Interaction effect and predictive efficacy of blood glucose and blood calcium on the prognosis of patients with acute severe pancreatitis / 中国临床药理学与治疗学

AIM: To investigate the interactive effects of blood glucose and blood calcium on the prognostic impact of patients with acute severe pancreatitis (SAP) and to analyze their predictive efficacy on prognosis. METHODS: One hundred and seven patients with SAP admitted to our hospital from September 2019 to October 2022 were selected for the study and were divided into poor and good groups according to their prognosis within 28 d. The blood glucose, blood calcium, modified Marshall score, bedside acute pancreatitis severity score (BISAP) were compared between the two groups before treatment, after 3 d of treatment, and after 7 d of treatment, and the correlation between blood glucose, blood calcium and modified Marshall score and BISAP score was analyzed. The blood glucose levels of patients with different blood calcium were compared. Cox regression was used to analyze the factors associated with prognosis. The presence and type of interaction between blood glucose and blood calcium on prognosis were analyzed using the interaction coefficient γ and relative risk (RR) values. The subject operating characteristic curve (ROC) was used to analyze the predictive efficacy of blood glucose and blood calcium on prognosis. RESULTS: The blood glucose, modified Marshall score, and BISAP score of the adverse group after treatment were higher than those of the good group, while the blood calcium was lower than that of the good group (P<0.05). After 3 and 7 days of treatment, blood glucose was positively correlated with improved Marshall score and BISAP score (P<0.05). The blood glucose level in patients with decreased blood calcium was higher than that in patients with normal blood calcium (P<0.05). The decrease of blood calcium had positive interaction with the increase of blood glucose (P<0.05). After 3 and 7 days of treatment, the AUC of blood glucose combined with blood calcium was greater than that predicted by single index (P< 0.05). CONCLUSION: Blood glucose and blood calcium are related to the severity of the disease in SAP patients. There is an interaction between blood glucose and blood calcium in predicting the prognosis of SAP patients. The combined detection of blood glucose and blood calcium has a certain predictive effect on the prognosis of SAP patients.

Clinical effect analysis of oral calcitriol and calcium in the treatment of infantile rickets / 中国现代医生

Objective To investigate the clinical effect of oral calcitriol and calcium in the treatment of infantile rickets. Methods A total of 84 children with pediatric rickets treated in the department of pediatrics of our hospital from June 2017 to June 2018 were randomly divided into two groups. The control group received conventional oral vitamin D drops and calcium acetate. The observation group received oral calcitriol combined with calcium acetate. The clinical efficacy, blood biochemical changes, bone mineral density changes, height and body weight changes were compared between the two groups. Results The effective rate of the observation group was 97.62％, which was significantly higher than that of the control group (78.57％), and the difference was statistically significant (P<0.05). The blood calcium, blood phosphorus and 25-(OH) D3 in the observation group after treatment were significantly higher those in the control group.The BALP in the observation group was significantly lower than that of the control group, and the difference was statistically significant (P<0.05). The tibia, ulnar salt level and bone mineral density were significantly higher in the observation group than those in the control group (P<0.05). The height growth and body mass growth of the observation group after treat ment were significantly higher than those of the control group. The incidences of night terror, sweating, and baldness were significantly lower than those of the control group, and the difference was statistically significant (P<0.05).Conclusion Oral calcitriol and calcium are effective in treating children with rickets, which effectively improve blood calcium level and bone density, promote growth and development of children, reduce the incidence of clinical symptoms, and have positive clinical significance.

Abnormal bone mineral density in health checkup population with subclinical thyroid dysfunction / 中华健康管理学杂志

Objective To investigate the relationship between abnormal bone mineral density (BMD) and subclinical thyroid dysfunction. Methods Thyroid function, biochemical indicators of bone metabolism and BMD were reviewed retrospectively in the subjects who received health checkups from July 1, 2009 to January 31, 2017 in the Health Check-up Department of Peking Union Medical College Hospital. People who had thyroid dysfunction, recognized risk factors for osteoporosis, and medication history were excluded. A cross-sectional analysis of thyroid status and biochemical indicators of bone metabolism was performed by the standard methods. BMD at the lumbar spine and femoral neck was measured using dual energy X-ray absorptiometry. Results A total of 6884 subjects (3726 women and 3158 men) were enrolled in the study, with an average age of (50.74 ± 10.41) years. They were divided into three groups:subclinical hyperthyroid, subclinical hypothyroid, and euthyroidism. The alkaline phosphatase in subclinical hyperthyroid group was higher than that in the euthyroidism group[ (67.95±20.64)U/L vs. (63.88±18.99)U/L]. Calcium and phosphorus in blood were higher in both subclinical hyperthyroid and subclinical hypothyroid groups. The rate of abnormal BMD in male euthyroidism, subclinical hyperthyroid and subclinical hypothyroid groups were 36.10％(1049/2906), 29.27％(12/41) and 27.01％(57/211), respectively. The rate of abnormal BMD showed no difference between subclinical hyperthyroid group and euthyroidism group (P>0.05). The rate of abnormal BMD was lower in subclinical hypothyroid group than in euthyroidism group (χ2=7.0901, P0.05). Conclusion There is no significant difference in the rate of abnormal BMD between subclinical thyroid dysfunction group and euthyroidism group, possibly because abnormal serum biochemical indicators preceded the presence of low BMD. More sensitive methods used to determine the status of bone metabolism await to be developed.

The effects of senile osteoporosis on fracture healing / 中国综合临床

Objective To explore the fraction risk in patients with osteoporosis and effects of antiosteoporosis therapy on fracture healing.Methods All the recruited subjects were senile patients with fracture in lower extremity and were treated in the Department of Orthopaedics in Shandong Qianfoshan Hospital from Aug.2006 to Feb.2011.In the total 15 cases,10 were female and 5 were male,aged from 53 to 65 years (average 56.7 years old).After surgical reduction and internal fixation,all the 15 patients did free-weight and continous passive motion (CPM) functional exercise and received anti-osteoporosis treatment.X-ray was taken to show the preoperative and postoperative lumbar vertebrae and fracture position.Meanwhile,bone mineral density and blood calcium level and phosphate level were measured.Results Thirteen out of 15 patients were healed for bone fracture after a 3-month treatment,meeting the clinical standards of the fracture healing.The clinical fracture healing rate was 86.67％.Blood calcium level,phosphate level and the bone mineral density were significantly different between that before and after the treatment ( P ＜ 0.05 ).Conclusion Osteoporosis not only increases the risk of fracture,but also has an adverse effect on the bone healing.Anti-osteoporosis therapy has a positive role to the fracture healing in the senile patients with osteoporosis.

Study on prediction of pre-eclampsia by measuring ?-HCG, blood calcium, hematocrit and mean arterial pressure / 中国医师进修杂志

Objective To investigate the clinical viability of pre-eclampsia by measuring the level of ?-HCG in blood,blood calcium,hematocrit(HCT)and the mean arterial blood pressure(mABP).The preventive value of calcium supplement was also evaluated. Methods 356 volunteers'(16th～20th gestational weeks)were measured ?-HCG in blood,blood calcium,HCT,meanwhile mABP from the same patients.If blood ?-HCG≥50 632 IU/L,blood calcium≤2.18 mmol/L,HCT≥0.35 and mABP≥85 mm Hg(1 mm Hg=0.133 kPa),a positive conclusion was made.Women with positive results were randomly divided into test group and control group. Results 71 cases turned out to be positive in this serial test.The positive predictive value was 81.82%,negative predictive value was(97.30%),the sensitivity and specificity were 84.38% and 96.77% respectively.In the study group,the incidence of pre-eclampsia was significantly decreased as compared with the control group(P

The variation of blood phosphorus and blood calcium level in patients with chronic renal failure

Blood levels of phosphorus and calcium were quantified in 151 subjects including 30 healthy subjects in control group, and 121 patients of chronical kidney failure of the stage I-IV and the age ranged from 18 to 50. Results demonstrated a reduce of kidney failure of the stage I-II in comparing with control, leading to secondary hyperparathyroid and a hypertrophy of parathyroid gland. The more kidney failure, the higher level of blood calcium, this is an important factor of dystrophy of bone in the patient