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Objective To investigate the etiological characteristics of infection after percutaneous biliary drainage or stent implantation in patients with malignant biliary obstruction (MBO). Methods Clinical data were collected from MBO patients who underwent interventional therapy in Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, from January 2016 to December 2020 and had or were suspected of biliary tract infection, with samples submitted for bile culture and/or simultaneous blood culture. Analysis was performed for the aspects of positive rate of culture, flora distribution, consistency between blood culture and bile culture, and drug resistance rate of major pathogenic bacteria. Results A total of 219 patients were enrolled, among whom 105(47.95%) were positive for bile culture, and the composition ratios of Gram-negative bacteria, Gram-positive bacteria, and fungi were 64.89%, 28.24%, and 6.87%, respectively. A total of 69 patients had samples submitted for blood culture during the same period of time, among whom 33(47.82%) had positive results. Positive results of both bile culture and blood culture were observed in 25 patients, and consistency analysis showed that the patients with complete consistency, partial consistency, and complete inconsistency accounted for 36%(9/25), 20%(5/25), and 44%(11/25), respectively. Common Gram-negative bacteria were Escherichia coli , Klebsiella pneumoniae , and Enterobacter cloacae , with a relatively low level of drug resistance to antibiotics including cefoperazone/sulbactam, amikacin, and imipenem. Common Gram-positive bacteria were Enterococcus faecium and Enterococcus faecalis , with a relatively low level(< 15%) of drug resistance to antibiotics including vancomycin, linezolid, and teicoplanin. Conclusion Common pathogens of infection after percutaneous biliary drainage or stent implantation in MBO patients include Escherichia coli , Klebsiella pneumoniae , Enterococcus, and Enterobacter cloacae . There is a relatively low level of consistency between blood culture and bile culture, and thus samples should be submitted for both tests.
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Objective:To investigate the changes and clinical significance of serum immunoregulatory cytokines in patients with rheumatoid arthritis (RA) complicated with osteoporosis (OP).Methods:The clinical data of 420 patients with RA admitted to Mianyang Central Hospital from January 2019 to December 2019 were analyzed. According to their bone mineral density, they were divided into OP group (220 cases) and non OP group (200 cases). The immunoregulatory cytokines and bone metabolism indexes of the two groups were compared, and the correlation between them was analyzed.Results:The age, course of disease, glucocorticoid use history, fracture history, swelling joint number and tenderness joint number of OP group were significantly higher than those of non OP group ( P<0.05). In OP group, the serum levels of interleukin (IL)-6, IL-17, tumor necrosis factor-α (TNF-α) and C-terminal peptide cross-linking (CTX) of type Ⅰ collagen were significantly higher than those in control group ( P<0.05), while the IL-10 and transforming growth factor-β1 (TGF-β1) were significantly higher than that of non OP group ( P<0.05). The serum level of CTX in patients with RA complicated with OP was positively corrected with IL-6, IL-17, TNF-α ( r=0.913, 0.915, 0.921, P<0.001), and negatively correlated with IL-10 and TGF-β1 ( r=-0.921, -0.920, P<0.001). Conclusions:RA patients complicated with OP have higher age, longer course of disease, history of fracture, history of glucocorticoid use, more joint swelling and pain, higher IL-6, IL-17, TNF-α levels, lower IL-10 and TGF-β1 levels. Immunoregulatory cytokines may regulate the proliferation and differentiation of osteoclasts and osteoblasts, and play an important role in RA complicated with OP.