Objective To explore the predictive value of sequential organ failure score(SOFA)combined with serum Clara cell protein 16(CC16)and angipoietin-2(Ang-2)in the prognosis of patients with acute respiratory distress syndrome(ARDS)caused by sepsis.Methods A total of 173 sepsis patients were divided into the concurrent group(n=76)and the non-concurrent group(n=97),based on whether ARDS occurred within 72 h after admission.According to the death situation within 30 days,patients in the concurrent group were divided into the death group(n=35)and the survival group(n=41).Enzyme-linked immunosorbent assay(ELISA)was used to detect serum CC16,Ang-2,C-reactive protein(CRP)and interleukin(IL)-6.The levels of triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and white blood cell count(WBC)were detected by automatic biochemical analyzer and hemocytometer.SOFA scores were performed on patients at admission.The biochemical indexes,SOFA score,CC16 and Ang-2 levels were compared between the two groups,and the poor prognosis of the patients was analyzed.Binary Logistic regression was used for influencing factor analysis.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of related factors in the poor prognosis of patients with sepsis complicated by ARDS.Results The serum levels of CRP,IL-6,CC16,Ang-2 and SOFA scores were higher in the concurrent group than those in the non-concurrent group(P＜0.05).The SOFA score,mechanical ventilation time,CRP,CC16 and Ang-2 were higher in the death group than those in the survival group(P＜0.05).High SOFA score,CC16 and Ang-2 were independent risk factors for poor prognosis in the concurrent group(P＜0.05).The area under the curve(AUC)of SOFA score,serum CC16 and Ang-2 levels in predicting poor prognosis in patients with sepsis complicated with ARDS were 0.806(0.700-0.888),0.801(0.693-0.884),0.845(0.743-0.918)and 0.945(0.867-0.984),respectively.Conclusion SOFA score combined with changes in CC16 and Ang-2 expression levels can be used to comprehensively evaluate prognosis of patients with sepsis complicated with ARDS.

Objective To explore the predictive value of sequential organ failure score(SOFA)combined with serum Clara cell protein 16(CC16)and angipoietin-2(Ang-2)in the prognosis of patients with acute respiratory distress syndrome(ARDS)caused by sepsis.Methods A total of 173 sepsis patients were divided into the concurrent group(n=76)and the non-concurrent group(n=97),based on whether ARDS occurred within 72 h after admission.According to the death situation within 30 days,patients in the concurrent group were divided into the death group(n=35)and the survival group(n=41).Enzyme-linked immunosorbent assay(ELISA)was used to detect serum CC16,Ang-2,C-reactive protein(CRP)and interleukin(IL)-6.The levels of triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and white blood cell count(WBC)were detected by automatic biochemical analyzer and hemocytometer.SOFA scores were performed on patients at admission.The biochemical indexes,SOFA score,CC16 and Ang-2 levels were compared between the two groups,and the poor prognosis of the patients was analyzed.Binary Logistic regression was used for influencing factor analysis.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of related factors in the poor prognosis of patients with sepsis complicated by ARDS.Results The serum levels of CRP,IL-6,CC16,Ang-2 and SOFA scores were higher in the concurrent group than those in the non-concurrent group(P＜0.05).The SOFA score,mechanical ventilation time,CRP,CC16 and Ang-2 were higher in the death group than those in the survival group(P＜0.05).High SOFA score,CC16 and Ang-2 were independent risk factors for poor prognosis in the concurrent group(P＜0.05).The area under the curve(AUC)of SOFA score,serum CC16 and Ang-2 levels in predicting poor prognosis in patients with sepsis complicated with ARDS were 0.806(0.700-0.888),0.801(0.693-0.884),0.845(0.743-0.918)and 0.945(0.867-0.984),respectively.Conclusion SOFA score combined with changes in CC16 and Ang-2 expression levels can be used to comprehensively evaluate prognosis of patients with sepsis complicated with ARDS.

Objective To compare the clinical characteristics of cirrhosis with or without portal vein thrombosis(PVT),and to analyze the therapeutic effect of transjugular intrahepatic portosystemic shunt(TIPS)in treating cirrhosis with or without PVT.Methods The clinical data of 193 patients with cirrhosis complicated by gastrointestinal bleeding,who received TIPS from October 2018 to October 2022,were retrospectively analyzed.According to the presence or absence of PVT before TIPS,the patients were divided into non-PVT group(n=118)and PVT group(n=75).After TIPS,the patients were followed up at one,3,6 months and every 6 months thereafter.The effect of PVT on the clinical characteristics of cirrhosis patients and on the therapeutic efficacy after TIPS were analyzed.Results The success rate of TIPS was 100％in both groups.The proportion of carrying out splenectomy or partial splenic artery embolization(PSE)in PVT group was 26.7％(20/75),which was obviously higher than 13.6％(16/118)in non-PVT group,the difference between the two groups was statistically significant(x2=5.192,P=0.023).In PVT group the preoperative Child-Pugh score,the model of end-stage liver disease(MELD)score and serum sodium model of end-stage liver disease(MELD-Na+)score were(8.1±1.9)points,(9.2±8.0)pointsand(9.2±8.0)points respectively,which in non-PVT group were(7.4±1.9)points,(7.7±5.8)points and(7.7±5.8)points respectively,the differences between the two groups were statistically significant(all P＜0.05).The incidence of overt hepatic encephalopathy in PVT group was 33.3％(25/75),which was strikingly higher than 19.5％(23/118)in non-PVT group,the difference between the two groups was statistically significant(P=0.030).No statistically significant differences in postoperative survival rate,rebleeding rate and stent dysfunction rate existed between the two groups(all P＞0.05).Conclusion For the treatment of cirrhotic patients with PVT complicated by gastrointestinal bleeding,TIPS is clinically safe and effective.In cirrhotic patients with PVT,the worse the liver function is,the higher the incidence of overt hepatic encephalopathy after TIPS will be.

Objective To compare and analyze the clinical characteristics and efficacy of transjugular intrahepatic portosystemic shunt(TIPS)in the treatment of liver cirrhosis with different portal vein thrombosis(PVT)grades.Methods A retrospective analysis was performed on 75 patients with liver cirrhosis and gastrointestinal bleeding who received TIPS.According to the Yerdel scale of PVT,the patients were divided into type Ⅰ(34 cases),type Ⅱ(25 cases)and type Ⅲ(16 cases).The patients were followed up 1,3,6 months after TIPS and every 6 months thereafter to compare the clinical data and the efficacy of TIPS in three types of PVT patients.Results The success rate of TIPS in three types of patients was 100％.There were differences in platelet to lymphocyte ratio(PLR)and proportion of different Child-Pugh grades among the three types of patients(P＜0.05).After TIPS,portal vein pressure was decreased compared with that before TIPS(P＜0.001).However,there were no significant differences in postoperative survival rate,rebleeding rate,over hepatic encephalopathy rate,stent dysfunction rate,thrombus complete recanalization rate and thrombus recurrence rate(P＞0.05).Conclusion The success rate of TIPS in three types of patients is higher,and the portal vein pressure is decreased significantly after TIPS,but there are no significant differences in the postoperative efficacy.Although the implementation of TIPS in cirrhotic PVT patients is challenging,it is still worth the effort to reshape the portal vein for the benefit of patients.