摘要:目的:動態監測急性胰腺炎(AP)患者外周血C反應蛋白(CRP)水平,探討CRP對AP的早期診斷與病情評估的參考價值。方法:分別檢測75例SAP患者和75例 MAP患者入院后第1、3、5、7、9天外周血CRP水平,并進行分析比較。結果: MAP組患者CRP高峰值出現在住院第3天,第7天開始下降,14天后恢復正常。而SAP組患者住院第1天即可出現CRP顯著增高,且下降速度緩慢,在后期CRP仍可維持在一個較高水平。入院第1天,SAP組血清CRP水平均顯著高于MAP組(Plt;0.01)。輕癥與重癥組(無并發癥或有并發癥)之間患者血清CRP水平差異均有高度顯著性(Plt;0.01)。結論: 動態監測CRP可作為AP早期診斷、疾病嚴重程度評估及預后判斷的一個獨立的衡量指標,值得臨床推廣應用。Abstract: Objective: To dynamic monitoring of acute pancreatitis (AP) in patients with Creactive protein (CRP) levels, CRP on the AP to explore the early diagnosis and prognostic evaluation of the reference value. Methods: 75 cases of SAP patients were examined and 75 patients with mild acute pancreatitis (MAP) after admission in patients with CRP levels in peripheral blood 1,3,5,7,9 days, and conduct analysis and comparison of. Results:MAP peak value of CRP in patients in hospital the first 3 days, 7 day drop in 14 days after return to normal. The SAP Group 1st day of hospitalization was significantly higher CRP can occur, and the rate of decline is slow, in the latter part of CRP can be maintained at a high level. Admission day 1, SAP serum levels of CRP were significantly higher than the MAP group (Plt;0.01). Between mild and severe group, no complications and complications in patients with serum CRP levels of SAP differences were highly significant (Plt;0.01). Conclusion:Dynamic monitoring of CRP can be used as AP early diagnosis, disease severity assessment and prognosis of an independent measure worthy of clinical application.
With the development of transcatheter aortic valve replacement, it has become the first-line treatment for elderly patients with aortic valve stenosis. A case of transcatheter aortic valve replacement in a patient at high risk of coronary artery occlusion was reported. The use of intravascular ultrasound to observe the spatial relationship between the coronary ostia and the valve was the characteristic of this case. This patient was an elderly male who was assessed as a high risk of acute coronary artery occlusion before transcatheter aortic valve replacement. After fully evaluation of the patient’s surgical risks\benefits, the strategy was formulated. Percutaneous coronary intervention was the first step. At the same time, intravascular ultrasound was used to observe the spatial relationship between the coronary ostia and the valve, and balloon was embedded for coronary protection. The procedure went smoothly.
Objective Exploring the correlation between intravesical pressure (IP) and diaphragm excursion (DE) in patients with severe acute pancreatitis (SAP) and acute respiratory distress syndrome (ARDS), and evaluating its predictive value for weaning outcomes. Methods A retrospective analysis was conducted on the clinical data of 144 SAP patients with ARDS admitted between 2020 and 2023. By collecting the outcome of weaning, collect data on gender, age, acute physiology and chronic health score II (APACHE II), oxygenation index, and IP and DE before weaning and extubation for all patients. Based on weaning outcomes, divide patients into successful and failed groups, and compare the differences in various indicators between the two groups; Use binary logistic regression to analyze whether IP and DE are risk factors affecting weaning in SAP patients with ARDS, and use Pearson correlation analysis to examine the correlation between IP and DE; Use receiver operating characteristic curve (ROC curve) to analyze the predictive value of IP and DE on weaning outcomes in SAP patients with ARDS. ResultsA total of 144 SAP patients with ARDS were included, of which 108 were successfully weaned and 36 were unsuccessful. There were no statistically significant differences in gender, age, and APACHE II scores between the successful and failed groups (males: 62.96% (68/108) compared to 69.44% (25/36), age (years): 41.91 ± 8.14 compared to 42.42 ± 6.22, APACHE II score (points): 18.28 ± 2.22 compared to 18.97 ± 1.83, P>0.05). The IP of the successful group was significantly lower than that of the failed group, and the DE was significantly higher than that of the failed group [IP (mmHg): 18.45 ± 3.76 compared to 23.92 ± 5.65, DE (mm): 16.18 ± 4.23 compared to 12.28 ± 4.44, all P<0.05]. All patients showed a significant negative correlation between IP and DE (r=–0.457, P<0.001). ROC curve analysis showed that the area under the curve (AUC) of IP predicting the withdrawal outcome of SAP patients with ARDS was 0.805, with a 95% confidence interval (95%CI) of 0.724-0.885 and P<0.001. When the cutoff value was 19.5 mmHg, the sensitivity was 91.57% and the specificity was 47.54%; The AUC for predicting the withdrawal outcome of SAP patients with ARDS by DE was 0.738, with a 95%CI of 0.641-0.834 and P<0.001. When the cutoff value was 11.5 points, the sensitivity was 84.82% and the specificity was 59.38%. Conclusions There is a significant negative correlation between IP and DE in SAP combined with ARDS patients, and both have certain predictive value for weaning outcomes.
Brain-computer interface (BCI) is a revolutionary human-computer interaction technology, which includes both BCI that can output instructions directly from the brain to external devices or machines without relying on the peripheral nerve and muscle system, and BCI that bypasses the peripheral nerve and muscle system and inputs electrical, magnetic, acoustic and optical stimuli or neural feedback directly to the brain from external devices or machines. With the development of BCI technology, it has potential application not only in medical field, but also in non-medical fields, such as education, military, finance, entertainment, smart home and so on. At present, there is little literature on the relevant application of BCI technology, the current situation of BCI industrialization at home and abroad and its commercial value. Therefore, this paper expounds and discusses the above contents, which are expected to provide valuable information for the public and organizations, BCI researchers, BCI industry translators and salespeople, and improve the cognitive level of BCI technology, further promote the application and industrial transformation of BCI technology and enhance the commercial value of BCI, so as to serve mankind better.
Objective To study the significance of detection the short-term fluctuation (SF) of macular light threshold detected by Octopus-123 automatic perimeter in suspected early age-related macular dege-neration (AMD). Methods SF of macular light sensitivity, Amsler chart and central visual acuity were examined in 51 patients(66 eyes) with suspected early AMD group and in 32 patients (40 eyes) in the control group. Results SF were significantly different in suspected early AMD group and control group. SF was more sensitive than the examination of central visual acuity and Amsler chart. SF was related to the quantity, location and quality of drusen. Conclusion Visual function of some suspected early AMD patients with drusen may be damaged, though the central visual acuity appears normal. (Chin J Ocul Fundus Dis, 2002, 18: 119-120)
Objective To evaluate the diagnosis of blue-on-yellow perimetry and macular threshold perimetry in early primary glaucoma. Methods Humphrey II 750 automatic perimetry was used to test 60 eyes of 60 cases in normal control group and 63 eyes of 63 cases in early primary glaucoma group with white-on-white perimetry (W/W), blue-on-yellow perimetry (B/Y)，and macular threshold perimetry (M TP). The results of the visual field defects detected by the three perimetries were compared and analyzed.Results The differences of mean sensibility of W/W, B/Y and MTP between the two groups had statistical significance［t=-3 .01, P=0.0054 (W/W); t=-2.95, P=0.006 3 (B/Y); t=-2.59,P=0. 0150 (MTP)］. In the diagnosis of early primary glaucoma, the sensitivity of MTP was the highest (83%), B/Y was the second (65%), and W/W was the lowest (48%). When B/Y and MTP were combined, the sensitivity was improved to 94% using parallel testing, and the specificity was improved to 87% using serial testing.Conclusions B/Y and MTP are valuable in diagnosis of early primary glaucoma, and the sensitivity and specificity of the diagnosis can be improved when B/Y and MTP are combined. (Chin J Ocul Fundus Dis，2003，19：102-105)
ObjectivesTo investigate the diagnostic value of different diffusion-weighted MRI (DWI) models between two Gaussian DWI models including mono-exponential and bi-exponential, and the non-Gaussian kurtosis model in poorly differentiated pancreatic ductal adenocarcinoma.MethodsSubjects comprised 52 patients with poorly differentiated pancreatic ductal adenocarcinoma which had been confirmed by surgery. All patients underwent DWI (1.5T, multi-b values: 0, 50, 100, 150, 200, 500, 800, 1000, 1 500, 2 000s/mm2). Mean values of DWI-derived metrics ADCstandard, ADCslow, ADCfast, f, MD, MK and ADCstandard were calculated from regions of interest in all tumours and non-tumorous parenchyma and compared. ANOVA and Mann Whitney U test was used to compare the MRI paremeters. ROC was used to evaluate the diagnostic efficiency.ResultsMean ADCstandard, ADCfast, f and MK values showed significant differences between tumours and non-tumorous parenchyma (P<0.05). AUC for ADCstandard, MD, ADCfast and f were 0.705, 0.665, 0.648, 0.614, respectively. The ROC curve integrated with ADCstandard and MD had better diagnostic efficiency (AUC was about 0.754).ConclusionsADCstandard, ADCfast, f and MK values can differentiate tumours from non-tumorous parenchyma. The combination of Gaussion distribution model and non-Gaussion distribution model has the potential to increase the diagnostic accuracy of DWI in patients with pancreatic ductal adenocarcinoma.
Objective To study the predictive value of red blood cell distribution width in severity stratification of community-acquired pneumonia(CAP). Methods One-hundred and seventeen CAP patients admitted between August 2014 and August 2015 were recruited in the study.According to the severity of CAP evaluated by pneumonia severity index (PSI)and CURB score,the patients were divided into a severe group,a moderate group and a mild group with 39 cases in each group.Meanwhile 39 healthy volunteers were recruited as control.The blood red blood cell distribution width and high sensitive C-reactive protein(hs-CRP)levels were measured in all subjects. Results The PSI score and CURB score were significantly higher in the CAP patients than the control group and increased with the deterioration of the disease.The red blood cell distribution width and hs-CRP level were also significantly higher in the CAP patients than the control group and increased with the deterioration of the disease (P<0.05). Conclusion The red blood cell distribution width is correlated with the severity of CAP and has predictive value in CAP severity stratification.
Objective To explore the predictive value of Composite Congestion Score (CCS) in predicting adverse events within 180 days in patients with acute heart failure (AHF) in emergency intensive care unit (EICU). Methods The patients with AHF who were admitted to EICU of Zigong Fourth People’s Hospital between January 1, 2018 and December 31, 2020 were included consecutively. The patients were followed up for 180 days, and were divided into poor prognosis group and good prognosis group according to whether there were adverse events. Logistic regression equation was used to screen independent risk factors for predicting adverse events in patients with AHF within 180 days after leaving EICU. To compare the discrimination, calibration and clinical usefulness of independent risk factors at EICU discharge and the Acute Physiology and Chronic Health Assessment SystemⅡ (APACHEⅡ) score at EICU admission to predict the occurrence of adverse events of AHF. Results A total of 71 patients were included, including 32 patients with good prognosis and 39 patients with poor prognosis. Except for age, APACHEⅡscore at EICU admission and CCS score at EICU discharge (P<0.05), there was no significant difference in other indicators between the two groups (P>0.05). Logistic regression analysis showed that CCS score at EICU discharge [odds ratio (OR)=2.806, 95% confidence interval (CI) (1.428, 5.512), P=0.003], age [OR=1.086, 95%CI (1.017, 1.159), P=0.013] were independent risk factors for predicting death or returning to hospital within 180 days. Among them, the CCS score at EICU discharge combining with age had a positive improvement ability compared with the CCS score at EICU discharge, the age, and the APACHE Ⅱ score at EICU admission. The calibration curves of the four scoring methods for predicting adverse events within 180 days showed that the CCS score at EICU discharge had the highest calibration and the calibration of age was the lowest. The decision curve showed that the clinical usefulness of age, the CCS score at EICU discharge and the CCS score at EICU discharge combining with age was better than the APACHE Ⅱ score at EICU admission. Conclusions The CCS score of patients with AHF at EICU discharge is closely related to adverse events within 180 days. The CCS score is designed based on clinical variables, simple and practical. The combination of age and the CCS score at EICU discharge will further enhance its clinical application value.
ObjectivesTo systematically review the value of cross-linked carboxy-terminal telopeptide of type I collagen (ICTP) in the diagnosis of bone metastases of lung cancer.MethodsThe Cochrane Library, PubMed, EMbase, WanFang Data and CBM databases were electronically searched to collect studies on ICTP in the diagnosis of lung cancer bone metastases from inception to November 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by QUADAS-2 standard. Meta-analysis was performed by using Meta-Disc 1.4 software.ResultsA total of 8 studies involving 781 patients were included. The results of meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio and area under the curve of summary receiver operating characteristics were 71% (95%CI 0.65 to 0.76), 80% (95%CI 0.76 to 0.84), 3.79 (95%CI 2.31 to 6.21), 0.35 (95%CI 0.25 to 0.49), 14.67 (95%CI 6.99 to 30.81) and 0.860 3, respectively.ConclusionsICTP cooperate with imaging tests may be accurate and practical in diagnosis of bone metastases of lung cancer. Due to the limited quality and quantity of included studies, the above results should be validated by more studies.