目的通过对临床常规检验指标进行数据分析,筛选出对低癌胚抗原(carcinoembryonic antigen,CEA)结直肠癌具有潜在诊断价值的指标,构建列线图预测模型,并验证该模型的预测效能。方法选取2019年9月~2023年12月安徽医科大学附属巢湖医院收...目的通过对临床常规检验指标进行数据分析,筛选出对低癌胚抗原(carcinoembryonic antigen,CEA)结直肠癌具有潜在诊断价值的指标,构建列线图预测模型,并验证该模型的预测效能。方法选取2019年9月~2023年12月安徽医科大学附属巢湖医院收治的低CEA结直肠癌患者194例设为低CEA结直肠癌组,另外选取同期结直肠良性疾病患者184例作为非结直肠癌组。先对两组的临床常规检验指标包括血常规、生化常规、凝血功能及肿瘤标志物进行单因素分析,然后筛选出差异有统计学意义(P<0.05)的指标,进一步进行多因素Logistic分析,得出低CEA结直肠癌发生的独立影响因素;采用R 4.3.3软件建立列线图预测模型,运用Bootstrap法重复抽样1000次对列线图预测模型进行内部验证,绘制受试者工作特征(receiver operating characteristic,ROC)曲线、Calibration校准曲线、决策曲线分析(decision curve analysis,DCA)评价模型的区分度、校准度以及临床实用性。结果多因素Logistic回归分析结果显示,血红蛋白与红细胞分布宽度比值(hemoglobin-to-erythrocyte distribution width ratio,HRR)、血白蛋白(albumin,ALB)及CEA是低CEA结直肠癌的独立影响因素。ROC曲线分析结果显示,三者联合预测模型的曲线下面积(area under the curve,AUC)为0.822(95%CI:0.781~0.864),敏感度为71.10%,特异性为79.90%,运用Bootstrap法进行内部验证并绘制Calibration校准曲线及决策曲线分析提示该列线图模型区分度、一致性及临床效能较好。结论HRR、ALB及CEA对低CEA结直肠癌具有一定的诊断价值,三者联合的诊断效能较高,基于这3项血清学指标构建的风险预测列线图模型具有较好的临床应用前景。展开更多
We focused on the efflorescence induced microstructural evolution of ettringite-rich systems prepared with calcium aluminate cement(CAC)and anhydrite.The effects of anhydrite on the visible efflorescence,and the corre...We focused on the efflorescence induced microstructural evolution of ettringite-rich systems prepared with calcium aluminate cement(CAC)and anhydrite.The effects of anhydrite on the visible efflorescence,and the corresponding capillary absorption of CAC-anhydrite mortars were revealed.The composition and microstructure of efflorescence-causing substances were investigated by optical microscope,in-situ Raman spectroscopy,scanning electron microscope,energy dispersive spectrometer,thermogravimetric analysis,and differential scanning calorimetry,at multi-scales.Results indicate that,besides the calcium carbonate,ettringite is another main component of efflorescence-causing substances.Compared with the neat CAC mortars,the addition of anhydrite has a significant effect on the degree of efflorescence by acting on the composition of hydration products and pore structure.In addition,methods are proposed for the prevention of efflorescence of CAC-anhydrite binary system.展开更多
文摘目的通过对临床常规检验指标进行数据分析,筛选出对低癌胚抗原(carcinoembryonic antigen,CEA)结直肠癌具有潜在诊断价值的指标,构建列线图预测模型,并验证该模型的预测效能。方法选取2019年9月~2023年12月安徽医科大学附属巢湖医院收治的低CEA结直肠癌患者194例设为低CEA结直肠癌组,另外选取同期结直肠良性疾病患者184例作为非结直肠癌组。先对两组的临床常规检验指标包括血常规、生化常规、凝血功能及肿瘤标志物进行单因素分析,然后筛选出差异有统计学意义(P<0.05)的指标,进一步进行多因素Logistic分析,得出低CEA结直肠癌发生的独立影响因素;采用R 4.3.3软件建立列线图预测模型,运用Bootstrap法重复抽样1000次对列线图预测模型进行内部验证,绘制受试者工作特征(receiver operating characteristic,ROC)曲线、Calibration校准曲线、决策曲线分析(decision curve analysis,DCA)评价模型的区分度、校准度以及临床实用性。结果多因素Logistic回归分析结果显示,血红蛋白与红细胞分布宽度比值(hemoglobin-to-erythrocyte distribution width ratio,HRR)、血白蛋白(albumin,ALB)及CEA是低CEA结直肠癌的独立影响因素。ROC曲线分析结果显示,三者联合预测模型的曲线下面积(area under the curve,AUC)为0.822(95%CI:0.781~0.864),敏感度为71.10%,特异性为79.90%,运用Bootstrap法进行内部验证并绘制Calibration校准曲线及决策曲线分析提示该列线图模型区分度、一致性及临床效能较好。结论HRR、ALB及CEA对低CEA结直肠癌具有一定的诊断价值,三者联合的诊断效能较高,基于这3项血清学指标构建的风险预测列线图模型具有较好的临床应用前景。
基金Funded by the National Key Research and Development Program of China(No.2022YFC3803400)National Natural Science Foundation of China(Nos.52378255,52278270)+1 种基金Shanghai Municipal Science and Technology Major Project(No.2021SHZDZX0100)the Fundamental Research Funds for the Central Universities and the Experimental Center of Materials Science and Engineering in Tongji University。
文摘We focused on the efflorescence induced microstructural evolution of ettringite-rich systems prepared with calcium aluminate cement(CAC)and anhydrite.The effects of anhydrite on the visible efflorescence,and the corresponding capillary absorption of CAC-anhydrite mortars were revealed.The composition and microstructure of efflorescence-causing substances were investigated by optical microscope,in-situ Raman spectroscopy,scanning electron microscope,energy dispersive spectrometer,thermogravimetric analysis,and differential scanning calorimetry,at multi-scales.Results indicate that,besides the calcium carbonate,ettringite is another main component of efflorescence-causing substances.Compared with the neat CAC mortars,the addition of anhydrite has a significant effect on the degree of efflorescence by acting on the composition of hydration products and pore structure.In addition,methods are proposed for the prevention of efflorescence of CAC-anhydrite binary system.
