Objective To investigate the postoperative biochemical changes and the strategy of steroid treatment for autoimmune pancreatitis （AIP）. Methods Six patients with AIP from January 2007 to October 2011 in this hospital were included in this study. Four patients received pancreaticoduodenectomy or distal pancreatectomy for being preoperatively misdiagnosed as malignant tumors. Two patients avoided the unnecessary resection and received the internal drainage for obstructive jaundice and postoperative steroid medication because of a confirmation of AIP by intraoperative frozen biopsy. All the patients underwent routine examinations， including liver function， CA19-9 level， and imaging data. Measurement of serum IgG or IgG4 was performed for fewer patients after operation. Results CA19-9 levels were normal or slightly elevated in six AIP patients. For five patients with AIP in the head of pancreas， preoperative serum γ-GT levels were elevated. For these patients， whether pancreaticoduodenectomy or the internal drainage were performed， TB/DB levels were transiently elevated on day 1 or 4 after operation but dropped to below preoperative levelsor normal levels on day 7 after operation， and serum γ-GT levels among them presented a downward. Serum γ-globulin levels exhibited a downward trend among four AIP patients after resection， while a upward trend was found in another two AIP patients receiving internal drainage. From the limited data， elevated serum level of IgG in the AIP patients were found. As to IgG4， the only case was tested on month 7 after operation， the serum IgG4 level was elevated. CT showed that the swollen status of pancreas obviously reduced on month 3 after operation as compared with before operation.Conclusions Postoperative steroid therapy of AIP should be based on the serum γ-globulin level and operation method. CT or MRI imaging is used to evaluate the response to steroid treatment for the AIP patients.
Objective To systematically review the impact of the centralized volume-based procurement (CVBP) of medical consumables on patients' hospitalization expenses in China. Methods The PubMed, Web of Science Core Collection, Scopus, CNKI, CBM, and WanFang Data were electronically searched to collect studies on the impact of CVBP medical consumables on patients' hospitalization expenses from Jan 1, 2000 to May 13, 2025. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 17.0 software. Results The meta-analysis showed that the implementation of the CVBP policy for medical consumables significantly reduced the average patient hospitalization expense (SMD=?4.754, 95%CI ?7.434 to ?2.075, P<0.001). Subgroup analysis indicated that the average patient hospitalization expense decreased after CVBP of coronary stents (SMD=?0.721, 95%CI ?1.040 to ?0.402, P<0.001) and intraocular lenses (SMD=?0.660, 95%CI ?0.984 to ?0.337, P<0.001), with the largest reduction observed after the procurement of artificial joints (SMD=?10.344, 95%CI ?15.147 to ?5.540, P<0.001). Conclusion Evidence from evaluations of the CVBP from the patient's perspective in China is mainly concentrated in developed provinces and cities. Moderate-quality evidence suggests that the largest reduction in average patients' hospitalization expenses occurred after the CVBP of artificial joints, followed by coronary stents and intraocular lenses. It is recommended to further expand the scope of CVBP in the future in China.
