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Objective:To investigate the threshold of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), synovial fluid white blood-cell count (WBC) and polymorphonuclear cells (PMN) proportion in the diagnosis of periprosthetic joint infection (PJI) in patients with rheumatoid arthritis (RA).Methods:The clinical data of 246 patients with RA and osteoarthritis (OA) who had previously undergone total knee and hip arthroplasty from January 2006 to December 2019 was retrospectively analyzed. The patients were divided into four groups according to the disease type and whether PJI occurred, namely 46 patients in the RA-PJI group, 64 patients in the RA-non-PJI group, 72 patients in the OA-PJI group, and 64 patients in the OA-non-PJI group. The receiver operating characteristics (ROC) curve was used to determine the optimum cut-off values of CRP, ESR, synovial fluid WBC and PMN proportion for diagnosing the RA-PJI and OA-PJI. The optimal cut-off values of serum and synovial fluid indexes were evaluated for the diagnostic efficacy of RA-PJI by comparing the area under curve (AUC) of each index. Further, the values were applied for joint test analysis.Results:For PJI prediction, the results of serological and synovial fluid indexes were different between RA-PJI group and OA-PJI group. The results of ROC curve analysis showed that the optimal cut-off values of each detection index were as follows. The optimal cut-off value of CRP for diagnosing RA-PJI was 14.4 mg/L, ESR was 39 mm/1 h, synovial fluid WBC was 3 654×10 6 /L, and PMN proportion was 0.659. The optimal cut-off value for diagnosing OA-PJI were 8.16 mg/L, 31 mm/1 h, 2 452×10 6 /L, and 0.625, respectively. In the RA-PJI group, the difference between the AUC of each detection index and AUC=0.5 was statistically significant ( P<0.05). Among them, the specificity of synovial fluid WBC was 92.3%, AUC was 0.879 (95% CI: 0.776, 0.982) with 87.8% positive predictive value and 10.21 positive likelihood ratio. These values were higher than those of CRP, ESR, and PMN proportion. The results of joint test analysis for the diagnosis of RA-PJI were as follows. The specificity of the series test was 100%, and the sensitivity of the parallel test was 100%; the specificity of the joint index diagnostic test was 100%, AUC was 0.926 (95% CI: 0.848, 1.000), the difference between AUC and AUC=0.5 was statistically significant ( P<0.05). Conclusion:The optimum cut-off values of CRP, ESR, synovial fluid WBC and PMN proportion for the diagnosis of PJI in patients with RA are all higher than those of patients with OA. Their optimal cut-off values can be used as important auxiliary indexes for a clear diagnosis of PJI in patients with RA. Compared with other indexes, the synovial fluid WBC has strong predicting power and lower misdiagnosis rate, which could be the best detection index for identifying PJI in patients with RA. The joint test could improve the sensitivity or specificity of PJI diagnosis in patients with RA. The combination with multiple detection indexes could provide a reference for the early and accurate diagnosis of PJI in patients with RA.
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Objective:To investigate the expression level of serum ficolin-3 (FCN3) in breast cancer patients and its relationship with prognosis.Methods:A total of 145 patients with breast cancer (the breast cancer group) who were treated in Boao Evergrande International Hospital from February 2014 to February 2016 and 148 healthy women during the same period (the healthy control group) were selected. The level of FCN3 was detected by using enzyme-linked immunosorbent assay (ELISA); the serum carbohydrate antigen 153 (CA153) level of the two groups was detected by using automatic electrochemiluminescence immunoassay; the diagnostic value of serum FCN3 for breast cancer was evaluated by using receiver operating characteristic curve (ROC). The relationship between the level of serum FCN3 and the clinicopathological characteristics of breast cancer patients was analyzed. Kaplan-Meier method was used to analyze and compare the 3-year overall survival rate of breast cancer patients with different serum FCN3 levels.Results:Serum FCN3 level in breast cancer group was (14.1±3.4) μg/ml, which was higher than that in the healthy control group [(9.1±3.0) μg/ml], and the difference was statistically significant ( t = 13.644, P < 0.01). The serum CA153 level in breast cancer group was (36.3±15.2) U/ml, which was higher than that in the healthy control group [(16.8±6.9) U/ml], and the difference was statistically significant ( t = 14.397, P < 0.01). The area under the curve (AUC) of serum FCN3 and CA153 for the diagnosis of breast cancer was 0.894 and 0.720, respectively. The AUC of combined detection of serum FCN3 and CA153 for the diagnosis of breast cancer was 0.909, which was higher than that of CA153 alone ( Z = 2.050, P = 0.040), but compared with FCN3 alone, the difference was not statistically significant ( Z = 0.157, P = 0.875). Serum FCN3 level in stage Ⅲ breast cancer patients was higher than that in stage Ⅰ and Ⅱ patients, and serum FCN3 level in stage Ⅱ patients was higher than that in stage Ⅰ patients (all P < 0.05). The breast cancer patients with lymph node metastasis had higher serum FCN3 level compared with those patients without lymph node metastasis ( P < 0.05). The 3-year overall survival rate of breast cancer patients in the low-level FCN3 group (≤12.07 μg/ml) was higher than that in the high-level group (>12.07 μg/ml) ( P = 0.033). Conclusion:Serum FCN3 is up-regulated in breast cancer patients, which is expected to be a potential index for diagnosis and prognosis evaluation of breast cancer.
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In this study a new soluble solid curcumin nanoemulsion powder was prepared using spray-drying technology to improve the solubility and bioavailability of curcumin. The liquid nanoemulsion consisted of curcumin, Capryol 90, Transcutol P, and Cremophor RH40. The solid nanoemulsion was prepared by spray-drying the liquid nanoemulsion in laboratory spray dryer, using lactose as solid carrier. The in vitro release from powder formulation was 97.6% within 15 min while the release from the curcumin crystalline was about 10%. An oral pharmacokinetic study was conducted in rats and the relative bioavailability of spray-dried curcumin powder significantly increased compared with that of curcumin crystalline. The Cmax value of solid curcumin nanoemulsion powder was 5.5-fold greater than the value of the curcumin crystalline in aqueous suspension. The absorption mechanism of the spray-dried curcumin powders was discussed. The results indicate that spray-drying in combination with nanoemulsion was a powerful methodology for improving the dissolution rate and oral bioavailability of curcumin
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Objective To investigate the relationship between the clinical features of patients with different cancer and their clin‐icalstage,lymphnodemetastasissituation.Methods 135cancerpatientsdiagnosedandtreatedinthehospitalfromJanuary2010to December 2014 were enrolled in the study ,in addition to that ,57 people who underwent healthy examination in the hospital and proved to be healthy were also recruited as control group .Prothrombin time(PT) ,thrombin clotting time(TT) ,activated partial thromboplastin time(APTT) ,D‐dimer ,fibrinogen(FIB) were tested for the people mentioned above .Results The level of routine coagulation indicators were statistically significant different between people with different types of cancers and control group(P<0 .05) .Compared with the control group ,PT ,APTT of the cancer patients significantly shortened ,FIB ,D‐dimer levels were signifi‐cantly increased(P<0 .05) .PT ,APTT was prolonged in lung cancer ,esophageal cancer ,breast cancer ,stomach cancer compared with lung cancer ,FIB ,D‐dimer decreased compared with other malignancies(P<0 .05) .PT ,APTT was decreased and D‐dimer ,FIB was significantly increased in cancer(lung ,esophagus ,breast ,stomach) with Ⅲ‐Ⅳ stage or lymph node metastasis than Ⅰ‐Ⅱstage or non‐lymph node metastasis ,the difference was statistically significant(P<0 .05) .Conclusion The malignant tumors were with hypercoagulable state ,there are differences in coagulation in different clinical stages ,lymph node metastasis .
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Objective To observe the serum γ-glutamyltransferase (γ-GGT) levels in patients with chronic hepatitis B virus (HBV) infection in different immune status and investigate their relationship with HBV DNA loads and ALT levels. Methods Blood samples were collected from 191 patients with chronic HBV infection in different immune status, including inactive HBV carrier state (group B,n = 55), immune tolerance phase (group C, n=47), HBeAg-negative CHB (group D, n =17), immune-reactive phase (group E, n=72) and 61 healthy individuals ( group A) for the detection of the serum γ-GGT, ALT level and HBV DNA loads. Results γ-GGT level were obviously higher in groups D and E than those in groups of A, B and C (P<0.01). Correlation analysis showed that the γ-GGT levels were positively correlated with serum ALT , AST levels in HBeAg-negative CHB and immune-reactive phase , but not correlated with HBV DNA loads. Conclusions The levels of γ-GGT are different during different immune status in patients with chronic HBV infection. The increased serum γ-GGT level may be an indicator for patients with chronic HBV infection entering immune active phase. The liver inflammation is the major impact factor to the γ-GGT levels.