Prediction of Abdominal Visceral Obesity From Body Mass Index,Waist Circumference and Waist-hip Ratio in Chinese Adults:Receiver Operating Characteristic Curves Analysis

Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific factor. 4) Among subjects with BMI≥28 kg/m2 or WC≥95 cm, 95% of men and 90% of women appeared to have abdominal visceral obesity. Conclusion Measurements of BMI, WC, and WHR can be used in the prediction of abdominal visceral obesity, of which WC was the one with better accuracy.

Using receiver operating characteristic curves to evaluate the diagnostic value of the combination of multislice spiral CT and alpha-fetoprotein levels for small hepatocellular carcinoma in cirrhotic patients

BACKGROUND： The various combination of multiphase enhancement multislice spiral CT （MSCT） makes the diagno- sis of a small hepatocellular carcinoma （sHCC） on the back- ground of liver cirrhosis possible. This study was to explore whether the combination of MSCT enhancement scan and alpha-fetoprotein （AFP） level ficiency for sHCC. could increase the diagnostic ef- METHODS： This study included 35 sHCC patients and 52 cir- rhotic patients without image evidence of HCC as a control group. The diagnoses were made by three radiologists em- ploying a 5-point rating scale, with postoperative pathologic results as the gold standard. Receiver operating characteristic （ROC） curve analysis was performed to evaluate the diag- nostic value of the three MSCT combination modes （arterial phase＋portal-venous phase, arterial phase＋delayed phase, arterial phase＋portal-venous phase＋delayed phase） and AFP levels for sHCC on the background of liver cirrhosis. RESULTS： The area under ROC curve （AUC）, sensitivity, and specificity of the combination of arterial phase＋portal- venous phase＋delayed phase were 0.93, 93%, and 82%, respectively. The average AUC of the arterial phase＋portal- venous phase＋delayed phase combination was significantly greater than that of the arterial phase＋portal-venous phase （AUC=0.84, P=0.01） and arterial phase＋delayed phase （AUC=0.85, P=0.03）. Arterial phase＋portal-venous phase had a smaller AUC （0.84） than arterial phase＋delayed phase （0.85）, but the difference was insignificant （P=0.15）. After combining MSCT enhancement scan with AFP, the AUC, sensitivity, and specificity were 0.95, 94%, and 83%, respectively, indicating a greatly increased diagnostic efficiency for sHCC. CONCLUSIONS： The combination of AFP and 3 phases MSCT enhancement scan could increase the diagnostic efficiency for sHCC on the background of liver cirrhosis. The application of ROC curve analysis has provided a new method and reference in HCC diagnosis.

Determining endemic values of cutaneous leishmaniasis in Iranian Fars province by retrospectively detected clusters and receiver operating characteristic curve analysis

Objective: To determine the endemic values of cutaneous leishmaniasis in different cities of Fars province, Iran. Methods: Totally, 29 201 cases registered from 2010 to 2015 in Iranian Fars province were selected, and the endemic values of cutaneous leishmaniasis were determined by retrospective clusters derived from spatiotemporal permutation modeling on a time-series design. The accuracy of the values was assessed using receiver operating characteristic(ROC) curve. SPSS version 22, Arc GIS, and ITSM 2002 software tools were used for analysis. Results: Nine statistically significant retrospective clusters(P<0.05) resulted in finding seven significant and accurate endemic values(P<0.1). These valid endemic scores were generalized to the other 18 cities based on 6 different climates in the province. Conclusions: Retrospectively detected clusters with the help of ROC curve analysis could help determine cutaneous leishmaniasis endemic values which are essential for future prediction and prevention policies in the area.

Determination of the diagnostic value of the resazurin reduction assay for evaluating boar semen by receiver operating characteristic analysis

Aim： To assess that metabolic status of spermatozoa could provide a useful tool for evaluation of semen quality. Methods： The accuracy of the spectrophotometric application of the resazurin reduction assay was assessed using receiver operating characteristic （ROC） analysis. Results： Areas under ROC curves （AUC） for motile sperm concentration and sperm index （SI） （sperm concentration multiplied by the square root of percentage sperm motility multiplied by the percentage normal sperm morphology） were 0.922. The best discrimination between poor and good semen samples according to the SI was achieved at a cut-off point of A610 = 0.209, where high sensitivity （94.1%） and specificity （91.7%） were calculated. The assay was less accurate when motile sperm concentration was used as the criterion value, yielding sensitivity of 88.2% and specificity of 87.5%, respectively. Likelihood ratios （LR） indicate that absorbances lower than 0.209 were at least 11.3 times as likely to be found in good semen samples than those in poor according to the SI, whereas in the case of motile sperm concentration, the LR was calculated to be 7.06. Conclusion： These results show that the resazurin reduction assay combined with spectrophotometry is an accurate method of assessing the quality of boar semen.

Preliminary Receiver Operating Characteristic Analysis on Voice Handicap Index of Laryngeal Inflammation in Greek Patients

Objective(s): Laryngeal inflammations lead to voice disorders. Medical conditions such as chronic laryngitis, gastroesophageal reflux, laryngopharyngeal reflux, Reinke edema and/or vocal folds hemorrhage, result in diverse symptoms including chronic cough, throat cleaning and dysphonia (e.g. hoarseness). In turn, the dysphonic symptoms can be evaluated via subjective and objective procedures. The objective procedures usually include self-perceived questionnaires like the Voice Handicap Index (VHI). Studies reported that VHI can distinguish objectively dysphonic and non-dysphonic populations using the cut-off points of Receiver Operating Characteristic Curves. The purpose of this study was to calculate the cut-off points for individuals exhibiting voice symptoms which had been developed from laryngeal inflammatory diseases in Greece. Methods: One hundred and twelve participants (90 non-dysphonic and 22 dysphonic) filled in the Hellenic Voice Handicap Index (VHI) and the Greek translated version of Voice Evaluation Template (VEF) were administrated. All subjects were evaluated by an Otolaryngologist and a Speech-Language Pathologist. Results: The group with voice disorders exhibited higher VHI scores (in total and in its 3 subdomains) compared to non-dysphonic subgroup. Statistical significant differences were found for all VHI’s total cut-off point of 19.50 (sensitivity: 0.882, 1-specificity: 0.011) and for its three subdomains [functional 6.50 (sensitivity = 0.636, and 1-specificity = 0.022);physical 9.50 (sensitivity = 0.636, and 1-specificity = 0.000);emotional 6.50 (sensitivity = 0.455, and 1-specificity = 0.133)]. Conclusion: The preliminary results showed that VHI could discriminate individuals having voice disorders from laryngeal inflammations. The Voice Handicap Index can be used as a primary health care tool and a self-monitoring procedure in acute and sub-acute phases of the laryngeal inflammation.

基于ROC曲线的几种创伤严重程度评估工具对老年创伤患者院内死亡预测效果的对比研究

目的比较新损伤严重程度评分(NISS)、指数型损伤严重程度评分(EISS)、创伤和损伤严重程度评分(TRISS)及老年创伤结局评分(GTOS)用于预测老年创伤患者院内死亡风险的效果。方法回顾性追溯选定时间跨度(2019年1月至2022年12月)内所有经急诊入院的老年创伤患者(共197例)的临床资料,计算并统计上述4种创伤严重程度评估工具的结果并绘制受试者工作特征(ROC)曲线,分析比较各评估工具的ROC曲线下面积(AUC)、约登指数以及敏感度、特异度,并以传统的损伤严重程度评分(ISS)的结果作为对照。结果4种改进型评估工具的预测效果均优于传统评估工具(ISS评分)。其中,TRISS评分的AUC、约登指数、敏感度和特异度均最高;NISS评分的AUC和约登指数均最低;GTOS评分的AUC和敏感度与EISS评分较为接近,但约登指数和特异度均显著高于EISS评分。结论TRISS评分在急诊老年创伤患者死亡风险预测评估方面的综合应用效果最佳,GTOS评分预测效果不及TRISS,但评估计算过程更简单,其改进和优化值得进一步探索。

Nomogram for predicting lymph node metastasis rate of submucosal gastric cancer by analyzing clinicopathological characteristics associated with lymph node metastasis

Background： To combine dinicopathological characteristics associated with lymph node metastasis for submucosal gastric cancer into a nomogram. Methods： We retrospectively analyzed 262 patients with submucosal gastric cancer who underwent D2 gastrectomy between 1996 and 2012. The relationship between lymph node metastasis and clinicopathological features was statistically analyzed. With multivariate logistic regression analysis, we made a nomogram to predict the possibility of lymph node metastasis. Receiver operating characteristic （ROC） analysis was also performed to assess the predictive value of the model. Discrimination and calibration were performed using internal validation. Results： A total number of 48 （18.3%） patients with submucosal gastric cancer have pathologically lymph node metastasis. For submucosal gastric carcinoma, lymph node metastasis was associated with age, tumor location, macroscopic type, size, differentiation, histology, the existence of ulcer and lymphovascular invasion in univariate analysis （all P〈0.05）. The multivariate logistic old, macroscopic type III or mixed, undifferentiated type, regression analysis identified that age _〈50 years and presence of lymphovascular invasion were independent risk factors of lymph node metastasis in submucosal gastric cancer （all P〈0.05）. We constructed a predicting nomogram with all these factors for lymph node metastasis in submucosal gastric cancer with good discrimination [area under the curve （AUC） =0.844]. Internal validation demonstrated a good discrimination power that the actual probability corresponds closely with the predicted probability. Conclusions： We developed a nomogram to predict the rate of lymph node metastasis for submucosal gastric cancer. With good discrimination and internal validation, the nomogram improved individualized predictions for assisting clinicians to make appropriated treatment decision for submucosal gastric cancer patients.

基于ROC曲线和决策曲线分析CTRP6和Irisin蛋白对2型糖尿病的预测价值

目的基于受试者工作特征(ROC)曲线和决策曲线探讨C1q/肿瘤坏死因子6(CTRP6)和鸢尾素(Irisin)蛋白对2型糖尿病的预测价值。方法研究共纳入116例受试者,其中健康体检者61例作为对照组,新诊断2型糖尿病的55例患者作为2型糖尿病组。比较两组患者临床生化指标以及血清CTRP6和Irisin蛋白水平。采用多因素Logistic回归分析2型糖尿病的独立预测因素。分别对患者血清CTRP6和Irisin蛋白水平与部分临床生化指标进行Pearson相关性分析。绘制CTRP6和Irisin蛋白水平预测2型糖尿病的ROC曲线,并进行分析。采用决策曲线分析CTRP6和Irisin蛋白单独以及联合预测2型糖尿病的净获益情况。结果单因素分析结果显示:两组患者体质量指数、甘油三酯、糖化血红蛋白、胰岛素抵抗指数(HOMA-IR)、C反应蛋白、白细胞介素(IL-6)、CTRP6以及Irisin蛋白比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示:糖化血红蛋白、HOMA-IR、CTRP6以及Irisin蛋白为2型糖尿病的独立预测因素(P<0.05),其中CTRP6每增加1 ng/mL,2型糖尿病风险增加1.178倍(HR:2.178,95%CI:1.245~2.875,P<0.001),Irisin蛋白每减少1μg/mL,2型糖尿病风险增加1.033倍(HR:0.492,95%CI:0.235~0.737,P=0.009)。Pearson相关性分析显示:2型糖尿病患者CTRP6与糖化血红蛋白、HOMA-IR、IL-6均呈正相关(r=0.695、0.748、0.589,P<0.05),Irisin蛋白与糖化血红蛋白、HOMA-IR、C反应蛋白均呈负相关(r=-0.643、-0.732、-0.537,P<0.05)。ROC曲线分析显示:CTRP6和Irisin蛋白预测2型糖尿病的曲线下面积(AUC)分别为0.859和0.793,而两项指标的联合预测的价值最高,AUC为0.939。决策曲线分析显示:在大部分高风险阈值范围内,CTRP6和Irisin蛋白预测有无2型糖尿病均具有良好的净获益,并且联合预测的净获益高于单一指标的净获益。结论CTRP6和Irisin蛋白对2型糖尿病均具有较高的预测价值。

Study on Diagnosis Criteria of Fire-Heat Syndrome Based on Receiver Operating Characteristic Curve and Principal Component Analysis

Objective： To establish the diagnostic quantitative criteria for fire-heat syndrome （FHS） of Chinese medicine （CM） based on the receiver operating characteristic （ROC） curve and principal component analysis （PCA）. Methods： The symptoms and signs of FHS cases and healthy subjects from Guangzhou, Henan and Hunan of China were collected through questionnaire, and the diagnostic quantitative score tables were established for the three regions, respectively, with the method of maximum likelihood analysis. The homogeneity test was then performed on the diagnostic score tables for the three regions with ROC curve, and the diagnostic efficiency of diagnostic score tables for the three regions was compared with the prospective test and retrospective test. The method of PCA was adopted to obtain the analysis matrix for classifying the tapes of FHS. Results： Twenty-seven elements of FHS were confirmed through Chi-square test, and the diagnostic score tables for the three regions were established with the method of maximum likelihood analysis on the basis of the collected case data. According to the ROC curve test, the areas under ROC curve of Guangzhou diagnostic score table assessment with candidates in Guangzhou, Henan and Hunan were 0.998, 0.961 and 0.956, respectively. It showed that the diagnostic efficiency of Guangzhou diagnostic score tables was the highest one. With the prospective test, the area under ROC of Guangzhou diagnostic score table was 0.949, and more than any other diagnostic score table. By PCA, FHS was classified into excess fire and deficiency fire, and then classified into syndrome of flaring up of Heart （Xin） fire, syndrome of Lung （Fei）-Stomach （Wei） excess fire, syndrome of deficiency of Liver （Gan）-yin and Kidney （Shen）-yin, and syndrome of deficiency of Lung-yin from the view of viscera. In the retrospective test, the consistency with clinicians＇ diagnosis was 69.4%, and in the prospective test, it was 70.1%. Conclusions： The Guangzhou diagnostic score table could be used as the recommended criteria for the diagnosis of FHS. The classification of FHS was basically in conformity with the clinical situation.

Receiver operating characteristic curve analysis for image quality in the detection of solitary pulmonary nodules on high resolution paper prints versus dry laser film

Along with the development of digital X-ray imaging technology, a new, economical and practicalpaper-based output system gradually emerged. To reduce cost, more and more radiologic institutions began to change from film copies to lower-priced paper prints for documenting radiologic findings.Therefore, laser paper printers are frequently used as an alternative to duplicating film though the use of printed images is not yet widespread. The aim of this study was to compare the practical value of high-resolution paper printer with dry film copies for detecting small solitary pulmonary nodules （SPNs）.

甲状腺功能障碍性视神经病变的视觉功能改变及早期诊断指标的ROC曲线分析

目的:甲状腺功能障碍性视神经病变(dysthyroid optic neuropathy,DON)严重危害甲状腺相关眼病患者视力。本研究观察DON患者的视觉功能改变,并评价DON检测指标的诊断价值。方法:回顾性分析2017年1月至2019年12月在中南大学湘雅医院就诊的49例DON患者(98眼)的临床资料。所有患者均行最佳矫正视力(best corrected visual acuity,BCVA)、Humphrey视野、视觉诱发电位(visual evoked potential,VEP)和对比敏感度检测。将98眼分为DON组(45眼)和非DON组(53眼)。采用t检验比较2组患者上述各项检测的相关指标,受试者操作特征(receiver operating characteristic,ROC)曲线分析各指标的敏感度和特异度。结果:DON组的BCVA和视野指数(visual field index,VFI)均显著低于非DON组(均P<0.05),平均缺损(mean deviation,MD)和模式标准偏差(pattern standard deviation,PSD)均显著高于非DON组(均P<0.05)。DON组的低频对比敏感度(low frequency contrast sensitivity,CSL)、中频对比敏感度(medium frequency contrast sensitivity,CSM)、高频对比敏感度(high frequency contrast sensitivity,CSH)均明显低于非DON组(均P<0.05),CSH尤为明显。在15°、30°和60°空间频率时,与非DON组比较,DON组的N135波幅显著降低,N75波、P100波、N135波的潜伏期显著延长(均P<0.05);在15°和30°空间频率时,DON组较非DON组P100波幅明显降低(均P<0.05)。ROC曲线分析结果显示:VFI、CSL、CSM、CSH和15°P100波幅诊断DON的曲线下面积(area under the curve,AUC)分别为0.812、0.841、0.880、0.784和0.791,以CSM的敏感度和特异度最高。结论:DON患者的视觉功能均存在不同程度的受损。VFI、CSL、CSM、CSH和15°P100波幅可能成为早期诊断DON的有效指标。

Optimizing Operating Cost of an Intrusion Detection System

Very often it so happens that the cost of operating an Intrusion Detection System (IDS) exceeds the cost of purchasing the IDS itself. In such cases, regular operation and maintenance of the system becomes expensive. Thus, it becomes essential to reduce the operating cost of the IDS without compromising on the performance and reliability of the IDS. Apart from the initial cost of procuring the IDS, other costs include cost of accessories required and cost of administration etc. In this paper we calculate the cost benefit tradeoffs of an IDS. We propose a method to determine the optimum operating point of the IDS. In an effort to solve the problems of the previously proposed metrics, we propose a decision tree based approach to calculate the cost of operating an IDS in a mobile ad hoc network. Mathematically and programmatically we deduce the minimum operating point of operation of an IDS and generate the receiver operating characteristic curve of the IDS. To further ascertain this, we use available network packet capture data and calculate the minimum operating cost of an IDS. The main motive behind this paper is to show that the cost of operating an IDS in a MANET can be minimized and hence the effectiveness and performance of the IDS can be maximized.

应用ROC曲线评价无创心输出量监测对急性呼吸困难鉴别诊断的临床价值

目的探讨应用ROC曲线评价无创心输出量监测(NICOM)技术对急性呼吸困难鉴别诊断的临床价值。方法回顾性分析2019年6月至2021年12月,入住苏州大学附属苏州九院重症医学科急性呼吸困难患者80例,根据病因分成心源性呼吸困难组(AHF组,38例)和非心源性呼吸困难组(NAHF组,42例),比较两组患者临床资料、血清B型脑钠肽(BNP)浓度及NICOM血流动力学参数,用logistic回归模型制作ROC曲线以评价NICOM参数和BNP对急性呼吸困难鉴别诊断的价值。结果AHF组BNP及胸腔液体含量较基线的变化率(TFCd0%)高于NAHF组,心指数(CI)低于NAHF组,差异有统计学意义(P<0.05)。logistic回归分析结果显示,BNP及TFCd0%是AHF独立危险因素(OR>1,P<0.05)。联合预测因子公式为L=BNP+327.5×TFCd0%,ROC曲线分析显示,联合预测因子L(AUC=93.7%)、BNP(AUC=89.9%)、TFCd0%(AUC=83.5%)及CI(AUC=63.4%)对AHF诊断均具有显著预测价值(P<0.05),并且联合预测因子L对AHF的诊断价值最高。结论NICOM监测TFCd0%和CI对AHF的诊断有较高的敏感度,但特异度较低,联合BNP检测可进一步提高其特异度。

基于ROC曲线分析子宫动脉超声联合超声心动图预测子痫前期的价值

目的基于ROC曲线分析子宫动脉超声及超声心动图联合预测子痫前期的价值。方法选择2021年1月至2022年6月进行产检后评估为低风险的314例初产妇为研究对象,均行子宫动脉超声、超声心动图检查,根据最终妊娠结局分为正常组(271例)和病例组(43例)。统计病例组中子痫前期产妇例数,比较正常组和子痫前期产妇的子宫动脉超声、超声心动图检查参数的差异。结果病例组43例中子痫前期22例,子痫前期产妇的子宫动脉超声检查参数[血流速度峰谷比(S/D)、阻力指数(RI)、血流搏动指数(PI)]均高于正常组(P<0.05);子痫前期产妇的超声心动图检查参数[左心室舒张末期内径(LVDd)、左心室收缩末期内径(LVDs)、舒张晚期最大流速(A峰)]均大于对照组(P<0.05),左心室射血分数(LVEF)、缩短分数(FS)、舒张早期最大流速(E峰)以及E/A比值均低于对照组(P<0.05)。ROC曲线分析发现,子宫动脉超声及超声心动图联合预测子痫前期的效果比单独预测好(P<0.05)。结论基于ROC曲线分析显示,子宫动脉超声联合超声心动图对子痫前期具有良好的预测价值,值得推广。

卡托普利抑制试验在原发性醛固酮增多症诊断和分型以及临床转归中的应用

背景 原发性醛固酮增多症(PA)作为继发性高血压中发病率最高、心脑血管危害大但手术后治愈率高的疾病,已被各大高血压指南推荐扩大筛查、早期诊断和治疗。但该类患者的确诊、分型和治疗后临床转归判定方式繁多且存在较多争议。卡托普利抑制试验(CCT)因其便捷、安全可直接用于社区、门诊,期望CCT能对PA患者进行全程管理以改善预后。目的 探究CCT对PA的诊断、分型以及临床转归的判断能力。方法 选取2020-10-01—2022-12-30在四川大学华西医院内分泌代谢科接受内分泌性高血压病因筛查并登记的824例患者为研究对象。经筛选后最终370例患者纳入研究,其中123例原发性高血压(EH)患者纳入EH组,247例PA患者分别纳入单侧醛固酮瘤(APA)组81例、特发性醛固酮增多症(IHA)组55例和未分型PA(u-PA)组111例。比较4组间差异并绘制CCT后各指标及联合诊断PA的受试者工作特征(ROC)曲线,确定最佳截断值。其次绘制CCT后各指标诊断APA和IHA亚型的ROC曲线,计算ROC曲线下面积(AUC)评估CCT对APA和IHA的分型判断能力。最后根据术后临床结局将单侧肾上腺切除患者分为3组:未缓解组11例、临床改善组27例和临床缓解组54例,比较3组间差异并判断CCT对APA患者术后临床转归的判断能力。结果 CCT后血浆醛固酮浓度(PAC)对PA的诊断效能最高(AUC=0.921,95%CI=0.893~0.950),最佳截断值为11.7 ng/dL,灵敏度、特异度分别为84.6%和86.0%;CCT后醛固酮/肾素比值(ARR)对PA也有较好的诊断效能(AUC=0.868,95%CI=0.823~0.923),最佳截断值为2.8(ng/dL)/(mU/L),灵敏度、特异度分别为82.2%和81.0%。CCT后PAC>17.0 ng/dL可协助诊断APA亚型,CCT后PAC<11.7 ng/dL同时ARR<2.8(ng/dL)/(mU/L)的患者可排除APA亚型。在接受手术治疗的患者中,有87.2%患者经CCT后PAC<11.7 ng/dL,89.7%患者CCT后ARR<2.8(ng/dL)/(mU/L)均接近术后临床缓解水平(88.0%)。结论 CCT可全程用于PA患者的诊断、分型和临床转归评价,CCT后PAC及CCT后ARR诊断PA的最佳截断值分别为11.7 ng/dL和2.8(ng/dL)/(mU/L),也可用于APA的分型判断以及术后生化缓解的判断。CCT前采血检验临床意义小,可适当简化流程。

基于新生儿、孕妇临床特征构建新生儿呼吸窘迫综合征的预测模型

目的基于新生儿、孕妇临床特征构建新生儿呼吸窘迫综合征(NRDS)的预测模型。方法选取2020年1月—2023年1月收治的102例NRDS患儿纳入NRDS组,另择同期健康新生儿150例纳入无NRDS组,回顾性收集临床资料。分析2组新生儿情况、孕妇情况,采用多因素Logistic回归分析NRDS发生的危险因素,建立预测模型,并绘制受试者工作特征(ROC)曲线分析预测模型对NRDS的预测价值。结果与无NRDS组比较,NRDS组胎龄<34周、出生体质量<2 kg、分娩方式为剖宫产、胎儿窘迫、胎膜早破、酸中毒比例高(P<0.05,P<0.01)。与无NRDS组比较,NRDS组孕妇年龄≥35岁、初产、妊娠期高血压疾病、妊娠期糖尿病、合并生殖道感染、产前检查低于9次比例高,血清25-羟基维生素D(25-OH-D)水平低(P<0.05,P<0.01)。胎龄<34周、出生体质量<2 kg、分娩方式为剖宫产、胎儿窘迫,以及孕妇年龄≥35岁、妊娠期糖尿病、产前检查低于9次为NRDS发生的独立危险因素(P<0.05,P<0.01);孕妇血清25-OH-D水平升高为其保护因素(P<0.01)。根据上述结果构建预测模型,并绘制ROC曲线,结果显示,当Logit(P)>18.570时,预测NRDS发生的曲线下面积为0.893,诊断敏感度为81.37%、特异度为82.00%。结论胎龄<34周、出生体质量<2 kg、分娩方式为剖宫产、胎儿窘迫,以及孕妇年龄≥35岁、妊娠期糖尿病、产前检查低于9次为NRDS的独立危险因素,孕妇血清25-OH-D水平升高为其保护因素,据此构建预测模型对NRDS预测价值较高,可为筛选高危患儿、制订临床干预策略提供依据。

Th17/Treg、Th1/Th2联合NEWS2评分预测肺炎病情进展效能研究

目的研究辅助性T淋巴细胞17/调节性T淋巴细胞(Th17/Treg)、辅助性T淋巴细胞1/辅助性T淋巴细胞2(Th1/Th2)联合国家早期预警评分2(NEWS2)预测肺炎病情进展的效能。方法选取2020年4月—2023年3月收治的105例肺炎,根据病情进展情况分为未进展组、进展组,比较2组Th17/Treg、Th1/Th2、NEWS2评分,采用多因素Logistic回归分析建立多指标联合预测肺炎病情进展的模型,使用Stata 10.0软件确定最佳截断值及该位置的预测准确度,绘制受试者工作特征(ROC)曲线,用曲线下面积(AUC)评价各协变量及联合预测因子预测肺炎病情进展的效能。结果进展组Th17/Treg、NEWS2评分高于未进展组,Th1/Th2低于未进展组(P<0.01);Th17/Treg、NEWS2评分升高是肺炎病情进展的独立危险因素,Th1/Th2升高是肺炎病情进展的独立保护因素(P<0.01);将原始协变量拟合,生成新联合预测因子New-pre,其最佳截断值为0.102,此时预测准确率为97.00%;绘制ROC曲线显示,New-pre预测肺炎病情进展的AUC(0.916)高于Th17/Treg(0.704)、Th1/Th2(0.747)、NEWS2评分(0.819)(P<0.05)。结论肺炎病情进展患者Th17/Treg、NEWS2评分升高,Th1/Th2降低,三者联合可作为预测个体病情进展定量方案,可为临床治疗、病情进展评估提供参考依据。

手助腹腔镜下活体供肾切取手术时间的影响因素及其与术后并发症的关系分析

目的探究手助腹腔镜下活体供肾切取手术时间的影响因素,并探究其与术后并发症严重程度间的关系。方法回顾性分析91例行手助腹腔镜下活体供肾切取术的供者的临床资料,分析供者术前基线资料与手术时间之间的相关性,研究手术时间与术后并发症的关系并确定手术时间的阈值。结果肾动脉数量多、肾周脂肪及肾脏后侧脂肪较厚、罹患代谢综合征、梅奥粘连概率(MAP)评分及Clavien-Dindo评分较高均会导致手术时间延长。通过分析受试者工作特征(ROC)曲线发现,当手术时间≥138 min时,供者术后并发症的发生率显著升高(P<0.05)。结论对于具有多支肾动脉、肾周及肾脏后侧脂肪厚度较厚、罹患代谢综合征、MAP评分及Clavien-Dindo评分较高的供者,可选择手术经验更为丰富的医师,做好充分的术前准备并在术后予以密切关注,以及时发现术后并发症并降低并发症的严重程度,改善供者预后。

应用ROC曲线评价N末端B型脑钠肽(NT-proBNP)及生化指标在心血管疾病中的诊断价值

目的评价N末端B型脑钠肽(NT-proBNP)、同型半胱氨酸(Hcy)、超敏肌钙蛋白T(cTnT)、肌钙蛋白I(cTnI)及其他生化项目对心血管疾病的诊断价值。方法应用受试者工作特征曲线(ROC)对131例心血管疾病患者、43例单纯性高血压患者和61例健康对照者的血清NT-proBNP、Hcy及cTnT、cTnI及其他生化指标进行分析,并对心血管疾病组患者NT-proB-NP与心功能分级进行相关性研究。结果 NT-proBNP、Hcy、cTnT、cTnI、CK-MB的水平在心血管病组和对照组两组间差异有统计学意义(P<0.05);NT-proBNP、cTnT、cTnI、CK-MB在心血管病组和高血压病组间存在统计学差异(P<0.05)。急性心肌梗死、风湿性心脏病、肺源性心脏病、心肌炎病患者血清NT-proBNP水平显著高于心绞痛、先天性心脏病、心律不齐等其他心血管病患者。NT-proBNP、cTnT、cTnI、CK-MB的ROC曲线下面积(AUC)分别为0.767,0.745,0.734,0.715。心血管病患者血清NT-proBNP、cTnT、cTnI、CK-MB水平与心血管病患者心功能分级间呈显著正相关,相关系数分别为0.912,0.891,0.816,0.718,均P<0.05。结论 NT-proBNP、cTnT、cTnI、CK-MB是临床诊断心血管疾病的有价值指标。

Logistic回归及ROC曲线综合评价CA15-3、CA125、CK19、CEA、AFP和CA199在乳腺癌术后监测中的应用价值

目的:应用Logistic回归模型及受试者工作特征曲线(Receiver operating characteristic curve,ROC曲线)探讨多种血清肿瘤标志物在乳腺癌术后监测中的应用价值。方法:采用化学发光免疫分析法测定34例术后复发转移患者及76例无复发患者的血清CA15-3、CA125、CK19、CEA、AFP、CA199水平,通过组间均值比较和Logistic逐步回归分析筛选出有效指标,并通过ROC曲线评价其在术后复发转移判断中的诊断价值。结果:其中3项血清肿瘤标志物CA15-3、CK19和CEA入选Logistic回归方程,对应的曲线下面积分别为0.974、0.922、0.913,阳性检出率分别为82.4%、73.5%和64.7%。结论:肿瘤标志物CA15-3、CK19、CEA在术后复发或转移诊断中有较高的应用价值,可作为乳腺癌术后监测复发转移的有效指标。