Comparison of bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity of hyperlipidemic acute pancreatitis(HLAP)

Background: In recent years,the incidence of hyperlipidemic acute pancreatitis(HLAP) is rapidly increasing.It is important for Clinical worker to identify the severity at early stage of HLAP. AIMS: The goal of this paper was to compare bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity and local complications of HLAP.Methods: We collected 167 patients with HLAP, including 133 cases of Mild acute pancreatitis(MAP), 34 cases of Moderately severe acute pancreatitis(MSAP) and Severe acute pancreatitis(SAP). The study retrospectively analyzed the clinical characteristics of two groups(MAP group,MSAP and SAP group) of patients.Correlation analysis was demonstrated by Spearman,s test. In addition,the accuracy was investigated through the study of the receiver operating characteristic(ROC) curve to predict the severity of HLAP by BISAP and MCTSI score.Results:There are significantly statistical differences(P<0.05) in Triglycerides(TG), Total cholesterols(TC),Hospitalization days,Fatty liver,and Local complications between two groups,While no statistical differences in Gender, Age,Serum amylase,Alanine aminotransferase(ALT),Aspertate aminotransferase(AST),Hypertension,Type2 diabetes,and Hyperuricemia. Positive relevance was established between BISAP and TG with r of 0.55. The Area Under the Curve(AUC) of BISAP and MCTSI in predicting the severity of HLAP respectively were0.89、0.78，sensitivity were 73.5%、79.4%, specificity were95.5%、60.2%, positive predictive value(PPV) were 80.6%、33.8%, negative predictive value(NPV) were 93.4%、92.0%.In predictionig local complications,the AUC respectively were 0.73、0.87, sensitivity were 37.5%、90.1%, specificity were 93.2%、78.6%, PPV were 77.4%、72.5%, NPV were 70.6%、93.1%.Conclusion: BISAP score has a meaningful prognostic value for predicting the severity of HLAP and higher AUC than MCTSI.In particular,there are significant association between BISAP and TG.Keywords:Hyperlipidemic acute pancreatitis；Triglycerides;BISAP score；MCTSI score; Severe acute pancreatitis

On the Action of Barbituric Acid Compounds

Since 1922, when Kläsi's work on prolonged narcosis with somnifen—a mixture of barbitals—appeared, this form of treatment has become an integral part of the armamentarium of psychiatry. Patients suffering from various psychoses were subjected for a longer or shorter period to intoxication by a hypnotic, with or without the production of a prolonged sleep. Successes—sometimes very great successes—were claimed for this treatment. The number of publications on this subject is so large and the successes described therein so numerous, that the clinical worker is in duty bound to form an independent opinion regarding this method. The question is whether there is anything in this therapeutic method which psychiatry should retain, what that something is, and whether or not we can improve its system of procedure. Too great an enthusiasm is equally dangerous here, as is underrating the method because of a single unfortunate experience during or following the treatment.