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Objective@#To analyze the influencing factors of hospitalization cost by back propagation(BP)neural network.@*Methods@#Inpatients with a total of 50 611 were collected from the hospital information system in a tertiary hospital. BP Neural network modeling was developed by SPSS 22.0 software to study the factors which influence the hospitalization cost.@*Results@#The hospitalization expenses prediction accuracies of training sample and test sample were 81.1% and 79.0% respectively. The top three factors were pharmaceutical cost(100.0%), general medical operation cost(88.8%)and disposable medical materials cost(60.7%).@*Conclusions@#The results show that BP model is suitable for dependent variable with the hospitalization expenses. The pharmaceutical cost, disposable medical materials cost and general medical operation cost were greater influencing factors than others. We should take actions by improving the treatment level and measures, so as to reduce the economic burden of patients and society
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Objective To investigate the dynamic changes in peripheral blood of patients with acute pancreatitis α-MSH,TNF-α,PCTS and the value of the patient assessment of disease severity.Methods Emergency surgery in the Second Affiliated Hospital of Anhui Medical University from March 2011 to March 2014 were treated 68 cases of acute pancreatitis patients,36 patients with mild,32 cases of severe group.All patients were extracted 1,3,5,7 days after admission blood,and α-MSH was measured by enzymelinked immunosorbent assay,the content of TNF-αand PCT.Results Compared with the mild group,the serum of patients with severe group of α-MSH concentrations were lower (P ＜ 0.05),while serum TNF-αand PCT levels higher than the mild group (P ＜ 0.05);in disease severity assessment,α-MSH sensitivity of 82.35％ and a specificity of 88.24％,the accuracy was 87.5％,TNF-α sensitivity of 76.47％ and a specificity of 82.35％,the accuracy was 81.25％,PCT sensitivity of 70.59％ and a specificity of 76.47％,75.00％ accuracy,PCT + TNF-α + α-MSH sensitivity of 88.24％ and a specificity of 94.12％,93.75％ accuracy;area under the PCT,TNF-α,α-MSH and the combination of the three curves 0.690,0.696,0.768 and 0.885,respectively.Conclusions Serum α-MSH,monitoring TNF-α,PCT levels have some clinical value in patients with acute pancreatitis disease severity assessment,including α-MSH in the condition assessment of the sensitivity,specificity and positive predictive value were higher than the latter two,and peripheral α-MSH in patients with a low level indicates a serious condition,poor prognosis;addition,combined detection with higher clinical value in the assessment of disease severity.
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Objective To study the change of serum diamine oxidase (DAO) level in patients with severely acute pancreatitis (SAP) in order to explore the role of DAO in assessing the severity of SAP and the magnitude of gastrointestinal dysfunction.Methods From January 2012 through December 2013,56 SAP patients with 33 male and 23 female and average age (45-± 14) years admitted within 3 days after onset were enrolled for this study.At admission,serum diamine oxidase (DAO) was detected,and APACHE Ⅱ score,computed tomography severity index (CTSI) score and Balthazar grading and gastrointestinal dysfunction score were calculated.And at the corresponding time,serum procalcitonin (PCT) was detected.The correlations between serum DAO level and 4 other markers were analyzed.Results The high level of serum DAO was found at admission in SAP patients correlating positively with serum PCT concentrations (r =0.516,P＜ 0.01),APACHE Ⅱ score (r =0.631,P＜ 0.01),CTIS score (r=0.640,P ＜ 0.01),and the degree of gastrointestinal dysfunction (r =0.730,P ＜ 0.01).Conclusions The role of serum DAO in assessing the severity of SAP and magnitude of gastrointestinal dysfunction in SAP patients is really valid.
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Invasion and metastasis are critical determinants on cancer morbidity.Genes and molecules participating in these steps have been demonstrated as potential prognostic factors.Growth factors and their receptors,cell-cycle regulators,cell-adhesion molecules and m trix-degrading enzymes are potentially used as prognostic factors.However,increased understandings for molecular mechanisms underlying carcinogenesis and its implementation in the treatment of gastric cancers have recently been focused on the development and incorporation of targeted agents with chemotherapy.
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ObjectiveTo investigate the values of C-reactive protein (CRP) and pleural effusion in predicting the severity in the early stage of severe acute pancreatitis (SAP) . Methods A total of 89patients with acute pancreatitis were collected from October 2008 through October 2010 for retrospective analysis. Patients were divided into two groups, namely mild acute pancreatitis (MAP) group and SAP group as per the Guidelines for Clinical Diagnosis and Classification of Acute Pancreatitis set by the Society of Chinese Medical Association in 2003. The levels of CRP were measured on the 1st, 2nd, 3rd and 7th days after admission. Pleural effusion was also observed on the 1 st day after admission. The data of two groups were analyzed and compared. ResultsThere were significant differences in CRP at all intervals between SAP group and MAP group (P ＜0.05) . The relative risk of increase in CRP ( ＞ 150 mg/L),pleural effusion and increase in CRP along with pleural effusion were analyzed, and each of these three markers can be used as an independent severity factor of SAP. Particularly, increase in CRP along with pleural effusion could be most sensitive in predicting the severity of SAP with relative risk (RR) to be 4. 8 and specificity of predictive value to be 100％. ConclusionsC-reactive protein and pleural effusion are available, simple and economic biomarkers which can help us predict the risk of acute pancreatitis in the early stage.
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OBJECTIVE To investigate the clinical characteristic and counter measure of nosocomial infection in puerperal women.METHODS The data of nosocomial infection in puerperal women from Jan 2004 to Dec 2007 were analyzed.RESULTS Among all puerperal women,169 (1.12%) were infected,from them 96 cases were infected in respiratory tract(56.80%);28 cases in operative incisional wound(16.57%);17 cases in gastrointestinal tract(10.06%);7 cases in urinary tract(4.14%);and 3 vases in cavity of uterus(1.78%).CONCLUSIONS Puerperal women are high risk group of nosocomial infection because of strength depletion,blood loss and perinatal injury.Paying attention to aseptic manipulation,making the rational use of antimicrobial agents and properly nursing can effectively decrease the incidence of nosocomial infection.
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Objective To improve the level of diagnosis and treatment of hilar cholangiocarcinoma by investgating it′s clinical characteristics.Methods The clinical data of 98 patients with hilar cholangiocarcinoma were analyzed retrospectively.Results According to the Bismuth-Corlitte grouping: typeⅠ,8 cases;typeⅡ,19 cases;type Ⅲ,17 cases;type Ⅲb,14 cases;and type Ⅳ,40 cases.Radical resection(49),palliative operation(12),endoscopic retrograde biliary drainage(16),and PTCD(5) were performed The median survival time of radical resection group was 28.6 months and the survival rate at 1,2,3,and 5 years was 74.2%,65.3%,37.5%,and 3.9% respectively,while the median survival time of palliative operation group was 17.6 months and the survival rate at 1,2,3,and 5 years was 71.7%,26.8%,8.9%,and 0% respectively.The median survival time of endoscopic retrograde biliary drainage group was 4.5 months and the survival rate at 1,2,3,and 5 years was 21%,13%,and 0% respectively.Conclusions Early diagnosis by adjunctive examinations is vital to treatment of hilar cholangiocarcinoma.Radical resection is the sole procedure to improve the outcome and prognosis of hilar cholangiocarcinoma.Multiple therapeutic methods should be adopted and should be individualized.
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Objective To investigate the level changes of plasma insulin,serum lipids in type 2 diabetes with cholelithiasis.Methods 159 cases of types 2 diabetic patients was studied during recently 3 years in our department of endocrinology,the levels of blood glucose,plasma insulin and insulin sensitivity index(ISI),serum lipids,apolipoproteins(ApoA 1,B) were measured both fasting and post-prandial,and investigated their correlation between type 2 diabetic patients with cholelithiasis(n=103) and without cholelithiasis(n=56).Results Female was predominated in fifty-six diabetic with cholelithiasis,they had higher triglyceride(TG),fasting or post-prandial insulins,ApoA 1,ApoB,the top body weight index and lower ISI than 103 diabetics without cholelithiasis.There were no significant differences in total cholesterol(CH),HDL-Ch,LDL-Ch,blood glucose concentrations between the groups.Conclusions Obesity,insulin resistance and lipids metabolic disturbance might be related to the development of cholelithiasis in type 2 diabetic patients.