Objective:To investigate the effectiveness of the systemic immune-inflammatory(SII)index and other inflammatory parameters in predicting mortality among patients with acute cholecystitis(AC).Methods:279 Patients prese...Objective:To investigate the effectiveness of the systemic immune-inflammatory(SII)index and other inflammatory parameters in predicting mortality among patients with acute cholecystitis(AC).Methods:279 Patients presented to the emergency department with abdominal pain and diagnosis of AC between September 2021 and September 2023 were included in the study.Demographic data,laboratory parameters,clinical follow-ups,and outcomes of the patients were recorded.Results:The mean age of the patients was(55.0±16.3)years and 36.6%were male.63.8%Had gallbladder/choledochal stones and 49.5%underwent surgery.The mortality rate was 6.1%.Advanced age(P=0.170)and prolonged hospitalization(P=0.011)were statistically significant risk factors for mortality.Decreased lymphocyte count(P=0.020)and increased C-reactive protein(CRP)levels(P=0.033)were found to be risk factors for mortality.According to the mortality predictor ROC analysis results,the cut-off for SII index was 3138(AUC=0.817,sensitivity=70.5%,specificity=84.7%),the cut-off for neutrophil count was 15.28×10^(3)/mm^(3)(AUC=0.761,sensitivity=52.9%,specificity=95.0%),the cut-off for leukocyte count was 19.0×10^(3)/mm^(3)(AUC=0.714,sensitivity=52.9%,specificity=98.0%),cut-off for CRP was 74.55(AUC=0.758,sensitivity=70.5%,specificity=79.0%),cut-off for aspartate transaminase(AST)was 33.0 IU/L(AUC=0.658,sensitivity=82.3%,specificity=50.3%).Conclusions:The SII index may be a good predictor of mortality with high sensitivity and specificity.Elevated levels of neutrophils,leukocytes,CRP,and AST are other inflammatory parameters that can be used to predict mortality associated with AC.展开更多
OBJECTIVE:To investigate the antipyretic effect of early treatment with Traditional Chinese Medicine(TCM) on coronavirus disease 2019(COVID-19) patients.METHODS:We retrospectively analyzed 369 patients from January 26...OBJECTIVE:To investigate the antipyretic effect of early treatment with Traditional Chinese Medicine(TCM) on coronavirus disease 2019(COVID-19) patients.METHODS:We retrospectively analyzed 369 patients from January 26th,2020 to April 15th,2020,who had been diagnosed with COVID-19.Among 92 eligible cases,45 cases were identified as treatment group Ⅰ(n = 45) and 47 cases were identified as treatment group Ⅱ.Patients in the treatment group Ⅰ were treated with TCM herbal decoction within 5 d after admission.Patients in the treatment group Ⅱ were treated with TCM herbal decoction after the 6th admission day.The onset time of antipyretic effect,the antipyretic time,the time of negative oropharyngeal swab nucleic acid conversion,and the changes of cell count in blood routine test were compared.RESULTS:The treatment group Ⅰ showed shorter average antipyretic duration(4 vs 7 d;P < 0.05),and shorter average time for polymerase chain reaction(PCR) nucleic acid test results to turn negative(7 vs 11 d;P < 0.05) than the treatment group II.For patients(n = 54) with body temperature > 38 ℃,patients in the treatment group I had shorter median onset time of antipyretic effect than those in the treatment group Ⅱ(3 vs 4 d;P < 0.05).The absolute lymphocyte(LYMPH) count and absolute eosinophil(EOS) count on the 3rd day after admission and the neutrophil/lymphocyte ratio on the 6th day after admission of patients in the treatment group I were notably different from those in the treatment group Ⅱ at the same time point(P < 0.05).Based on Spearman’s rank correlation analysis,the change of body temperature on the 3rd day after admission was positively correlated with the increase of EOS count and the increase of EOS count and LYMPH counts on the 6th day after admission(P < 0.01).CONCLUSIONS:Early TCM intervention within 5 d after hospital admission shortened the onset time of antipyretic effect and fever duration of COVID-19 patients,reduced the time required for PCR test results to turn negative.Moreover,early TCM intervention also improved the results of inflammatory markers for COVID-19 patients.LYMPH and EOS counts can be used as indicators of TCM antipyretic effect.展开更多
文摘Objective:To investigate the effectiveness of the systemic immune-inflammatory(SII)index and other inflammatory parameters in predicting mortality among patients with acute cholecystitis(AC).Methods:279 Patients presented to the emergency department with abdominal pain and diagnosis of AC between September 2021 and September 2023 were included in the study.Demographic data,laboratory parameters,clinical follow-ups,and outcomes of the patients were recorded.Results:The mean age of the patients was(55.0±16.3)years and 36.6%were male.63.8%Had gallbladder/choledochal stones and 49.5%underwent surgery.The mortality rate was 6.1%.Advanced age(P=0.170)and prolonged hospitalization(P=0.011)were statistically significant risk factors for mortality.Decreased lymphocyte count(P=0.020)and increased C-reactive protein(CRP)levels(P=0.033)were found to be risk factors for mortality.According to the mortality predictor ROC analysis results,the cut-off for SII index was 3138(AUC=0.817,sensitivity=70.5%,specificity=84.7%),the cut-off for neutrophil count was 15.28×10^(3)/mm^(3)(AUC=0.761,sensitivity=52.9%,specificity=95.0%),the cut-off for leukocyte count was 19.0×10^(3)/mm^(3)(AUC=0.714,sensitivity=52.9%,specificity=98.0%),cut-off for CRP was 74.55(AUC=0.758,sensitivity=70.5%,specificity=79.0%),cut-off for aspartate transaminase(AST)was 33.0 IU/L(AUC=0.658,sensitivity=82.3%,specificity=50.3%).Conclusions:The SII index may be a good predictor of mortality with high sensitivity and specificity.Elevated levels of neutrophils,leukocytes,CRP,and AST are other inflammatory parameters that can be used to predict mortality associated with AC.
基金Supported by Foundation of Shanghai Science and Technology Committee,Clinical Study on the Treatment of COVID-19 with Traditional Chinese Medicine(No.2041195020002)Shanghai Infectious Disease Prevention and Treatment Ability Cultivation Project of Traditional Chinese Medicine(ZYYB-NLPY-09, ZYYBNLPY-15)+2 种基金Shanghai Key Clinical Specialty(No.shslczdzk05101)Shanghai Key Clinical Laboratory of Traditional Chinese Medicine(No.20dz2272200)Shanghai Health Commission,Shanghai Chinese Medicine Administration Emergency Scientific Research Project,Clinical Study on Prevention and Treatment of New Coronavirus Pneumonia with Integrated Chinese And Western Medicine(2020YJ01)。
文摘OBJECTIVE:To investigate the antipyretic effect of early treatment with Traditional Chinese Medicine(TCM) on coronavirus disease 2019(COVID-19) patients.METHODS:We retrospectively analyzed 369 patients from January 26th,2020 to April 15th,2020,who had been diagnosed with COVID-19.Among 92 eligible cases,45 cases were identified as treatment group Ⅰ(n = 45) and 47 cases were identified as treatment group Ⅱ.Patients in the treatment group Ⅰ were treated with TCM herbal decoction within 5 d after admission.Patients in the treatment group Ⅱ were treated with TCM herbal decoction after the 6th admission day.The onset time of antipyretic effect,the antipyretic time,the time of negative oropharyngeal swab nucleic acid conversion,and the changes of cell count in blood routine test were compared.RESULTS:The treatment group Ⅰ showed shorter average antipyretic duration(4 vs 7 d;P < 0.05),and shorter average time for polymerase chain reaction(PCR) nucleic acid test results to turn negative(7 vs 11 d;P < 0.05) than the treatment group II.For patients(n = 54) with body temperature > 38 ℃,patients in the treatment group I had shorter median onset time of antipyretic effect than those in the treatment group Ⅱ(3 vs 4 d;P < 0.05).The absolute lymphocyte(LYMPH) count and absolute eosinophil(EOS) count on the 3rd day after admission and the neutrophil/lymphocyte ratio on the 6th day after admission of patients in the treatment group I were notably different from those in the treatment group Ⅱ at the same time point(P < 0.05).Based on Spearman’s rank correlation analysis,the change of body temperature on the 3rd day after admission was positively correlated with the increase of EOS count and the increase of EOS count and LYMPH counts on the 6th day after admission(P < 0.01).CONCLUSIONS:Early TCM intervention within 5 d after hospital admission shortened the onset time of antipyretic effect and fever duration of COVID-19 patients,reduced the time required for PCR test results to turn negative.Moreover,early TCM intervention also improved the results of inflammatory markers for COVID-19 patients.LYMPH and EOS counts can be used as indicators of TCM antipyretic effect.