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Objective:To explore the diagnostic value of serum procalcitonin (PCT) level combined with Quantitative Computed Tomography (QCT) in elderly women with painful osteoporosis and its correlation with disease severity.Method:This study is a prospective study. From Jan. 2019 to Apr. 2020, 596 elderly women who underwent physical examination in our hospital were selected as the research subjects. All of them underwent dual-energy X-ray, PCT examination, and QCT examination serum. The diagnostic value of PCT and QCT in elderly women with painful osteoporosis was analyzed; Pearson correlation was used to analyze the correlation between the bone mineral density of lumbar vertebral 1, 2 vertebra, PCT and the severity of painful osteoporosis.Result:Among 596 elderly women, painful osteoporosis patients accounted for 50.84% (303/596) , bone mass reduction accounted for 21.98% (131/596) , and normal bone mass accounted for 27.18% (162/596) . Compared with the results of the diagnosis of painful osteoporosis by DAX, the diagnostic coincidence rates of PCT, QCT, QCT+PCT were 81.88% (488/596) , 93.62% (558/596) , and 97.31% (580/596) . QCT examination, QCT+PCT diagnosis coincidence rate is higher than PCT examination ( χ2=43.650, 83.187, P<0.05) ; QCT+PCT diagnosis coincidence rate is higher than QCT examination ( χ2=9.388, P=0.002) . The sensitivity, specificity, positive predictive value, and negative predictive value of QCT+PCT in the diagnosis of abnormal bone mass are higher than those of PCT ( P<0.05) ; the specificity and negative predictive value of QCT+PCT in diagnosing abnormal bone mass are higher than QCT Check ( P<0.05) . The bone density detected by QCT in the osteopenia group and the painful osteoporosis group was lower than that in the normal bone mass group, and the serum PCT level was higher than that in the normal bone mass group, the difference was statistically significant ( P<0.05) ; the painful osteoporosis group was in QCT detection of bone. The density was lower than that of the osteopenia group, and the serum PCT level was higher than that of the osteopenia group, the difference was statistically significant ( P<0.05) . The severity of painful osteoporosis was negatively correlated with bone mineral density detected by QCT ( r=-0.54, P<0.05) , and positively correlated with serum PCT ( r=0.59, P<0.05) . Conclusion:QCT vertebral bone mineral density determination combined with serum PCT detection has high accuracy, sensitivity, and specificity in the diagnosis of painful osteoporosis, and is closely related to the severity of painful osteoporosis, and can be used for clinical evaluation of the condition of painful osteoporosis patients.
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Objective:To investigate the early predictive value of lupus anticoagulant (LA) ratio, D-dimer (D-D) and soluble endothelial protein C receptor (sEPCR) on deep vein thrombosis (DVT).Methods:Thirty hundred and fifty patients who performed surgery for lower extremity fracture and suspected DVT in Zhejiang Rongjun Hospital from October 2018 to October 2019 were enrolled. With deep vein contrast of the lower extremity as the gold standard, 82 patients with confirmed DVT were treated as the observation group and 268 patients without DVT as the control group. The levels of LA, D-D and sEPCR of two groups were detected by coagulation, immunoturbidimetry and enzyme linked immunosorbent assay—sandwich technique respectively. Indexes of the two groups were compared. Pearson correlation was used to analyze the relationship between plasma levels of LA, D-D and sEPCR, and the predictive value of plasma sEPCR, LA ratio and D-D level on DVT was evaluated by receiver operator characteristic (ROC) curve.Results:The plasma sEPCR, LA ratio and D-D levels in the observation group were significantly higher than those in the control group [(143.30 ± 11.28) μg/L vs.(112.56 ± 14.62) μg/L, 1.51 ± 0.24 vs. 1.22 ± 0.18, (1 013.00 ± 319.54) μg/L vs. (425.17 ± 100.36) μg/L] with statistically significant differences ( P < 0.05). There was no significant differences in activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT) between the two groups ( P > 0.05). In the observation group, plasma sEPCR level was positively correlated with LA ratio and D-D level ( r = 0.280, P = 0.011; r = 0.563, P < 0.001), and LA ratio was positively correlated with D-D level( r = 0.741, P < 0.001). The area under curve (AUC) of D-D in diagnosis of DVT was 0.940, and the sensitivity and specificity were 87.80% and 87.69% when the cut-off value was 569.43 μg/L. The AUC of LA ratio in the diagnosis of DVT was the smallest, which was 0.912, the sensitivity and specificity were 87.80% and 91.25% when the cut-off value was 1.23. The sensitivity was 95.12% and specificity was 95.00% of sEPCR and LA ratio combined with DD in diagnosis of DVT. Conclusions:LA and D-D combined with sEPCR has high predictive value for DVT.
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Objective:To explore the application value of dynamic monitoring of serum soluble interleukin-2 receptor (sIL-2R) and stromal cell-derived factor 1 α (SDF-1α) in patients with acute leukemia (AL).Methods:A total of 187 patients with AL admitted to the Second Hospital of Shanxi Medical University from March 2017 to August 2018 were selected and 90 healthy subjects at the same period were selected as the healthy controls. The levels of serum sIL-2R and SDF-1α were detected at the initial diagnosis, remission phase and relapse phase, respectively. The clinical value of dynamic monitoring of sIL-2R and SDF-1α was analyzed.Results:Among 187 patients with AL, 135 patients (72.19%) had complete remission (CR) after chemotherapy, 52 patients (27.81%) had partial remission, and 43 patients (31.85%) relapsed. The level of serum sIL-2R at the AL initial diagnosis period was (533±32) U/ml, which was higher than that in the healthy controls [(247±30) U/ml], and the difference was statistically significant ( t = 71.976, P < 0.01); the level of serum SDF-1α at the AL initial diagnosis was (2 968±305) pg/ml, which was higher than that in the healthy controls [(1 358±160) pg/ml], and the difference was statistically significant ( t = 47.043, P < 0.01). The levels of serum sIL-2R [(308±30) U/ml] and SDF-1α [(1 576±184) pg/ml] in the CR phase were lower than those in the initial diagnosis of patients with AL; and the levels of sIL-2R [(599±36) U/ml] and SDF-1α [(2 894±301) pg/ml] in the relapse phase were higher than those in the CR phase of patients with AL (all P < 0.01). Conclusions:The levels of serum sIL-2R and SDF-1α in patients with AL are increased, and there are big differences in the levels of sIL-2R and SDF-1α at the initial diagnosis, remission phase, and relapse phase. Dynamic monitoring of both can provide the data support for early clinical intervention.
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Objective@#To investigate the clinical characteristics, cell morphology, genetics, gene mutations of the patients with chronic neutrophilic leukemia (CNL).@*Methods@#Five CNL patients from the Second Hospital of Shanxi Medical University between May 2011 and May 2017 who conformed to 2016 World Health Organization (WHO) diagnostic criteria were retrospectively analyzed from clinical characteristics, laboratory features and treatment methods.@*Results@#The peripheral blood white blood cell count (WBC) of 5 CNL patients was significantly increased, and the average WBC was 81.26×109/L [(29-217)×109/L]. Morphological analysis of peripheral blood cell showed a sustained increasing number of matured neutrophilia (0.80-0.85). Neutrophil alkaline phosphatase (NAP) activity was increased (144-266). Bone marrow cell morphology typically showed granulocyte proliferation without obvious dysplasia. Gene detection showed 3 patients with CSF3R T618I mutation and 2 patients with JAK2 V617F mutation in 5 WHO-defined CNL patients. Bone marrow biopsy with reticular staining showed that marrow fibrosis (MF) degree in patients with JAK2 V617F mutation (MF≥2) was higher than that in patients with CSF3R T618I mutation(MF<2).@*Conclusions@#CNL is a rare type of chronic leukemia, and CSF3R T618I mutation is a specific diagnostic index for CNL. JAK2 V617F mutations alone may be related to myelofibrosis, which remains to be further studied.
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Objective To observe the clinical effect of Chinese herbal medicine gargle on the prevention of aspiration pneumonia in elderly patients with long-term nasal feeding. Methods 93 elderly patients over 60 years old with indwelling nasogastric tube for 30 days were randomly divided into 48 cases of the experimental group and 45 cases of the control group. We compared incidence of aspiration pneumonia of the elderly patients with long-term nasal feeding in two groups of oral care solution by using the self-made traditional Chinese medicine gargle for oral nursing in the experimental group and treated with saline in the control group. Results The oral bacterial colony count and the incidence of aspiration pneumonia in the experimental group were lower than those in the control group, with two different kinds of nursing fluid. Conclusion Using the self-made traditional Chinese medicine gargle for oral care, could effectively reduce the number of oral bacteria, reduce the incidence of aspiration pneumonia, the application effect is good, and could be in clinical promotion and application.
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Objective To determine whether pattern of WT1 gene expression is a useful marker for establishing prognosis and tracking disease progression in patients with myelodysplastic syndromes (MDS). Methods RNA were extracted from bone marrow smears of 45 patients with MDS, the WT1 expression were tested by FQ-RT-PCR. Results The degree of WT1 expression was increased during disease progression of MDS. The WT1 expression level was increased more a logarithm grade when a RA patient developed into RAEB, the fluctuation of WT1 expression level was decreased a logarithm grade during RA. Conclusion WT1 gene is a useful marker for assessment in MDS patients. It pointed out may diagnosis RA if the WT1 expression level higher two logarithm grade than the mean of normal control for patients which didn't diagnose by morphology. It may suggest disease progress of MDS if the WT1 expression level increased more a logarithm grade recently. Further confirmation was needed because the case was limited.