ObjectiveTo analyze the clinical characteristics of acute pancreatitis (AP) complicated with pulmonary infection and to explore the value of BISAP, APACHEⅡ and CTSI scores combined with C-reactive protein (CRP) in early diagnosis and prognosis of AP complicated with pulmonary infection.MethodsFour hundreds and eighty-four cases of AP treated in the Affiliated Hospital of North Sichuan Medical College from January 2018 to January 2020 were selected. After screening, 460 cases were included as the study object, and the patients with pulmonary infection were classified as the infection group (n=114). Those without pulmonary infection were classified as the control group (n=346). The baseline data, clinical characteristics, laboratory test indexes, length of stay, hospitalization cost, and outcome of the two groups were collected, and the risk factors and early predictive indexes of pulmonary infection in patients with AP were analyzed.ResultsHospitalization days and expenses, outcome, fluid replacement within 24 hours, drinking, smoking, age, APACHEⅡ score, BISAP score, CTSI score, hemoglobin (Hb), albumin (ALB), CRP, procalcitonin (PCT), total bilirubin (TB), lymphocyte count, international standardized ratio (INR), blood glucose, and blood calcium, there were significant differences between the two groups (P<0.05). There were no significant difference in BMI, sex, recurrence rate, fatty liver grade, proportion of patients with hypertension and diabetes between the two groups (P>0.05). The significant indexes of univariate analysis were included in multivariate regression analysis, the results showed that Hb≤120 g/L, CRP≥56 mg/L, PCT≥1.65 ng/mL, serum calcium≤2.01 mmol/L, BISAP score≥3, APACHEⅡ score≥8, CTSI score≥3, and drinking alcohol were independent risk factors of AP complicated with pulmonary infection. The working characteristic curve of the subjects showed that the area under the curve (AUC) of CRP, BISAP score, APACHEⅡ score and CTSI score were 0.846, 0.856, 0.882, 0.783, respectively, and the AUC of the four combined tests was 0.952. The AUC of the four combined tests was significantly higher than that of each single test (P<0.05).Conclusions The CRP level, Apache Ⅱ score, bisap score and CTSI score of AP patients with pulmonary infection are significantly higher, which are closely related to the severity and prognosis of AP patients with pulmonary infection. The combined detection of the four items has more predictive value than the single detection in the early diagnosis and prognosis evaluation of AP complicated with pulmonary infection. Its application in clinic is of great significance to shorten the duration of hospitalization and reduce the cost of hospitalization and mortality.
ObjectiveTo study the clinical value of procalcitonin (PCT), WBC count, and C-reactive protein (CRP) in diagnosis of common bile duct stones with acute bile duct infection and systemic inflammatory response syndrome (SIRS).MethodsA total of 80 patients with bile duct stones were retrospectively analyzed, which were divided into two groups, SIRS group (n=40) and non-SIRS group (n=40). The numerical value of PCT, WBC count, and CRP were detected on 1, 4, and 7 day after admission, and calculated the score of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) on 1 day after admission. Then analyzed the clinical value of PCT, WBC count, and CRP in diagnosis of common bile duct stones with acute bile duct infection and SIRS.ResultsEach area under the ROC curve of PCT, CRP, and WBC count were 0.81, 0.78, and 0.72, respectively, with significant difference (P<0.05). The PCT, CRP, and WBC count had a certain accuracy in diagnosis of common bile duct stones with acute bile duct infection and SIRS. The positive-relationship between PCT, CRP, WBC count and APACHE Ⅱ score was significant (r=0.91, P<0.01; r=0.88, P<0.01; r=0.69, P<0.01).ConclusionTo detect the numerical value of PCT, WBC count, and CRP had significant clinical value in diagnosis of common bile duct stones with acute bile duct infection and SIRS.
Objective To explore the value of fecal calprotectin （FCP） in the activity evaluation for ulcerative colitis （UC）. Methods Sixty three patients with UC （UC group） and 30 patients with gastrointestinal symptoms but without abnormal results of colonoscopy （control group）， who were treated in The Forth Affiliated Hospital of China Medical University between Sep. 2007 to Dec. 2009 were enrolled to examine the FCP， C-creative protein （CRP）， and erythrocyte sedimentation rate （ESR）. Then comparison between UC group and control group was performed. Results Levels of FCP and CRP in active gradeⅠ，Ⅱ， and Ⅲ group were all significantly higher than those of control group and inactive UC group （P＜0.05）， with the increase of active grade of UC， the level of FCP gradually increased （P＜0.05）. The levels of CRP in active grade Ⅱ and Ⅲ group were all significantly higher than those of gradeⅠgroup （P＜0.05）， but didn’t differed between active grade Ⅱ and Ⅲ group （P＞0.05）. There were no significant difference among 5 groups on ESR （P＞0.05）. Levels of FCP （rs=0.807， P＜0.01）， CRP（rs=0.651， P＜0.01）， and ESR （rs=0.371， P＜0.05） in active grade group were significantly related to histological grade under colonoscopy. Conclusion FCP examination is simple， inexpensive， repeatable， and noninvasive， and FCP can be used as an marker of activity evaluation in UC.
Objective To explore the clinical significances of serum procalcitonin ( PCT) and Creactive protein( CRP) in diagnosis and severity assessment of sepsis. Methods A total of 72 patients with different severities of sepsis admitted to Wenzhou Second People’s Hospital from June 2005 to September 2007, including 22 cases of sepsis, 26 cases of severe sepsis, and 24 cases of sepsis shock. Meanwhile, twenty non-sepsis patients were enrolled as control group. The differences of serum PCT and CRP levels, acute physiology and chronic health evaluation Ⅱ ( APACHEⅡ) scores and sepsis related organ failure assessment ( SOFA) scores were compared in controls and the septic patients with different severities and different prognosis. Results The PCT levels of patients with sepsis, severe sepsis and sepsis shock were significantly higher than that in the non-sepsis group [ ( 1. 51 ±1. 57) , ( 5. 62 ±3. 78) and ( 13. 56 ±8. 16) vs ( 0. 12 ± 0. 33) μg/L, P lt;0. 05 or P lt; 0. 01, respectively] . The CRP level, APACHEⅡ and SOFA were also increased in septic patients compared to control and progressively elavated by the severities of sepsis patients ( P lt; 0. 05 or P lt; 0. 01) , however, CRP levels were not significant different ( P gt; 0. 05) . The PCT levels, APACHEⅡ and SOFA of the patients with good prognosis were lower than those with poor prognosis( all P lt; 0. 01) , but the CRP levels was not significant different( P gt;0. 05) . Conclusion The serumlevel of PCT is superior to serumlevel of CRP in severity classification and prognosis assessment.
ObjectiveTo investigate the efficacy and safety of internal rib fixation for patients with multiple rib fractures. MethodsA total of 141 patients with multiple rib fractures who were admitted to Department of Thoracic Surgery of the Sixth Affiliated Hospital of Xinjiang Medical University between January 2010 and January 2013 and whose chest trauma score (AIS-ISS) was 9-20 (16±2) were recruited in this study. Using the random number generator of SPSS, all the patients were randomly divided into an internal fixation group [69 patients including 41 males and 28 females with their age of 25-61 (37±4) years] who underwent internal rib fixation, and a control group [72 patients including 43 males and 29 females with their age of 24-63 (35±5) years] who received conservative therapy. Plasma C-reactive protein (CRP) patients' satisfaction degree with thoracic appearance,incidence of lung infection,pain-relieving efficacy,postoperative chest drainage duration and length of hospital stay were compared between the 2 groups. ResultsPlasma CRP levels of the internal fixation group were not statistically different from those of the control group in 1-3 days after injury (P>0.05) but were significantly lower than those of the control group in 4-12 days after injury (P<0.05). Patients' satisfaction degree with thoracic appearance (97.1% vs. 48.6%,P<0.05) and pain-relieving efficiency (91.3% vs. 68.1%,P<0.05) of the internal fixation group were significantly higher than those of the control group. Incidence of lung infection of the internal fixation group was significantly lower than that of the control group(11.6% vs. 37.5%,P<0.01). Postoperative chest drainage duration [(3±2) d vs. (7±4) d,P<0.05] and length of hospital stay [(9±4) d vs. (15±7) d,P<0.05] of the internal fixation group were significantly shorter than those of the control group. ConclusionsFor patients with multiple rib fractures and stable vital signs,internal fixation surgery is helpful to shorten length of hospital stay, relieve chest pain and improve thoracic appearance. It can also reduce lung inflammation and increase surgical safety so as to improve treatment outcomes of multiple rib fractures.
ObjectiveTo examine and compare the value of procalcitonin (PCT), C-reactive protein (CRP) and interleukin (IL)-6 in diagnosing fetal sepsis in premature neonates. MethodsPreterm neonates with premature rupture of membrane between January 2010 and September 2012 were screened, and the serum levels of PCT, CRP and IL-6 were detected in the first day of life. All preterm neonates were divided into two groups according to the development of sepsis (45 cases with sepsis and 39 cases without sepsis). ResultsThe levels of PCT, CRP and IL-6 in premature neonates with sepsis were all significantly higher than those without sepsis. The cut-off value of PCT in diagnosis of sepsis was 2.14 μg/L, with a sensitivity and specificity of 76% and 85% respectively; the cut-off value of CRP in diagnosis of sepsis was 7.90 mg/L, with a sensitivity and specificity of 67% and 61% respectively. For IL-6, the cut-off value in diagnosis of sepsis was 13.80 ng/L, and its sensitivity and specificity were high to 90% and 94%, respectively. ConclusionIL-6 is the most reliable biochemical marker for the detection of early-onset sepsis in preterm neonates with premature rupture of membrane.
ObjectiveTo explore the changes of plasma prealbumin (PA), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) levels before and after treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and analyze the correlation of PA and Hcy with hs-CRP and body mass index (BMI).MethodsA total of 132 hospitalized AECOPD patients with GOLD lung function as grade III-IV were recruited as an experimental group and 45 healthy subjects as a control group. The levels of plasma PA, Hcy and hs-CRP were measured by automatic biochemical analyzer, and the main indexes of pulmonary function were determined in all subjects.ResultsCompared with the control group, the level of plasma PA before and after treatment in the experimental group decreased significantly [(146.49±36.53) mg/L and (219.60±41.29) mg/L vs. (269.48±42.63) mg/L], the level of plasma Hcy before and after treatment increased significantly [(16.44±5.21) μmol/L and (12.61±4.56) μmol /L vs. (10.13±3.25) μmol/L], and the levels of plasma hs-CRP before and after treatment increased significantly [(45.24±29.94) mg/L and (7.71±3.41) mg/L vs. (5.01±1.52) mg/L] (all P<0.05). The levels of plasma PA, Hcy and hs-CRP after treatment were significantly better than before treatment in the experimental group (allP<0.01). The plasma PA values before and after treatment were negatively correlated with the level of hs-CRP before and after treatment, and positively correlated with BMI (bothP<0.05).ConclusionsThe levels of plasma PA, Hcy and hs-CRP are significantly different before and after the treatment in AECOPD patients and the healthy controls. PA is negatively correlated with hs-CRP and positively correlated with BMI. The detection of plasma PA and Hcy can help to determine the condition and efficacy of patients with COPD, and PA can reflect the level of inflammation and nutritional status to a certain extent.
ObjectiveTo investigate the relationship between preoperative C-reactive protein (CRP)/albumin ratio (CAR) and National Institutes of Health (NIH) risk classification in patients with gastric stromal tumors.MethodsClinical data of 108 patients with gastric stromal tumors admitted to the First Affiliated Hospital of Kunming Medical University from February 2010 to November 2016 were retrospectively collected. With the median of CAR as the critical value, patients were divided into high CAR group (CAR>0.048) and low CAR group (CAR≤0.048). Then observed the general clinicopathological characteristics and survival status of patients with higher and lower CAR value.ResultsThere were significant differences in NIH classification, tumor diameter, and mitosis between the high CAR group and low CAR group (P<0.05). Compared with the low CAR group, the tumors in the high CAR group had larger diameter, higher mitotic figure, and higher NIH grade. Survival analysis showed that the prognosis of the low CAR group was better than that of the high CAR group (χ2=15.152, P<0.001).ConclusionsCAR is closely related to the malignant index and NIH risk classification of gastric stromal tumors. It can be used as an index for evaluating the malignant degree of gastric stromal tumors, and it is expected to be an important reference factor for clinical NIH risk classification and prognosis.
Aortic dissection is a life-threatening cardiovascular disease with devastating complications and high mortality. It requires rapid and accurate diagnosis and a focus on prognosis. Many laboratory tests are routinely performed in patients with aortic dissection including D-dimer, brain natriuretic peptide, cardiac troponin I, C-reactive protein, and procalcitonin. D-dimer shows vital performance in the diagnosis of aortic dissection, and brain natriuretic peptide, cardiac troponin I, C-reactive protein, and procalcitonin exhibits important value in risk stratification and prognostic effect in aortic dissection patients. Our review summarized the clinical utility of these laboratory tests in patients with aortic dissection, aiming to provide advanced and comprehensive evidence for clinicians to better understand these laboratory tests and help their clinical practice.
ObjectiveTo investigate the relation between preoperative peripheral blood neutrophil/albumin (NEU/ALB) or hypersensitive C-reactive protein (hs-CRP)/ALB ratio and seroma after laparoscopic transabdominal preperitoneal (LTAPP) hernia repair. MethodsThe patients diagnosed with inguinal hernia and underwent LTAPP hernia repair admitted to the Heji Hospital Affiliated to Changzhi Medical College from June 2020 to June 2023 were retrospectively collected. The multivariate logistic regression analysis was conducted to identify the risk factors affecting the occurrence of seroma after LTAPP hernia repair. The area under receiver operating characteristic curve (AUC) and 95% confidence interval (95%CI) were used to evaluate the discriminatory value of preoperative peripheral blood NEU/ALB ratio and hs-CRP/ALB ratio for seroma after LTAPP hernia repair. Delong test was used to compare the discriminatory value of these indicators. The test level was α=0.05. ResultsA total of 357 patients who met the inclusion criteria were included in this study, and the seroma occurred in 42 cases (11.8%). The results of multivariate logistic regression analysis showed that the larger the diameter of the hernia sac [OR (95%CI)=4.654 (2.829, 7.657), P<0.001], the more intraoperative bleeding [OR (95%CI)=3.021 (1.498, 6.094), P=0.002], and the higher NEU/ALB ratio [OR (95%CI)=2.585 (1.618, 4.130), P<0.001] or hs-CRP/ALB ratio [OR (95%CI)=1.874 (1.239, 2.834), P=0.003], the higher the probability of seroma after LTAPP hernia repair. The AUC (95%CI) of NEU/ALB or hs-CRP/ALB indicator for predicting seroma after LTAPP hernia repair was 0.750 (0.702, 0.794) and 0.762 (0.715, 0.806), respectively. The optimal cutoff values were 2.970 and 4.001, with sensitivity of 78.6% and 73.8%, and specificity of 60.3% and 65.7%, respectively. The AUC (95%CI) of the NEU/ALB in combination with hs-CRP/ALB in predicting seroma after LTAPP hernia repair was 0.851 (0.810, 0.886), with sensitivity and specificity of 71.4% and 87.0%, respectively. The AUC of the NEU/ALB in combination with hs-CRP/ALB in predicting seroma after LTAPP hernia repair was higher than that of NEU/ALB (Z=2.864, P=0.004) or hs-CRP/ALB alone (Z=2.956, P=0.003). ConclusionFrom the data analysis results of this study, the occurrence rate of seroma after LTAPP hernia repair is not low, and the occurrence of seroma should be paid close attention to patients with larger hernia sac diameter, more intraoperative bleeding, and higher NEU/ALB or hs-CRP/ALB ratio.