Establishment of a modified BISAP scoring system and its clinical significance in the early diagnosis and prognostic evaluation of severe acute pancreatitis / 临床肝胆病杂志

ObjectiveTo establish a modified BISAP scoring system， and to investigate the value of the BISAP scoring system versus the modified BISAP scoring system in assessing the severity and condition of acute pancreatitis （AP）. MethodsFor the establishment of the new scoring system， a retrospective analysis was performed for the clinical data of 1 033 patients with AP who were admitted to Third Xiangya hospital of central South University from January 2019 to December 2021， and according to the revised Atlanta classification， they were divided into mild acute pancreatitis （MAP） group with 827 patients and severe acute pancreatitis （SAP） group with 206 patients. The two groups were compared in terms of clinical features， laboratory markers， and imaging data. A binary logistic regression analysis was performed for the statistically significant indicators to screen for the independent risk factors for SAP. The receiver operating characteristic （ROC） curve was used to obtain the optimal cut－off value corresponding to the maximum Youden index for each independent risk factor， and a score of 0 or 1 was assigned depending on different situations， which was integrated into the BISAP scoring system to establish a modified BISAP scoring system. For the validation of the new scoring system， a retrospective analysis was performed for the clinical data of 473 patients with AP who were admitted to Third Xiangya hospital of central South University from January 2017 to December 2018. BISAP score and modified BISAP score were determined for each patient， and the area under the ROC curve （AUC） was used to compare the value of the two scoring systems in predicting the severity and prognosis of AP. The chi－square test or the Fisher’s exact test was used for comparison of categorical data between two groups， and the independent－samples t test and the Mann－Whitney U test were used for comparison of continuous data between two groups. ResultsFor the establishment of the new scoring system， there were significant differences between the MAP group and the SAP group in mode of admission， length of hospital stay， ICU admission rate， number of deaths， underlying diseases， and incidence rate of complications （all P<0.05）. The binary logistic regression analysis showed that body temperature， neutrophil－to－lymphocyte ratio （NLR）， C－reactive protein （CRP）， albumin， triglycerides， D－dimer， fibrinogen， and MCTSI score were independent risk factors for SAP （all P<0.05）. The ROC curve analysis showed that CRP （AUC=0.921）， NLR （AUC=0.798）， D－dimer （AUC=0.768）， and MCTSI score （AUC=0.931） had a good predictive value for SAP， and the combination of these four indicators had an AUC of 0.976 and showed a significantly higher diagnostic efficiency than each indicator alone or the combination of two or three indicators （all P<0.05）. For the validation of the new scoring system， a total of 473 patients were enrolled， with 408 in the MAP group and 65 in the SAP group， and there were significant differences between the two groups in mode of admission， length of hospital stay， ICU admission rate， number of deaths， and incidence rate of complications （all P<0.05）. The modified BISAP score was better than the BISAP score in predicting SAP （AUC： 0.972 vs 0.887， P<0.05）， with an optimal cut－off value of >3 points. The modified BISAP score also had a relatively high value in predicting the mortality of AP patients （AUC=0.910）， but there was no significant difference between the modified BISAP score and the BISAP scoring system （AUC： 0.910 vs 0.896， P=0.707）. ConclusionThe modified BISAP score is better than the BISAP score in predicting the severity of AP and has a relatively high value in predicting the mortality of AP patients， giving a more accurate， objective， and early assessment of the condition of AP patients.

The diagnosis value of TNF-α ,IL-6 and NSE in cerebrospinal fluid of children with central nervous system infection / 国际检验医学杂志

Objective To explore the diagnostic value of tumor necrosis factor-alpha (TNF-α) , interleukin-6 (IL-6) and neuron enolase (NSE) in the cerebrospinal fluid of children with central nervous sys-tem infection (CNSI).Methods 54 cases of CNSI hospitalized children ,admitted in the hospital from October 2015 to January 2017 ,were enrolled in the study and divided into viral meningitis group (30 cases) and suppu-rative meningitis group (24 cases).Another 20 cases who underwent cerebrospinal fluid examination and other related examinations were enrolled in the study as the control group.The levels of three biomarkers TNF-α , IL-6 and NSE in cerebrospinal fluid of three groups were detected by enzyme linked immunosorbent assay (ELISA).Results The levels of TNF-α ,IL-6 and NSE in purulent meningitis group were the hightest ,and the levels of these three factors in viral meningitis group were highter than the control group ,and the differ-ence was statistically significant in three groups (P＜0.05).But there were a lot of data overlaps.There was no significant difference in the levels of TNF-α ,IL-6 and NSE between the brain group and the control group (P＞0.05).Conclusion The detection of TNF-α ,IL-6 and NSE in cerebrospinal fluid has a certain clinical val-ue for the diagnosis of CNSI ,but it needs to be further verified by a large sample clinical trial.

Application of endorectal elastography to evaluate local advanced rectal cancer after neoadjuvant radiochemotherapy:compared with pathology / 中华超声影像学杂志

Objective To evaluate the value of endorectal elastography with strain ratio to estimate local advanced rectal cancer after neoadjuvant radiochemotherapy.Methods In a retrospective study, endorectal ultrasound,endorectal elastography and enhanced rectal MRI were performed in 67 patients with local advanced rectal cancer after neoadjuvant radiochemotherapy.The imaging results were compared with postoperative pathological T stage and NCCN TRG.Results There was no significant difference in the diagnosis accuracy between T stage of ERUS(55.2%)and MRI(56.7%).Endorectal elastography results showed lesions confined to the rectal wall(T0-2 stage)were softer than lesions invaded the peripheral fat (T3)and the difference was statistically significant(P <0.05).When the cut-off point was set at SR<2.78,the sensitivity,specificity and accuracy of diagnosis of T0-2 were 64.7%,87.5% and 70.1% respectively.The lesion tended to have a greater SR value when residual tumor components increased(a higher NCCN TRG).Conclusions Endorectal elastography is an useful and effective imaging method to evaluate local advanced rectal cancer after neoadj uvant radiochemotherapy.It can help ERUS and rectal MRI to evaluate the lesions.

A STEPWISE REGRESSION ANALYSIS FOR BODY DENSITY AND FAT ON ANTHROPOMETRIC MEASUREMENTS OF CHINESE MALES / 营养学报

Body composition by body voluraetry (water displacement), height, body weight, 5 skinfolds thickness and circumference of 6 body parts were measured in 101 Chinese men. A stepwise regression analysis of these data gave the following regression equations.Body density = 1.11197 - 0.00228S1 - 0.00046S2 - 0.00039S3-Fat(%)= 0.91137S1 + 0.17871S2 + 0.15381S3 - 3.60146S1. S2 and S3 represent the skinfolds thickness of tricepital, subscapular, and suprailiac respectively.Lean body weight = Body weight. (1-Fat%)

EFFECTS OF DIETARY ZINC ON EXPERIMENTAL BURNS IN RABBITS / 营养学报

We report herein the effects of varying dietary zinc contents on burns healing in 15% body surface area (BSA) Ⅲ? burned Lop rabbits. 18 adult male rabbits were given a low zinc diet for two weeks, resulting in a decrease of serum zinc concentration which further decreased postburn without restoration. On the contrary, serum was restored rapidly to normal levels in the zinc supplemented groups. Similar changes were found in serum alkaline phosphatase (AKP) activity, and there was a close relationship between serum zinc and serum AKP activity. Burns healing in the high zinc group was markedly faster than that in the low zinc group. These results strongly suggested that zinc might be a factor benefiting burns healing. We concluded that serum AKP activity could be used as a diagnostic criterion of postburn hypozincemia as well as a valid index in the assessment of the effectiveness of supplemented zinc.

EFFECTS OF SQUALENE, ALGAE, LAVER ANDCAULIFLOWER ON SERUM T-C, HDL-C,LDL-C AND VLDL-C IN RATS / 营养学报

Effects of squalene, algae (Enteromorpha prolifera), laver (Prophyra hai-tanensis) and cauliflower on serum total cholesterol (T-C), high density li-poprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) were separatly observed in Wistar male albino rats fed on a diet containing 0.5% cholesterol,5% lard and 0.5% bile salt. Squalene was supplemented at 5% of the diet, and algae, laver, cauliflower at 10% of the diet.After the rats had been fed on the diet described above for 30 days, serum T-C, HDL-C, LDL-C and VLDL-C levels were determined. The results showed that the rats fed on a diet containing 5% squalene or 10% algae were significantly lower in serum T-C, HDL-C and VLDL-C but higher in serum HDL-C than those of the controls, and the rats fed on a diet containing 10% laver or 10% cauliflower were significantly lower in serum T-C than that of the controls.

NUTRITION STUDIES OF HUMANS DURING A HELIUM-OXYGEN DIVE TO A SIMULATED DEPTH OF 200M / 营养学报

Nutrition studies were made on four divers performing a helium-oxygen saturation dive to a simulated depth of 200m in a hyperbaric chamber for about seven days. Daily intake of food was surveyed by regular weighing method and its calories and nutrients were calculated from Chinese food composition table. Fasting blood and 24h urine samples were collected on several occasions before, during and after the dive for estimation of free amino acid, nitrogen and minerals. Vitamin load test was conducted for evaluation of vitamin status. The results showed that during the dive intakes of cereal, meat and oil of divers were decreased, but vegetable, fruit and beverage intakes increased. An average body weight loss of 1.75 kg was found after a 7-day period, but little changes in the body fat. Free amino acid levels of serum and urinary output were reduced, especially the essential amino acids. The urinary excretion of minerals was in an acceptable range, but thiamin decreased markedly and not returned to an acceptable range until 10 days after leaving the hyperbaric chamber.