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Objective:To explore the independent risk factors of portal vein thrombosis (PVT) in liver cirrhosis, and to establish and evaluate a risk prediction model for PVT in patients with cirrhosis.Methods:A total of 295 cases of cirrhosis hospitalized in Renmin Hospital of Wuhan University from December 2019 to October 2021 were divided into a modeling set ( n=207) and an internal validation set ( n=88) by the random number table. In addition, patients with cirrhosis hospitalized in Yichang Central People's Hospital, Wuhan Puren Hospital, No.2 People's Hospital of Fuyang City and People's Hospital of China Three Gorges University during the same period were collected as an external validation set ( n=92). The modeling set was divided into PVT group ( n=56) and non-PVT group ( n=151). Univariate analysis was used to preliminarily screen the related indicators of PVT, and then multivariate logistic regression analysis with forward stepwise regression was used to determine independent risk factors for PVT. A nomogram prediction model was constructed based on the independent risk factors obtained. The internal and external validation set were used to verify the predictive ability of the model. Distinction degree was used to evaluate the ability of the model to distinguish patients with or without PVT. Hosmer-Lemeshow goodness-of-fit test was used to evaluate the consistency between predicted risk and the actual risk of the model. Results:Univariate analysis showed that smoking, history of splenectomy, trans-jugular intrahepatic portosystemic shunt (TIPS), gastrointestinal bleeding and endoscopic variceal treatment, and levels of hemoglobin, alanine aminotransferase, aspartate aminotransferase and D-dimer were significantly different between the PVT group and the non-PVT group ( P<0.05). Multivariate logistic regression analysis found that smoking ( P=0.020, OR=31.21, 95% CI: 1.71-569.40), levels of D-dimer ( P=0.003, OR=1.12, 95% CI: 1.04-1.20) and hemoglobin ( P=0.039, OR=0.99, 95% CI: 0.97-1.00), history of TIPS ( P=0.011, OR=18.04, 95% CI: 1.92-169.90) and endoscopic variceal treatment ( P=0.001, OR=3.21, 95% CI: 1.59-6.50) were independent risk factors for PVT in patients with liver cirrhosis. Receiver operator characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) for the internal validation set was 0.802 (95% CI: 0.709-0.895) ( P<0.001), and the AUC for the external validation set was 0.811 (95% CI: 0.722-0.900) ( P<0.001). Both AUC were larger than 0.75. The calibration curve of Hosmer-Lemeshow goodness-of-fit test showed that the P values of both internal validation set ( χ2=3.602, P=0.891) and the external validation set ( χ2=11.025, P=0.200) were larger than 0.05. Conclusion:Smoking, history of TIPS or endoscopic variceal treatment, levels of D-dimer and hemoglobin are independent risk factors for PVT in patients with liver cirrhosis. The prediction nomogram model based on the above factors has strong predictive ability.
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Objective:To evaluate the efficacy and safety of lactulose combined with polyethylene glycol for bowel preparation before colonoscopy in patients of different risks.Methods:A total of 208 patients undergoing colonoscopy were enrolled, including 108 high-risk and 100 low-risk patients. The high-risk patients were divided into group A (54 taking lactulose + polyethylene glycol) and group B (54 taking polyethylene glycol), and the low-risk patients were divided into group C (49 taking lactulose + polyethylene glycol) and group D (51 taking polyethylene glycol). The Boston bowel preparation score, cecal intubation time, withdrawal time, the detection rate of colonic polyps and adenoma, and the incidence of adverse reactions were observed.Results:Among the high-risk patients, the Boston bowel preparation score and adenoma detection rate in group A [(6.35±1.15) scores, 46.3%] were significantly higher than those in group B [(5.76±0.89) scores, 22.2%, both P<0.05], and the first defecation interval in group A was significantly shorter than that in group B [(1.20±0.85) h VS (3.29 ± 2.93) h, P<0.05]. There was no significant difference in adequate bowel preparation rate, polyp detection rate, frequency of defecation or incidence of adverse reactions between group A and B. In the low-risk patients, the first defecation interval in group C was significantly shorter than that in group D [(1.65 ± 1.35) h VS (3.42 ± 2.64) h, P<0.05], and the incidence of adverse reactions was significantly lower than that in group D (44.9% VS 64.7%, P<0.05). There was no significant difference in adequate bowel preparation rate, Boston bowel preparation score, adenoma detection rate, polyp detection rate or frequency of defecation between group C and D. Conclusion:For the high-risk patients, the effect of lactulose combined with polyethylene glycol for bowel cleansing is better than that of traditional polyethylene glycol in the improvement of the Boston bowel preparation score, adenoma detection rate, and the first defecation interval. For low-risk patients, lactulose combined with polyethylene glycol regimen has few advantages over traditional polyethylene glycol regimen.
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Objective To examine the interleukin-27 (IL-27) levels in the serum of the patients with neuromyelitis optica (NMO) and healthy controls (HCs) and explore the correlation of the serum IL-27 level with disease severity.Methods Serum concentrations of IL-27 from 39 patients with NMO and 39 HCs were measured by using enzyme-linked immunosorbent assay (ELISA).Mann-Whitney U test was performed to analyze the difference in the IL-27 levels between the NMO group and the HCs.Spearman's rank correlation analysis was used to analyze the correlations of serum IL-27 levels with clinical parameters (EDSS,spinal cord lesion length,annual relapse rate and antibody titers of AQP-4) of NMO.Results The serum IL-27 levels were significantly lower in NMO group than in HCs (P＜0.001).Serum IL-27 levels were negatively correlated with EDSS,total length of spinal cord lesion identified by MRI at the sampling,and the average relapse rate during two-year follow-up (r=-0.439,P=0.010;r=-0.434,P=0.006;r=-0.451,P=0.031).There was no significant correlation between IL-27 levels and antibody titers of AQP-4 (r=-0.027,P=0.871).Multivariate regression analysis showed that serum IL-27 levels were negatively correlated with EDSS (B=-0.025,P=0.023).Conclusion IL-27 may participate in the pathogenic process of NMO and might be a prognosis marker of the disease.
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Objective To examine the interleukin-27 (IL-27) levels in the serum of the patients with neuromyelitis optica (NMO) and healthy controls (HCs) and explore the correlation of the serum IL-27 level with disease severity.Methods Serum concentrations of IL-27 from 39 patients with NMO and 39 HCs were measured by using enzyme-linked immunosorbent assay (ELISA).Mann-Whitney U test was performed to analyze the difference in the IL-27 levels between the NMO group and the HCs.Spearman's rank correlation analysis was used to analyze the correlations of serum IL-27 levels with clinical parameters (EDSS,spinal cord lesion length,annual relapse rate and antibody titers of AQP-4) of NMO.Results The serum IL-27 levels were significantly lower in NMO group than in HCs (P＜0.001).Serum IL-27 levels were negatively correlated with EDSS,total length of spinal cord lesion identified by MRI at the sampling,and the average relapse rate during two-year follow-up (r=-0.439,P=0.010;r=-0.434,P=0.006;r=-0.451,P=0.031).There was no significant correlation between IL-27 levels and antibody titers of AQP-4 (r=-0.027,P=0.871).Multivariate regression analysis showed that serum IL-27 levels were negatively correlated with EDSS (B=-0.025,P=0.023).Conclusion IL-27 may participate in the pathogenic process of NMO and might be a prognosis marker of the disease.
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Objective To explore the efficacy of glutathione (GSH ) combined with early nursing intervention for treating neo‐natal jaundice ,and to investigate its influence on serum malondialdehyde (MDA ) ,superoxides dismutase(SOD) and glutathione‐Px (GSH‐Px) levels .Methods Sixty‐eight cases of neonatal jaundice were chosen and randomly divided into the observation group (n=34) and conventional group (n= 34) .Contemporaneous 20 full term healthy neonates were selected as the healthy control group .The observation group was added with GSH and early nursing intervention on the basis of the conventional group .Serum to‐tal bilirubin(TBIL) ,direct bilirubin(DBIL) ,MDA ,SOD and GSH‐Px levels were detected before and after treatment .Results The total effective rate in the observation group was 91 .2% ,which was significantly higher than 73 .5% in the conventional group(P<0 .05);compared with before treatment ,serum TBIL and DBIL levels after treatment in the two group were significantly decreased (P<0 .01) ,moreover the levels of TBIL and DBIL after treatment in the observation group were significantly lower than those in the conventional group(P<0 .01) .The serum MDA level before treatment in both groups were significantly higher than that in the healthy control group(P<0 .01) ,while serum SOD and GSH‐Px levels in the two groups were significantly lower than those in the healthy control group(P<0 .01);after treatment ,serum MDA level in both groups were significantly decreased (P<0 .01 or P<0 .05) ,while serum SOD and GSH‐Px levels in the two group were significantly increased (P<0 .01 or 0 .05);compared with the conventional group ,decrease of serum MDA level in the observation group was more significant (P<0 .05) and serum GSH‐Px level was markedly increased(P<0 .05) .Conclusion GSH combined with early nursing intervention has better effect in the treatment of neotatal jaundice and effectively reduces the levels of serum TBIL ,DBIL and MDA ,and increases the levels of SOD and GSH‐Px , which has positive clinical significance .
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Increasing studies have shown that endothelial progenitor cel s can not only promote the damaged endothelial cel s and vascular repair in ischemic brain tissue, but also promote neurogenesis, and thus promote neurological function recovery. Endothelial progenitor cel s transplantation may become an effective approach for the treatment of ischemic stroke.