Purpose: The drug resistance pattern in tuberculosis (TB) is still under investigated. We analyzed the clinical data from the patients with smear positive TB and applied the model to predict the patients with smear-po...Purpose: The drug resistance pattern in tuberculosis (TB) is still under investigated. We analyzed the clinical data from the patients with smear positive TB and applied the model to predict the patients with smear-positive TB. Materials and Methods: Medical records information of 6977 cases was included from 11,950 inpatients from January 2009 to November 2013. The cases data were divided into a training set, test set and prediction set. Logistic regression analysis was applied to the training set data to establish a prediction classification model, the effect of which was then evaluated using the test set by receiver operating characteristic (ROC) analysis. The model was then applied to the prediction set to identify incidence of snMDR-TB. Results: Sixteen factors which correlate with MDR-TB-including frequency of hospitalization, province of origin, anti-TB drugs, and complications, were identified from the comparison between SP-TB and spMDR-TB. The area under the ROC curve (AUC) of the prediction model was 0.752 (sensitivity = 61.3%, specificity = 83.3%). The percentage of all inpatients with snMDR-TB (snMDR-TB/Total) was 28.7% ± 0.02%, while that of all SN-PTB with snMDR-TB (snMDR-TB/SN-PTB) was 26.5% ± 0.03%. The ratio of snMDR-TB to MDR-TB (snMDR-TB/MDR-TB) was 2.09 ± 0.33. Conclusion: snMDR-TB as an important source of MDR-TB is a significant hidden problem for MDR-TB control and can be identified by the prediction model. A kind of vicious circle with a certain delay effect exists between snMDR-TB and MDR-TB. To better control MDR-TB, it is necessary to pay greater attention to snMDR-TB, conduct further research and develop targeted therapeutic strategies.展开更多
Objective:To explore the general characteristics,traditional Chinese medicine(TCM)syndromes and medication of patients with rectal cancer in China.Methods:The clinical data of inpatients with rectal cancer from the in...Objective:To explore the general characteristics,traditional Chinese medicine(TCM)syndromes and medication of patients with rectal cancer in China.Methods:The clinical data of inpatients with rectal cancer from the information system of 17 tertiary A‑level traditional Chinese medicine hospitals in China were collected.After data standardization,descriptive analysis was performed on the general information,syndrome distribution and medication characteristics of the included patients,and association rule analysis was performed on the drug usage.Results:A total of 15424 hospitalized patients with rectal cancer were included.The ratio of male to female patients was 1.6:1,the average age was 60.87 years old,and the age was mainly in the range of 50 to 79 years old.Among the 12146 patients with rectal cancer,the top 5 TCM syndromes were Qi and Yin deficiency syndrome(25%),phlegm and blood stasis syndrome(19%),spleen deficiency syndrome(14%),Qi stagnation and blood stasis syndrome(7%)and Qi and blood deficiency syndrome(6%).After excluding the anti‑tumor western medicine recommended by the guidelines,adrenal corticosteroids(43.55%),antibiotics(42.94%)and immunomodulatory drugs(42.66%)ranked the top three in the frequency of western medicine use.Dexamethasone(38.15%),metoclopramide tablets(20.51%)and furosemide injection(19.71%)were the three most commonly used western medicines.Among the three western medicines combined,cimetidine,granisetron hydrochloride dextrose injection+dexamethasone were the most common(support 8.23%,confidence 96.4%,and improvement 2.48%).Heat‑clearing and detoxifying agents(53.72%),Yiqi‑fuzheng agents(49.76%)and blood‑activating and stasis‑removing agents(15.68%)ranked the top 3 in the frequency of use of traditional Chinese medicine.Shenqi Fuzheng injection,Shenqi Fuzheng injection(21.59%),Compound Kushen injection(17.52%)and Aidi injection(11.96%)were the three most commonly used Chinese patent medicines.Conclusion:The main syndromes of patients with rectal cancer may be Qi and Yin deficiency syndrome,phlegm and blood stasis syndrome,and spleen deficiency syndrome,etc.The treatment needs to focus on the supplementation of vital essence,combination of dredging and tonifying method,and the integration of traditional Chinese and western medicine.展开更多
文摘Purpose: The drug resistance pattern in tuberculosis (TB) is still under investigated. We analyzed the clinical data from the patients with smear positive TB and applied the model to predict the patients with smear-positive TB. Materials and Methods: Medical records information of 6977 cases was included from 11,950 inpatients from January 2009 to November 2013. The cases data were divided into a training set, test set and prediction set. Logistic regression analysis was applied to the training set data to establish a prediction classification model, the effect of which was then evaluated using the test set by receiver operating characteristic (ROC) analysis. The model was then applied to the prediction set to identify incidence of snMDR-TB. Results: Sixteen factors which correlate with MDR-TB-including frequency of hospitalization, province of origin, anti-TB drugs, and complications, were identified from the comparison between SP-TB and spMDR-TB. The area under the ROC curve (AUC) of the prediction model was 0.752 (sensitivity = 61.3%, specificity = 83.3%). The percentage of all inpatients with snMDR-TB (snMDR-TB/Total) was 28.7% ± 0.02%, while that of all SN-PTB with snMDR-TB (snMDR-TB/SN-PTB) was 26.5% ± 0.03%. The ratio of snMDR-TB to MDR-TB (snMDR-TB/MDR-TB) was 2.09 ± 0.33. Conclusion: snMDR-TB as an important source of MDR-TB is a significant hidden problem for MDR-TB control and can be identified by the prediction model. A kind of vicious circle with a certain delay effect exists between snMDR-TB and MDR-TB. To better control MDR-TB, it is necessary to pay greater attention to snMDR-TB, conduct further research and develop targeted therapeutic strategies.
基金supported by the self‑selected project of China Academy of Chinese Medical Sciences(No.Z0472)。
文摘Objective:To explore the general characteristics,traditional Chinese medicine(TCM)syndromes and medication of patients with rectal cancer in China.Methods:The clinical data of inpatients with rectal cancer from the information system of 17 tertiary A‑level traditional Chinese medicine hospitals in China were collected.After data standardization,descriptive analysis was performed on the general information,syndrome distribution and medication characteristics of the included patients,and association rule analysis was performed on the drug usage.Results:A total of 15424 hospitalized patients with rectal cancer were included.The ratio of male to female patients was 1.6:1,the average age was 60.87 years old,and the age was mainly in the range of 50 to 79 years old.Among the 12146 patients with rectal cancer,the top 5 TCM syndromes were Qi and Yin deficiency syndrome(25%),phlegm and blood stasis syndrome(19%),spleen deficiency syndrome(14%),Qi stagnation and blood stasis syndrome(7%)and Qi and blood deficiency syndrome(6%).After excluding the anti‑tumor western medicine recommended by the guidelines,adrenal corticosteroids(43.55%),antibiotics(42.94%)and immunomodulatory drugs(42.66%)ranked the top three in the frequency of western medicine use.Dexamethasone(38.15%),metoclopramide tablets(20.51%)and furosemide injection(19.71%)were the three most commonly used western medicines.Among the three western medicines combined,cimetidine,granisetron hydrochloride dextrose injection+dexamethasone were the most common(support 8.23%,confidence 96.4%,and improvement 2.48%).Heat‑clearing and detoxifying agents(53.72%),Yiqi‑fuzheng agents(49.76%)and blood‑activating and stasis‑removing agents(15.68%)ranked the top 3 in the frequency of use of traditional Chinese medicine.Shenqi Fuzheng injection,Shenqi Fuzheng injection(21.59%),Compound Kushen injection(17.52%)and Aidi injection(11.96%)were the three most commonly used Chinese patent medicines.Conclusion:The main syndromes of patients with rectal cancer may be Qi and Yin deficiency syndrome,phlegm and blood stasis syndrome,and spleen deficiency syndrome,etc.The treatment needs to focus on the supplementation of vital essence,combination of dredging and tonifying method,and the integration of traditional Chinese and western medicine.
