Objective Exploring the diagnostic value of T-cell enzyme-linked immunospot assay(T-SPOT.TB)combined with rifampicin-resistant Mycobacterium tuberculosis real-time fluorescence quantitative nucleic acid ampli-fication detection(XpertMTB/RIF)in geriatric AIDS patients with Mycobacterium tuberculosis(MTB)infection.Methods From May 2022 to May 2024,86 elderly patients with AIDS suspected MTB in Hengshui Third People's Hospital were gathered and separated into AIDS complicated with MTB(research group)and AIDS without MTB(control group)according to the pathological examination results.MTB culture,T-SPOT.TB and XpertMTB/RIF were performed.Kappa analysis was applied to evaluate the consistency between T-SPOT.TB combined with Xpert-MTB/RIF and the gold standard for diagnosing MTB coinfection in AIDS patients.ROC curve and four grid table were plotted to analyze the value of the combination of T-SPOT.TB and XpertMTB/RIF in the diagnosis of AIDS complicated with MTB infection.Results The blood γ-interferon,the positive detection rates of T-SPOT.TB and XpertMTB/RIF in the research group were higher than those in the control group(P＜0.05).The AUC of T-SPOT.TB in diagnosing AIDS with MTB infection was 0.810,that of Xpert MTB/RIF in diagnosing AIDS with MTB infection was 0.835,and the AUC of the two in diagnosing AIDS with MTB infection was 0.910.The Kappa values of T-SPOT.TB,Xpert MTB/RIF and their combined diagnosis for AIDS with MTB infection were 0.624,0.674 and 0.825,respectively.The accuracy of T-SPOT.TB in the diagnosis of AIDS with MTB was 82.56%,the accuracy of XpertMTB/RIF in the diagnosis of AIDS with MTB was 84.88%,and the accuracy of the combined di-agnosis for AIDS with MTB was 91.86%.Conclusions T-SPOT.TB combined with XpertMTB/RIF can improve the accuracy of diagnosis of AIDS with MTB,and can be used as a clinical auxiliary diagnosis method for AIDS pa-tients complicated with MTB.

Objective:To explore the experience of the treatment of patella inferior pole fracture with non excitation tension band technique.Methods:From April 2009 to December 2019, 76 patients with inferior patellar fracture were treated with non excitation tension band technique. There were 42 males and 34 females; The age was 35.48 ± 18.12 years (17-66 years), with an average of 35 years. There were 45 cases on the left and 31 cases on the right. Causes of injury: fall injury in 46 cases, bicycle injury in 16 cases and traffic accident injury in 14 cases. The time from injury to operation was 0.25-5 d, with an average of 3.2 d. There were 18 cases of open fractures, 64 cases of articular surface fractures and 52 cases of comminuted fractures. Open fracture patients were debridement first, and all cases were fixed with non excitation tension band technique. The intraoperative fracture reduction, postoperative fracture healing and internal fixation were observed. The knee function was evaluated according to the degree of claudication, the use of supports, the feeling of joint strangulation, joint instability, pain, swelling, stair climbing and squatting.Results:All 76 patients successfully completed the operation and were followed up for 18.24 ± 6.18 months (range 12-24 months). There was no wire fracture during and after operation. All incisions healed in the first stage after operation, and there was no deep venous thrombosis of lower limbs. The X-ray film showed that there was no further fracture and fracture displacement after operation, and there was no Kirschner wire slip before the internal fixation was taken out. Only one case had steel wire relaxation due to buckle (which did not affect fracture healing). All fractures healed well, with an average of 7.5 weeks, and the fracture line basically disappeared. 12 months after operation, according to Lysholm knee score standard, the knee function of patients was evaluated. The score of 76 cases was 95.40±4.60 points (range 82-100 points): excellent in 54 cases, good in 21 cases and fair in 1 case. The excellent and good rate was 98.7%. According to the visual analogue scale (VAS) pain score standard, the patients were scored for postoperative pain. The score of 76 cases was 0.09±2.05 points (range 0-3 points): 4 cases had mild pain, with an average score of 0.09.Conclusion:The results of the treatment of patellar inferior pole fracture with tension free band technique are satisfactory, the pain caused by tissue irritation by the internal fixation was lower, clinical application can be popularized.