1. Risk factors for biochemical leak progressing to grade B pancreatic fistula after pancreaticoduodenectomy early
Chinese Journal of Surgery 2019;57(9):654-659
Objective:
To analyze the risk factors for biochemical leak progressing to grade B pancreatic fistula after pancreaticoduodenectomy(PD) early.
Methods:
Retrospective analysis was conducted in the whole clinical data of 190 patients who had incurred biochemical leak from November 2014 to April 2017 at the First Hospital of China Medical University.There were 112 males and 78 females, aging of (73±6) years(range:22 to 77 years).And all the potential factors for progressing from biochemical leak to grade B were analyzed with univariate and logistic regression multivariate model. These statistically significant preoperative indicators which enabled the plotting of the receiver operation characteristic(ROC) curves were selected for plotting the ROC curves, calculating the area under the curve(AUC) and evaluating the forecast values. With pertinence to indicators with the forecast values above the medium level, the maximum predictive performance of the critical value was determined by using the different cut-off values to calculate the Youden index and other indicators.
Results:
Among the 190 cases of PD patients, there were 81 cases had incurred biochemical leak including 36 cases with no progression, 41 cases progressing to grade B and 4 cases progressing from grade B to grade C.Univariate analysis showed CT value of pancreatic body, acute pancreatitis preoperatively, and the platelet(PLT), prealbumin, ALT on postoperative 3-4 days were risk factors for progressing from biochemical leak to grade B. Multivariate analysis showed CT value, acute pancreatitis preoperatively, and the PLT on postoperative 3-4 days were independent risk factors. Postoperatively patients with biochemical leak got acute pancreatitis before surgery were more likely to progress to grade B as well as those with the lower CT value before surgery or the lower PLT at 3-4 days after surgery. The AUC of CT value was 0.734. Using 39.8 HU as CT value, the sensitivity, specificity and Youden index were 73.2%, 75.0% and 0.482, with the highest performance prediction.
Conclusion
The analysis of CT value of pancreatic body for standardized judgment of pancreas texture, the rational treatments of acute pancreatitis preoperatively and appropriate administration of patients with platelet-related drugs during perioperative period can respectively forecast and prevent progressing from biochemical leak to grade B.
2.Effectiveness of basketball exercise on body composition among obese junior middle school students
SONG Zhongliang, JI Hongjing, PENG Chong, TONG Weicheng, SUN Guilong
Chinese Journal of School Health 2021;42(11):1717-1719
Objective:
To investigate effectiveness of different intensities of basketball exercise on body compositions among obese junior middle school students, and to provide theoretical support for healthy weight loss among obese children and adolescents.
Methods:
From September to November 2020,a typical sampling method was used to select 48 obese junior middle school students were recruited from Wuhan Optical Valley Experimental Middle School according to body mass index(BMI), all the students were divided into high, moderate and low intensity basketball training group, as well as the control group, the 45 min per times basketball exercise intervention was administered three times per week for 12 weeks, while the control group did not received no intervention, body composition was assessed before and after intervention.
Results:
After 12 weeks of low intensity basketball exercise, the percentage of body fat of obese junior high school students after intervention was significantly higher than that before intervention[(32.16±2.26)% v.s. (34.33±2.35)%] ( t =3.52, P <0.05). There was no significant difference in other indexes body weight, body mass index, waist circumference, skeletal musclebetween before and after intervention ( t =2.31, 1.98, 1.26,-1.65, P >0.05). For moderate intensity basketball exercise group obdy weight, BMI, percentage of body fat and waist circumference showed statistical changes before and after intervention( t=3.44, 3.76, 6.56, 2.45, P <0.05). For high intensity basketball exercise group, all body composition indicators showed significant changes( t=4.14, 5.18, 11.26, 5.89, -2.56, P <0.05).
Conclusion
Twelve weeks of basketball exercise can effectively improve body composition of obese junior middle school students, with higher the intensity of exercise, the better the effectiveness.
3.Association between serum testosterone level and insulin resistance in elderly male hypertensive patients
Gaili WEI ; Wenna JI ; Liang XUE ; Weicheng WANG ; Qiong YANG
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2018;20(6):603-606
Objective To study the association between serum testosterone level and insulin resistance (IR) in elderly male hypertensive patients.Methods One hundred and seven elderly male hypertensive patients were divided into IR group (n=44) and IR-free group (n=63).Their total TST level was measured,their FAI and TSI were assayed.The patients were further divided into TST≥14 nmol/L group (n=72) and TST<14 nmol/L group (n=35).The association between serum testosterone level and IR in elderly male hypertensive patients was analyzed.Results The serum TST level,FAI and TSI were significantly lower in IR group than in IR-free group (12.02±2.66 nmol/L vs 15.98±3.98 nmol/L;20.16%±2.75% vs 28.53%±4.74%;2.26±0.49 nmol/U vs 3.21±0.55 nmol/U,27.67%±5.49% vs 25.98%±4.98%;2.95±0.39 nmol/U vs 2.78±0.64 nmol/U,P<0.05).The FAI and TSI were significantly higher in hypertention grade 1 patients than in hypertension grade 3 patients (P<0.05).The IR was significantly lower while the serum TST level,FAI and TSI were significantly higher in TST≥14 nmol/L group than in TST<14 nmol/L group (33.3% vs 57.1%,P=0.019;18.43±3.41 nmol/L vs 12.15±2.23 nmol/L,P=0.002;32.49%±5.67% vs 24.57%±6.94%,P=0.036;3.53±0.87 nmol/U vs 2.55±0.62 nmol/U,P=0.016).TST,FAI and TSI were negatively associated with HOMA-IR (r=-0.406,r=-0.469,r=-0.429,P=0.000).Conclusion Low serum TST level is a risk factor for IRin elderly male hypertensive patients.
4.Risk factors for biochemical leak progressing to grade B pancreatic fistula after pancreaticoduodenectomy early
Chinese Journal of Surgery 2019;57(9):654-659
Objective To analyze the risk factors for biochemical leak progressing to grade B pancreatic fistula after pancreaticoduodenectomy(PD) early. Methods Retrospective analysis was conducted in the whole clinical data of 190 patients who had incurred biochemical leak from November 2014 to April 2017 at the First Hospital of China Medical University.There were 112 males and 78 females, aging of (73±6)years(range:22 to 77 years).And all the potential factors for progressing from biochemical leak to grade B were analyzed with univariate and logistic regression multivariate model. These statistically significant preoperative indicators which enabled the plotting of the receiver operation characteristic(ROC) curves were selected for plotting the ROC curves,calculating the area under the curve(AUC)and evaluating the forecast values. With pertinence to indicators with the forecast values above the medium level, the maximum predictive performance of the critical value was determined by using the different cut?off values to calculate the Youden index and other indicators.Results Among the 190 cases of PD patients,there were 81 cases had incurred biochemical leak including 36 cases with no progression,41 cases progressing to grade B and 4 cases progressing from grade B to grade C.Univariate analysis showed CT value of pancreatic body, acute pancreatitis preoperatively,and the platelet(PLT),prealbumin,ALT on postoperative 3-4 days were risk factors for progressing from biochemical leak to grade B. Multivariate analysis showed CT value, acute pancreatitis preoperatively, and the PLT on postoperative 3-4 days were independent risk factors. Postoperatively patients with biochemical leak got acute pancreatitis before surgery were more likely to progress to grade B as well as those with the lower CT value before surgery or the lower PLT at 3-4 days after surgery. The AUC of CT value was 0.734. Using 39.8 HU as CT value, the sensitivity, specificity and Youden index were 73.2%, 75.0% and 0.482, with the highest performance prediction. Conclusion The analysis of CT value of pancreatic body for standardized judgment of pancreas texture,the rational treatments of acute pancreatitis preoperatively and appropriate administration of patients with platelet?related drugs during perioperative period can respectively forecast and prevent progressing from biochemical leak to grade B.
5.Risk factors for biochemical leak progressing to grade B pancreatic fistula after pancreaticoduodenectomy early
Chinese Journal of Surgery 2019;57(9):654-659
Objective To analyze the risk factors for biochemical leak progressing to grade B pancreatic fistula after pancreaticoduodenectomy(PD) early. Methods Retrospective analysis was conducted in the whole clinical data of 190 patients who had incurred biochemical leak from November 2014 to April 2017 at the First Hospital of China Medical University.There were 112 males and 78 females, aging of (73±6)years(range:22 to 77 years).And all the potential factors for progressing from biochemical leak to grade B were analyzed with univariate and logistic regression multivariate model. These statistically significant preoperative indicators which enabled the plotting of the receiver operation characteristic(ROC) curves were selected for plotting the ROC curves,calculating the area under the curve(AUC)and evaluating the forecast values. With pertinence to indicators with the forecast values above the medium level, the maximum predictive performance of the critical value was determined by using the different cut?off values to calculate the Youden index and other indicators.Results Among the 190 cases of PD patients,there were 81 cases had incurred biochemical leak including 36 cases with no progression,41 cases progressing to grade B and 4 cases progressing from grade B to grade C.Univariate analysis showed CT value of pancreatic body, acute pancreatitis preoperatively,and the platelet(PLT),prealbumin,ALT on postoperative 3-4 days were risk factors for progressing from biochemical leak to grade B. Multivariate analysis showed CT value, acute pancreatitis preoperatively, and the PLT on postoperative 3-4 days were independent risk factors. Postoperatively patients with biochemical leak got acute pancreatitis before surgery were more likely to progress to grade B as well as those with the lower CT value before surgery or the lower PLT at 3-4 days after surgery. The AUC of CT value was 0.734. Using 39.8 HU as CT value, the sensitivity, specificity and Youden index were 73.2%, 75.0% and 0.482, with the highest performance prediction. Conclusion The analysis of CT value of pancreatic body for standardized judgment of pancreas texture,the rational treatments of acute pancreatitis preoperatively and appropriate administration of patients with platelet?related drugs during perioperative period can respectively forecast and prevent progressing from biochemical leak to grade B.