Use of factor scores for determining the relationship between body measurements and semen traits of cocks

Semen evaluation is required to predict fertility. In most rural African communities, facilities for microscopic evaluation of semen are not available. Therefore, an indirect method of predicting semen traits of cocks is required by poultry farmers. The objective of this study was to use factor scores derived from factor analysis of body measurements to predict some semen traits of cocks. Correlation matrix was obtained by calculating the correlations between body measurements and semen traits of cocks. Kais-er-Meyer-Olkin (KMO) measure of sampling adequacy and Bartletts test of sphericity were used to test the appropriateness of factor analysis on the data. The extraction of the factors was done by calculating the eigenvalues of the correlation matrix. Variance maximizing rotation of the transformation matrix was done to facilitate the interpretation of the factor loadings. Two factors with eigenvalues greater than 1 were extracted which accounted for 76.96% of the variations present in the original variables. The two factors were used to obtain the factor score coefficients. When utilized as independent variables in multiple regression analysis, the two factors explained 53.20% and 40.80% of the variations in sperm motility and sperm concentration respectively. Factor 1 had more impact on sperm motility than factor 2 as it was significantly related to it. Factor 2 was significantly more related to sperm concentration than factor 1. The relationship between body measurements and semen volume, live sperm and abnormal sperm were weak and mostly negative. Therefore, they were not predicted using factor scores.

Understanding Osteoporosis: Pathophysiology, Risk Factors, Diagnosis, and Management

Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and deterioration of bone architecture, resulting in reduced bone strength and, consequently, increased susceptibility to fractures which poses a significant public health concern worldwide, particularly in aging populations [1]. The health-economic impact of vertebral and hip fractures has been extensively explored and it is well known that these fractures are associated with morbidity/disability and increased mortality;they also account for a substantial portion of the direct fracture costs. This review aims to provide a comprehensive overview of osteoporosis, including its pathophysiology, risk factors, diagnostic approaches, and management strategies. By elucidating the multifaceted nature of this condition, healthcare providers can better identify individuals at risk, implement preventive measures, and optimize treatment to reduce the burden of osteoporotic fractures.

A predictive score for retinopathy of prematurity by using clinical risk factors and serum insulin-like growth factor-1 levels

AIM：To detect the impact of insulin-like growth factor-1（IGF-1）and other risk factors for the early prediction of retinopathy of prematurity（ROP）and to establish a scoring system for ROP prediction by using clinical criteria and serum IGF-1 levels.METHODS：The study was conducted with 127 preterm infants.IGF-1 levels in the 1st day of life,1st,2nd,3rd and4th week of life was analyzed.The score was established after logistic regression analysis,considering the impact of each variable on the occurrences of any stage ROP.A validation cohort containing 107 preterm infants was included in the study and the predictive ability of ROP score was calculated.RESULTS：Birth weights（BW）,gestational weeks（GW）and the prevalence of breast milk consumption were lower,respiratory distress syndrome（RDS）,bronchopulmonarydysplasia（BPD）and necrotizing enterocolitis（NEC）were more frequent,the duration of mechanical ventilation and oxygen supplementation was longer in patients with ROP（P〈0.05）.Initial serum IGF-1 levels tended to be lower in newborns who developed ROP.Logistic regression analysis revealed that low BW（〈1250 g）,presence of intraventricular hemorrhage（IVH）and formula feeding increased the risk of ROP.Afterwards,the scoring system was validated on 107 infants.The negative predictive values of a score less than 4 were 84.3%,74.7%and 79.8%while positive predictive values were 76.3%,65.5%and71.6%respectively.CONCLUSION：In addition to BW〈1250 g and IVH,formula consumption was detected as a risk factor for the development of ROP.Breastfeeding is important for prevention of ROP in preterm infants.

MELD score,insulin-like growth factor 1 and cytokines on bone density in end-stage liver disease

AIM:To determine the contributions of insulin-like growth factor 1 (IGF-1),cytokines and liver disease severity to bone mineral density in patients pre-transplantation.METHODS:Serum IGF-1,tumor necrosis factor-α (TNFα) and interleukin 6 (IL-6) were measured and the Model for End-Stage Liver Disease (MELD) score calculated in 121 adult patients referred to a single centre for liver transplantation.Bone mineral density (BMD) of the lumbar spine and femoral neck were assessed via dual energy X-ray absorptiometry.Demographics,liver disease etiology,medication use and relevant biochemistry were recorded.RESULTS:A total of 117 subjects were included,with low BMD seen in 68.6%,irrespective of disease etiol-ogy.In multivariable analysis,low body mass index (BMI),increased bone turnover and low IGF-1 were independent predictors of low spinal bone density.At the hip,BMI,IGF-1 and vitamin D status were predictive.Despite prevalent elevations of TNFα and IL-6,levels did not correlate with degree of bone loss.The MELD score failed to predict low BMD in this pre-transplant population.CONCLUSION:Osteopenia/osteoporosis is common in advanced liver disease.Low serum IGF-1 is weakly predictive but serum cytokine and MELD score fail to predict the severity of bone disease.

Correlation between SYNTAX Score and Pattern of Risk Factors in Patients Referred for Coronary Angiography in Cardiology Department, Menoufia University

Objectives: The role of SYNTAX (SX) score in assessing the complexity of coronary artery disease (CAD) is well established. In this study we investigate the relationship between conventional risk factors of CAD with its complexity using SX score. Methods: The study consisted of 52 patients with CAD who were admitted to Cardiology Department—Menoufia University Hospitals for elective coronary angiography. The overall SX score was calculated prospectively using the SX score algorithm. Then comparison was done between populations with and without each risk factor. Results: There was a statistically significant correlation between age, hypertension, diabetes mellitus, dyslipidemia and smoking with SX score results (p 0.05). In a multivariate regression analysis, including conventional risk factors of CAD as independent covariates, it revealed that aging, having diabetes mellitus and smoking were identified as significant independent risk factors for CAD complexity. Conclusion: Advanced age, having diabetes mellitus and cigarette smoking are considered to be independent risk factors for the complexity of CAD. Therefore, when these factors present, we expect that the SX score of the patient to be high indicating a complex CAD.

引入重要度修正因子的复杂光电系统可靠性分配研究

以某新型复杂光电系统为研究对像,针对传统评分分配法客观性差、分配偏差大的缺点,构建重要度修正因子,提出了一种引入重要度修正因子的可靠性评分分配法。首先,运用模糊层次分析法,得到功能单元对上级功能单元/系统可靠性影响的相对重要度;然后,基于相对重要度,按照专家评分规则,得到功能单元对上级功能单元/系统可靠性影响的绝对重要度;最后,基于相对重要度和绝对重要度,构建功能单元重要度修正因子,以此修正各功能单元的评分结果。经对比验证,关重功能单元可靠性分配值较传统评分分配值至少提高6%,引入重要度修正因子的评分分配法能有效削弱传统评分分配法的主观影响,释放关重功能单元可靠性余量,提高功能单元可靠性分配的科学性、合理性,进而提高复杂系统可靠性设计水平。

The Factors of the Failure in the Treatment of Congenital Equinus Clubfoot Varus by the Ponseti Method at the Reference Health Care Center (CSREF) of Commune III of Bamako

Clubfoot malformation is the most common serious congenital anomaly affecting the foot in children. Its treatment by the Ponseti method is simple, profitable and widely used in the world. Objective: The objective of this study was to identify the factors of the failure of its treatment by the Ponseti method. Material and Method: We carried out a retrospective and descriptive study of cases of congenital equinus clubfoot varus at the Reference Health Care Center of Commune III of Bamako over 26 months from September 2020 to November 2022. Data were treated with the utmost anonymity. Result: This study was performed on 44 children seen for clubfoot: male (68%) and female (32%), with a sex ratio of 2.1. We obtained 13 cases of recidivism including 7 boys and 6 girls. We found 21 cases of unilateral and 23 bilateral;among which 9 recurrences were found against 4 in the unilateral forms. 85% of recurrences did not have good adherence to the splint and 62% did not come regularly for follow-up consultation. We obtained 33 children with idiopathic clubfeet (75%) with a recurrence of 24%, and 7 children with secondary clubfeet with 71 % recurrence. There was no recurrence in the postural type. Among the recurrences, 38.5% started treatment between 1 and 6 months, 23.1% from 0 to 1 month and 15.4% at 2 years and more. 85% of recurrences had a Pirani score between 4.5 to 6 at the start of treatment and 15% at a score of 2.5 to 4. Conclusion: The factors of the failure of the Ponseti method are mainly non-compliance with treatment, secondary clubfeet, and a high Pirani score at the start of treatment.

肝硬化合并食管胃底静脉曲张患者发生破裂出血的危险因素分析

目的探究肝硬化合并食管胃底静脉曲张(EGV)患者发生破裂出血的相关危险因素。方法纳入309名EGV患者,根据其住院期间是否发生EGV破裂出血,分为出血组(n=62)和非出血组(n=247),收集患者的一般特征、实验室及影像学资料并进行统计分析。连续变量应用Mann-Whitney U检验或t检验,分类变量应用χ2分析探究组间差异,应用二元Logistic回归探究EGV破裂出血的危险因素并构建预测模型。将上述患者按照7∶3分为建模组及验证组,应用bootstrap法进行内部验证,应用ROC曲线对两组模型效能予以检验。结果高密度脂蛋白(HDL)(P<0.001,OR=0.131,95%CI=0.049~0.350)、C-反应蛋白(CRP)(P=0.010,OR=2.657,95%CI=1.269~5.563)、门静脉宽度(PVW)(P=0.050,OR=1.156,95%CI=1.000~1.336)、脾脏厚度(P=0.035,OR=1.492,95%CI=1.028~2.165)、Child-Pugh B级(P=0.003,OR=11.320,95%CI=2.232~57.407)及Child-Pugh C级(P=0.002,OR=3.888,95%CI=1.659~9.114)与EGV破裂出血相关,ROC曲线示建模组集预测模型的AUC值为0.802,验证组为0.836。结论CRP升高、Child-Pugh B级和C级、HDL降低、门静脉增宽和脾脏增厚是EGV患者发生破裂出血的危险因素。

鼠神经生长因子联合丙种球蛋白治疗慢性格林巴利综合征临床疗效观察

目的探讨鼠神经生长因子(mNGF)联合丙种球蛋白(IVIG)治疗格林巴利综合征(GBS)的临床疗效及对炎性因子及肌力评分的影响。方法我院收治的73例GBS患者,按治疗方法分为观察组(mNGF联合IVIG治疗)40例和对照组(IVIG治疗)33例。对比两组临床疗效、炎性因子、肌力评分及肢体功能Hughes量表评分,并记录治疗期间不良反应发生率。结果观察组治疗总有效率显著高于对照组(P<0.05);治疗后观察组血清IL-4水平高于对照组,IL-21、IL-23水平低于对照组(P<0.05);治疗后观察组上、下肢肌力评分高于对照组,肢体功能Hughes评分低于对照组(P<0.05)。结论mNGF联合IVIG对慢性GBS的临床效果优于单纯使用IVIG治疗,二者联合治疗可有效抑制相关促炎因子的表达,明显改善患者肌力和肢体功能。

基于倾向性评分匹配法的老年患者重度低钠血症危险因素分析

目的分析老年患者重度低钠血症的危险因素。方法选取医院2020年1月至2022年12月收治的老年(≥60岁)住院患者7608例,依据《2014欧洲低钠血症诊疗指南》分为重度低钠血症组(76例)和非重度低钠血症组(7532例),采用倾向性评分匹配法对两组患者进行1∶2匹配,采用单因素分析法分析老年患者重度低钠血症的危险因素,并对有统计学差异的变量进行Logistic多因素回归分析。结果倾向性评分匹配成功223例患者,其中重度低钠血症组75例,非重度低钠血症组148例。单因素分析结果显示,与非重度低钠血症组比较,重度低钠血症组危重症及使用利尿剂、非甾体抗炎药、利奈唑胺/环磷酰胺/卡马西平患者的重度低钠血症发生率显著升高(P<0.05)。Logistic多因素回归分析结果显示,老年患者重度低钠血症的危险因素为危重症(P<0.001)、使用利尿剂(P=0.003)、使用非甾体抗炎药(P=0.002)。结论对于危重症、长期使用利尿剂和非甾体抗炎药的老年患者,需密切关注其重度低钠血症的发生风险。

Prevalence and Predictive Factors of Severe Coronary Lesions in Algerian Patients Undergoing Coronary Angiography

Background: The severity of coronary lesions in patients with coronary artery disease (CAD) has important prognostic and therapeutic consequences. Clinical symptoms not always reflect the disease severity and this study aimed to evaluate coronary lesions in the Algerian population where these data are scarce. Methods: It was a prospective cross-sectional study conducted in consecutive patients with an age ≥20 years who underwent clinically-indicated coronary angiography in our center. The objective of the study was to determine the prevalence of severe coronary lesions assessed with the Gensini score. The predictive factors of severity were evaluated in a multivariate analysis. Results: A total of 507 patients were included (male, 79.7%;mean age, 58.8 years). Coronary angiography was prescribed most frequently for ST-segment elevation myocardial infarction (STMI) (46.9%) and non-STMI (38.1%). The prevalence of severe coronary lesions was 69.6% (95% CI 65.5 - 73.5). In multivariate analysis, the independent predictive factors of severe coronary lesions were male sex (odds ratio [OR] 2.00;p = 0.0141), diabetes (OR 1.92;p = 0.0070), left ventricular dysfunction (OR 1.81;p = 0.0059), age (OR 1.72;p = 0.0297) and no lipid-lowering treatment (OR, 0.47;p = 0.0388). Conclusions: Severe coronary lesions were present in two out three patients in this cohort of Algerian patients undergoing coronary angiography. Independent predictive factors of severe coronary lesions were male sex, diabetes, age, left ventricular dysfunction and no lipid-lowering treatment. It is important to identify these at-risk patients, as they should be explored at an asymptomatic stage before a cardiovascular event and receive prompt treatment with angioplasty or surgery.

腹针引气归元法联合透刺电针对急性期周围性面瘫患者Portmann评分、神经营养因子的影响

目的观察腹针引气归元法联合透刺电针对急性期周围性面瘫患者Portmann评分、神经营养因子的影响。方法选取2020年1月—2023年6月期间80例周围性面瘫急性期患者作为研究对象,采用随机数字表法分为观察组、对照组各40例,对照组予以基础治疗配合透刺电针治疗,观察组在对照组的基础上联合腹针引气归元法治疗,连续治疗4周。比较两组临床疗效,治疗前后急性伴随症状积分、Portmann评分、血清神经营养因子水平。结果观察组总显效率和痊愈率均高于对照组(P<0.05);治疗7 d时,两组耳痛、面部肿痛、颈强不适、恶寒发热症状积分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);治疗4周后,两组Portmann评分皱眉、闭眼、张大鼻孔、吹口哨、微笑、鼓腮均较治疗前提高(P<0.05),且观察组高于对照组(P<0.05);治疗4周后,两组血清神经生长因子(nerve growth factor,NGF)、胶质细胞源性神经营养因子(glial cell-derived neurotrophic factor,GDNF)水平均较治疗前提高(P<0.05),且观察组高于对照组(P<0.05)。结论腹针引气归元法联合透刺电针可显著提高急性期周围性面瘫患者的治疗效果,有效缓解伴随症状,提高Portmann评分,促进神经营养因子的释放。

严重多发外伤患者并发脓毒症的危险因素及风险预测模型构建

目的分析严重多发外伤患者并发脓毒症的危险因素,并建立风险预测模型。方法收集南阳市第一人民医院2021年1月至2022年12月收治的120例严重多发外伤患者临床资料进行回顾性分析,依据是否并发脓毒症分为脓毒症组41例与非脓毒症组79例。采用logistic回归分析影响严重多发外伤患者并发脓毒症的危险因素,依据回归分析结果构建风险预测模型,并计算一致性指数(C-index)判断模型区分度。结果脓毒症组年龄、中性粒细胞与淋巴细胞计数比值(NLR)、活化部分凝血活酶时间(APTT)、创伤严重程度评分(ISS)、序贯器官衰竭(SOFA)评分均大于非脓毒症组,机械通气患者占比高于非脓毒症组,差异有统计学意义(P<0.05);经logistic回归分析显示,NLR、APTT、ISS评分为严重多发外伤患者并发脓毒症的独立危险因素(OR>1,P<0.05);绘制列线图构建严重多发外伤患者并发脓毒症的风险预测模型,验证模型区分度显示C-index值=0.908,区分度良好;绘制标准曲线显示,校准曲线和Y-X直线紧密贴合,模型准确度良好。结论NLR、APTT、ISS评分为严重多发外伤患者并发脓毒症的危险因素,基于上述因素构建的风险预测模型对严重多发外伤患者并发脓毒症具有较高预测价值。

ABCD2评分、PAF、sCD40L、C1q对短暂性脑缺血发作后脑梗死的预测价值及其危险因素分析

目的探讨ABCD2评分及血清血小板活化因子(PAF)、可溶性CD40配体(sCD40L)、补体1q(C1q)对短暂性脑缺血发作后脑梗死的预测价值。方法回顾性选取2020年11月至2022年12月该院收治的94例短暂性脑缺血发作后脑梗死患者作为脑梗死组,另选取同期收治的146例短暂性脑缺血发作后非脑梗死患者作为非脑梗死组。比较两组临床资料,采用多因素Logistic回归分析短暂性脑缺血发作后脑梗死的危险因素,并绘制受试者工作特征(ROC)曲线分析ABCD2评分及血清PAF、sCD40L、C1q单独及联合检测对短暂性脑缺血发作后脑梗死的预测价值。结果脑梗死组和非脑梗死组颈部血管斑块、发作持续时间、发作频率情况,ABCD2评分及血清PAF、sCD40L、C1q、白细胞介素(IL)-6、超敏C反应蛋白(hs-CRP)水平比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,有颈部血管斑块、发作持续时间≥15 min、发作频率≥2次/月,以及ABCD2评分,血清PAF、sCD40L、C1q、IL-6、hs-CRP水平升高是短暂性脑缺血发作后脑梗死的独立危险因素(P<0.05)。ROC曲线分析结果显示,ABCD2评分及血清PAF、sCD40L、C1q联合预测短暂性脑缺血发作后脑梗死的灵敏度、曲线下面积分别为96.81%、0.927,高于或大于ABCD2评分及血清PAF、sCD40L、C1q单独预测(P<0.05);ABCD2评分、血清PAF单独预测的灵敏度分别高于血清sCD40L、C1q单独预测的灵敏度(P<0.05);ABCD2评分及血清PAF、sCD40L单独预测的特异度高于血清C1q单独、4项指标联合预测的特异度(P<0.05),血清C1q单独预测的特异度高于4项指标联合预测的特异度(P<0.05)。结论短暂性脑缺血发作后脑梗死的发生与患者有颈部血管斑块、发作持续时间≥15 min、发作频率≥2次/月,以及ABCD2评分,血清PAF、sCD40L、C1q、IL-6、hs-CRP水平升高均密切相关,且ABCD2评分及血清PAF、sCD40L、C1q联合检测对短暂性脑缺血发作后脑梗死的预测价值更高。

左氧氟沙星致心律失常的发生特点和危险因素分析

目的 了解大样本住院人群中左氧氟沙星致心律失常的发生特点、临床表现和相关危险因素。方法 借助“临床药品不良事件主动监测与智能评估警示系统-Ⅱ”(ADE-ASAS-Ⅱ),回顾性监测2019年使用左氧氟沙星的住院患者电子病历信息,获得发生心律失常患者的相关数据,采用倾向性评分匹配法选取未发生心律失常患者,通过单因素和多因素条件logistic回归分析左氧氟沙星导致心律失常的危险因素。结果12 879例使用左氧氟沙星人群的相关心律失常发生率为1.64%,其中65岁及以上人群发生率为3.22%;主要表现为期外收缩(0.84%)、心动过速(0.63%)、QT间期延长(0.44%),无尖端扭转型室性心动过速和室颤等严重心律失常。多因素条件logistic回归分析结果显示,用药疗程较长[OR=1.030,95%CI(1.009,1.050),P=0.004]和静脉给药[OR=2.392,95%CI(1.478,3.870),P <0.001]是左氧氟沙星致心律失常的独立危险因素。结论 左氧氟沙星引起的心律失常较为常见,分布类型多样,其中QT间期延长为偶见;临床应用时,应更多关注静脉用药的老年患者,并尽量避免长疗程用药。

住院人群心房颤动发病风险的动态评估

目的:本研究旨在评估随访中的C2HEST评分在预测住院人群新发心房颤动风险中的作用。方法:本研究采由北京大学第三医院大数据管理中心建立的临床随访数据库。标记随访过程中包含在C2HEST评分内的新发疾病。计算基线状态及随访中的C2HEST评分。评价随访C2HEST评分在预测新发心房颤动风险中的表现。结果:共计120133例患者(346,400人-年随访)纳入分析,2304例研究对象出现心房颤动(发病率0.67/100人/年)。C2HEST评分在随访过程中显著增长,其中发生心房颤动的患者平均C2HEST评分从1.62增长至2.96,高于无心房颤动发生组。相当比例的患者出现新诊断疾病(心房颤动组:61.9%delta-C2HEST≥1;非心房颤动组:14.6%delta-C2HEST≥1)。心房颤动组患者的主要新增合并症为心力衰竭(绝对增长22.4%)与冠心病(绝对增长20.2%)。非心房颤动组患者主要新增合并症为高血压(绝对增长7.5%)。随访中的C2HEST评分在预测新发心房颤动中的表现显著优于基线时的C2HEST评分(曲线下面积:0.874比0.758),净临床改善指数显著(24.7%),同时临床决策曲线更佳。结论:在该住院随访人群中,个体新发心房颤动风险随时间推移、年龄增长逐渐增加。随访中的C2HEST评分在预测新发心房颤动中的表现明显优于基线状态下的C2HEST评分。

基于重要性分数的CUR矩阵分解识别WSN异常节点

现有异常节点识别方法普遍存在精度低或者功耗大等不足,针对这些不足,提出一种基于低秩矩阵分解的无线传感器网络异常节点识别算法。根据传感器节点的特性进行特征选取和属性矩阵构建;通过改进的CUR矩阵分解方法计算异常矩阵;依据异常矩阵中节点向量的总体均值和标准差设定控制限,判断节点是否发生异常。实验结果表明,与其它异常识别方法相比,该方法具有较高的识别准确率。

消化道穿孔患者感染性休克早期预警评分系统的构建及诊断效果

目的 调查分析消化道穿孔(DTP)患者感染性休克的发生率和主要危险因素,并构建早期预警评分系统以指导临床实践。方法 回顾性纳入2021年1月—2023年1月南通市肿瘤医院诊断DTP患者共188例,将其分为休克组59例和无休克组129例,比较两组患者的临床资料,采用单因素与多因素Logistic回归分析筛选休克发生的危险因素。结果 与无休克组比较,休克组入院急性生理与慢性健康评估(APACHEⅡ)、快速序贯器官衰竭评估(qSOFA)和Logistic器官功能障碍评分(LODS)、平均心率、血钾、血乳酸、血肌酐、降钙素原(PCT)、C反应蛋白(CRP)和病死率明显升高,而白蛋白、氧合指数(PaO_(2)/FiO_(2))和pH值显著降低(P<0.05)。单因素与多因素Logistic回归模型均显示,LODS≥11分(β=1.468,OR=3.025,P<0.001)、平均心率≥100次/min(β=0.568,OR=1.568,P<0.001)、乳酸≥5.8 mmol/L(β=0.859,OR=1.958,P<0.001)、PCT≥5.0μg/L(β=1.002,OR=2.124,P<0.001)、CRP≥20.0 mg/L(β=0.685,OR=1.647,P<0.001)是DTP患者感染性休克的危险因素。根据β值分别赋值为3、1、1、2和1分,总分8分。受试者工作曲线(ROC)显示,评分系统预测休克的曲线下面积(AUC)为0.902(95%CI=0.856~0.933,P<0.001),高于APACHEⅡ、qSOFA和LODS的AUC值(Z≥3.526,均P<0.01)。结论 DTP患者有较高的感染性休克发生率,入院LODS、平均心率、乳酸、PCT和CRP升高是休克发生的主要危险因素,根据上述因素建立的新型评分系统对指导临床早期识别休克高危患者具有较好的预警作用,有推广应用的潜力。

维持性血液透析患者认知功能障碍的影响因素研究

目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者认知功能障碍(cognitive impairment,CI)的影响因素。方法通过便利抽样法选取2023年3—5月浙江中医药大学附属杭州市中医院血液净化中心MHD患者作为研究对象。根据蒙特利尔认知评估基础量表得分,将患者分为CI组(68例)和非CI组(131例),收集一般资料、透析相关资料、生化指标、合并症、睡眠状况及Ishii评分等相关资料,采用Logistic回归分析CI的影响因素,并使用受试者工作特征曲线探讨Ishii评分对CI的预测价值。结果共纳入199例MHD患者,34.2%的患者存在CI。二元Logistic回归分析显示高龄、高Ishii评分、高胆固醇水平、睡眠状况差、低文化程度是CI的独立危险因素(OR值分别为7.694、3.259、1.567、1.085、0.318,95%CI分别为2.484~23.830、1.417~7.494、1.084~2.265、1.016~1.159、0.148~0.684,P值分别为<0.001、0.005、0.017、0.015、0.003)。进一步做Ishii评分的受试者工作特征曲线,结果显示其预测总体、男性、女性MHD患者CI的最佳临界值分别为98.03、105.17、125.49分,曲线下面积分别为0.809、0.813、0.802,敏感度分别为85.30%、80.00%、68.40%,特异性分别为63.40%、72.60%、79.30%。结论CI在MHD患者中患病率高,受多种因素影响,高Ishii评分是MHD患者CI的独立危险因素,对CI有较好的预测价值。

针对连续暴露因素的广义倾向评分方法在环境健康领域中的应用

目的介绍针对连续暴露因素的广义倾向评分(GPS)方法原理,探索其在环境健康领域中的应用,为测量环境健康风险提供有效工具。方法利用北京市“空气污染与人群健康队列研究”基线调查数据(2017—2018年),评价针对连续暴露因素的GPS方法在大气污染对健康效应估计中的应用效果。结果应用针对连续暴露水平的GPS方法后,不同暴露水平人群的混杂因素均衡性得到明显改善。PM_(2.5)暴露每增加10μg/m^(3),高血压患病的风险增加比例从原来的10.3%上升到11.9%。结论针对连续暴露水平的GPS方法在一定程度上为大气污染与健康的关联研究提供更准确的流行病学证据。