BACKGROUNDSpontaneous bacterial peritonitis (SBP) is a detrimental infection of the asciticfluid in liver cirrhosis patients, with high mortality and morbidity. Earlydiagnosis and timely antibiotic administration have...BACKGROUNDSpontaneous bacterial peritonitis (SBP) is a detrimental infection of the asciticfluid in liver cirrhosis patients, with high mortality and morbidity. Earlydiagnosis and timely antibiotic administration have successfully decreased themortality rate to 20%-25%. However, many patients cannot be diagnosed in theearly stages due to the absence of classical SBP symptoms. Early diagnosis ofasymptomatic SBP remains a great challenge in the clinic.AIMTo establish a multivariate predictive model for early diagnosis of asymptomaticSBP using positive microbial cultures from liver cirrhosis patients with ascites.METHODSA total of 98 asymptomatic SBP patients and 98 ascites liver cirrhosis patients withnegative microbial cultures were included in the case and control groups,respectively. Multiple linear stepwise regression analysis was performed toidentify potential indicators for asymptomatic SBP diagnosis. The diagnosticperformance of the model was estimated using the receiver operatingcharacteristic curve.RESULTSPatients in the case group were more likely to have advanced disease stages,cirrhosis related-complications, worsened hematology and ascites, and higher mortality. Based on multivariate analysis, the predictive model was as follows: y (P) = 0.018 + 0.312 × MELD (model of end-stage liver disease) + 0.263 × PMN(ascites polymorphonuclear) + 0.184 × N (blood neutrophil percentage) + 0.233 ×HCC (hepatocellular carcinoma) + 0.189 × renal dysfunction. The area under thecurve value of the established model was 0.872, revealing its high diagnosticpotential. The diagnostic sensitivity was 73.5% (72/98), the specificity was 86.7%(85/98), and the diagnostic efficacy was 80.1%.CONCLUSIONOur predictive model is based on the MELD score, polymorphonuclear cells,blood N, hepatocellular carcinoma, and renal dysfunction. This model mayimprove the early diagnosis of asymptomatic SBP.展开更多
Most of the existing multivariable grey models are based on the 1-order derivative and 1-order accumulation, which makes the parameters unable to be adjusted according to the data characteristics of the actual problem...Most of the existing multivariable grey models are based on the 1-order derivative and 1-order accumulation, which makes the parameters unable to be adjusted according to the data characteristics of the actual problems. The results about fractional derivative multivariable grey models are very few at present. In this paper, a multivariable Caputo fractional derivative grey model with convolution integral CFGMC(q, N) is proposed. First, the Caputo fractional difference is used to discretize the model, and the least square method is used to solve the parameters. The orders of accumulations and differential equations are determined by using particle swarm optimization(PSO). Then, the analytical solution of the model is obtained by using the Laplace transform, and the convergence and divergence of series in analytical solutions are also discussed. Finally, the CFGMC(q, N) model is used to predict the municipal solid waste(MSW). Compared with other competition models, the model has the best prediction effect. This study enriches the model form of the multivariable grey model, expands the scope of application, and provides a new idea for the development of fractional derivative grey model.展开更多
基金Supported by the Digestive Medical Coordinated Development Center of Beijing Municipal Administration,No.XXZ0403.
文摘BACKGROUNDSpontaneous bacterial peritonitis (SBP) is a detrimental infection of the asciticfluid in liver cirrhosis patients, with high mortality and morbidity. Earlydiagnosis and timely antibiotic administration have successfully decreased themortality rate to 20%-25%. However, many patients cannot be diagnosed in theearly stages due to the absence of classical SBP symptoms. Early diagnosis ofasymptomatic SBP remains a great challenge in the clinic.AIMTo establish a multivariate predictive model for early diagnosis of asymptomaticSBP using positive microbial cultures from liver cirrhosis patients with ascites.METHODSA total of 98 asymptomatic SBP patients and 98 ascites liver cirrhosis patients withnegative microbial cultures were included in the case and control groups,respectively. Multiple linear stepwise regression analysis was performed toidentify potential indicators for asymptomatic SBP diagnosis. The diagnosticperformance of the model was estimated using the receiver operatingcharacteristic curve.RESULTSPatients in the case group were more likely to have advanced disease stages,cirrhosis related-complications, worsened hematology and ascites, and higher mortality. Based on multivariate analysis, the predictive model was as follows: y (P) = 0.018 + 0.312 × MELD (model of end-stage liver disease) + 0.263 × PMN(ascites polymorphonuclear) + 0.184 × N (blood neutrophil percentage) + 0.233 ×HCC (hepatocellular carcinoma) + 0.189 × renal dysfunction. The area under thecurve value of the established model was 0.872, revealing its high diagnosticpotential. The diagnostic sensitivity was 73.5% (72/98), the specificity was 86.7%(85/98), and the diagnostic efficacy was 80.1%.CONCLUSIONOur predictive model is based on the MELD score, polymorphonuclear cells,blood N, hepatocellular carcinoma, and renal dysfunction. This model mayimprove the early diagnosis of asymptomatic SBP.
基金supported by the National Natural Science Foundation of China (51479151,61403288)。
文摘Most of the existing multivariable grey models are based on the 1-order derivative and 1-order accumulation, which makes the parameters unable to be adjusted according to the data characteristics of the actual problems. The results about fractional derivative multivariable grey models are very few at present. In this paper, a multivariable Caputo fractional derivative grey model with convolution integral CFGMC(q, N) is proposed. First, the Caputo fractional difference is used to discretize the model, and the least square method is used to solve the parameters. The orders of accumulations and differential equations are determined by using particle swarm optimization(PSO). Then, the analytical solution of the model is obtained by using the Laplace transform, and the convergence and divergence of series in analytical solutions are also discussed. Finally, the CFGMC(q, N) model is used to predict the municipal solid waste(MSW). Compared with other competition models, the model has the best prediction effect. This study enriches the model form of the multivariable grey model, expands the scope of application, and provides a new idea for the development of fractional derivative grey model.
基金funded by grants from the National Natural Science Foundation of China[Grant No.81573507]the National Natural Science Foundation of China[Grant No.81473283]+3 种基金the National Natural Science Foundation of China[Grant No.81173131]the National Natural Science Foundation of China[Grant No.81320108027]the Natural Major Projects for Science and Technology Development from Science and Technology Ministry of China[Grant No.2012ZX09506001-004]the Major Scientific and Technological Project of Guangdong Province,China[Grant No.2011A080300001].