AIM：To detect the impact of insulin-like growth factor-1（IGF-1）and other risk factors for the early prediction of retinopathy of prematurity（ROP）and to establish a scoring system for ROP prediction by using clini...AIM：To detect the impact of insulin-like growth factor-1（IGF-1）and other risk factors for the early prediction of retinopathy of prematurity（ROP）and to establish a scoring system for ROP prediction by using clinical criteria and serum IGF-1 levels.METHODS：The study was conducted with 127 preterm infants.IGF-1 levels in the 1st day of life,1st,2nd,3rd and4th week of life was analyzed.The score was established after logistic regression analysis,considering the impact of each variable on the occurrences of any stage ROP.A validation cohort containing 107 preterm infants was included in the study and the predictive ability of ROP score was calculated.RESULTS：Birth weights（BW）,gestational weeks（GW）and the prevalence of breast milk consumption were lower,respiratory distress syndrome（RDS）,bronchopulmonarydysplasia（BPD）and necrotizing enterocolitis（NEC）were more frequent,the duration of mechanical ventilation and oxygen supplementation was longer in patients with ROP（P〈0.05）.Initial serum IGF-1 levels tended to be lower in newborns who developed ROP.Logistic regression analysis revealed that low BW（〈1250 g）,presence of intraventricular hemorrhage（IVH）and formula feeding increased the risk of ROP.Afterwards,the scoring system was validated on 107 infants.The negative predictive values of a score less than 4 were 84.3%,74.7%and 79.8%while positive predictive values were 76.3%,65.5%and71.6%respectively.CONCLUSION：In addition to BW〈1250 g and IVH,formula consumption was detected as a risk factor for the development of ROP.Breastfeeding is important for prevention of ROP in preterm infants.展开更多
The utility of the polygenic risk score(PRS)to identify individuals at higher risk of stroke beyond clinical risk remains unclear,and we clarified this using Chinese population-based prospective cohorts.Cox proportion...The utility of the polygenic risk score(PRS)to identify individuals at higher risk of stroke beyond clinical risk remains unclear,and we clarified this using Chinese population-based prospective cohorts.Cox proportional hazards models were used to estimate the 10-year risk,and Fine and Gray’s models were used for hazard ratios(HRs),their 95%confidence intervals(CIs),and the lifetime risk according to PRS and clinical risk categories.A total of 41,006 individuals aged 30–75 years with a mean follow-up of 9.0 years were included.Comparing the top versus bottom 5%of the PRS,the HR was 3.01(95%CI 2.03–4.45)in the total population,and similar findings were observed within clinical risk strata.Marked gradients in the 10-year and lifetime risk across PRS categories were also found within clinical risk categories.Notably,among individuals with intermediate clinical risk,the 10-year risk for those in the top 5%of the PRS(7.3%,95%CI 7.1%–7.5%)reached the threshold of high clinical risk(≥7.0%)for initiating preventive treatment,and this effect of the PRS on refining risk stratification was evident for ischemic stroke.Even among those in the top 10%and 20%of the PRS,the 10-year risk would also exceed this level when aged≥50 and≥60 years,respectively.Overall,the combination of the PRS with the clinical risk score improved the risk stratification within clinical risk strata and distinguished actual high-risk individuals with intermediate clinical risk.展开更多
目的:分析粒细胞缺乏伴发热(febrile neutropenia,FN)的实体癌患者发生严重不良事件(serious adverse events,SAE)的危险因素,并对稳定发热性中性粒细胞减少症临床指数(clinical index of stable febrile neutropenia,CISNE)与多国癌症...目的:分析粒细胞缺乏伴发热(febrile neutropenia,FN)的实体癌患者发生严重不良事件(serious adverse events,SAE)的危险因素,并对稳定发热性中性粒细胞减少症临床指数(clinical index of stable febrile neutropenia,CISNE)与多国癌症支持治疗协会(Multinational Association of Supportive Care in Cancer,MASCC)风险分层模型的预测效能进行比较。方法:回顾性收集2016年1月至2021年6月重庆大学附属肿瘤医院诊治的所有经化疗后发生FN的实体癌患者。将患者分为SAE组和非SAE组,SAE的定义:①FN治疗期间出现感染性休克或脏器功能衰竭且必需转入ICU治疗;②FN发生后60 d内死亡。比较2组临床资料,采用二元logistic回归分析SAE的独立危险因素。计算患者CISNE评分和MASCC评分,比较CISNE、MASCC评分识别低危FN的效能。结果:共入选91例患者,其中SAE 18例(19.78%)。二元logistic回归分析发现SAE的独立危险因素为:ECOG评分≥2分、血钾<3.5 mmol/L、降钙素原(procalcitonin,PCT)≥0.5 ng/mL和单核细胞计数≤0.02×10^(9)个/L(OR=8.619、11.358、30.612、11.202,95%CI=1.124~66.094、1.696~76.047、5.013~186.947、1.889~66.440,P<0.05)。SAE组与非SAE组的CISNE、MASCC评分均具有统计学差异(P<0.05)。CISNE 0分(低危)与MASCC评分≥21分(低危)患者SAE的发生率明显低于非低危组(P<0.05)。CISNE 0分与MASCC≥21分识别低危FN的敏感性、特异性、阳性和阴性预测值分别为21.9%、100.0%、100.0%、24.0%和91.8%、38.9%、85.9%、53.8%。结论:ECOG评分≥2分、血钾<3.5 mmol/L、PCT≥0.5 ng/mL和单核细胞计数≤0.02×10^(9)个/L是FN患者发生SAE的独立危险因素。CISNE 0分比MASCC≥21分预测低危FN的特异性和阳性预测值更高。展开更多
文摘AIM：To detect the impact of insulin-like growth factor-1（IGF-1）and other risk factors for the early prediction of retinopathy of prematurity（ROP）and to establish a scoring system for ROP prediction by using clinical criteria and serum IGF-1 levels.METHODS：The study was conducted with 127 preterm infants.IGF-1 levels in the 1st day of life,1st,2nd,3rd and4th week of life was analyzed.The score was established after logistic regression analysis,considering the impact of each variable on the occurrences of any stage ROP.A validation cohort containing 107 preterm infants was included in the study and the predictive ability of ROP score was calculated.RESULTS：Birth weights（BW）,gestational weeks（GW）and the prevalence of breast milk consumption were lower,respiratory distress syndrome（RDS）,bronchopulmonarydysplasia（BPD）and necrotizing enterocolitis（NEC）were more frequent,the duration of mechanical ventilation and oxygen supplementation was longer in patients with ROP（P〈0.05）.Initial serum IGF-1 levels tended to be lower in newborns who developed ROP.Logistic regression analysis revealed that low BW（〈1250 g）,presence of intraventricular hemorrhage（IVH）and formula feeding increased the risk of ROP.Afterwards,the scoring system was validated on 107 infants.The negative predictive values of a score less than 4 were 84.3%,74.7%and 79.8%while positive predictive values were 76.3%,65.5%and71.6%respectively.CONCLUSION：In addition to BW〈1250 g and IVH,formula consumption was detected as a risk factor for the development of ROP.Breastfeeding is important for prevention of ROP in preterm infants.
基金supported by the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(2021-I2M-1-010,2019-I2M-2-003,and 2017-I2M-1-004)the National High Level Hospital Clinical Research Funding(2022-GSP-GG-1,2022-GSPGG-2)+5 种基金Research Unit of Prospective Cohort of Cardiovascular Diseases and Cancers,CAMS(2019RU038)the National Key Research and Development Program of China(2018YFE0115300 and 2017YFC0211700)the National Natural Science Foundation of China(82030102,1212660291857118)Taikang Yicai Public Health and Epidemic Control Fund(TKYC-GW-2020)the National Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences(NCRC2020006)。
文摘The utility of the polygenic risk score(PRS)to identify individuals at higher risk of stroke beyond clinical risk remains unclear,and we clarified this using Chinese population-based prospective cohorts.Cox proportional hazards models were used to estimate the 10-year risk,and Fine and Gray’s models were used for hazard ratios(HRs),their 95%confidence intervals(CIs),and the lifetime risk according to PRS and clinical risk categories.A total of 41,006 individuals aged 30–75 years with a mean follow-up of 9.0 years were included.Comparing the top versus bottom 5%of the PRS,the HR was 3.01(95%CI 2.03–4.45)in the total population,and similar findings were observed within clinical risk strata.Marked gradients in the 10-year and lifetime risk across PRS categories were also found within clinical risk categories.Notably,among individuals with intermediate clinical risk,the 10-year risk for those in the top 5%of the PRS(7.3%,95%CI 7.1%–7.5%)reached the threshold of high clinical risk(≥7.0%)for initiating preventive treatment,and this effect of the PRS on refining risk stratification was evident for ischemic stroke.Even among those in the top 10%and 20%of the PRS,the 10-year risk would also exceed this level when aged≥50 and≥60 years,respectively.Overall,the combination of the PRS with the clinical risk score improved the risk stratification within clinical risk strata and distinguished actual high-risk individuals with intermediate clinical risk.
文摘目的:分析粒细胞缺乏伴发热(febrile neutropenia,FN)的实体癌患者发生严重不良事件(serious adverse events,SAE)的危险因素,并对稳定发热性中性粒细胞减少症临床指数(clinical index of stable febrile neutropenia,CISNE)与多国癌症支持治疗协会(Multinational Association of Supportive Care in Cancer,MASCC)风险分层模型的预测效能进行比较。方法:回顾性收集2016年1月至2021年6月重庆大学附属肿瘤医院诊治的所有经化疗后发生FN的实体癌患者。将患者分为SAE组和非SAE组,SAE的定义:①FN治疗期间出现感染性休克或脏器功能衰竭且必需转入ICU治疗;②FN发生后60 d内死亡。比较2组临床资料,采用二元logistic回归分析SAE的独立危险因素。计算患者CISNE评分和MASCC评分,比较CISNE、MASCC评分识别低危FN的效能。结果:共入选91例患者,其中SAE 18例(19.78%)。二元logistic回归分析发现SAE的独立危险因素为:ECOG评分≥2分、血钾<3.5 mmol/L、降钙素原(procalcitonin,PCT)≥0.5 ng/mL和单核细胞计数≤0.02×10^(9)个/L(OR=8.619、11.358、30.612、11.202,95%CI=1.124~66.094、1.696~76.047、5.013~186.947、1.889~66.440,P<0.05)。SAE组与非SAE组的CISNE、MASCC评分均具有统计学差异(P<0.05)。CISNE 0分(低危)与MASCC评分≥21分(低危)患者SAE的发生率明显低于非低危组(P<0.05)。CISNE 0分与MASCC≥21分识别低危FN的敏感性、特异性、阳性和阴性预测值分别为21.9%、100.0%、100.0%、24.0%和91.8%、38.9%、85.9%、53.8%。结论:ECOG评分≥2分、血钾<3.5 mmol/L、PCT≥0.5 ng/mL和单核细胞计数≤0.02×10^(9)个/L是FN患者发生SAE的独立危险因素。CISNE 0分比MASCC≥21分预测低危FN的特异性和阳性预测值更高。
