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Objective To evaluate the value of tumor necrosis factor -α( TNF-α) ,leptin ( LEP) ,interleu-kin-6 (IL-6) and carcinoma embryonic antigen (CEA) in both serum and pleural effusion in differential diagnosis of tuberculosis and malignant tumor .Methods Detection were performed on tuberculosis and malignant tumor patients,comparation was conducted on the level and positive ratio of TNF -α,LEP,IL -6 and CEA in different groups.Results The levels of TNF-α,LEP,CEA in serum decreased significantly compared with malignant tumor patients[(34.45 ±17.11)μg/L vs (70.26 ±19.31)μg/L,(490.71 ±197.58)μg/L vs (2 013.62 ±596.22)μg/L, (226.81 ±87.09)μg/L vs (5 329.62 ±1 523.58)μg/L;t=5.221,9.673,12.078;P=0.012,0.031,0.000],but IL-6 was not [(159.73 ±30.33)μg/L vs (22.31 ±3.20)μg/L;t=-16.114;P=0.001];The level of TNF-α, LEP,CEA in pleural effusion was decreased significantly compared with malignant tumor patients [( 20.31 ± 5.62)μg/L vs (42.06 ±14.07)μg/L,(702.46 ±375.01)μg/L vs (4 532.27 ±2 307.83)μg/L,(112.25 ± 48.72)μg/L vs (4 190.84 ±1 534.29)μg/L;t=5.017,12.096,12.236;P=0.022,0.016,0.033],but IL-6 was not [(92.15 ±32.64)μg/L vs (10.29 ±3.91)μg/L,t=-11.583;P=0.031].The positive ratio of TNF -α, LEP,CEA in serum was decreased significantly compared with malignant tumor patients (17.8% vs 72.2%,20.0%vs 91.7%,0.0% vs 100.0%;χ2 =24.341,41.145,81.000;P =0.000,0.000,0.000),but IL -6 was not (100.0%vs 0.0%,χ2 =81.000;P=0.000);The positive ratio of TNF -α,LEP,CEA in pleural effusion was decreased significantly compared with malignant tumor patients (28.9% vs 75.0%,4.4% vs 100.0%,0.0% vs 97.2%;χ2 =17.012,73.326,77.038;P=0.000,0.000,0.000),but IL -6 was not(97.8% vs 0.0%,χ2 =77.059;P=0.000).Conclusion The level and positive ratio of malignant tumor patients are higher than tuberculo-sis patients,but IL-6 is not,these indicators are helpful in diagnosing tuberculosis and malignant tumor .
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BACKGROUND:There are many methods that can repair Pilon fracture, but the effects are not ideal. With the development of science and technology, fundamental change of fracture fixation principle and innovation of technology and idea has brought new opportunities for Pilon fracture repair. Biological immobilization technology can further reduce the further damage to blood supply of bone outer membrane on the fracture end, do not disturb biomechanical environment of fracture healing, and is the new trend of present research and development. OBJECTIVE:To investigate the effect of locking compression plate fixation for repair of Pilon fracture using biological fixation technique. METHODS:Clinical data of 76 patients with Pilon fracture treated using locking compression plate fixation in the Nanhai District Economic Development Zone Guanyao Branch of the People’s Hospital from June 2008 to December 2013 were retrospectively analyzed. There were 49 males and 27 females, at the age of 39.5 years on average (range from 19 to 60 years). According to Ruedi-Algower classification, there were 54 cases of type II and 22 cases of type III. In accordance with biological fixation technique, locking compression plate fixation was applied to treat Pilon fracture. Folowing treatment, they were regularly folowed up. Reduction quality was assessed by Burwel-Charnley radiological criteria. X-ray films were reviewed to observe fracture healing. During final folow-up, ankle function was evaluated according to Baird-Jackson score. RESULTS AND CONCLUSION:A total of 76 patients were folowed up for 6 to 24 months. Reduction quality assessed by Burwel-Charnley radiological criteria was as folows: anatomic reduction of 68 cases, reduction of 8 cases, 71 cases of one-stage wound healing, and 5 cases of wound healing after dressing change, with the rate of one-stage healing of 93%. Fractures of al patients were healed. The healing time was 4 to 8.5 months, averagely 6.25 months. During final folow-up, ankle function assessed by Baird-Jackson score was as folows: there were 69 excelent cases, 5 good cases and 2 average cases. These results indicate that locking compression plate fixation for Pilon fracture obtained good stability, could effectively avoid the damage of fracture end blood supply, shorten the healing time; it was simple to operate, had smal injury to soft tissue, and was an effective fixation method to repair Pilon fracture.