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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of humanized anti-IL-6 receptor monoclonal antibody (tocilizumab) in treatment of systemic juvenile idiopathic arthritis (sJIA).</p><p><b>METHODS</b>Thirteen sJIA patients admitted between December 2015 and November 2016 and received tocilizumab treatment were enrolled in the study. The complete blood count (CBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6) and ferritin levels were measured; American College of Rheumatology Pediatric(ACR Pedi)30/50/70/90 scores were assessed; and the use of glucocorticosteroid and adverse events were documented.</p><p><b>RESULTS</b>Compared with the baseline levels, the CRP and ESR at d3 were decreased (all<0.05); hemoglobin was increased and platelet was decreased at week 2 (all<0.05), ferritin decreased at week 4, white blood cell (WBC) decreased at week 8 after treatment with tocilizumab (all<0.05). The level of IL-6 was rising at d3 and week 2 and descending at week 4, but no significant difference was observed compared with the baseline level (all>0.05). All 13 patients achieved ACR Pedi 30 remission at week 4, 61.5% achieved ACR Pedi 90 remission and glucocorticosteroids were withdrawn at week 20. Twenty two adverse events occurred, and infection accounted for 54.5% (12/22); no severe adverse reactions were observed during 20-week follow-up.</p><p><b>CONCLUSIONS</b>Tocilizumab is safe and effective in treatment of sJIA, with decreasing inflammation, improving disease activity and reducing glucocorticosteroid use.</p>
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Objective To assess the clinical characteristics of postoperative myocardial infarction (PMI) in patients undergoing off-pump coronary artery bypass grafting(OPCAB).Methods Two hundred and sixty-six patients undertook OPCAB in the Shandong Provincial Chest Hospital from January 2008 to June 2015 were selected,there were 22 cases clinical diagnosis of PMI as PMI group,44 cases patients whose general information matched MI group were selected as no PMI group.The data of two groups including preoperative records and postoperative symptoms,electrocardiogram (ECG),cTnI and echocardiography change were compared.Results There were no significant differences about preoperative indexes between the two groups(P ＞0.05).Incidences of severe chest pain and new pathological Q-waves and elevated ST segments were significantly higher in PMI group than those in no PMI group (90.9％ (20/22) vs.18.2％ (8/44),27.3％ (6/22) vs.4.5％(2/44),95.4％(21/22) vs.27.3％(12/44)),the differences were significant(P＜0.005).Peak serum levels of cTnI during the first 24 h after operation were significantly higher in patients of PMI group than those in no PMI group,the difference was significant((4.52±2.81) μg/L vs.(0.26±0.22) μg/L,P=0.04).There was no significant difference in the incidence of myocardial segmental motion.Conclusion It is difficult to predict coronary artery bypass grafting after myocardial infarction.It has great value of postoperative ECG,the patient complained in diagnosis of postoperative myocardial infarction.CTn is a very sensitive indicator,but its diagnosis clinical myocardial infarction boundary value still need to be open to question.
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Urine samples from diabetic and healthy subjects were detected by H4 protein chip and surface-enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS).Some significantly differential proteins between diabetic and controls were found.Four top-scored protein peaks were finally selected as the potential "fingerprints" for detection of early diabetic nephropathy by artificial neural network (ANN) classifier.