ABSTRACT
BACKGROUND: Obtaining synovial fluid for diagnostic test of periprosthetic joint infection is invasive and painful to patients. Platelet count is a regular blood test which has been used as a possible predictor of several infectious diseases. Presumably, it could be one of the indicators of periprosthetic joint infection. OBJECTIVE: To identify the accuracies of platelet combined with white blood cell, erythrocyte sedimentation rate or C-reactive protein in the diagnosis of periprosthetic joint infection. METHODS: Patients undergoing revision arthroplasty from March 2013 to December 2018 in the First Affiliated Hospital of Guangzhou University of Chinese Medicine were retrospectively enrolled. A diagnosis of periprosthetic joint infection was confirmed in 77 patients according to the criterions from the Musculoskeletal Infection Society; the remaining 137 patients were confirmed as aseptic cases. White blood cell, erythrocyte sedimentation rate, or C-reactive protein and platelet count were compared between the two groups. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated. RESULTS AND CONCLUSION: The platelet values were significantly increased in periprosthetic joint infection cases. Sensitivity and specificity of the platelet for periprosthetic joint infection were 64.94％ and 86.13％, respectively. Platelet demonstrated a higher accuracy when compared to erythrocyte sedimentation rate and C-reactive protein. In such cases, the platelet shows a certain reference value in confirming the diagnosis of periprosthetic joint infection. Platelet was enough used as adjunct diagnostic tool in patients suspected with periprosthetic joint infection.
ABSTRACT
Objective To explore the diagnostic value of CD4 cell count and IL-6/IL-10 ratio in combination for the diagnosis of AIDS complicated with Pneumocystis pneumonia. Methods A total of 100 AIDS patients with pneumocystis pneumonia admitted to the Nanchong Central Hospital from January 2018 to May 2019 were enrolled in the AIDS pneumonia group, 100 AIDS patients were enrolled in the AIDS group, and 100 healthy subjects were included in the control group. The number of CD4+T cells in serum was detected by flow cytometry, and the expression levels of IL-6 and IL-10 in serum were detected by enzyme-linked immunosorbent assay. The AUC of receiver operating characteristic curve (ROC) was used to analyze the CD4 cell count and the diagnostic significance of IL-6/IL-10 detection in AIDS with pneumocystis pneumonia. Results The number of CD4 cells in the serum of AIDS patients with Pneumocystis pneumonia was significantly lower than that of AIDS patients and healthy subjects (t=28.31, P<0.0001; t=36.90, P<0.0001), but the ratio of IL-6/IL-10 was higher than that of AIDS patients and healthy individuals (t=7.184, P<0.0001; t=19.03, P<0.0001). The sensitivity of CD4 cell count and IL-6/IL-10 ratio in the diagnosis of AIDS patients with Pneumocystis pneumonia was 92.00%, the specificity was 88.00%, and the accuracy was 89.33%. Conclusion The detection of CD4 cell count and IL-6/IL-10 ratio can be used as a potential marker for the diagnosis of AIDS with Pneumocystis pneumonia.