1.Application of bedside ultrasound measurement of gastric antrum cross-sectional area combined with AGIUS score in early individualized enteral nutrition therapy for sepsis patients
Ren HUANG ; Yan SHAGN ; Shuqi LI ; Mingying TANG ; Yanhong XU ; Wenjuan HUANG ; Rongwen WAN
Chongqing Medicine 2025;54(4):845-851
Objective To investigate the application value of bedside ultrasound measurement of gastric antrum cross-sectional area(CSA)combined with acute gastrointestinal injury ultrasound(AGIUS)score in guiding early individualized enteral nutrition therapy for sepsis patients.Methods From January 2023 to July 2024,61 sepsis patients meeting diagnostic criteria were enrolled and divided into an observation group(n=30)and a control group(n=31).The observation group underwent bedside ultrasound monitoring of gastric antrum CSA to calculate gastric residual volume(GRV)and AGIUS score for formulating individualized en-teral nutrition strategies.The control group used gastric tube withdrawal method for GRV measurement to guide enteral nutrition.Clinical baseline characteristics,enteral nutrition-related complications,nutritional/in-fection indicators,and disease severity parameters were compared between groups.Predictive efficacy was ana-lyzed using receiver operating characteristic(ROC)curve and area under the curve(AUC).Results Both groups showed gradual increases in enteral nutrition feeding rates and total volumes over time,with the obser-vation group demonstrating significantly higher values than the control group at each time point(P<0.05).The observation group started nasogastric feeding earlier than the control group(P<0.05).Target calorie a-chievement rates on day 3,5,and 7 were better in the observation group(P<0.05).The incidence of feeding intolerance progressively decreased in the observation group but increased in the control group over day 1,3,and 5,with significant intergroup differences at each time point(P<0.05).By day 7,the observation group exhibited significantly higher prealbumin(PA),albumin(ALB),and transferrin(TF)levels compared to day 1 and the control group(P<0.05).Both groups showed reductions in APACHE Ⅱ,SOFA,and AGI scores by day 7,with the observation group displaying significantly lower scores than the control group(P<0.05).The observation group had shorter ICU stays[(10.83±3.26)d vs.(14.55±3.14)d,P<0.05].The combination of gastric antrum CSA measurement and AGIUS scoring demonstrated excellent predictive value for feeding intolerance(AUC=0.920,95%CI:0.848-0.963),with 95.50%sensitivity and 82.50%specificity,achieving 87.60%predictive accuracy.Conclusion Bedside ultrasound measurement of gastric antrum cross-sectional area(CSA)combined with AGIUS scoring shows good effect as a safe and effective monitoring modality for guiding early individualized enteral nutrition therapy in sepsis patients.
2.Comparative study of MRI manifestations and EEG and pathology of drug refractory epilepsy
jun Hong LIU ; Li SHAGN ; zhen Wu YU ; yan Xiao ZHANG ; zhang Shou WANG
Chinese Journal of Biochemical Pharmaceutics 2017;37(10):421-422
Objective To investigate the results of MRI and electroencephalogram examination and pathological examination of drug refractory epilepsy. Methods 70 cases with drug refractory epilepsy were treated with systemic antiepileptic drugs, but they still could not control their condition, and they were given MRI, EEG and pathological examination respectively. MRI, EEG and pathological findings of 70 cases were recorded, and the conclusion was drawn after statistical analysis. Results Compared with pathological examination, the localization accuracy of MRI for epileptogenic foci and related lesions was 88.57%, the accuracy of localization of EEG for epileptogenic foci and related disease was 51.43%, the difference was statistically significant (P<0.05); MRI examination of the epileptogenic lesions and qualitative accuracy the rate of up to 75.71%. Conclusion According to the patients with drug intractable epilepsy, the coincidence rate of MRI examination and pathological examination is higher. Compared with EEG, it can provide clinicians with more reliable basis for the diagnosis and treatment of drug refractory epilepsy. It is helpful to protect the curative effect of these patients.

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