Risk factors for occult nodal metastasis in patients with stage ⅠA peripheral non-small cell lung cancer

Objective To study the risk factors of mediastinal lymph node metastasis in patients with ≤3 cm peripheral non small cell lung cancer. Methods From January 2000 to December 2010,a total of 281 patients with NSCLC [152 men and 129 women,aged (60. 31 ± 12. 13) years; ≤ 3 cm in diameter]underwent lobectomy or partial resection with systematic mediastinal lymphadenectomy in hospital. Clinical data included age,gender,

Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis

AIM To investigate the incidence and risk factors of portosplenomesenteric vein thrombosis(PSMVT) in the early stage of severe acute pancreatitis(SAP).METHODS Patients with SAP in a tertiary care setting from January 2014 to December 2016 were retrospectively reviewed. All contrast-enhanced computed tomography(CT) studies were reassessed and reviewed. Clinical outcome measures were compared between SAP patients with and without PSMVT in the early stage of the disease. Univariate and multivariate logistic regression analyses were sequentially performed to assess potential risk factors for the development of PSMVT in SAP patients. A receiver operating characteristic(ROC) curve was generated for the qualifying independent risk factors.RESULTS Twenty-five of the one hundred and forty(17.86%) SAP patients developed PSMVT 6.19 ± 2.43 d after acute pancreatitis(AP) onset. PSMVT was confirmed by contrast-enhanced CT. Multivariate stepwise logistic regression analyses showed that Balthazar's CT severity index(CTSI) scores [odds ratio(OR): 2.742; 95% confidence interval(CI): 1.664-4.519; P = 0.000], hypoalbuminemia(serum albumin level < 25 g/L)(OR: 32.573; 95%CI: 2.711-391.353; P = 0.006) and gastrointestinal wall thickening(OR: 4.367, 95%CI: 1.218-15.658; P = 0.024) were independent risk factors for PSMVT developed in patients with SAP. The area under the ROC curve for Balthazar's CTSI scores was 0.777(P = 0.000), the sensitivity was 52%, and the specificity was 93% at a cut-off value of 5.5.CONCLUSION High Balthazar's CTSI scores, hypoalbuminemia and gastrointestinal wall thickening are independent risk factors for PSMVT developed in the early stage of SAP.

Research on Influencing Factors of Reservoir Construction Risk Based on Interpretative Structural Modeling

Reservoir plays an important role in the allocation and rational use of water resources, especially water resources in China are centrally distributed in the western region, and large reservoirs should be built to meet the people’s livelihood needs of each region. The construction of large reservoirs has numerous risks, the clarity of these risks helps us to better plan and make decisions before implementing the project. Search through literature reading and professional information, determined 11 risk factors in the construction phase of the reservoir construction project case, construct a risk influencing factor system under the application of ISM (Interpretative Structural Modeling). Studies have shown that the risks of strategic guidelines and policies and changes in infrastructure planning have the deepest impact on construction risk management. Among them, the strategic policy risk is the root impact, and the impact of the infrastructure planning change risk has a far-reaching impact. Through the above conclusions, providing management countermeasures and suggestions for the risk control of reservoir construction.

Considerations on Research of Environmental Risk Prevention and Control in “12th Five-Year Plan” Period

Along with the environmental pollution causes complexity and diversity increases ceaselessly, “national environmental protection” Twelfth Five “planning” (hereinafter referred to as “planning”) will be the environmental risk prevention as the “12th Five-Year Plan” one of the important tasks, including advancing environmental risk management in the whole process, key areas the environmental risk prevention measures. The whole process environmental risk management covers a risk source recognition, receptor vulnerability assessment, environmental risk characterization, risk decision and risk assessment of accident loss. This article from the environmental risk source classification, environmental risk classification management, environmental emergency response and environmental risk and insurance environment four aspects put forward the “12th Five-Year Plan” whole process environmental risk management content, to further reduce our country environmental pollution accident risk and policy makers to provide some decision support.

Parenting Skills Determinant in Preventing Adolescents’ Sexual Health Risk Behavior

Parenting skill is one of the crucial needs that parents must have in caring adolescents’ sexual health risk behavior. Present study aims to determine predictors of parenting skills in preventing adolescents’ sexual health risk behavior. A cross sectional study was conducted among adolescents’ parents who attended government health clinics in a semi-urban district, West Malaysia. Data were collected by systematic random sampling using validated questionnaire from eight government health clinics based on routine daily out-patient services. There were 386 respondents participated with 98.9% of response rate. Parental skill is categorized as appropriate or inappropriate based on Trans-Theoretical Model (TTM) staging. Eighteen independent variables were used: parental socioeconomic status, adolescent characteristic, parenting style, parent-adolescent communication, parental stress, perception on adolescent sexual risk, comfortable in discussing sexual issues, knowledge in sexual reproductive health (SRH) and knowledge in HIV/AIDS. Assessment of parenting skills using the TTM stage showed 139 respondents (36%) had inappropriate parenting skills, in which they were in pre contemplation, contemplation or preparedness stages, while 247 respondents (64%) showed appropriate parenting skills when they were in action and maintenance stages of TTM. Older parent, late adolescent, low parental education level, extended family living arrangement, comfortable in discussing sexual issues, good parent-adolescent communication and higher knowledge in HIV/AIDS were found significant in bivariate analysis. Multivariate logistic regression analysis identified older parent (AOR = 1.927, 95% CI = 1.889 - 1.966, p < 0.001), lower parental education (AOR = 2.394, 95% CI = 1.348 - 4.254, p = 0.003), comfortable in discussing sexual issues (AOR = 3.810, 95% CI = 1.622 - 8.948, p = 0.002), good parent-adolescent communication (AOR = 4.741, 95% CI = 2.478 - 9.071, p ≤ 0.001) and having higher knowledge on HIV/AIDS (AOR = 2.804, 95% CI = 1.528 - 5.147, p = 0.001) as significant predictors for appropriate parenting skills in preventing adolescent sexual health risk behavior. In conclusion, more than one third of parents were still not ready in preventing adolescent sexual risk behavior. Targeting the young parents and those having difficulty in communicating sexual issues with theirs adolescents should be emphasized in early intervention program for parents. Self-assessment using TTM stage questionnaire will help parents to identify their parenting skills in preventing adolescent sexual health risk behavior.

多层螺旋CT对2~5 cm胃间质瘤危险度分级的评估价值

目的探讨多层螺旋CT对2~5cm胃间质瘤(GST)危险度分级的评估价值。方法选取165例经手术病理证实的2~5cm GST患者的临床、病理及影像学资料,根据病理结果分为肿瘤倾向良性生物学行为组(116例)和倾向恶性生物学行为组(49例),分析两组患者临床、CT特征的差异,运用多因素logistic回归分析及受试者工作特征曲线(ROC)分析独立影响因素对肿瘤危险度分级的诊断效能。结果GST的最大径、最小径、生长方式、形态、溃疡、囊变或坏死、肿瘤血管、肿瘤周围淋巴结、强化方式、强化程度等方面在危险度分级中差异均有统计学意义(P<0.05),其中肿瘤最大径、最小径、肿瘤血管与病理危险度分级呈中度正相关,肿瘤最大径的曲线下面积(AUC)最大,为0.894,特异度、准确度最高,分别为87.8%、87.3%。经Logistic回归分析,GST最大径线(OR=7.560,P<0.001)、生长方式(OR=2.747,P=0.002)、肿瘤血管(OR=5.817,P=0.001)为鉴别GST不同危险度分级的独立影响因素。将肿瘤最大径、生长方式、肿瘤血管联合,AUC为0.936,诊断效能均高于单一方法(Z=2.016~5.770,P=0.001~0.044);敏感度为83.3%,特异度为91.8%,准确度为89.6%,均高于单一方法。结论多层螺旋CT对2~5cm GST危险度的分级有重要诊断价值,联合肿瘤最大径、生长方式、肿瘤血管可以更好的评估肿瘤危险度分级,对患者术前评估及治疗方式的选择有重要意义。

基于上下游市场联动的燃煤电厂两阶段决策模型

随着大宗能源价格大幅波动及新能源上网冲击,作为现阶段不可或缺的燃煤电厂经营举步艰难。对上游燃料采购及仓储成本进行优化管控的同时,对下游电力市场竞价上网进行联动决策,可在一定程度上提高双碳背景下火力发电企业的生存空间。针对上下游市场联动决策周期不一致以及固定发电成本二次曲线无法反映发电成本变动的问题,提出一种基于上下游市场联动的购煤与竞价燃煤电厂两阶段优化决策模型。首先提出燃煤电厂上下游市场的联动模型;其次建立购煤与竞价策略两阶段决策模型,并讨论条件风险价值对决策的影响;最后以燃煤电厂A进行算例分析和两阶段决策模型的有效性验证。算例结果表明,所提两阶段决策模型可以解决上述问题,实现利润最大化。

早期宫颈癌宫旁转移的危险因素分析

目的:分析早期宫颈癌(ⅠA2和ⅠB1期)患者发生宫旁转移的危险因素。方法:选取2005年1月—2019年12月广东省妇幼保健院收治的630例ⅠA2~ⅠB1期宫颈癌患者为研究对象。根据病理诊断结果,将患者分为宫旁转移组和未宫旁转移组。比较两组临床资料(年龄、分期、肿瘤直径、病理类型、组织学分级、脉管浸润情况、淋巴转移情况、间质浸润情况、累及阴道情况)。采用Logistic回归分析早期宫颈癌宫旁转移的独立危险因素。结果:本研究630例患者中,发生宫旁转移48例,占比7.62%。两组年龄、分期、病理类型、组织学分级比较,无统计学差异(P>0.05);宫旁转移组肿瘤直径大于未宫旁转移组,脉管浸润、淋巴转移、累及阴道占比大于未宫旁转移组,间质浸润深于未宫旁转移组(P<0.05)。Logistic分析结果显示,肿瘤直径>2 cm、脉管浸润、淋巴转移是早期宫颈癌患者宫旁转移的独立危险因素(P<0.05)。结论:早期宫颈癌患者肿瘤直径>2 cm或发生脉管浸润、淋巴转移,则其发生宫旁转移的风险较高,有必要开展根治性子宫切除术。

Risk factors for impaired glucose tolerance in obese children and adolescents

AIM:To investigate which obese children have an increased risk for impaired glucose tolerance(IGT),a risk factor for later diabetes.METHODS:We studied 169 European untreated obese children and adolescents with normal glucose tolerance at baseline.Waist circumference,fasting glucose,lipids,blood pressure,pubertal stage,2 h glucose in oral glucose tolerance test(oGTT),and HbA1c were deter mined at baseline and 1 year later.RESULTS:One year after baseline,19(11.2) children demonstrated IGT,4(2.4) children had impaired fas ting glucose,no(0) child suffered from diabetes,and 146(86) children still showed normal glucose tolerance.At baseline,the children with IGT and with normal glucose tolerance in a one-year follow-up did not differ significantly in respect of any analyzed parameter,apart from pubertal stage.The children developing IGT entered puberty significantly more frequently(37 vs 3,P < 0.001).One year after baseline,the childr en with IGT demonstrated significantly increased waist circumference,blood pressure values,insulin and triglyceride concentrations,and insulin resistance index HOMA.The children remaining in the normal glucose tolerance status 1 year after baseline did not demonstrate any significant changes.CONCLUSION:During the study period of 1 year,more than 10 of the obese children with normal glucose tolerance converted to IGT.Repeated screening with oGTT seems meaningful in obese children entering puberty or demonstrating increased insulin resistance,waist circumference,blood pressure,or triglyceride concen trations.

气候变化对公司绩效的影响研究——基于上市公司的实证检验

【目的】气候变化问题日益加剧,影响波及各行各业,需对气候变化产生的经济后果进行研究。【方法】以2013—2022年我国A股上市公司为样本,使用静态面板双向固定效应模型,实证研究气候变化对企业经营绩效的影响。【结果】研究发现,随着极端气温的影响,企业的经营绩效显著下降。机制检验发现,气候变化通过降低企业营运能力、增加企业融资约束从而削弱企业绩效。异质性分析发现,重污染行业和国有企业的受气候变化的影响程度更为明显。进一步分析发现,高温天气并未对企业绩效产生负面影响,而低温天气显著降低了企业的经营绩效。【结论】气候变化的物理风险与转型风险对生产活动造成较大阻碍,加强政策保护与自身预防可以有效降低气候变化带来的不利影响,提高适应环境变化的能力。

腹腔镜下胆总管切开取石一期缝合术后胆漏相关危险因素分析

目的探讨腹腔镜下胆总管切开取石一期缝合术后胆漏的独立危险因素,并做出相应预防策略;为临床行腹腔镜下胆道切开取石一期缝合提供帮助,减少术后胆漏的发生。方法回顾性分析我院肝胆外科在2019年至2023年收治的102例胆总管结石并行腹腔镜下胆道切开取石一期缝合手术患者的临床资料,根据患者术后是否发生胆漏分为胆漏组(n=18)和非胆漏组(n=84)。分析所有患者的一般资料、血清白蛋白、结石数目、胆总管直径、手术时间、术中出血量、缝合方式、主刀医生手术经验。通过单因素分析及多因素Logistic回归分析探索术后发生胆漏的危险因素,将危险因素指标纳入受试者工作特征(ROC)曲线进行分析。结果102例患者中18例患者出现胆漏,包括16例A级胆漏以及2例B级胆漏,对两组患者的临床资料行单因素及多因素Logistic回归分析结果显示:术者经验<30例,术前血清白蛋白低,使用连续性缝合的胆管缝合方式是患者术后发生胆漏的独立危险因素,差异有统计学意义(均P<0.05)。受试者工作特征(ROC)曲线分析结果:术前白蛋白水平界值为37.45 g/L(P<0.05)。结论术前血清白蛋白<37.45 g/L,连续缝合胆总管切口,术者手术经验<30例可作为预测腹腔镜下胆总管切开取石一期缝合术后发生胆漏的重要理论依据。

河南省冬小麦灌浆期连阴雨灾害风险评估

基于河南省24个农业气象观测站1981—2020年冬小麦发育期资料和91个气象观测站1961—2020年逐日气象观测资料、冬小麦产量资料,统计了河南省冬小麦灌浆期连阴雨过程均日数、过程均雨量、过程均日照时数、年均过程次数及多年发生频率,利用主成分分析法构建了连阴雨风险强度指数,从发生频率、风险强度指数、产量损失率对河南省冬小麦灌浆期连阴雨开展风险评估。结果表明:河南省冬小麦灌浆期连阴雨过程均日数、过程均日照时数、年均过程次数空间上均呈带状分布;构建的连阴雨风险强度指数对连阴雨灾害有较高的识别能力;连阴雨灾害发生频率、风险强度指数均呈纬向型分布,南部偏高、北部偏低;河南省冬小麦灌浆期连阴雨中、低风险区占比90.3%,高风险区主要分布在南阳东部地区。

溢出风险约束下省间省内两级电力现货市场协同出清方法

新能源的快速发展对电力市场机制提出了新的要求。为促进新能源消纳与保障电力供应,中国建立了省间和省内两级电力现货市场。然而,随着省间市场交易规模和占比的提升,各省电力供应间联系更为紧密,加剧了省内市场间的风险传递。首先,基于当前省间省内两级现货市场衔接机制分析了各省现货市场间的风险传递特征,进而引入溢出风险价值的概念以量化评估省间省内两级市场下的风险传递;其次,为抑制省间省内两级市场下的风险传递,基于两阶段随机优化理论,构建了溢出风险约束下的省间省内两级现货市场协同出清模型;进一步,考虑因各市场运营机构不同而带来的隐私保护需求,建立了基于交替方向乘子法(ADMM)的省间省内两级现货市场协同出清模型求解方法;最后,通过算例分析验证了所提出的市场出清模型与方法在抑制省间省内两级市场协同下风险传递中的有效作用。

河南省夏玉米不同生长阶段干旱风险分析

【目的】研究夏玉米各生长阶段的抗干旱风险,为预防夏玉米受干旱影响导致产量和品质下降,降低干旱造成的损失提供理论依据。【方法】本研究利用河南省16个气象站1981—2019年的逐日气象数据,以作物水分亏缺指数(CWDI)为评判指标,根据《北方夏玉米干旱等级》(QX/T 260—2015)对该地区玉米5个生长发育时期进行了干旱等级划分,分析各等级干旱发生的频率、干旱风险指数的时空分布规律。【结果】河南省夏玉米各生长阶段干旱发生总频率在豫北地区最高,其次是豫中和豫东。干旱发生总频率均在夏玉米抽雄—乳熟期最大,高达96%以上,且以中旱和特旱为主。不同等级干旱发生的频率具有差异性,但豫南地区各生长阶段各等级干旱发生的频率相对较低。在夏玉米播种—出苗、出苗—拔节期,河南省各地区干旱风险指数呈由南向北逐渐增加的空间分布特征;在拔节—抽雄、抽雄—乳熟和乳熟—成熟期,该指数基本在30以上。【结论】各地区夏玉米在拔节—抽雄、抽雄—乳熟和乳熟—成熟期干旱发生的风险均较高。夏玉米各个生长阶段干旱发生的风险均为豫北地区最高,豫南地区最低。应重点关注豫北地区的防旱减灾工作。

注意缺陷多动障碍患儿行为特征调查及非遗传学危险因素分析

目的:探讨注意缺陷多动障碍(ADHD)患儿的行为特征及非遗传学危险因素。方法:选取2021年3月—2022年4月于清华大学附属垂杨柳医院儿科就诊的2000例儿童作为研究对象,其中确诊为ADHD的患儿109例,为观察组,按1︰1从未确诊ADHD的儿童中随机选取109例为对照组。比较两组行为问题、社会行为、情绪问题,并采用多因素logistic回归模型分析导致ADHD发生的相关因素。结果:观察组的品行问题、心身障碍、学习障碍、冲动-多动、焦虑及多动指数评分均高于对照组(P<0.05)。与对照组相比,观察组的社会反应量表(SRS)评分、长处与困难问卷(SDQ)评分均更高(P<0.05)。观察组男、母亲孕期吸烟、训斥为主的教育方式、偏食、儿童开始视屏年龄<3岁的占比均高于对照组,婴儿期母乳喂养占比则低于对照组(P<0.05)。多因素logistic回归分析显示,母亲孕期吸烟、训斥为主的教育方式、偏食及儿童开始视屏年龄<3岁是导致ADHD发生的危险因素,婴儿期母乳喂养是其保护因素(P<0.05)。结论:母亲孕期吸烟、训斥为主的教育方式、偏食及儿童开始视屏年龄<3岁均是ADHD发生的危险因素,婴儿期母乳喂养是其保护因素,临床上应积极干预危险因素,以降低ADHD发生率;家长应多关注儿童日常生活行为特征,实现疾病的早发现、早治疗。

慢性肾脏病进展的危险因素及延缓策略

慢性肾脏病(CKD)是一种病程复杂的慢性疾病,早期往往无症状,随着时间的推移,可导致肾功能障碍并发展为终末期肾病(ESRD),并伴随心血管疾病(CVD)等多种并发症。CKD的易感因素包括性激素、甲状腺激素及家族遗传因素等,疾病发生和进展的危险因素包括肾小球肾炎、高血压、糖尿病、蛋白尿、高脂血症及尿毒素的累积等。目前,CKD治疗目的为减缓其进展和预防CVD,需要开发新的治疗方法来阻止。本文主要对CKD进展的危险因素及延缓策略进行综述。

高龄胃癌患者微创胃癌根治术后早期并发症的危险因素及干预对策

目的研究微创胃癌根治术治疗高龄胃癌患者术后早期发生并发症的危险因素及干预对策。方法回顾性收集2019年5月至2023年9月宝鸡市中医医院收治的423例行微创胃癌根治术治疗的高龄胃癌患者的临床资料,根据患者早期(术后1周内)是否发生并发症,将患者分为发生并发症组115例、未发生并发症组308例。统计高龄胃癌患者的临床资料,利用单因素分析(t检验、χ^(2)检验)和logistic回归分析高龄胃癌患者术后发生早期并发症的相关危险因素,并对应构建受试者操作特征曲线(ROC)预测模型。结果发生并发症组中男78例、女37例,年龄(88.08±2.85)岁,体重指数(BMI)(22.77±2.23)kg/m2,肿瘤长径≥4 cm 71例、<4 cm 44例;未发生并发症组中男185例、女123例,年龄(83.46±2.07)岁,BMI(22.81±2.21)kg/m2,肿瘤长径≥4 cm 176例、<4 cm 132例。单因素分析结果显示,发生并发症组的年龄、术前合并症、术中出血量、脉管侵犯、血清前白蛋白(PA)水平与未发生并发症组比较,差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果显示,影响高龄胃癌患者术后早期并发症发生的独立危险因素为年龄偏高(OR=1.514,95%CI=1.167~1.965)、术前合并症(OR=1.766,95%CI=1.322~2.361)、术中出血量≥200 ml(OR=1.501,95%CI=1.116~2.018)、脉管侵犯(OR=1.395,95%CI=1.090~1.786)、血清PA水平偏低(OR=1.484,95%CI=1.148~1.919)(均P<0.05)。ROC分析结果显示,当logit(P)>12.91时,曲线下面积(AUC)值为0.762,95%CI=0.687~0.826,灵敏度为79.65%,特异度为61.90%。结论年龄偏高、术前合并症、术中出血量≥200 ml、脉管侵犯、血清PA水平偏低均为影响微创胃癌根治术治疗高龄胃癌患者术后发生早期并发症的独立危险因素,临床可对有以上特征微创胃癌根治术治疗的高龄胃癌患者进行针对性干预,以降低其术后早期并发症发生率。

维持性血液透析患者死亡危险因素分析及预测模型构建

目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者死亡风险的影响因素,并构建预测模型。方法在安徽医科大学附属巢湖医院血液净化中心,选取了2019年1月至2022年1月接受MHD治疗的198例患者作为研究对象。按照是否存活,将其分为生存组(152例)和死亡组(46例)。收集患者的临床资料,并应用Logistic回归分析影响MHD患者死亡风险的独立危险因素。利用R软件构建列线图模型,并应用受试者工作特征曲线(receiver operating characteristic,ROC)曲线下面积(area under the curve,AUC)和校准曲线(calibration curve,CA)来验证模型的区分能力和校准程度,并绘制决策曲线分析(decision curve analysis,DCA)以评估其在实际临床中的应用价值。结果本研究纳入了198例MHD患者,发现死亡率为23.23%(46例)。通过Logistic回归分析,我们确定了血镁(OR=0.585,95%CI:0.375~0.912)、hs-CRP(OR=1.173,95%CI:1.063~1.294)、mCI(OR=0.691,95%CI:0.566~0.844)和SII(OR=1.030,95%CI:1.016~1.045)均为MHD患者死亡风险的独立危险因素。我们以这4个因素为基础,建立了预测MHD患者死亡风险的列线图模型,其AUC为0.884(95%CI:0.819~0.949),具有80.26%的特异度和89.13%的敏感度,表明该模型具有良好的区分度。通过1000次bootstrap方法进行内部验证后,AUC为0.876(95%CI:0.812~0.933),校准曲线与实际曲线吻合良好,提示该模型的校准度较高。绘制的DCA曲线显示,当阈值概率在0.03~0.99范围内,净收益均大于0,进一步证实了该模型的有效性。结论基于血镁、hs-CRP、mCI和SII这4项危险因素构建的列线图模型对MHD患者死亡风险的预测展现出了出色的区分度和校准度,具备一定的临床应用价值。

血清Serpin B1水平对终末期肾病新入血液透析患者发生心血管事件有预测价值

目的:探讨血清丝氨酸蛋白酶抑制剂B1(Serpin B1)水平与终末期肾病新入血液透析患者发生心血管事件关联性。方法:回顾性分析160例终末期肾病患者的临床资料,根据患者治疗期间是否发生心血管事件将患者分为发生组(94例)与未发生组(66例)。比较2组患者一般资料(性别、年龄、合并症等)、血生化指标(总胆固醇、血红蛋白、甘油三酯等)。采用单因素分析终末期肾病新入血液透析患者发生心血管事件发生的影响因素,并将有统计学意义的项目纳入多因素Logistic回归,分析终末期肾病血液透析患者发生心血管事件的危险因素。采用受试者工作特征(ROC)曲线分析血清Serpin B1水平对终末期肾病新入血液透析患者发生心血管事件的预测价值。结果:2组患者年龄、甘油三酯、肌钙蛋白、C反应蛋白、血肌酐、甲状旁腺激素及Serpin B1比较,差异有统计学意义(P均<0.05)。进一步进行Logistic回归分析,结果显示年龄(OR=2.34,95%CI:1.11~4.93)、C反应蛋白(OR=3.57,95%CI:2.22~5.76)、肌钙蛋白(OR=7.19,95%CI:3.15~16.37)及血清Serpin B1(OR=14.94,95%CI:2.69~82.85)是终末期肾病新入血液透析患者发生心血管事件的危险因素(P均<0.05)。ROC曲线分析表明血清Serpin B1具有较高的预测价值,其最佳截断值为70.34 ng/mL,曲线下面积(AUC)为0.879(95%CI:0.84~0.92),其敏感度与特异性分别为79.89%与76.65%。结论:终末期肾病新入血液透析发生心血管事件患者血清Serpin B1水平较高,血清Serpin B1水平对于预测此类患者发生心血管事件提供一定参考价值。

宫颈癌根治性放疗后直肠炎的危险因素分析

目的探讨并分析宫颈癌根治性放疗后直肠炎的危险因素。方法回顾性分析本院2021年1月至2023年12月接诊的107例接受宫颈癌根治性放疗患者的病历资料,将发生直肠炎40例作为直肠炎组,将未发生直肠炎的67例作为未发生直肠炎组。比较两组的年龄、文化程度、肿瘤直径、浸润程度、临床分期、病理类型、身体质量指数(BMI)及放疗总剂量,并采用Logistic回归分析法分析宫颈癌根治性放疗后直肠炎的危险因素。结果两组的文化程度、病理类型、BMI比较,无统计学意义(P>0.05);直肠炎组年龄≥60岁、肿瘤直径≥4 cm、浸润程度≥1/2、临床分期Ⅲ~Ⅳ期、放疗总剂量50.4Gy的占比明显高于未发生直肠炎组,有统计学意义(P<0.05);经Logistic回归分析结果显示,年龄、肿瘤直径、浸润程度、临床分期、放疗总剂量均是影响宫颈癌根治性放疗后直肠炎的危险因素(P<0.05)。结论宫颈癌根治性放疗后发生直肠炎与年龄、肿瘤直径、浸润程度、临床分期、放疗总剂量密切相关,在临床中需要对这些危险因素进行临床干预,以减少宫颈癌根治性放疗后直肠炎的发生。