1. Activity And Quality Of Life Assessment Of Juvenile Idiopathic Arthritis 2. Clinical Analysis Of Multiple Arteritis In Children

SECTION 1: STUDY OF THE CLINICAL VALUE OF SERUM AMYLOID A PROTEIN(SAA)IN THE ASSESSMENT OF JUVENILE IDIOPATHIC ARTHRITIS(JIA)DISEASE ACTIVITYObjective: To study the clinical value of serum amyloid A protein(SAA)in the assessment of juvenile idiopathic arthritis(JIA)disease activity.Methods: 102 children with JIA were selected and their blood routine,SAA,ESR,C-reactive protein(CRP)and bone mineral density were collected.The degree of disease activity was evaluated by the juvenile arthritis disease activity score(JADAS-27).Result: Serum SAA levels were elevated in systemic JIA compared with other types.The level of SAA and other indexes in children with active JIA was significantly higher than those in the stable state,while bone mineral density was significantly decreased.SAA was significantly correlated with CRP and ESR(r1 = 0.819;r2 = 0.712,p <0.001).The area under the ROC curve of SAA(AUC)was 0.795,which was lower than that of ESR(AUC = 0.860),but higher than that of CRP and other inflammatory indexes.When SAA or platelet is abnormal,and the sum of the two is greater than 354,the sensitivity of disease activity is 0.71,the specificity is 0.84.JADAS-27 score was significantly correlated with SAA and CRP(r = 0.33-0.48,p <0.01),and was significantly correlated with ESR(r = 0.64).SAA was significantly higher in high disease activity.Conclusion: SAA is significantly elevated in systemic and active JIA,and has good correlation with CRP and ESR.SAA is positively correlated with JADAS and can distinguish disease from high activity.We expect SAA to become a new JIA disease activity assessment indicators.SECTION 2: FORMULATION OF CHINESE VERSION OF THE PEDIATRIC RHEUMATOLOGY QUALITY OF LIFE SCALE(PRQL)AND PRELIMINARY STUDY ON APPLICATIONObjective: To develop a Chinese version of the Pediatric Rheumatology Quality of Life Scale(PRQL),and to evaluate the quality of life of children with juvenile idiopathic arthritis(JIA).Methods: English version of the PRQL was translated into Chinese by Brislin's double-translation & back-translation method and we carried out a preliminary assessment of 82 JIA patients' quality of life in our hospital.Results: In the Chinese version of PRQL,Cronbach's ? coefficient of the total score,the modules and the dimensions ranged 0.774-0.946,the re-test reliability ranged 0.859-0.877.Two factors were extracted by principal components analysis,contributing 64.8% variance.The meaning of the factors was consistent with the structure of the English version.In content validity analysis,each item has a significant correlation with the total score of corresponding dimension.PRQL scores in active group were significantly higher than those in inactive group.There was no significant difference in quality of life between different age,sex and duration.Whether hormone was used or not,and whether bone density was normal or not,the PRQL showed no significant difference.The correlation between module of parents and children ranged 0.75-0.94.JIA children had different degrees of damage in different dimensions.Limitation of high-magnitude activities and pain were the most serious factors.Conclusion: The quality of life of children with JIA was impaired in different degrees.The limitation of high-magnitude activities and pain were the mostly influential factor.Background: Delayed diagnosis of childhood Takayasu arteritis(TA)is common due to its atypical symptoms.The objective of the present study was to summarize the clinical features of childhood TA to raise awareness and improve management.Methods: Eleven children diagnosed with TA at our hospital(2000-2015)were enrolled.Clinical information,diagnosis,treatment,and outcome were then examined retrospectively.The Pediatric Vasculitis Activity Score(PVAS)and the Indian Takayasu Clinical Activity Score(ITAS2010)were used to assess disease activity.Results: Male-to-female ratio was 4:7.The mean age was 9.4(1.4–14)years and the average time to diagnosis was 40.6 days(12–90 days).All patients suffered from hypertension and few had immunologic abnormalities.Two patients had low levels of autoantibodies and one had elevated immunoglobulin E levels.Aberrant(elevated)laboratory parameters included erythrocyte sedimentation rate(ESR)(9/10 patients,90.0%),protein excretion(8/9 patients,88.9%),renin-angiotensin-aldosterone system(RAAS)activity(5/5 patients,100.0%),and serum lipid levels(3/5 patients,60%).The common onset patterns were headache with convulsions(27.2%)and kidney damage(27.2%).The abdominal aorta(81.8%)and renal artery(72.7%)were the most commonly involved vessels.At presentation,the mean PVAS and ITAS2010 scores were 12.1(6–26)/63 and 9.7(5–14)/57,respectively.All patients were treated with glucocorticoids and antihypertensive agents;two underwent renal artery stent placement.Conclusion: The diagnosis of TA should be considered in patients with pediatric hypertension and high expression of inflammatory markers or abnormal urine results.Doppler ultrasonography of major vessels may be helpful.PVAS and ITAS2010 both help to evaluate disease activity,and the PVAS is recommended for patients with kidney damage.Glucocorticoid and antihypertensive agents are effective.Interventional therapy can be an option for patients with persistent hypertension.