ABSTRACT
Objective@#To establish a visualized nomogram with early predictive value for the severity of first-onset acute pancreatitis (AP).@*Methods@#706 cases of first-onset AP patients admitted to the First Affiliated Hospital of Wenzhou Medical University within 72 hours from January 2013 to January 2016 were collected. According to the revised Atlanta classification of AP in 2012, AP patients was divided into non-severe pancreatitis (NSAP, also called mild acute pancreatitis and moderately severe acute pancreatitis) group and severe acute pancreatitis (SAP) group. The demographic data (age, body mass index and admission time, etc) and laboratory tests (serum amylase, blood sugar, albumin, white blood cells, creatinine, urea nitrogen) were collected and statistically analyzed. Logistic univariate and multivariant regression analysis were performed based on the relevant clinical indicators. The statistically significant indicators were used to obtain regression equations. The R-language software was used to obtain the visualized nomogram via LR model, which was further validated by ROC curve analysis.@*Results@#In univariate logistic regression analysis, the OR (95% CI) values of blood glucose, creatinine at admission and 24 h after admission, urea nitrogen at admission and 24 h after admission, white blood cell, albumin in NSAP group and SAP group were 1.132(1.080-1.186), 1.019(1.013-1.025), 1.026(1.020-1.033), 1.066(1.035-1.099), 1.333(1.241-1.432), 1.083(1.032-1.136), and 0.853(0.811-0.889), and all the differences were statistically significant (all P values <0.05). Multivariate logistic regression analysis showed that the regression equation of the LR model was Y=-2.657-0.116×albumin(g/L)+ 0.082×white blood cell(×109/L)+ 0.118× glycemia(mmol/L)+ 0.022× 24 h after admission creatinine (μmol/L). A total score of more than 60 points on the nomogram predicted the possibility of SAP. If the total score exceeded 130, the possibility of SAP may be up to 14% or more. Furthermore, the ROC curve analysis confirmed that the sensitivity and specificity of LR model established in this study for predicting of SAP were superior to those of urea nitrogen, creatinine and BISAP score alone by AUC, respectively.@*Conclusions@#This nomogram may be a useful clinical tool for predicting the severity of the first-onset acute pancreatitis.
ABSTRACT
Objective To establish a visualized nomogram with early predictive value for the severity of first-onset acute pancreatitis ( AP ) . Methods 706 cases of first-onset AP patients admitted to the First Affiliated Hospital of Wenzhou Medical University within 72 hours from January 2013 to January 2016 were collected. According to the revised Atlanta classification of AP in 2012, AP patients was divided into non-severe pancreatitis ( NSAP, also called mild acute pancreatitis and moderately severe acute pancreatitis) group and severe acute pancreatitis ( SAP) group. The demographic data ( age, body mass index and admission time, etc) and laboratory tests (serum amylase, blood sugar, albumin, white blood cells, creatinine, urea nitrogen) were collected and statistically analyzed. Logistic univariate and multivariant regression analysis were performed based on the relevant clinical indicators. The statistically significant indicators were used to obtain regression equations. The R-language software was used to obtain the visualized nomogram via LR model, which was further validated by ROC curve analysis. Results In univariate logistic regression analysis, the OR ( 95％CI) values of blood glucose, creatinine at admission and 24 h after admission, urea nitrogen at admission and 24 h after admission, white blood cell, albumin in NSAP group and SAP group were 1. 132(1. 080-1. 186), 1. 019(1. 013-1. 025), 1. 026(1. 020-1. 033), 1. 066(1. 035-1. 099), 1. 333(1. 241-1. 432), 1. 083 (1.032-1.136), and 0.853(0.811-0.889), and all the differences were statistically significant (all P values <0. 05). Multivariate logistic regression analysis showed that the regression equation of the LR model was Y= -2. 657-0. 116 × albumin(g/L) +0. 082 × white blood cell( × 109/L) +0. 118 × glycemia(mmol/L) +0. 022 × 24 h after admission creatinine (μmol/L). A total score of more than 60 points on the nomogram predicted the possibility of SAP. If the total score exceeded 130, the possibility of SAP may be up to 14％ or more. Furthermore, the ROC curve analysis confirmed that the sensitivity and specificity of LR model established in this study for predicting of SAP were superior to those of urea nitrogen, creatinine and BISAP score alone by AUC, respectively. Conclusions This nomogram may be a useful clinical tool for predicting the severity of the first-onset acute pancreatitis.
ABSTRACT
Objective To comparative analysis the intracytoplasmic sperm injection (ICSI)result and rate of sperm DNA in-tegrity (DNA fragmentation index,DFI)about testicular and epididymis sperm.Methods Totally 183 obstructed azoospermia pa-tients were choosed to use ICSI.80 cycles by PESA and 103 cycles by TESA,compared two groups of sperm DNA integrity rate and ICSI outcome.Results Sperm DNA integrity rate,fertilization rate,cleavage rate,good-qualityembryo rate and pregnancy rate com-pared with no difference by ICSI(P >0.05).Conclusion DNA integrity rate and ICSI outcomes of the testis and epididymis sperm have no significant differences,clinicians can be based on personal experiences or patients,wills to select sperm for ICSI.
ABSTRACT
Objective To investigate the effects of the serum from rats with hemorrhagic shock and Shenfu injection, on the expression of endothelial cell protein C receptor (EPCR) in human umbilical vein endothelial cells (HUVECs) cultured with rat serum. Method The soluble endothelial protein C receptor (sEPCR) in supernatant, the expression of EPCR mRNA and protein level of EPCR in HUVECs were detected by using enzyme linked immunosorbent assay ( ELISA), reverse transcription polymerase chain reaction (RT-PCR), and western bloting (WB) in normal control group, hemorrhagic shock serum (3 h, 12 h, 24h, 72 h) group, and Shenfu-treated (3 h, 12 h, 24 h, 72 h) group, respectively. Results The mean levels of sEPCR and the expression of EPCR mRNA were significantly higher in hemorrhagic shock serum (12 h, 24 h) group, and Shenfu -treated(24 h)group than those in normal control group (all P ＜0.01 ),the mean levels of sEPCR and the expressions of EPCR mRNA were significantly higher in Shenfu-treated ( 12 h) group than those in normal control group ( all P ＜0. 05 ), while the levels of protein were lower in hemorrhagic shock serum ( 12 h, 24 h) group and in Shenfu-treated(24 h)group than those in normal control group ( both P ＜0.01 ), and the level of EPCR protein was lower in Shenfu-treated( 12 h) group than that in normal control group ( P ＜ 0. 05) . The mean levels of sEPCR and the expressions of EPCR mRNA were significantly lower in Shenfu-treated ( 12 h, 24 h) group than those in hemorrhagic shock serum ( 12 h,24 h) group (all P ＜0.05), while the levels of EPCR protein were higher in Shenfu-treated ( 12 h, 24 h)group than those in hemorrhagic shock serum ( 12 h, 24 h) group ( P ＜ 0.05 ). Conclusions These data suggest that Shenfu injectio could affect the expression of EPCR mRNA and the level of EPCR protein, thereby it might be effective in prevention of development of hemorrhagic shock.