C-reactive protein/lymphocyte ratio as a prognostic biomarker in acute pancreatitis: a cross-sectional study assessing disease severity.

BACKGROUND: The C-reactive protein/lymphocyte ratio (CLR) is a prognostic biomarker of various diseases. However, its significance in acute pancreatitis (AP) remains unknown. The main aim of this study was to investigate the association between the CLR and disease severity in patients with AP. METHODS: This cross-sectional study included 476 AP patients [mild acute pancreatitis (MAP), n =176; moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP), n =300]. The primary exposure of interest was the baseline CLR. The primary outcome was the incidence of moderate to severe AP. Multivariate logistic regression and restricted cubic spline analyses were performed to evaluate the association between the CLR and the incidence of moderate to severe AP. Receiver operating characteristic (ROC) analysis was conducted to assess the predictive efficacy, sensitivity, and specificity of CLR in predicting the incidence of moderate to severe AP. RESULTS: The mean age of the patients was 44±13.2 years, and 76.5% were male. The distribution of CLR was 31.6 (interquartile range, 4.5, 101.7). Moderate to severe AP occurred in 300 cases (63.0%). After multiple adjustments, CLR was independently associated with the incidence of moderate to severe AP (odds ratio, 1.04; 95% CI: 1.03-1.05; P < 0.001). A nonlinear relationship was found between CLR and the incidence of moderate to severe AP, with a threshold of approximately 45. The effect size and CI below and above the threshold value were 1.061 (1.033-1.089) and 1.014 (0.997-1.031), respectively. The area under the curve (AUC) for CLR was 87.577% (95% CI: 84.443- 90.710%) with an optimal cut-off value of 30.835, resulting in a sensitivity of 73.7% and a specificity of 88.6%. CONCLUSIONS: There was a nonlinear relationship with a saturation effect between the CLR and the incidence of moderate to severe AP. The CLR measured within 24 h of admission may serve as a promising biomarker for predicting the emergence of moderate to severe AP, thereby providing a more scientifically grounded basis for preventing such cases. Nonetheless, further research is warranted to validate and strengthen these findings.

Analysis of Prognostic Risk Factors of Endoscopic Submucosal Dissection (ESD) and Curative Resection of Gastrointestinal Neuroendocrine Neoplasms.

Objective: To explore the prognostic risk factors of ESD curative resection of gastrointestinal-neuroendocrine neoplasms (GI-NENs). Methods: A total of 97 patients treated with ESD successfully in our hospital were selected, their surgical site, size, number of resection lesions, operation time, intraoperative complications (such as bleeding and perforation), and treatment status were recorded, and the number of hemostatic clamps used after the postoperative follow-up results and the independent risk factors for ESD complications were obtained through the comparison between the noncomplication group and the ESD complication group using regression analysis. Results: A total of 97 patients with gastrointestinal neuroendocrine tumors were treated with ESD. 61 were males, 36 were females, the ratio of male to female was 1.7 : 1, onset age was 20-78 years old, and median onset age was 50 years old. In 81 cases, tumors were located in the stomach, 10 in the duodenum, and 6 in the rectum. A total of 103 lesions were detected by endoscopy, including 1 case with 2 sites in the stomach, 5 cases with 2 sites in the rectum, and the rest were single. The tumor diameter was 0.3 ∼ 2.5 cm, and the median diameter was 0.6 cm; there were 25 sites with a diameter less than 5 cm. There were 57 places with 10 mm, 16 places with 10-15 mm, and 5 places with >15 mm. All ESD operations were performed in one piece, with a total resection rate of 100%; 89.6% (60/67) of postoperative pathology showed negative basal, and 90.3% (56/62) showed negative resection margin, with a complete resection rate of 88.9% (48/54). ESD's operation time is 6 ∼ 66 min, and the median time is 18 min. During the operation, 5 cases had small amount of bleeding, 3 cases were perforated, 2 cases of delayed postoperative bleeding, 1 case of bleeding was caused by the patient's failure to follow the advice of the doctor to eat a large amount of solid food too early, and 1 case of delayed perforation (all recovered and discharged). ESD operation that bled, age, gender, and perforation location, pathological grade, pathological classification, tumor diameter, tumor surface, operation time, number of titanium clips, origin, echo uniformity, and echo level were statistically insignificant (P > 0.05). Postoperative bleeding was related to the operation time (P=0.017), but it was not an independent risk factor for postoperative bleeding (P=0.118; OR, 0.226; 95% CI, 0.035-1.461). 59 cases were followed up by endoscopy after the operation, and recurrence or no new tumors were found. Conclusion: ESD is an effective and safe treatment method for gastrointestinal neuroendocrine tumors with a diameter of 1-2 cm without invading the muscularis propria. The intraoperative complications seem to have little relationship with the patient; postoperative delayed bleeding is closely related to the ESD operation time but it is not an independent risk factor.

Intra-Articular Injection of PRP in the Treatment of Knee Osteoarthritis Using Big Data.

Observing data on the characteristics of intra-articular injection of sodium citrate for knee osteoarthritis is an important reference value for human safety and evacuation design. To address the problems of slow data collection and poor accuracy of results of knee osteoarthritis behavior, under intensive conditions of intra-articular injection for knee osteoarthritis, this paper designs a data mining-based feature extraction system for intra-articular injection of sodium citrate for knee osteoarthritis. Using the Hadoop architecture, we extract the basic data of human behavior in the two-dimensional plane by storing and stitching the collected continuous data and discriminate the behavioral categories of knee osteoarthritis. We collected a real dataset from 84 patients with knee osteoarthritis treated in our hospital from October 2019 to October 2020. The dataset was divided into 42 patients in the tretinoin group and 42 patients in the sodium glutamate group according to the randomized number table method. The trimethoprim group was treated with intra-articular injection of trimethoprim, and the sodium citrate group was treated with intra-articular injection of sodium citrate. The clinical efficacy, joint mobility, intra-articular fluid volume, Lysholm score of knee joint, numerical pain intensity scale (NRS) score, and adverse effects of the two groups were compared before and after treatment. In our experiments, we observed that, compared with triamcinolone acetonide intra-articular injection, sodium hyaluronate intra-articular injection is more effective in the treatment of knee osteoarthritis. It can effectively improve knee function and reduce pain and adverse reactions.

An Exploratory Study on the Treatment of Obstructive Apnea-Hypopnea Syndrome by Nasal Cavity Expansion.

Background: Respiratory disorder is a disease with a very high incidence, in which obstructive apnea-hypopnea syndrome is the most harmful. It has become a common and frequently occurring disease, which seriously influences the health of the affected population. The pathogenesis of obstructive sleep apnea/hypopnea syndrome (OSAHS) is numerous. With the continuous research on OSAHS disease, it has been found that one of its main pathogeneses is caused by the anatomical characteristics of upper airway obstruction induced during sleep. The narrowing and collapse of any plane can affect the ventilation of the upper respiratory tract. In recent years, with the deepening of research, the importance of the upper respiratory tract obstruction as a source of the disease has attracted increasing attention. Nasal stenosis can cause increased nasal resistance, increased pharyngeal inhalation negative pressure, soft palate collapse, and narrow pharyngeal cavity, resulting in open mouth breathing, which can be the initiating factor of the upper airway obstruction. With the development and popularization of nasal endoscopy technology, domestic and foreign scholars have reported more on the treatment of rhinogenic OSAHS with nasal cavity expansion, but they are different. There is still more controversy; the main controversy centered on the effective rate of surgical treatment and the improvement of objective indicators. Therefore, this study performed individualized nasal cavity expansion for patients with OSAHS who are mainly rhinogenic, from subjective symptoms, objective indicators, and effective rate of surgery. Methods and Patients. Conduct research and analysis to provide references for the clinical treatment of such patients. For patients with the obstructive apnea-hypopnea syndrome with nasal congestion, individualized nasal cavity expansion was performed to study the clinical effect of nasal cavity expansion in the treatment of OSAHS. This article mainly screens cases through big data and selects a large hospital in China to perform individualized nasal cavity expansion surgery to treat 43 adult OSAHS patients with nasal congestion. Results: There are uploaded sleep monitoring, nasal reflex, nasal resistance, and nasal symptoms before and after surgery. Conclusion: Spirometer examination records, along with apnea-hypopnea index and minimum arterial blood oxygen saturation, the minimum cross-sectional area of the nasal cavity, nasal cavity volume, nasal airway resistance, total nasal respiratory volume, and other information. Also we fill in the nasal obstruction symptom assessment scale, sleepiness scale, and study and analyze the surgical effect of nasal cavity expansion.

Ginsenoside Rg3 enhances the anticancer effect of 5­FU in colon cancer cells via the PI3K/AKT pathway.

Chemotherapy is one of the most commonly used treatments for patients with advanced colon cancer, yet the toxicity of chemotherapy agents, such as 5­fluorouracil (5­FU), limits the effectiveness of chemotherapy. Ginsenoside Rg3 (Rg3) is an active ingredient isolated from ginseng. Rg3 has been shown to display anticancer effects on a variety of malignancies. Yet, whether Rg3 synergizes the effect of 5­FU to inhibit the growth of human colon cancer remains unknown. The present study was designed to ascertain whether Rg3 is able to enhance the anti­colon cancer effect of 5­FU. The results revealed that combined treatment of Rg3 and 5­FU significantly enhanced the inhibition of the proliferation, colony formation, invasion and migration of human colon cancer cells (SW620 and LOVO) in vitro. We also found that combined treatment of Rg3 and 5­FU significantly enhanced the apoptosis of colon cancer cells by activating the Apaf1/caspase 9/caspase 3 pathway and arrested the cell cycle of the colon cancer cells in G0/G1 by promoting the expression of Cyclin D1, CDK2 and CDK4. In addition, the PI3K/AKT signaling pathway in colon cancer cells was suppressed by Rg3 and 5­FU. In vivo, Rg3 synergized the effect of 5­FU to inhibit the growth of human colon cancer xenografts in nude mice. Similarly, combined treatment of Rg3 and 5­FU altered the expression of colon cancer protein in vivo and in vitro. Collectively, the present study demonstrated that ginsenoside Rg3 enhances the anticancer effect of 5­FU in colon cancer cells via the PI3K/AKT pathway.

Molecular dynamics investigation of water-exchange reactions on lanthanide ions in water/1-ethyl-3-methylimidazolium trifluoromethylsufate ([EMIm][OTf]).

We report a kinetic study of the water exchange on lanthanide ions in water/[1-ethyl-3-methylimidazolium][trifluoromethylsufate] (water/[EMIm][OTf]). The results from 17O-NMR measurements show that the water-exchange rates in water/[EMIm][OTf] increase with decreasing size of the lanthanide ions. This trend for water-exchange is similar to the previously reported trend in water/1-ethyl-3-methylimidazolium ethyl sulfate (water/[EMIm][EtSO4]) but opposite to that in water. To gain atomic-level insight into these water-exchange reactions, molecular dynamics simulations for lanthanide ions in water/[EMIm][OTf] have been performed using the atomic-multipole-optimized-energetics-for-biomolecular-application polarizable force field. Our molecular dynamics simulations reproduce the experimental water-exchange rates in terms of the trend and provide possible explanations for the observed experimental behavior. The smaller lanthanide ions in water/[EMIm][OTf] undergo faster water exchange because the smaller lanthanide ions coordinate to the first shell [OTf]- anions more tightly, resulting in a stronger screening effect for the second-shell water. The screening effect weakens the interaction of the lanthanide ions with the second-shell water molecules, facilitating the dissociation of water from the second-shell and subsequent association of water molecules from the outer solvation shells.

The first 2-year home environment in relation to the new onset and remission of asthmatic and allergic symptoms in 4246 preschool children.

The home environment can influence childhood allergies and respiratory health but there is little information on associations between early life exposure at home and new onset and remission of the asthmatic or allergic symptoms in preschool children. A questionnaire survey was performed in a random cluster sample of 4246 preschool children in Urumqi, China. Information on the home environment (perceptions of odors and indicators of pollution sources) and children's health (wheeze, rhinitis and eczema) was collected for the first 2 years of life and the last year (before answering the questionnaire) from one of the parents or another guardian of the child. Associations between the home environment the first 2 years of life and new onset and remission of childhood symptoms were analyzed by multiple logistic regression. Home environment factors reported for the first 2 years of life were consistently positively associated with new onset of symptoms and negatively associated with remission of symptoms. Visible mold (OR 1.46, 95% CI 1.12-1.90), moldy odor (OR 2.15, 95% CI 1.45-3.18), air dryness (OR 1.31, 95% CI 1.08-1.59), stuffy odor (OR 1.25, 95% CI 1.01-1.54) and parental smoking (OR 1.36, 95% CI 1.13-1.65) were associated with new onset of symptoms. These factors were negatively associated with the remission of symptoms. In conclusion, mold contamination at home (moldy odor/visible mold), poor indoor air quality (stuffy odor, air dryness) and exposure to environmental tobacco smoke (ETS) in the first 2 years of life can increase the incidence of asthmatic and allergic symptoms and decrease the remission from these symptoms in preschool children.

Water-exchange rates of lanthanide ions in an ionic liquid.

The first ligand-exchange rate measurements of lanthanide ions in an ionic liquid are reported here. The trend of water-exchange rates in the ionic liquid is the opposite of the trend in water.

Optical imaging of phantoms from real data by an approximately globally convergent inverse algorithm.

A numerical method for an inverse problem for an elliptic equation with the running source at multiple positions is presented. This algorithm does not rely on a good first guess for the solution. The so-called "approximate global convergence" property of this method is shown here. The performance of the algorithm is verified on real data for Diffusion Optical Tomography. Direct applications are in near-infrared laser imaging technology for stroke detection in brains of small animals.

Recyclable fluorescent gold nanocluster membrane for visual sensing of copper(II) ion in aqueous solution.

Recently, metal-selective fluorescent chemosensors have attracted intense attention for their simple and real-time tracking of metal ions in environmental samples. However, most of the existing fluorescent sensors are one-off sensors and thus suffer from large amount of reagent consumption, significant experimental cost and raising the risk of environmental pollution. In this paper, we developed a green (low reagent consumption, low-toxicity reagent use), recyclable, and visual sensor for Cu(2+) in aqueous solution by using a fluorescent gold nanoclusters membrane (FGM) as the sensing unit, basing on our findings on gold nanoclusters (Au NCs) that the bovine serum albumin (BSA)-coated Au NCs exhibit excellent membrane-forming ability under the isoelectric point of BSA, and thus enable us to obtain a new type of sensing membrane (i.e. FGM) by denaturing Au NCs; the fluorescence of FGM can be significantly quenched by Cu(2+) ion, and the quenched fluorescence can be totally recovered by histidine; the as-prepared FGM is very stable and recyclable, which makes it an ideal sensing material.

[Closed reduction and percutaneous Kirschner pin fixation combined with plaster support for the treatment of supracondylar humerus fractures in children].

OBJECTIVE: To investigate the therapeutic effects of closed reduction and percutaneous Kirschner pin fixation combined with plaster support for the treatment of supracondylar humerus fractures in children. METHODS: From June 2007 to December 2008, 27 patients with Gartland III supracondylar fractures were treated with closed reduction and percutaneous Kirschner wire fixation combined with plaster support. Among the patients, 18 patients were male and 9 patients were female, ranging in age from 6 to 12 years,with an average of 8.1 years. Fifteen patients were extension type, 12 patients were buckling type; fourteen patients were ulnar deviation, 13 patients were radial deviation. The duration from injury to treatment ranged from 0.5 to 8 days, averaged 3.6 days. RESULTS: Twenty-seven patients were followed up, and the duration ranged from 6 to 24 months, averaged 13.5 months. The healing time ranged from 4 to 6 weeks after surgery, with a mean of 4.5 weeks. Complications including implants loosening, fracture re-displacement, Volkmarm contraction, needle point or deep infection, ulnar nerve injury, myositis ossificans were found during follow-up. Two patients had postoperative elbow varus, but the varus angle was not more than 15 degree,which may be due to inappropriate functional exercise or early removal of external fixation. According to Flynn criteria, 19 patients got an excellent result, 5 good, 2 poor and 1 bad. CONCLUSION: Closed reduction and percutaneous Kirschner wire fixation combined plaster support for the treatment of unstable supracondylar fractures in children has advantages including little trauma, reliable fixation, good elbow function and appearance.

[Effectiveness comparison between open reduction combined with internal fixation and artificial radial head replacement in treating Mason type-III comminuted fractures of radial head].

OBJECTIVE: To compare the effectiveness between open reduction combined with internal fixation and artificial radial head replacement in treating Mason type-III comminuted fracture of radial head, to provide the evidence for available treatment methods. METHODS: Between January 2004 and June 2008, 65 cases of Mason type-III comminuted fractures were treated with open reduction, AO mini plate and screw system or a combination of Kirschner treatment (internal fixation group, n = 35) and with artificial radial head replacement (replacement group, n = 30). In internal fixation group, there were 21 males and 14 females with an age range of 21 to 35 years (mean, 30.7 years); the causes of injury were traffic accident in 12 cases, falling from height in 8 cases, and a fall in 15 cases; the locations were left side in 23 cases and right side in 12 cases; and the time between injury and surgery was 1-7 days (mean, 3 days). In replacement group, there were 19 males and 11 females with an age range of 23 to 67 years (mean, 32.5 years); the causes of injury were traffic accident in 7 cases, falling from height in 8 cases, and a fall in 15 cases; the locations were left side in 17 cases and right side in 13 cases; and the time between injury and surgery was 1-6 days (mean, 1.5 days). There was no significant difference in gender, age, disease cause, disease duration, or other general information between 2 groups (P > 0.05), so that 2 series of patients had comparability. RESULTS: Incisions healed primarily in 2 groups. All patients were followed up 1 to 4 years with an average of 2.5 years. There were significant differences in elbow flexion angle, extension angle, and forearm rotation angle between 2 groups (P < 0.05), but no significant difference in elbow pronation or supination weakness (P > 0.05). In internal fixation group, primary union occurred in 29 cases, delayed union in 2 cases, nonunion with ectopic ossification in 2 cases, and internal fixation failure in 2 cases. In replacement group, elbow flexion angle lost beyond 30 degrees in 1 case after 1 year, elbow stiffness occurred in 1 case because prosthesis was too long. According to Broberg and Morrey elbow scores system, the scores were 69.51 +/- 10.23 in internal fixation group and 81.55 +/- 12.06 in replacement group, showing significant difference (P < 0.05). The results were excellent in 15 cases, good in 5 cases, fair in 11 cases, and poor in 4 cases with an excellent and good rate of 57.1% in internal fixation group; the results were excellent in 17 cases, good in 5 cases, fair in 6 cases, and poor in 2 cases with an excellent and good rate of 73.3%. CONCLUSION: Artificial radial head replacement can achieve better joint function compared with open reduction combined with internal fixation in treating Mason type-III comminuted fractures of radial head.