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@#AIM: To study the changes of serum IL-35 and TGF-β1 expression levels and the correlation between them in patients with acute anterior uveitis, and to explore the clinical significance of IL-35 and TGF-β1 levels in patients with acute anterior uveitis.<p>METHODS: Thirty patients with acute anterior uveitis confirmed in the Department of Ophthalmology of Gansu Provincial Hospital into 2018-05/2019-05 were selected as the case group, and thirty healthy patients who received physical examination at the Gansu Provincial Hospital during the same period were selected as the control group. Serum IL-35 and TGF-β1 expression levels between the two groups were detected by Elisa. Modified endotoxin-induced uveitis(EIU)clinical standard was used for the severity of acute anterior uveitis. <p>RESULTS: Serum IL-35 and TGF-β1 expression levels in the acute anterior uveitis group were significantly higher than that in the healthy control group(all<i> P</i><0.05), and there was no significant correlation between serum IL-35 and TGF-β1 levels as well as the severity of acute anterior uveitis(<i>r</i>s=0.087, 0.044, all<i> P</i>>0.05). There was a significant positive correlation between serum IL-35 and TGF-β1 expression levels in patients with acute anterior uveitis(<i>r</i>s=0.637, <i>P</i><0.001).<p>CONCLUSION: The expression levels of IL-35 and TGF-β1 in serum are closely related to the occurrence and development of acute anterior uveitis and may play a synergistic role in immunosuppression in acute anterior uveitis.
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Objective To investigate the clinical application value of fluorescence polymerase chain reaction (PCR) .in the human leucocyte antigen-B27(HLA-B27) gene and gene typing detection of ankylosing spondy-litis (AS) patients .Methods A total of 43 clinical blood samples of AS and 56 samples of healthy controls were collected in Shenzhen Futian hospital for rheumatic diseases from January 2014 to March 2015 .HLA-B27 gene was detected by flow cytometry .HLA-B27 gene and gene typing was also detected by the fluorescence PCR method .Results Among 43 samples ,40 samples were HLA-B27 positive(93 .02%) by flow cytometry while 39 samples were HLA-B27 positive (90 .70%) by fluorescence PCR .The total coincidence rate was 97 .50% .Among 39 positive samples ,32 samples were HLA-B2704 positive (82 .05%) and 7 samples were HLA-B2705 positive (17 .95%) .Conclusion The fluorescence PCR is an accurate method to detect HLA-B27 gene and presents high consistency with flow cytometry .It can also detect the HLA-B27 gene typing .It may have great clinical application value and prospects .
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Objective To investigate the clinical features,auxiliary examination,treatment and efficacy of human leucocyte antigen(HLA)-B27-positive enthesitis related arthritis (ERA).Methods The clinical manifestations,auxiliary examination,treatment and follow-up of HLA-B27-positive ERA diagnosed in the Children's Hospital of Chongqing Medical University from January 2007 to August 2017 were analyzed retrospectively.SPSS 19.0 software was used for data processing.Results A total of 70 children were enrolled,including 67 males and 3 females,and the average age of onset was(10.08 ± 2.67) years old.Clinical features:all of the 70 children had peripheral arthritis with or without enthesitis,and axial arthritis symptoms appeared in 24.3％ (17/70 cases) children,and 35.7％ (25/70 cases) children showed enthesitis.The onset of peripheral arthritis accounted for 87.1％ (61/70 cases),and all cases showed peripheral arthritis during the course of the disease,mostly the knees.Two cases were complicated with uveitis.Forty-seven cases (67.1％) were positive in Patrick test,and 9 cases(12.9％) had sacroiliac joint tenderness.The average Juvenile Arthritis Disease Activity Score with 27 joints (JADAS27) score was 20.12 ± 8.61.Twenty-seven cases (38.6％) had positive family history.Auxiliary examination:Erythrocyte sedimentation rate,C-reactive protein(CRP) and platelets increased in most children,and a few with leukocytosis increased slightly,nearly half of children with anemia mildly or moderately,and serum tumor necrosis factor-α(TNF-α),interleukin (IL)-6,IL-1β,IL-10 levels increased.Eighty-eight point six percent (31/35 cases) children had decreased bone mass;the positive rate of X-ray examination was 81.1％ (43/53 cases),including 5 cases of sacroiliac joint disease;the positive rate of uhrasonography was 81.5 ％ (44/54 cases);the positive rate of nuclear magnetic resonance (MRI) was 95.1％ (58/61 cases),including 30 cases (42.9％) of sacroiliitis.Treatment and outcome:Nonsteroidal antiinflammatory drugs (NSAIDs),disease modifying antirheumatic drugs (DMARDs),glucocorticoids,calcium and alfacalcidol were added,and 50.0％ (35/70 cases) patients had added TNF-α antagonist.The follow-up of all of the patients showed improvement in terms of clinical symptoms,laboratory tests and JADAS27 score after standard treatment.Conclusions It is difficult to diagnose but easy to misdiagnose because of the lack of specificity of ERA clinical symptoms.The improvement of imaging techniques,especially MRI,is helpful for the early diagnosis of ERA.To strengthen the understanding and management of ERA,and to grasp its clinical features,immunology and imaging features,help to make timely diagnosis and reasonable treatment,and to improve physical function and quality of life of patients,and to avoid or delay disability.
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Objective To study the relationship between the positive expression of human leukocyte antigen B27 (HLA-B27) in different age groups and genders in Uygur and Han nationality in Xinjiang,and explore the clinical value of HLA-B27 in different ethnic groups.Methods From January 2013 to November 2016,1 416 cases of Uygur and Han patients with positive expression of HLA-B27 were detected by flow cytometry.There were 369 cases of Uygur and 1 047 cases of Han.Results Independent samples t-test showed that the positive expression of HLA-B27 in Uygur and Han population was statistically significant (165.22±8.262 vs 163.99±8.113,t=2.479,P=0.013).In male,there was a significant difference in the positive expression of HLA-B27 between Uygur and Han population (165.40 ± 8.237 vs 163.99 ± 8.164,t =2.187,P =0.029).In the age of 41～60 years old and ＞60 years old,the positive expression of HLA-B27 in Uygur was higher than that in Han nationality (166.18 ± 7.650 vs 164.53 ± 8.018,t =2.215,P =0.027;171.63 ± 8.134 vs 167.40 ± 9.469,t =2.126,P=0.035).There was no significant difference in the positive expression of HLA-B27 between Uygur and Han nationality in women,as well as in the age of 20 years and 21～40 years (t=-0.029～1.257,all P＞0.05).Conclusion The investigation showed that the positive expression of HLA-B27 in Uygur was higher than that in Han nationality.The content of HLA-B27 positive expression has racial difference.
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Objective To analyze human leucocyte antigen B27(HLA-B27) diagnostic value in spondyloarthritis(SpA) .Methods Using flow cytometry to detect HLA-B27 expressions of 298 SpA patients(SpA group) and 195 non-SpA patients(non-SpA group) .Results 227 patients were positive in the 493 patients .In SpA group ,the positive rates of HLA-B27 expressing in ankylo-sing spondylitis (AS ) ,juvenile spondyloarthritis (JSpA ) ,reactive arthritis (ReA ) ,undifferentiated spondyloarthritis (USpA ) , psoriatic arthritis(PsA) were 87 .66% ,59 .09% ,58 .33% ,37 .18% ,25 .00% ,respectively .In non-SpA group ,the positive rates of HLA-B27 expressing in rheumatoid arthritis ,rheumatic arthritis ,cervical or lumbar disease ,osteoarthritis ,gouty arthritis were 18 . 18% ,17 .86% ,16 .67% ,11 .76% ,0 .00% ,respectively .The SpA group and the non-SpA group of HLA-B27 positive comparative differences was statistically significant(P<0 .01) .Conclusion The HLA-B27 is correlated with SpA ,and can provide reference for clinical diagnosis of SpA especially the AS .
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Background Human leucocyte antigen (HLA)-B27-associated uveitis is one of the most common causes of non-infectious uveitis.T helper 17 (Th17) cells play an important role in human autoimmune diseases,but the pathology research on the production of Th17 cells in acute anterior uveitis patients positive for HLA-B27 was rarely reported.Objective The aim of this study was to investigate the expression and significance of the peripheral blood T helper cell subsets (Th1,Th2,Th17) in acute anterior uveitis patients positive for HLA-B27.Methods This study meets the criteria of the Helsinki Declaration.Informed consent was obtained from all the participants.A prospective cohort design was used in this study.Twenty-two patients with acute anterior uveitis positive for HLA-B27 were enrolled from Affiliated Second Hospital of Nanjing Medical University,and 16 normal healthy subjects with matched gender and age were enrolled as controls.The expression of interferon-γ (IFN-γ),interleukin-4 (IL-4) and IL-17 on lymphocytes (CD4+) in blood were assessed by flow cytometry,and immunoturbidimetry was used to detect the C reactive protein (CRP) level in blood.The degree of the severity of disease was evaluated by clinical scoring.The correlations between the percentage of IFN-γ+Th1,IL-4+Th2,or IL-17+Th17 with clinical factors and CRP were analyzed.Results The percentages of IFN-γ+Th1 and IL-17+Th17 in the peripheral blood were (23.11 ±9.69) ％ and (3.96±2.92) ％ in the patient group,showing a significant increase in comparison with (16.00±4.26)％ and (1.68±0.60) ％ in the control group (P=0.041,P=0.002).However,the IL-4+Th2 level was not significantly different between the patient group (0.33％ ±0.36％) and the control group (0.56％ ±0.34％) (P=0.122).No significant correlations were found between the percentage of IFN-γ+ Th1 with disease severity and CRP (r =0.197,P =0.500 ; r =0.253,P =0.383),between the percentage of IL-4+ Th2 with disease severity and CRP (r =0.068,P =0.817 ; r =0.439,P =0.116) as well as between the percentage of IL-17 + Th17 with CRP (r =0.226,P =0.436).However,a positive correlation was seen between the percentage of IL-17+ Th17 with disease severity (r =0.805,P =0.001).Conclusions IFN-γ and IL-17 in human CD4+T cells are significantly elevated in the blood of HLA-B27-related acute anterior uveitis patients.Disease severity is associated with the percentage of IL-17 +Th17,suggesting that Th1 cells together with Th17 cells participate in the pathogenesis of the disease and Th17 cells might play a dominant role in the disease.
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Objective To evaluate the diagnostic value for ankylosing spondylitis (AS).Methods Ninety-two patients with confirmed diagnosis of AS were allcated to Group A and 70 non-AS cases served as the control(Group B).Human leucocyte antigen B 27(HLA-B 27)was determined by micro-lymphocytoxicity test.Results The sensitivity and specificity of HLA-B 27 in diagnosing AS were 87.0% and 91.4% respectively.In a randomized human group,the morbidity rate of AS was 2.57% for those with HLA-B 27 being positive.In clinic,when the assumed morbidity rate of AS was 50%,the morbidity rate arrived at 91.01% for the cases of HLA-B 27 being positive.Conclusion HLA-B 27 is an important accessory diagnostic index for AS,but it can not be ued as a confirmed diagnostic index for AS.