Modelling the response of larch growth to age,density,and elevation and the implications for multifunctional management in northwest China

Plantations of Rupprecht's larch(Larix principis-rupprechtii)have been widely established in the drylands of northwest and north China under traditional fastgrowing plantation management strategies.These strategies and the long-term logging ban have led to over-populated stands with lower structural and functional stability,less economic benefit and higher water consumption.To guide the sustainable management of larch plantations,field surveys and historical data compilation were undertaken in the Liupan Mountains of northwest China.The main influencing factors(stand structure and site condition)and their effects on mean tree height,mean DBH and timber volumes were determined based on up-boundary line analysis.Tree growth models coupling the effects of tree age,stand density,and elevation were established.Both height and DBH markedly increased initially and then slowly with tree age,decreased with stand density,and showed unimodal change with elevation.The coupled growth models accounted for72-78%of the variations in tree height,DBH and timber growth.Recommendations for future plantation management are:(1)prolong the rotation to at least 60 years to produce large-diameter,high-quality timber and maintain greater carbon stocks;(2)zone the target functions of stands by elevation;and,(3)reduce stand density for balanced supply of multiple ecosystem services.The growth models developed can predict growth response of larch plantations to density alteration under given ages and elevations,and assist the transformation from traditional management for maximum timber production to site-specific and multifunctional management with longer rotations and moderate tree density.

Influencing factors and growth state classification of a natural Metasequoia population

By analyzing the importance of influencing factors and conducting a comparative study of the effects of different sorting algorithms, a new method is proposed that is suitable for classifying the growth state of a natural Metasequoia glyptostroboides Hu and W.C. Cheng population. We studied 2817 M. glyptostroboides trees over 100 years old and analyzed their growth state by measuring 15 factors from stumpage, site condition, and environmental data. The dimensionality of all factors were reduced using the random forest algorithm, and we classified the remaining factors using the following algorithms: random forest, back-propagation(BP) neural networks, and support vector machine(SVM). The applicability of each sorting algorithm was analyzed. When all the d factors are used for classification and modeling, the model's overall accuracy,kappa coefficient and test accuracy were 85.5%, 0.739 and 85.8%, respectively. By reducing the dimensionality of the factors using the random forest algorithm, 11 factors most strongly influenced the classifications of the growth state of the Metasequoia population: diameter at breast height,height, crown width, age from stumpage data; longitude,latitude, elevation, slope aspect, gradient and slope position from the site condition data; and the edge of the field from the environmental data. For classifying the Metasequoia population, the random forest algorithm has the highest overall accuracy at 87.2%, which is 3.4 and 2.3% higher than the BP neural networks and SVM algorithms,respectively. The SVM algorithm is superior to the random forest algorithm with respect to classifying the state of mortality. The combination of the random forest and SVM algorithms and their combined information can be used to classify and predict the growth state of this natural M.glyptostroboides population to provide a scientific basis for its effective protection.

Influencing factors of forestry economic growth in Guangdong province

Based on the data of Guangdong Rural Statistical Yearbooks(2011-2018)and Guangdong statistical yearbook(2011-2018),the grey correlation analysis method was used to analyze the factors influencing the growth of forestry economy in Guangdong province.The results show that the correlation of GDP and forestry economic growth,the correlation of afforestation area and forestry economic growth,the correlation of sunshine hours and forestry economic growth,the correlation of population density and forestry economic growth,the correlation of forest coverage rate and forestry economic growth,the correlation of annual average temperature and forestry economic growth,the correlation of average annual rainfall and forestry economic growth,the correlation of the number of forestry workers and the growth of forestry economy,the correlation of total forestry investment and forestry economic growth,are gradually decreased.

Factors influencing improvement of visual field after trans-sphenoidal resection of pituitary macroadenomas:a retrospective cohort study

AIM: To investigate the influencing factors of visual field improvement after trans-sphenoidal resection of pituitary macroadenomas. METHODS: This retrospective cohort study included 201 patients (366 eyes) with visual field defect induced by pituitary macroadenomas. All of them were treated with trans-sphenoidal surgery. Ophthalmologic evaluation, best -corrected visual acuity (BCVA), and visual field examination were performed before and 3mo after surgery. BCVA, visual field defect index mean deviation (MD), duration of symptoms, age, sex, and volume of tumors were compared. Expression of vascular endothelial growth factor (VEGF) and Ki-67 of tumor tissue were detected by immunohistochemical technique. RESULTS: The mean age of patients was 44.23 +/- 1.29y. Ninety -three patients were female and 108 were male. The mean tumor volume was 14.36 +/- 6.23 cm(3). The mean duration of preoperative symptoms was 11.50 +/- 0.88mo. Mean preoperative MD was -17.50 +/- 0.82 dB. Mean Preoperative visual acuity was 0.64 +/- 0.04. Postoperative visual field improved in 270 (73.77%) eyes, unchanged in 96 (26.23%) eyes. Multivariate logistic regression displayed that the factors independently influencing visual field improvement were young age (OR=1.71, 95%CI: 1.325-2.387, P=0.013), low preoperative MD absolute value (OR=1.277, 95%CI: 1.205-1.355, P<0.001), small volume of tumor (OR=1.458, 95%CI: 1.060-4.289, P<0.001), low expression of VEGF in tumor tissue (OR=1.554, 95%CI: 1.089-2.457, P=0.022), and low expression of Ki-67 in tumor tissue (OR=1.552, 95%CI: 1.161-2.847, P=0.026). CONCLUSION: After pituitary macroadenomas trans sphenoidal resection, the independent influencing factors of the visual fields recovery were low preoperative MD absolute value, young age, small volume of tumor, and expression levels of VEGF/Ki-67.

Influence of chelator and near-infrared dye labeling on biocharacteristics of dual-labeled trastuzumab-based imaging agents

Objective： To investigate the effect of fluorescent dye labeling on the targeting capabilities of 111 In- （DTPA）.-trastuzumab-（IRDye 800）m. Methods： Trastuzumab-based conjugates were synthesized and conjugated with diethylenetriaminepentaacetic acid （DTPA） at molar ratios of I, 2, 3 and 5 and with a fluorescent dye （IRDye 800CW） at molar ratios of 1, 3 and 5. Immunoreactivity and internalization were assessed on SKBR-3 cells, overexpressing human epidermal growth factor receptor 2. The stability in human serum and phosphate-buffered saline （PBS） was evaluated. The biodistribution of dual-labeled conjugates was compared with that of 111In-（DTPA）2-trastuzumab in a SKBR-3 xenograft model to evaluate the effect of dye-to-protein ratio. Results： All trastuzumab-based conjugates exhibited a high level of chemical and optical purity. Flow cytometry results showed that increasing dye-to-protein ratios were associated with decreased immunoreactivity. Stability studies revealed that the conjugate was stable in PBS, while in human serum, increased degradation and protein precipitation were observed with increasing dye-to-protein ratios. At 4 h, the percentages of internalization of dual-labeled conjugates normalized by dye-to-protein ratio （m） were 24.88%±2.10%, 19.99%±0.59%, and 17.47%±1.26% for ＂m＂ equal to 1, 3, and 5, respectively. A biodistribution study revealed a progressive decrease in tumor uptake with an increase in the dye-to-protein ratios. The liver, spleen and kidney showed a marked uptake with increased dye-to-protein ratios, particularly in the latter. Conclusions： With non-specific-site conjugation of the fluorescent dye with a protein based on imaging agent, the increase in dye-to-protein ratios negatively impacted the immunoreactivity and stability, indicating a reduced tumor uptake.

The Influencing Factors on the Growth of Economic and Management Talents Based on Structural Equation Model—A Case Study of Sichuan Province

To analyze the influencing factors on the growth of economic and management talents in China's Sichuan Province, this paper constructs an analysis framework for the growth of economic and management talents, takes 340 economic management scholars in 53 higher education institutions in Sichuan Province as the research objects, uses CV analysis to organize their CVs and information, and constructs an evaluation index system combined with system science theory for the influencing factors from five dimensions: Educational experience, work experience, research experience, part-time experience, and award experience. Correlation analysis and structural equation model are used to systematically analyze the influencing factors on the growth of economic and management talents. The experimental results show that work experience, research experience, and award experience have a direct positive significant influence on talent growth;research experience and award experience play mediating roles in the influence of talent growth. This paper enriches the theoretical dimensions of this research field and explores the interactions among these factors. It also helps to improve the cultivation and development mode of economic and management talents in the western region. Furthermore, it provides guidance and reference for the role of talents in promoting economic growth, industrial upgrading, and sustainable development.

胎儿生长受限患者胎盘组织中VEGFA、HIF-1α表达及临床意义

目的:探究胎儿生长受限(FGR)患者胎盘组织中血管内皮生长因子A(VEGFA)、缺氧诱导因子(HIF)-1α表达及临床意义。方法:选择2020年5月-2022年9月在本院确诊FGR并住院分娩的孕妇116例(FGR组)、分娩正常孕妇(新生儿正常)116例为对照组临床资料。qRT-PCR检测胎盘组织中VEGFA、HIF-1α的mRNA表达情况,免疫组化法检测VEGFA、HIF-1α的蛋白表达情况。Pearson相关性分析VEGFA与HIF-1α的相关性以及与FGR患者临床资料相关性;多因素logistic回归分析影响FGR发生的因素。结果:FGR组VEGFA蛋白阳性表达率(25.9%)低于对照组(64.7%),HIF-1α蛋白阳性表达率(67.2%)高于对照组(24.1%);FGR组胎盘组织中VEGFA mRNA表达水平(0.75±0.20)低于对照组(1.00±0.23),HIF-1α mRNA表达水平(1.26±0.25)高于对照组(1.01±0.19)(均P<0.05)。FGR患者胎盘组织中VEGFA mRNA与HIF-1α mRNA呈负相关(P<0.05)。FGR患者新生儿出生1 min Apgar评分、胎盘重量、胎盘体积、新生儿体重与VEGFA表达水平呈正相关,与HIF-1α表达水平呈负相关;HIF-1α升高为影响FGR发生的危险因素,VEGFA升高为保护因素(均P<0.05)。结论:FGR患者胎盘组织中VEGFA低表达、HIF-1α高表达,二者影响FGR的发生及新生儿出生质量。

基于森林资源清查资料的盈江县森林生物量和生长量分析

为确定盈江县森林碳储量和碳汇潜力的变化特征及其影响因子,以便更好地分析盈江县森林生物量和生长量。基于盈江县2012年和2017年森林资源清查数据,利用生物量换算因子连续函数法和异速生长方程,评估盈江县森林碳储量和碳汇潜力的变化特征及其影响因子。结果显示:(1)盈江县森林生物量储量丰富,达85.55 t/hm^(2)。其中:栎类林最大,为168.3 t/hm^(2);核桃林最低,为7.10 t/hm^(2)。(2)不同林龄林分生物量差异较大,近熟林最高,其次分别为中龄林、成熟林、过熟林、幼龄林。(3)常绿阔叶林的林分生长量最大,其次是落叶阔叶林和针叶林。结果表明:盈江县森林生物量储量丰富且以阔叶林为主;林龄和年均气温是影响林分生长和生物量的主要因素。

单纯性乳房早发育女童的临床特征及进展为中枢性性早熟的影响因素分析

目的探讨单纯性乳房早发育(IPT)女童的临床特征及进展为中枢性性早熟(CPP)的影响因素。方法选取2017年1月—2021年12月于我院首诊的85例IPT女童为研究对象,根据1年内是否进展为CPP分为进展组与未进展组,比较2组患儿的临床随访资料。采用Logistic回归分析IPT患儿进展为CPP的独立影响因素;采用受试者工作特征(ROC)曲线来分析相关指标对患儿进展为CPP的预测价值。结果全部患儿中,1年内共有20例进展为CPP,发生率为23.5%。进展组患儿的发病年龄,身高、体质量及身体质量指数(BMI)的标准差评分,Tanner分期为3期的比例,骨龄与实际年龄的比值,子宫长径,血胰岛素样生长因-1(IGF-1)水平均明显大/高于未进展组(P<0.05);进展组患儿的母亲初潮年龄小于未进展组(P<0.05)。Logistic回归分析结果表明,Tanner分期、血IGF-1水平、子宫长径是IPT患儿进展为CPP的独立影响因素(P<0.05)。ROC曲线分析结果表明,IPT患儿初诊时的IGF-1水平与子宫长径对其1年内进展为CPP具有较高的预测价值,其曲线下面积(AUC)分别为0.789、0.729(P<0.05)。结论IPT女童进展为CPP并不少见,与Tanner分期、血IGF-1水平、子宫长径等有关,临床上应加强对高危患儿的随访干预。

急诊科护士第二受害者经验与支持现状及影响因素研究

目的基于积极心理学视角对急诊科护士第二受害者经验与支持现状进行调查,并探讨其影响因素。方法采用一般资料问卷、第二受害者经验及支持量表、心理脱离量表和创伤后成长自评量表,对浙江省10所综合性医院的355名急诊科护士进行问卷调查,分析第二受害者经验与支持发生情况,并采用多元线性回归进行影响因素分析。结果样本人群中急诊科护士第二受害者经验及支持量表、创伤后成长量表、心理脱离量表总分分别为(89.63±10.83)分、(66.80±16.33)分、(13.23±3.63)分。第二受害者支持、心理脱离、创伤后成长得分呈正相关(r=0.275、0.434、0.212,均P<0.001)。单因素分析显示,急诊科护士性别、学历、职称、职务、平均月收入、是否为带教老师、对个人影响时间、是否听说过第二受害者概念是第二受害者经验与支持的影响因素(P<0.05);多因素分析中,急诊科护士性别、学历、对个人影响时间、是否听说过第二受害者概念、心理脱离、创伤后成长是急诊科护士第二受害者经验与支持的主要影响因素(P<0.05)。结论急诊科护士第二受害者经验与支持得分较高,心理困扰情况严重,但创伤后成长水平较高。建议医院完善相关支持,帮助护士培养积极情绪,提升急诊科护士职业获益感。

冠状动脉旁路移植患者术后疲劳发展轨迹及影响因素研究

目的探讨冠状动脉旁路移植术(coronary artery bypass grafting,CABG)患者术后疲劳发展轨迹及其影响因素。方法采用便利抽样法,选取2022年10月-2023年8月在我院心脏外科行CABG的145例患者为研究,随访过程中剔除18例,最终共纳入124例患者。分别在出院前1 d及出院后1、2、4个月采用一般资料调查表、中文版多维疲劳量表(multidimensional fatigue inventory-20,MFI-20)及Barthel指数评定量表对患者术后疲劳水平进行追踪调查,利用潜类别增长模型(latent class growth model,LCGM)识别潜在的术后疲劳轨迹类别,采用多分类logistic回归分析患者术后疲劳轨迹类别的影响因素。结果患者术后MFI-20得分随时间呈下降趋势(F=310.039,P<0.001),得分从出院前1 d(58.44±8.65)分降至出院后4个月(36.92±9.89)分;最终识别出3种术后疲劳轨迹类别,根据其特征分别命名为中至轻度明显下降组、中度缓慢下降组、重至中度缓慢下降组,分别占比53.2%、32.3%、14.5%。单因素分析显示:有无心肌梗死病史、有无脑卒中病史、NYHA心功能分级、术后ICU停留天数、术后左室射血分数(LVEF)、红细胞计数、血红蛋白、总胆固醇、低密度脂蛋白、日常生活活动能力与术后疲劳轨迹类别有关(均P<0.05);多因素logistic回归分析显示:术后ICU停留天数、有无心肌梗死病史、NYHA心功能分级、有无脑卒中病史、日常生活活动能力是CABG患者术后疲劳轨迹类别的主要影响因素(均P<0.05)。结论CABG患者术后疲劳发展轨迹存在异质性,医护人员应根据不同变化轨迹制定针对性护理措施,积极改善可控因素,缓解患者术后疲劳程度。

糖尿病足截肢患者创伤后成长现状及影响因素分析

目的了解糖尿病足截肢患者创伤后成长现状,探讨其影响因素。方法采用便利抽样法选择2021年5-12月天津市2所三级甲等医院319例已行糖尿病足截肢术的住院患者为研究对象,采用一般人口学资料与疾病资料调查表、疾病不确定感量表、家庭关怀度量表、医学应对方式量表和创伤后成长量表对其进行调查。结果糖尿病足截肢患者的创伤后成长得分(64.29±15.99)分,疾病不确定感、应对方式(面对)、家庭关怀度、家庭人均月收入、身体质量指数(>29.9 kg/m^(2))、职业(个体)、截肢次数(2~3次)、应对方式(回避)、糖尿病足病程(>3~6月)是糖尿病足截肢患者创伤后成长的影响因素(均P<0.05),共解释创伤后成长总变异的47.50%。结论糖尿病足截肢患者的创伤后成长处于中等水平,创伤后成长受多个因素影响;护理人员应采取个性化措施,进一步帮助患者获得创伤后成长。

基于潜变量增长混合模型的鼻咽癌同步放化疗患者心理一致感变化轨迹分析

目的探讨鼻咽癌(nasopharyngeal carcinoma,NPC)患者同步放化疗期间心理一致感的纵向发展轨迹,分析其影响因素。方法2022年11月至2023年6月,便利抽样选取广西某三级甲等综合医院同步放化疗患者225例作为研究对象,在放疗第1次、15次、30次时采用一般资料调查表、症状困扰量表、心理一致感量表-13对其进行调查,使用潜变量增长混合模型识别其心理一致感发展轨迹,采用Logistic回归分析其影响因素。结果NPC同步放化疗患者,其心理一致感存在3种轨迹,分别为持续低平组(20.00%)、持续下降组(28.00%)、持续上升组(52.00%)。Logistic回归分析显示,症状严重程度、年龄、学历、居住地、照护者和肿瘤分期是鼻咽癌患者心理一致感的独立影响因素(均P<0.05)。结论鼻咽癌同步放化疗患者心理一致感存在群体异质性,应基于患者心理一致感变化轨迹有针对性地进行评估和干预。

晚期癌症患者预立医疗照护计划参与现状及影响因素研究

目的了解晚期癌症患者预立医疗照护计划参与现状,分析影响因素,为针对性干预提供参考。方法采用一般资料调查表、中文版预立医疗照护计划参与问卷、家庭支持量表、创伤后成长量表对349例晚期癌症患者进行调查与分析。结果患者中文版预立医疗照护计划参与总分为84.54±23.05;处于行为改变前意识阶段、思考阶段、准备阶段、行动阶段的患者比例依次为36.7%、37.2%、22.3%及3.7%。回归分析显示,文化程度、病程、替别人做过医疗决定、家庭支持、创伤后成长是患者预立医疗照护计划参与的主要影响因素(均P<0.05)。结论晚期癌症患者预立医疗照护计划参与水平处于中等偏下,仅少部分患者处于行为改变准备与行动阶段;应加强文化程度低、病程短、家庭支持及创伤后成长水平较低患者的干预与支持。

急性缺血性脑卒中患者血清可溶性生长刺激表达基因2蛋白、脑钠肽与颈动脉粥样硬化程度的相关性

目的分析急性缺血性脑卒中患者血清可溶性生长刺激表达基因2蛋白(sST2)、脑钠肽(BNP)与颈动脉粥样硬化程度的相关性。方法选取205例急性缺血性脑卒中患者为研究组,并根据颈动脉粥样硬化程度将其分为轻度组100例、中度组70例和重度组35例。另选同期接受体检的150例健康人员为对照组。比较各组血清sST2、BNP水平。分析sST2、BNP水平与颈动脉粥样硬化程度间的相关性。分析急性缺血性脑卒中患者颈动脉粥样硬化程度的影响因素。分析sST2、BNP联合评估对急性缺血性脑卒中患者颈动脉粥样硬化程度的预测价值。结果研究组的血清sST2水平低于对照组,BNP水平高于对照组,差异有统计学意义(P<0.05)。中度组、重度组的sST2水平低于轻度组,BNP水平高于轻度组,且重度组BNP水平高于中度组,sST2水平低于中度组,差异有统计学意义(P<0.05)。急性缺血性脑卒中患者颈动脉粥样硬化程度与其年龄、有无高血压史、有无吸烟史、有无糖尿病史及总胆固醇(TC)、C反应蛋白(CRP)、同型半胱氨酸(Hcy)、低密度脂蛋白(LDL)水平有关(P<0.05)。年龄、高血压史、吸烟史、糖尿病史、TC、CRP、Hcy、LDL、BNP、sST2为患者颈动脉粥样硬化程度的影响因素(P<0.05)。血清BNP水平与颈动脉粥样硬化程度呈正相关,sST2与颈动脉粥样硬化程度呈负相关(P<0.001)。sST2、BNP联合预测的曲线下面积(AUC)大于sST2、BNP单独预测,差异有统计学意义(P<0.001)。结论临床观察急性缺血性脑卒中患者的血清sST2、BNP水平变化,可有效评估其疾病发展情况,有利于改善患者颈动脉粥样硬化程度。sST2、BNP联合评估对急性缺血性脑卒中患者颈动脉粥样硬化程度的诊断效能较好。

肝移植患者术后早期疲劳发展轨迹研究

目的:探讨肝移植患者术后早期疲劳发展轨迹及其影响因素。方法:纳入2019年1月至2023年3月于首都医科大学附属北京佑安医院肝移植中心肝移植后随访的96例患者为研究对象。采用疲劳评定量表(FAI)评估患者术后1周、2周、1个月、3个月、6个月疲劳情况,并采用增长混合模型(LGMM)分析识别肝移植术后患者早期疲劳发展轨迹;并采集患者一般资料、社会支持、心理状态等资料对早期疲劳发展轨迹的影响进行多因素Logistic回归分析。结果:96例在肝移植术后患者6个月的随访中均有完整FAI评分共91例,最终纳入91例患者。LGMM分析显示肝移植术后患者早期疲劳发展趋势分为3个类型,分别为下降组(36例)、稳定组(34例)、升高组(21例);3个组别的疲劳发展均有时间效应,下降组FAI评分随时间显著降低,稳定组随时间无显著变化,升高组随时间显著升高。多因素Logistic回归分析显示年龄、焦虑、抑郁、睡眠状态及社会支持水平是肝移植术后患者早期疲劳发展轨迹的影响因素(P<0.05)。结论:肝移植术后患者早期疲劳发展轨迹具异质性,存在不同类别的发展趋势,其中年龄、焦虑、抑郁、睡眠状态及社会支持水平是其影响因素。

产前多超声参数评估胎儿生长受限的价值及诊断假阴性影响因素分析

目的:探究产前彩色多普勒超声评估胎儿生长受限(FGR)的价值,分析超声诊断假阴性的影响因素。方法:选择2019年10月至2023年7月于我院行产前彩色多普勒超声诊断为FGR并获得产后随访确诊的118例胎儿作为FGR真阳性组,60例产前彩色多普勒超声诊断为FGR阴性而产后确诊为FGR的胎儿作为FGR假阴性组。比较首次检查时两组间不同孕周的超声参数;比较两组胎儿的临床资料,采用随机森林算法及多因素Logistic回归分析筛选影响超声诊断FGR假阴性的因素;构建多因素Logistic回归模型并评价其预测效能。结果:孕12~14周假阴性组胎儿的腹围、股骨长明显长于真阳性组,血流收缩末期峰值(S)/舒张末期峰值(D)明显低于真阳性组(P<0.05);孕15~27周假阴性组胎儿的腹围、股骨长明显长于真阳性组(P<0.05);孕28~37周假阴性组胎儿的腹围明显长于真阳性组(P<0.05);随机森林算法及多因素Logistic回归分析结果显示,孕期增重高于标准、妊娠糖尿病、胎方位为臀位、分娩胎龄>40周、胎儿性别为男性、腹围增加是影响超声诊断FGR假阴性的危险因素(P<0.05);当模型预测超声诊断FGR假阴性概率为0.85时,约登指数最大(74.46),敏感度为86.45%,特异度为88.01%,逻辑回归拟合优度检验结果显示模型Bootstrap验证前后的Nagelkerke R 2=0.602。结论:随着孕周的增加(12~37周),首次超声检查诊断FGR真阳性和假阴性胎儿间存在显著差异的指标数量逐渐减少,孕期增重、妊娠糖尿病、胎方位等是影响超声诊断FGR假阴性的危险因素。

中青年意外创伤病人创伤后成长的研究进展

从创伤后成长的定义、测量工具、影响因素和干预措施等方面进行综述,旨在为相关领域的研究提供参考和借鉴。

竹类植物生长影响因素研究进展

竹林是森林生态系统的重要组成部分,具生长迅速、采伐周期短等特点,在应对全球气候变化与实现碳中和目标中具重要意义。竹林在经营过程中,竹子生长受多种环境因素与人为因素的共同影响。文中通过文献梳理,综述了光照、水分、温度、海拔高度以及经营措施等因素对竹林生长影响的研究进展,提出今后应加强对不同经营措施竹林固定样地的长期动态监测、竹林生态配置模式、竹材材性、竹林经营模式优化等方面的研究,以期为竹林高效培育、充分发挥竹林经济效益与生态效益、实现可持续经营提供参考。

HER2阴性乳腺癌化疗患者复发转移的影响因素及风险预测模型构建

目的探讨人表皮生长因子受体-2(HER2)阴性乳腺癌化疗患者复发转移的影响因素,并构建风险预测模型。方法回顾性分析180例接受新辅助化疗的HER2阴性乳腺癌患者病历资料和随访资料,根据2年内复发转移情况将患者分为复发转移组(35例)和未复发转移组(145例)。采用Logistic回归分析HER2阴性乳腺癌化疗患者复发转移的影响因素,依据回归分析结果构建风险预测模型,计算一致性指数(C-index)检验模型准确性。绘制受试者工作曲线(ROC),以曲线下面积(AUC)检验风险预测模型对HER2阴性乳腺癌化疗患者复发转移的预测价值。结果复发转移组和未复发转移组在月经状态、临床分期、p53蛋白、Ki-67、VEGF方面比较,差异有统计学意义(P<0.05)。Logistic回归分析显示,月经状态、临床分期、p53蛋白、Ki-67、VEGF是HER2阴性乳腺癌化疗患者复发转移的影响因素(P<0.05)。基于上述因素构建风险预测模型,结果显示该列线图模型的校准曲线和Y=X直线相近,模型校准度良好,C-index值为0.844,提示该模型具有良好区分度。绘制ROC曲线发现,列线图风险预测模型预测HER2阴性乳腺癌化疗患者复发转移的AUC为0.844。结论月经状态、临床分期、p53蛋白、Ki-67、VEGF是HER2阴性乳腺癌化疗患者复发转移的影响因素,基于上述影响因素构建的风险预测模型可有效评估患者复发转移。