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Impaired immune reaction and increased lactate and C-reactive protein for early prediction of severe morbidity and pancreatic fistula after pancreatoduodenectomy

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Hepatobiliary & pancreatic Diseases International 2020年第1期19卷 58-67页

作者： Mario Rodriguez-Lopez Francisco j.Tejero-pintor Martin bailon-Cuadrado Asterio Barrera-Rebollo Baltasar perez-Saborido David pacheco-Sanchez General and Digestive Surgery Department Rio-Hortega University Hospital

Background: prediction of complications after pancreatoduodenectomy (pD) remains of interest. Blood parameters and biomarkers during rst and second postoperative days (pOD1, pOD2) may be early indi- cators of complications. Methods: This case-control study included 50 patients. Baseline, pOD1 and pOD2 values of leukocytes, neutrophils, lymphocytes, platelets, hemoglobin, C-reactive protein (CRp), procalcitonin and arterial lactate were compared between individuals presenting Clavien ≥ III morbidity, pancreatic stula (pF) or clinically relevant pF (CRpF) and those without these morbidities. Common variables reaching signi cance were further analyzed in order to calculate a predictive score. Results: Severe morbidity, pF and CRpF rates were 28.0%, 26.0% and 14.0%, respectively. patients with severe morbidity had lower leukocytes on pOD2 (p=0.04). patients with pF presented higher CRp on pOD2 (p=0.001), higher lactate on pOD1 (p=0.007) and pOD2 (p=0.008), and lower lymphocytes on pOD1 (p=0.007) and pOD2 (p=0.008). patients with CRpF had lower leukocytes and neutrophils on pOD1 (p =0.048, p =0.038), lower lymphocytes on pOD1 (p =0.001) and pOD2 (p =0.003), and higher CRp on pOD2 (p =0.001). Baseline parameters and procalcitonin obtained no statistical associations. Score was de ned according to lymphocytes on pOD1 p on pOD2 ≥ 250 mg/L allocating patients in 3 risk categories. pF and CRpF rates were statistically higher as risk category increased (pperating characteristic curves and Hosmer Lemeshow tests showed a good accuracy. Conclusions: Impaired immunological reaction during early postoperative period (lower leukocytes and, particularly, lymphocytes) in response to surgical aggression would favor complications after pD. Likewise, acidosis (higher arterial lactate) could behave as risk factor of pF. An elevated CRp on pOD2 is also an early biomarker of pF. Our novel score based on postoperative lymphocyte count and CRp seems reliable

关键词： pancreatoduodenectomy Morbidity pancreatic fistula Biomarker prediction Score

Severe morbidity after pancreatectomy is accurately pre dicte d by preoperative pancreatic resection score(pREpARE): A prospective validation analysis from a medium-volume center

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Hepatobiliary & pancreatic Diseases International 2018年第6期17卷 559-565页

作者： Mario Rodriguez-Lopez Francisco j. Tejero-pintor Baltasar perez-Saborido Asterio Barrera-Rebollo Martin bailon-Cuadrado David pacheco-Sanchez General and Digestive Surgery Department Rio-Hortega University Hospital

Background: Major morbidity in pancreatic surgery remains high. Different scores for predicting complications have been described. preoperative pancreatic resection(pREpARE) score is based on objective preoperative variables and offers good predictive accuracy for Clavien ≥ III complications. This study aimed to validate this score and analyze other preoperative variables in a prospective study performed in a medium-volume center. Methods: A total of 50 pancreatic resections were included. preoperative variables were registered and pREpARE was calculated. The main outcome was severe morbidity(Clavien ≥ III) up to 30 days after discharge. The secondary outcomes were length of stay(LOS) and readmission. Statistical validation was performed to compare severe morbidity rate among the scores categories. Association with other preoperative variables(not included in pREpARE) was also tested. Results: Of the 50 pancreatic resections, the severe morbidity was 34.0%, with median LOS of 11 days. Readmission rate was 25.5%. Severe morbidity rates according to pREpARE categories were 18.5% in lowrisk group, 41.7% in intermediate-risk group, and 63.6% in high-risk group, respectively( p = 0.023). The accuracy was 72%(Hosmer–Lemeshow, p = 0.86). ROC curve was obtained both for pREpARE score expressed as incremental values and categorized as the three risk groups, showing an area under curve(AUC) of 0.736(95% CI: 0.586–0.887; p = 0.007) and 0.712(95% CI: 0.555–0.869; p = 0.015), respectively. pREpARE was significant in multivariate analysis. Median LOS was statistically higher as pREpARE category increases(9, 11 and 15 days in low-, intermediate-and high-risk groups, respectively; p = 0.009). Readmission was not associated with any variables. Conclusions: pREpARE behaves as an independent risk factor for severe morbidity after pancreatic surgery. Score validation shows good accuracy prediction. Increasing pREpARE category is also associated with longer LOS.

关键词： pancreatic surgery Morbidity Complications preoperative pancreatic resection score Validation

preoperative pancreatic resection score:a preliminary prospective validation from Spain

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Hepatobiliary & pancreatic Diseases International 2016年第6期15卷 667-668页

作者： Mario Rodriguez-Lopez Martin bailon-Cuadrado Francisco j Tejero-pintor Baltasar perez-Saborido Enrique Asensio-Diaz Asterio Barrera-Rebollo General and Digestive Surgery Department Rio Hortega University HospitalDulzaina 247012ValladolidSpain

To the Editor：We read with outstanding interest the article by Celik et al. It is the first external description of the Hamburg＇s preoperative pancreatic resection （pREpARE） score since it was published in 2014 by Uzunoglu et al. According to the latter authors, it is necessary to stratify risk of major morbidity and mortality before performing a pancreatic resection, and pREpARE score is a simple index, validated in a multicenter cohort of patients undergoing this group of technically demanding procedures.

关键词： preoperative pancreatic resection score

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文献计量学：经验拟合方面的缺陷

管理科学学报 2007年第A1期10卷 13-22页

作者： R. bailon-Moreno E. jurado-Alameda R. Ruiz-Banos j. p. Courtial 刘鸿雁（译）党亚茹（校） Departamento de Ingenieria Quimica. Facuhad de Ciencias Universidad de GranadaGranada （Spain） Departamento de Biblioteconomia y Documentacion Facuhad de Biblioteconomia yDocumentacion Universidad de Granada Granada （Spain） Laboratoire de psychologie.Education . Cognition Developpement （ LabECD） Universite de Nantes Nantes （France））

文献计量学中，zipf定律、Bradford定律和Lotka定律都有多种不同的数学表达式．但这些定律通常在对实际数值的拟合上存在问题或缺陷．这些缺陷存在于词语的频率、作者的作品数量、期刊及计量经济和人口统计方面．这表明，这些定律所依... 详细信息

文献计量学中，zipf定律、Bradford定律和Lotka定律都有多种不同的数学表达式．但这些定律通常在对实际数值的拟合上存在问题或缺陷．这些缺陷存在于词语的频率、作者的作品数量、期刊及计量经济和人口统计方面．这表明，这些定律所依据的分形模型有待改进或者完善．因为，用Zipf-Mandelbrot类型的幂函数的倒数有些失妥，需要将指数因素也考虑进去．这种改进一定将会影响文献计量学、科学计量学，还能应用于经济、人口统计及一般自然科学方面．

关键词：文献计量学缺陷拟合 zipf定律人口统计数学表达式科学计量学分形模型

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统一科学计量模型——分形与交叉分形

管理科学学报 2007年第A1期10卷 23-35页

作者： R. bailon-Moreno E. jurado-Alameda R. Ruiz-Baiios j. p. Courtial 苏道明（译）王莉亚（译）党亚茹（校） Departamento de Ingenieria Qulmica. Facuhad de Ciencias Universidad de Granada Granada （Spain） Departamento de Biblioteconomia y Documentacion Facuhad de Biblioteconomla y DocumentacionUniversidad de Granada Granada （Spain） Laboratoire de psychologie. Education. Cognition Developpement （LabECD） Universite de Nantes Nantes （France））

在七大原理（即行动者网络原理、转换原理、空间原理、数量原理、合成原理、中心-外围或晶核形成原理和累积优势的统一原理）的基础上，建立了统一科学计量模型．分形指数和交叉分形指数的引入扩展了分形模型的范例．该文章中对提出的... 详细信息

在七大原理（即行动者网络原理、转换原理、空间原理、数量原理、合成原理、中心-外围或晶核形成原理和累积优势的统一原理）的基础上，建立了统一科学计量模型．分形指数和交叉分形指数的引入扩展了分形模型的范例．该文章中对提出的模型首次进行阐述，将文献计量学中的各种定律，包括结构分布定律（齐夫定律、布拉德福定律和洛特卡定律）、普赖斯科学指数增长定律和布鲁克斯-阿拉莫斯库老化定律，以及各种定律的数学表达式进行推导．

关键词：分形模型计量模型科学洛特卡定律网络原理布拉德福定律文献计量学数学表达式

基于统一科学计量模型的物理化学活性物质的文献计量分析及匹配的相关变化指标

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管理科学学报 2007年第A1期10卷 36-42页

作者： R. bailon-Moreno E. jurado-Alameda R. Ruiz-Baiios j. p. Courtial 王永亮（译）王莉亚（译）党亚茹（校） Departamento de Ingenierla Quimica. Facuhad de Ciencias Universidad de GranadaGranada （Spain） Departamento de Biblioteconomia y Documentacion Facuhad deBiblioteconomia y Documentacion Universidad de Granada Granada （Spain） Laboratoire de psychologie. Education Cognition Developpement （LabECD） Universite de Nantes Nantes （France））

本文使用CopalRed的信息系统和63543篇论文的参考文献，利用统一科学计量模型分析了物理化学活性物质领域的文献．研究表明，各个指标（国家，中心，研究实验室、杂志、研究人员、关键词）的分布符合齐夫统一定律而不是齐夫一曼德尔布... 详细信息

本文使用CopalRed的信息系统和63543篇论文的参考文献，利用统一科学计量模型分析了物理化学活性物质领域的文献．研究表明，各个指标（国家，中心，研究实验室、杂志、研究人员、关键词）的分布符合齐夫统一定律而不是齐夫一曼德尔布罗特定律．该模型特别适合于分析相关指标，例如文献的分布状态和集中情况．根据统一布拉德福定律，三个适配区域为：核心区、直接后继区和格瑞斯下垂．离散指标能够显示分散与交叉的知识结构．总之，统一科学计量模型的适应性和整合能力，是适合说明科学的发展状况的模型．

关键词：文献计量分析计量模型科学计量活性物质物理化学布拉德福定律匹配参考文献

2004-2015年西班牙原发性肺高血压特征及其转归：基于医院出院数据库的回顾性分析

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中华高血压杂志 2019年第11期27卷 1069-1069页

作者：陈嘉睿(译) 叶鹏(审校) de-Miguel-Diez j Lopez-de-Andres A Hernandez-Barrera V jimenez-Trujillo I Mendez-bailon M de Miguel-Yanes jM Mu oz-Rivas N Romero-Maroto M jimenez-Garcia R 不详

为了检查2004-2015年西班牙原发性肺高血压(primary pulmonary hypertension,ppH)的发病率、临床特征和转归的趋势,及确定影响西班牙住院患者住院死亡率(in-hospital mortality,IHM)的因素,研究患者纳入西班牙国家医院出院数据库的所有... 详细信息

为了检查2004-2015年西班牙原发性肺高血压(primary pulmonary hypertension,ppH)的发病率、临床特征和转归的趋势,及确定影响西班牙住院患者住院死亡率(in-hospital mortality,IHM)的因素,研究患者纳入西班牙国家医院出院数据库的所有ppH住院患者,共分析了46883例出院患者(7.14%以ppH为主要诊断)。

关键词：住院死亡率肺高血压 ppH hypertension 出院患者 pulmonary 临床特征转归