Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomo...Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomography Severity Index(CTSI)in predicting the severity of acute pancreatitis based on Atlanta 2012 definitions in a tertiary care hospital in northern India.Methods:Fifty patients with acute pancreatitis admitted to our hospital during the period of March 2015 to September 2016 were included in the study.APACHE II,BISAP and Ranson’s score were calculated for all the cases.Modified CTSI was also determined based on a pancreatic protocol contrast enhanced computerized tomography(CT).Optimal cut-offs for these scoring systems and the area under the curve(AUC)were evaluated based on the receiver operating characteristics(ROC)curve and these scoring systems were compared prospectively.Results:Of the 50 cases,14 were graded as severe acute pancreatitis.Pancreatic necrosis was present in 15 patients,while 14 developed persistent organ failure and 14 needed intensive care unit(ICU)admission.The AUC for modified CTSI was consistently the highest for predicting severe acute pancreatitis(0.919),pancreatic necrosis(0.993),organ failure(0.893)and ICU admission(0.993).APACHE II was the second most accurate in predicting severe acute pancreatitis(AUC 0.834)and organ failure(0.831).APACHE II had a high sensitivity for predicting pancreatic necrosis(93.33%),organ failure(92.86%)and ICU admission(92.31%),and also had a high negative predictive value for predicting pancreatic necrosis(96.15%),organ failure(96.15%)and ICU admission(95.83%).Conclusion:APACHE II is a useful prognostic scoring system for predicting the severity of acute pancreatitis and can be a crucial aid in determining the group of patients that have a high chance of need for tertiary care during the course of their illness and therefore need early resuscitation and prompt referral,especially in resource-limited developing countries.展开更多
为了解我国不同品种马铃薯全粉中蛋白质的营养品质,收集我国马铃薯主栽品种22个,分别制备成全粉,采用国际通用的WHO/FAO氨基酸评分模式及化学评分等评价方法对其蛋白质营养品质进行评价,并比较了不同品种间的差异。结果表明,22个品种马...为了解我国不同品种马铃薯全粉中蛋白质的营养品质,收集我国马铃薯主栽品种22个,分别制备成全粉,采用国际通用的WHO/FAO氨基酸评分模式及化学评分等评价方法对其蛋白质营养品质进行评价,并比较了不同品种间的差异。结果表明,22个品种马铃薯全粉粗蛋白含量范围为6.57-12.84 g/100 g DW,除色氨酸外,第一限制性氨基酸是亮氨酸;平均必需氨基酸含量占总氨基酸含量的41.92%,高于WHO/FAO推荐的必需氨基酸组成模式（36%）,接近标准鸡蛋蛋白。从氨基酸评分、化学评分、必需氨基酸指数、生物价和营养指数可综合反映出大西洋蛋白的营养价值最高,夏波蒂、一点红次之;青薯9号、陇薯3号、中薯9号和中薯10号的蛋白营养价值较低,中薯11号最低。展开更多
AIM： Acute pancreatitis （AP） is a process with variable involvement of regional tissues or organ systems. Multifactorial scales included the Ranson, Acute Physiology and Chronic Health Evaluation （APACHE Ⅱ） syst...AIM： Acute pancreatitis （AP） is a process with variable involvement of regional tissues or organ systems. Multifactorial scales included the Ranson, Acute Physiology and Chronic Health Evaluation （APACHE Ⅱ） systems and Balthazar computed tomography severity index （CTSI）. The purpose of this review study was to assess the accuracy of CTSI, Ranson score, and APACHE II score in course and outcome prediction of AP. METHODS： We reviewed 121 patients who underwent helical CT within 48 h after onset of symptoms of a first episode of AP between 1999 and 2003. Fourteen inappropriate subjects were excluded; we reviewed the 107 contrastenhanced CT images to calculate the CTSI. We also reviewed their Ranson and APACHE Ⅱ score. In addition, complications, duration of hospitalization, mortality rate, and other pathology history also were our comparison parameters. RESULTS： We classified 85 patients （79%） as having mild AP （CTSI 〈5） and 22 patients （21%） as having severe AP （CTSI ≥5）. In mild group, the mean APACHE II score and Ranson score was 8.6±1.9 and 2.4±1.2, and those of severe group was 10.2±2.1 and 3.1±0.8, respectively. The most common complication was pseudocyst and abscess and it presented in 21 （20%） patients and their CTSI was 5.9±1.4. A CTSI ≥5 significantly correlated with death, complication present, and prolonged length of stay. Patients with a CTSI ≥5 were 15 times to die than those CTSI 〈5, and the prolonged length of stay and complications present were 17 times and 8 times than that in CTSI 〈5, respectively. CONCLUSION： CTSI is a useful tool in assessing the severity and outcome of AP and the CTSI ≥5 is an index in our study. Although Ranson score and APACHE II score also are choices to be the predictors for complications, mortality and the length of stay of AP, the sensitivity of them are lower than CTSI.展开更多
目的探讨脉络宁注射液联合脑苷肌肽注射液治疗急性缺血性脑血管病的临床疗效。方法选取2015年3月—2017年3月在上海市松江区九亭医院进行治疗的缺血性脑血管病患者142例为研究对象,随机将患者分为对照组和治疗组,每组各71例。对照组静...目的探讨脉络宁注射液联合脑苷肌肽注射液治疗急性缺血性脑血管病的临床疗效。方法选取2015年3月—2017年3月在上海市松江区九亭医院进行治疗的缺血性脑血管病患者142例为研究对象,随机将患者分为对照组和治疗组,每组各71例。对照组静脉滴注脑苷肌肽注射液,20 m L加入到0.9%氯化钠注射液250 m L中,1次/d;治疗组在对照组基础上静脉滴注脉络宁注射液,20 m L加入到0.9%氯化钠注射液500 m L中,1次/d。两组患者均治疗3周。观察两组的临床疗效,比较两组的美国国立卫生研究院卒中量表(NIHSS)评分、改良的Rankin量表(m RS)评分、血清学指标和血液流变学指标。结果治疗后,对照组和治疗组的总有效率分别为80.28%、95.77%,两组比较差异有统计学意义(P<0.05)。治疗后,两组NIHSS评分和m RS评分均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清超敏C反应蛋白(hs-CRP)、可溶性血管细胞间黏附分子-1(s VCAM-1)、白细胞介素-6(IL-6)、单核细胞趋化蛋白(MCP-1)水平均显著降低,胰岛素样生长因子-1(IGF-1)水平显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血浆黏度(PV)、全血黏度高切(HS)、红细胞聚集指数(EAI)、纤维蛋白原(FIB)水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论脉络宁注射液联合脑苷肌肽注射液治疗急性缺血性脑血管病具有较好的临床疗效,可有效地改善患者神经功能和血液流变学指标,降低机体炎症反应,提高患者生活质量,具有一定的临床推广应用价值。展开更多
目的评估神经保护剂是否能改善急性缺血性脑卒中的神经功能并对比神经保护剂之间的疗效。方法全面检索依达拉奉、丁苯酞、神经节苷脂、长春西汀、胞磷胆碱等神经保护剂改善急性缺血性脑卒中神经功能的随机对照试验,检索时间为建库至2019...目的评估神经保护剂是否能改善急性缺血性脑卒中的神经功能并对比神经保护剂之间的疗效。方法全面检索依达拉奉、丁苯酞、神经节苷脂、长春西汀、胞磷胆碱等神经保护剂改善急性缺血性脑卒中神经功能的随机对照试验,检索时间为建库至2019年9月,并进行质量评价,采用R3.5.1软件调用GeMtc程序包及JAGS软件对数据进行网状Meta分析。结果共纳入56篇研究,共计5310名患者。网状Meta分析结果显示,依达拉奉与神经节苷脂在7、14、28 d NIHSS评分与14、90 d Barthel指数均显著优于基础治疗或安慰剂(P<0.05),且两者间差异无统计学意义;丁苯酞在短期治疗中(<28 d)对神经功能的改善优于基础治疗(P<0.05),在长期(90 d)治疗中与基础治疗差异无统计学意义,总体丁苯酞氯化钠注射优于丁苯酞软胶囊;长春西汀仅在14 d NIHSS评分方面与基础治疗差异有统计学意义;胞磷胆碱与基础治疗或安慰剂之间差异无统计学意义。结论依达拉奉和神经节苷脂对于急性脑梗死的神经功能改善情况疗效较好;丁苯酞次之;长春西汀和胞磷胆碱疗效不太理想,同时需要高质量头对头的研究对结果进行进一步的验证。展开更多
文摘Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomography Severity Index(CTSI)in predicting the severity of acute pancreatitis based on Atlanta 2012 definitions in a tertiary care hospital in northern India.Methods:Fifty patients with acute pancreatitis admitted to our hospital during the period of March 2015 to September 2016 were included in the study.APACHE II,BISAP and Ranson’s score were calculated for all the cases.Modified CTSI was also determined based on a pancreatic protocol contrast enhanced computerized tomography(CT).Optimal cut-offs for these scoring systems and the area under the curve(AUC)were evaluated based on the receiver operating characteristics(ROC)curve and these scoring systems were compared prospectively.Results:Of the 50 cases,14 were graded as severe acute pancreatitis.Pancreatic necrosis was present in 15 patients,while 14 developed persistent organ failure and 14 needed intensive care unit(ICU)admission.The AUC for modified CTSI was consistently the highest for predicting severe acute pancreatitis(0.919),pancreatic necrosis(0.993),organ failure(0.893)and ICU admission(0.993).APACHE II was the second most accurate in predicting severe acute pancreatitis(AUC 0.834)and organ failure(0.831).APACHE II had a high sensitivity for predicting pancreatic necrosis(93.33%),organ failure(92.86%)and ICU admission(92.31%),and also had a high negative predictive value for predicting pancreatic necrosis(96.15%),organ failure(96.15%)and ICU admission(95.83%).Conclusion:APACHE II is a useful prognostic scoring system for predicting the severity of acute pancreatitis and can be a crucial aid in determining the group of patients that have a high chance of need for tertiary care during the course of their illness and therefore need early resuscitation and prompt referral,especially in resource-limited developing countries.
文摘为了解我国不同品种马铃薯全粉中蛋白质的营养品质,收集我国马铃薯主栽品种22个,分别制备成全粉,采用国际通用的WHO/FAO氨基酸评分模式及化学评分等评价方法对其蛋白质营养品质进行评价,并比较了不同品种间的差异。结果表明,22个品种马铃薯全粉粗蛋白含量范围为6.57-12.84 g/100 g DW,除色氨酸外,第一限制性氨基酸是亮氨酸;平均必需氨基酸含量占总氨基酸含量的41.92%,高于WHO/FAO推荐的必需氨基酸组成模式（36%）,接近标准鸡蛋蛋白。从氨基酸评分、化学评分、必需氨基酸指数、生物价和营养指数可综合反映出大西洋蛋白的营养价值最高,夏波蒂、一点红次之;青薯9号、陇薯3号、中薯9号和中薯10号的蛋白营养价值较低,中薯11号最低。
文摘AIM： Acute pancreatitis （AP） is a process with variable involvement of regional tissues or organ systems. Multifactorial scales included the Ranson, Acute Physiology and Chronic Health Evaluation （APACHE Ⅱ） systems and Balthazar computed tomography severity index （CTSI）. The purpose of this review study was to assess the accuracy of CTSI, Ranson score, and APACHE II score in course and outcome prediction of AP. METHODS： We reviewed 121 patients who underwent helical CT within 48 h after onset of symptoms of a first episode of AP between 1999 and 2003. Fourteen inappropriate subjects were excluded; we reviewed the 107 contrastenhanced CT images to calculate the CTSI. We also reviewed their Ranson and APACHE Ⅱ score. In addition, complications, duration of hospitalization, mortality rate, and other pathology history also were our comparison parameters. RESULTS： We classified 85 patients （79%） as having mild AP （CTSI 〈5） and 22 patients （21%） as having severe AP （CTSI ≥5）. In mild group, the mean APACHE II score and Ranson score was 8.6±1.9 and 2.4±1.2, and those of severe group was 10.2±2.1 and 3.1±0.8, respectively. The most common complication was pseudocyst and abscess and it presented in 21 （20%） patients and their CTSI was 5.9±1.4. A CTSI ≥5 significantly correlated with death, complication present, and prolonged length of stay. Patients with a CTSI ≥5 were 15 times to die than those CTSI 〈5, and the prolonged length of stay and complications present were 17 times and 8 times than that in CTSI 〈5, respectively. CONCLUSION： CTSI is a useful tool in assessing the severity and outcome of AP and the CTSI ≥5 is an index in our study. Although Ranson score and APACHE II score also are choices to be the predictors for complications, mortality and the length of stay of AP, the sensitivity of them are lower than CTSI.
文摘目的探讨脉络宁注射液联合脑苷肌肽注射液治疗急性缺血性脑血管病的临床疗效。方法选取2015年3月—2017年3月在上海市松江区九亭医院进行治疗的缺血性脑血管病患者142例为研究对象,随机将患者分为对照组和治疗组,每组各71例。对照组静脉滴注脑苷肌肽注射液,20 m L加入到0.9%氯化钠注射液250 m L中,1次/d;治疗组在对照组基础上静脉滴注脉络宁注射液,20 m L加入到0.9%氯化钠注射液500 m L中,1次/d。两组患者均治疗3周。观察两组的临床疗效,比较两组的美国国立卫生研究院卒中量表(NIHSS)评分、改良的Rankin量表(m RS)评分、血清学指标和血液流变学指标。结果治疗后,对照组和治疗组的总有效率分别为80.28%、95.77%,两组比较差异有统计学意义(P<0.05)。治疗后,两组NIHSS评分和m RS评分均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清超敏C反应蛋白(hs-CRP)、可溶性血管细胞间黏附分子-1(s VCAM-1)、白细胞介素-6(IL-6)、单核细胞趋化蛋白(MCP-1)水平均显著降低,胰岛素样生长因子-1(IGF-1)水平显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血浆黏度(PV)、全血黏度高切(HS)、红细胞聚集指数(EAI)、纤维蛋白原(FIB)水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论脉络宁注射液联合脑苷肌肽注射液治疗急性缺血性脑血管病具有较好的临床疗效,可有效地改善患者神经功能和血液流变学指标,降低机体炎症反应,提高患者生活质量,具有一定的临床推广应用价值。
文摘目的评估神经保护剂是否能改善急性缺血性脑卒中的神经功能并对比神经保护剂之间的疗效。方法全面检索依达拉奉、丁苯酞、神经节苷脂、长春西汀、胞磷胆碱等神经保护剂改善急性缺血性脑卒中神经功能的随机对照试验,检索时间为建库至2019年9月,并进行质量评价,采用R3.5.1软件调用GeMtc程序包及JAGS软件对数据进行网状Meta分析。结果共纳入56篇研究,共计5310名患者。网状Meta分析结果显示,依达拉奉与神经节苷脂在7、14、28 d NIHSS评分与14、90 d Barthel指数均显著优于基础治疗或安慰剂(P<0.05),且两者间差异无统计学意义;丁苯酞在短期治疗中(<28 d)对神经功能的改善优于基础治疗(P<0.05),在长期(90 d)治疗中与基础治疗差异无统计学意义,总体丁苯酞氯化钠注射优于丁苯酞软胶囊;长春西汀仅在14 d NIHSS评分方面与基础治疗差异有统计学意义;胞磷胆碱与基础治疗或安慰剂之间差异无统计学意义。结论依达拉奉和神经节苷脂对于急性脑梗死的神经功能改善情况疗效较好;丁苯酞次之;长春西汀和胞磷胆碱疗效不太理想,同时需要高质量头对头的研究对结果进行进一步的验证。
