RESUMEN
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 â ¡ (APACHE â ¡) 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 â ¡ 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 â ¡ 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 â ¡.
Asunto(s)
Pancreatitis , Enfermedad Aguda , Adulto , Femenino , Humanos , Masculino , Pancreatitis/diagnóstico por imagen , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos XRESUMEN
To investigate the effect of dietary chromium (Cr) as Cr methionine (CrMet) on growth performance, carcass traits, pork quality, meat colour and expression of meat colour-related genes in growing-finishing pigs, 189 crossbred Duroc×(Landrace×Yorkshire) growing-finishing pigs (male, castrated, average initial BW 74.58±1.52 kg) were selected and randomly allocated into four groups. Dietary treatments per kg of feed were as follows: 0 (CT), 0.3 mg/kg (T1), 0.6 mg/kg (T2) and 0.9 mg/kg (T3) Cr (in the form of CrMet; as-fed basis), and each treatment was replicated five times with 8 to 10 pigs per replicate pen. During the 28 d of the experiment, both the ADG and the ADFI increased linearly (p<0.05) as the level of dietary Cr increased. The F/G ratio decreased linearly (p<0.05). As dietary Cr increased, loin muscle areas (linear, p = 0.013) and average backfat thickness (linear, p = 0.072) decreased. Shear force (linear, p = 0.070) and Commission Internationale de I'Éclairage (CIE) redness (quadratic, p = 0.028) were increased. In addition, CIE Lightness (quadratic, p = 0.053) were decreased as dietary Cr increased. As dietary Cr increased, total myglobin (Mb) content (quadratic, p = 0.015) and the mb mRNA levels (quadratic, p = 0.046) in longissimus muscles of pigs were up-regulated. In conclusion, supplementation of dietary Cr improved growth and meat colour, but increased shear force and decreased IMF reduced palatability of longissimus muscles. Moreover, the increasing total Mb content and mb mRNA levels indicated that CrMet dietary supplementation may improve meat colour via up-regulating expression of the mb gene.
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A four-wavelength microspectrophotometric method has been developed to determine both O2 and CO saturation of hemoglobin in frozen small vessels. This method compensates for the nonspecific light loss related to the ice crystals and in addition can simultaneously measure both hemoglobin O2 and CO saturation in frozen blood. By using four wavelengths in the 540-580 nm range, it is possible to determine both O2 and CO saturations in frozen blood. This four-wavelength method demonstrated an accuracy of 6-8% within 95% confidence limits (SE of estimate = 3-4%) for both CO and O2 saturation determinations in frozen blood. The linear regression of the hemoglobin O2 saturation calibration was significant with an r2 value of 0.989. The linear regression of the CO saturation calibration was also significant with an r2 of 0.996. The repeatability of each measurement was on the order of 1-6%. This method also represents an accuracy within 5% for measurements in the frozen rabbit heart for both CO and O2 in vessels between 20 and 100 microns in diameter. It compares favorably with other previously reported methods. It shows a similar accuracy but requires fewer repeat measurements than the three-wavelength method. This method can provide accurate measurement of O2 and CO saturation in small frozen arterioles and venules of any organ.
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Arteriolas , Carboxihemoglobina/análisis , Congelación , Oxihemoglobinas/análisis , Vénulas , Animales , Oximetría/métodos , Conejos , Análisis de Regresión , Espectrofotometría/métodosRESUMEN
The variable portion of a human lambda-type Bence Jones protein (Lee) has been prepared by limited tryptic digestion. Its amino acid sequence is determined from analysis of tryptic peptides, CNBr cleavage fragments prepared from the reduced-aminoethylated protein. Peptides are aligned by homology to other lambda-type proteins. The Lee L-chain has an unusual extension of two amino acid residues (Val-Thr) at the N-terminus. An idiotypic antibody of Lee can react with two other lambda-type Bence Jones proteins, Meg (V lambda IV) and Cap (V lambda III). Application of the principle of Chou and Fasman to the sequence data indicates that two portions on the surface of the V-region have identical secondary structures similar to the portions of the Meg and Cap lambda-chains. This appears to relate to the idiotypic similarities of the three proteins.