RESUMEN
Objective To evaluate the efifcacy and safety of endoscopic submucosal dissection in treatment of prolapse of gastric mucosa.Methods to meet the typical gastric mucosal prolapse of gastric mucosa under endoscopy, the ultrasonic gastroscopy confirmed that the lesion was in the mucosal layer, and the disease was excluded. After PPI continuous treatment for 3 months, no signiifcant improvement in symptoms, in patients with informed consent under the premise of endoscopic mucosal stripping. After 3 months of the operation return visit section for outpatients re-examination of gastroscopy.Results 10 cases of complications of endoscopic submucosal dissection of gastric mucosa prolapse patients had no hemorrhage, perforation after operation, postoperative patients were followed up for 3 months, the symptoms were improved obviously, no antral mucosal prolapse was observed under endoscope.Conclusion Endoscopic submucosal dissection is effective and safe in treatment of gastric mucosal prolapse.
RESUMEN
Objective To investigate the correlation between 28-day prognosis and red cell distribution width (RDW) in sepsis patients.Methods This was a prospective observational study.Two hundred and thirteen sepsis patients were consecutively selected,and the patients were divided into 2 groups according to RDW:normal RDW group (RDW ＜ 0.15,160 cases) and high RDW group (RDW≥0.15,53 cases).The general conditions,acute physiology and chronic health evaluation (APACHE) 1Ⅱ score,sequential organ failure assessment (SOFA),hypersensitive C reactive protein (hs-CRP),procalcitonin (PCT),arterial blood lactic acid,liver function injury,renal function injury and 28-day mortality were compared between 2 groups.The independent risk factors of 28-day prognosis were analyzed by multifactor Logistic regression analysis.Kaplan-Meier survival analysis was used to draw the 28-day survival curve,and the survival rate was compared between 2 groups by log-rank test.Results The 28-day mortality in high RDW group (35.8％,19/53) was significantly higher than that in normal RDW group (17.5％,28/160),and there was statistical difference (P =0.007).RDW ≥0.15 was the independent risk factor of 28-day death in sepsis patients (OR =2.634,95％ CI 1.316-5.273,P =0.006).After adjusted by gender,age and other relative factors,RDW≥0.15 was the independent risk factor of 28-day death in sepsis patients (OR =2.895,95％ CI 1.155-7.252,P =0.023).The 28-day accumulative survival rate in high RDW group was significantly lower than that in normal RDW group (50.5％ vs.63.0％),and there was statistical difference (P =0.014).Conclusion The high RDW in sepsis patients is the independent risk factor of 28-day death,and RDW ≥0.15 shows an important predictive value in the prognosis of sepsis patients.
RESUMEN
Objective To investigate the prognostic value of red cell distribution width (RDW) and relationship between RDW and severity of critical illness patients and prognostic role of RDW.Methods This was a prospective observational and diagnostic test study.From February 2011 to May 2013,196 medical patients in ICU were enrolled to study.Blood samples were taken within 24 hrs after admission to ICU for blood routine test and other chemical routine test,including RDW.Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score were also calculated.The patients were divided into survival group (n =126) and death group (n =70) based on their hospital outcomes.Differences in RDW levels and APACHE Ⅱ score between survival and death groups were compared with One-way ANOVA.The correlation between RDW and APACHE Ⅱ score were analyzed by Spearman correlation test.Receiver operator curve (ROC) test was used to determine the predictive value of RDW and APACHE Ⅱ for hospital death.Results Both RDW level and APACHE Ⅱ score were significantly higher in death group than those in survival group,whichwere (13.35 ±2.21) vs.(11.34 ±1.32) and (20.43 ±6.41) vs.(13.94 ±6.77) respectively (both P ＜ 0.01).RDW significantly correlated with APACHE Ⅱ score (r =0.309,P ＜0.01).To predict hospital death area under curve (AUC) of ROC curve by RDW and APACHE Ⅱ score were 0.792 (0.725,0.860) and 0.754 (0.686,0.822) respectively.The best cut-off value was determined by Yoden Index were 12.35 for RDW and 17.5 for APACHE Ⅱ score.The Accuracy of prediction was 76.5％ and 70.4％ respectively.In addition,all the 12 paticnts whose RDW level ＞ 15.4 were dead.Conclusion RDW level at admission to ICU correlate well with the severity of critical illness.RDW level has an additional predictive value for the prognosis of critical ill patients.