ObjectiveTo summarize the effect of the multi-disciplinary treatment (MDT) for a patient with giant pancreatic cystic lymphangioma.MethodsThe clinical data of a patient with pancreatic lymphangioma admitted to the Affiliated Hospital of North Sichuan Medical College in March 2020 was retrospectively analyzed, then reviewed the literatures, and summarized the preoperative diagnosis, treatment, and management of perioperative period and long-term period after surgery of this rare disease.ResultsAfter admission, the patient was diagnosed as pancreatic tumor by various imaging and laboratory examinations. The nature was unknown. After discussion by MDT, it was decided to undergo a total pancreatectomy (TP). After the operation, drugs and diet were given to regulate blood glucose. The patient’s tumor disappeared after the operation, and no tumor recurrence was found in the three months after discharge.ConclusionsPancreatic lymphangioma is rare and lacks a clear diagnosis and treatment plan. The MDT mode can bring a clearer diagnosis and more effective treatment for it.
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 investigate predictive value of a new blood biochemical scoring system (CPWAG scoring system) on severity and mortality of acute pancreatitis (AP).MethodsThe AP patients who met the inclusion and exclusion criteria in our hospital from January 2017 to June 2019 were collected, then were divided into severe acute pancreatitis (SAP) group and non-SAP group according to the latest Atlanta classification. The differences of clinical characteristics and related blood biochemical indicators between the SAP group and the non-SAP group were compared. Univariate logistic regression analysis was used to screen blood biochemical risk indicators related to SAP. The receiver operating characteristic (ROC) curve was used to obtain the best cut-off value corresponding to the maximum Youden index of statistical significant risk factors and was assigned as 0 or 1 point according to different situations. At the same time, the pleural effusion of the BISAP score was included and assigned as 0 (yes) or 1 (no) point, then the CPWAG score was obtained by adding the point of the above indexes.The areas under the ROC curve (AUC) of the CPWAG, BISAP, APACHEⅡ, CTSI, and Ranson scoring systems in predicting severity and death of AP patients were also compared.ResultsA total of 451 patients with AP were included in this study, including 85 patients with SAP and 366 patients with non-SAP. Compared with the non-SAP group, the etiology of AP was mainly biliary (P<0.05), with higher levels of white blood cell count (WBC), C reactive protein (CRP), procalcitonin (PCT), and glucose (P<0.05), greater red blood cell distribution width value (P<0.05), longer prothrombin time (PT) and hospital stay (P<0.05), lower albumin (ALB) and blood calcium levels (P<0.05), higher BISAP, APACHEⅡ, CTSI and Ranson points (P<0.05), and higher proportions of patients with pleural effusion, multiple organ dysfunction syndrome, and death (P<0.05) in the SAP group. The highest score of the CPWAG scoring system included CRP, PCT, WBC, ALB, glucose, blood calcium, and pleural effusion was 7. With the increase of CPWAG score, the proportion of SAP and death patients showed an increasing trend (P<0.001). The AUC of the CPWAG scoring system in predicting SAP was 0.866, which was higher than those of Ranson (AUC=0.722, Z=5.317, P<0.001), APACHEⅡ (AUC=0.706, Z=5.019, P<0.001), and CTSI (AUC=0.805, Z=1.962, P=0.005) scoring system, but which had no statistically significant difference as compared with the BISAP scoring system (AUC=0.819, Z=1.816, P=0.070). The AUC of the CPWAG scoring system in predicting death had a high ability (AUC=0.823), which had no significant differences as compared with the Ranson, APACHEⅡ, CTSI, and BISAP scoring systems (P>0.05).ConclusionThe CPWAG score is valuable in predicting the severity and mortality of AP patients, allowing accurate and early assessment of AP patients.
ObjectiveTo investigate and analysis the data of patients with hepatic echinococcosis in Ganzi County in 2018, and to understand the epidemiological characteristics of hepatic echinococcosis in Ganzi County, Sichuan Province.MethodsA total of 811 patients were enrolled. The basic information of sex, age, weight, occupation, nation, educational level, family address and so on were recorded. The location, number, classification, transverse diameter and longitudinal diameter of hepatic echinococcosis masses were recorded by abdominal color Doppler ultrasonography.ResultsIn 2018, 811 new cases of hepatic echinococcosis were reported in Ganzi County, with a prevalence rate of 4.6% (811/17 650), and 17.81% (572/3 212) in the Datongma area. Patients ranged in age from 6 to 92, the average age was (44.8±16.6) years old. The majority of patients were Tibetans (98.5%), herdsmen (71.8%) and illiterates (83.5%). The most common lesions were in right liver (84.2%) and single (91.4%).ConclusionsThere is serious transmission of hepatic echinococcosis in Ganzi County, especially in pure pastoral areas, and HAE is more prevalent than HCE. Most of the infected people are Tibetan herdsmen with illiterate educational background and more females than males. The peak incidence of hepatic echinococcosis is 30-55 years old. Close monitoring should be carried out for these people.
Objective To observe the effect of forkhead box Q1(FOXQ1) short hairpin RNA (shRNA) on sensitivity of oxaliplatin chemotherapy in hepatpcellular carcinoma cell line SMMC-7721. Methods ① Complementary shRNA oligonucleotides targeting the FOXQ1 gene and negative control-shRNA were designed and inserted into lentiviral vector. shRNA lentivirus vectors were transfected into SMMC-7721 cells and the lentivirus vector with the best silencing effect was screened. ② SMMC-7721 cells were divided into interference group (SMMC-7721 cells were transfected with FOXQ1-shRNA-1), negative control group (SMMC-7721 cells were transfected with negative control-shRNA), and blank control group (SMMC-7721 cells did not received any treatment), and the expressions of FOXQ1 mRNA and its protein in SMMC-7721 cells were detected at 72 hours after transfection. ③ SMMC-7721 cells were divided into interference group, negative control group, blank control group, interference+oxaliplatin group, negative control+oxaliplatin group, and blank control+oxaliplatin group, apoptosis rates and viability of SMMC-7721 cells were detected at 48 hours after transfection. Results ① The expressions of FOXQ1 mRNA and its protein in SMMC-7721 cells of the FOXQ1-shRNA-1 group were both lower than those of the FOXQ1-shRNA-2 group and FOXQ1-shRNA-3 group (P<0.05), so the FOXQ1-shRNA-1 was the best lentiviral vector. ② Compared with the negative control group and the blank control group, the expressions of FOXQ1 mRNA and its protein of the interference group were both lower (P<0.05), but there was no significant difference between the negative control group and the blank control group (P>0.05). ③ Whether added oxaliplatin or not, compared with the negative control group and the blank control group, the apoptosis rates of the interference group were higher (P<0.05), but the viability of the interference group was lower (P<0.05), and there was no significant difference between the negative control group and the blank control group under the same condition (P>0.05). The apoptosis rates of groups (including the interference group, the negative control group, and the blank control group) which added oxaliplatin were higher than those groups didn’t add oxaliplatin (P<0.05), but viability of groups (including the interference group, the negative control group, and the blank control group) which added oxaliplatin was lower than those groups didn’t add oxaliplatin (P<0.05). Conclusion Down-regulation of expression of FOXQ1 by shRNA in hepatocellular carcinoma cell line SMMC-7721 can effectively induce apoptosis and increase sensitivity of SMMC-7721 cells to oxaliplatin.