Prediction of postoperative pancreatic fistula using a nomogram based on the updated definition

PURPOSE: The International Study Group on Pancreatic Fistula's definition of postoperative pancreatic fistula (POPF) has recently been updated. This study aimed to identify risk factors for POPF in patients having pancreaticoduodenectomy (PD) and to generate a nomogram to predict POPF.METHODS: Data on 298 patients who underwent PD from March 2012 to October 2017 was retrospectively reviewed and POPF statuses were redefined. A nomogram was constructed using data from 220 patients and validated using the remaining 78 patients. Independent risk factors for POPF were identified using univariate and multivariate analyses. A predictive nomogram was established based on the independent risk factors and was compared with existing models.RESULTS: Texture of the pancreas, size of the main pancreatic duct, portal vein invasion, and definitive pathology were the identified risk factors. The nomogram had a C-index of 0.793 and was internally validated. The nomogram performed better (C-index of 0.816) than the other most cited models (C-indexes of 0.728 and 0.735) in the validation cohort. In addition, the nomogram can assign patients into low- (less than 10%), intermediate- (10% to 30%), and high-risk (equal or higher than 30%) groups to facilitate personalized management.CONCLUSION: The nomogram accurately predicted POPF in patients having PD.

Statistical analysis of monitoring data regarding the state of Keshan disease in Wudu district, Longnan city, Gansu province in 2009 / 中国地方病学杂志

Objective To study the current cases of Keshan disease aims at providing scientific and basic evidence for prevention and control of the disease. Methods In accordance with historical cases, in 2009, an investigation was conducted in the permanent resident population in seriously infected representative villages of landscapes and ways of living such as Xujialeng, Zhuping and some other adjacent villages in Wudu district, Longnan city. People in those areas were examined and carefully observed based on the scheme of Keshan disease surveillance. Then they were enquired about their medical history, given normal clinical examinations and electrocardiogram(ECG) examination, the suspected cases were chest X-rayed. At the same time, some samples of their hair of some children under 12 and adults were collected to be examined for the selenium content. Results Among the total number of 515 subjects, 20 were diagnosed with Keshan disease with a total detection rate of 3.9% (20/515), among whom 13 were potential patients with a detection rate of 2.5%( 13/515), 7 were chronic patients with a detection rate of 1.4%(7/515). In the total number of 515 ECG, 48 were found with abnormal ECG at a detection of 9.3%(48/515). In the 20 patients, the potential patients were mostly featured with incomplete right bundle-branch block(5 cases), complete right bundle-branch block(3 cases), frequent ventricular premature beat (2 cases) and left ventricle high voltage(2 cases), while the chronic patients were mostly featured with incomplete right bundle-branch block(2 cases). Of the 29 chest X-ray films, 17 cases had heart enlargement with a detection rate of 58.6%( 17/29). The selenium content in the hair of 10 adults and 10 children were (0.38±0.09), (0.31±0.12) mg/kg, respectively. Conclusion There are still existing some cases and obvious virulence factors of Keshan disease in Wudu district, Longnan city.

Hair root fragile X mental retardation protein assay for the diagnosis of fragile X syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Fragile X syndrome (FXS) may be identified by many methods, such as PCR assay and Southern blot. However, each method has its limits or shortcomings. This study explored the reliability of the rapid, convenient and inexpensive hair root fragile X mental retardation protein (FMRP ) assay in the identification of FXS.</p><p><b>METHODS</b>FMRP in hair roots was determined by immunohistochemistry assay in 80 healthy children, in 40 children with mental retardation of unknown etiology and in 12 family members in one pedigree of FXS. FXS was confirmed by 7-deza-dGTP PCR.</p><p><b>RESULTS</b>There was a high expression of FMRP in hair roots (> or =80%) in healthy children. Two children were confirmed with FXS by 7-deza-dGTP PCR in 40 children with mental retardation of unknown etiology. FMRP expression was 10% and zero respectively in the two children. The other 38 children had FMRP expression of more than 80%. FMRP was not expressed in the two cases of FXS from the pedigree of FXS.</p><p><b>CONCLUSIONS</b>Inexpensive, rapid and convenient hair root FMRP assay is reliable for the diagnosis of FXS and may be widely applied for screening and diagnosing FXS in children with mental retardation.</p>