目的:探讨胃癌病人淋巴结转移率分组界值及其对预后的评估。方法:回顾性分析2004年1月至2008年7月复旦大学附属中山医院392例行胃癌根治术,分期为美国癌症联合委员会(American Joint Committee on Cancer,AJCC)(第8版)Ⅱ~Ⅲ期的病人。利...目的:探讨胃癌病人淋巴结转移率分组界值及其对预后的评估。方法:回顾性分析2004年1月至2008年7月复旦大学附属中山医院392例行胃癌根治术,分期为美国癌症联合委员会(American Joint Committee on Cancer,AJCC)(第8版)Ⅱ~Ⅲ期的病人。利用X-tile软件进行淋巴结转移率的分组,评估淋巴结转移率与其他临床病理因素的相关性和对病人预后的评估。建立列线图预测模型,绘制校准曲线,与实际作比较。用Bootstrap法进行内部验证,计算一致性指数(C-index)评估模型准确性。结果:X-tile获得淋巴结转移率的最佳截断值为0.20(20%)和0.70(70%)。将淋巴结转移率分为1组(0~20%)、2组(21%~69%)和3组(70%~100%)。3组病人的生存差异有统计学意义(P<0.001)。单因素分析显示,淋巴结转移率、TNM分期、T分期、N分期、淋巴管浸润和年龄是影响预后的相关因素。多因素分析显示,淋巴结转移率、T分期、N分期、淋巴管浸润及年龄是影响预后的独立因素。分别以淋巴结转移率、TNM分期、淋巴管浸润及年龄绘制病人总体生存率的受试者操作特征曲线,其曲线下面积分别为0.699、0.667、0.587、0.561。采用淋巴结转移率、TNM分期、淋巴管浸润和年龄构建列线图预测模型,其C-index为0.707(95%CI:0.705~0.708)。校正曲线显示的1、3及5年预测生存率与实际相符。结论:淋巴结转移率是影响Ⅱ~Ⅲ期胃癌根治术后病人生存的独立危险因素。在判断Ⅱ~Ⅲ期胃癌根治术后病人预后时,淋巴结转移率是N分期的有效补充,可指导合理治疗。展开更多
According to the data in the past nine years in Heyuan urban district and its adjacent five counties,annual,seasonal and monthly change characteristics of heat island effect in Heyuan City and its meteorological influ...According to the data in the past nine years in Heyuan urban district and its adjacent five counties,annual,seasonal and monthly change characteristics of heat island effect in Heyuan City and its meteorological influence factors were analyzed. The results showed that the intensity of heat island effect in central urban district and suburb of Heyuan City overall showed an upward trend from 2007 to 2015. From 2007 to 2012,heat island effect showed a slow weakening trend; from 2012 to 2013,heat island effect significantly enhanced and then weakened; after 2013,heat island effect significantly reduced. Heat island effect of Heyuan was the strongest in winter,followed by autumn,and it was the weakest in summer.The strongest heat island effect occurred in October,while the weakest occurred in July. According to the grey correlation analysis,the main factors affecting urban heat island effect of Heyuan were analyzed,and the order of each influence factor was as follows: average wind speed > relative humidity > rainfall > sunshine hours.展开更多
目的了解中国血吸虫病患者共病抑郁和焦虑患病率以及使用心理干预治疗的效果,为改善患者心理健康状况提供依据。方法在中国期刊全文数据库(CNKI)、万方数据资源系统、PubMed、Web of Science、Embase中,检索公开发表的有关中国血吸虫病...目的了解中国血吸虫病患者共病抑郁和焦虑患病率以及使用心理干预治疗的效果,为改善患者心理健康状况提供依据。方法在中国期刊全文数据库(CNKI)、万方数据资源系统、PubMed、Web of Science、Embase中,检索公开发表的有关中国血吸虫病患者共病焦虑、抑郁,以及心理干预治疗的文献。对文献进行筛选后,提取共病率、心理治疗方法、治疗前后抑郁自评量表(self-rating depression scale,SDS)和焦虑自评量表(self-rating anxiety scale,SAS)评分等数据,采用meta分析对中国血吸虫病患者抑郁、焦虑共病率进行分析,并评价心理干预方法治疗患者焦虑、抑郁的效果。结果共检索到231篇文献,最终筛选出符合纳入和排除标准的14篇文献,包括2篇英文文献、12篇中文文献。Meta分析结果显示,中国血吸虫病患者抑郁共病率为61%[95%可信区间(confidence interval,CI):(48%,72%)],焦虑共病率为64%[95%CI:(42%,81%)]。经心理干预治疗后,血吸虫病患者SDS量表评分[1.45,95%CI:(1.30,1.60)]、SAS量表评分[2.21,95%CI:(2.05,2.38)]均较治疗前降低,病例组SDS量表评分[-0.47,95%CI:(-0.69,-0.25)]、SAS量表评分[-1.30,95%CI:(-1.52,-1.09)]均低于对照组。结论中国血吸虫病患者共病焦虑及抑郁情绪问题较普遍,临床常用心理干预方法有助于改善血吸虫病患者抑郁和焦虑症状。展开更多
文摘目的:探讨胃癌病人淋巴结转移率分组界值及其对预后的评估。方法:回顾性分析2004年1月至2008年7月复旦大学附属中山医院392例行胃癌根治术,分期为美国癌症联合委员会(American Joint Committee on Cancer,AJCC)(第8版)Ⅱ~Ⅲ期的病人。利用X-tile软件进行淋巴结转移率的分组,评估淋巴结转移率与其他临床病理因素的相关性和对病人预后的评估。建立列线图预测模型,绘制校准曲线,与实际作比较。用Bootstrap法进行内部验证,计算一致性指数(C-index)评估模型准确性。结果:X-tile获得淋巴结转移率的最佳截断值为0.20(20%)和0.70(70%)。将淋巴结转移率分为1组(0~20%)、2组(21%~69%)和3组(70%~100%)。3组病人的生存差异有统计学意义(P<0.001)。单因素分析显示,淋巴结转移率、TNM分期、T分期、N分期、淋巴管浸润和年龄是影响预后的相关因素。多因素分析显示,淋巴结转移率、T分期、N分期、淋巴管浸润及年龄是影响预后的独立因素。分别以淋巴结转移率、TNM分期、淋巴管浸润及年龄绘制病人总体生存率的受试者操作特征曲线,其曲线下面积分别为0.699、0.667、0.587、0.561。采用淋巴结转移率、TNM分期、淋巴管浸润和年龄构建列线图预测模型,其C-index为0.707(95%CI:0.705~0.708)。校正曲线显示的1、3及5年预测生存率与实际相符。结论:淋巴结转移率是影响Ⅱ~Ⅲ期胃癌根治术后病人生存的独立危险因素。在判断Ⅱ~Ⅲ期胃癌根治术后病人预后时,淋巴结转移率是N分期的有效补充,可指导合理治疗。
文摘According to the data in the past nine years in Heyuan urban district and its adjacent five counties,annual,seasonal and monthly change characteristics of heat island effect in Heyuan City and its meteorological influence factors were analyzed. The results showed that the intensity of heat island effect in central urban district and suburb of Heyuan City overall showed an upward trend from 2007 to 2015. From 2007 to 2012,heat island effect showed a slow weakening trend; from 2012 to 2013,heat island effect significantly enhanced and then weakened; after 2013,heat island effect significantly reduced. Heat island effect of Heyuan was the strongest in winter,followed by autumn,and it was the weakest in summer.The strongest heat island effect occurred in October,while the weakest occurred in July. According to the grey correlation analysis,the main factors affecting urban heat island effect of Heyuan were analyzed,and the order of each influence factor was as follows: average wind speed > relative humidity > rainfall > sunshine hours.