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Objective:To investigate serum C-reactive protein (CRP) , procalcitonin (PCT) and neutrophil CD64 in predicting early infection after internal fixation of limb fractures.Methods:A total of 2 572 patients with limb fractures undergoing internal fixation in Taishun County People’s Hospital from January 2016 to December 2022 were enrolled. Postoperative infection occurred in 121 cases (infected group) and did not occur in 2 451 cases (uninfected group). Serum levels of PCT, CRP and CD64 were tested at admission and d1, d3, d5 and d7 after operation. Repeated measurement analysis of variance was used to compare the serum levels of PCT, CRP and CD64 at different time points between two groups, the receiver operating characteristic curve (ROC) was used to evaluate the predictive value of each index or in combination for early infection after internal fixation of limbs fractures.Results:The early infection rate after internal fixation was 4.70% (121/2 572). The levels of PCT, CRP and CD64 in the infection group began to rise after operation and decreased on d7; there were significant differences in PCT, CRP and CD64 levels between the two groups on d3, d5 and d7 after operation (PCT: Ftime=678.607, Fintergroup=2 218.323, Finteraction=653.150; CRP: Ftime=392.724, Fintergroup=1 812.502, FInteraction =379.577; CD64: Ftime=373.686, Fintergroup=4 817.438, Finteraction=528.353, all P< 0.001) . The area under the ROC curve of combined detection of PCT, CPR, and CD64 for predicting early infection was 0.856; the sensitivity and specificity of combined detection were 69.2% and 94.7%, respectively. The combined detection of three indicators showed better prediction values than PCT, CRP and CD64 alone ( Z=6.176, 3.838 and 2.431, P<0.01 or <0.05), and also better than combined detection of PCT and CRP ( Z=2.875, P=0.019). Conclusions:The combined detection of CD64, PCT and CRP is of value in prediction of postoperative infection after internal fixation of limb fractures, which is worthy of clinical application.
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【Objective】 To establish a magnetic bead enrichment strategy for the detection of human immunodeficiency virus deoxyribonucleic acid (HIV DNA) in peripheral blood, and to verify the improvement of the sensitivity of this method for the detection of HIV DNA in HIV infected patients after early antiretrovital treatment (ART). 【Methods】 Peripheral whole blood was collected at 4 timepoints in one ART HIV window period (WP) patient. Peripheral blood mononuclear cells (PBMCs) were isolated on a Ficoll gradient. CD4+ T lymphocytes were enriched from total PBMCs by negative sorting. HIV DNA concentration in magnetic beads enriched group and whole blood group was detected by HIV DNA detection kit. 【Results】 CD4+ T cells were isolated by magnetic beads and identified by FCM for purity at (96.4 ± 2.6)%. The viability was (95.9 ± 2.9)%, as demonstrated by trypan blue staining. The person on continued ART treatment in this study had significantly greater reduction in HIV viral load and undetectable HIV plasma RNA at follow up timepoint 4. No HIV DNA was detected in the whole blood group at all 4 timepoints. The quantitative results of HIV DNA in the CD4+ T lymphocyte group of the magnetic bead enrichment group were 73.4, 429.3, 137.1, 449.9 copies/106 CD4+ T cell′s respectively. 【Conclusion】 The magnetic bead enrichment method can be more sensitive in detecting the limit low copy HIV DNA in blood samples, and provide early confirmatory data for HIV WP infection and breakthrough infection after ART treatment.
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Objective To evaluate the effect of donor-derived infection on the clinical prognosis of the recipients undergoing liver transplantation. Methods Clinical data of 75 donors and recipients undergoing liver transplantation were retrospectively analyzed. According to the culture results of donor organ lavage fluid, all recipients were divided into the positive group (n=26) and negative group (n=49). Clinical parameters of the recipients during perioperative period were observed in the positive and negative groups. The sputum and peritoneal drainage fluid of the recipients undergoing liver transplantation were cultured. The incidence of postoperative infection of the recipients was observed. The 1.5-year survival curve of the recipients was analyzed by Kaplan-Meier method. Results In the positive group, the incidence of portal vein stenosis and thrombosis was significantly higher than that in the negative group (P < 0.05). Among 75 recipients undergoing liver transplantation, 33 cases (44%) developed postoperative infection mainly in the lung and abdominal cavity. The infection rate significantly differed between the positive group (77%) and negative group (27%, P < 0.05). In the positive group, sputum culture was positive in 10 recipients and peritoneal drainage culture was positive in 11 recipients. The sputum culture outcomes of 4 recipients were consistent with those of the organ lavage fluid culture of their donors. The peritoneal drainage culture results of 6 recipients were consistent with those of the organ lavage fluid culture of their donors. After anti-infection treatment, 2 recipients in the positive group died at postoperative 5 and 12 d, and the culture results of the remaining recipients were negative. In the negative group, 7 recipients were positive for sputum culture and 6 recipients were positive for peritoneal drainage culture. The culture results of all recipients were negative following anti-infection therapy. Two recipients died from graft failure at postoperative 1 month and 1 year. The 1.5-year survival rate did not significantly differ between the positive and negative groups (P > 0.05). Conclusions The effect of donor-derived infection on the early prognosis of liver transplant recipients cannot be neglected, whereas it exerts mild impact on the intermediate- and long-term clinical prognosis of the recipients.
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Objective To discuss the diagnostic value of soluble scavenger receptor(sCD163)for the patients of malignant tumor associated with fever in early infection .Methods Collect 102 cases of patients confirmed with malignant tumor in this hospi-tal since January to December 2014 ,all the patients were examined with blood culture .102 patients were divided into two groups ac-cording to the results of blood culture :infection group (60 cases) and uninfected group (42 cases) .ELISA ,electrochemical lumines-cence and immune transmission turbidimetric methods were used to detect the levels of sCD163 ,PCT and CRP in serum ,to compare the differences in the above indicators between two groups .The receiver-operating characteristic curve (ROC curve) was applied to evaluate the application value of sCD163 in diagnosing of malignant tumor associated with fever in early infection .Results The lev-el of sCD163 ,PCT and CRP had statistically difference in two groups(P< 0 .05) ;the critical values of sCD163 、PCT and CRP were 110 .80 ng/mL ,0 .45 ng/mL ,15 .60 mg/L respectively which can suggest the patients with malignant tumor complicated with fever in early infection .The area under the curve were 0 .894 ,0 .835 ,0 .743 respectively ,among that sCD163 area was the largest ;The corresponding sensitivity were 88 .9% ,77 .9% and 88 .0% ;specificity were 77 .0% ,74 .0% and 50 .0% respectively .Conclusion Compared with PCT ,CRP ,sCD163 has more value for diagnosing the patients of malignant tumor associated with fever in early in-fection .
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Objective To analyze the clinical value of gastric bacterial cultivation in the early diagnosis of bacterial infection in preterm infants.Methods 174 preterm with risk perinatal factors of infection in NICU of Chang’an Hospital from January 2013 to December 2014 were collected,they were given the gastric juice cultivation checking in 1 hour after birth before eat-ing,watering and giving medicine.According to the clinical symptoms and laboratory test results,they were divided into the infected group and non-infected group.Their Gastric cultivation inspection was compared and analyzed in two groups.Results The positive rate of bacterial culture of gastric fluid was 40.8% (71/174),and located in the top four is Escherichia coli 30.99% (22/71),coagulase-negative staphylococci 21.13%(15/71),Staphylococcus aureus 14.08%(10/71)and group B streptococcus 8.45% (6/71).There was relation between premature infants with bacterial culture positive and meconium stained amniotic fluid,maternal infection during pregnancy,premature rupture of membranes,but not with gestational hyper-tension,fever unrelated to the mother giving birth.Conclusion There was high positive rate of gastric juice bacterial culture with a significant correlation of early onset infection.