Background. It is critical to accurately identify patients with severe acute pancreatitis (SAP) and moderately SAP (MSAP) in a timely manner. The study was done to establish two early multi-indicator prediction models of MSAP and SAP. Methods. Clinical data of 469 patients with acute pancreatitis (AP) between 2015 and 2020, at the First Affiliated Hospital of Fujian Medical University, and between 2012 and 2020, at the Affiliated Union Hospital of Fujian Medical University, were retrospectively analyzed. The unweighted predictive score (unwScore) and weighted predictive score (wScore) for MSAP and SAP were derived using logistic regression analysis and were compared with four existing systems using receiver operating characteristic curves. Results. Seven prognostic indicators were selected for incorporation into models, including white blood cell count, lactate dehydrogenase, C-reactive protein, triglyceride, D-dimer, serum potassium, and serum calcium. The cut-offs of the unwScore and wScore for predicting severity were set as 3 points and 0.513 points, respectively. The unwScore ( AUC = 0.854 ) and wScore ( AUC = 0.837 ) were superior to the acute physiology and chronic health evaluation II score ( AUC = 0.526 ), the bedside index for severity in AP score ( AUC = 0.766 ), and the Ranson score ( AUC = 0.693 ) in predicting MSAP and SAP, which were equivalent to the modified computed tomography severity index score ( AUC = 0.823 ). Conclusions. The unwScore and wScore have good predictive value for MSAP and SAP, which could provide a valuable clinical reference for management and treatment.
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.Objective The objective of this study is to investigate the predictive value of a parametric model constructed by using procalcitonin, C-reactive protein (CRP) and D dimer within 48 h after admission in moderately severe and severe acute pancreatitis. Methods A total of 238 patients were enrolled, of which 170 patients were moderately severe and severe acute pancreatitis (MSAP+SAP). The concentrations of procalcitonin, CRP and D dimer within 48 h after admission were obtained. The predictive value of the parametric model, modified computed tomography severity index (MCTSI), bedside index for severity in acute pancreatitis (BISAP), Ranson score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, modified Marshall score and systemic inflammatory response syndrome (SIRS) score of all patients was calculated and compared. ResultsThe area under receiver operator characteristic curve, sensitivity, specificity, Youden index and critical value of the parametric model for predicting MSAP+SAP were 0.853 (95% CI, 0.804-0.903), 84.71%, 70.59%, 55.30% and 0.2833, respectively. The sensitivity of the parametric model was higher than that of MCTSI (84.00%), Ranson score (73.53%), BISAP (56.47%), APACHE II score (27.65%), modified Marshall score (17.06%) and SIRS score (78.24%); the specificity of it were higher than that of MCTSI (52.94%) and Ranson score (67.65%), but lower than BISAP (73.53%), APACHE II score (76.47%), modified Marshall score (100%)and SIRS score (100.00%). ConclusionThe parametric model constructed by using procalcitonin 48 h, CRP 48 h and D dimer 48 h can be regarded as an evaluation model for predicting moderately severe and severe acute pancreatitis.
Background: There is an urgent need to develop a non-invasive imaging technique for detecting colorectal dysplasia and cancer. Technology for early and real-time microscopic assessments to select the most representative biopsy sites would also be of clinical value. In this study, we explored the sensitivity of optical coherence tomography (OCT) in detecting local lesions to demonstrate its potential for the early detection of colorectal dysplasia and cancer.Methods: An azoxymethane/dextran sodium sulfate mouse model of colorectal carcinogenesis was utilized.Mice were imaged by OCT, and colorectal tissue sections were observed with hematoxylin and eosin staining. The results of the parallel analyses were compared to evaluate the performance of OCT in imaging and early screening of colorectal lesions.Results: Dysplasia and cancer could be distinguished from normal colon tissues based on the OCT images. However, simple morphological changes observed in the OCT images were not sufficient to distinguish different degrees of dysplasia or distinguish dysplasia from cancerous tissues. The Youden index and diagnostic efficiency of OCT for colorectal dysplasia and cancer were 62.50% and 82.14%, respectively, while the sensitivity and specificity were 87.50% and 75.00%, respectively. Further, the positive and negative predictive values were 82.35% and 81.82%, respectively.Conclusions: Based on our findings, we predict that OCT is a promising non-invasive imaging technique that can offer excellent positive detection rates and diagnostic accuracy for early colorectal dysplasia and cancer. This technique is expected to be valuable in realizing real-time qualitative analysis and guided targeted biopsy.
Today, with the development of medical technology, stomach cancer remains to be one of the most common causes of death associated with cancer. Studies show that the incidence of stomach cancer varies in different areas but is more common in China. Most patients were diagnosed late with local or remote metastasis. The data show that the survival rate within five years is less than 10%. Therefore, it is very important to study the gastric cancer cells systematically, explore the factors that lead to the change of the number of gastric cancer cells, and put forward practical suggestions for the prevention and control of the disease. This paper analyzes the disease-related information of several patients with gastric cancer in a hospital, discusses the growth of gastric cancer cells and season-related factors, and analyzes the single factor of gastric cancer patients and season-related possible factors. In this paper, we choose to observe gastric cancer cells in different seasons under the microscopic environment to further explore the influence of seasons on gastric cancer cells. The results showed that gastric cancer cells grew faster under microscope in spring and summer. We found that the incidence rate of gastric cancer in spring and summer was higher than that in autumn and winter. Diabetic patients and diabetes history are important risk factors of gastric cancer in spring and summer. Therefore, we advocate healthy lifestyle, pay attention to their poor performance in life, and actively help them to correct, which is of positive significance for the prevention and control of gastric cancer.
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