ABSTRACT
Objective To assess the value of flow cytometry in the diagnosis of postoperative infection following renal transplantation. Methods According to postoperative imaging findings and laboratory examination outcomes, 51 recipients undergoing the first renal transplantation were divided into the bacteria (n=33), fungus (n=9) and BK virus (n=9) groups. Twenty-eight recipients with stable conditions after renal transplantation were assigned into the stable group. Flow cytometry was adopted to detect the percentage and absolute counting of lymphocyte subpopulation in the peripheral blood of recipients in each group. Renal function, percentage and absolute counting of lymphocyte subpopulation in the peripheral blood were statistically compared among different groups. Receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of the percentage and absolute counting of lymphocyte subpopulation in infectious diseases after renal transplantation. Results Compared with the stable group, the serum creatinine (Scr) and blood urea nitrogen (BUN) levels in the bacteria, fungus and BK virus groups were significantly up-regulated, respectively (P=0.035, 0.007, 0.024; 0.037, 0.006, 0.032). Compared with the stable group, the percentage of CD16+CD56+natural killer (NK) cells was significantly declined in the bacterial (P=0.036) and fungus groups (P=0.015), and the proportion of CD4+/CD8+T cells was dramatically decreased in the fungus group (P=0.004). Compared with the bacterial group, the percentage of CD3+CD8+T cells was significantly elevated (P=0.013 and 0.008), the proportion of CD3+CD4+T cells was considerably declined (P=0.003 and 0.010), and the percentage of CD4+/CD8+T cells was significantly declined (P=0.003 and 0.005) in the fungus and BK virus groups. Compared with the stable group, the quantity of CD3+T cells, CD3+CD8+T cells and CD16+CD56+NK cells was significantly declined in the bacterial, fungus and BK virus groups, respectively (P=0.025, 0.002, 0.003; 0.015, 0.005, 0.006; 0.001, 0.001, 0.031). In addition, the quantity of CD3+CD4+T cells was considerably decreased in the fungus and BK virus groups (P=0.001, 0.003). The quantity of CD19+B cells was significantly reduced in the BK virus group (P=0.019). Compared with the bacterial group, the quantity of CD3+CD4+T cells was considerably lower in the fungus group (P=0.023). ROC curve analysis revealed that the quantity of CD3+CD4+T cells [area under curve(AUC)=0.8492] and CD16+CD56+NK cells (AUC=0.8889) yielded relatively high accuracy in the diagnosis of fungal infection. The quantity of CD3+T cells (AUC=0.8472), CD3+CD4+T cells (AUC=0.8452) and CD19+B cells (AUC=0.8115) yielded relatively high accuracy in the diagnosis of BK virus infection. Conclusions Flow cytometry detection of the lymphocyte subpopulation in peripheral blood can evaluate the immune function of patients. Absolute counting of lymphocyte subpopulation can directly assess the degree of immunity. These two combined parameters provide guiding significance for the diagnosis and differential diagnosis of infectious diseases in recipients after renal transplantation.
ABSTRACT
Objective To observe the clinical efficacy of acupuncture at the nine acupoints on nape in treating vertebrobasilar ischemia (VBI). Methods Totally 100 VBI patients were randomized into a treatment group and a control group, 50 in each group. The treatment group was intervened by acupuncture at Fengfu (GV 16), Fengchi (GB 20), Wangu (GB 12), Tianzhu (BL 10), and Jiaji (EX-B 2, C3);while the control group was by oral administration of Nimodipine tablets. The parameters in Transcranial Doppler (TCD) and Dizziness Assessment Rating Scale (ADRS) were observed before and after intervention, and the clinical efficacies were compared. Results The TCD parameters were significantly changed in the treatment group after intervention (P<0.05). The TCD parameters [Vs (RVA), Vd (BA, LVA), Vm (BA, RVA), PI (BA)] were significantly changed in the control group after intervention (P<0.05). After intervention, there were significant differences in comparing the TCD parameters [Vs (BA, LVA, RVA), Vd (BA, RVA), Vm (BA, LVA), PI (BA)] between the two groups (P<0.05). The DARS average scores were significantly changed in both groups after 7-day treatment (P<0.01). The DARS average scores after the whole intervention were significantly different from that after 7-day treatment in both groups (P<0.01). There were significant differences in comparing the DARS average scores between the two groups after 7-day intervention and after the whole intervention (P<0.01). The recovery-markedly effective rate and total effective rate were respectively 76.0%and 98.0%in the treatment group versus 44.0%and 96.0%in the control group, and there was a significant difference in comparing the recovery-markedly effective rate (P<0.05). Conclusions Acupuncture at the nine nape acupoints is an effective method in treating VBI.