Serum Fibrinogen Test Performs Well for the Diagnosis of Periprosthetic Joint Infection.

BACKGROUND: Serum fibrinogen (FIB) is an acute-phase glycoprotein in the infection response that may stop excessive bleeding. The purposes of this study are to determine the value of FIB that can be used to differentiate between periprosthetic joint infection (PJI) and aseptic loosening of the prosthesis, and to determine the clinical significance of FIB for analyzing infection outcomes after first-stage surgery. METHODS: This retrospective study included 90 patients undergoing total knee arthroplasty or total hip arthroplasty revision from January 2015 to August 2019. PJI was confirmed in 53 patients (group A), and the other 37 patients were diagnosed with aseptic loosening of the prosthesis (group B). Only 21 patients in group A documented the results for serum FIB, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) after spacer insertion, so the postoperative serological marker levels of the these patients were also assessed. RESULTS: The FIB, CRP, and ESR levels were significantly higher in group A than in group B (P < .001). The area under the receiver operating characteristic curve was highest for FIB at 0.928. Analyses of FIB levels revealed a sensitivity of 79.25% and a specificity of 94.59%. FIB levels were significantly lower in patients with PJI after spacer insertion (P < .001). CONCLUSION: FIB is an adequate test to aid in diagnosing PJI, and it is not inferior to CRP and ESR in distinguishing between PJI and aseptic loosening of the prosthesis. It is an especially useful tool in assessing infection outcomes after first-stage surgery.

Effect of HNO3 concentration on a novel silica-based adsorbent for separating Pd(II) from simulated high level liquid waste.

A new kind of silica-based (Crea + TODGA)/SiO2-P adsorbent with high selectivity adsorption for palladium (Pd) was synthesized to examined the applicability for partitioning process of high level liquid waste (HLLW). Adsorption behavior of Pd(II) towards (Crea + TODGA)/SiO2-P adsorbent and stability of adsorbent against HNO3 solution were investigated by batch method. The degradation parts of (Crea + TODGA)/SiO2-P dissolved in liquid phase were estimated by total organic carbon (TOC) analyzer. (Crea + TODGA)/SiO2-P adsorbent showed good selectivity adsorption for Pd(II) and reached equilibrium within 24 hr. The adsorption ability of (Crea + TODGA)/SiO2-P for Pd(II) and the content of TOC leaked decreased with the increasing of HNO3 concentration. In 3 M HNO3, the average of K d values were 85.03 cm3/g and 26.10 cm3/g after contact time one to 28 days at 298 K and 323 K, respectively. While the content of TOC leaked from the adsorbent after 28 days were 1095 ppm (298 K) and 2989 ppm (323 K), respectively. Therefore, the adsorbent showed good stability at 298 K after contact with nitric acid for a long time. All results indicated (Crea + TODGA)/SiO2-P can be proposed as an applicable and efficient absorbent for separation of Pd(II) in 3 M HNO3 at 298 K.