Background:Current guidelines for the treatment of patients with necrotizing acute pancreatitis(NAP)recommend that invasive intervention for pancreatic necrosis should be deferred to 4 or more weeks from disease onset...Background:Current guidelines for the treatment of patients with necrotizing acute pancreatitis(NAP)recommend that invasive intervention for pancreatic necrosis should be deferred to 4 or more weeks from disease onset to allow necrotic collections becoming“walled-off”.However,for patients showing signs of clinical deterioration,especially those with persistent organ failure(POF),it is controversial whether this delayed approach should always be adopted.In this study,we aimed to assess the impact of differently timed intervention on clinical outcomes in a group of NAP patients complicated by POF.Methods:All NAP patients admitted to our hospital from January 2013 to December 2017 were screened for potential inclusion.They were divided into two groups based on the timing of initial interven-tion(within 4 weeks and beyond 4 weeks).All the data were extracted from a prospectively collected database.Results:Overall,131 patients were included for analysis.Among them,100(76.3%)patients were in-tervened within 4 weeks and 31(23.7%)underwent delayed interventions.As for organ failure prior to intervention,the incidences of respiratory failure,renal failure and cardiovascular failure were not signifi-cantly different between the two groups(P>0.05).The mortality was not significantly different between the two groups(35.0%vs.32.3%,P=0.83).The incidences of new-onset multiple organ failure(8.0%vs.6.5%,P=1.00),gastrointestinal fistula(29.0%vs.12.9%,P=0.10)and bleeding(35.0%vs.35.5%,P=1.00),and length of ICU(30.0 vs.22.0 days,P=0.61)and hospital stay(42.5 vs.40.0 days,P=0.96)were com-parable between the two groups.Conclusion:Intervention within 4 weeks did not worsen the clinical outcomes in NAP patients compli-cated by POF.展开更多
Introduction:The Mediterranean-dietary approaches to stop hypertension(DASH)intervention for neurodegenerative delay(MIND)diet has demonstrated benefits for brain health,yet evidence regarding its antihypertensive eff...Introduction:The Mediterranean-dietary approaches to stop hypertension(DASH)intervention for neurodegenerative delay(MIND)diet has demonstrated benefits for brain health,yet evidence regarding its antihypertensive effects among older adults remains limited and inconsistent.This study investigated associations between the MIND diet and blood pressure outcomes among Chinese older adults.Methods:Logistic regression analysis was used to examine associations between MIND diet scores and both baseline hypertension prevalence and incident hypertension.Repeated measures analysis of variance assessed adjusted mean differences in blood pressure between MIND diet score groups.Sensitivity analysis was conducted after imputing missing blood pressure values at follow-up using multiple imputation techniques.Results:Logistic regression analyses revealed that high MIND diet scores were negatively associated with baseline hypertension prevalence(P<0.05);however,no significant relationship was observed between MIND diet adherence and incident hypertension.Among participants who completed follow-up,those with high MIND diet scores had significantly lower blood pressure(P<0.05)compared to those with low scores.The adjusted mean differences for systolic blood pressure(SBP)and diastolic blood pressure(DBP)were−1.46[95%confidence interval(CI):−2.59,−0.31]mmHg and−1.09(95%CI:−1.76,−0.41)mmHg,respectively.Similar results were observed among both participants with hypertension taking medication at baseline and those without hypertension at baseline.Sensitivity analyses following multiple imputation confirmed these findings.Conclusion:The study revealed the potential of the MIND diet to reduce blood pressure levels,providing new approaches for hypertension prevention among older adults.展开更多
In recent years,the use of coronary functional evaluation derived by fractional flow reserve(FFR)to guide percutaneous coronary intervention(PCI)treatment has been recommended by several mainstream guidelines.Typicall...In recent years,the use of coronary functional evaluation derived by fractional flow reserve(FFR)to guide percutaneous coronary intervention(PCI)treatment has been recommended by several mainstream guidelines.Typically,FFR>0.80 in coronary artery indicates the lesions do not affect the coronary blood flow.展开更多
文摘Background:Current guidelines for the treatment of patients with necrotizing acute pancreatitis(NAP)recommend that invasive intervention for pancreatic necrosis should be deferred to 4 or more weeks from disease onset to allow necrotic collections becoming“walled-off”.However,for patients showing signs of clinical deterioration,especially those with persistent organ failure(POF),it is controversial whether this delayed approach should always be adopted.In this study,we aimed to assess the impact of differently timed intervention on clinical outcomes in a group of NAP patients complicated by POF.Methods:All NAP patients admitted to our hospital from January 2013 to December 2017 were screened for potential inclusion.They were divided into two groups based on the timing of initial interven-tion(within 4 weeks and beyond 4 weeks).All the data were extracted from a prospectively collected database.Results:Overall,131 patients were included for analysis.Among them,100(76.3%)patients were in-tervened within 4 weeks and 31(23.7%)underwent delayed interventions.As for organ failure prior to intervention,the incidences of respiratory failure,renal failure and cardiovascular failure were not signifi-cantly different between the two groups(P>0.05).The mortality was not significantly different between the two groups(35.0%vs.32.3%,P=0.83).The incidences of new-onset multiple organ failure(8.0%vs.6.5%,P=1.00),gastrointestinal fistula(29.0%vs.12.9%,P=0.10)and bleeding(35.0%vs.35.5%,P=1.00),and length of ICU(30.0 vs.22.0 days,P=0.61)and hospital stay(42.5 vs.40.0 days,P=0.96)were com-parable between the two groups.Conclusion:Intervention within 4 weeks did not worsen the clinical outcomes in NAP patients compli-cated by POF.
基金National Key R&D Program of China(2020YFC2003000).
文摘Introduction:The Mediterranean-dietary approaches to stop hypertension(DASH)intervention for neurodegenerative delay(MIND)diet has demonstrated benefits for brain health,yet evidence regarding its antihypertensive effects among older adults remains limited and inconsistent.This study investigated associations between the MIND diet and blood pressure outcomes among Chinese older adults.Methods:Logistic regression analysis was used to examine associations between MIND diet scores and both baseline hypertension prevalence and incident hypertension.Repeated measures analysis of variance assessed adjusted mean differences in blood pressure between MIND diet score groups.Sensitivity analysis was conducted after imputing missing blood pressure values at follow-up using multiple imputation techniques.Results:Logistic regression analyses revealed that high MIND diet scores were negatively associated with baseline hypertension prevalence(P<0.05);however,no significant relationship was observed between MIND diet adherence and incident hypertension.Among participants who completed follow-up,those with high MIND diet scores had significantly lower blood pressure(P<0.05)compared to those with low scores.The adjusted mean differences for systolic blood pressure(SBP)and diastolic blood pressure(DBP)were−1.46[95%confidence interval(CI):−2.59,−0.31]mmHg and−1.09(95%CI:−1.76,−0.41)mmHg,respectively.Similar results were observed among both participants with hypertension taking medication at baseline and those without hypertension at baseline.Sensitivity analyses following multiple imputation confirmed these findings.Conclusion:The study revealed the potential of the MIND diet to reduce blood pressure levels,providing new approaches for hypertension prevention among older adults.
文摘In recent years,the use of coronary functional evaluation derived by fractional flow reserve(FFR)to guide percutaneous coronary intervention(PCI)treatment has been recommended by several mainstream guidelines.Typically,FFR>0.80 in coronary artery indicates the lesions do not affect the coronary blood flow.
