Résumé
Objective:To investigate the value of autoantibodies and serum levels of IgG4 and CA19-9 in the diagnosis of IgG4 associated cholangitis (IgG4-SC).Methods:Detect the serum IgG4 and CA19-9 of 41 clinical cases of IgG4-SC patients,162 clinical cases of non IgG4-SC patients and 40 healthy human serum samples by immunoassay and direct chemiluminescence methods, also detect the antinuclear antibodies (ANA),anti neutrophil antibody (ANCA),anti smooth muscle antibody (SMA) and anti mitochondrial antibody (AMA) of the above serum samples by indirect immunofluorescence and analyze the detection results.Results:①The positive rates of ANA,ANCA,SMA and AMA in patients with IgG4-SC were 41.46%,7.32%,0 and 2.44%.Among them,the positive rate of ANA was significantly different from that of the normal control group(P<0.01),and the positive rate of SMA and AMA was significantly different from that of non IgG4-SC group(P<0.01),and so as the positive rate of ANCA do with that of PSC group.②The number of serum IgG4 and CA19-9 increased samples were significantly compared with the normal control group (P<0.01);the area under the ROC curve (AUC) was 0.979 and 0.646,respectively,and P<0.05.Conclusion:The high level of serum IgG4 and CA19-9 and autoantibody detection are of great accuracy and important clinical value in the differential diagnosis of IgG4-SC.
Résumé
<p><b>OBJECTIVE</b>To investigate methods and therapeutic effects of sequential drugs treatment for central pain following spinal cord injury.</p><p><b>METHODS</b>A total of 28 patients suffered from central pain following spinal cord injury were treated with sequential drugs from 1994 to 2008, including 23 males and 5 females, ranging in age from 25 to 59 years (mean 42 years). According to the patients' response to drugs, the therapy grade was adjusted step by step until the pain was relieved. Basing on VAS scores before and after drugs treatment, analgesic effect was evaluated. The first grade drugs: COX-2 inhibitors. The second grade drugs: Tricyclic antidepressant drugs (Amitriptyline) + COX-2 inhibitors + Carbamazepine. The third grade drugs: Tricyclic antidepressant drugs (Amitriptyline) + Gabapentin + Neurotropin/COX-2 inhibitors.</p><p><b>RESULTS</b>The pain of all of 28 patients was relieved to different extent. The VAS scores decreased by 23.3 +/- 1.2 in the first grade drugs treatment group. The VAS scores decreased by 54.5 +/- 3.8 in the second grade drugs treatment group. The VAS scores decreased by 65.8 +/- 5.1 in the third grade drugs treatment group (P<0.05).</p><p><b>CONCLUSION</b>The sequential drugs treatment for central pain following spinal cord injury has a good analgesia effect and little adverse reaction.</p>