[Evaluation of severity and prognosis of acute pancreatitis by CT severity index and modified CT severity index].

Objectives: To explore the role of computed tomography (CT) severity index (CTSI) and modified CT severity index (MCTSI) in assessing the severity of acute pancreatitis (AP) under the revised Atlanta classification (RAC) and predicting the clinical prognosis. Methods: Based on the prospectively entered AP database, the clinical data of consecutive adult AP inpatients admitted to the Department of Gastroenterology of the First Affiliated Hospital of Nanchang University from January 2012 to December 2020 were retrospectively screened. The imaging data were independently evaluated by two radiologists and entered to the database to calculate the CTSI and MCTSI scores. Their relationship with the difference of RAC severity grade and clinical prognosis was analyzed. Compared with Acute Physiology and Chronic Health Assessment Ⅱ (APACHE Ⅱ) score, the receiver operating characteristic curve was used to evaluate the predictive value of CTSI and MCTSI scores for persistent organ failure and infectious pancreatic necrosis (IPN). Results: A total of 2 612 patients with AP, aged (50±15) years, were included in the study, including 1 547 males (59.2%) and 1 065 females (40.8%). According to RAC standard, AP was divided into 699 cases (26.8%) of mild pancreatitis (MAP), 1 098 cases (42.0%) of moderately severe pancreatitis (MSAP), and 815 cases (31.2%) of severe pancreatitis (SAP). MCTSI judged AP severity similarly to RAC, with 668 cases of MAP (25.6%), 1 207 cases of MSAP (46.2%) and 737 cases of SAP (28.2%), while CTSI judged SAP patients less(400 cases, 15.3%). The severity of AP determined by CTSI and MCTSI scores was significantly correlated with clinical prognosis (r=0.06-0.43, all P<0.05). Compared with APACHE Ⅱ score, CTSI had the highest area under the curve (AUC) for predicting IPN (AUC=0.85, 95%CI: 0.83-0.87), followed by MCTSI (AUC=0.82, 95%CI: 0.80-0.85). APACHE Ⅱ was more accurate in predicting persistent organ failure than CTSI and MCTSI scores,with AUC of 0.73 (95%CI: 0.71-0.75), 0.72 (95%CI: 0.70-0.74) and 0.72 (95%CI: 0.70-0.74), respectively. Conclusions: AP severity judged by MCTSI is consistent with RAC, and SAP patients judged by CTSI are less than RAC. CTSI and MCTSI are significantly correlated with clinical prognosis. CTSI and MCTSI have higher accuracy in predicting IPN, but lower accuracy in predicting persistent organ failure than APACHE Ⅱ.

[Developing and application of an autoverification system for clinical chemistry and immunology test results].

Objective: To develop and validate an autoverification system for biochemistry and immunology test results for application in routine work. Methods: Algorithms was designed and translated into the laboratory information system. Parameters including verify limit, delta check, logic relation between tests was set up in the system. Verification rate of every test and the causes of fails were analyzed, according to which the system and parameters were modified. The autoverified reports were evaluated by chief technicians. Only when all of the autoverified results pass the evaluation, the system applied for routine work of releasing the results. Autoverification rate and turnaround time(TAT) were calculated for evaluation of the efficiency of the system. Results: A brand new autoverification system was developed and applied for routine work. The autoverification rate for each single test was 91.1%-96.6%. The autoverification rate for reports was 74%. With the autoverification system, the media of TAT reduced from 111.6(53.9-270.7) min to 87.2(45.4-202.4) min, whereas the time from instrument finishing analysis to releasing the reports reduced from 18.6(1.0-99.3) min to 0.1(0-58.3)min. The number of staff specified for results validation reduced from three to one. Conclusions: The newly developed system can be used for autoverification of biochemistry and immunology test results. The autoverification system can greatly reduce TAT and raise working efficiency. It's essential to employ carefully designed algorithm, appropriate parameters and comprehensive evaluation when developing a new autoverification system.

Analysis of symptom clusters in Chinese cervical cancer patients undergoing radiotherapy, chemoradiotherapy, or postoperative chemoradiotherapy.

OBJECTIVE: To assess the common symptom clusters in cervical cancer patients treated with radiotherapy alone, chemorachothierapy, or postoperative chemoradiotherapy, and evaluate differences among multi-modality treatment in these symptom clusters. MATERIALS AND METHODS: Ninety-three patients diagnosed with cervical cancer were recruited to the survey, in which destination time was the fourth friday of radiotherapy. Symptoms of patients were evaluated by the Chinese version of the 13-item M.D. Anderson Symptom Inventory (MDASI). RESULTS: Among the symptoms, lack of appetite was the most common and the most severe symptome, treatment modalities may have important effects on symptom clusters in cervical cancer patients undergoing radiotherapy. CONCLUSION: The results offer valuable information for the future development treatment-based symptom cluster intervention.

Protein-protein interaction network construction for cancer using a new L1/2-penalized Net-SVM model.

Identifying biomarker genes and characterizing interaction pathways with high-dimensional and low-sample size microarray data is a major challenge in computational biology. In this field, the construction of protein-protein interaction (PPI) networks using disease-related selected genes has garnered much attention. Support vector machines (SVMs) are commonly used to classify patients, and a number of useful tools such as lasso, elastic net, SCAD, or other regularization methods can be combined with SVM models to select genes that are related to a disease. In the current study, we propose a new Net-SVM model that is different from other SVM models as it is combined with L1/2-norm regularization, which has good performance with high-dimensional and low-sample size microarray data for cancer classification, gene selection, and PPI network construction. Both simulation studies and real data experiments demonstrated that our proposed method outperformed other regularization methods such as lasso, SCAD, and elastic net. In conclusion, our model may help to select fewer but more relevant genes, and can be used to construct simple and informative PPI networks that are highly relevant to cancer.

[Effects of no and endothelium on carotid baroreceptor activity].

The present study was undertaken to examine the effects of endothelium and exogenous NO on the baroreceptor discharge of the carotid sinus. The baroreceptor activity (BRA) was recorded from the rabbit carotid sinus-sinus nerve (CS-CSN) preparation using a chamber for superfusing and perfusing the tissue. The results are as follows. (1) The CSN basal discharge could be divided into two components, a low-amplitude component and a high-amplitude one. The high-amplitude discharge was dependent on pulsatory perfusing pressure, but did not respond to classical chemoreceptor stimulants, indicating its baroreceptive origin. (2) The BRA was decreased after removal of the endothelium. (3) L-arginine (L-arg), as exogenous NO, initiated BRA in a dose-dependent manner, which was prevented by precedent inhibition of NO synthase or by removal of the endothelium. (4) Inhibition of guanine nucleotide cyclase with methylene blue affected neither the basal BRA nor the response of BRA to L-arg. These results indicate that stimulation of BRA by exogenous NO may be mediated by the endothelium, but cGMP dose not seem to be involved.

Lack of effects of tetracaine in rat nucleus paragigantocellularis (PGC) on analgesia from periqueductal gray (PAG) met-enkephalin (ME) injections (in raphe magnus-blocking doses), and on baseline tail-flick latency.

We showed previously that (1 microgram) tetracaine block of PAG prevents the analgesic effect of PGC-ME injections, and also produces hyperalgesia regarding baseline tail-flick latencies. In the present study we injected PGC (unilaterally and bilaterally) with tetracaine so as to study its possible role in tonic descending inhibition of pain, as well as its necessity for analgesia due to PAG opiate injection. Two micrograms of tetracaine in PGC unilaterally or bilaterally failed to affect baseline tail-flick latencies and failed to attenuate at all the distinct analgesic effect of 2 micrograms ME injected into PAG. This analgesic effect was seen as a change in mean tail-flick latency from about 5.5 to 7.0 seconds 8-12 minutes post-injection, recovering to 5.5 second baseline by 25 minutes. Two micrograms tetracaine in nucleus raphe magnus (RM) was however sufficient to block the analgesic effect of RM stimulation. Thus PGC does not appear to participate in tonic descending pain inhibition (as PAG appears to do) nor is its functional integrity necessary for PAG ME analgesia (though PAG is necessary for PGC analgesia).

Reversible tetracaine block of rat periaqueductal gray (PAG) decreases baseline tail-flick latency and prevents analgesic effects of met-enkephalin injections in nucleus paragigantocellularis (PGC).

One micrograms of tetracaine in the rat periaqueductal gray (PAG) produced a decline in baseline tail-flick latencies (hyperalgesia) from about 5 to 3.5 s over the course of 9 min, after which the latencies increased to about 4.5 s. One micrograms of Met-enkephalin in PGC caused an expected increase in latencies (analgesia) from about 4.25 to 6.2 s in 9 min, with recovery to 4.7 s after 15 min post-injection. Giving the preceding 2 nanoinjections simultaneously led to an essentially total block of the PGC analgesia. A control injection in PAG simultaneous with a Met-enkephalin injection in PGC did not block the latter's analgesic effect. Single control (artificial cerebrospinal fluid) injections in PAG or PGC were without effect. The hyperalgesic effect of PAG tetracaine supports the involvement of PAG in normally occurring, tonic descending pain inhibition. The block of PGC met-enkephalin analgesia by distant injection of tetracaine in PAG supports the necessity of PAG integrity for PGC analgesic function.

Behavioral and trigeminal neuronal effects of rat brainstem-nanoinjected opiates.

Single injections of Met-enkephalin (ME; 27 rats) and artificial cerebrospinal fluid (ACF; 9 rats) in nucleus reticularis paragigantocellularis (PGC) and periaqueductal gray (PAG), and simultaneous conjoint PAG + PGC injections were made, and effects on facial responsiveness and caudal-trigeminal nuclear neuronal activity studied. It was found that all ME injections depressed the evoked excitatory neuronal and behavioral responses to noxious stimulation. Conjoint injections had apparently additive effects in comparison to single injection effects. Neither conjoint nor single injections had systematic effects on spontaneous neuronal activity. The ACF had no effects on any neuronal or behavioral activity.

Effects of single nanoinjections of Met-enkephalin in the minimally anesthetized rat brainstem on trigeminal nuclear neurons: differential effects on spontaneous versus evoked activity and noci-evoked versus innocuously-evoked responses.

Two separate studies were done on two sets of rats (33 rats, 101 cells in Expt. 1; 16 rats, 25 cells in Expt. 2). In the first study trigeminal nuclear neurons were categorized by adequate stimulus and receptive field. A total of 43.6% responded to light touch and noxious (pinch and heat) stimulation; 27.7% responded only to noxious pinch and/or heat; 8.9% responded exclusively to innocuous touch, and the remainder were non-responsive. Ninety percent of the responsive cells showed increased discharge rates in response to noxious stimulation. In the second study, after characterization of response properties, single nanoinjections of Met-enkephalin (ME) were separately made into midbrain periaqueductal gray (PAG) and nucleus reticularis paragigantocellularis (PGC). The effects of ME on spontaneous (SD) and evoked (ED) discharge were assessed, and then in 8 cells, the effects were repeated and successfully challenged with naloxone. The major findings were: (1) ME applied either to PAG or PGC causes naloxone-reversible reduction of noci-evoked ED with no effect on SD; and (2) the responses of neurons to innocuous light touch were unaffected by ME.

Effects of single and simultaneous combined nanoinjections of Met-enkephalin into rat midbrain and medulla on activity of differentially nociresponsive ventral medullary neurons.

UNLABELLED: Neuronal activity classified by receptive field, adequate stimulus, and raphe-spinal (R-S) projection in 48 lightly anaesthetized rats was recorded from raphe magnus (RM) area. Effects of nanoinjections of Met-enkephalin in periaqueductal gray (PAG; 2 or 10 micrograms), nucleus reticularis paragigantocellularis (PGC; 1 or 5 micrograms), and both sites (conjointly) were studied. Most of the 78 neurons studied responded to noxious stimulation, some with increased responses ('on-cells') and some with decreased responses ('off-cells'). MAJOR FINDINGS: (1) Met-enkephalin in PAG and PGC depressed the response of on-cells and enhanced the response of off-cells; (2) for a given RM or R-S cell, PAG and PGC effects were typically identical; and (3) conjoint injections tended to produce greater effects than single effects, whether enhancing or depressing.

The effect of sodium crompromate in the prevention of exercise-induced asthma.

Sodium crompromate (SCP) is an isomer of disodium cromoglycate (DSCG). The two chemicals are pharmacologically similar but with different chemical synthesis. A comparative double-blind latin square study of the preventive effect of SCP and DSCG versus a placebo aerosol was carried out on a group of nine cases of exercise-induced asthma (EIA). Compared with the placebo, both SCP and DSCG were able to prevent asthma under exercise provocation, as monitored by chest auscultation and FEV1. There was no significant difference in the percentage fall of FEV1 on challenge. This suggests that SCP has a similar prophylactic effect as that of DSCG on EIA.