD ( OR: 2.324, P=0.046), but this association was greatly enhanced when combined with α-PAD2 [anti-PAD2 (-)] ( OR: 4.059, P=0.007). Conclusions:The findings delineate the clinical relevance of α-PAD2 and α-PAD4 in RA and suggest that the combined testing for α-PAD2 and α-PAD4 may provide additional diagnostic value to the current clinically available assays in RA, in particular in identifying patients at risk of RA-ILD.
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Objective @#To explore the association between coffee intake and all cancer mortality in East Asian populations. @*Methods @#We searched literatures which assessed the relationship between coffee intake and cancer mortality in Asian populations published by December 10th,2018 from China National Knowledge Infrastructure,Wanfang Database,VIP Database and PubMed. We conducted category and dose-response meta-analyses using Stata 15.0. @*Results @#A total of 335 relevant articles were retrieved; five articles were finally included in the meta-analyses,of which four were carried out in Japanese population and one in Singaporean Chinese population. The total sample size of the five articles was 361 802,and the number of deaths from cancer was 17 664. The results showed that coffee intake reduced the risk of all cancer mortality in East Asian populations（RR=0.93,95%CI：0.87-0.99）. There was no statistical significant association between coffee intake and all cancer mortality in East Asian men（RR=0.94,95%CI：0.77-1.15）. Among East Asian women,coffee consumption reduced the risk of all cancer mortality by 12%（RR=0.88,95%CI：0.81-0.95）. All cancer mortality risk decreased with the increase of coffee intake,and reached the lowest point at one and a half cups of coffee per day（RR=0.92,95%CI：0.86-0.98）. @*Conclusion @#Coffee intake reduced the risk of all cancer mortality in East Asian populations,which was obviously found in East Asian women. Drinking one and a half cups of coffee a day had the lowest risk of all cancer mortality.
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Objective To evaluate values of Serum IgG 4,IgG4/IgG ratio,and IgG4/IgG1 ratio for distinguishing Mikulicz′s disease(MD)from primary Sj?gren′s syndrome(pSS).Methods It retrospectively analyzed 186 patients subjected to serum IgG subclass testing to differentiate MD from primary Sj?gren′s syndrome(pSS)at Peking University People′s Hospital from July 2012 to July 2016.This sample included 42 MD patients and 144 pSS patients.Serum IgG subclass concentrations were measured using Siemens reagents with nephelometry and BNⅡinstrument.In partial patients,serum antinuclear antibodies (ANA)were detected by indirect immunofluorescence assay, and serum anti-SSA antibodies and anti-SSB antibodies were detected by Western blot.Serum IgG subclass test results,ANA test results,serum anti-SSA antibody,and anti-SSB antibody test results were collected.The quantitative data were represented by median(quantile range).The Mann-Whitney U test was used to compare the medians between the two groups.Categorical variables were analyzed with a χ2test and were shown as percentages.The ROC curve was constructed to identify the optimal cut-off values and the area under the curve(AUC)values of the serum IgG4,IgG4/IgG ratio,and IgG4/IgG1 ratio for distinguishing MD patients from pSS patients.Results The medians of serum IgG4, IgG4/IgG ratio and IgG4/IgG1 ratio in MD patients were 11 200 mg/L(17 330),0.444(0.314)and 1.318(1.920), as compared with 329 mg/L(490),0.016(0.025)and 0.023(0.039)respectively in pSS patients(Z=-9.368, -9.560, and -9.571, respectively, P<0.001).For distinguishing MD from pSS, the optimal cut-off values of serum IgG4, IgG4/IgG ratio, and IgG4/IgG1 ratio were 1 870 mg/L,0.111, and 0.206, respectively.The corresponding AUC values were 0.976,0.985,and 0.986,respectively.Comparison of the ROC curves showed that there was no significant difference between AUC of serum IgG4/IgG ratio and IgG4/IgG1 ratio(Z=0.283, P=0.777).But AUC of serum IgG4/IgG ratio and IgG4/IgG1 ratio were significantly higher than AUC of serum IgG 4(Z=2.360 and 1.975,repectively,P=0.018 and 0.048,respectively).The positive rates of serum ANA in MD and pSS group were 10%and 85.8%,respectively(χ2=71.340,P<0.001).The positive rates of anti-SSA antibody and anti-SSB antibody in MD were 6.7%and 0%,respectively.Compared to 72.3%and 38.3%in pSS group, they were lower(χ2=44.773 and 16.792, P<0.001).Conclusions Measurements of serum IgG4 concentration,IgG4/IgG ratio, and IgG4/IgG1 ratio were of important values in differentiating MD from pSS.Serum IgG4/IgG ratio or IgG4/IgG1 ratio was superior to serum IgG4.
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Objective To explore the predictive value of serum CEA and cytokeratin-19 fragments (CYFRA21-1)prior treatment for the epidermal growth factor receptor (EGFR) mutation and efficacy of tyrosine kinase inhibitors ( TKI ) in patients with non-small cell lung cancer.Methods The study was a clinical research.Totally 101 matched tissue and plasma samples were collected from Peking University People′s Hospital from 2012 to 2013.All clinical specimens were analyzed for EGFR mutations in exons of 18, 19, 20 and 21 by ADx-ARMS and direct sequencing, and the serum levels of CEA and CYFRA21-1 were analyzed by ECLI.The correlation between EGFR mutant status and efficacy of EGFR-TKI and clinicopathological parameters were analyzed by χ2 test, Log-rank text and Cox proportional hazards regression model.Results The mutation rate was 60.4%(61/101) by ADx-ARMS and 33.7%(34/101) by direct sequencing.Mutations were more frequently observed in the higher serum CEA level patients(≥5μg/L,78.8%).However, the rates of EGFR mutations of different CEA levels were similar.Among the patients receiving TKI therapy, the efficacy of EGFR-TKI was closely related to serum CYFRA21-1 level prior treatment and EGFR mutation (χ2 =8.903, P =0.003; χ2 =28.590, P <0.001 ).And serum CYFRA21-1 level prior treatment and EGFR mutation were independent factors for EGFR-TKI treatment affecting PFS (RR=0.298, P<0.001;RR=0.086, P<0.001).Conclusion The mutation rate of EGFR was significantly related with the expression level of CEA prior treatment, and serum CEA and CYFRA21-1 levels prior treatment could be potential predictors of EGFR-TKI efficacy.
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Objective To explore the functional orientation of township hospitals in developed areas to achieve goals of the ongoing health reform.Methods Two rounds of Delphi consultation was made among 18 experts from around the country to learn the degree of importance of every function.Results The experts' average seniority of service in their fields was 23.28±10.41 years.The positivity coefficients of the two-round consultation were 100％.Kendall' S coefficients of the two-round consultation were 0.226 and 0.265 (p＜0.01).These data are of statistical importance,suggesting consensus among these experts and the consultation meeting the needs of forecast.In these consultation,seven class-1 functions and and 27 class-2 functions were determined.Medical services and public health services account for similar proportion of work of township hospitals.Conclusion The functional orientation was feasible and forward looking,for reference of township hospitals in developed areas.
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Objectives To observe influences of two functionally important polymorphisms (5'-UTR and 3 -UTR) in thymidylate synthase (TS) gene and their combinative effects with drinking on the susceptibility of colorectal cancer (CRC). Methods A case-control study was designed, which included 140 CRC patients and 343 control subjects. Risk of CRC was estimated by unconditional Logistic model. Results The genotype distributions of the polymorphisms did not show significant differences between the cases and the controls. However, in those with -6 bp/-6 bp genotypes, the 2R carriers had a decreased risk (OR = 0. 60, 95%CI, 0. 23-1. 52) , but in +6 bp carriers, the 2R carriers had an elevated risk (OR=1. 87, 95%CI, 0. 94-3. 72). The likelihood test revealed the interaction existed between these two polymorphisms (P for interaction = 0. 05). Moreover, the combinative effect between the 3 -UTR polymorphism and alcohol drinking showed a significant association with the susceptibility of CRC (P for interaction =0. 01). In non-drinkers, the-6 bp allele carriers had a significant decreased risk (OR = 0. 57, 95%CI, 0. 32-0. 99) , but in ever and current drinkers, the +6 bp allele (6-bp insertion) carriers had an elevated risk (OR=1. 88, 95%CI, 0. 80-4. 41) , in which OR values ascended with the prolongation of drink-time. Conclusions The polymorphisms of thymidylate synthase at 5'-UTR and 3'-UTR may not be regarded as independent predictive factors for the susceptibility of CRC. However, interactions exist in these two polymorphisms and between the 3'-UTR polymorphism and drinking. Further studies with larger sample size and in different ethnic groups are needed.