Use of the ulcerative colitis endoscopic index of severity and Mayo endoscopic score for predicting the therapeutic effect of mesalazine in patients with ulcerative colitis

Objective:The ulcerative colitis endoscopic index of severity(UCEIS)and the Mayo endoscopic score(MES)are developed as objective methods of evaluating endoscopic severity in patients with ulcerative colitis(UC).The aim of this study is to investigate the diagnostic accuracy of the UCEIS and MES in predicting the patient's response to mesalazine.Methods:Consecutive patients with UC who had undergone colonoscopy within 1 month before starting mesalazine between October 2011 and July 2016 were retrospectively collected at the Department of Gastroenterology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.The median follow-up was 81 months,and all the data were analyzed in January 2021.The primary outcome was the need for step-up treatment,which included the use of corticosteroids,immunomodulatory,or surgery during admission and follow-up.Data were analyzed using the c2 or Fisher exact test,Spearman test,t-test,and ManneWhitney U test.Results:Totally,65 patients were enrolled,of whom 12(18.5%)needed step-up treatment due to nonresponse to mesalazine.The UCEIS score,MES,and the ulcerative colitis disease activity index(UCDAI)score were significantly higher in patients who had nonresponse to mesalazine(UCEIS score:6.92±0.69 vs.4.45±1.17,p<0.001;MES:2.67±0.49 vs.2.15±0.69,p=0.024;UCDAI score:9.33±1.87 vs.6.70±2.38,p=0.002).In the multivariate analysis,the UCEIS score(OR=25.65,95%CI:3.048 e45.985,p=0.003),UCDAI score(OR=1.605,95%CI:1.144e2.254,p=0.006),and C-reactive protein level(OR=1.056,95%CI:1.006e1.108,p=0.026)were independent risk factors of nonresponse.The area under the ROC curve of UCEIS was 0.95,with a sensitivity of 100%and specificity of 84.6%,a cut-off value of 6,which outperformed the MES with an area under the ROC curve of 0.70.When the UCEIS score≥6,60%of patients eventually needed step-up treatment.Conclusions:The UCEIS is a useful instrument for predicting the therapeutic effect in patients with UC treated with mesalazine.The high probability of mesalazine treatment failure and benefits of other therapies should be discussed in patients with baseline UCEIS score≥6.

Dietary inflammatory index and its impact on severity and recurrence of Tourette syndrome in children

BACKGROUND Tourette syndrome(TS)is a neurodevelopmental disorder characterized by the presence of motor and vocal tics,typically beginning in childhood.Despite signifi-cant research efforts,the exact pathophysiology of TS remains incompletely understood.Recent studies suggest that inflammation may play a role in the severity and progression of TS,pointing to the potential influence of dietary and lifestyle factors on the condition.Currently,research on the specific connection between dietary inflammatory index(DII)and TS is still in its early stages,requir-ing additional clinical and epidemiological studies to validate the strength and specific mechanisms of this connection.METHODS A total of 207 children diagnosed with TS in the pediatric department of Qingdao Chengyang People’s Hospital from January 2022 to January 2023 were selected.They were divided into stable and unstable groups based on follow-up condi-tions.Before enrollment,general information of the children[age,gender,body mass index(BMI),guardian’s education level,DII score,medical history,family history,academic stress,electronic device usage,medication,and disease progression]was assessed,and serum inflammatory levels were measured during follow-up visits.DII scores and Yale Global Tic Severity Scale(YGTSS)scores were calculated.Furthermore,based on YGTSS scores,the children were classified into mild,moderate,and severe groups.The DII,interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-alpha(TNF-α)levels in each group were compared.RESULTS Follow-up surveys were completed by 207 children and their guardians.Among them,117 children were in the stable group,and 90 were in the recurrent group.We found no statistically significant differences in age,gender,comorbidities,BMI,and disease duration between the two groups(P>0.05).However,academic stress,electronic device usage,medication,guardian’s education level,and DII scores showed statistically significant differences between the groups(P<0.05).Multifactorial regression analysis revealed that guardian’s anxiety level,DII score,medication,academic stress,and family history were statistically significant factors(P<0.05)affecting the recurrence of TS in children.Therefore,anxiety level,DII score,medication status,electronic device usage,and academic stress were identified as factors influencing the recurrence of TS in children.Among them,DII score,academic stress,and family history had odds ratios(OR)greater than 1,indicating risk factors,whereas medication status and guardian’s education level had OR values less than 1,indicating protective factors.According to the YGTSS scores,children were categorized into mild,moderate,and severe groups.Comparative analysis of DII and inflammatory levels in children with different degrees of tic disorders revealed that the severe group had the highest DII and inflammatory levels,followed by the moderate group,and the mild group had the lowest levels.The trend of TS progression was consistent with the DII results.Receiver operating characteristic curves were plotted to predict disease progression in patients with TS via inflammatory markers.The areas under the curve for IL-6,CRP,and TNF-αwere 0.894(95%CI:0.817-0.969),0.793(95%CI:0.694-0.893),and 0.728(95%CI:0.614-0.843)respectively,with statistically significant differences(P<0.05).According to the Youden index,the optimal cutoff values were IL-6=3.775 ng/L(sensitivity 68.1%and specificity 68.4%),CRP=6.650 mg/L(sensitivity 60.6%and specificity 68.4%),and TNF-α=0.666(sensitivity 60.6%and specificity 71.1%).CONCLUSION We found a certain correlation between DII and the severity,recurrence,and inflammatory levels of TS in children.Reasonable reduction in the intake of pro-inflammatory foods may be beneficial in reducing the risk of disease progression in children with TS.

Systemic immune-inflammation index combined with pediatric appendicitis score in assessing the severity and prognosis for paediatric appendicitis

BACKGROUND Pediatric appendicitis is a common cause of abdominal pain in children and is recognized as a significant surgical emergency.A prompt and accurate diagnosis is essential to prevent complications such as perforation and peritonitis.AIM To investigate the predictive value of the systemic immune-inflammation index(SII)combined with the pediatric appendicitis score(PAS)for the assessment of disease severity and surgical outcomes in children aged 5 years and older with appendicitis.METHODS Clinical data of 104 children diagnosed with acute appendicitis were analyzed.The participants were categorized into the acute appendicitis group and chronic appendicitis group based on disease presentation and further stratified into the good prognosis group and poor prognosis group based on prognosis.The SII and PAS were measured,and a joint model using the combined SII and PAS was constructed to predict disease severity and surgical outcomes.RESULTS Significant differences were observed in the SII and PAS parameters between the acute appendicitis group and chronic appendicitis group.Correlation analysis showed associations among the SII,PAS,and disease severity,with the combined SII and PAS model demonstrating significant predictive value for assessing disease severity[aera under the curve(AUC)=0.914]and predicting surgical outcomes(AUC=0.857)in children aged 5 years and older with appendicitis.CONCLUSION The study findings support the potential of integrating the SII with the PAS for assessing disease severity and predicting surgical outcomes in pediatric appendicitis,indicating the clinical utility of the combined SII and PAS model in guiding clinical decision-making and optimizing surgical management strategies for pediatric patients with appendicitis.

Retrospective analysis of two northern California wild-land fires via Landsat five satellite imagery and Normalized Difference Vegetation Index (NDVI)

Wild-land fires are a dynamic and destructive force in natural ecosystems. In recent decades, fire disturbances have increased concerns and awareness over significant economic loss and landscape change. The focus of this research was to study two northern California wild-land fires: Butte Humboldt Complex and Butte Lightning Complex of 2008 and assessment of vegetation recovery after the fires via ground based measurements and utilization of Landsat 5 imagery and analysis software to assess landscape change. Multi-temporal and burn severity dynamics and assessment through satellite imagery were used to visually ascertain levels of landscape change, under two temporal scales. Visual interpretation indicated noticeable levels of landscape change and relevant insight into the magnitude and impact of both wild-land fires. Normalized Burn Ratio (NBR) and delta NBR (DNBR) data allowed for quantitative analysis of burn severity levels. DNBR results indicate low severity and low re-growth for Butte Humboldt Complex “burned center” subplots. In contrast, DNBR values for Butte Lightning Complex “burned center” subplots indicated low-moderate burn severity levels.

Reliability and Validity of Chinese Version of the Addiction Severity Index among Drug Users in the Community

Objective To assess the reliability and validity of a new Chinese version of the Addiction Severity Index （ASI-C） in drug users in the community. Methods Three hundred and eighty-one drug users in the community in Chengdu, Sichuan province were recruited. They were interviewed with a questionnaire consisting of the ASI-C revised on the basis of the previous Chinese version and 38 were interviewed for the second time at an interval of 7 days to evaluate test-retest reliability. Results Cronbach＇s c~ coefficients for the internal consistency of the scale varied from 0.49 to 0.86. Test-retest correlation coefficients ranged from 0.50 to 0.93. Criterion validity was found acceptable, as compared with the Symptom Checklist 90 （SCL-90）. Conclusion The ASI-C presented acceptable reliability and validity in a sample of drug users in the community.

Could Metabolic Risk Factors Affect the Severity of Knee Osteoarthritis in Type-2 Diabetes Mellitus Patients? A Cross-Sectional Study

Introduction: Osteoarthritis (OA) is a common joint disease with varying degrees of severity. Patients with type-2 diabetes mellitus (T2DM) demonstrate a higher prevalence of OA, and several mechanisms have been proposed to explain the severity of OA in DM. In this study, we aimed to explore the effect of metabolic risk factors on the severity of knee OA in T2DM patients. Methods: This cross-sectional study was conducted in 2018 and included 57 patients with T2DM. Data were collected in terms of demographic variables and metabolic tests. After obtaining a medical history and examination, anteroposterior (AP) and lateral radiographs of both knees were taken, and the severity of OA was classified using the Kellgren-Lawrence (KL) classification system and categorized into two groups. Group A demonstrated patients with mild OA equivalent to grade 1 or 2 KL and group B showed moderate to severe OA (grade 3 or 4 KL). Results: A total of 57 patients with T2DM enrolled in the study, of which 32 patients exhibited grade 1 or 2 KL (group A) and 25 with grade 3 or 4 KL (group B). The mean age and mean body mass index (BMI) were higher in group B compared to group A, and the differences were statistically significant (P-value = 0.01). As with the other metabolic tests, the mean serum hemoglobin A1C (HbA1c) level was not statistically significant (P-value = 0.34). Conclusion: The data revealed that metabolic factors play a minor role in the severity of OA in patients with DM and that these changes are primarily influenced by increasing BMI and age.

The role of quick Sepsis-related Organ Failure Assessment score as simple scoring system to predict Fournier gangrene mortality and the correlation with Fournier’s Gangrene Severity Index: Analysis of 69 patients

Objective:Fournier’s gangrene is a rare but life-threatening infection disease with high mortality rate.The quick Sepsis-related Organ Failure Assessment(qSOFA)is a new and simpler scoring system that may identify patients with suspected infection who are at greater risk for a poor outcome.The purpose of this study was to find out role of qSOFA in determining prognosis of Fournier’s gangrene patients.Methods:This study is a case control with retrospective review of Fournier’s gangrene patients treated at Hasan Sadikin Hospital from January 2013 to December 2017 who met inclusion criteria.Participants were divided into two groups according to qSOFA score as high qSOFA(2-3)and low qSOFA(0-1).Results:From 69 patients,the mortality rate was 24.6%.The sensitivity of qSOFA score to predict mortality was 88.2%;the specificity was 94.2%;positive predictive value was 83.3%;negative predictive value was 96.1%;positive likelihood ratio was 15.2;negative likelihood ratio was 0.12;and the area under the receiver operating characteristic curve of qSOFA was 94.2%.There was significant association between qSOFA scale and mortality with p-value of 0.0001.The qSOFA score has strong positive correlation with Fournier’s Gangrene Severity Index(p<0.0001,r=0.704).Conclusion:qSOFA scoring system has a high prognostic value and can be used to determine prognosis of Fournier’s gangrene patients.

Pain Efficacy of a Home-Based Low-Intensity Continuous Ultrasound Stimulator for Knee Arthritis: A Single-Arm, Open-Label, Prospective Clinical Trial

1) Background: Osteoarthritis (OA) is defined as a degenerative joint disease that mainly affects the bone. This study aims to evaluate the effect of low-intensity continuous ultrasound (LICUS) treatment on the knee of osteoarthritis patients through home-based intervention using the LICUS medical device. 2) Methods: The clinical trials were designed in a single-arm, open-label, and intervention study. Thirty-five participants, including those who dropped out (12%), were screened and enrolled. The patients received LICUS (1.1 MHz, 1.5 W/cm2, collimated beams) on the knee by the instructions of the investigator at home (5 min/session, 3 times/day, for four-weeks). Outcome measures were assessed using the Visual Analog Scale (VAS) as a primary endpoint and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as a secondary endpoint to evaluate pain relief and functional recovery of the knee between pre-treatment (baseline) and post-treatment (four-weeks). 3) Results: Knee pain scores measured using the VAS and WOMAC indices were significantly reduced after a four-week treatment with LICUS compared to baseline. Knee stiffness and functional capacity were significantly reduced after the LICUS application. In addition, there were no reports of adverse effects during the study period. 4) Conclusion: Long-term and home-based application of LICUS can be recommended as an alternative option for the treatment of OA patients, as evidenced by the effect of pain relief and knee function recovery.

Assessment of early factors for identification or prediction severe acute pancreatitis in pregnancy

BACKGROUND Acute pancreatitis in pregnancy(APIP)is a rare and serious condition,and severe APIP(SAPIP)can lead to pancreatic necrosis,abscess,multiple organ dysfunction,and other adverse maternal and infant outcomes.Therefore,early identification or prediction of SAPIP is important.AIM To assess factors for early identification or prediction of SAPIP.METHODS The clinical data of patients with APIP were retrospectively analyzed.Patients were classified with mild acute pancreatitis or severe acute pancreatitis,and the clinical characteristics and laboratory biochemical indexes were compared between the two groups.Logical regression and receiver operating characteristic curve analyses were performed to assess the efficacy of the factors for identification or prediction of SAPIP.RESULTS A total of 45 APIP patients were enrolled.Compared with the mild acute pancreatitis group,the severe acute pancreatitis group had significantly increased(P<0.01)heart rate(HR),hemoglobin,neutrophil ratio(NEUT%),and neutrophil–lymphocyte ratio(NLR),while lymphocytes were significantly decreased(P<0.01).Logical regression analysis showed that HR,NEUT%,NLR,and lymphocyte count differed significantly(P<0.01)between the groups.These may be factors for early identification or prediction of SAPIP.The area under the curve of HR,NEUT%,NLR,and lymphocyte count in the receiver operating characteristic curve analysis was 0.748,0.732,0.821,and 0.774,respectively.The combined analysis showed that the area under the curve,sensitivity,and specificity were 0.869,90.5%,and 70.8%,respectively.CONCLUSION HR,NEUT%,NLR,and lymphocyte count can be used for early identification or prediction of SAPIP,and the combination of the four factors is expected to improve identification or prediction of SAPIP.

Therapeutic and recurrence-preventing effects of Qi-Replenishing and Blood-Activating Formula in rats with acetic acid-induced gastric ulcer

Objective:To explore the therapeutic and recurrence-preventing effects of Qi-Replenishing and Blood-Activating Formula in rats with acetic acid-induced gastric ulcer.Methods:A total of 138 SD rats were selected to make rat models with gastric ulcer induced by acetic acid(24 rats with sham operation served as sham operation group),and were randomly divided into model group(n=30),western medicine group(n=30),traditional Chinese medicine(TCM) group(n=24) and combination group(combined western medicine and TCM group,n=30).Western medicine group was gavaged with omeprazole in the morning and with iso-volumetric distilled water in the afternoon;TCM group and TCM sham operation group were gavaged with iso-volumetric distilled water in the morning and with Qi-Replenishing and Blood-Activating Formula in the afternoon;combination group was gavaged with omeprazole in the morning and with Qi-Replenishing and Blood-Activating Formula in the afternoon;sham operation group and model group were gavaged with iso-volumetric distilled water both in the morning and afternoon.Ulcer indexes and degree of mucosal degree in rats at different time points after gavage were observed.Twentyeight days after gavage,interleukin(IL)-1β was given to induce ulcer recurrence so as to observe the recurrent severity and rate of ulcer in each group.Results:Compared with model group and western medicine group,treatment in combination group could prominently reduce the ulcer index of rats with peptic ulcer,and increase the healing rate and inhibition rate of peptic ulcer.After IL-1β-induced ulcer recurrence,combination group was significantly superior to model group and western medicine group in ulcer recurrent rate[50%(3/6) vs.100%(6/6)]and severity.Conclusions:Basic acid-suppression therapy combined with Qi-Replenishing and BloodActivating Formula can effectually improve the ulcer healing quality and reduce ulcer recurrence.

Model for end-stage liver disease score versus Child score in predicting the outcome of surgical procedures in patients with cirrhosis

AIM： To determine factors affecting the outcome of patients with cirrhosis undergoing surgery and to compare the capacities of the Child-Turcotte-Pugh （CTP） and model for end-stage liver disease （MELD） score to predict that outcome. METHODS： We reviewed the charts of 195 patients with cirrhosis who underwent surgery at two teaching hospitals over a five-year period. The combined endpoint of death or hepatic decompensation was considered to be the primary endpoint. RESULTS： Patients who reached the endpoint had a higher MELD score, a higher CTP score and were more likely to have undergone an urgent procedure. Among patients undergoing elective surgical procedures, no statistically significant difference was noted in the mean MELD （12.8 ＋ 3.9 vs 12.6 ＋ 4.7, P = 0.9） or in the mean CTP （7.6 ± 1.2 vs 7.7 ± 1.7, P = 0.8） between patients who reached the endpoint and those who did not. Both mean scores were higher in the patients reaching the endpoint in the case of urgent procedures （MELD： 22.4 ± 8.7 vs 15.2 ± 6.4, P = 0.0007; CTP： 9.9 ± 1.8 vs 8.5 ± 1.8, P = 0.008）. The performances of the MELD and CTP scores in predicting the outcome of urgent surgery were only fair, without a significant difference between them （AUC = 0.755 ± 0.066 for MELD vs AUC = 0.696 ± 0.070 for CTP, P = 0.3）. CONCLUSION： The CTP and MELD scores performed equally, but only fairly in predicting the outcome of urgent surgical procedures. Larger studies are needed to better define the factors capable of predicting the outcome of elective surgical procedures in patients with cirrhosis.equally, but only fairly in predicting the outcome of urgent surgical procedures. Larger studies are needed to better define the factors capable of predicting the outcome of elective surgical procedures in patients with cirrhosis.

Performance of different drought indices for agriculture drought in the North China Plain

The Palmer drought severity index （PDSI）, standardized precipitation index （SPI）, and standardized precipitation evapotranspiration index （SPEI） are used worldwide for drought assessment and monitoring. However, substantial differences exist in the performance for agricultural drought among these indices and among regions. Here, we performed statistical assessments to compare the strengths of different drought indices for agricultural drought in the North China Plain. Small differences were detected in the comparative performances of SPI and SPEI that were smaller at the long-term scale than those at the short-term scale. The correlation between SPI/SPEI and PDSI considerably increased from 1- to 12-month lags, and a slight decreasing trend was exhibited during 12- and 24-month lags, indicating a 12-month scale in the PDSI, whereas the SPI was strongly correlated with the SPEI at 1- to 24-month lags. Interestingly, the correlation between the trend of temperature and the mean absolute error and its correlation coefficient both suggested stronger relationships between SPI and the SPEI in areas of rapid climate warming. In addition, the yield-drought correlations tended to be higher for the SPI and SPEI than that for the PDSI at the station scale, whereas small differences were detected between the SPI and SPEI in the performance on agricultural systems. However, large differences in the influence of drought conditions on the yields of winter wheat and summer maize were evident among various indices during the crop-growing season. Our findings suggested that multi-indices in drought monitoring are needed in order to acquire robust conclusions.

Clinical significance of melatonin concentrations in predicting the severity of acute pancreatitis

AIM: To assess the value of plasma melatonin in predicting acute pancreatitis when combined with the acute physiology and chronic health evaluation?II?(APACHEII) and bedside index for severity in acute pancreatitis (BISAP) scoring systems.METHODS: APACHEII and BISAP scores were calculated for 55 patients with acute physiology (AP) in the first 24 h of admission to the hospital. Additionally, morning (6:00 AM) serum melatonin concentrations were measured on the first day after admission. According to the diagnosis and treatment guidelines for acute pancreatitis in China, 42 patients suffered mild AP (MAP). The other 13 patients developed severe AP (SAP). A total of 45 healthy volunteers were used in this study as controls. The ability of melatonin and the APACHEII and BISAP scoring systems to predict SAP was evaluated using a receiver operating characteristic (ROC) curve. The optimal melatonin cutoff concentration for SAP patients, based on the ROC curve, was used to classify the patients into either a high concentration group (34 cases) or a low concentration group (21 cases). Differences in the incidence of high scores, according to the APACHEII and BISAP scoring systems, were compared between the two groups.RESULTS: The MAP patients had increased melatonin levels compared to the SAP (38.34 ng/L vs 26.77 ng/L) (P = 0.021) and control patients (38.34 ng/L vs 30.73 ng/L) (P = 0.003). There was no significant difference inmelatoninconcentrations between the SAP group and the control group. The accuracy of determining SAP based on the melatonin level, the APACHEII score and the BISAP score was 0.758, 0.872, and 0.906, respectively, according to the ROC curve. A melatonin concentration ≤ 28.74 ng/L was associated with an increased risk of developing SAP. The incidence of high scores (≥ 3) using the BISAP system was significantly higher in patients with low melatonin concentration (≤ 28.74 ng/L) compared to patients with high melatonin concentration (> 28.74 ng/L) (42.9% vs 14.7%, P = 0.02). The incidence of high APACHEII scores (≥ 10) between the two groups was not significantly different.CONCLUSION: The melatonin concentration is closely related to the severity of AP and the BISAP score. Therefore, we can evaluate the severity of disease by measuring the levels of serum melatonin.

Reliability and Validity of Addiction Severity Index in Drug Users with Methadone Maintenance Treatment in Guizhou Province, China

Objective To evaluate the reliability and validity of the Chinese version of addiction severity index （ASI）-5th version （ASI-C-5）, in illegal drug users receiving methadone maintenance treatment （MMT） in China. Methods One hundred and eighty-six heroin addicts （144 men and 42 women） receivihg MMT at three clinics in Guizhou province, southwest China, were recmited. They were all interviewed with a questionnaire of ASI-C-5 and 35 were re-interviewed at an interval of seven days to assess its test-retest reliability. Results Cronbach＇s alpha for internal consistency of CSs varied from 0.60 to 0.81 in all domains. Test-retest reliability of composite scores （CSs） of ASI-C-5 were satisfactory （r=0.38-0.97）. Based on item analysis and expert＇s suggestions, five items were deleted and one item was modified in ASI-C-5. Criterion validity of ASI-C-5 was found acceptable, as compared to addicts＇ self-rating anxiety scale （SAS） and self-rating depression scale （SDS） （r=0.59 and 0.45） except for social support rating scale （SSRS）. Conclusions ASI-C-5 can be used for heroin addicts receiving MMT with acceptable reliability and validity.

Application of emergency severity index in pediatric emergency department

BACKGROUND： The purpose of triage is to identify patients needing immediate resuscitation, toassign patients to a pre-designed patient care area, and to initiate diagnostic/therapeutic measures asappropriate. This study aimed to use emergency severity index （ESI） in a pediatric emergency room.METHODS： From July 2006 to August 2010, a total of 21 904 patients visited the InternationalDepartment of Beijing Children＇s Hospital. The ESI was measured by nurses and physicians, andcompared using SPSS.RESULTS： Nurses of the hospital took approximately 2 minutes for triage. The results of triagemade by nurses were similar to those made by doctors for ESI in levels 1-3 patients. This findingindicated that the nurses are able to identify severe pediatric cases.CONCLUSION： In pediatric emergency rooms, ESI is a suitable tool for identifying severecases and then immediate interventions can be performed accordingly.

Magnetic resonance imaging and Crohn's disease endoscopic index of severity: Correlations and concordance

AIM To examine the correlation between magnetic resonance imaging(MRI) and endoscopic index of severity(CDEIS) in patients with Crohn's disease(CD).METHODS This was a retrospective study of 104 patients with CD that were treated at the Ruijin Hospital between March 2015 and May 2016. Among them, 61 patients with active CD were evaluated before/after treatment. MRI and endoscopy were performed within 7 d. CDEIS was evaluated. MRI parameters included Ma RIA scores, total relative contrast enhancement(tRCE), arterialRCE(aRCE), portalRCE(pRCE), delay phaseRCE(dRCE), and apparent diffusion coefficient. The correlation and concordance between multiple MRI findings and CDEIS changes before and after CD treatment were examined.RESULTS Among the 104 patients, 61 patients were classified as active CD and 43 patients as inactive CD. Gender, age, disease duration, and disease location were not significantly different between the two groups(all P > 0.05). CRP levels were higher in the active group than in the inactive group(25.12 ± 4.12 vs 5.14 ± 0.98 mg/L, P < 0.001). Before treatment, the correlations between CDEIS and MaRIAs in all patients were r = 0.772 for tRCE, r = 0.754 for aRCE, r = 0.738 for pRCE, and r = 0.712 for dRCE(all MaRIAs, P < 0.001), followed by MRI single indexes. Among the active CD patients, 44 cases were remitted to inactive CD after treatment. The correlations between CDEIS and MaRIAs were r = 0.712 for aRCE, r = 0.705 for tRCE, r = 0.685 for pRCE, and r = 0.634 for dRCE(all MaRIAs, P < 0.001).CONCLUSION Arterial Ma RIA should be an indicator for CD follow-up and dynamic assessment. CD treatment assessment was not completely concordant between CDEIS and MRI.

Projected Changes of Palmer Drought Severity Index under an RCP8.5 Scenario

The potential change of drought measured by the Palmer Drought Severity Index （PDSI） is projected by using a coupled climate system model under a Representative Pathway 8.5 （RCP8.5） scenario.The PDSI changes calculated by two potential evapotranspiration algorithms are compared.The algorithm of Thomthwaite equation overestimates the impact of surface temperature on evaporation and leads to an unrealistic increasing of drought frequency.The PM algorithm based on the Penman-Monteith equation is physically reasonably and necessary for climate change projections.The Flexible Global Ocean-Atmosphere-Land System model,Spectral Version 2 （FGOALS-s2） projects an increasing trend of drought during 2051-2100 in tropical and subtropical areas of North and South America,North Africa,South Europe,Southeast Asia,and the Australian continent.Both the moderate drought （PDSI ＜-2） and extreme drought （PDSI ＜-4） areas show statistically significant increasing trends under an RCP8.5 scenario.The uncertainty in the model projection is also discussed.

Drought fluctuations based on dendrochronology since 1786 for the Lenglongling Mountains at the northwestern fringe of the East Asian summer monsoon region

The Lenglongling Mountains （LLM） located in northeastern part of the Tibet Plateau, belong to a marginal area of the East Asian summer monsoon （EASM） and are sensitive to monsoon dynamics. Two tree-ring width chronologies developed from six sites of Picea crassifolia in the LLM were employed to study the regional drought variability. Correlation and temporal correlation analyses showed that relationships between the two chronologies and self-calibrated Palmer Drought Severity Index （sc_PDSI） were significant and stable across time, demonstrating the strength of sc_PDSI in modeling drought conditions in this region. Based on the relationships, the mean sc_PDSI was reconstructed for the period from 1786 to 2013. Dry conditions prevailed during 1817-1819, 1829-1831, 1928-1931 and 1999-2001. Relatively wet periods were identified for 1792-1795 and 1954-1956. Spatial correlations with other fourteen precipitation/drought reconstructed series in previous studies revealed that in arid regions of Northwest China, long-term variability of moisture conditions was synchronous before the 1950s at a decadal scale （1791-1954）. In northwestern margin of the EASM, most of all selected reconstructions had better consistency in low-frequency variation, especially during dry periods, indicating similar regional moisture variations and analogous modes of climate forcing on tree growth in the region.

Can ultrasound predict the severity of acute pancreatitis early by observing acute fluid collection?

INTRODUCTIONThe spectrum of acute pancreatitis (AP) ranges from a mild spontaneously resolved disorder to severe disease with mortality up to 20%-48.4%[1-3]. sAP is defined as the AP with organ failure and /or local complications which developed form acute fluid collection (AFC) including necrosis ,abscess , pseudocyst formation into or around the pancreas [4].

Spatiotemporal analysis of drought variability based on the standardized precipitation evapotranspiration index in the Koshi River Basin, Nepal

Drought is an inevitable condition with negative impacts in the agricultural and climatic sectors,especially in developing countries.This study attempts to examine the spatial and temporal characteristics of drought and its trends in the Koshi River Basin(KRB)in Nepal,using the standardized precipitation evapotranspiration index(SPEI)over the period from 1987 to 2017.The Mann-Kendall test was used to explore the trends of the SPEI values.The study illustrated the increasing annual and seasonal drought trends in the KRB over the study period.Spatially,the hill region of the KRB showed substantial increasing drought trends at the annual and seasonal scales,especially in summer and winter.The mountain region also showed a significant increasing drought trend in winter.The drought characteristic analysis indicated that the maximum duration,intensity,and severity of drought events were observed in the KRB after 2000.The Terai region presented the highest drought frequency and intensity,while the hill region presented the longest maximum drought duration.Moreover,the spatial extent of drought showed a significant increasing trend in the hill region at the monthly(drought station proportion of 7.6%/10 a in August),seasonal(drought station proportion of 7.2%/10 a in summer),and annual(drought station proportion of 6.7%/10 a)scales.The findings of this study can assist local governments,planners,and project implementers in understanding drought and developing appropriate mitigation strategies to cope with its impacts.