Objective:To evaluate the predictive value of the ratio of bedside index of severity in acute pancreatitis (BISAP) to serum calcium (BISAP/Ca) within 24 hours of admission in the severity of acute pancreatitis (AP).Methods:From January 1, 2020, to December 31, 2022, 711 AP patients visited the First Affiliated Hospital of Soochow University were enrolled. According to the severity of AP, the 711 patients were divided into mild AP group (586 cases) and severe AP group (including moderately severe and severe AP patients, 125 cases). According to the occurrence of respiratory dysfunction, the 711 patients were divided into a group without respiratory dysfunction (594 cases) and a group with respiratory dysfunction (117 cases). Acute physiology and chronic health evaluation-Ⅱ (APACHE-Ⅱ) score was calculated based on the worst indicators (highest or lowest values) within 24 hours of admission. BISAP score was calculated based on the indicator values of the patients within 24 hours of admission. And modified computed tomography (CT) severity index (MCTSI) score was calculated based on the results of enhanced CT within 72 hours of admission. Mann-Whitney U test and chi-square test were used for statistical comparison. The predictive value of BISAP/Ca for the severity of AP was assessed by receiver operating characteristic curve (ROC), and the optimal cut-off value was calculated based on sensitivity and specificity. Univariate and multivariate logistic regression analyses were used to analyze the risk factors of developing respiratory dysfunction in AP patients. Results:The hospital stay, proportion of patients with systemic inflammatory response syndrome, proportion of patients with pleural effusion, and scores of APACHE-II, BISAP, MCTSI, and BISAP/Ca of the severe AP group were higher than those of the mild AP group (18.00 d (12.00 d, 29.00 d) vs. 9.00 d (6.00 d, 12.00 d), 74.4% (93/125) vs. 22.5% (132/586), 90.4% (113/125) vs. 42.3% (248/586), 9.00(6.00, 13.50) vs. 4.00(2.00, 7.00), 2.00(2.00, 3.00) vs. 1.00(0.00, 1.00), 4.00(4.00, 6.00) vs. 4.00(2.00, 4.00), 1.05(0.92, 1.54) vs. 0.47(0.00, 0.55)), all the differences were statistically significant ( Z=-12.39, χ2=128.16 and 95.28, Z=-10.83, -12.50, -11.54, and -13.27; all P<0.001). The results of ROC analysis showed that the area under the curve (95% confidence interval) of BISAP/Ca, BISAP, serum calcium, MCTSI, and APACHE-Ⅱ score for predicting the severity of AP were 0.873 (0.842 to 0.904), 0.839 (0.804 to 0.875), 0.797 (0.752 to 0.843), 0.802 (0.762 to 0.842), and 0.807 (0.762 to 0.852), respectively, all the differences were statistically significant (all P<0.001). According to the Youden index, the optimal cut-off value of BISAP/Ca distinguishing mild AP from severe AP was 0.515, with a sensitivity of 0.880 and a specificity of 0.722. The result of multivariate logistic regression analyses showed that BISAP/Ca >0.515 was an independent risk factor of developing respiratory dysfunction in AP ( OR (95% confidence interval) 27.588(14.083 to 54.045), 12.057 (5.762 to 25.229), both P<0.001). Conclusion:BISAP/Ca may be a valuable predictive indicator for the severity and developing respiratory dysfunction in AP patients.

Objective To explore the proliferation characteristics of primary small intestinal epithelial cells of tree shrews and the characteristics of human rotavirus(RV) G1P[8] infection to these cells,and establish a model of tree shrew primary small intestinal epithelial cells infected with human rotavirus G1P[8].Methods The primary small intestinal epithelial cells were obtained by collagenase Ⅺ and dispase I digestion from tree shrew.After purification and identification,the obtained primary small intestinal epithelial cells were infected with RV.Then,culture supernatants of infected cells were collected every 12 hours after infection.Viral titer and viral load were subsequently determined.Western blot and indirect immunofluorescence observation were used to detect the expression of RV protein VP6 in the primary cells.The infectivity of RV to the tree shrew primary cells was finally evaluated.Results After purification and identification of primary epithelial cells from the tree shrew,high purity above 90% primary tree shrew small intestinal epithelial cells was obtained.These primary small intestinal epithelial cells could be infected with RV virus by comparing the virus infectivity to primary renal cells,HCT116 cells and MA104 cells.The virus titer reached to 2.0×105TCID 50/mL at 72 h after infection.Using Western blot and indirect immunofluorescence observation,the specific viral protein of VP6 was determined to be expressed in the tree shrew primary small intestinal epithelial cells,and were located in the cytoplasm from days 1 to 5.Conclusions The separation,purification and cultivation methods of tree shrew primary small intestinal epithelial cells are successful,and the tree shrew model of RV-infected the tree shrew primary small intestinal epithelial cells is successfully established.

Objective:To investigate the effects of mucosal strengthening treatment on preventing recurrence of closedvarices. Methods: In 264 patients with esophageal varices obliteration by banding ligation and sclerotherapy, of 136 patientswere gone on to treat with strengthening mucosa, and 128 patients without strengthening treatment. All patients had beenobserved out of hospital for 1-13 years. Results: There were no recurrence and rebleeding of esophageal varices in the groupwith strengthening treament. But in the group without strengthening treatment, 25 patients (19. 5%) had isolated or strip-like varices with red colour signI small veins grew thick and part of mucosa appeared clear hyperaemia in 21 patients(16.4% ); 6 patients (4.7% ) rebleeded. There were significant differences between two groups (P