Development and validation of a nomogram for predicting survival in patients with acute pancreatitis

BACKGROUND:Acute pancreatitis(AP)is a complex and heterogeneous disease.We aimed to design and validate a prognostic nomogram for improving the prediction of short-term survival in patients with AP.METHODS:The clinical data of 632 patients with AP were obtained from the Medical Information Mart for Intensive Care(MIMIC)-IV database.The nomogram for the prediction of 30-day,60-day and 90-day survival was developed by incorporating the risk factors identified by multivariate Cox analyses.RESULTS:Multivariate Cox proportional hazard model analysis showed that age(hazard ratio[HR]=1.06,95%confidence interval[95%CI]1.03-1.08,P<0.001),white blood cell count(HR=1.03,95%CI 1.00-1.06,P=0.046),systolic blood pressure(HR=0.99,95%CI 0.97-1.00,P=0.015),serum lactate level(HR=1.10,95%CI 1.01-1.20,P=0.023),and Simplified Acute Physiology Score II(HR=1.04,95%CI 1.02-1.06,P<0.001)were independent predictors of 90-day mortality in patients with AP.A prognostic nomogram model for 30-day,60-day,and 90-day survival based on these variables was built.Receiver operating characteristic(ROC)curve analysis demonstrated that the nomogram had good accuracy for predicting 30-day,60-day,and 90-day survival(area under the ROC curve:0.796,0.812,and 0.854,respectively;bootstrap-corrected C-index value:0.782,0.799,and 0.846,respectively).CONCLUSION:The nomogram-based prognostic model was able to accurately predict 30-day,60-day,and 90-day survival outcomes and thus may be of value for risk stratification and clinical decision-making for critically ill patients with AP.

Improved hemimorphite flotation using xanthate as a collector with S(Ⅱ) and Pb(Ⅱ) activation

The flotation of hemimorphite using the S(Ⅱ)–Pb(Ⅱ)–xanthate process,which includes sulfidization with sodium sulfide,activation by lead cations,and subsequent flotation with xanthate,was investigated.The flotation results indicated that hemimorphite floats when the S(Ⅱ)–Pb(Ⅱ)–xanthate process is used; a maximum recovery of approximately 90% was obtained.Zeta-potential,contact-angle,scanning electron microscopy–energy-dispersive spectrometry(SEM–EDS),and diffuse-reflectance infrared Fourier transform spectroscopy(DRIFTS) measurements were used to characterize the activation products on the hemimorphite surface and their subsequent interaction with sodium butyl xanthate(SBX).The results showed that a Zn S coating formed on the hemimorphite surface after the sample was conditioned in an Na2 S solution.However,the formation of a Zn S coating on the hemimorphite surface did not improve hemimorphite flotation.With the subsequent addition of lead cations,Pb S species formed on the mineral surface.The formation of the Pb S species on the surface of hemimorphite significantly increased the adsorption capacity of SBX,forming lead xanthate(referred to as chemical adsorption) and leading to a substantial improvement in hemimorphite flotation.Our results indicate that the addition of lead cations is a critical step in the successful flotation of hemimorphite using the sulfidization–lead ion activation–xanthate process.

Bilateral Lower Limb and Abdominal Elephantiasis Due to Erysipelas

To the Editor： Elephantiasis results from chronic lymphedema and is characterized by gross enlargement of the arms, legs, or genitalia. It occurs due to various obstructive diseases of the lymphatic system. The most common form of lymphedema is secondary lymphedema involving resection or ablation of the regional lymph nodes by surgery, radiation, tumor invasion, direct trauma, or an infection. We present an unusual case of bilateral lower limb and abdominal elephantiasis due to extensive lymph node destruction by erysipelas.