Investigation of the Clinical Diagnostic Significance of the T-Cell Test for Tuberculosis combined with Erythrocyte Sedimentation Test in Pulmonary Tuberculosis

Objective:To investigate the clinical diagnostic significance of peripheral blood T-cell test(T-spot test)for tuberculosis(TB)infection combined with erythrocyte sedimentation rate(ESR)in pulmonary TB.Methods:41 patients with a clinical diagnosis of TB during hospitalization from January 2020 to April 2023 in our hospital were selected as the experimental group,and 45 patients without TB(bronchopneumonia patients)were selected as the control group.The diagnostic specificity,sensitivity,and accuracy of the T-spot TB test,ESR test,and the combined test of the two were calculated respectively.Results:The sensitivity,specificity,and accuracy of the T-spot TB test combined with ESR for the diagnosis of TB in the experimental group were significantly higher than the individual results of the T-spot TB test and ESR test alone(P<0.05).Conclusion:The T-spot TB test combined with the ESR test for TB diagnosis has greater clinical value than carrying out the tests individually.

Relationship between reference value (Wintrobe) of Chinese people's erythrocyte sedimentation rate (ESR) and geographical factors

In order to provide a scientific basis for laying out a unified standard of the reference value (Wintrobe) of Chinese people's erythrocyte sedimentation rate (ESR). this paper studies the relationship between the reference values (Wintrobe) of Chinese healthy people's ESR, and the test is done according to the Wintrobe Laws and five geographical factors. It is found that the altitude is the modt important factor affecting the reference value (Wintrobe) of Chinese people's ESR. As altitude increases gradually, the reference value (Wintrobe) of people's ESR decreases accordingly, the correlation is quite obvious. By using the method of regression analysis, two multivariate regression equations and ten univariate regression equations are deduced If the geographical index values in a particular area are known, the reference value (Wintrobe) of Chinese people's ESR of this region can be established by means of the regression equations. Furthermore, according to the dependent relationship of the reference value (Wintrobe) of Chinese people's ESR on geographical factors.China can be divided into sin districts: Qinghai-Tibet, Southwest. Northwest. Southeast, North and Northeast China.

A New Method to Predict Erythrocyte Sedimentation Rate with Natural Geographical Factors and Location by Case-based Reasoning: A Case Study of China

Reference values of erythrocyte sedimentation rate(ESR)are the key to interpret ESR blood test in clinic.The common local reference ESR values are more accuracy in blood test that are established with natural geographical factors by using the multiple linear regression(MLR)model and the artificial neural network(ANN).These knowledge-based methods have limitations since the knowledge domains of ESR and natural geographical factors are limited.This paper presents a new cases-depended model to establish reference ESR values with natural geographical factors and location using case-based reasoning(CBR)since knowledge domain of ESR and geographical factors is weak.Overall 224 local normal ESR values of China that calculated from 13623 samples were obtained,and the corresponding natural geographical factors and location that include altitude,sunshine hours,relative humidity,temperature,precipitation,annual temperature range and annual average wind speed were obtained from the National Geomatics Center of China.CBR was used to predict the unseen local reference ESR values with cases.The average absolute deviation(AAD),mean square error(MSE),prediction accuracy(PA),and Pearson correlation coefficient(r)between the observed and estimated data of proposed model is 33.07%,9.02,66.93% and 0.78,which are better than those of ANN and MLR model.The results show that the proposed model provides higher prediction accuracy than those of the artificial neural network and multiple linear regression models.The predicted values are very close to the observed values.Model results show significant agreement of cases data.Consequently,the model is used to predict the unseen local reference ESR with natural geographical factors and location.In spatial,the highest ESR reference areas are distributed in the southern-western district of China that includes Sichuan,Chongqing,Guangxi and Guizhou provinces,and the reference ESR values are greater than 23 mm/60 min.The higher ESR reference values are distributed in the middle part and northern-eastern of China which include Hubei,Henan,Shaanxi,Shanxi,Jilin and Heilongjiang provinces,and the reference ESR values are greater than 18 mm/60min.The lowest ESR reference values are distributed in the northern-western of China that includes Tibet and Xinjiang,and the reference ESR values are lower than 5 mm/60min.

Unexplained elevation of erythrocyte sedimentation rate in a patient recovering from COVID-19:A case report

BACKGROUND A disease caused by a novel coronavirus virus,named coronavirus disease 2019(COVID-19),broke out in Wuhan,China in December 2019,and spread around the word.As of March 4,2020,93090 confirmed cases and 2984 deaths have been reported in more than 80 countries and territories.It has triggered global public health security.However,the features and prognosis of COVID-19 are incompletely understood.CASE SUMMARY We here report that the erythrocyte sedimentation rate(ESR)increased in a confirmed COVID patient.The high level of ESR sustained for a long time even after the patient recovered from COVID-19,while all results related to tumor,tuberculosis,rheumatic diseases,anemia,etc.cannot explain the abnormal elevation of ESR presented in this case.CONCLUSION Although the increased ESR cannot be explained by all existing evidence,it possibly links the abnormal pathologic change in some COVID-19 patients and negative prognosis,and provides the clue to dissect the mechanism of illness progressing in COVID-19 and its prognosis.

Clinical efficacy and safety of flexible ureteroscopy and percutaneous nephrolithotomy for large kidney stones:A retrospective comparative study

BACKGROUND Renal stones ranging 20–40 mm are very common in China.Although no largesample clinical studies have confirmed the clinical efficacy and safety of this method,there is also a lack of comparative data with traditional treatment.AIM To investigate the clinical efficacy of flexible ureteroscopy(FURS)and percutaneous nephrolithotomy(PCNL)by postoperative stone clearance and changes in soluble vascular cell adhesion molecule 1(sVCAM-1)and kidney injury molecule 1(KIM-1)levels in patients with large kidney stones(>2 cm in diameter).METHODS This single-center observational study was performed at a Chinese hospital between January 1,2021,and October 30,2023.All 250 enrolled patients were diagnosed with large kidney stones(>2 cm)and divided into a FURS group(n=145)and a PCNL group(n=105)by the surgical method.The FURS group was treated with flexible ureteroscopy and the PCNL group was treated with percutaneous nephrolithotomy.The operation time,time to palinesthesia,intraoperative blood loss,drop in hemoglobin,length of hospital stay,stone clearance rate,and complications were recorded in the two groups.Preoperative and postoperative serum sVCAM-1 levels,erythrocyte sedimentation rate(ESR),urine KIM-1 levels,preoperative and postoperative pain visual analog scale(VAS)and Wisconsin Stone Quality of Life Questionnaire(WISQOL)scores were also documented.RESULTS All 250 eligible patients completed the follow-up.There were no significant differences in baseline characteristics between the two groups(P>0.05).The operation time in the FURS group was significantly greater than that in the PCNL group.The time to ambulation,intraoperative blood loss,decrease in hemoglobin,and length of hospital stay were significantly lower in the FURS group than in the PCNL group.The FURS group also had a significantly higher stone clearance rate and a lower incidence of postoperative complications.There was no significant difference in antibiotic use between the groups.Postoperative serum sVCAM-1 levels,urine KIM-1 levels,and VAS scores were lower in the FURS group than in the PCNL group,but postoperative ESR and WISQOL scores were greater in the FURS group than in the PCNL group.CONCLUSION FURS demonstrated superior clinical efficacy in treating large kidney stones(>2 cm in diameter)compared PCNL.It not only improved the postoperative stone clearance rate and reduced complications and recovery time but also positively affected serum SCM-1,ESR,and urine KIM-1 levels,subsequent improvement of patient quality of life.

Relevant detection indicator of prethrombotic state in patients with primary hypertension

BACKGROUND Hypertension is a common chronic disease that affects many people worldwide.Only a few reports related to the exploration of relevant indicators of the prethrombotic state in patients with primary hypertension(PH)in clinical settings were available.AIM To detect prethrombotic state-related indicators in patients with PH and analyze their differences in different patient populations to provide a laboratory basis for the clinical prevention and control of hypertensive thrombotic diseases.METHODS The general data of patients with PH who attended the Department of Cardiovascular Medicine,The First Affiliated Hospital of Jiangxi Medical College,from January 2022 to December 2022 were collected retrospectively.The patients were divided into three groups of 40 patients each according to the Grade of PH:Grade 1,Grade 2,and Grade 3 hypertension experimental group.The baseline data of 40 volunteers,who underwent physical examination in our hospital but were not diagnosed with PH during the same period,were included in the control group.The relevant indicators of prethrombotic state of the participants were compared,and mainly included inflammation-related indicators,hemorheology-related indicators,and coagulation function related indicators.The relationship between the aforementioned indicators and the progression of PH was analyzed.RESULTS No significant differences were observed in age,sex,diabetes mellitus,smoking history,drinking history,body mass index,New York Heart Association functional classification,or the course of hypertension among the four groups(P>0.05).The expressions of high-sensitivity C-reactive protein(hs-CRP),thrombomodulin(TM),hematocrit(Hct),erythrocyte sedimentation rate(ESR),P-selectin on platelet surface(CD62P),and fibrinogen(FIB)in the control group were<Grade 1 hypertension group<Grade 2 hypertension group<Grade 3 hypertension group,and the expressions of platelet(PLT),activated partial thromboplastin time(APTT),prothrombin(PT),and plasma thrombin time(TT)in the control group was>Grade 1 hypertension group>Grade 2 hypertension group>Grade 3 hypertension group,and the difference was statistically significant(P<0.05).The results of the multivariate logistic regression model showed that the expression of hs-CRP,TM,Hct,ESR,CD62P,PLT,APTT,PT,TT,and FIB in the included participants was related to the progression of PH.Among these,high expression of hs-CRP,TM,Hct,ESR,CD62P,APTT,PT,and TT,and low expression of PLT and FIB were risk factors for PH(OR>1,P<0.05).The results of the receiver operating characteristic curve analysis showed that the area under the curve of hs-CRP,TM,ESR,CD62P,APTT,PT,TT,and FIB for the prediction of PH were>0.80,and the prediction value was ideal.Linear correlation analysis with bivariate Spearman showed that hs-CRP,TM,Hct,ESR,CD62P,APTT,PT,and TT were positively correlated with each other(r>0,P<0.05);PLT and FIB were negatively correlated with hs-CRP,TM,Hct,ESR,CD62P,APTT,PT,and TT(r<0,P<0.05);and PLT and FIB were positively correlated(r>0,P<0.05).Linear correlation analysis using bivariate Spearman showed that hs-CRP,TM,Hct,ESR,CD62P,and FIB were positively correlated with each other(r>0,P<0.05),whereas PLT,APTT,PT,and TT were negatively correlated with hs-CRP,TM,Hct,ESR,CD62P,and FIB(r<0,P<0.05).There was a positive correlation between PLT,APTT,PT,and TT(r>0,P<0.05).CONCLUSION The relevant indicators of the prethrombotic state in patients with PH,such as hs-CRP,TM,Hct,ESR,CD62P,PLT,APTT,PT,TT,and FIB,showed differences.High expression of hs-CRP,TM,Hct,ESR,CD62P,and FIB,and low expression of PLT,APTT,PT,and TT are the keys to the occurrence,progression,and thrombotic state of PH.Based on the above serum indicators’expression in patients,targeted interventions can be administered to patients with abnormal expression levels to control the progression of their disease and reduce the risk of developing a prethrombotic state.

Musculoskeletal Ultrasonography for the Assessment of Combined Drug Therapy for Rheumatoid Arthritis

Background: To evaluate the effect of treatment on musculoskeletal ultrasound (MSUS) and explore whether MSUS are associated with therapeutic response in rheumatoid arthritis (RA) patients treated with Tofacitinib in combination with methotrexate (MTX). Methods: We enrolled 102 RA patients treated with Tofacitinib in combination with MTX from a multicenter, exploratory, short-term, prospective and observational ultrasound cohort study of patients who received biologic or targeted synthetic disease-modifying antirheumatic drug (DMARD) therapy. We evaluated the patients’ clinical disease activity and musculoskeletal ultrasound (MSUS) scores. The serum concentrations of two venous blood inflammatory indicators were evaluated (c-reactive protein [CRP], erythrocyte sedimentation rate [ESR]) by multiplex bead assays at baseline, 3, and 6?months: the change over 6?months was defined as the P value. Before MSUS score treatment, an associate chief physician tested the wrist joints of each patient at the first treatment, and the attending physician with 3 years of MSUS experience and 7 years of work experience also performed semi-quantitative scores on the same RA patients and tested the consistency of the results. Results: Tofacitinib in combination with MTX significantly improved the clinical disease activity and MSUS score over 6?months. Serum ESR and CRP were significantly elevated at 6?months after the Tofacitinib in combination with MTX introduction (P P P Conclusions: MSUS scores may be useful for predicting RA patients’ therapeutic responses to abatacept.

Kawasaki disease without changes in inflammatory biomarkers:A case report

BACKGROUND Kawasaki disease(KD)is diagnosed based on clinical features.Blood tests and other tests are auxiliary diagnostic tools.Since KD is a disease caused by arterial inflammation,many patients with KD have elevated levels of inflammatory biomarkers,such as C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),and serum amyloid A protein(SAA)in blood tests.We report our experience of a patient with KD who did not have elevated levels of inflammatory biomarkers.CASE SUMMARY A 1-year-old boy presented with a 3-day history of fever.Five of the six symptoms of KD were observed,except for changes in the lips and oral cavity.Blood tests revealed no elevation in CRP,ESR,or SAA levels.Although the blood test results were atypical,the patient was diagnosed with KD based on clinical symptoms and was admitted to the hospital for treatment.The patient was administered intravenous immunoglobulin(IVIG)and aspirin.Despite commencing treatment,the fever persisted;therefore,additional IVIG was administered,the dosage of aspirin was increased,and ulinastatin was added.Three doses of IVIG were administered and the fever resolved on day 11 of KD symptoms started.Blood tests performed during hospitalization showed normal levels of inflammatory biomarkers.We examined leucine-rich alpha-2-glycoprotein 1-a protein that is elevated during the acute phase of KD.The protein levels did not increase during hospitalization.CONCLUSION This case suggests the need to identify criteria and biomarkers for detecting KD conditions that do not require KD treatment.

Comparative study of 99Tc-MDP and zoledronic acid in the treatment of osteoporosis

Objective:To compare the efficacy and mechanism of zoledronic acid and Tc-MDP in the treatment of osteoporosis.Methods:From July 2011 to November 2015,232 patients with primary osteoporosis were selected and treated in The First Affiliated Hospital of Hainan Medical College were selected and were divided into the 116 patients in the Tc-MDP group and 116 patients in the zoledronic acid group accorded to the treatment ways.The zoledronic acid group were given zoledronic acid treatment,1 time in one year.The Tc-MDP group were given Tc-MDP treatment,and the treatment were treated for 10 days for 1 course,1 course for 3 months,and a total of 3 years of treatment were observed.The prognosis and the changes of bone mineral density and hematological parameters were recorded.Results:The total effective rates of the zoledronic acid group and Tc-MDP group were 99.1%and 90.0%,respectively,and the zoledronic acid group were significantly higher than the Tc-MDP group(P<0.05).The bone mineral density of lumbar vertebrae and hip after treatment were significantly higher than that of the two groups before treatment,and the zoledronic acid group were also significantly higher than the Tc-MDP group(P<0.05).The joint tenderness scores of the two groups were significantly lower than those before treatment,and the Tc-MDP group were also significantly lower than the zoledronic acid group(P<0.05).There were no significant differences in serum calcium and blood phosphorus levels compared between the two groups(P>0.05),and the erythroeyte sedimentation rate(ESR)levels were lower than before treatment(P<0.05),The ESR levels of the Tc-MDP group were also significantly lower than that of the zoledronic acid group(P<0.05).Conclusion:The zoledronic acid and the application of Tc-MDP in the treatment of osteoporosis can increase bone density,relieve joint tenderness symptoms,reduce ESR content,and will not affect patients'blood calcium and blood phosphorus levels.However,zoledronic acid increases bone density significantly are better than the Yunke,and Yunke relieves joint pain significantly are more than zoledronic acid.

Evaluation of Some Inflammatory Biomarkers in Male Albino Wistar Rats Following Ingestion of Crude Oil and the Role of Bee Honey, Vitamins C and E

Evaluation of some biomarkers of inflammation in male Albino Wistar rats following ingestion of Nigerian Bonny Light Crude Oil (NBLCO) and the effect of antioxidant supplementation was the focus of this study. Forty-eight adult male Albino Wistar rats weighing 150 - 180 g were randomly divided 8 per group into: group I (control) oral gavaged 3 ml/kg of normal saline;group II received 3 ml/kg of NBLCO;groups III, IV and V received in addition to 3 ml/kg of NBLCO 1 ml/kg vitamin C, vitamin E and 3 ml/kg of honey bee respectively;group VI received 3 ml/kg of honey. After 28 days of treatment, all animals were anaesthetized with chloroform and blood collected by cardiac puncture for analysis. Results showed that NBLCO administration significantly increased erythrocyte sedimentation rate and C-reactive protein while supplementation with antioxidant significantly reversed such effects (p < 0.05). NBLCO significantly reduced platelets and fibrinogen levels compared with the control group (p < 0.05). Interestingly, the vitamin supplementation significantly reduced platelets and fibrinogen levels compared to group II (NBLCO) (p < 0.05). Honey supplementation on the other hand significantly reduced platelets and fibrinogen compared to group II (NBLCO) (p < 0.05). From the results obtained it is concluded that ingestion of NBLCO has the potential to induce development and progression of inflammation but could substantially be mitigated by supplementation with antioxidant vitamins C, E and honey.

Diabetic Renal-Retinal Syndrome and Inflammatory Markers of Acute Phase

Objective: To determine the association between the acute inflammatory markers and Diabetic Renal-Retinal Syndrome in our patients. Methods: A total of 44 patients were included in this transverse (cross sectional), observational, analytical, and comparative study. Two groups of patients were created. Results: In patients with chronic renal failure, stages 3, 4, or 5 (scale 1 to 5) were identified and divided into two groups: Group I (Patients with concomitant diabetic retinopathy stabilized with photocoagulation) 22 patients. Group II (Patients with progression of retinopathy, after photocoagulation, in the form of intraocular bleeding) 22 patients. The number of patients with chronic renal failure in stage 3 was: Group I;16. In Group II;12 patients (OR: 1.0). Stage 4: Group I;4 patients. Group II: 3 patients (OR: 1.0, CI 95%;0.3843 - 2.021). Stage 5: Group I;2 patients. Group II;7 patients (OR: 1.8148, CI 95%;1.0448 - 3.1523;Chi-squared (x2) 2.7450, p = 0.097). t-Test found statistical significance in Erythrocyte Sedimentation Rate (ESR): p < 0.0001 (CI 95%;7.8959 - 23.2515);R = 0.56 p = 0.001;and OR = 1.959 (CI 95%;1.193 - 3.217). By non-parametric tests, C-reactive protein with binomial test showed p < 0.001. ESR showed p < 0.001 with U of Mann Whitney. Conclusions: With this study revealed a possible association of inflammatory markers with Diabetic Renal-Retinal Syndrome.

Correlations between the Maximum Standard Uptake Value of Positron Emission Tomography/Computed Tomography and Laboratory Parameters before and after Treatment in Patients with Lymphoma

Background： After the first examination of patients with lymphoma diagnosis, important laboratory tests such as complete blood count; albumin, kidney and liver function tests; uric acid; 132-microglobulin; C-reactive protein （CRP）; erythrocyte sedimentation rate （ESR）; and lactate dehydrogenase （LDH） examinations are recommended. In this study, our aim was to find the relationship between laboratory parameters and the maximum standard uptake value （SUVmax） of positron emission tomography/computed tomography （PET/CT） in patients with lymphoma at the diagnosis and after treatment. Methods： Thirty-tbur lymphoma patients treated at Mustafa Kemal University Internal Medicine Clinic between 2014 and 2017 were included in this retrospective study. Results ofCRP, ESR, LDH, albumin, and white blood cell （WBC） count were recorded betbre each PET scan test, and each parameter was analyzed for correlation with SUV measurements. Results： Spearman＇s correlation test showed that the after-treatment SUV values were significantly correlated with the alter-treatment LDH, ESR, and CRP values （for LDH, ESR, and CRP, R2： 0.453, 0.426, and 0.351; P = 0.007, 0.012, and 0.042, respectively）. On the other hand, albumin and WBC count did not show a significant correlation with the after-treatment SUVmax values （all P 〉 0.05）. Conclusions： CRP, ESR, and LDH values may also be good predictors in patients for whom PET/CT imaging cannot be performed.

Acromioclavicular joint septic arthritis in an immunocompetent child： A case report

Septic arthritis of acromioclavicular （AC） joint is a rare entity. It is generally seen in patients who are immunocompromised. Only 15 cases have been reported till now, with only one case series of 6 patients, We report a case of septic arthritis of AC joint in an immunocompetent child. A 9 years old girl presented with history of pain in left shoulder for 4 days associated with fever, No history suggestive of any immunocompromised state was complained. On local examination, a swelling of around 3 cm in diameter was found over left AC joint region with raised local temperature, tenderness on palpation and positive response in fluctuation test. Total leukocyte count was 18.7 - 109/L with 80% of neutrophils. Erythrocyte sedimentation rate （ESR） was 28 mm/1 h. C-reactive protein （CRP） was 12 mg/L. X-ray showed enlarged left AC joint space. Ultrasound revealed hypoechoic collection in the AC joint and the surrounding area. The aspirate was thick and purulent in nature, revealing Gram positive cocci at staining. Arthrotomy and thorough lavage of AC joint was done. Culture of the aspirate showed Methicillin Resistant Staphylococcus Aureus （MRSA） after 48 hours that was sensitive to amikacin, gentamicin, erythromycin and teicoplanin. Patient was symptom-free at 2 months of follow-up with no signs of osteomyelitis on the radiographs. Thus this is the first case of AC joint septic arthritis in healthy individual. Being proximal to the shoulder joint, AC joint septic arthritis can be confused with the shoulder joint septic arthritis. Thus, high index of suspicion is required for accurate diagnosis.