A retrospective study of patients complaining of nontraumatic acute abdominal pain,admitted in the emergency department of an urban hospital in China

Background:Nontraumatic acute abdominal pain(AAP)accounts for a large proportion of emergency department(ED)admissions.This study aimed to explore the underlying correlations among basic information,imaging examinations,and diagnoses.Methods:A total of 7453 patients complaining of AAP,admitted to the ED of Zhongnan Hospital of Wuhan University,were enrolled in this retrospective study from January 1 to December 30,2019.We collected the following information from the patients:sex,age,date of visit,pain location,nature of pain,level of severity,imaging(computed tomography,x-ray,and ultrasound),diagnosis,and outcomes(re-lease from the hospital,transfer to another hospital,transfer to another department,observation room,hospitalization,or death).Results:According to this study,AAP was more common in female than male.A total of 82.11%patients of AAP were in level 3 of se-verity,while 0.19%patients were in level 1.A total of 77.20%of the patients had undergone imaging.Swelling pain and colic are the 2 most common types of AAP.Nonspecific abdominal pain(NSAP)is the most common diagnosis.In the diagnosis of NSAP and gastroenteritis,female patients were more prevalent than male patients,but for renal colic,male patients were 3 times as many as female patients.Non-specific abdominal pain,biliary colic,and cholecystitis are the 3 leading causes in patients 65 years or older.Nonspecific abdominal pain,renal colic,and gastroenteritis are the 3 leading causes of AAP in patients younger than 65 years.Conclusion:With the help of imaging,clinicians can specify a diagnosis and perform corresponding treatment in most cases.However,making a precise diagnosis of AAP within a short period is still challenging.Further research should be conducted to seek safer and more effective techniques to streamline clinicians’work.

Generalized Integral Representations for Functions with Values in C(V_(3,3))

By using the solution to the Helmholtz equation u-λu = 0(λ≥ 0),the explicit forms of the so-called kernel functions and the higher order kernel functions are given.Then by the generalized Stokes formula,the integral representation formulas related with the Helmholtz operator for functions with values in C(V3,3) are obtained.As application of the integral representations,the maximum modulus theorem for function u which satisfies Hu = 0 is given.

Important scoring systems for assessing the severity of COVID-19 based on COVID-19-related deaths in Wuhan,China

Background:This study aimed to investigate the clinical characteristics of 21 deaths and evaluate potential factors affecting disease severity and mortality risk in patients with coronavirus disease(COVID-19).Methods:This retrospective analysis assessed clinical data of 21 patients who died owing to COVID-19.Disease severity and mortality risk were assessed using Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ);Sepsis-related Organ Failure Assessment(SOFA);multilobular infiltration,hypo-lymphocytosis,bacterial coinfection,smoking history,hypertension and age(MuLBSTA);and pneumonia severity index(PSI)scores.Results:The mean age of the patients was 66±14 years and 15(71.4%)patients were men.Sixteen(76.2%)patients had chronic medical illnesses.Twelve(57.1%)patients were overweight.Decreased lymphocyte proportions were observed in 17(81.0%)patients on admission.Elevated D-dimer levels were observed in 11(52.4%)patients,and the levels significantly increased when pneumonia deteriorated.The initial APACHE II and SOFA scores demonstrated that 18(85.7%)and 13(61.9%)patients,respectively,were in the middle-risk level.MuLBSTA and PSI scores after admission were associated with higher risks of mortality in 13(61.9%)patients.Most patients developed organ failure and subsequently died.Conclusions:Older,overweight,male patients with a history of chronic illnesses and continuously decreased lymphocyte proportions and increased D-dimer levels might have higher risks of death owing to COVID-19.The combination of general scoring(SOFA)and pneumonia-specific scoring(MuLBSTA and PSI)systems after admission might be sensitive in assessing the mortality risk of patients with COVID-19 who are in critical condition.