Objective To study infection of the lung tissue by bronchoalveolar lavage for BALF and explore whether GM can help improve the he diagnosis efficiency in patients without granulocyte deficiency with IPA, and find the threshold of GM values. Methods Between January 2011 and December 2011, 173 cases of patients were considered possible invasive pulmonary aspergillosis in parallel BALF GM detection in the center of the respiratory endoscopic examination.. According to the diagnostic criteria at home and abroad, all the cases were divided into four groups, including group of IPA, group of tuberculosis, group of bacterial pneumonia and group of non-infection. Using ELISA method for determination of serum and BALF GM. The diagnostic value was made by statistical methods in BALF GM detection without patients of granulocyte deficiency with IPA. Results There were 11 cases in the group of IPA, 23 cases in the group of tuberculosis, 90 cases in the group of bacterial pneumonia and 49 cases in the group of non-infection. In patients without granulocyte deficiency with IPA,BALF GM value was higher comparing with the patients without IPA. There were significant difference between the two groups; Comparing the GM value in the serum, the detection of BALF GM was higher in IPA. ROC curve analysis found that when the BALF GM test value was 0.95 or higher, there was highest possible with IPA. Conclusion BALF GM testing is beneficial to patients of invasive pulmonary aspergillosis without granulocyte deficiency in early identification with IPA. This study found that BALF GM best value is 0.95 or higher.

Objective:To investigate the efficacy of an additional augmentative locking compression plate combined with bone graft for aseptic subtrochanteric fracture nonunion after intramedullary nailing.Methods:From October 2016 to October 2019, 32 patients (25 males and 7 females) were treated at Department of Orthopedics, The Sixth People's Hospital Affiliated to Shanghai Jiaotong University for aseptic subtrochanteric fracture nonunion after intramedullary nailing. Their ages ranged from 27 to 68 years (average, 50.5 years) and their nonunion time from 9 to 24 months (average, 12.2 months). According to the Weber-Cech classification for nonunions, 9 cases belonged to the highly vascular type and 23 to the ischemic type. With the original intramedullary nails retained, all patients were fixated with an additional augmentative locking compression plate before simultaneous autologous iliac bone grafting. All patients were followed up regularly for fracture union, function of the affected hip and complications.Results:The 32 patients were followed up for 6 to 24 months (average, 12.9 months). All nonunions obtained clinical and imaging union. The clinical union time ranged from 3 to 8 months (average, 5.2 months), and the imaging union time from 6 to 10 months (average, 7.4 months). At the last follow-up, the therapeutic efficacy was evaluated as excellent in 28 cases and as good in 4, giving a good to excellent rate of 100%(32/32), according to the Sanders scoring for post-traumatic hip joint; the efficacy was evaluated as excellent in 21 cases, as good in 10 cases and as fair in one, giving a good to excellent rate of 96.9%(31/32), according to the Harris hip scoring. No such complications occurred as infection or loosening or breakage of internal fixation.Conclusion:An additional augmentative locking compression plate combined with bone graft is a reliable and effective treatment for aseptic subtrochanteric fracture nonunion after intramedullary nailing.

Objective To evaluate the clinical value of hs-CRP,Tbil and BUA in the diagnosis of coronary atherosclerosis on 320 slice dynamic volume computed tomography(320-DVCT).Methods 160 patients with stable angina pectoris were included.All patients underwent 320-DVCT coronary artery imaging and laboratory testing including plasma hs-CRP,Tbil and BUA.The plaques of coronary artery were classified as soft plaque,fibrous plaque and calcified plaque on CT values.The three indicators were used to confirm the ability of diagnosis on number of lesions,plaque character and the degree of stenosis.100 healthy persons served as the control group.Results With the concentration of hs-CRP,BUA increased and Tbil concentration decreased,the number and the stenosis degree of coronary lesions became increased,and easier to form a soft plaque.Conclusion The hs CRP,Tbil and BUA can offer the accurate diagnosis of lesions number,plaque character and stenosis degree of the coronary artery,which is showed on 320-DVCT.The hs-CRP,Tbil and BUA are conducive to the risk assessment of coronary atherosclerosis.

Humans ; Asthma/drug therapy* ; Biological Therapy