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Objective:To investigate the value of modified early warning score (MEWS) combined with D-dimer test in the establishment of an acute pancreatitis severity evaluation model.Methods:The clinical data of 357 patients with acute pancreatitis who received treatment in the Second Affiliated Hospital of Anhui Medical University, China between January 2017 and December 2018 were collected for this study. The receiver operating characteristic curve was used to determine the optimal cut-off value of MEWS combined with D-dimer test for predicting non-mild acute pancreatitis. The relationship between MEWS and D-dimer level was analyzed using regression analysis. The area under the curve (AUC) was used to evaluate the ability of each factor to predict the severity of acute pancreatitis. The sensitivity and specificity of the new model to predict non-mild acute pancreatitis were calculated.Results:According to the receiver operating characteristic curve, the AUC of D-dimer, MEWS, and new model were 0.702, 0.628 and 0.734 respectively ( P < 0.05). The AUC of the new model in predicting non-mild acute pancreatitis was significantly higher than that of MEWS and D-dimer test (0.734 > 0.702 > 0.628, Z = 3.20, P < 0.01). Conclusion:The ability of the new model established based on MEWS and D-dimer to predict the severity of acute pancreatitis is stronger than that of each of MEWS and D-dimer. The new model is simple, convenient and more suitable for clinical use.
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4 holding time were observed among the three groups.After repeated doses,the PMs showed a significantly higher intragastric pH value than that of the homEMs or hetEMs.Conclusion The pharmacodynamic effects of omeprazole and its pharmacokinetics depend on the CYP2C19 genotype status in Chinese volunteers.
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Objective To evaluate the diagnostic accuracy of drug-induced liver injury over a 10-year period . Methods The 112 cases of drug-induced liver injury were retrospectively studied. Inter-national consensus criteria were applied to assess the causality of suspected drug hepatotoxicity,in which the chronological criteria and elimination of other causes were analysed. Results Among 1127 adult inpatients with acute hepatitis over 10-year period, 112 patients(10%) were recorded as drug-induced liver injury. Based on the causality assessment of 112 cases, either incompatible time to apparent onset of the reaction or incompatible course of the reaction was found in 60 cases(53.6%) and 20 cases(17.9%), respectively. The presence of other possible causes for the reaction was found in 34 patients (37.5%). Therefore, 26 cases(23.2%) of liver injury were related to the incriminated drug, 25 cases(22.3%) unrelated,61(54.5%) were considered to indeterminate cause. Conclusions The international consensus criteria were helpful to identify drug-related or unrelated liver injury, but more than half of reported hepatic adverse drug reactions are still in suspected condition. The current diagnostic methods for drug-induced liver injury are needed to be revised in clinical practice.