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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.
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Objective To investigate the risk factors for progressive motor deficit (PMD) in patients with acute isolated pontine infarction.Methods Patients with new onset of acute isolated pontine infarction admitted to the Department of Neurology,the Second Hospital of Tianjin Medical University from January 2016 to December 2018 were enrolled retrospectively.The demography,vascular risk factors,laboratory examinations,and imaging features were compared between PMD group and non-PMD group.Multivariate logistic regression analysis was used to determine the independent risk factors for PMD.Results A total of 117 patients with acute isolated pontine infarction were enrolled,including 46 females (39.3％) and 71 males (60.7％),aged 70.62 ± 9.07 years.Twenty-six patents (22.2％) were in the PMD group and 91 (77.8％) were in the non-PMD group.The blood glucose at admission (7.28[6.68-8.27] mmol/L vs.6.66[5.64-7.87]mmol/L;Z =-2.367,P =0.018] and the proportion of hypertension (80.8％ vs.57.1％;x2=4.811,P=0.028),paramedian pontine infarction (80.8％ vs.45.1％;x2=10.355,P=0.001),and lower pontine infarction (46.2％ vs.25.3％;x2 =4.205,P =0.040) in the PMD group was significantly higher than those in the non-PMD group.Multivariate logistic regression analysis showed that hyperglycemia at admission (odds ratio 1.444,95％ confidence interval 1.048-1.988;P=0.024) and paramedian pontine infarction (odds ratio 3.266,95％ confidence interval 1.061-10.055;P =0.030) were the independent risk factors for PMD in patients with acute isolated pontine infarction.Conclusion Hyperglycemia at admission and paramedian pontine infarction were the independent risk factors for PMD in patients with acute isolated pontine infarction.
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BACKGROUND:In order to avoid heterotopic ossification after total hip arthroplasty, nonsteroidal anti-inflammatory drugs are commonly used for prevention. OBJECTIVE:To compare the effect of meloxicam and indomethacin in the prevention of heterotopic ossification after total hip arthroplasty. METHODS:Fifty-one patients who treated in the Department of Orthopedics, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from 2010 to 2011 were col ected. Among the 51 patients, nine patients were treated with bilateral total hip arthroplasty, and al the patients had total hip arthroplasty with the posterior-lateral approach. The patients were divided into the control group and the experimental group according to the drugs used after replacement, and the patients in the two groups were administered with indomethacin sustained-release tablet 25 mg+omeprazole capsule 20 mg or meloxicam tablet 15 mg after replacement. RESULTS AND CONCLUSION:There were no significant differences in the incidence of heterotopic ossification, pain, modified D’Aubigne and Postel scores after replacement between two groups (P>0.05). But, the gastrointestinal adverse reactions of the experimental group were less than those of the control group. The application of meloxicam only can effectively avoid the heterotopic ossification and release pain. Consequently, we recommend meloxicam as postoperative drug for the prevention of heterotopic ossification and pain remission fol owing total hip arthroplasty.
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Objective To observe the Th17 and regulatory T cells(Tr) equilibrium state as well as their changes of tuberculosis patients in six-month's anti-Tuberculosis treatment.Methods Select thirty-two tuberculosis patients received anti-Tuberculosis treatment while thirty-two healthy volunteers as controls.Flow cytometry was used to analyze Th17 and Tr cells in venous blood at the time of pre-therapy,3th,6th month.Results The ratio of Th17 cells in CD4 cells in tuberculosis patients and volunteers were (1.10±0.39)％,(2.50±1.03) ％,(3.90±1.34) ％,(4.50±1.52)％,respectively; the ratio of Tr cells were (9.17±3.26)％,(6.85±2.73)％,(5.46±1.69)％,(4.35±0.86)％,respectively.Conclusion Tuberculosis could make Th17 cells and Tr cells lost their balance,but the immune equilibrium state may gradually recover after anti-tuberculosis.The change of the amount of immune cells was likely to be the reference indexes to observe the progress of tuberculosis and the treatment effect of anti-tuberculosis.
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Objective To study the effectiveness of microwave ablation in treating HCC.Methods A total of 98 nodules in 56 cases of HCC were treated via appropriate puncture approach ac-cording to the volume, amount and site of tumor nodules. Results Only 1 patient failed to finish treatment since he could not suffer the pain. The other 55 patients finished without a hitch. Clinical and imaging findings were analyzed for change of physiology. Conclusion The microwave ablation is effective for the treatment of HCC. Such therapy can be important supplement of direct surgical man-agement. Its effect mainly depends on accurate puncture approach and enough diametric range. Mean-while, reasonable puncturing method should be selected.
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Objective To evaluate the safety and efficacy of hepatectomy in combination with portal azygous disconnection for primary hepatocellular carcinoma (HCC) complicated with severe portal hypertension (PHT). Methods Clinical data of 30 cases of HCC complicated with PHT treated in our hospital from April 2005 to April 2008 were retrospectively analyzed. All 30 cases were randomly divided into the single operation group (group Ⅰ ) and combined group (group Ⅱ ). Results After operation, there were no significant statistical differences in rates of complications such as hepatic encephalopathy, ascites, stress ulcer, etc. and recovery of liver function between the 2 groups. The WBC and PLT counts in the blood samples of group Ⅱ were higher than those in group Ⅰ after operation. The postoperative 1- and 2-year hemorrhagic rates were lower in group Ⅱ than in group Ⅰ .Conclusion Hepatectomy in combination with portal azygous disconnection is safe and feasible for treatment of HCC complicated with PHT.