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Objective To explore the diagnostic values of combined detection of serum procalcitonin (PCT) and β2 microglobulin (β2MG) in tsutsugamushi disease.Methods Serum PCT and β2MG were compared in cases of tsutsugamushi disease and fever patients at the same time,who were hospitalized at Fourth Affiliated Hospital of Guangxi Medical University from June 2014 to May 2017.The best diagnosis cut-off value of tsutsugamushi disease was calculated by receiver operating characteristic (ROC) curve.Results A total of 57 cases of tsutsugamushi disease,40 cases of sepsis,17 cases of acquired immunodeficiency syndrome (AIDS),17 cases of severe community-acquired pneumonia (SCAP),63 cases of common community-acquired pneumonia (CCAP),14 cases of pulmonary tuberculosis (PTB),20 cases of upper respiratory tract infection,13 cases of other infectious fever and 28 cases of non-infectious fever patients were selected.The level of serum PCT in tsutsugamushi disease [0.87 (0.68-1.34) μg/L] was higher than those in AIDS [0.47 (0.20-1.12) μg/L],CCAP [0.17 (0.09-0.51) μg/L],PTB [0.13 (0.05-0.18) μg/L],upper respiratory tract infection [0.23 (0.05-0.48) μg/L] and non-infectious fever [0.09 (0.06-0.13) μg/L],but was lower than those in sepsis [5.00 (1.04-18.78) μg/L] and SCAP [3.35 (0.76-14.41) p,g/L,P ＜ 0.05],while the difference was not significant compared with other infectious fever [0.76 (0.13-1.99) μg/L,P ＞ 0.05].The level of serum β2MG in tsutsugamushi disease [(5.67 (4.47-7.90) mg/L] was higher than those in sepsis [2.83 (2.10-4.54) mg/L],AIDS [3.85 (3.19-5.22) mg/L],SCAP [3.83 (2.98-5.58) mg/L],CCAP [1.99 (1.51-2.75) mg/L],PTB [1.92 (1.37-3.00) mg/L],upper respiratory tract infection [2.02 (1.25-2.74) mg/L],other infectious fever [2.45 (1.51-4.12) mg/L] and non-infectious fever [2.99 (2.06-4.30) mg/L,P ＜ 0.05].ROC curve showed that the most suitable diagnosis cut-off value of serum PCT in tsutsugamushi disease was 0.53 μg/L,the sensitivity was 94.7％,and the specificity was 60.4％.The critical value of serum β2MG was 3.74 mg/L in diagnosis of tsutsugamushi disease,its corresponding sensitivity and specificity were 91.2％ and 75.9％,respectively.The sensitivity and specificity of combined serum PCT and β2MG in diagnosis of tsutsugamushi disease was 87.7％ and 86.3％,respectively.Conclusion Combined detection with serum PCT and β2MG can improve early diagnosis of tsutsugamushi disease.
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OBJECTIVE:To compare anesthesia effects of 3 anesthesia methods,to investigate anesthesia improvement method for bronch fiber oscope. METHODS:315 patients undergoing bronch fiber oscope were randomly divided into group A(106 cas-es),group B(104 cases)and group C(105 cases). Group A was treated with traditional bronch fiber oscope lidocaine atomization local anesthesia,group B was treated with modified bronch fiber oscope pethidine combined with lidocaine atomization local anes-thesia and group C was treated with three-limb tube connected with laryngeal mask and target-controlled propofol and remifentanil general anesthesia. SaO2,SBP,DBP,heart rate,breathing rate,excellent anesthesia rate,compliance rate,the rate of bodymove-ment and choking,pain recalling rate were compared among 3 groups before and during examination,and ADR was observed. RE-SULTS:Compared with before examination,SaO2 of group A was decreased significantly during examination,with statistical sig-nificance(P<0.05);that of group B and C had no obvious change before and during examination. Blood pressure,heart rate and breathing rate of 3 groups had no obvious change before and during examination. The excellent anesthesia rate and compliance rate of group A were significantly lower than those of group B and C,but the rate of bodymovement cough and pain recalling rate were significantly higher than group B and C,with statistical significantly(P<0.05). The excellent anesthesia rate and compliance rate of group B were significantly lower than those of group C,but the rate of bodymovement cough and pain recalling rate were signifi-cantly higher than group C,with statistical significance (P<0.05). No ADR was found in 3 groups. CONCLUSIONS:Modified bronchoscope atomization local anesthesia and modified painless bronchoscope are better than traditional bronch fiber oscope atomi-zation local anesthesia in anesthesia effect,safety,degree of comfort and acceptability. Modified bronchoscope atomization local an-esthesia was best but most expensive,so these methods can be chosen according to patient’s condition.
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Objective To explore the difference of C-reactive protein(CRP)in non-smokers,ex-smokers,and smokers with chronic obstructive pulmonary disease experiencing exacerbations(AECOPD)and the relation of blood white cells in order to study the role of smoking to CRP.Methods Five hundreds and sixty-eight patients with AECOPD were enrolled in the retrospective case-study.Patients were divided into three groups:non-smokers,ex-smokers,and smokers.CRP and WBC were measured to compare their changes.Results Serum CRP levels of three groups were 5.7 mg/L,5.6 mg/L and 5.8 mg/L,respectively;there was no significant difference among them;cigarette smoking had no effect on the raised serum CRP levels;similarity,WBC of theirs were 8.6?109/L,9.1?109/L and 8.5?109/L,respectively;there was also no significant difference among them(P=0.299).There was little relationship between CRP and WBC.Conclusion Serum CRP levels in non-smokers,ex-smokers,and smokers with AECOPD are raised and are independent of cigarette smoking.Maybe CRP is related to infection.