Acute pancreatitis represents a disease characterized by acute necro-inflammatory changes in the pancreas, which is histologically characterized by destruction of alveolar cells. We aim to explore whether evidence-based care can improve treatment compliance and quality of life of patients with acute pancreatitis. The changes of hemoglobin (HGB), serum pre-albumin (PAB), and serum albumin (ALB) before and after care were observed, as well as the incidence of complications after care, total effective rate after care, disease severity (bedside index for severity in acute pancreatitis, BISAP) before and after care, and psychological scores of the two groups before and after care were observed. Patients’ compliance after care, self-management scores after care, and quality of life after care were compared between the two groups. After care, HGB, PAB, and ALB increased significantly in both groups ( p < 0.05 ) and were higher in OG than CG. Compared with CG, OG had significantly lower incidence of complications ( p = 0.009 ), significantly higher total effective rate ( p = 0.011 ), significantly lower disease severity ( p < 0.05 ), significantly better psychological condition scores ( p < 0.05 ), significantly higher compliance scores ( p < 0.05 ), higher self-management scores ( p < 0.05 ), and significantly higher quality of life ( p < 0.001 ). Evidence-based care can improve treatment compliance of patients with acute pancreatitis and can effectively improve their quality of life.

The objective of this study is to determine whether the frequency of visits would affect disease activity and disease damage in patients with systemic lupus erythematosus (SLE). We recruited 147 patients who met the 1997 American College of Rheumatology (ACR) criteria for SLE. Patients were divided into three groups based on follow-up frequency: ≤ 6 visits/year (group 1), 6-12 visits/year (group 2), and > 12 visits/year (group 3). Disease activity and organ damage were evaluated using the SLE disease activity index (SLEDAI) and Systemic Lupus International Collaborative Clinics (SLICC)/ACR criteria, respectively. Data on disease features, patient characteristics, and treatment were retrospectively reviewed. We found that the SLICC score was significantly lower in patients with > 12 visits/year (P = 0.008), while the SLEDAI score showed no significant difference. The age at symptom onset (32.68 ± 13.53) and the age at SLE diagnosis (33.32 ± 13.81) in group 3 were significantly older than those in the other two groups. In univariate regression analysis, the frequency of visits, the age at symptom onset, and the age at SLE diagnosis were found to be associated with the SLICC scores. Visit frequency has no impact on SLE disease activity, but may be associated with less disease damage, an important outcome.

BackgroundIn addition to gender and ethnicity, modifiable variables like geography, socioeconomic status, health system structure, education, and physician expertise may influence outcomes in systemic lupus erythematosus (SLE).ObjectivesTo compare characteristics of and treatment options for subsets of Chinese and American patients with SLE to elucidate factors that contribute to disease activity and damage.MethodsChart review of 77 Chinese (Qingdao) and 48 Midwestern American (Louisville, Kentucky) patients meeting American College of Rheumatology (ACR) criteria for a diagnosis of SLE followed up for four years were analyzed retrospectively. Organ damage was assessed using the Systemic Lupus International Collaborating Clinics (SLICC)/ACR Damage Index (SDI), and disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Statistics were parametric exploratory tests of significance and multiple regression analyses in this hypothesis-generating effort.ResultsThe interval between the time of onset and diagnosis was 44 months shorter in the Chinese arm (p=0.001), and Chinese patients followed up at six times greater frequency than American patients (p<0.001). Despite the lack of formal matching, the two cohorts featured similar disease activity according to the SLEDAI. Based on the SDI, rates of organ damage were higher in the American group. Chinese patients received more steroids, cyclophosphamide, hydroxychloroquine, intravenous immune globulin, and cyclosporine than the Louisville group, while the Louisville patients received more mycophenolate mofetil and azathioprine (p=0.001).Table 1VariableQingdao (n=77),Louisville (n=48), p-value mean ± SDmean ± SD Onset age (years)30.24±11.9530.21±12.210.989Age at diagnosis (years)30.89±11.9234.5±12.990.114Duration between SLE onset and diagnosis (months)7.94±18.4652.30±89.900.001Clinic visits per year10.93±7.093.02±1.91<0.001Interval between the last two times of follow up (months)1.89±1.3112.32±28.320.014Disease duration (years)5.97±5.725.22±5.530.466SLEDAI5.81±4.324.63±4.770.156SDI0.44±0.641.23±1.057<0.001Table 2MedicationQingdao (n=77)Louisville (n=48) p-value Prednisone77 (100%)29 (60.42%)<0.0001Cyclophosphamide34 (44.16%)6 (12.50%)<0.0001Hydroxychloroquine72 (93.51%)32 (66.67%)<0.0001Methotrexate9 (11.69%)3 (6.25%)0.489Mycophenolate mofetil10 (12.99%)18 (37.50%)0.001Azathioprine2 (2.60%)5 (10.42%)0.147Intravenous immune globulin12 (15.58%)1 (2.08%)0.035Cyclosporine17 (22.08%)1 (2.08%)0.005ConclusionsThe establishment of follow-up and treatment of SLE differs in specific, identifiable ways between these subsets of Chinese and midwestern American patients. Greater access to and increased frequency of follow-up appears associated with a lesser degree of organ damage, supporting the treat-to-target concept as applied to SLE. Complete, controlled trials in both settings are necessary, and further detailed comparison of larger cohorts may inform conclusions about the likelihood of generalizability of trial results from one settin...