ABSTRACT
Objective:To analyze the effect and clinical significance of continuous renal replacement therapy (CRRT) on severe acute pancreatitis complicated with different grades of intra-abdominal hypertension, and to determine whether the level of intra-abdominal pressure can be used as one of the indicators of CRRT in these patients.Methods:From September 2020 to September 2022, the clinical data of 66 patients with severe acute pancreatitis complicated by intra-abdominal pressure (IAP) ≥12 mmHg who were treated with CRRT and admitted to the EICU of Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. According to the level of IAP, they were divided into group A: 12 mmHg≤IAP < 15 mmHg, 22 cases; group B: 15 mmHg≤IAP≤20 mmHg, 23 cases and group C: IA P>20 mmHg, 21 cases. The general clinical data and IAP values before and after CRRT treatment, as well as the ΔIAP (difference of IAP before and after treatment) were recorded. The difference of IAP before and after treatment and the ΔIAP between group B and group C were compared by independent sample t test. The relationship between IAP before treatment and ?IAP was analyzed by spearman test. Results:There were no significant differences in gender, age, modified Marshall score, APACHE Ⅱ score, number of mechanical ventilation, and etiology among the three groups before treatment( P>0.05). After CRRT treatment, IAP of group A was no significantly changed before and after treatment ( P>0.05). IAP in groups B and C was significantly lower after treatment than before treatment ( P<0.05), and the ΔIAP of group C was significantly higher than that of group B ( P<0.05). There was a positive correlation between IAP before treatment and ?IAP in group B and Group C ( P<0.05). Conclusions:1．For patients with severe pancreatitis complicated with intra-abdominal hypertension, CRRT treatment can effectively reduce IAP when IAP≥15 mmHg, and the higher the IAP, the more obvious effect of CRRT treatment in controlling intra-abdominal pressure. 2. IAP≥15 mmHg can be used as one of the indicators for CRRT in SAP patients.
ABSTRACT
Objective There is close relationship between ubiquitin-specific protease 9X(USP9X) and the biological behav-ior of some tumor.The aim of this study is to investigate the expression and clinical significance of USP 9X in pancreatic carcinoma of elderly patients. Methods The expression of USP9X was detected in 30 pieces of surgically resected primary pancreatic carcinoma tissue and adjacent nontumorous pancreatic tissue of elderly patients by streptavidin -perosidase immunohistochemical method . Results The rate of USP9X positive expression was 56.7%, there was not positive expression in adjacent nontumorous pancreatic tissue .There was no relation between the expression of USP 9X with gender, age, the tumor positin, the tumor size and degree of differentiation (P>0.05), while it was significantly correlated with lymph node metastasis and TNM stages (P<0.05).By using Cox proportional haz-ards analysis, multivariable analysis revealed that TNM stages , lymph node metastasis and USP9X expression were independent risk factor(P<0.05). Conclusion The results indicated that USP9X may play a role in the pathogenesis and prognosis of pancreatic cancer of elderly patients .