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1.
Article in Chinese | WPRIM | ID: wpr-1018901

ABSTRACT

Objective:To study the clinical characteristics and risk factors for hypertriglyceridemia-induced severe acute pancreatitis (HTG-SAP) complicated by acute kidney injury.Methods:The clinical data of HTG-SAP patients admitted to the Department of Critical Care Medicine of the Second Affiliated Hospital of Anhui Medical University from January 2014 to July 2022 were retrospectively collected, and divided into an AKI group and a non-AKI group according to whether AKI occurred. The general condition, laboratory data and clinical characteristics of the two groups were compared. Factors with statistically significant differences were screened for logistic regression analysis and a predictive model was constructed. We plotted the receiver operating characteristic curve and used the area under the curve (AUC) to evaluate the predictive ability of each predictor for HTG-SAP complicated with AKI.Results:A total of 91 patients were included, including 37 (40.7%) with AKI and 54 (59.3%) without AKI. The proportions of extrapancreatic infection, sepsis and multiple organ dysfunction syndrome, requiring mechanical ventilation, continuous renal replacement therapy (CRRT), retroperitoneal puncture, and surgical intervention were higher in the AKI group than in the non-AKI group (all P<0.05). The length of ICU stay, total length of hospitalization, and mortality rate in the AKI group were higher than those in the non-AKI group (all P<0.05). Multivariate logistic regression analysis showed that acute physiology and chronic health status scoreⅡ (APACHEⅡ) ( OR=2.069, 95% CI: 1.286-3.417, P=0.003), abdominal pressure ( OR=1.469, 95% CI: 1.108-1.958, P=0.007), and lactic acid ( OR=3.156, 95% CI: 1.013-9.831, P=0.047) were independent risk factors for AKI in HTG-SAP patients. The AUCs of the APACHEⅡ score, abdominal pressure, lactic acid level and combined prediction model were 0.951, 0.918, 0.837 and 0.986, respectively. Conclusions:Patients with HTG-SAP complicated with AKI were more likely to have complications related to extrapancreatic infection, sepsis and multiple organ dysfunction, and the proportion of mechanical ventilation, CRRT, retroperitoneal puncture and surgical intervention required during hospitalization was greater, the lengths of ICU stay and total hospital stay were longer, and the mortality rate was higher. APACHEⅡ score, abdominal pressure and lactic acid were independent risk factors for HTG-SAP concurrent AKI, and the prediction model established based on these three factors had higher value in predicting HGT-SAP concurrent AKI

2.
Article in Chinese | WPRIM | ID: wpr-993264

ABSTRACT

Objective:To study the clinical effect of different application times of antibiotics in patients with hypertriglyceridemic severe acute pancreatitis(HTG-SAP).Methods:The clinical data of 92 patients with HTG-SAP who were treated at the Department of Critical Care Medicine of the Second Affiliated Hospital of Anhui Medical University from January 2016 to February 2022 were analyzed retrospectively. There were 65 males and 27 females, aged (40.82±10.55) years old. These patients were divided into three groups based on the time of prophylactic use of antibiotics: the early prevention group (used within 72 h after admission, n=39), the delayed prevention group (used after 72 h after admission, n=30) and the nonprevention group ( n=23). The clinical data such as the general data, length of stay and all cause mortality rate of the three groups of patients were analyzed. Results:Compared with patients in the nonprevention group, the incidence rate of pancreatic/peripancreatic infection [10.0%(3/30) vs. 39.1%(9/23)] and the incidence rate of bloodstream infection [6.7%(2/30) vs. 34.8%(8/23)] in the delayed prevention group were significantly decreased (pancreas/peripancreatic infection: χ 2=6.31, P=0.012; bloodstream infection: χ 2=6.72, P=0.010). The infection rate of multiple/pan resistant bacteria in the early prevention group [23.1%(9/39)] was significantly higher than the nonprevention group [4.3%(1/23)] (χ 2=4.49, P=0.034). There were no significant differences in the all cause mortality rate, length of stay, duration of intensive care, hospitalization cost, incidence of intestinal fistula and retroperitoneal hemorrhage, and the proportion of patients requiring surgery among the 3 groups (all P>0.05). Conclusions:Pophylactic use of antibiotics within 72 h of hospital admission significantly reduced the incidence of pancreatic/peripancreatic infection and bloodstream infection in patients with HTG-SAP. There were no significant differences in the final prognosis among these patients with HTG-SAP treated with antibiotics at different times.

3.
Article in Chinese | WPRIM | ID: wpr-406995

ABSTRACT

ObjectiveTo investigate risk factors for colorectal adenoma.Methods1260 subjects who received health check-ups were included.A questionnaire on life style was answered and anthropometric measurements including height, weight, waist circumference and blood pressure were taken.Fasting venous blood was obtained and fasting plasma glucose, total cholesterol, triglycerides(TG), highdensity lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured.Fatty liver was diagnosed by ultrasonography. Colonoscopy was performed on each subject. Categorical data were compared using Pearson's chi-squared test, and multivariate logistic regression analysis was used to estimate the strength of association between the colorectal adenoma and various factors. ResultsThe frequency of colorectal adenoma was significantly higher among males, older patients( ≥55 years), current smokers and subjects with less physical activity, abdominal obesity, fasting hyperglycemia or fatty liver (x2 =4.355, 11.549, 4.440, 4.608, 6.211, 4.510, 4.156, P<0. 05). Male sex (OR: 1.61,CI:1.13 -2. 57), old age (OR: 4.41,CI:3.32- 10.27)and abdominal obesity (OR: 1.75,CI:1.21 -2.86)were independent risk factors for colorectal adenoma. However, the frequency of colorectal adenoma was not different in subjects above 55 years old according to gender and abdominal obesity( x2 = 1. 139, 3. 413 ,P >0. 05 ). ConclusionsAbdominal obesity, old age and male sex were significantly associated with colorectal adenoma. However, the effect of abdominal obesity and male sex on the development of colorectal adenoma is less significant in subjects above 55 years of age. It is especially important for people under 55 years old to prevent colorectal adenoma by avoiding abdominal obesity.

4.
Article in Chinese | WPRIM | ID: wpr-388019

ABSTRACT

Objective To explore surgical management of bilateral thyroid papillary carcinoma. Methods The clinical data of 55 patients with bilateral thyroid papillary carcinoma were analyzed retrospectively. Among the 55 patients, total thyroidectomy was performed in 52 cases, total affected lobectomy plus isthmus and opposite near total lobectomy thyroidectomy was performed in 3 cases. Results Among the cases of bilateral functional neck lymph node dissection ,5 cases were all of bilateral neck lymph node metastasis, the positive rate was 100.0%(5/5);, among the cases of unilateral functional neck lymph node dissection,9 cases were found neck lymph node metastasis,the positive rate was 81.8%(9/11); among the cases of bilateral central region lymph node dissection, 1 case was of central region lymph node metastasis, the positive rate was 25.0% (1/4); among the cases of unilateral central region lymph node dissection, 14 cases were of central region lymph node metastasis, the positive rate was 66.7%(14/21). Fifty-three cases were tumor free survival, 2 cases accompanied distant metastasis also gained good effect Conclusions Total thyroidectomy should be performed for bilateral thyroid papillary carcinoma because of its characteristics of multiple tumors. It is considered that whether the neck lymph node dissection should be done depends on the stage of the tumor.

5.
Article in Chinese | WPRIM | ID: wpr-389191

ABSTRACT

Objective To clarify the expression of Tbx3 gene in breast cancer tissues and its clinical significance, and the expression of Tbx3 gene in different clinical pathological characteristic breast cancer. Methods Expression of Tbx3 gene in 53 specimens of breast cancer and 28 specimens of normal breast tissues were investigated by immunohistochemistry, analysing the clinical significance. Meanwhile the correlation of expression of Tbx3 gene in breast cancer classified was investigated by estrogen receptor ( ER),lymph node metastasis, Her-2 status. Results Positive rate of Tbx3 gene in breast cancer tissues was significantly higher than that in normal breast tissues [73.58% (39/53) vs 14.29% (4/28)] (P < 0.05).Positive rate of Tbx3 gene in ER positive breast cancer tissues was higher than that in ER negative breast cancer tissues [ 84.38% (27/32) vs 57.14% ( 12/21 ) ] (P < 0.05 ). Positive rate of Tbx3 gene in breast cancer tissues with lymph node metastasis was higher than that in breast cancer tissues without lymph node metastasis [86.21%(25/29) vs 58.33% (14/24) ] (P < 0.05). Positive rate of Tbx3 gene in Her-2 positive breast cancer tissues was higher than that in Her-2 negative breast cancer tissues[ 93.75%(15/16) vs 64.86% (24/37) ] (P < 0.05). Conclusions Tbx3 gene is over expressed in breast cancer tissues. It is related to ER, lymph node metastasis, Her-2 status.

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