目的应用Meta分析评价超声弹性成像技术对精索静脉曲张(VC)患者睾丸硬度的诊断价值。方法检索PubMed、Embase、Web of Science、Cochrane图书馆、CNKI、万方及维普数据库,严格按照纳入及排除标准筛选文献、提取资料,应用RevMan 5.3软件...目的应用Meta分析评价超声弹性成像技术对精索静脉曲张(VC)患者睾丸硬度的诊断价值。方法检索PubMed、Embase、Web of Science、Cochrane图书馆、CNKI、万方及维普数据库,严格按照纳入及排除标准筛选文献、提取资料,应用RevMan 5.3软件对数据进行Meta分析。结果最终纳入15篇文献,包含980例左侧VC患者(VC组)和524例健康对照者(对照组),其中7篇文献使用剪切波弹性成像检测睾丸剪切波速度(SWV),Meta分析汇总结果显示:VC组SWV较对照组增大,差异有统计学意义[MD=-0.02,95%可信区间(-0.03,-0.01),P=0.0004];3篇文献使用应变弹性成像(SE)检测睾丸应变比(SR),Meta分析汇总结果显示:VC组SR较对照组减低,但差异无统计学意义[MD=-0.01,95%可信区间(-0.13,0.12),P=0.92];5篇文献使用SE检测睾丸应变均值(Mean),Meta分析汇总结果显示:VC组Mean较对照组增大,差异有统计学意义[MD=0.36,95%可信区间(0.12,0.61),P=0.003]。经亚组分析和敏感性分析显示,剔除异质性大的文献后,两组SWV、SR、Mean比较差异均有统计学意义(均P<0.05)。结论超声弹性成像技术可用于检测VC患者睾丸硬度。展开更多
OBJECTIVE: To investigate blood pressure rhythm(BPR)in Yin deficiency syndrome of hypertension(YDSH)patients and develop a random forest model for predicting YDSH.METHODS: Our study was consistent with technical proce...OBJECTIVE: To investigate blood pressure rhythm(BPR)in Yin deficiency syndrome of hypertension(YDSH)patients and develop a random forest model for predicting YDSH.METHODS: Our study was consistent with technical processes and specification for developing guidelines of Evidence-based Chinese medicine clinical practice(T/CACM 1032-2017). We enrolled 234 patients who had been diagnosed with primary hypertension without antihypertensive medications prior to the enrollment. All participants were divided into Yin deficiency group(YX, n = 74) and non-Yin deficiency group(NYX, n = 160).Participants were professionally grouped by three experienced chief Traditional Chinese Medicine(TCM)physicians according to four examinations(i.e.,inspection, listening and smelling, inquiry and palpation).We collected data on 24 h ambulatory blood pressure monitoring(ABPM) and YDSH rating scale. We divided 24 h of a day into 12 two-hour periods [Chen-Shi(7:00-9:00), Si-Shi(9:00-11:00), Wu-Shi(11:00-13:00), Wei-Shi(13:00-15:00), Shen-Shi(15:00-17:00), You-Shi(17:00-19:00), Xu-Shi(19:00-21:00), Hai-Shi(21:00-23:00), ZiShi(23:00-1:00), Chou-Shi(1:00-3:00), Yin-Shi(3:00-5:00), Mao-Shi(5:00-7:00)] according to the theory of “midnight-midday ebb flow”. We used random forest to build the diagnostic model of YDSH, with whether it was Yin deficiency syndrome as the outcome. RESULTS: Compared with NYX group, YX group had more female participants with older age, lower waist circumference, body mass index(BMI), diastolic blood pressure(DBP), and smoking and drinking rate(all P < 0.05). The YDSH rating scores of YX group [28.5(21.0-36.0)] were significantly higher than NYX group [13.0(8.0-22.0)](P < 0.001), and the typical symptoms of YX group included vexing heat in the chest, palms and soles, dizziness, dry eyes, string-like and fine pulse, soreness and weakness of lumbus and knees, palpitations, reddened cheeks, and tinnitus(all P < 0.05). The ratio of non-dipper hypertension in YX group was higher than in NYX group(56.9% vs 44.4%, P = 0.004). Compared with NYX group, 24 h DBP standard deviation(SD), nighttime DBP SD, Si-Shi DBP, Si-Shi mean arterial pressure(MAP), Hi-Shi systolic blood pressure(SBP), Hi-Shi DBP, Hi-Shi MAP, Zi-Shi SBP, Zi-Shi DBP, Zi-Shi MAP, ChouShi SBP SD, Chou-Shi DBP SD, Chou-Shi SBP coefficient of variation(CV) were lower in YX group(all P < 0.05). Binary Logistic Regression analysis showed that the diagnosis of YDSH was positively correlated with age, heart rate, YDSH rating scores, and four TCM symptoms including vexing heat in the chest, palms and soles, string-like and fine pulse, soreness and weakness of lumbus and knees, and reddened cheeks(all P < 0.05), but was negatively correlated with smoking(P﹥0.05). In addition, the diagnosis of YDSH was positively correlated with daytime SBP SD, nighttime SBP SD, nighttime SBP CV, and Hi-Shi SBP CV, but was negatively correlated with 24 h SBP CV, daytime DBP SD, nighttime DBP SD, and Hi-Shi DBP(all P < 0.05). Hi-Shi SBP CV had independent and positive correlation with the diagnosis of YDSH after adjusting the variables of age, gender, course of hypertension, BMI, waist circumference, SBP, DBP, heart rate, smoking and drinking(P = 0.029). Diagnostic model of YDSH was established and verified based on the random forest. The results showed that the calculation accuracy, specificity and sensitivity were 77.3%, 77.8% and 76.9%, respectively. CONCLUSION: The BPR was significantly attenuated in YDSH patients, including lower 24 h DBP SD and nighttime DBP SD, and Hi-Shi SBP CV is independently correlated with the diagnosis of YDSH. The prediction accuracy of diagnosis model of YDSH based on the random forest was good, which could be valuable for clinicians to differentiate YDSH and non-Yin deficiency patients for more effective hypertensive treatment of TCM.展开更多
文摘目的应用Meta分析评价超声弹性成像技术对精索静脉曲张(VC)患者睾丸硬度的诊断价值。方法检索PubMed、Embase、Web of Science、Cochrane图书馆、CNKI、万方及维普数据库,严格按照纳入及排除标准筛选文献、提取资料,应用RevMan 5.3软件对数据进行Meta分析。结果最终纳入15篇文献,包含980例左侧VC患者(VC组)和524例健康对照者(对照组),其中7篇文献使用剪切波弹性成像检测睾丸剪切波速度(SWV),Meta分析汇总结果显示:VC组SWV较对照组增大,差异有统计学意义[MD=-0.02,95%可信区间(-0.03,-0.01),P=0.0004];3篇文献使用应变弹性成像(SE)检测睾丸应变比(SR),Meta分析汇总结果显示:VC组SR较对照组减低,但差异无统计学意义[MD=-0.01,95%可信区间(-0.13,0.12),P=0.92];5篇文献使用SE检测睾丸应变均值(Mean),Meta分析汇总结果显示:VC组Mean较对照组增大,差异有统计学意义[MD=0.36,95%可信区间(0.12,0.61),P=0.003]。经亚组分析和敏感性分析显示,剔除异质性大的文献后,两组SWV、SR、Mean比较差异均有统计学意义(均P<0.05)。结论超声弹性成像技术可用于检测VC患者睾丸硬度。
基金National Key R&D Program of China Project:Study on Syndrome Differentiation Standard of Yin deficiency Syndrome in Hypertension (No. 2018YFC1704403)National Key R&D Program of China Project:Systematic Study on the Standard of Syndrome Differentiation of Yin Deficiency Syndrome (No. 2018YFC1704400)+1 种基金the Natural Science Foundation of Jiangsu Province:Exploring the Cardioprotective Effect and Mechanism of Qinggan Zishen Formula on Obesity and Hypertension Based on Nrf2 Regulation of Cardiac Homeostasis (No. BK20221422)the Natural Science Foundation of Jiangsu Province:Mechanism Study on the Promotion of Cardiac Energy Metabolism Balance and Inhibition of DOX Induced Heart Failure through Nr1d1/Nfil3 Mediated Circadian Pathway by Yiqi Wenyang Formula (No. BK20220739)。
文摘OBJECTIVE: To investigate blood pressure rhythm(BPR)in Yin deficiency syndrome of hypertension(YDSH)patients and develop a random forest model for predicting YDSH.METHODS: Our study was consistent with technical processes and specification for developing guidelines of Evidence-based Chinese medicine clinical practice(T/CACM 1032-2017). We enrolled 234 patients who had been diagnosed with primary hypertension without antihypertensive medications prior to the enrollment. All participants were divided into Yin deficiency group(YX, n = 74) and non-Yin deficiency group(NYX, n = 160).Participants were professionally grouped by three experienced chief Traditional Chinese Medicine(TCM)physicians according to four examinations(i.e.,inspection, listening and smelling, inquiry and palpation).We collected data on 24 h ambulatory blood pressure monitoring(ABPM) and YDSH rating scale. We divided 24 h of a day into 12 two-hour periods [Chen-Shi(7:00-9:00), Si-Shi(9:00-11:00), Wu-Shi(11:00-13:00), Wei-Shi(13:00-15:00), Shen-Shi(15:00-17:00), You-Shi(17:00-19:00), Xu-Shi(19:00-21:00), Hai-Shi(21:00-23:00), ZiShi(23:00-1:00), Chou-Shi(1:00-3:00), Yin-Shi(3:00-5:00), Mao-Shi(5:00-7:00)] according to the theory of “midnight-midday ebb flow”. We used random forest to build the diagnostic model of YDSH, with whether it was Yin deficiency syndrome as the outcome. RESULTS: Compared with NYX group, YX group had more female participants with older age, lower waist circumference, body mass index(BMI), diastolic blood pressure(DBP), and smoking and drinking rate(all P < 0.05). The YDSH rating scores of YX group [28.5(21.0-36.0)] were significantly higher than NYX group [13.0(8.0-22.0)](P < 0.001), and the typical symptoms of YX group included vexing heat in the chest, palms and soles, dizziness, dry eyes, string-like and fine pulse, soreness and weakness of lumbus and knees, palpitations, reddened cheeks, and tinnitus(all P < 0.05). The ratio of non-dipper hypertension in YX group was higher than in NYX group(56.9% vs 44.4%, P = 0.004). Compared with NYX group, 24 h DBP standard deviation(SD), nighttime DBP SD, Si-Shi DBP, Si-Shi mean arterial pressure(MAP), Hi-Shi systolic blood pressure(SBP), Hi-Shi DBP, Hi-Shi MAP, Zi-Shi SBP, Zi-Shi DBP, Zi-Shi MAP, ChouShi SBP SD, Chou-Shi DBP SD, Chou-Shi SBP coefficient of variation(CV) were lower in YX group(all P < 0.05). Binary Logistic Regression analysis showed that the diagnosis of YDSH was positively correlated with age, heart rate, YDSH rating scores, and four TCM symptoms including vexing heat in the chest, palms and soles, string-like and fine pulse, soreness and weakness of lumbus and knees, and reddened cheeks(all P < 0.05), but was negatively correlated with smoking(P﹥0.05). In addition, the diagnosis of YDSH was positively correlated with daytime SBP SD, nighttime SBP SD, nighttime SBP CV, and Hi-Shi SBP CV, but was negatively correlated with 24 h SBP CV, daytime DBP SD, nighttime DBP SD, and Hi-Shi DBP(all P < 0.05). Hi-Shi SBP CV had independent and positive correlation with the diagnosis of YDSH after adjusting the variables of age, gender, course of hypertension, BMI, waist circumference, SBP, DBP, heart rate, smoking and drinking(P = 0.029). Diagnostic model of YDSH was established and verified based on the random forest. The results showed that the calculation accuracy, specificity and sensitivity were 77.3%, 77.8% and 76.9%, respectively. CONCLUSION: The BPR was significantly attenuated in YDSH patients, including lower 24 h DBP SD and nighttime DBP SD, and Hi-Shi SBP CV is independently correlated with the diagnosis of YDSH. The prediction accuracy of diagnosis model of YDSH based on the random forest was good, which could be valuable for clinicians to differentiate YDSH and non-Yin deficiency patients for more effective hypertensive treatment of TCM.
