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Objective:To investigate the clinical significance of detecting serum 25-hydroxyl-vitamin D [25(OH)D] level and albumin/fibrinogen ratio (AFR) in patients with rheumatoid arthritis (RA).Methods:This retrospective study included 131 patients (95 patients with RA and 36 with arthralgia excluding autoimmune diseases), who were treated in Bozhou People′s Hospital from May 2017 to January 2020. Forty healthy controls underwent health checkups during the same period served as healthy control. RA group was divided into high (>5.1, 25 cases), medium (3.2<DAS28-CRP≤5.1), 40 cases and low (≤3.2, 30 cases) subgroups by disease activity (DAS28-CRP) based on 28 joint counts and the level of C-reactive protein(CRP). RA patients were further divided into normal (≥30 ng/ml, 17 cases), insufficient (20 ng/ml ≤ 25(OH)D<30 ng/ml, 31 cases) and deficient (<20 ng/ml, 47 cases) subgroups according to the serum 25(OH)D concentration; 4 age subgroups (≤44 years of 21 cases, 45-59 years of 43 cases, 60-74 years of 21 cases and ≥75 years of 10 cases); 2 sex subgroups (79 female and 16 male). Serum 25(OH)D, albumin and fibrinogen levels were measured in all patients and healthy controls. The general clinical and laboratory indexes were collected and analyzed. Multivariate logistic regression analyses were performed to determine the independent risk factors of RA.Results:The serum 25(OH)D concentration and albumin/fibrinogen ratio were lower ( P<0.05) in rheumatoid arthritis patients than those in other groups, and serum 25(OH)D insufficiency or deficiency was evidenced in 82.11% (78/95) rheumatoid arthritis patients. Among patients with rheumatoid arthritis, the levels of 25(OH)D were apparently different in various age groups ( P<0.05) and significantly lower in female than those in male ( P<0.05). In addition, a significant negative correlation was found between AFR and DAS28-CRP ( r=-0.497, P<0.01). Logistic regression analysis showed that 25(OH)D ( OR=0.852, 95% CI: 0.768-0.944, P=0.002) and AFR ( OR=0.626, 95% CI 0.480-0.817, P=0.001), RF-IgM ( OR=1.044, 95% CI 1.019-1.069, P<0.001) and anti-CCP antibodies ( OR=1.017, 95% CI 1.002-1.032, P=0.030) were independent risk factors for disease activity in RA patients. Conclusions:The serum 25(OH)D and AFR levels are significantly reduced and 5(OH)D insufficiency or deficiency is common in RA patients, suggesting that low levels of 25(OH)D and AFR may be the risk factors reflecting the RA disease activity.
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Objective To explore the adverse effects of recurrence of acute ischemic stroke at discharge.Methods Continuously including 3 440 acute ischemic stroke patients from June 1,2009 to May 31, 2012 in Department of Neurology of the People's Hospital of Xinganmeng of Inner Mongoha Autonomous Region were esearch objects.Poor outcome was defined as the occurrence of disability or death at discharge.Disability was defined as the Modified Rankin ' s Scale (MRs), when MRs was 3 or more.Binary logistic regression was used to analysis the risk factors ,calculated the odds ratios(OR) and 95％ confidence interval (95％CI).Results A total of 359 (10.44％) patients occurred poor outcomes, of whom 136 (37.88％) patients occurred the recurrence of ischemic stroke.Multiple logistic regression analysis showed that age (OR=1.24,95％CI 1.09-1.41), body temperature (OR =1.92,95 ％ CI 1.43-2.57), hypertension (OR =1.73,95 ％ CI 1.33-2.24), high blood sugar (OR=1.67,95％CI 1.26-2.20) ,glycerin trilaurate(OR=0.41,95％CI0.27-0.62) ,smoking (OR =1.37,95％CI 1.01-1.85) and recmrrence(OR=1.49,95％CI 1.15-1.95) were independent risk factors of poor outcome at discharge.The recurrence of acute ischemic stroke can increase the risk of the occurrence of poor outcome at discharge up to 49％.Conclusion Recurrence is an independent risk factor for the poor outcome of acute ischemic stroke, we should focus on secondary prevention of stroke patients at the clinical work and health education to reduce the recurrence of ischemic stroke.
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Objective To validate the clinical applicability of the published standard reference interval of routine clinical chemistry(WS/T 404.1-2012,WS/T 404.1-2012) based on the results of health examination.Methods This was a retrospective study.The results of serum TP(Biuret),ALB (BCG),ALT(Rate without 5'-pyridoxal phosphate),AST (Rate without 5'-pyridoxal phosphate),ALP (Rate,AMP),GGT(Rate) from healthy examinatiou individuals (from January to July,2013) were collected to calculate the 2.5％ and 97.5％ pereentiles,excluding the significant abnormal results according to the Medical Deciding Level 2 recommended by Staland.The number of the cases after excluding were 19 708(M 12 044,F 7 664) 、19 728(M 12 069,F 7 659) 、45 569(M 26 299,F 19 270) 、45 877(M 26 739,F 19 138)、5 965(M 4 208,F 1 757)、4 726(M 3 164,F 1 562),respectively.The proportions of all the examined results (with and without the excluded results) that fell in the published standard reference interval were also calculated.Results The test of normality revealed that the frequency distributions of all verified items were skewed distributions after excluded the abnormal results.The 2.5％-97.5％ percentiles of TP,ALB,ALT(M),ALT(F),AST (M),AST (F),ALP (F20-49),ALP (F50-79),GGT (M) and GGT (F) were 64-79 g/L,40-59 g/L,9-52 U/L,7-39 U/L,13-41 U/L,12-33 U/L,42-116 U/L,36-98 U/L,44-130 U/L,11-72 U/L and 7-50 U/L respectively.More than 90％ results of TP,ALB,ALT(M),ALT(F),AST (M),AST(F),ALP(F20-49),ALP(F50-79),GGT(M) and GGT(F) (with and without the excluded results) fell in the reference intervals of national standards,GGT(M) was 80％ and 91％.Conclusions The published standard reference interval of routine clinical chemistry (WS/T 404.1-2012,WS/T 404.1-2012) are applicable to our laboratory.