1.Diagnostic value of 99mTc-MDP three-phase bone scintigraphy combined with C-reaction protein for periprosthetic joint infection.
Guojie LIU ; Xiaolan SONG ; Pei ZHAI ; Shipeng SONG ; Weidong BAO ; Yawei DUAN ; Wei ZHANG ; Yafeng LIU ; Yongqiang SUN ; Shuailei LI
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(9):1180-1186
OBJECTIVE:
To investigate the diagnostic efficacy of 99mTc-MDP three-phase bone scintigraphy (TPBS) combined with C-reactive protein (CRP) for periprosthetic joint infection (PJI).
METHODS:
The clinical data of 198 patients who underwent revision surgery of artificial joint between January 2017 and January 2024 and received TPBS examination before surgery were retrospectively analyzed. There were 77 males and 121 females with an average age of 63.74 years ranging from 24 to 92 years. There were 90 cases of hip arthroplasty and 108 cases of knee arthroplasty. PJI was diagnosed according to the 2013 American Musculoskeletal Infection Society (MSIS) standard diagnostic criteria. The sensitivity, specificity, accuracy, negative predictive value (NPV), and positive predict value (PPV) were calculated. The receiver operating characteristic (ROC) curve was used to compare the diagnostic performance of the three methods, and the area under curve (AUC) was used to evaluate the diagnostic performance.
RESULTS:
According to the 2013 MSIS criteria, 116 cases were diagnosed as PJI, and the remaining 82 cases were aseptic loosening. The cases of PJI diagnosed by TPBS, CRP, and TPBS-CRP were 125, 109, and 137 respectively, and the cases of aseptic loosening were 73, 89, and 61 respectively. The sensitivity, accuracy, NPV, and PPV of TPBS-CRP combination in the diagnosis of PJI were higher than those of TPBS and CRP, but the specificity was lower than that of TPBS and CRP. ROC curve analysis further showed that the AUC value of TPBS-CRP combination was better than that of TPBS and CRP. The severity of bone defect and the duration of symptoms in patients with false positive TPBS diagnosis were worse than those in patients with true negative TPBS diagnosis (P<0.05), but there was no significant difference in the survival time of prosthesis between the two groups (P>0.05). Among the patients diagnosed with PJI by TPBS, CRP, and TPBS-CRP, 49, 35, and 54 patients had received antibiotic treatment 2 weeks before diagnosis, respectively. There was no significant difference in the diagnostic accuracy of TPBS and TPBS-CRP before diagnosis between patients treated with and without antibiotics and those not treated (P>0.05). The diagnostic accuracy of antibiotic therapy before CRP diagnosis was significantly lower than that of untreated patients (P<0.05).
CONCLUSION
TPBS and CRP have limited specificity in differentiating PJI from aseptic loosening. The TPBS-CRP combination diagnostic method can synergize the local bone metabolic characteristics and systemic inflammatory response to achieve higher diagnostic accuracy, but caution should be exercised in patients with severe bone defects and longer symptom duration.
Humans
;
Prosthesis-Related Infections/blood*
;
Middle Aged
;
Male
;
Female
;
Aged
;
C-Reactive Protein/metabolism*
;
Retrospective Studies
;
Adult
;
Radionuclide Imaging/methods*
;
Arthroplasty, Replacement, Knee/adverse effects*
;
Aged, 80 and over
;
Technetium Tc 99m Medronate
;
Arthroplasty, Replacement, Hip/adverse effects*
;
Sensitivity and Specificity
;
Knee Prosthesis/adverse effects*
;
ROC Curve
;
Reoperation
;
Radiopharmaceuticals
;
Young Adult
2.Establishment and application of a clustered management plan for pulmonary care of massive burn casualties
Shujun WANG ; Chunting MA ; Hongyan LU ; Xihe SONG ; Yuezeng NIU ; Guojie CHEN ; Ti ZHOU ; Chuan′an SHEN
Chinese Journal of Burns 2020;36(8):665-670
Objective:To establish a clustered management plan for pulmonary care of massive burn casualties (hereinafter referred to as the clustered management plan for pulmonary care), and to explore its application effects.Methods:(1) A clustered care intervention group was established, including the medical and nursing staff from the Department of Burns and Plastic Surgery, Department of Respiratory Medicine, and Department of Infection Control at the Fourth Medical Center of PLA General Hospital (hereinafter referred to as our hospital). Four major links, including pulmonary care assessment, chest and lung physical therapy, artificial airway management, and specialized infection control were sorted out according to the key points and difficulties in pulmonary care for massive burn casualties. Evidence-based nursing methods were employed to retrieve articles related to the above-mentioned four links from PubMed, Chinese Journal Full- Text Database, VIP Database and Wanfang Data using terms of " mass burn, respiratory management and airway management" and terms of "成批烧伤,肺部护理,集束化管理" , and the clustered management plan for pulmonary care was established based on reading and discussion in combination with clinical practice and experience. (2) In this non-randomized controlled study, the clustered management plan for pulmonary care was applied to 73 massive burn patients (48 males and 25 females, aged 32 (25, 38) years) who were admitted to our hospital from January 2016 to December 2019 and met the inclusion criteria, and they were included into the clustered care group; 43 massive burn patients (25 males and 18 females, aged 35 (17, 45) years) who were admitted to our hospital from January 2013 to December 2015, received routine care and met the inclusion criteria were retrospectively included into routine care group. The pulmonary infection rate and mortality of patients in the two groups were recorded during the hospital stay. Data were statistically analyzed with chi-square test, Mann-Whitney U test, and independent sample t test. Results:(1) The clustered management plan for pulmonary care included a total of 12 specific measures covering four aspects of pulmonary care. The contents in pulmonary care assessment clearly stated to include the previous medical history, history of injury, respiratory status, hoarseness, pulmonary auscultation, etc. Chest and lung physical therapy included how to guide patients to effectively cough and do pursed lip breathing and abdominal breathing exercise, etc. Artificial airway management specified the preparation for the establishment of artificial airway at clinical reception, the observation index and frequency after tracheotomy, the method of humidification, the method and frequency of sputum suction, and the management of mechanical ventilation, etc. Specialized infection control required to strengthen hand hygiene and ventilator management. (2) The pulmonary infection rate and mortality of patients in the clustered care group were 2.74% (2/73) and 4.11% (3/73), respectively, significantly lower than 25.58% (11/43) and 18.60% (8/43) in routine care group ( χ2=11.986, 5.043, P<0.05 or P<0.01). Conclusions:The clustered management plan for pulmonary care developed for massive burn casualties focuses on the major links and key points. The measures are systemic and comprehensive, simple but precise, and highly operable, covering the entire process of massive burn care, hereby reducing the pulmonary infection rate significantly and improving the success rate of treatment.
3.Establishment and evaluation of a novel mouse model of orthotopic colon cancer in the mesenteric triangle of the cecum.
Xiangfeng HE ; Wen SHI ; Song WEN ; Yongqiang SUN ; Guojie LING ; Kang SHEN ; Chunlei PENG ; Baoan CHEN ; Jianhong WANG
Chinese Journal of Oncology 2015;37(6):418-421
OBJECTIVETo explore the feasibility of preparation of a mouse model of orthotopic colon cancer by injecting tumor cell suspension into mesenteric triangle of the cecum.
METHODSTwenty SPF 8-week old BALB/c mice (male:female = 1:1) were used in this study. The mouse caecum was exposed by laparostomy, and suspension of mouse colon adenocarcinoma CT26. WT cells was injected into the mesenteric triangle of cecum for preparation of a mouse model of orthotopic colon cancer.
RESULTSMouse orthotopic colon cancer was developed by injection of tumor cell suspension into mesenteric triangle of the cecum showing a successful rate of 100%, without intestinal obstruction, and the liver, spleen, diaphragm and mesenteric lymph nodes metastasis rates were high in all the 20 experimental mice.
CONCLUSIONSThe establishment of mouse models of orthotopic colon cancer by injection of tumor cell suspension into the mesenteric triangle is a simple, rapid, and easy to master procedure, causing less damage to the colon wall, safe and with less trauma to the mice. This method may provide an ideal mouse model of orthotopic colon cancer for the study of pathogenesis as well as liver metastasis mechanisms of colon cancer.
Adenocarcinoma ; pathology ; secondary ; Animals ; Cecal Neoplasms ; pathology ; Cecum ; Colonic Neoplasms ; pathology ; Disease Models, Animal ; Feasibility Studies ; Female ; Liver Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Mice ; Mice, Inbred BALB C ; Neoplasm Transplantation ; methods
4.Establishment and evaluation of a novel mouse model of orthotopic colon cancer in the mesenteric triangle of the cecum
Xiangfeng HE ; Wen SHI ; Song WEN ; Yongqiang SUN ; Guojie LING ; Kang SHEN ; Chunlei PENG ; Baoan CHEN ; Jianhong WANG
Chinese Journal of Oncology 2015;(6):418-421
Objective To explore the feasibility of preparation of a mouse model of orthotopic colon cancer by injecting tumor cell suspension into mesenteric triangle of the cecum. Methods Twenty SPF 8?week old BALB/c mice ( male ∶ female=1 ∶ 1) were used in this study. The mouse caecum was exposed by laparostomy, and suspension of mouse colon adenocarcinoma CT26.WT cells was injected into the mesenteric triangle of cecum for preparation of a mouse model oforthotopic colon cancer. Results Mouse orthotopic colon cancer was developed by injection of tumor cell suspension into mesenteric triangle of the cecum showing a successful rate of 100%, without intestinal obstruction, and the liver, spleen, diaphragm and mesenteric lymph nodes metastasis rates were high in all the 20 experimental mice. Conclusions The establishment of mouse models of orthotopic colon cancer by injection of tumor cell suspension into the mesenteric triangle is a simple, rapid, and easy to master procedure, causing less damage to the colon wall, safe and with less trauma to the mice. This method may provide an ideal mouse model of orthotopic colon cancer for the study of pathogenesis as well as liver metastasis mechanisms of colon cancer.
5.Establishment and evaluation of a novel mouse model of orthotopic colon cancer in the mesenteric triangle of the cecum
Xiangfeng HE ; Wen SHI ; Song WEN ; Yongqiang SUN ; Guojie LING ; Kang SHEN ; Chunlei PENG ; Baoan CHEN ; Jianhong WANG
Chinese Journal of Oncology 2015;(6):418-421
Objective To explore the feasibility of preparation of a mouse model of orthotopic colon cancer by injecting tumor cell suspension into mesenteric triangle of the cecum. Methods Twenty SPF 8?week old BALB/c mice ( male ∶ female=1 ∶ 1) were used in this study. The mouse caecum was exposed by laparostomy, and suspension of mouse colon adenocarcinoma CT26.WT cells was injected into the mesenteric triangle of cecum for preparation of a mouse model oforthotopic colon cancer. Results Mouse orthotopic colon cancer was developed by injection of tumor cell suspension into mesenteric triangle of the cecum showing a successful rate of 100%, without intestinal obstruction, and the liver, spleen, diaphragm and mesenteric lymph nodes metastasis rates were high in all the 20 experimental mice. Conclusions The establishment of mouse models of orthotopic colon cancer by injection of tumor cell suspension into the mesenteric triangle is a simple, rapid, and easy to master procedure, causing less damage to the colon wall, safe and with less trauma to the mice. This method may provide an ideal mouse model of orthotopic colon cancer for the study of pathogenesis as well as liver metastasis mechanisms of colon cancer.
6.Effects of CTGF on the periodontal tissue remolding during orthodontic tooth movement
Jiangtian HU ; Song LI ; Guojie GAO ; Bing YU ; Shaoying SHEN ; Yali LIU
Journal of Practical Stomatology 2010;26(1):24-28
Objective: To study the effects of CTGF on the periodontal tissue remolding during orthodontic tooth movement. Methods: A mouse model of orthodontic tooth movement was established. The CTGF and NS were injected into the periodontal tissue of the first molar. HE staining, immunohistochemical staining and automatic image analysis system were used to detect the changes of periodontal tissue and the expression of VEGF. Results: The periodontal tissue remolding accompanied the over expression of VEGF during the orthodontic tooth movement. At day 7, the remolding was most active and the expression of VEGF was the highest. CTGF injection induced acceleration of periodontal remolding and up-regulating the expression of VEGF during orthodontic tooth movement, especially at day 7 and day 15 after the orthodontic force were applied. Conclusion: In the mouse model of orthodontic tooth movement, periodontal CTGF injection induces over expression of VEGF and accelerates the periodontal remodeling during orthodontic tooth movement.
7.Effects of pentoxifylline on ventricular remodeling and cardiac function of dilated cardiomyopathy rats
Pei ZHAO ; Guojie SONG ; Kaizheng GONG ; Xiaolei LV ; Zhifeng DONG ; Jian LIU ; Hongguang SUN ; Xiaoping YU ; Yongling DING ; Ping BU ; Zhengang ZHANG
Chinese Journal of Pathophysiology 1986;0(04):-
AIM:To explore the effects of pentoxifylline (PTX) on ventricular remodeling and cardiac function in dilated cardiomyopathy (DCM) rats.METHODS: Lewis rats were randomly allocated to a myocin-induced dilated cardiomyopathy (DCM) group receiving saline (n=10), a DCM group receiving PTX (PTX group; 25 mg?kg-1?d-1, ip, for 30 days, n=10) or healthy control group (n=10). The levels of tumor necrosis factor-? (TNF-?), interleukin-6 (IL-6) and IL-10 in the blood plasma were analyzed by ELISA. The extent of fibrosis was estimated using Masson's staining and immunohistochemistry analyses. Cardiac structure and function were measured by echocardiography.RESULTS: PTX decreased plasma levels of TNF-? and IL-6, and increased IL-10 level in DCM animals compared with DCM group [TNF-?: (7.21?0.24) ?g/L vs (19.30?1.31) ?g/L, P

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