ABSTRACT
Objective:To investigate the predictive value of emergency bedside echocardiography on acute pancreatitis (AP) severity by assessing cardiac dysfunction.Methods:The clinical data used in this study was prospectively collected from AP patients in the Emergency Department of Beijing Shijitan Hospital, Capital Medical University from June 2018 to December 2020. According to the Atlanta Classification revised at the 2012 Atlanta International Conference, patients were divided into three groups of mild acute pancreatitis (MAP), moderate-severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP). The differences of comprehensive score index, blood-related index, and echocardiography-related index were compared among the three groups. Besides, the predictive factors of SAP were analyzed by Logistic regression, receiving operating characteristic (ROC) curves of subjects were drawn, and the area under the curve (AUC) was analyzed to evaluate the predictive efficiency.Results:A total of 116 patients were enrolled in this study. Compared with the non-SAP group (MAP group+MSAP group), acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, Ranson score, procalcitonin, cardiac troponin I (cTnI), N-terminal pro-brain natriuretic peptide (NTproBNP), EDD, A-peak, E/A, E'/A', and stroke volume (SV) exhibited significant differences (all P<0.05). There was no significant difference in end-systolic diameter, E-peak, and left ventricular ejection fraction among the three groups ( P>0.05). Logistic regression analysis revealed that SOFA score, Ranson score, cTnI, NTproBNP, E'/A', and SV were important predictors of AP severity (all AUC>0.7). Moreover, the predictive value of echocardiography cardiac function assessment index (E'/A' +SV, AUC=0.969) and score index (SOFA score +Ranson score, AUC=0.989) for SAP was better than that of blood index (cTnI+NTproBNP, AUC=0.732). Conclusions:Echocardiographic indicators E'/A' and SV have acceptable predictive values for SAP, providing certain guiding significance for the clinical treatment of AP patients.
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Objective:To investigate the risk factors of postpartum embryo residues associated with uterine arteriovenous fistula.Methods:From January 2000 to December 2020, 26 cases of postpartum embryo residue complicated with uterine arteriovenous fistula in Tangshan Maternal and Child Health Hospital were selected as the case group, and 32 cases of postpartum embryo residue without uterine arteriovenous fistula were selected as control group.Both the case group and the control group had embryo residue in cesarean scar.Univariate and multivariate logistic analysis were used to screen the risk factors of postpartum embryo residue combined with uterine arteriovenous fistula.Results:There were 26 patients in the case group, including 3 patients after medical abortion, 17 patients after artificial abortion, 2 patients after cesarean section, and 4 patients after mid-term induced labor.There were 32 patients in the control group, including 7 patients after medical abortion, 11 patients after induced abortion, 8 patients after cesarean section, and 6 patients after mid-term induced labor.There were 11 patients in the case group and 3 patients in the control group.Univariate analysis showed that: the occurrence of postpartum embryo residue combined with uterine arteriovenous fistula was related to the time of vaginal bleeding, HCG value before and after treatment, hemoglobin value before treatment, platelet count and residual embryo area(all P<0.05). Multivariate regression analysis showed that the increase of hCG before treatment ( OR 20.319, 95% CI 1.348-306.187) and the decrease of hemoglobin before treatment ( OR 0.870, 95% CI 0.788-0.960) were the independent risk factors of postpartum embryo residue combined with uterine arteriovenous fistula (all P<0.05). Conclusion:The risk factors of uterine arteriovenous fistula in postpartum embryo residue patients with elevated hCG value and decreased hemoglobin value before treatment should be highly vigilant to reduce the rate of clinical missed diagnosis.
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Objective:To explore the molecular mechanism of comprehensive treatment of irritable bowel syndrome (IBS) from the perspective of alleviating gastrointestinal symptoms and neuropsychiatric symptoms by using network pharmacology and molecular docking.Methods:To retrieve the TCMSP database to obtaine the main active ingredients and the targets of Sini Powder, and the target genes of IBS were screened out through GeneCards and TTD databases. Then use STRING database and Cytoscape software to construct protein interaction network and screen the core genes, verifying the molecular docking of the core targets-drug component based on CB-Dock online molecular docking tool. Finally, used DAVID and Metascape databases respectively to conduct GO and KEGG pathways analysis. Results:There were 112 active ingredients of Sini Powder and 204 effective targets, 2 805 IBS-related genes, and 152 targets in total, which mainly concerning IL-17 signaling pathway, VEGF signaling pathway, NF-κB signaling pathway, dopaminergic synaptic pathway, serotonin synaptic pathway and calcium signaling pathway. Conclusion:Sini Powder could treat IBS by regulating neuroendocrine pathway, immune balance, improving mild intestinal inflammation and repairing intestinal barrier through multi-component, multi-path and multi-target ways.