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Objective To analyze the diagnosis and prognosis value of abdominal CT scans in patients with acute pancreatitis complications.Methods 151 cases with acute pancreatitis were selected.The relationship between abdominal CT performances and the common complications and death in patients was analyzed.The prognosis of patients with different Balthazar CT severity index (CTSI) grade was compared.Results The complication rate of patients with CT signs of fatty liver, pleural effusion, liver gap effusion, adrenal gland involvement (AGI), penirenal space involvement (PSI) and gastric bare area involvement (GBAI) was significantly higher than that of patients with negative CT findings above (P<0.05).With CTSI grading increasing, the patient''s fasting time, heating time, hospital stay, recovery time of blood amylase were extended, and the incidence of pseudo cyst, transit surgery, organ failure and death was gradually increasing (P<0.05).Conclusion Severe fatty liver, AGI, GBAI, PSI and liver gap effusion are risk factors for acute complications and death in patients with pancreatitis.
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Objective To evaluate the association between the decrease of the perioperative serum carcinoembryonic antigen (CEA) level during perioperative period and the prognosis in patients with colon cancer after a curative resection.Methods Retrospective analysis was conducted to evaluate the relationship between preoperative serum CEA level and different clinicopathologic features in 605 cases who underwent a curative resection for colon cancer from January 2006 to April 2011.According to the preoperative serum CEA level,the patients were divided into two groups:≤5 ng/ml and ＞5 ng/ml group.The critical value of the CEA decreasing rate in preoperative serum CEA ＞ 5 ng/ml group was calculated,and the relationship between this critical value and survival rate was then analyzed.Univariate and multivariate models were used to detect the risk factors of overall survival rate (OS) and disease free survival (DFS) in preoperative serum CEA ＞ 5 ng/ml patients.Results The preoperative serum CEA levels were significantly associated with lymphatic invasion (x2 =14.122,P＜0.001),T stages (x2 =40.153,P ＜0.001),N stages (x2 =22.721,P ＜0.001) and pathological stages (x2 =38.576,P ＜ 0.001),except for sex (x2 =0.453,P =0.501),age (x2 =0.195,P =0.659) and histological stages (x2 =6.135,P =0.112).The critical values of CEA decreasing rate for OS and DFS were 48.95％ and 50.81％ in preoperative serum CEA ＞5 ng/ml group respectively.There were significant differences of 5-year OS (31.37％ vs.76.63％,x2 =43.235,P ＜ 0.001) and 5-year DFS (27.69％ vs.72.10％,x2 =55.561,P ＜0.001) between patients after operation whose CEA decreasing rate were lower than critical value and those whose were higher.Univariate analysis showed that the decreasing rate of CEA was an influence factor for OS (x2 =43.235,P ＜ 0.001) and DFS (x2 =55.561,P ＜ 0.001) of preoperative serum CEA ＞ 5 ng/ml patients.The N stages and pathological stages were both related to OS (x2 =14.683,P＜0.001;x2 =12.295,P＜0.001) and DFS (x2 =16.212,P＜0.001;x2 =13.704,P＜0.001)respectively.Multivariate model showed that the decreasing rate of CEA level and N stages were both associated withOS (x2=18.885,P＜0.001;x2 =7.523,P＜0.001) and DFS (x2 =19.275,P＜0.001;x2 =6.997,P ＜ 0.001) of preoperative serum CEA ＞ 5 ng/ml patients.Conclusion A high decreasing rate of serum CEA level after operation in colon cancer patients who have high CEA levels before the curative resection can be a protective factor for prognosis,especially when the decreasing rate is higher than the critical value.
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Objective To investigate the influence of diversification continuing care on quality of life and activities of daily living of epilepsy patients secondary to cerebral hemispheric atrophy.Methods Twenty epilepsy patients with cerebral hemispheric atrophy,admitted to Second Department of Neurosurgery of Hebei Provincial People's Hospital from March 2012 to December 2014 were selected by convenience sampling method,and divided into the intervention group (12 cases) and control group (8 cases),Patients in the control group were given routine guidance discharge,and intervention group were given continuing nursing intervention.The influence of diversification continuing care on quality of life and activities of daily living of epilepsy patients were compared between two groups.Results Twelve months after discharge,QOL in the control group and the intervention group scored 58.8±20.9 and 77.2±14.3,t=2.37,P ＜ 0.05.The ADL scored 49.42±8.14 and 62.72±7.06,t=2.39,P ＜0.05.Conclusions Diversification continuing nursing intervention is helpful to improve quality of life and activities of daily living of epilepsy patients secondary to cerebral hemispheric atrophy.
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Objective To evaluate the left ventricular and right ventricular systolic function by two‐dimensional speckle tracking echocardiography ( 2D‐STE) in patients with rheumatoid arthritis ( RA ) . Methods Fifty five patients with RA and 50 healthy subjects were received echocardiography . 2D‐STE were applied for all the subjects to obtain left ventricular global longitudinal strain ( LVGLS) and right ventricular global longitudinal strain ( RVGLS) .Tricuspid annular plane systolic excursion ( TAPSE) and the change ratio of right ventricular area ( RVACR) were measured by echocardiography . The anti‐cyclic citrullinated peptide antibodies ( anti‐CCP‐II) ,rheumatoid factor ( RF) ,C‐reactive protein ( CRP) and erythrocyte sedimentation rate ( ESR) were detected in both group . The LVGLS and RVGLS in RA group were used to conduce correlation analysis with the level of anti‐CCP‐II ,RF ,CRP , ESR and the duration of disease . Results There was a significant decrease in RVGLS and LVGLS in RA group compared with control group( P 0 .05) . The anti‐CCP‐II ,RF ,CRP and ESR in RA group increased significantly compared with control group ( P < 0 .001 ) . The result of correlation analysis showed there was no correlation between RVGLS ,LVGLS and anti‐CCP‐II ,RF ,CRP ,ESR in RA group . However ,RVGLS and LVGLS were negatively correlated with the duration of disease . Conclusions LVGLS and RVGLS in RA patients were lower than those in healthy people ,strain decreases with the extension of disease duration ,2D‐STE may be an efficacious assessment to assess left ventricular and right ventricular systolic function in patients w ith RA .
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Systemic lupus erythematosus [SLE] is a complicated autoimmune disease. Although its pathogenesis is not clear, cytokine may be involved in it. So we investigated serum levels of macrophage-derived chemokine [MDC], and matrix metalloproteinase-9 [MMP-9], and to determine the relationship between serum levels and the disease activity of SLE. Serum levels of MDC and MMP-9 were measured by enzyme-linked immuno sorbent assay [ELISA]. Significantly decreased serum levels of MDC and MMP-9 were found in SLE as compared to those in controls [P<0.001 P<0.001], but serum levels of MDC and MMP-9 increased after treatment [P<0.001 P<0.05]. Serum levels of MDC and MMP-9 were lower in patients with active disease than those with inactive disease [P<0.001 P<0.05]. Significantly decreased serum levels of MDC and MMP-9 were found in patients with renal damage than those without the damage [P<0.001 P<0.05]. Serum level of MDC was lower in patients with arthritis than those without the damage [P<0.001], but serum level of MMP-9 has no significant difference in two groups [P>0.05]. The present data suggest that MDC and MMP-9 may be involved in the pathogenesis of SLE, and serum levels of MDC and MMP-9 could be markers of monitoring disease activity, renal damage, disease progression and improvement in SLE
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Objective To assess the association of synovial cyclic citrullinated peptide(CCP)expression with T helper 17(Th17) cells/Regulatory T cells (Treg) imbalance,the histological and clinical features of synovitis in rheumatoid arthritis (RA).Methods CCP expression in synovial specimens from 39 patients with RA and 35 controls was detected by immunohistochemistry assay(IH) using 6×His tagged anti-CCP single chain fragment V (ScFv) antibodies,which were generated by pHEN2 phagemid recombinant antibodies display system.The frequencies of Th17/Treg cells in the peripheral blood mononuclear cells (PBMCs) were determined by flow cytometry (FCM).Th17/Treg cells associated cytokines were analyzed by enzyme-linked immunosorbent assay (ELISA).The histological scores and clinical features of synovitis were included in the study.Chi-square test and ANOVA were used for statistical analysis.Results ① The prevalences of synovial C CP expression were significantly different between RA group and the control(76.9％ and 11.4％ respectively,X2=31.9,P＜0.01).② The frequencies of Th17 cells,Th17/Treg ratio,Th17 cells associated cytokines as IL-6,IL-17a,IL-23,TNF-α,and the Treg cells associated cytokines TGF-31,the serum and synovial fluid anti-CCP antibodies in the RA patients with synovial CCP positive expression were significantly higher in RA patients with CCP positive than those with CCP negative.Disease activity score DAS28 index and histological features quantified variations of the synovial biopsy specimens (synoviocyte hyperplasia,focal aggregates of lymphocytes,and diffuse infiltrat(e)s of lymphocytes) in RA were higher in synovial CCP positive expression patients than in the negative.Conclusion Synovial CCP expression is strongly associated with the Th17/Treg imbalance and synovitis,which may play a crucial role in the pathogenesis of RA.