目的构建老年胃肠镜检查患者苏醒延迟风险预测模型,并验证模型临床应用价值。方法本研究选取2020年1月—2025年1月首都医科大学附属北京友谊医院收治的450例拟行胃肠镜检查的老年患者为研究对象,按照7∶3比例分别纳入训练集(n=315)、验...目的构建老年胃肠镜检查患者苏醒延迟风险预测模型,并验证模型临床应用价值。方法本研究选取2020年1月—2025年1月首都医科大学附属北京友谊医院收治的450例拟行胃肠镜检查的老年患者为研究对象,按照7∶3比例分别纳入训练集(n=315)、验证集(n=135)。按照训练集患者苏醒延迟情况,将其分别纳入延迟组、非延迟组,比较2组患者临床资料。使用logistic多因素回归模型分析影响老年胃肠镜检查患者苏醒延迟的相关因素。基于相关因素构建风险预测Nomogram图,使用受试者工作特征(ROC)曲线评估模型区分效能,使用校准曲线和Hosmer-Lemeshow拟合优度检验评估模型一致性,使用决策曲线分析评估模型临床净收益。结果老年胃肠镜检查患者中共有81例发生苏醒延迟,发生率为18.00%。其中,训练集中57例患者发生苏醒延迟,验证集中24例患者发生苏醒延迟,发生率分别为18.10%、17.78%。多因素logistic回归分析显示,年龄≥75岁(OR=3.152,95%CI:1.667~5.960)、麻醉时长≥45 min(OR=4.011,95%CI:2.223~7.235)、术中输液量≥1500 m L(OR=2.532,95%CI:1.393~4.603)、美国麻醉师协会(ASA)分级Ⅲ级(OR=2.875,95%CI:1.526~5.414)、术中低体温(OR=2.790,95%CI:1.514~5.142)是老年胃肠镜检查患者苏醒延迟的独立危险因素(P<0.05)。基于影响因素建立的列线图模型内部验证结果显示,训练集、验证集曲线下面积(AUC)分别为0.892(95%CI:0.851~0.933)、0.878(95%CI:0.817~0.939)。校准曲线显示预测概率与实际发生概率具有良好的一致性。Hosmer-Lemeshow拟合优度检验在训练集(χ^(2)=8.150,P=0.419)和验证集(χ^(2)=6.980,P=0.539)中均表明模型校准度良好。决策曲线分析显示,当风险阈值概率在0.10~0.75时,使用该模型进行干预决策的净收益高于“全员干预”或“全员不干预”策略。结论老年胃肠镜检查患者苏醒延迟风险较高,且受年龄、麻醉时长、术中输液量、ASA分级、术中低体温等多种因素影响,基于上述因素建立的风险预测模型能够为高危个体的识别提供可靠参考依据。展开更多
OBJECTIVE:To examine the efficacy of Qinghuayin(清化饮,QHY)in rat chronic atrophic gastritis(CAG)models and explored the molecular mechanism of QHY in treating CAG.METHODS:In total,65 Wistar rats were randomly divided...OBJECTIVE:To examine the efficacy of Qinghuayin(清化饮,QHY)in rat chronic atrophic gastritis(CAG)models and explored the molecular mechanism of QHY in treating CAG.METHODS:In total,65 Wistar rats were randomly divided into the control(n=10)and CAG groups(n=55).CAG model rats were further divided into five groups:model(n=10),vitacoenzyme(n=10),low-dose QHY(n=10),medium-dose QHY(n=10),and high-dose QHY groups(n=10).We analyzed histopathological changes using hematoxylin and eosin staining and measured interleukin(IL)-6 and IL-8 levels in serum using enzyme-linked immunosorbent assay(ELISA)(Boster Bio,Pleasanton,USA).In addition,gastrin(GAS),pepsinogen I(PGI),and PGII expressions were evaluated using ELISA.The protein and m RNA expression of toll-like receptor 4(TLR4)and toll or interleukin-1 receptor domaincontaining adaptor inducing interferon-β(TRIF)was detected by Western blotting and quantitative reverse transcription-polymerase chain reaction,respectively.RESULTS:Our results revealed that histopathological changes in CAG model rates could be restored by low-,medium-,and high-dose QHY.The changes in GAS and PGI/II expression demonstrated that QHY improved CAG.Serum IL-6 and IL-levels were decreased by QHY administration.TLR4 and TRIF were upregulated at the m RNA and protein levels in the model group but downregulated by QHY administration.CONCLUSION:We concluded that QHY could effectively improve the histopathological changes of the gastric mucosa induced by CAG in rats.The therapeutic mechanism of QHY may be related to inhibition of the inflammatory factors IL-6 and IL-8 and suppression of TLR4/TRIF m RNA and protein expression.展开更多
With enormous growth of the number of Internet users and appearance of new applications, characterization of Internet traffic has attracted more and more attention and has become one of the major challenging issues in...With enormous growth of the number of Internet users and appearance of new applications, characterization of Internet traffic has attracted more and more attention and has become one of the major challenging issues in telecommunication network over the past few years. In this paper, we study the network traffic pattern of the aggregate traffic and of specific application traffic, especially the popular applications such as P2P, VoIP that contribute most network traffic. Our study verified that majority Internet backbone traffic is contributed by a small portion of users and a power function can be used to approximate the contribution of each user to the overall traffic. We show that P2P applications are the dominant traffic contributor in current Internet Backbone of China. In addition, we selectively present the traffic pattern of different applications in detail.展开更多
文摘目的构建老年胃肠镜检查患者苏醒延迟风险预测模型,并验证模型临床应用价值。方法本研究选取2020年1月—2025年1月首都医科大学附属北京友谊医院收治的450例拟行胃肠镜检查的老年患者为研究对象,按照7∶3比例分别纳入训练集(n=315)、验证集(n=135)。按照训练集患者苏醒延迟情况,将其分别纳入延迟组、非延迟组,比较2组患者临床资料。使用logistic多因素回归模型分析影响老年胃肠镜检查患者苏醒延迟的相关因素。基于相关因素构建风险预测Nomogram图,使用受试者工作特征(ROC)曲线评估模型区分效能,使用校准曲线和Hosmer-Lemeshow拟合优度检验评估模型一致性,使用决策曲线分析评估模型临床净收益。结果老年胃肠镜检查患者中共有81例发生苏醒延迟,发生率为18.00%。其中,训练集中57例患者发生苏醒延迟,验证集中24例患者发生苏醒延迟,发生率分别为18.10%、17.78%。多因素logistic回归分析显示,年龄≥75岁(OR=3.152,95%CI:1.667~5.960)、麻醉时长≥45 min(OR=4.011,95%CI:2.223~7.235)、术中输液量≥1500 m L(OR=2.532,95%CI:1.393~4.603)、美国麻醉师协会(ASA)分级Ⅲ级(OR=2.875,95%CI:1.526~5.414)、术中低体温(OR=2.790,95%CI:1.514~5.142)是老年胃肠镜检查患者苏醒延迟的独立危险因素(P<0.05)。基于影响因素建立的列线图模型内部验证结果显示,训练集、验证集曲线下面积(AUC)分别为0.892(95%CI:0.851~0.933)、0.878(95%CI:0.817~0.939)。校准曲线显示预测概率与实际发生概率具有良好的一致性。Hosmer-Lemeshow拟合优度检验在训练集(χ^(2)=8.150,P=0.419)和验证集(χ^(2)=6.980,P=0.539)中均表明模型校准度良好。决策曲线分析显示,当风险阈值概率在0.10~0.75时,使用该模型进行干预决策的净收益高于“全员干预”或“全员不干预”策略。结论老年胃肠镜检查患者苏醒延迟风险较高,且受年龄、麻醉时长、术中输液量、ASA分级、术中低体温等多种因素影响,基于上述因素建立的风险预测模型能够为高危个体的识别提供可靠参考依据。
基金Supported by Natural Science Foundation of Fujian Province(Based on NLRP3 Inflammatory Body/Caspase-1-mediated Gastric Epithelial Cell Death to Explore the Molecular Mechanism of Qinghua Decoction in the Treatment of Chronic Atrophic Gastritis,No.2020J01253)。
文摘OBJECTIVE:To examine the efficacy of Qinghuayin(清化饮,QHY)in rat chronic atrophic gastritis(CAG)models and explored the molecular mechanism of QHY in treating CAG.METHODS:In total,65 Wistar rats were randomly divided into the control(n=10)and CAG groups(n=55).CAG model rats were further divided into five groups:model(n=10),vitacoenzyme(n=10),low-dose QHY(n=10),medium-dose QHY(n=10),and high-dose QHY groups(n=10).We analyzed histopathological changes using hematoxylin and eosin staining and measured interleukin(IL)-6 and IL-8 levels in serum using enzyme-linked immunosorbent assay(ELISA)(Boster Bio,Pleasanton,USA).In addition,gastrin(GAS),pepsinogen I(PGI),and PGII expressions were evaluated using ELISA.The protein and m RNA expression of toll-like receptor 4(TLR4)and toll or interleukin-1 receptor domaincontaining adaptor inducing interferon-β(TRIF)was detected by Western blotting and quantitative reverse transcription-polymerase chain reaction,respectively.RESULTS:Our results revealed that histopathological changes in CAG model rates could be restored by low-,medium-,and high-dose QHY.The changes in GAS and PGI/II expression demonstrated that QHY improved CAG.Serum IL-6 and IL-levels were decreased by QHY administration.TLR4 and TRIF were upregulated at the m RNA and protein levels in the model group but downregulated by QHY administration.CONCLUSION:We concluded that QHY could effectively improve the histopathological changes of the gastric mucosa induced by CAG in rats.The therapeutic mechanism of QHY may be related to inhibition of the inflammatory factors IL-6 and IL-8 and suppression of TLR4/TRIF m RNA and protein expression.
文摘With enormous growth of the number of Internet users and appearance of new applications, characterization of Internet traffic has attracted more and more attention and has become one of the major challenging issues in telecommunication network over the past few years. In this paper, we study the network traffic pattern of the aggregate traffic and of specific application traffic, especially the popular applications such as P2P, VoIP that contribute most network traffic. Our study verified that majority Internet backbone traffic is contributed by a small portion of users and a power function can be used to approximate the contribution of each user to the overall traffic. We show that P2P applications are the dominant traffic contributor in current Internet Backbone of China. In addition, we selectively present the traffic pattern of different applications in detail.
