OBJECTIVE: To explore the difference in level of pain experienced by patients with total hip arthroplasty between aseptic loosening and periprosthetic infection, and to examine the correlation between C-reactive protein (CRP) and pain. METHODS: Fifty-one patients (recruited from our hospital between March 2010 and November 2011) suffering aseptic loosening or periprosthetic infection after total hip arthroplasty were included in this study: 24 males and 27 females, with mean age 68.13 years. The patients were divided into an aseptic loosening group (n=31) and a periprosthetic infection group (n=20). Both the visual analog scale (VAS) and Harris pain score were used to estimate the level of pain experienced by the patients. CRP levels in serum were measured. The difference in assessment of pain by VAS and Harris pain score was compared between the two groups, and the correlation between pain and CRP was analyzed. RESULTS: The mean VAS in the aseptic loosening group was 5.39 (2.10-8.13) compared with 5.48 (2.09-8.30) in the periprosthetic infection group; however, the difference was not statistically significant (P=0.85). The mean rank of Harris pain score was 26.23 in the aseptic loosening group and 25.65 in the periprosthetic infection group, but again there was no significant difference (P=0.88). The CRP level in the periprosthetic infection group (36.20-101.40 mg/L, mean 72.86 mg/L) was obvious higher than that in the aseptic loosening group (1.37-13.70 mg/L, mean 6.53 mg/L), and the difference was statistically significant (P<0.01). The VAS was related with the CRP level in the periprosthetic infection group (r=0.87, P<0.01), and the correlation between Harris pain score and CRP level was conspicuous (r=0.92, P<0.01) in this group. However, those correlations were not evident in the aseptic loosening group (r=0.25, P=0.17; r=0.19, P=0.65). CONCLUSION There is no difference in perception of pain in patients after total hip arthroplasty between those with aseptic loosening and those with periprosthetic infection. It is therefore unreliable to make a initial diagnosis only according to the level of pain. However, the level of CRP is a sensitive and effective way of differentiating the two conditions. The positive correlation between CRP and pian exists in patients with periprosthetic infection but not with aseptic loosening.
Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; C-Reactive Protein ; analysis ; Female ; Humans ; Male ; Middle Aged ; Pain Measurement ; Prosthesis Failure ; etiology ; Prosthesis-Related Infections ; blood ; physiopathology

Objective:To investigate the efficacy and safety of camrelizumab in the treatment of advanced hepatocellular carcinoma complicated with hepatitis B virus infection.Methods:One hundred cases of patients with advanced primary hepatocellular carcinoma complicated with hepatitis B virus infection admitted to the Fuyang Cancer Hospital from July 2020 to July 2021 were selected and divided into the observation group (48 cases) and the control group (52 cases) by the random number table method. The control group was treated with transhepatic arterial chemoembolization (TACE) and entecavir, and the observation group was treated with camrelizumab on the basis of the control group. After 3 months of treatment, the efficacy was evaluated, serum Alpha-fetoprotein (AFP) was determined, and the incidence of adverse reactions was counted. Progression-free survival (PFS) and overall survival (OS) were compared in follow-up visits.Results:After 3 months of treatment, the objective remission rates of the observation group and the control group were 47.92% (23/48) and 23.08% (12/52), respectively, and the disease control rates were 85.42% (41/48) and 65.38% (34/52), respectively, with statistically significant differences ( P<0.05); the AFP level in the observation group was significantly lower than that in the control group: (55.41 ± 10.22) μg/L vs. (78.52 ± 9.63) μg/L, with statistically significant differences ( P<0.05); the incidence of reactive skin capillary hyperplasia in the observation group was significantly higher than that in the control group: 83.33% (40/48) vs. 0, with statistically significant differences ( P<0.05); the median PFS and OS in the observation group were significantly longer than those in the control group: 8.00 (6.27, 9.73) months vs. 5.90 (4.70, 7.10) months and 15.50 (13.47, 17.00) months vs. 12.80 (10.21, 15.39) months, with statistically significant differences ( P<0.05). Conclusions:Camrelizumab combined with entecavir and TACE is effective in the treatment of patients with advanced hepatocellular carcinoma complicated with hepatitis B virus infection. Compared with the short-term efficacy and long-term survival of entecavir alone combined with TACE, camrelizumab combined with TACE is more advantageous, and the degree of adverse reactions is less. Therefore, this regimen may have better benefits when considering the efficacy and tolerability.