ObjectiveTo explore the clinical characters and histopathologic differences between patients with culture-positive and culture-negative prosthetic joint infection (PJI).
MethodsBetween January 2012 and July 2013, 66 PJI patients in accord with diagnostic criteria were enrolled. According to the results of preoperative aspiration and intraoperative cultures, the patients were divided into culture-negative group (CN group, n=21) and culture-positive group (CP group, n=45). There was no significant difference in gender, age, height, weight, and body mass index between 2 groups (P>0.05). Preoperative C reactive protein (CRP), erythrocyte sedimentation rate (ESR), and prosthesis survival time were compared between 2 groups. Intraoperative frozen sections and paraffin sections were both performed to identify infections, and histological typing was performed according to Morawietz's methods.
ResultsThe preoperative CRP was (1.29±1.84) mg/ dL in CN group and (5.08±9.57) mg/dL in CP group, showing significant difference (t=2.094, P=0.038). The preoperative ESR was (22.86±28.42) mm/1 h in CN group and (36.74±31.26) mm/1 h in CP group, showing significant difference (t=7.761, P=0.000). The median survival time of prosthesis was 72 months (range, 8-504 months) in CN group and 25 months (range, 15 days-300 months) in CP group, showing significant difference (U=2.231, P=0.026). Morawietz's histological typing results showed that 2 cases were rated as type I, 7 cases as type II, and 12 cases as type III in CN group; 6 cases were rated as type I, 25 cases as type II, 13 cases as type III, and 1 case as type IV in CP group. The positive culture rate was 68.18% (45/66), and pathogenic bacteria was dominated by Staphylococcus, accounting for 68.89%.
ConclusionThe patients with culture-negative PJI have slow onset and mild inflammatory response, so comprehensive diagnosis should be made based on pathological detection, laboratory examination, and intraoperative cultures.
【Abstract】ObjectiveTo study the effect of bile reinfusion on immunologic function of erythrocyte in patients with obstructive jaundice after external drainage of biliary tract.MethodsPatients with obstructive jaundice who had received biliary tract external drainage were randomly divided into bile reinfusion group (n=24) and simple external drainage group (n=27). Patients without jaundice,who received cholecystectomy in the same period with the above ones,were selected randomly as control group(n=25). In external drainage groups patients’ bile was collected daily, and was filtered through gauze, and then, pumped back into the patients’ duodenum or jejunum after being heated to 38 ℃-40 ℃. The bile reinfusion could be started after the intestinal function recovered postoperatively. The changes of C3bRRT, ICRT, RFER and RFIR were observed before and after operation. The data were analysed through SPSS8.0.ResultsPreoperative C3bRRT and RFER levels in patients with obstructive jaundice were lower than those without jaundice significantly, and Preoperative ICRT and RFIR levels in patients with obstructive jaundice were higher than those without jaundice significantly. C3bRRT levels in bile reifusion group was higher obviously than those in simple drainage group (P＜0.05) on the 14th postoperative day. ConclusionImmunologic function of erythrocyte in patients with obstructive jaundice is inhibited, and bile reinfusion after biliary tract external drainage can be helpful to the recovery of immunologic function of erythrocyte.
Objective
To explore the relationship between the diabetic retinopathy (DR) and the changes of erythrocyte deformability(ED),erythrocyte membrane phospholipid and spectrin.
Methods
One hundred and eight patients with non-insulin dependent diabetes mellitus were divided into DR group(55 cases)and nonDR(NDR)group(53 cases).The changes of erythrocyte filtration index(EFI),erythrocyte membrane phospholipid and spectrin dimers(SP-D)and spectrin tetramers (SP-T)were measured in patients of DR and NDR groups and compared with the results of 53 cases of normal control group.
Results
The EFI,SP-D, SP-D/SP-T,sphingomyelin (SM) /phophatidylcholine(PC)were higher,and SPT,SM,PC,phophatidylserine(PS)and phatidylethanolamine(PE)were lower in patients with DR than those in control and NDR patients (F=8.467～18.925,q=6.845～12.627,Plt;0.001).The changes of all indicators in proliferative DR(PDR) patients were more obvious than those in background DR(BDR) patients(t=5,825-15.443,Plt;0.001).The EFI in DR patients was positively correlated to SM/PC,SP-D and SP-D/SP-T(Plt;0.01)，negatively correlated to SM,PC,PE,PS and SP-T(Plt;0.01).
Conclusions
The decrease of ED caused by the abnormalities of erythrocyte membrane phospholipid and spectrin might participate in the occurance and development of DR,and correlated to the degree of pathologic changes.
(Chin J Ocul Fundus Dis, 1999, 15: 160-162)
Objective
To study the relationship between insulinase activity of erythrocytes(EIA)and diabetic retinopathy(DR)in non insulin dependent diabetes mellitus (NIDDM) patients．
Methods
EIA,fasting plasma glucose (FPG),fasting plasma insulin (FINS) and glycosylated hemoglobin (HbA1c) were determined in 55 healthy controls,42 NIDDM patients with DR and 44 NIDDM patients without DR．
Results
EIA was lower,disease duration was longer,and FPG and HbA1c were higher in NIDDA patients with DR.EIA was decreased,duration of NIDDM was lengthened,FPG and HbA1c were increased in NIDDM patients with proliferative DR as compared with NIDDM patients with background DR．The correlation analysis showed,in NIDDM patients with DR,EIA was inversely correlated with FPG,HbA1c and duration of NIDDM．
Conclusion
Insulinase may play certain role in the onset and development of DR．
(Chin J Ocul Fundus Dis,1998,14:132-134)
Objective To investigate the effects of cimetidine on the red cell immune function and interleukin-2(IL-2) in rats with obstructive jaundice. Methods Sixty SD rats were divided into bile duct ligation(BDL) group, cimetidine therapy (BDLC) group and sham operation(SO) group respectively. The red cell immue function and serum IL-2 level were determined with the red cell yeast-rosttes test and radioimmunoassay respectively. Results The red blood cell C3b receptor rosette rate(RBC-C3bRR), the red blood cell immune complex rosette rate(RICR), the red blood cell C3b receptor rosette-forming excited rate(RFER) and serum IL-2 level were significantly lower in BDL group as compared with SO group, the red blood cell C3b receptor rosette-forming inhibitory rate(RFIR) in BDL group was higher than that of SO group. After 7 days’ cimetidine therapy RBCC3bRR, RICR, RFER and IL-2 became higher than those of BDL group, but RFIR was lower than that of BDL group. Conclusion Supplemental cimetidine can significantly enhance the impaired red cell immune function and IL-2 production in rats with obstructive jaundice.
Objective To explore the value of fecal calprotectin （FCP） in the activity evaluation for ulcerative colitis （UC）. Methods Sixty three patients with UC （UC group） and 30 patients with gastrointestinal symptoms but without abnormal results of colonoscopy （control group）， who were treated in The Forth Affiliated Hospital of China Medical University between Sep. 2007 to Dec. 2009 were enrolled to examine the FCP， C-creative protein （CRP）， and erythrocyte sedimentation rate （ESR）. Then comparison between UC group and control group was performed. Results Levels of FCP and CRP in active gradeⅠ，Ⅱ， and Ⅲ group were all significantly higher than those of control group and inactive UC group （P＜0.05）， with the increase of active grade of UC， the level of FCP gradually increased （P＜0.05）. The levels of CRP in active grade Ⅱ and Ⅲ group were all significantly higher than those of gradeⅠgroup （P＜0.05）， but didn’t differed between active grade Ⅱ and Ⅲ group （P＞0.05）. There were no significant difference among 5 groups on ESR （P＞0.05）. Levels of FCP （rs=0.807， P＜0.01）， CRP（rs=0.651， P＜0.01）， and ESR （rs=0.371， P＜0.05） in active grade group were significantly related to histological grade under colonoscopy. Conclusion FCP examination is simple， inexpensive， repeatable， and noninvasive， and FCP can be used as an marker of activity evaluation in UC.
Objective To study oxygen carrying capacity of red blood cell in children with congenital left-to-right shunt (CLRS) and discuss its clinical significance. Methods A total of 62 children with CLRS were selected as a trial group and 40 healthy children who had accepted clinical physical examination as a control group. ELISA test was applied to determine 2,3 -DPG content of red blood cells. At the same time, pH, PaO2, PaCO2, Hb, P50O2 and relevant outcomes were tested for correlation analysis. Results Red blood cell 2,3-DPG (2.76±0.98 μmol/mL) was higher than that of the control group. PaO2, pH, Hb were lower than those of the control group with significant differences. Among the types of CLRS, 2,3 -DPG of ventricular septal defect was the highest and that of patent ductus arteriosus ranked the second, the two of which had a significant difference (P=0.007). As for red blood cell of children with congenital heart diseases, there was linear correlation between 2,3- DPG and PaO2 as [2,3-DPG=12.007 8– (0.154 7×PaO2)], as well as between P50O2 and 2,3 -DPG as [P50O2=26.303 6+ (1.799 2×2,3-DPG)]. Conclusion Children with congenital left-to-right shunt tend to have low oxygen. Therefore, it is important to detect 2,3-DPG of red blood cell, blood gas analysis, and hemoglobin level change, in order to well understand the mechanism of congenital heart disease as well as to guide clinical practice.
ObjectiveTo observe and analyze the correlation between erythrocyte count and hemoglobin level in early life and retinopathy of prematurity (ROP). MethodsA clinical retrospective study. From January 2020 to December 2022, a total of 303 premature infants, who underwent fundus screening in Children's Hospital of Henan Province were included. There were 219 males and 84 females, with the average gestational age of (30.36±1.52) weeks and the average birth weight of (1 368.43±171.37) g. Early life was defined as 14 days after birth. According to the screening results, patients were divided into ROP group and no ROP group (control group). The results of red blood cell count, hematocrit and hemoglobin concentration of the two groups were compared and observed on the 3rd, 7th and 14th day after birth. The measurement data were compared by t-test, and the count data were compared by χ2 test. The risk factors of ROP were analyzed by logistic regression. The correlation between red blood cell count as well as hemoglobin concentration in early life and ROP was analyzed by receiver operating characteristics (ROC) curve. ResultsAmong the 303 premature infants screened, a total of 101 preterm infants were included in the ROP group, with the average gestational age of (30.39±1.48) weeks. And a total of 202 preterm infants were included in the control group, with the average gestational age of (30.35±1.55) weeks. There was no significant difference between the two groups in sex composition ratio (χ2=0.296) and gestational age (t=0.251) (P＞0.05). There were significant differences in birth weight (t=－2.024), blood transfusion times (U=－4.957), invasive mechanical ventilation duration (U=－2.215) and continuous positive airway pressure ventilation time (U=－5.224) between the two groups (P＜0.05). The incidence of periventricular leukomalacia (χ2=5.069), bronchopulmonary dysplasia (χ2=9.794) and sepsis (χ2=8.041) were significantly different (P＜0.05). The average hemoglobin level of patients in the ROP group on the 3rd, 7th and 14th day after birth were lower than those in the control group (t=－3.813, －2.753, －2.847; P＜0.05). Logistic regression analysis showed that low frequency of blood transfusion [odds ratio (OR)=1.241, 95% confidence interval (CI) 1.016-1.517] and short duration of continuous positive airway pressure (OR=1.128, 95%CI 1.031-1.234) were protective factors for ROP. The ROC curve analysis indicated that the abnormal threshold values of hematocrit and hemoglobin were the highest on the 14th day after birth, which were 115.5 g/L and 36.25% respectively. The sensitivities were 88.1% and 83.2%, respectively. ConclusionRed blood cell count and hemoglobin level in early life of preterm infants may have a certain correlation with the occurrence and development of ROP.
ObjectiveTo observe the changing patterns of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum amyloid A protein (SAA) levels before and after hip replacement surgery, and explore their clinical significances.
MethodsNinety-seven consecutive patients enrolled in clinical pathway in our hospital for hip replacement from April 2011 to May 2013 were included in the present study. ESR, CRP and SAA levels were investigated preoperatively and post-operatively at day 1, 3, 5, 7, 14, Month 1 and 3. All the cases were followed up, among which there were 14 cases of total hip replacement, 56 cases of cementless hemianthroplasty, and 27 cases of biotype hemianthroplasty.
ResultsAll three of ESR, CRP and SAA levels were elevated post-operatively. Levels of CRP and SAA peaked at day 3 after surgery, and then subsided gradually to pre-operative levels after 1 month. ESR level peaked at day 7 postoperatively, and then subsided gradually to pre-operative levels after 3 months. There was a significant correlation between levels of CRP and levels of SAA.
ConclusionCompared with ESR and SAA, CRP appears to be a faster and more sensitive parameter. Cementless hemianthroplasty is associated with changes of SAA levels but not with CRP levels. Close monitoring of evolutionary changes in ESR, SAA and CRP levels may help to diagnose and treat early infection after hip replacement surgery.
In order to study the immune function of patients with obstructive jaundice, the rate of RBC-C3b receptor rosette (RCR), tumour-RBC rosettes (TRR), RBC-immune complex rosette (RICR) and CD３+,CD4+,CD8+ cells were investigated. In these patients, the pre-operative erythrocyte and T lymphocyte subsets immune functions were lower than those of the control (Ｐ＜0.001). At the 5th day after operation, there was no significant change and 14th day after operation the erythrocyte and T lymphocyte substes immune functions were significantly elevated(Ｐ＜0.05), while, compared with the normals, which was still depressed in some degree. Operation is useful to the recovery of the immune function in all patients.
