Clinical Evaluation of Continuous Renal Replacement Therapy in Combination with Ultrasound-Guided Percutaneous Transhepatic Gallbladder Drainage for Acute Severe Biliary Pancreatitis: a Retrospective Study

Association between neutrophil to high-density lipoprotein cholesterol ratio and disease severity in patients with acute biliary pancreatitis

BACKGROUND

The neutrophil to high-density lipoprotein cholesterol ratio (NHR) is independently associated with the severity of various diseases. However, its association with acute biliary pancreatitis (ABP) remains unknown.

METHODS

This study included 1335 eligible patients diagnosed with ABP from April 2016 to December 2022. Patients were divided into low- and high-NHR level groups using an optimal cut-off value determined utilizing Youden's index. Multivariate logistic regression analysis was used to investigate the correlation between NHR and ABP severity. Multivariate analysis-based limited restricted cubic spline (RCS) method was used to evaluate the nonlinear relationship between NHR and the risk of developing moderate or severe ABP.

RESULTS

In this study, multivariate logistic regression analysis indicated an independent association between NHR and ABP severity (p < .001). The RCS analysis showed a linear correlation between NHR and the risk of developing moderate or severe ABP (P for non-linearity > 0.05), and increased NHR was found to be independently associated with a more severe form of the disease.

CONCLUSIONS

Our study suggests that NHR is a simple and practical independent indicator of disease severity, serving as a potential novel predictor for patients with ABP.

Risk factors and prognosis of acute respiratory distress syndrome following abdominal surgery

Risk factors and prognosis of acute respiratory distress syndrome (ARDS) following abdominal surgery were investigated. Five hundred and thirty-two patients who underwent abdominal surgery in Dongyang People's Hospital from February 2006 to May 2016 were enrolled. Among them, 113 patients had ARDS after surgery and 45 patients died. Those patients were included in observation group. The 419 patients who did not develop ARDS were included in control group, and 11 patients died. General data of patients were statistically analyzed, and the factors with statistical significance were subjected to multivariate logistic regression analysis to analyze the risk factors of ARDS. There was a significant difference in age, infection, trauma-to-surgery time, and prognosis between the two groups (P<0.05). Perioperative blood loss, blood transfusion volume, and fluid volume in the observation group were significantly higher than those in the control group (P<0.05). Heart rate, ratio of PaO2/FiO2, ratio of high (low) blood glucose, levels of procalcitonin (PCT) and albumin (ALB) were significantly different between the two groups. Heart rate, PCT, long-term health assessment (APACHE) II scores were higher in observation group than those in control group (P<0.05). Percentage of hyperglycemic patients, PaO2/FiO2, and ALB were lower in observation group than those in control group (P<0.05). Occurrence of ARDS after abdominal surgery was related to age, infection, heart rate, PaO2/FiO2, and PCT levels (P<0.05). Age, infection, heart rate, PaO2/FiO2, ALB and APACHE II scores were related to the prognosis of patients with ARDS after abdominal surgery (P<0.05). Age, infection, heart rate, PaO2/FiO2, PCT levels, blood loss, blood transfusion volume, and infusion volume may be risk factors for ARDS after abdominal surgery. Age, infection, heart rate, PaO2/FiO2, ALB, and APACHE II scores may be related to prognosis of patients with ARDS after abdominal surgery.

Impact of octreotide combined with omeprazole on gastrointestinal hormones and intestinal mucosal barrier function in patients with acute pancreatitis

AIM

To evaluate the effect of octreotide combined with omeprazole on gastrointestinal hormones and intestinal mucosal barrier function in patients with acute pancreatitis (AP).

METHODS

One hundred and twenty-four patients with AP treated from July 2016 to June 2017 at People's Hospital of Guyuan were divided into an observation group and a control group. The control group was given omeprazole alone, and the observation group was given octreotide combined with omeprazole. Two weeks after treatment, the clinical efficacy, clinical symptoms, gastrointestinal hormones, intestinal mucosal barrier function, and adverse reactions were compared between the two groups.

RESULTS

The effective rate was significantly higher in the observation group than in the control group [90.32% (59/62) vs 80.65% (50/62), χ² = 6.143, P < 0.05). Time to disappearance of fever, abdominal pain, nausea and vomiting, abdominal distension, abdominal tenderness, and other clinical symptoms and signs was significantly shorter in the observation group than in the control group (2.12 d ± 0.55 d vs 4.56 d ± 0.72 d, 1.75 d ± 0.42 d vs 4.34 d ± 0.70 d, 2.23 d ± 0.56 d vs 4.65 d ± 0.74 d, 2.54 d ± 0.60 d vs 4.12 d ± 0.76 d, 2.12 d ± 0.53 d vs 4.24 d ± 0.75 d; t = 21.205, 24.982, 20.533, 20.185, 18.177, P < 0.01). Serum MTL was significantly higher and serum GAS and VIP were significantly lower in the observation group than in the control group (318.36 pg/mL ± 30.24 pg/mL vs 256.45 pg/mL ± 34.23 pg/mL, 14.12 μmol/L ± 16.25 μmol/L vs 130.24 μmol/L ± 16.45 μmol/L, 58.12 pg/mL ± 7.25 pg/mL vs 64.36 pg/mL ± 8.12 pg/mL; t = 10.673, 5.489, 4.514, P < 0.05 or P < 0.01). Serum ET, DLA, DAO, and AMY were significantly lower in the observation group than in the control group (53.12 ng/L ± 7.25 ng/L vs 64.20 ng/L ± 7.36 ng/L, 4.45 μg/L ± 0.78 μg/L vs 6.42 μg/L ± 0.86 μg/L, 6.47 U/L ± 1.12 U/L vs 9.10 U/L ± 1.26 U/L, 124.36 U/L ± 24.35 U/L vs 160.21 U/L ± 26.54 U/L; t = 8.445, 13.360, 12.284, 7.818, P < 0.05 or P < 0.01). The rate of adverse reactions was significantly lower in the observation group than in the control group [8.06% (5/62) vs 24.19% (15/62), χ² = 5.962, P < 0.05].

CONCLUSION

Octreotide combined with omeprazole can improve clinical symptoms and clinical curative effect and reduce adverse reactions in patients with AP, which may be related to regulating gastrointestinal hormones and improving intestinal mucosal barrier function.