BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is often combined with respiratory failure,which increases the patient's morbidity and mortality.Diaphragm ultrasound(DUS)has developed...BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is often combined with respiratory failure,which increases the patient's morbidity and mortality.Diaphragm ultrasound(DUS)has developed rapidly in the field of critical care in recent years.Studies with DUS monitoring diaphragm-related rapid shallow breathing index have demonstrated important results in guiding intensive care unit patients out of the ventilator.Early prediction of the indications for withdrawal of non-invasive ventilator and early evaluation of patients to avoid or reduce disease progression are very important.AIM To explore the predictive value of DUS indexes for non-invasive ventilation outcome in patients with AECOPD.METHODS Ninety-four patients with AECOPD who received mechanical ventilation in our hospital from January 2022 to December 2023 were retrospectively analyzed,and they were divided into a successful ventilation group(68 cases)and a failed ventilation group(26 cases)according to the outcome of ventilation.The clinical data of patients with successful and failed noninvasive ventilation were compared,and the independent predictors of noninvasive ventilation outcomes in AECOPD patients were identified by multivariate logistic regression analysis.RESULTS There were no significant differences in gender,age,body mass index,complications,systolic pressure,heart rate,mean arterial pressure,respiratory rate,oxygen saturation,partial pressure of oxygen,oxygenation index,or time of inspiration between patients with successful and failed mechanical ventilation(P>0.05).The patients with successful noninvasive ventilation had shorter hospital stays and lower partial pressure of carbon dioxide(PaCO_(2))than those with failed treatment,while potential of hydrogen(pH),diaphragm thickening fraction(DTF),diaphragm activity,and diaphragm movement time were significantly higher than those with failed treatment(P<0.05).pH[odds ratio(OR)=0.005,P<0.05],PaCO_(2)(OR=0.430,P<0.05),and DTF(OR=0.570,P<0.05)were identified to be independent factors influencing the outcome of mechanical ventilation in AECOPD patients.CONCLUSION The DUS index DTF can better predict the outcome of non-invasive ventilation in AECOPD patients.展开更多
Objective:To study the predictive value of serum pregenomic RNA(pgRNA)on HBeAg clearance in patients with chronic hepatitis B with low HBeAg levels during pegylated interferon therapy.Methods:Twenty chronic hepatitis ...Objective:To study the predictive value of serum pregenomic RNA(pgRNA)on HBeAg clearance in patients with chronic hepatitis B with low HBeAg levels during pegylated interferon therapy.Methods:Twenty chronic hepatitis B patients with HBeAg positive and quantitative<50S/CO were selected for this study.The subjects underwent pegylated interferon therapy for 48-96 weeks and were followed up in the outpatient clinic after treatment.The patients were then divided into groups based on whether their HbeAg turned negative.The predictive ability of each indicator for HBeAg negative conversion was evaluated in the HBeAg negative group and the HBeAg positive group.Results:The results of logistic regression analysis suggested that pgRNA and HBcrAg were better indicators for predicting the clearance of HBeAg after treatment.Conclusion:For patients with chronic hepatitis B with low HBeAg levels,pgRNA is a good indicator in predicting HBeAg clearance during pegylated interferon therapy.展开更多
BACKGROUND:The major issue with intraoperative cholangiography (IOC) is whether its diagnostic accuracy for common bile duct (CBD) stones matches that of other diagnostic procedures,and thus,whether it will become a r...BACKGROUND:The major issue with intraoperative cholangiography (IOC) is whether its diagnostic accuracy for common bile duct (CBD) stones matches that of other diagnostic procedures,and thus,whether it will become a routine diagnostic procedure.The current study aimed to address the main determinants of CBD stone diagnosis in IOC among an Iranian population.METHODS:In a retrospective review database-based study conducted in Taleghani Hospital in Tehran between 2006 and 2008,baseline data and perioperative information of 2060 patients (male to female ratio 542:1518,mean age 53.7 years) who were candidates for cholecystectomy and underwent concomitant IOC for confirming CBD stones were reviewed.The predictive power of this procedure for diagnosis of abnormal biliary ducts with the focus on biliary stones was determined.RESULTS:Overall mortality and morbidity following cholecystectomy in the study population were 0.6% and 2.6%,respectively.Both early mortality and morbidity due to cholecystectomy were higher in male than female.The prevalence of CBD stones in IOC was 3.4% (5.2% in male and 2.8% in female,P=0.008).Among those without gallstones,8.7% had CBD stones and only 3.1% had concomitant gallstones and CBD stones.The main predictors of stone appearance as an abnormal feature of IOC during cholecystectomy were:advanced age (OR=1.022,P=0.001),male gender (OR=1.498,P=0.050),history of abdominal surgery (OR=1.543,P=0.040) and preoperative endoscopic retrograde cholangiopancreatography (OR=5.400,P<0.001).CONCLUSIONS:IOC is a safe and accurate method for the assessment of bile duct anatomy and stones.Therefore,the routine use of IOC within cholecystectomy seems reasonable and is recommended.展开更多
As one of the earliest markers for predicting pregnancy outcomes, human chorionic gonadotropin(h CG) values have been inconclusive on reliability of the prediction after frozen and fresh embryo transfer(ET). In this r...As one of the earliest markers for predicting pregnancy outcomes, human chorionic gonadotropin(h CG) values have been inconclusive on reliability of the prediction after frozen and fresh embryo transfer(ET). In this retrospective study, patients with positive h CG(day 12 after transfer) were included to examine the h CG levels and their predictive value for pregnancy outcomes following 214 fresh and 1513 vitrified-warmed single-blastocyst transfer cycles. For patients who got clinical pregnancy, the mean initial h CG value was significantly higher after frozen cycles than fresh cycles, and the similar result was demonstrated for patients with live births(LB). The difference in h CG value existed even after adjusting for the potential covariates. The area under curves(AUC) and threshold values calculated by receiver operator characteristic curves were 0.944 and 213.05 m IU/m L for clinical pregnancy after fresh ET, 0.894 and 399.50 m IU/m L for clinical pregnancy after frozen ET, 0.812 and 222.86 m IU/m L for LB after fresh ET, and 0.808 and 410.80 m IU/mL for LB after frozen ET with acceptable sensitivity and specificity, respectively. In conclusion, single frozen blastocyst transfer leads to higher initial h CG values than single fresh blastocyst transfer, and the initial h CG level is a reliable predictive factor for predicting IVF outcomes.展开更多
Aim: To determine the predictive value of the hypo-osmotic swelling (HOS) test to identify viable, non-motile sperm. Methods: Semen samples from 20 men with severe asthenozoospermia underwent traditional seminal analy...Aim: To determine the predictive value of the hypo-osmotic swelling (HOS) test to identify viable, non-motile sperm. Methods: Semen samples from 20 men with severe asthenozoospermia underwent traditional seminal analysis, eosin-nigrosin (EN) staining and the HOS test. A further EN stain was then performed on a HOS pre-treated aliquot and a total of 2000 further sperm examined. Results: The median sperm density was 5.1 million/mL (IQR 4.3-13.1) and the median motility was 3.0 % (IQR 0-7). Seven samples showed complete asthenozoospermia. Initial EN staining showed 59 % viability (range 48-69) despite the poor standard parameters and 47 % (range 33-61) in the complete asthenozoospermia subgroup. The HOS test showed 49.9 % reacted overall (range 40-59) and 41.7 % (range 22-61) in the complete asthenozoospermia subgroup. The combined HOS/EN stain showed the positive predictive value of the HOS test to identify viable sperm was 84.2 % overall and 79.7 % in the complete asthenozoospermia subgroup. Conclusion: The HOS test can effectively predict sperm viability in patients with severe and complete asthenozoospermia.展开更多
BACKGROUND Preoperative therapy is widely used in locally advanced rectal cancer.It can improve local control of rectal cancer.However,there are few indicators that can predict the effect of preoperative chemotherapy ...BACKGROUND Preoperative therapy is widely used in locally advanced rectal cancer.It can improve local control of rectal cancer.However,there are few indicators that can predict the effect of preoperative chemotherapy accurately.AIM To investigate whether the increase in serumα-fetoprotein(AFP)can predict better efficacy of preoperative chemotherapy.METHODS This was a retrospective study.We analyzed 125 patients admitted between 2017 and 2019 with locally advanced rectal cancer.All patients received six cycles of preoperative chemotherapy(mFOLFOX6 every 2 wk).Serum AFP of 26 patients rose slightly after three or four cycles of chemotherapy,and fell to normal again within 2 mo.The other 99 patients had a normal level of serum AFP during chemotherapy.Patients were divided into two groups(AFP risen and AFP normal).According to postoperative pathology,we compared tumor regression and complete response rate between the two groups.The primary outcome measure was the tumor regression grade(TRG)after chemotherapy.The difference in pathological complete response between the two groups was also investigated.RESULTS There were no tumor progression and distant metastasis in both groups during preoperative chemotherapy.Patients in the AFP risen group achieved better TRG 0/1 than those in the AFP normal group(61.5%vs 39.4%).The increase in AFP was a significant predictor for better tumor regression[χ2=4.144,odds ratio(OR)=2.666,P=0.04].In the AFP risen group,the complete response rate was 30.8%,which was higher than in the AFP normal group(30.8%vs 12.1%,χ2=4.542,OR=3.251,P=0.03).CONCLUSION Patients with a slight increase in serum AFP can achieve better tumor regression during preoperative chemotherapy,and are more likely to achieve pathological complete response.展开更多
BACKGROUND Irritable bowel syndrome(IBS)is a common functional bowel disease that shares features with many organic diseases and cannot be accurately diagnosed by symptom-based criteria.Alarm symptoms have long been a...BACKGROUND Irritable bowel syndrome(IBS)is a common functional bowel disease that shares features with many organic diseases and cannot be accurately diagnosed by symptom-based criteria.Alarm symptoms have long been applied in the clinical diagnosis of IBS.However,no study has explored the predictive value of alarm symptoms in suspected IBS patients based on the latest Rome IV criteria.AIM To investigate the predictive value of alarm symptoms in suspected IBS patients based on the Rome IV criteria.METHODS In this multicenter cross-sectional study,we collected data from 730 suspected IBS patients evaluated at 3 tertiary care centers from August 2018 to August 2019.Patients with IBS-like symptoms who completed colonoscopy during the study period were initially identified by investigators through medical records.Eligible patients completed questionnaires,underwent laboratory tests,and were assigned to the IBS or organic disease group according to colonoscopy findings and pathology results(if a biopsy was taken).Independent risk factors for organic disease were explored by logistic regression analysis,and the positive predictive value(PPV)and missed diagnosis rate were calculated.RESULTS The incidence of alarm symptoms in suspected IBS patients was 75.34%.Anemia[odds ratio(OR)=2.825,95%confidence interval(CI):1.273-6.267,P=0.011],fecal occult blood[OR=1.940(95%CI:1.041-3.613),P=0.037],unintended weight loss(P=0.009),female sex[OR=0.560(95%CI:0.330-0.949),P=0.031]and marital status(P=0.030)were independently correlated with organic disease.The prevalence of organic disease was 10.41%in suspected IBS patients.The PPV of alarm symptoms for organic disease was highest for anemia(22.92%),fecal occult blood(19.35%)and unintended weight loss(16.48%),and it was 100%when these three factors were combined.The PPV and missed diagnosis rate for diagnosing IBS were 91.67%and 74.77%when all alarm symptoms were combined with Rome IV and 92.09%and 34.10%when only fecal occult blood,unintended weight loss and anemia were combined with Rome IV,respectively.CONCLUSION Anemia,fecal occult blood and unintended weight loss have high predictive value for organic disease in suspected IBS patients and can help identify patients requiring further examination but are not recommended as exclusion criteria for IBS.展开更多
<strong>Objective:</strong> To assess the diagnostic accuracy and predictive values of clinical symptoms in patients with suspected mild COVID-19 to identify target groups for self-isolation and outpatient...<strong>Objective:</strong> To assess the diagnostic accuracy and predictive values of clinical symptoms in patients with suspected mild COVID-19 to identify target groups for self-isolation and outpatient treatment without additional testing. <strong>Methods:</strong> We conducted an open-label prospective study in patients aged 18 to 72 years with suspected mild COVID-19. The clinical diagnosis was based on the acute onset of such symptoms as olfactory dysfunction, hyperthermia, myalgia, nasal congestion, nasal discharge, cough, rhinolalia, sore throat, without pneumonia in persons in contact with a confirmed case of COVID-19. The physician assessed clinical symptoms using a 4-point scale. The patient self-assessed clinical symptoms using a ten-point visual analogue scale (VAS). All enrolled patients underwent laboratory testing to confirm the diagnosis of COVID-19. <strong>Results:</strong> Of the 120 patients underwent testing, the diagnosis of mild COVID-19 was confirmed in 96 patients and ruled out in 24 patients. When assessing symptoms by a physician according to the correlation analysis, hyperthermia, myalgia, nasal congestion and rhinolalia have a positive predictive value with a significance level of more than 0.6. When self-assessing symptoms by a patient, fever, myalgia and nasal congestion have a diagnostic accuracy with a significance level of more than 0.5. Nasal discharge, cough and sore throat have negative predictive values. <strong>Conclusion: </strong>The presence of these symptoms in patients with an acute onset of the disease can help to make a clinical diagnosis of coronavirus disease and identify target groups for self-isolation and outpatient treatment without additional testing. Highly suspect asymptomatic patients are not considered as those who have possible mild COVID-19 infection.展开更多
In this retrospective study, a total of 275 solid masses were examined for cytopathologic diagnosis. Twenty four percent (67/275) of these cytologic samples were followed by surgical biopsy and histopathologic diagnos...In this retrospective study, a total of 275 solid masses were examined for cytopathologic diagnosis. Twenty four percent (67/275) of these cytologic samples were followed by surgical biopsy and histopathologic diagnosis, allowing for comparisons. On average, the cutaneous and subcutaneous solid masses were recognized when the dogs were aged between 6 and 9 years old. The origins of the solid masses included connective tissue tumors 37.1% (23/62), epithelial tissue tumors 33.9% (21/62), round cell tumors 19.4% (12/62), masses of inflammatory lesions 4.8% (3/62) and lesions due to other causes 4.8% (3/62). The sensitivity and positive predictive value (PPV) of cytopathology in the diagnosis of solid masses were 93% (62/67) and 97% (62/64), respectively. Generally, neo-plasms were over diagnosed by cytopathology as was indicated by the positive predictive value. Both the sensitivity and the PPV of cytopathology comparative to histopathology in the diagnosis of inflammatory processes were 100% (3/3). The inflammatory lesions were eventually confirmed as necrotizing myositis, necro-suppurative cystitis and endocrine inflammatory dermatopathy based on histopathology. Less than 8% (5/67) of samples were incorrectly diagnosed by cytology. The study showed high accuracy between cytological and histopathological examination of solid masses in dogs, and thus a reliable diagnostic tool in patient care.展开更多
Objective To evaluate the performance of the Sino System for Coronary Operative Risk Evaluation (SinoSCORE) on in hospital mortality and postoperative complications in patients undergoing coronary artery bypass grafti...Objective To evaluate the performance of the Sino System for Coronary Operative Risk Evaluation (SinoSCORE) on in hospital mortality and postoperative complications in patients undergoing coronary artery bypass grafting (CABG) in a single heart center. Methods From January 2007 to December 2008,clinical information of 201 consecutive patients undergoing isolated CABG in our hospital was collected. The SinoSCORE was used to展开更多
This study aimed to compare the predictive value of six selected anthropometric indicators for benign prostatic hyperplasia(BPH).Males over 50 years of age who underwent health examinations at the Health Management Ce...This study aimed to compare the predictive value of six selected anthropometric indicators for benign prostatic hyperplasia(BPH).Males over 50 years of age who underwent health examinations at the Health Management Center of the Second Xiangya Hospital,Central South University(Changsha,China)from June to December 2020 were enrolled in this study.The characteristic data were collected,including basic anthropometric indices,lipid parameters,six anthropometric indicators,prostate-specific antigen,and total prostate volume.The odds ratios(ORs)with 95%confidence intervals(95%CIs)for all anthropometric parameters and BPH were calculated using binary logistic regression.To assess the diagnostic capability of each indicator for BPH and identify the appropriate cutoff values,receiver operating characteristic(ROC)curves and the related areas under the curves(AUCs)were utilized.All six indicators had diagnostic value for BPH(all P≤0.001).The visceral adiposity index(VAI;AUC:0.797,95%CI:0.759–0.834)had the highest AUC and therefore the highest diagnostic value.This was followed by the cardiometabolic index(CMI;AUC:0.792,95%CI:0.753–0.831),lipid accumulation product(LAP;AUC:0.766,95%CI:0.723–0.809),waist-to-hip ratio(WHR;AUC:0.660,95%CI:0.609–0.712),waist-to-height ratio(WHtR;AUC:0.639,95%CI:0.587–0.691),and body mass index(BMI;AUC:0.592,95%CI:0.540–0.643).The sensitivity of CMI was the highest(92.1%),and WHtR had the highest specificity of 94.1%.CMI consistently showed the highest OR in the binary logistic regression analysis.BMI,WHtR,WHR,VAI,CMI,and LAP all influence the occurrence of BPH in middle-aged and older men(all P≤0.001),and CMI is the best predictor of BPH.展开更多
Background Some studies found that cholinesterase (ChE) can be an independent risk factor for patients with multiple organ dysfunction syndrome. To assess aged patients with systemic inflammatory response syndrome ...Background Some studies found that cholinesterase (ChE) can be an independent risk factor for patients with multiple organ dysfunction syndrome. To assess aged patients with systemic inflammatory response syndrome (SIRS) early and predict their prognosis, the predictive value of ChE for the prognosis of aged patients with SIRS was analyzed. Methods From September 2009 to September 2010, all aged patients with SIRS in the ICU of the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively analyzed if they met inclusion criteria: patients aged 〉65 years and met American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference criteria for SIRS. Serum ChE, albumin, D-dimer, lactic acid and C-reactive protein (CRP) were measured, and the Acute Physiology and Chronic Health Evaluation (APACHE) II and Glasgow Coma Scale (GCS) scores were evaluated within the first 24 hours in the ICU. Fisher's exact test was used for comparison of the primary disease between the deceased group and surviving group. For comparison of study variables between the two groups, the Student's t test or Mann-Whitney U test was used. Multivariate significance was tested with binary Logistic regression analysis. Results The clinical data of 124 aged patients with SIRS were collected and analyzed. Sixty-six patients (46 male, 20 female, mean age (78.70±8.08) years) who died were included in the deceased group and 58 patients (34 male, 24 female, mean age (76.02±6.57) years) who survived were included in the surviving group. There were no significant differences in age, gender, APACHE II score and GCS score between the deceased group and surviving group (all P 〉0.05), but there were significant differences in lactic acid (P=0.011), D-dimer (P=0.011), albumin (P=0.007), CRP (P=0.008), and ChE (P 〈0.0001). The correlation analysis showed that the APACHE II score and CRP were not correlated with ChE (both P 〈0.05). D-dimer and albumin were correlated with ChE (Spearman's rho correlation coefficients were -0.206 and 0.324, the corresponding P values were 0.022 and 〈0.0001). Multiple Logistic regression analysis showed that age, gender, lactic acid, D-dimer, albumin, CRP, APACHE II score, and GCS score were not independent risk factors for prognosis of aged patients with SIRS, but that ChE was (P 〈0.0001). The receiver operating characteristic curve of ChE had an area under the curve of 0.797 (standard error=0.04; P 〈0.0001), and a ChE of 103.00 U/L was the cut-off value with sensitivity=0.793, specificity=0.742. Conclusion Serum ChE might be a predictive marker for the prognosis of aged patients with SIRS, with low serum ChE levels indicating poor prognosis.展开更多
Background:The current study aimed to evaluate the value of immune cell counts and neutrophilto-lymphocyte ratio(NLR)when attempting to predict 28-day mortality.Methods:We conducted an observational retrospective stud...Background:The current study aimed to evaluate the value of immune cell counts and neutrophilto-lymphocyte ratio(NLR)when attempting to predict 28-day mortality.Methods:We conducted an observational retrospective study that included consecutive septic patients.Severity scores on the first day and peripheral circulating immune cell counts(at day 1,day 3,day 5 and day 7 of admission)were collected during each patient’s emergency intensive care unit stay.We assessed the associations of peripheral circulating immune cell counts and NLR with the severity of illness.The relationships between 28-day mortality and peripheral circulating immune cell counts and NLR with were evaluated using Cox proportional cause-specific hazards models.Results:A total of 216 patients diagnosed with sepsis caused by IAI were enrolled.The lymphocyte counts(days 1,3,5 and 7)and monocyte counts(days 3,5 and 7)were significantly lower in nonsurvivors(n=72)than survivors(n=144).The NLR values at each time point were significantly higher in non-survivors.The day 1 lymphocyte counts,as well as the monocyte counts,were significantly lower in the highest-scoring group,when stratified by the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores,than in the other groups(p<0.05).The day 1 NLR was significantly higher in the highest-scoring group than in the other groups(p<0.05).The day 5 and day 7 lymphocyte counts,day 3 and day 7 monocyte counts and day 7 NLR were significant predictors of 28-day mortality in the Cox proportional hazards models(day 5 lymphocyte count:hazard ratio,0.123(95%CI,0.055–0.279),p<0.001;day 7 lymphocyte count:hazard ratio,0.115(95%CI,0.052–0.254),p<0.001;day 3 monocyte count:hazard ratio,0.067(95%CI,0.005–0.861),p=0.038;day 7 monocyte count:hazard ratio,0.015(95%CI,0.001–0.158),p<0.001;day 7 NLR:hazard ratio,0.773(95%CI,0.659–0.905),p=0.001).Conclusions The results showed that circulating lymphocytes and monocytes were dramatically decreased within 7 days in non-survivors following sepsis from an IAI.Lymphocyte counts,monocyte counts and NLR appeared to be associated with the severity of illness,and they may serve as independent predictors of 28-day mortality in septic patients with IAIs.展开更多
Objective To evaluate the predictive value and impact for the index of microcirculatory resistance(IMR)in myocardial infarction(MI)patients with elective percutaneous coronary intervention(PCI)for treating coronary ar...Objective To evaluate the predictive value and impact for the index of microcirculatory resistance(IMR)in myocardial infarction(MI)patients with elective percutaneous coronary intervention(PCI)for treating coronary artery occlusion.Methods A total of 34 patients with STEMI or non-STEMI treated after 12h time window展开更多
Risk assessment in coronary artery disease plays an essential role in the early identification of high-risk patients.However,conventional invasive imaging procedures all require long intraprocedural times and high cos...Risk assessment in coronary artery disease plays an essential role in the early identification of high-risk patients.However,conventional invasive imaging procedures all require long intraprocedural times and high costs.The rapid development of coronary computed tomographic angiography(CCTA)and related image processing technology has facilitated the formulation of noninvasive approaches to perform comprehensive evaluations.Evidence has shown that CCTA has outstanding performance in identifying the degree of stenosis,plaque features,and functional reserve.Moreover,advancements in radiomics and machine learning allowmore comprehensive interpretations of CCTA images.This paper reviews conventional as well as novel diagnostic and risk assessment tools based on CCTA.展开更多
Objective: To determine the predictive ability of biomarkers for responses to neoadjuvant endocrine therapy (NET) in postmenopausal breast cancer. Methods: Consecutive 160 postmenopausal women with T 1-3 N 0-1 M 0...Objective: To determine the predictive ability of biomarkers for responses to neoadjuvant endocrine therapy (NET) in postmenopausal breast cancer. Methods: Consecutive 160 postmenopausal women with T 1-3 N 0-1 M 0 hormone receptor (HR)-positive invasive breast cancer were treated with anastrozole for 16 weeks before surgery. New slides of tumor specimens taken before and after treatment were conducted centrally for biomarker analysis and classified using the Applied Imaging Ariol MB-8 system. The pathological response was evaluated using the Miller & Payne classification. The cell cycle response was classified according to the change in the Ki67 index after treatment. Multivariable logistic regression analysis was used to calculate the combined index of the biomarkers. Receiver operating characteristic (ROC) curves were used to determine whether parameters may predict response. Results: The correlation between the pathological and cell cycle responses was low (Spearman correlation coefficient =0.241, P〈0.001; Kappa value =0.119, P=0.032). The cell cycle response was significantly associated with pre-treatment estrogen receptor (ER) status (P=0.001), progesterone receptor (PgR) status (P〈0.001), human epidermal growth factor receptor 2 (Her-2) status (P=0.050) and the Ki67 index (P〈0.001), but the pathological response was not correlated with these factors. Pre-treatment ER levels [area under the curve (AUC) =0.634, 95% confidence interval (95% CI), 0.534-0.735, P=0.008] and combined index of pre-treatment ER and PgR levels (AUC =0.684, 95% CI, 0.591-0.776, P〈0.001) could not predict the cell cycle response, but combined index including per-treatment ER/PR/Her-2/Ki67 expression levels could (AUC =0.830, 95% CI, 0.759-0.902, P〈0.001). Conclusions: The combined use of pre-treatment ER/PgR/Her-2/Ki67 expression levels, instead of HR expression levels, may predict the cell cycle response to NET.展开更多
BACKGROUND Colon cancer(CC)has a high incidence rate.Radical resection is the main treatment method for CC;however,liver metastasis(LM)often occurs post-surgery.The liver contains both innate and adaptive immune cells...BACKGROUND Colon cancer(CC)has a high incidence rate.Radical resection is the main treatment method for CC;however,liver metastasis(LM)often occurs post-surgery.The liver contains both innate and adaptive immune cells that monitor and remove abnormal cells and pathogens.Before LM,tumor cells secrete cytokines and exosomes to adjust the immune microenvironment of the liver,thus forming an inhibitory immune microenvironment for colonization by circulating tumor cells.This indicates that the immune state of patients with CC plays a crucial role in the occurrence and progression of LM.AIM To observe and analyze the relationship between immune status and expression of tumor factors in patients with LM of CC,and to provide a scientific interven-tion method for promoting the patient prognosis.METHODS A retrospective analysis was performed.The baseline data of 100 patients with CC and 100 patients with CC who suffered from postoperative LM and were admitted to our hospital from May 2021 to May 2023 were included in the non-occurrence and occurrence groups,respectively.The immune status of the pa-tients and the expression of tumor factor-related indicators in the two groups were compared,and the predictive value of the indicators for postoperative LM in patients with CC was analyzed.RESULTS Compared with the non-occurrence group,the expression of serum carcinoem-bryonic antigen(CEA),CA19-9,CA242,CA72-4 and CA50 in patients in the occurrence group were significantly higher,while the expression of CD3+,CD4+,CD8+,natural killer(NK)and CD4+/CD25 in patients in the occurrence group were significantly lower(P<0.05).No significant difference was observed in other baseline data between groups(P>0.05).Multivariate logistic regression model analysis revealed that the expressions of CEA,CA19-9,CA242,CA72-4,CA50,CD3+,CD4+,CD8+,NK,and CD4+/CD25 were associated with the LM in patients with CC.High expressions of serum CEA,CA19-9,CA242,CA72-4 and CA50,and low expressions of CD3+,CD4+,CD8+,NK,and CD4+/CD25 in patients with CC were risk factors for LM(OR>1,P<0.05).The receiver operating characteristic curve showed that the area under curve for CEA,CA19-9,CA242,CA72-4,CA50,CD3+,CD4+,CD8+,NK,and CD4+/CD25 in the prediction of LM in patients with CC were all>0.80,with a high predictive value.CONCLUSION The expression of tumor factors and immune state-related indices in patients with CC is closely associated with the occurrence of LM.展开更多
A statistically significant research finding should not be defined as a P-value of 0.05 or less, because this definition does not take into account study power. Statistical significance was originally defined by Fishe...A statistically significant research finding should not be defined as a P-value of 0.05 or less, because this definition does not take into account study power. Statistical significance was originally defined by Fisher RA as a P-value of 0.05 or less. According to Fisher, any finding that is likely to occur by random variation no more than 1 in 20 times is considered significant. Neyman J and Pearson ES subsequently argued that Fisher's definition was incomplete. They proposed that statistical significance could only be determined by analyzing the chance of incorrectly considering a study finding was significant(a Type Ⅰ?error) or incorrectly considering a study finding was insignificant(a Type Ⅱ error). Their definition of statistical significance is also incomplete because the error rates are considered separately, not together. A better definition of statistical significance is the positive predictive value of a P-value, which is equal to the power divided by the sum of power and the P-value. This definition is more complete and relevant than Fisher's or Neyman-Peason's definitions, because it takes into account both concepts of statistical significance. Using this definition, a statistically significant finding requires a P-value of 0.05 or less when the power is at least 95%, and a P-value of 0.032 or less when the power is 60%. To achieve statistical significance, P-values must be adjusted downward as the study power decreases.展开更多
BACKGROUND This study aimed to analyze the predictive value of multi-slice spiral computed tomography(CT)perfusion imaging for upper gastrointestinal bleeding in patients with cirrhotic portal hypertension.A total of ...BACKGROUND This study aimed to analyze the predictive value of multi-slice spiral computed tomography(CT)perfusion imaging for upper gastrointestinal bleeding in patients with cirrhotic portal hypertension.A total of 62 patients with cirrhotic portal hypertension and 28 healthy individuals were included.The results showed that multi-slice spiral CT perfusion imaging had a significant predictive value for upper gastrointestinal bleeding in patients with cirrhotic portal hypertension.The vascular area,number of vascular cross-sections,and gastric coronary vein diameter(GCVD)showed high predictive values,with the vascular area having the best predictive value.AIM To investigate the predictive accuracy of multi-slice spiral CT perfusion imaging for upper gastrointestinal bleeding in patients with cirrhosis and portal hypertension.METHODS This study included 62 patients with cirrhotic portal hypertension(disease group)and 28 healthy individuals(control group).The disease group was further divided into two subgroups:Group A(n=27,bleeding)and group B(n=35,no bleeding).All patients underwent multi-slice spiral CT perfusion imaging at our hospital,and we compared various parameters such as liver blood flow,vein size,number of blood vessels,and blood vessel area between the two groups.We employed statistical analysis to identify factors associated with upper gastrointestinal bleeding and created a graph comparing the predictive value of different factors for bleeding.RESULTS We found no difference in hepatic artery(HAP)levels among the three groups(all P>0.05).The portal vein levels in groups A and B were much lower than in the control group;group A was much lower than group B(all P<0.05).The HAP perfusion index levels in groups A and B were much higher than in the control group;group A was much higher than group B(all P<0.05).The portal vein diameter,splenic vein diameter,and GCVD levels in groups A and B were much higher than in the control group;those in group A were much higher than those in group B(all P<0.05).The number of blood vessels and blood vessel area in groups A and B were much higher than in the control group;those in group A were much higher than those in group B(all P<0.05).The statistical method showed a strong link between GCVD,number of blood vessels,blood vessel area,and upper gastrointestinal bleeding(odds ratio=1.275,1.346,1.397,P<0.05).The graph showed that GCVD,number of blood vessels,and blood vessel area could predict bleeding well,with blood vessel area having the best prediction power.CONCLUSION That multi-slice spiral CT perfusion imaging can predict upper gastrointestinal bleeding well in patients with cirrhosis and high blood pressure in the portal vein.GCVD,number of blood vessels,and blood vessel area had high prediction power.The blood vessel area had the best prediction power,with an area under the curve of 0.831.展开更多
The improved calculation method of b value is presented in tills paper. The method can enlarge the role of earthquake occurrence frequency in b value calculation and thus increase the b value variation amplitude. In t...The improved calculation method of b value is presented in tills paper. The method can enlarge the role of earthquake occurrence frequency in b value calculation and thus increase the b value variation amplitude. In this case,the combination structure variation between earthquake magnitudes and corresponding frequencies could be shown clearly. According to the calculation and analysis for limited mainshocks in the complete seismicity data of selected monitored area with assigned consistent lowest magnitude, the precursor anomaly features, quantitative indexes and the calculation formula of relative subject function of b value variation have been preliminarily worked out. The prediction in short period (from 1 to 3 months) for damage earthquakes in the monitored area mentioned above can be put forward on the basis of the results of quantitative calculation and analysis.展开更多
文摘BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is often combined with respiratory failure,which increases the patient's morbidity and mortality.Diaphragm ultrasound(DUS)has developed rapidly in the field of critical care in recent years.Studies with DUS monitoring diaphragm-related rapid shallow breathing index have demonstrated important results in guiding intensive care unit patients out of the ventilator.Early prediction of the indications for withdrawal of non-invasive ventilator and early evaluation of patients to avoid or reduce disease progression are very important.AIM To explore the predictive value of DUS indexes for non-invasive ventilation outcome in patients with AECOPD.METHODS Ninety-four patients with AECOPD who received mechanical ventilation in our hospital from January 2022 to December 2023 were retrospectively analyzed,and they were divided into a successful ventilation group(68 cases)and a failed ventilation group(26 cases)according to the outcome of ventilation.The clinical data of patients with successful and failed noninvasive ventilation were compared,and the independent predictors of noninvasive ventilation outcomes in AECOPD patients were identified by multivariate logistic regression analysis.RESULTS There were no significant differences in gender,age,body mass index,complications,systolic pressure,heart rate,mean arterial pressure,respiratory rate,oxygen saturation,partial pressure of oxygen,oxygenation index,or time of inspiration between patients with successful and failed mechanical ventilation(P>0.05).The patients with successful noninvasive ventilation had shorter hospital stays and lower partial pressure of carbon dioxide(PaCO_(2))than those with failed treatment,while potential of hydrogen(pH),diaphragm thickening fraction(DTF),diaphragm activity,and diaphragm movement time were significantly higher than those with failed treatment(P<0.05).pH[odds ratio(OR)=0.005,P<0.05],PaCO_(2)(OR=0.430,P<0.05),and DTF(OR=0.570,P<0.05)were identified to be independent factors influencing the outcome of mechanical ventilation in AECOPD patients.CONCLUSION The DUS index DTF can better predict the outcome of non-invasive ventilation in AECOPD patients.
基金the grant from SPPH Incubator Fund for Development of Science and Technology(2021YJY-19)SPPH Foundation for Development of Science and Technology(2021BJ-26)International Science and Technology Cooperation Projects of Shaanxi Province(2022KW-14).
文摘Objective:To study the predictive value of serum pregenomic RNA(pgRNA)on HBeAg clearance in patients with chronic hepatitis B with low HBeAg levels during pegylated interferon therapy.Methods:Twenty chronic hepatitis B patients with HBeAg positive and quantitative<50S/CO were selected for this study.The subjects underwent pegylated interferon therapy for 48-96 weeks and were followed up in the outpatient clinic after treatment.The patients were then divided into groups based on whether their HbeAg turned negative.The predictive ability of each indicator for HBeAg negative conversion was evaluated in the HBeAg negative group and the HBeAg positive group.Results:The results of logistic regression analysis suggested that pgRNA and HBcrAg were better indicators for predicting the clearance of HBeAg after treatment.Conclusion:For patients with chronic hepatitis B with low HBeAg levels,pgRNA is a good indicator in predicting HBeAg clearance during pegylated interferon therapy.
文摘BACKGROUND:The major issue with intraoperative cholangiography (IOC) is whether its diagnostic accuracy for common bile duct (CBD) stones matches that of other diagnostic procedures,and thus,whether it will become a routine diagnostic procedure.The current study aimed to address the main determinants of CBD stone diagnosis in IOC among an Iranian population.METHODS:In a retrospective review database-based study conducted in Taleghani Hospital in Tehran between 2006 and 2008,baseline data and perioperative information of 2060 patients (male to female ratio 542:1518,mean age 53.7 years) who were candidates for cholecystectomy and underwent concomitant IOC for confirming CBD stones were reviewed.The predictive power of this procedure for diagnosis of abnormal biliary ducts with the focus on biliary stones was determined.RESULTS:Overall mortality and morbidity following cholecystectomy in the study population were 0.6% and 2.6%,respectively.Both early mortality and morbidity due to cholecystectomy were higher in male than female.The prevalence of CBD stones in IOC was 3.4% (5.2% in male and 2.8% in female,P=0.008).Among those without gallstones,8.7% had CBD stones and only 3.1% had concomitant gallstones and CBD stones.The main predictors of stone appearance as an abnormal feature of IOC during cholecystectomy were:advanced age (OR=1.022,P=0.001),male gender (OR=1.498,P=0.050),history of abdominal surgery (OR=1.543,P=0.040) and preoperative endoscopic retrograde cholangiopancreatography (OR=5.400,P<0.001).CONCLUSIONS:IOC is a safe and accurate method for the assessment of bile duct anatomy and stones.Therefore,the routine use of IOC within cholecystectomy seems reasonable and is recommended.
文摘As one of the earliest markers for predicting pregnancy outcomes, human chorionic gonadotropin(h CG) values have been inconclusive on reliability of the prediction after frozen and fresh embryo transfer(ET). In this retrospective study, patients with positive h CG(day 12 after transfer) were included to examine the h CG levels and their predictive value for pregnancy outcomes following 214 fresh and 1513 vitrified-warmed single-blastocyst transfer cycles. For patients who got clinical pregnancy, the mean initial h CG value was significantly higher after frozen cycles than fresh cycles, and the similar result was demonstrated for patients with live births(LB). The difference in h CG value existed even after adjusting for the potential covariates. The area under curves(AUC) and threshold values calculated by receiver operator characteristic curves were 0.944 and 213.05 m IU/m L for clinical pregnancy after fresh ET, 0.894 and 399.50 m IU/m L for clinical pregnancy after frozen ET, 0.812 and 222.86 m IU/m L for LB after fresh ET, and 0.808 and 410.80 m IU/mL for LB after frozen ET with acceptable sensitivity and specificity, respectively. In conclusion, single frozen blastocyst transfer leads to higher initial h CG values than single fresh blastocyst transfer, and the initial h CG level is a reliable predictive factor for predicting IVF outcomes.
文摘Aim: To determine the predictive value of the hypo-osmotic swelling (HOS) test to identify viable, non-motile sperm. Methods: Semen samples from 20 men with severe asthenozoospermia underwent traditional seminal analysis, eosin-nigrosin (EN) staining and the HOS test. A further EN stain was then performed on a HOS pre-treated aliquot and a total of 2000 further sperm examined. Results: The median sperm density was 5.1 million/mL (IQR 4.3-13.1) and the median motility was 3.0 % (IQR 0-7). Seven samples showed complete asthenozoospermia. Initial EN staining showed 59 % viability (range 48-69) despite the poor standard parameters and 47 % (range 33-61) in the complete asthenozoospermia subgroup. The HOS test showed 49.9 % reacted overall (range 40-59) and 41.7 % (range 22-61) in the complete asthenozoospermia subgroup. The combined HOS/EN stain showed the positive predictive value of the HOS test to identify viable sperm was 84.2 % overall and 79.7 % in the complete asthenozoospermia subgroup. Conclusion: The HOS test can effectively predict sperm viability in patients with severe and complete asthenozoospermia.
基金the China-Japan Friendship Hospital Institutional Review Board,No.2021-117-K75.Youth Foundation of China–Japan Friendship Hospital,No.2019-1-QN-42。
文摘BACKGROUND Preoperative therapy is widely used in locally advanced rectal cancer.It can improve local control of rectal cancer.However,there are few indicators that can predict the effect of preoperative chemotherapy accurately.AIM To investigate whether the increase in serumα-fetoprotein(AFP)can predict better efficacy of preoperative chemotherapy.METHODS This was a retrospective study.We analyzed 125 patients admitted between 2017 and 2019 with locally advanced rectal cancer.All patients received six cycles of preoperative chemotherapy(mFOLFOX6 every 2 wk).Serum AFP of 26 patients rose slightly after three or four cycles of chemotherapy,and fell to normal again within 2 mo.The other 99 patients had a normal level of serum AFP during chemotherapy.Patients were divided into two groups(AFP risen and AFP normal).According to postoperative pathology,we compared tumor regression and complete response rate between the two groups.The primary outcome measure was the tumor regression grade(TRG)after chemotherapy.The difference in pathological complete response between the two groups was also investigated.RESULTS There were no tumor progression and distant metastasis in both groups during preoperative chemotherapy.Patients in the AFP risen group achieved better TRG 0/1 than those in the AFP normal group(61.5%vs 39.4%).The increase in AFP was a significant predictor for better tumor regression[χ2=4.144,odds ratio(OR)=2.666,P=0.04].In the AFP risen group,the complete response rate was 30.8%,which was higher than in the AFP normal group(30.8%vs 12.1%,χ2=4.542,OR=3.251,P=0.03).CONCLUSION Patients with a slight increase in serum AFP can achieve better tumor regression during preoperative chemotherapy,and are more likely to achieve pathological complete response.
基金Supported by the Key Research and Development Program of Shaanxi Province,No.2017ZDXMSF-046.
文摘BACKGROUND Irritable bowel syndrome(IBS)is a common functional bowel disease that shares features with many organic diseases and cannot be accurately diagnosed by symptom-based criteria.Alarm symptoms have long been applied in the clinical diagnosis of IBS.However,no study has explored the predictive value of alarm symptoms in suspected IBS patients based on the latest Rome IV criteria.AIM To investigate the predictive value of alarm symptoms in suspected IBS patients based on the Rome IV criteria.METHODS In this multicenter cross-sectional study,we collected data from 730 suspected IBS patients evaluated at 3 tertiary care centers from August 2018 to August 2019.Patients with IBS-like symptoms who completed colonoscopy during the study period were initially identified by investigators through medical records.Eligible patients completed questionnaires,underwent laboratory tests,and were assigned to the IBS or organic disease group according to colonoscopy findings and pathology results(if a biopsy was taken).Independent risk factors for organic disease were explored by logistic regression analysis,and the positive predictive value(PPV)and missed diagnosis rate were calculated.RESULTS The incidence of alarm symptoms in suspected IBS patients was 75.34%.Anemia[odds ratio(OR)=2.825,95%confidence interval(CI):1.273-6.267,P=0.011],fecal occult blood[OR=1.940(95%CI:1.041-3.613),P=0.037],unintended weight loss(P=0.009),female sex[OR=0.560(95%CI:0.330-0.949),P=0.031]and marital status(P=0.030)were independently correlated with organic disease.The prevalence of organic disease was 10.41%in suspected IBS patients.The PPV of alarm symptoms for organic disease was highest for anemia(22.92%),fecal occult blood(19.35%)and unintended weight loss(16.48%),and it was 100%when these three factors were combined.The PPV and missed diagnosis rate for diagnosing IBS were 91.67%and 74.77%when all alarm symptoms were combined with Rome IV and 92.09%and 34.10%when only fecal occult blood,unintended weight loss and anemia were combined with Rome IV,respectively.CONCLUSION Anemia,fecal occult blood and unintended weight loss have high predictive value for organic disease in suspected IBS patients and can help identify patients requiring further examination but are not recommended as exclusion criteria for IBS.
文摘<strong>Objective:</strong> To assess the diagnostic accuracy and predictive values of clinical symptoms in patients with suspected mild COVID-19 to identify target groups for self-isolation and outpatient treatment without additional testing. <strong>Methods:</strong> We conducted an open-label prospective study in patients aged 18 to 72 years with suspected mild COVID-19. The clinical diagnosis was based on the acute onset of such symptoms as olfactory dysfunction, hyperthermia, myalgia, nasal congestion, nasal discharge, cough, rhinolalia, sore throat, without pneumonia in persons in contact with a confirmed case of COVID-19. The physician assessed clinical symptoms using a 4-point scale. The patient self-assessed clinical symptoms using a ten-point visual analogue scale (VAS). All enrolled patients underwent laboratory testing to confirm the diagnosis of COVID-19. <strong>Results:</strong> Of the 120 patients underwent testing, the diagnosis of mild COVID-19 was confirmed in 96 patients and ruled out in 24 patients. When assessing symptoms by a physician according to the correlation analysis, hyperthermia, myalgia, nasal congestion and rhinolalia have a positive predictive value with a significance level of more than 0.6. When self-assessing symptoms by a patient, fever, myalgia and nasal congestion have a diagnostic accuracy with a significance level of more than 0.5. Nasal discharge, cough and sore throat have negative predictive values. <strong>Conclusion: </strong>The presence of these symptoms in patients with an acute onset of the disease can help to make a clinical diagnosis of coronavirus disease and identify target groups for self-isolation and outpatient treatment without additional testing. Highly suspect asymptomatic patients are not considered as those who have possible mild COVID-19 infection.
文摘In this retrospective study, a total of 275 solid masses were examined for cytopathologic diagnosis. Twenty four percent (67/275) of these cytologic samples were followed by surgical biopsy and histopathologic diagnosis, allowing for comparisons. On average, the cutaneous and subcutaneous solid masses were recognized when the dogs were aged between 6 and 9 years old. The origins of the solid masses included connective tissue tumors 37.1% (23/62), epithelial tissue tumors 33.9% (21/62), round cell tumors 19.4% (12/62), masses of inflammatory lesions 4.8% (3/62) and lesions due to other causes 4.8% (3/62). The sensitivity and positive predictive value (PPV) of cytopathology in the diagnosis of solid masses were 93% (62/67) and 97% (62/64), respectively. Generally, neo-plasms were over diagnosed by cytopathology as was indicated by the positive predictive value. Both the sensitivity and the PPV of cytopathology comparative to histopathology in the diagnosis of inflammatory processes were 100% (3/3). The inflammatory lesions were eventually confirmed as necrotizing myositis, necro-suppurative cystitis and endocrine inflammatory dermatopathy based on histopathology. Less than 8% (5/67) of samples were incorrectly diagnosed by cytology. The study showed high accuracy between cytological and histopathological examination of solid masses in dogs, and thus a reliable diagnostic tool in patient care.
文摘Objective To evaluate the performance of the Sino System for Coronary Operative Risk Evaluation (SinoSCORE) on in hospital mortality and postoperative complications in patients undergoing coronary artery bypass grafting (CABG) in a single heart center. Methods From January 2007 to December 2008,clinical information of 201 consecutive patients undergoing isolated CABG in our hospital was collected. The SinoSCORE was used to
文摘This study aimed to compare the predictive value of six selected anthropometric indicators for benign prostatic hyperplasia(BPH).Males over 50 years of age who underwent health examinations at the Health Management Center of the Second Xiangya Hospital,Central South University(Changsha,China)from June to December 2020 were enrolled in this study.The characteristic data were collected,including basic anthropometric indices,lipid parameters,six anthropometric indicators,prostate-specific antigen,and total prostate volume.The odds ratios(ORs)with 95%confidence intervals(95%CIs)for all anthropometric parameters and BPH were calculated using binary logistic regression.To assess the diagnostic capability of each indicator for BPH and identify the appropriate cutoff values,receiver operating characteristic(ROC)curves and the related areas under the curves(AUCs)were utilized.All six indicators had diagnostic value for BPH(all P≤0.001).The visceral adiposity index(VAI;AUC:0.797,95%CI:0.759–0.834)had the highest AUC and therefore the highest diagnostic value.This was followed by the cardiometabolic index(CMI;AUC:0.792,95%CI:0.753–0.831),lipid accumulation product(LAP;AUC:0.766,95%CI:0.723–0.809),waist-to-hip ratio(WHR;AUC:0.660,95%CI:0.609–0.712),waist-to-height ratio(WHtR;AUC:0.639,95%CI:0.587–0.691),and body mass index(BMI;AUC:0.592,95%CI:0.540–0.643).The sensitivity of CMI was the highest(92.1%),and WHtR had the highest specificity of 94.1%.CMI consistently showed the highest OR in the binary logistic regression analysis.BMI,WHtR,WHR,VAI,CMI,and LAP all influence the occurrence of BPH in middle-aged and older men(all P≤0.001),and CMI is the best predictor of BPH.
文摘Background Some studies found that cholinesterase (ChE) can be an independent risk factor for patients with multiple organ dysfunction syndrome. To assess aged patients with systemic inflammatory response syndrome (SIRS) early and predict their prognosis, the predictive value of ChE for the prognosis of aged patients with SIRS was analyzed. Methods From September 2009 to September 2010, all aged patients with SIRS in the ICU of the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively analyzed if they met inclusion criteria: patients aged 〉65 years and met American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference criteria for SIRS. Serum ChE, albumin, D-dimer, lactic acid and C-reactive protein (CRP) were measured, and the Acute Physiology and Chronic Health Evaluation (APACHE) II and Glasgow Coma Scale (GCS) scores were evaluated within the first 24 hours in the ICU. Fisher's exact test was used for comparison of the primary disease between the deceased group and surviving group. For comparison of study variables between the two groups, the Student's t test or Mann-Whitney U test was used. Multivariate significance was tested with binary Logistic regression analysis. Results The clinical data of 124 aged patients with SIRS were collected and analyzed. Sixty-six patients (46 male, 20 female, mean age (78.70±8.08) years) who died were included in the deceased group and 58 patients (34 male, 24 female, mean age (76.02±6.57) years) who survived were included in the surviving group. There were no significant differences in age, gender, APACHE II score and GCS score between the deceased group and surviving group (all P 〉0.05), but there were significant differences in lactic acid (P=0.011), D-dimer (P=0.011), albumin (P=0.007), CRP (P=0.008), and ChE (P 〈0.0001). The correlation analysis showed that the APACHE II score and CRP were not correlated with ChE (both P 〈0.05). D-dimer and albumin were correlated with ChE (Spearman's rho correlation coefficients were -0.206 and 0.324, the corresponding P values were 0.022 and 〈0.0001). Multiple Logistic regression analysis showed that age, gender, lactic acid, D-dimer, albumin, CRP, APACHE II score, and GCS score were not independent risk factors for prognosis of aged patients with SIRS, but that ChE was (P 〈0.0001). The receiver operating characteristic curve of ChE had an area under the curve of 0.797 (standard error=0.04; P 〈0.0001), and a ChE of 103.00 U/L was the cut-off value with sensitivity=0.793, specificity=0.742. Conclusion Serum ChE might be a predictive marker for the prognosis of aged patients with SIRS, with low serum ChE levels indicating poor prognosis.
基金supported by grants from the Key Project of Military Medical Program of Chinese PLA(Nos.18CXZ026,BLJ18J006)the National Natural Science Foundation of China(No.81730057)the National Key Research and Development Program of China(No.2017YFC1103302).
文摘Background:The current study aimed to evaluate the value of immune cell counts and neutrophilto-lymphocyte ratio(NLR)when attempting to predict 28-day mortality.Methods:We conducted an observational retrospective study that included consecutive septic patients.Severity scores on the first day and peripheral circulating immune cell counts(at day 1,day 3,day 5 and day 7 of admission)were collected during each patient’s emergency intensive care unit stay.We assessed the associations of peripheral circulating immune cell counts and NLR with the severity of illness.The relationships between 28-day mortality and peripheral circulating immune cell counts and NLR with were evaluated using Cox proportional cause-specific hazards models.Results:A total of 216 patients diagnosed with sepsis caused by IAI were enrolled.The lymphocyte counts(days 1,3,5 and 7)and monocyte counts(days 3,5 and 7)were significantly lower in nonsurvivors(n=72)than survivors(n=144).The NLR values at each time point were significantly higher in non-survivors.The day 1 lymphocyte counts,as well as the monocyte counts,were significantly lower in the highest-scoring group,when stratified by the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores,than in the other groups(p<0.05).The day 1 NLR was significantly higher in the highest-scoring group than in the other groups(p<0.05).The day 5 and day 7 lymphocyte counts,day 3 and day 7 monocyte counts and day 7 NLR were significant predictors of 28-day mortality in the Cox proportional hazards models(day 5 lymphocyte count:hazard ratio,0.123(95%CI,0.055–0.279),p<0.001;day 7 lymphocyte count:hazard ratio,0.115(95%CI,0.052–0.254),p<0.001;day 3 monocyte count:hazard ratio,0.067(95%CI,0.005–0.861),p=0.038;day 7 monocyte count:hazard ratio,0.015(95%CI,0.001–0.158),p<0.001;day 7 NLR:hazard ratio,0.773(95%CI,0.659–0.905),p=0.001).Conclusions The results showed that circulating lymphocytes and monocytes were dramatically decreased within 7 days in non-survivors following sepsis from an IAI.Lymphocyte counts,monocyte counts and NLR appeared to be associated with the severity of illness,and they may serve as independent predictors of 28-day mortality in septic patients with IAIs.
文摘Objective To evaluate the predictive value and impact for the index of microcirculatory resistance(IMR)in myocardial infarction(MI)patients with elective percutaneous coronary intervention(PCI)for treating coronary artery occlusion.Methods A total of 34 patients with STEMI or non-STEMI treated after 12h time window
基金This study was supported by the National Natural Science Foundation of China(Grant No.81400267)Postdoctoral fellow support fund from Sichuan University(Grant No.20826041E4070)Sichuan Science and Technology Program(Grant No.2021YFS0330).
文摘Risk assessment in coronary artery disease plays an essential role in the early identification of high-risk patients.However,conventional invasive imaging procedures all require long intraprocedural times and high costs.The rapid development of coronary computed tomographic angiography(CCTA)and related image processing technology has facilitated the formulation of noninvasive approaches to perform comprehensive evaluations.Evidence has shown that CCTA has outstanding performance in identifying the degree of stenosis,plaque features,and functional reserve.Moreover,advancements in radiomics and machine learning allowmore comprehensive interpretations of CCTA images.This paper reviews conventional as well as novel diagnostic and risk assessment tools based on CCTA.
文摘Objective: To determine the predictive ability of biomarkers for responses to neoadjuvant endocrine therapy (NET) in postmenopausal breast cancer. Methods: Consecutive 160 postmenopausal women with T 1-3 N 0-1 M 0 hormone receptor (HR)-positive invasive breast cancer were treated with anastrozole for 16 weeks before surgery. New slides of tumor specimens taken before and after treatment were conducted centrally for biomarker analysis and classified using the Applied Imaging Ariol MB-8 system. The pathological response was evaluated using the Miller & Payne classification. The cell cycle response was classified according to the change in the Ki67 index after treatment. Multivariable logistic regression analysis was used to calculate the combined index of the biomarkers. Receiver operating characteristic (ROC) curves were used to determine whether parameters may predict response. Results: The correlation between the pathological and cell cycle responses was low (Spearman correlation coefficient =0.241, P〈0.001; Kappa value =0.119, P=0.032). The cell cycle response was significantly associated with pre-treatment estrogen receptor (ER) status (P=0.001), progesterone receptor (PgR) status (P〈0.001), human epidermal growth factor receptor 2 (Her-2) status (P=0.050) and the Ki67 index (P〈0.001), but the pathological response was not correlated with these factors. Pre-treatment ER levels [area under the curve (AUC) =0.634, 95% confidence interval (95% CI), 0.534-0.735, P=0.008] and combined index of pre-treatment ER and PgR levels (AUC =0.684, 95% CI, 0.591-0.776, P〈0.001) could not predict the cell cycle response, but combined index including per-treatment ER/PR/Her-2/Ki67 expression levels could (AUC =0.830, 95% CI, 0.759-0.902, P〈0.001). Conclusions: The combined use of pre-treatment ER/PgR/Her-2/Ki67 expression levels, instead of HR expression levels, may predict the cell cycle response to NET.
文摘BACKGROUND Colon cancer(CC)has a high incidence rate.Radical resection is the main treatment method for CC;however,liver metastasis(LM)often occurs post-surgery.The liver contains both innate and adaptive immune cells that monitor and remove abnormal cells and pathogens.Before LM,tumor cells secrete cytokines and exosomes to adjust the immune microenvironment of the liver,thus forming an inhibitory immune microenvironment for colonization by circulating tumor cells.This indicates that the immune state of patients with CC plays a crucial role in the occurrence and progression of LM.AIM To observe and analyze the relationship between immune status and expression of tumor factors in patients with LM of CC,and to provide a scientific interven-tion method for promoting the patient prognosis.METHODS A retrospective analysis was performed.The baseline data of 100 patients with CC and 100 patients with CC who suffered from postoperative LM and were admitted to our hospital from May 2021 to May 2023 were included in the non-occurrence and occurrence groups,respectively.The immune status of the pa-tients and the expression of tumor factor-related indicators in the two groups were compared,and the predictive value of the indicators for postoperative LM in patients with CC was analyzed.RESULTS Compared with the non-occurrence group,the expression of serum carcinoem-bryonic antigen(CEA),CA19-9,CA242,CA72-4 and CA50 in patients in the occurrence group were significantly higher,while the expression of CD3+,CD4+,CD8+,natural killer(NK)and CD4+/CD25 in patients in the occurrence group were significantly lower(P<0.05).No significant difference was observed in other baseline data between groups(P>0.05).Multivariate logistic regression model analysis revealed that the expressions of CEA,CA19-9,CA242,CA72-4,CA50,CD3+,CD4+,CD8+,NK,and CD4+/CD25 were associated with the LM in patients with CC.High expressions of serum CEA,CA19-9,CA242,CA72-4 and CA50,and low expressions of CD3+,CD4+,CD8+,NK,and CD4+/CD25 in patients with CC were risk factors for LM(OR>1,P<0.05).The receiver operating characteristic curve showed that the area under curve for CEA,CA19-9,CA242,CA72-4,CA50,CD3+,CD4+,CD8+,NK,and CD4+/CD25 in the prediction of LM in patients with CC were all>0.80,with a high predictive value.CONCLUSION The expression of tumor factors and immune state-related indices in patients with CC is closely associated with the occurrence of LM.
文摘A statistically significant research finding should not be defined as a P-value of 0.05 or less, because this definition does not take into account study power. Statistical significance was originally defined by Fisher RA as a P-value of 0.05 or less. According to Fisher, any finding that is likely to occur by random variation no more than 1 in 20 times is considered significant. Neyman J and Pearson ES subsequently argued that Fisher's definition was incomplete. They proposed that statistical significance could only be determined by analyzing the chance of incorrectly considering a study finding was significant(a Type Ⅰ?error) or incorrectly considering a study finding was insignificant(a Type Ⅱ error). Their definition of statistical significance is also incomplete because the error rates are considered separately, not together. A better definition of statistical significance is the positive predictive value of a P-value, which is equal to the power divided by the sum of power and the P-value. This definition is more complete and relevant than Fisher's or Neyman-Peason's definitions, because it takes into account both concepts of statistical significance. Using this definition, a statistically significant finding requires a P-value of 0.05 or less when the power is at least 95%, and a P-value of 0.032 or less when the power is 60%. To achieve statistical significance, P-values must be adjusted downward as the study power decreases.
基金Supported by the Hebei Medical Science Project Research Program Project,No.20201411.
文摘BACKGROUND This study aimed to analyze the predictive value of multi-slice spiral computed tomography(CT)perfusion imaging for upper gastrointestinal bleeding in patients with cirrhotic portal hypertension.A total of 62 patients with cirrhotic portal hypertension and 28 healthy individuals were included.The results showed that multi-slice spiral CT perfusion imaging had a significant predictive value for upper gastrointestinal bleeding in patients with cirrhotic portal hypertension.The vascular area,number of vascular cross-sections,and gastric coronary vein diameter(GCVD)showed high predictive values,with the vascular area having the best predictive value.AIM To investigate the predictive accuracy of multi-slice spiral CT perfusion imaging for upper gastrointestinal bleeding in patients with cirrhosis and portal hypertension.METHODS This study included 62 patients with cirrhotic portal hypertension(disease group)and 28 healthy individuals(control group).The disease group was further divided into two subgroups:Group A(n=27,bleeding)and group B(n=35,no bleeding).All patients underwent multi-slice spiral CT perfusion imaging at our hospital,and we compared various parameters such as liver blood flow,vein size,number of blood vessels,and blood vessel area between the two groups.We employed statistical analysis to identify factors associated with upper gastrointestinal bleeding and created a graph comparing the predictive value of different factors for bleeding.RESULTS We found no difference in hepatic artery(HAP)levels among the three groups(all P>0.05).The portal vein levels in groups A and B were much lower than in the control group;group A was much lower than group B(all P<0.05).The HAP perfusion index levels in groups A and B were much higher than in the control group;group A was much higher than group B(all P<0.05).The portal vein diameter,splenic vein diameter,and GCVD levels in groups A and B were much higher than in the control group;those in group A were much higher than those in group B(all P<0.05).The number of blood vessels and blood vessel area in groups A and B were much higher than in the control group;those in group A were much higher than those in group B(all P<0.05).The statistical method showed a strong link between GCVD,number of blood vessels,blood vessel area,and upper gastrointestinal bleeding(odds ratio=1.275,1.346,1.397,P<0.05).The graph showed that GCVD,number of blood vessels,and blood vessel area could predict bleeding well,with blood vessel area having the best prediction power.CONCLUSION That multi-slice spiral CT perfusion imaging can predict upper gastrointestinal bleeding well in patients with cirrhosis and high blood pressure in the portal vein.GCVD,number of blood vessels,and blood vessel area had high prediction power.The blood vessel area had the best prediction power,with an area under the curve of 0.831.
文摘The improved calculation method of b value is presented in tills paper. The method can enlarge the role of earthquake occurrence frequency in b value calculation and thus increase the b value variation amplitude. In this case,the combination structure variation between earthquake magnitudes and corresponding frequencies could be shown clearly. According to the calculation and analysis for limited mainshocks in the complete seismicity data of selected monitored area with assigned consistent lowest magnitude, the precursor anomaly features, quantitative indexes and the calculation formula of relative subject function of b value variation have been preliminarily worked out. The prediction in short period (from 1 to 3 months) for damage earthquakes in the monitored area mentioned above can be put forward on the basis of the results of quantitative calculation and analysis.