RESUMEN
Objective:To analyze the clinical efficacy of two-stage total hip arthroplasty in the treatment of chronic septic hip arthritis.Methods:From January 2008 to March 2020, 17 patients with chronic septic hip arthritis (17 hips) received two-stage total hip arthroplasty at Department of Orthopaedic Surgery, The First Affiliated Hospital to of Fujian Medical University. They were 11 males and 6 females, with an average age of 54.5 years (from 19 to 77 years) and 9 left and 8 right hips affected. There were 10 cases of primary septic hip and 7 cases of secondary infection after hip surgery. Three patients had undergone debridement in other hospitals and one patient had developed a sinus tract. In the first stage operation, the diseased femoral head and neck were resected to implant an articulating spacer after thorough debridement; in the second stage operation, the spacer was removed to implant a uncemented artificial hip prosthesis in 16 cases or a cemented artificial hip prosthesis in one case. Recorded were the results of microbial culture, operation time, intraoperative blood loss, and therapeutic outcomes of the patients.Results:Pathogenic data were available in 13 patients and the culture was negative in 4. The pathogens were detected by metagenomic next-generation sequencing in 2 patients with culture negative. In the first stage operation, operation time averaged 140.6 min (from 90 to 176 min) and intraoperative blood loss 361.8 mL(from 100 to 1 000 mL); in the second stage operation, operation time averaged 130.3 min (from 91 to 166 min)and blood loss 291.2 mL(from 50 to 700 mL). The average interval between the first and the second stage operations was 115.0 days(from 66 to 227 d). During the interval, spacer fracture occurred in one case, spacer dislocation in one case and lower extremity deep venous thrombosis in one case. All the patients were followed up for 12 to 82 months (average, 36.7 months) after second stage operation. The inflammatory indexes decreased to normal in all the 17 patients and infection recurrence was observed in none of them.Conclusions:Two-stage total hip arthroplasty may result in a high rate of successful treatment of chronic septic hip arthritis. Specific use of sensitive antibiotics after identification of specific pathogenic microorganisms by multiple methods is the key to a successful treatment.
RESUMEN
Objective To evaluate conventional ultrasound combined with real-time elastography in differential diagnosis of metastatic axillary lymph nodes of breast cancer with a logistic regression model.Methods Conventional ultrasound and real-time elastography were performed in 112 breast cancer patients with 113 axillary lymph nodes.All the cases were confirmed with pathological examinations after surgery. A binary logistic regression model based on ultrasonographic features was developed.A receiver operator characteristic ( ROC) curve was constructed to assess the performance of the model.Results There were 28 nodes with no metastasis and 85 with metastasis in a total of 113 axillary lymph nodes.Three ultrasonographic features including the elastic strain ratio(SR), elastic score and shape were finally selected into the logistic regression model .The correct rate of the logistic regression model for predicting axillary lymph node metastasis was 93.8%, and the area under ROC curve was 0.962.Conclusion The binary classification logistic regression model has a good diagnostic efficacy in the diagnosis of benign and malignant axillary lymph nodes,while real-time elastography can improve the accuracy of conventional ultrasound in the diagnosis of axillary lymph nodes.
RESUMEN
Objective:To investigate the clinic significance of vascular endothelial cell growth factor ( VEGF) expression and dendritic cells ( DCs ) infiltration in colon cancer tissues , and to analysis the correlation between the sera VEGF with DCs activation.Methods:The expressions of VEGF and S-100 protein in colon carcinoma tissue and pericarcinous tissue were determined by immumohistochemistry.The serum VEGF level of colon carcinoma patients in preoperation and healthy subjects was detected using ELISA.Peripheral blood monocytes were isolated in preoperative patients and healthy subjects and induced to DCs by TNF -αin vitro.The surface expression of CD 83 in DCs was assayed with flow cytometry.Results: Expression of VEGF protein positive in colon carcinoma tissue was significantly higher than the pericarcinous tissue (P<0.01),while S-100 positive expression of colon carcinoma tissue was significantly lower than the pericarcinous tissue ( P<0.01 ).The serum VEGF level in colon carcinoma patients was significantly higher than healthy subjects ( P<0.01 ) ,while the CD83 level in peripheral blood DCs was significantly lower than healthy subjects ( P<0.01 ).The expression of VEGF and S-100 protein in colon carcinoma tissue was correlated with tumor differentiation , stage and lymph node metastasis ( P<0.01 ).The expression of VEGF was inversely correlated with S-100 ( P<0.01 ) in colon carcinoma tissue , while positively correlated with the serum VEGF ( P<0.01 ) and inversely correlated with DCs activation.The infiltration degree of DCs was inversely correlated with serum VEGF , and positively correlated with the DCs activation.Conclusion:VEGF expression in colon carcinoma tissue and DCs infiltration co-participate in the progress of colon cancer ,and VEGF could inhibit the infiltration and activation of DCs.
RESUMEN
Objective:Tumor common antigen of an extract of plant and applying in early stage diagnosis for tumor were studied.Methods:Tumor cells and lymphocytes proliferate responses were determined by 3H-TdR intervening.Fresh tumor tissue from human transplant to mice,the survival rate of transplanted tumor was observed.DNA content of tumor cells was measured by flowcytometery.The chemical nature was analyzed by chromatography and measured by ultraviolet-spectrometer.Results:The extract of plant markedly stimulated the lymphocytes from tumor patients and atypical hyperplasia patient to proliferate,but failed to health persons(P