BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gast...BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gastrectomy;however,post-surgical pancreatic fistula remain a serious issue.These fistulas can lead to abdominal infections,anastomotic leakage,increased costs,and pain;thus,early diagnosis and prevention are crucial for a better prognosis.Currently,C-reactive protein(CRP),procalcitonin(PCT),and total bilirubin(TBil)levels are used to predict post-operative infections and anastomotic leakage.However,their predictive value for pancreatic fistula after radical gastrectomy for gastric cancer remains unclear.The present study was conducted to determine their predictive value.AIM To determine the predictive value of CRP,PCT,and TBil levels for pancreatic fistula after gastric cancer surgery.METHODS In total,158 patients who underwent radical gastrectomy for gastric cancer at our hospital between January 2019 and January 2023 were included.The patients were assigned to a pancreatic fistula group or a non-pancreatic fistula group.Multivariate logistic analysis was conducted to assess the factors influencing development of a fistula.Receiver operating characteristic(ROC)curves were used to determine the predictive value of serum CRP,PCT,and TBil levels on day 1 postsurgery.RESULTS On day 1 post-surgery,the CRP,PCT,and TBil levels were significantly higher in the pancreatic fistula group than in the non-pancreatic fistula group(P<0.05).A higher fistula grade was associated with higher levels of the indices.Univariate analysis revealed significant differences in the presence of diabetes,hyperlipidemia,pancreatic injury,splenectomy,and the biomarker levels(P<0.05).Logistic multivariate analysis identified diabetes,hyperlipidemia,pancreatic injury,CRP level,and PCT level as independent risk factors.ROC curves yielded predictive values for CRP,PCT,and TBil levels,with the PCT level having the highest area under the curve(AUC)of 0.80[95%confidence interval(CI):0.72-0.90].Combined indicators improved the predictive value,with an AUC of 0.86(95%CI:0.78-0.93).CONCLUSION Elevated CRP,PCT,and TBil levels predict risk of pancreatic fistula post-gastrectomy for gastric cancer.展开更多
Objective:To evaluate the predictive value of secreted phosphoprotein 1(SPP1)gene expression for postoperative survival in patients with advanced liver cancer undergoing hepatic artery interventional chemoembolization...Objective:To evaluate the predictive value of secreted phosphoprotein 1(SPP1)gene expression for postoperative survival in patients with advanced liver cancer undergoing hepatic artery interventional chemoembolization treatment.Method:Bioinformatics methods,including gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis,were used to identify genes related to survival prognosis in hepatocellular carcinoma(HCC)patients.A retrospective analysis of 115 advanced liver cancer patients treated between January 2016 and October 2017 was conducted.Patients were categorized into SPP1 high-expression(n=89)and low-expression groups(n=26).Additionally,115 healthy individuals served as the control group.The relationship between SPP1 expression and clinical pathological features was analyzed.A 60-month follow-up and logistic regression analysis identified risk factors affecting survival.Results:SPP1 mRNA expression was significantly higher in liver cancer patients compared to healthy controls(P<0.05).SPP1 expression levels were significantly associated with tumor size,Child-Pugh grading,lymph node metastasis,and BCLC staging(P<0.05).High SPP1 expression,along with tumor size,Child-Pugh grading,lymph node metastasis,and BCLC staging,were independent risk factors for survival(P<0.05).The 60-month survival rate was 17.39%,with a median survival of 40 months in the low-expression group versus 18 months in the high-expression group(P<0.05).Conclusion:SPP1 expression is significantly upregulated in advanced liver cancer patients and has predictive value for postoperative survival following hepatic artery chemoembolization treatment.SPP1,combined with clinical indicators such as tumor size,Child-Pugh grading,lymph node metastasis,and BCLC staging,may serve as a prognostic biomarker for interventional treatment outcomes.展开更多
BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is often combined with respiratory failure,which increases the patient's morbidity and mortality.Diaphragm ultrasound(DUS)has developed...BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is often combined with respiratory failure,which increases the patient's morbidity and mortality.Diaphragm ultrasound(DUS)has developed rapidly in the field of critical care in recent years.Studies with DUS monitoring diaphragm-related rapid shallow breathing index have demonstrated important results in guiding intensive care unit patients out of the ventilator.Early prediction of the indications for withdrawal of non-invasive ventilator and early evaluation of patients to avoid or reduce disease progression are very important.AIM To explore the predictive value of DUS indexes for non-invasive ventilation outcome in patients with AECOPD.METHODS Ninety-four patients with AECOPD who received mechanical ventilation in our hospital from January 2022 to December 2023 were retrospectively analyzed,and they were divided into a successful ventilation group(68 cases)and a failed ventilation group(26 cases)according to the outcome of ventilation.The clinical data of patients with successful and failed noninvasive ventilation were compared,and the independent predictors of noninvasive ventilation outcomes in AECOPD patients were identified by multivariate logistic regression analysis.RESULTS There were no significant differences in gender,age,body mass index,complications,systolic pressure,heart rate,mean arterial pressure,respiratory rate,oxygen saturation,partial pressure of oxygen,oxygenation index,or time of inspiration between patients with successful and failed mechanical ventilation(P>0.05).The patients with successful noninvasive ventilation had shorter hospital stays and lower partial pressure of carbon dioxide(PaCO_(2))than those with failed treatment,while potential of hydrogen(pH),diaphragm thickening fraction(DTF),diaphragm activity,and diaphragm movement time were significantly higher than those with failed treatment(P<0.05).pH[odds ratio(OR)=0.005,P<0.05],PaCO_(2)(OR=0.430,P<0.05),and DTF(OR=0.570,P<0.05)were identified to be independent factors influencing the outcome of mechanical ventilation in AECOPD patients.CONCLUSION The DUS index DTF can better predict the outcome of non-invasive ventilation in AECOPD patients.展开更多
Background Acute myocarditis is a disease characterized by inflammation of the heart muscle, usually caused by viral infection, autoimmune reactions, or toxins, resulting in damage and dysfunction of cardiomyocytes. I...Background Acute myocarditis is a disease characterized by inflammation of the heart muscle, usually caused by viral infection, autoimmune reactions, or toxins, resulting in damage and dysfunction of cardiomyocytes. In recent years, the incidence of acute myocarditis has gradually increased, especially in young people and athletes, which can cause serious cardiac complications and even lead to heart failure, cardiac arrest or major adverse cardiovascular events(MACEs). Methods A total of 90 patients with acute myocarditis(acute myocarditis group) and 30 healthy subjects(control group) admitted to our hospital from November 2021 to November 2023 were selected. Cardiac magnetic resonance(CMR) T1 and T2 mapping sequence scanning and cardiac function parameter measurement was performed on all subjects. The acute myocarditis group was followed up for 12 months and divided into the MACEs group and the non-MACEs group according to whether MACEs occurred. The differences in CMR parameters were analyzed, and receiver operating characteristic(ROC) curve was applied to analyze the predictive value of cardiac CMR T1 and T2 techniques for the occurrence of MACEs in patients with acute myocarditis. Results Compared with the control group, the level of left ventricular ejection fraction(LVEF) in the acute myocarditis group was significantly decreased, while left ventricular end-diastole volume(LVEDV), left ventricular endsystolic volume(LVESV), lactate dehydrogenase(LDH) and creatine kinase MB isoenzyme(CK-MB) increased significantly(P<0.05);T1 and T2 values, late gadolinium enhancement(LGE) percentage of left ventricle, left ventricular entropy and extracellular volume(ECV) in acute myocarditis group were significantly higher than those in the control group(P<0.05). Pearson correlation analysis showed that T1 and T2 values were negatively correlated with LVEF, while T1 and T2 values were positively correlated with LVESV, CK-MB, left ventricular entropy and ECV in patients with acute myocarditis(P<0.05). Among patients with acute myocarditis, the values of T1 and T2, left ventricular entropy and ECV in MACEs group were higher than those in non-MACEs group(P<0.05). Further multivariate analysis also showed that T1 and T2 values had independent predictive capacity for MACEs in patients with acute myocarditis(P<0.05). The maximum area under ROC curve was 0.894 and 0.912, and the sensitivity was 89.35% and 90.40% in patients with acute myocarditis predicted by T1 and T2 mapping. The specificity was 80.34% and 84.25%. Conclusions CMR T1 and T2 mapping techniques can effectively evaluate the cardiac function status of patients with acute myocarditis, and provide an important reference for the prognosis assessment of acute myocarditis.展开更多
BACKGROUND:The major issue with intraoperative cholangiography (IOC) is whether its diagnostic accuracy for common bile duct (CBD) stones matches that of other diagnostic procedures,and thus,whether it will become a r...BACKGROUND:The major issue with intraoperative cholangiography (IOC) is whether its diagnostic accuracy for common bile duct (CBD) stones matches that of other diagnostic procedures,and thus,whether it will become a routine diagnostic procedure.The current study aimed to address the main determinants of CBD stone diagnosis in IOC among an Iranian population.METHODS:In a retrospective review database-based study conducted in Taleghani Hospital in Tehran between 2006 and 2008,baseline data and perioperative information of 2060 patients (male to female ratio 542:1518,mean age 53.7 years) who were candidates for cholecystectomy and underwent concomitant IOC for confirming CBD stones were reviewed.The predictive power of this procedure for diagnosis of abnormal biliary ducts with the focus on biliary stones was determined.RESULTS:Overall mortality and morbidity following cholecystectomy in the study population were 0.6% and 2.6%,respectively.Both early mortality and morbidity due to cholecystectomy were higher in male than female.The prevalence of CBD stones in IOC was 3.4% (5.2% in male and 2.8% in female,P=0.008).Among those without gallstones,8.7% had CBD stones and only 3.1% had concomitant gallstones and CBD stones.The main predictors of stone appearance as an abnormal feature of IOC during cholecystectomy were:advanced age (OR=1.022,P=0.001),male gender (OR=1.498,P=0.050),history of abdominal surgery (OR=1.543,P=0.040) and preoperative endoscopic retrograde cholangiopancreatography (OR=5.400,P<0.001).CONCLUSIONS:IOC is a safe and accurate method for the assessment of bile duct anatomy and stones.Therefore,the routine use of IOC within cholecystectomy seems reasonable and is recommended.展开更多
As one of the earliest markers for predicting pregnancy outcomes, human chorionic gonadotropin(h CG) values have been inconclusive on reliability of the prediction after frozen and fresh embryo transfer(ET). In this r...As one of the earliest markers for predicting pregnancy outcomes, human chorionic gonadotropin(h CG) values have been inconclusive on reliability of the prediction after frozen and fresh embryo transfer(ET). In this retrospective study, patients with positive h CG(day 12 after transfer) were included to examine the h CG levels and their predictive value for pregnancy outcomes following 214 fresh and 1513 vitrified-warmed single-blastocyst transfer cycles. For patients who got clinical pregnancy, the mean initial h CG value was significantly higher after frozen cycles than fresh cycles, and the similar result was demonstrated for patients with live births(LB). The difference in h CG value existed even after adjusting for the potential covariates. The area under curves(AUC) and threshold values calculated by receiver operator characteristic curves were 0.944 and 213.05 m IU/m L for clinical pregnancy after fresh ET, 0.894 and 399.50 m IU/m L for clinical pregnancy after frozen ET, 0.812 and 222.86 m IU/m L for LB after fresh ET, and 0.808 and 410.80 m IU/mL for LB after frozen ET with acceptable sensitivity and specificity, respectively. In conclusion, single frozen blastocyst transfer leads to higher initial h CG values than single fresh blastocyst transfer, and the initial h CG level is a reliable predictive factor for predicting IVF outcomes.展开更多
Aim: To determine the predictive value of the hypo-osmotic swelling (HOS) test to identify viable, non-motile sperm. Methods: Semen samples from 20 men with severe asthenozoospermia underwent traditional seminal analy...Aim: To determine the predictive value of the hypo-osmotic swelling (HOS) test to identify viable, non-motile sperm. Methods: Semen samples from 20 men with severe asthenozoospermia underwent traditional seminal analysis, eosin-nigrosin (EN) staining and the HOS test. A further EN stain was then performed on a HOS pre-treated aliquot and a total of 2000 further sperm examined. Results: The median sperm density was 5.1 million/mL (IQR 4.3-13.1) and the median motility was 3.0 % (IQR 0-7). Seven samples showed complete asthenozoospermia. Initial EN staining showed 59 % viability (range 48-69) despite the poor standard parameters and 47 % (range 33-61) in the complete asthenozoospermia subgroup. The HOS test showed 49.9 % reacted overall (range 40-59) and 41.7 % (range 22-61) in the complete asthenozoospermia subgroup. The combined HOS/EN stain showed the positive predictive value of the HOS test to identify viable sperm was 84.2 % overall and 79.7 % in the complete asthenozoospermia subgroup. Conclusion: The HOS test can effectively predict sperm viability in patients with severe and complete asthenozoospermia.展开更多
This study aimed to compare the predictive value of six selected anthropometric indicators for benign prostatic hyperplasia(BPH).Males over 50 years of age who underwent health examinations at the Health Management Ce...This study aimed to compare the predictive value of six selected anthropometric indicators for benign prostatic hyperplasia(BPH).Males over 50 years of age who underwent health examinations at the Health Management Center of the Second Xiangya Hospital,Central South University(Changsha,China)from June to December 2020 were enrolled in this study.The characteristic data were collected,including basic anthropometric indices,lipid parameters,six anthropometric indicators,prostate-specific antigen,and total prostate volume.The odds ratios(ORs)with 95%confidence intervals(95%CIs)for all anthropometric parameters and BPH were calculated using binary logistic regression.To assess the diagnostic capability of each indicator for BPH and identify the appropriate cutoff values,receiver operating characteristic(ROC)curves and the related areas under the curves(AUCs)were utilized.All six indicators had diagnostic value for BPH(all P≤0.001).The visceral adiposity index(VAI;AUC:0.797,95%CI:0.759–0.834)had the highest AUC and therefore the highest diagnostic value.This was followed by the cardiometabolic index(CMI;AUC:0.792,95%CI:0.753–0.831),lipid accumulation product(LAP;AUC:0.766,95%CI:0.723–0.809),waist-to-hip ratio(WHR;AUC:0.660,95%CI:0.609–0.712),waist-to-height ratio(WHtR;AUC:0.639,95%CI:0.587–0.691),and body mass index(BMI;AUC:0.592,95%CI:0.540–0.643).The sensitivity of CMI was the highest(92.1%),and WHtR had the highest specificity of 94.1%.CMI consistently showed the highest OR in the binary logistic regression analysis.BMI,WHtR,WHR,VAI,CMI,and LAP all influence the occurrence of BPH in middle-aged and older men(all P≤0.001),and CMI is the best predictor of BPH.展开更多
BACKGROUND Preoperative therapy is widely used in locally advanced rectal cancer.It can improve local control of rectal cancer.However,there are few indicators that can predict the effect of preoperative chemotherapy ...BACKGROUND Preoperative therapy is widely used in locally advanced rectal cancer.It can improve local control of rectal cancer.However,there are few indicators that can predict the effect of preoperative chemotherapy accurately.AIM To investigate whether the increase in serumα-fetoprotein(AFP)can predict better efficacy of preoperative chemotherapy.METHODS This was a retrospective study.We analyzed 125 patients admitted between 2017 and 2019 with locally advanced rectal cancer.All patients received six cycles of preoperative chemotherapy(mFOLFOX6 every 2 wk).Serum AFP of 26 patients rose slightly after three or four cycles of chemotherapy,and fell to normal again within 2 mo.The other 99 patients had a normal level of serum AFP during chemotherapy.Patients were divided into two groups(AFP risen and AFP normal).According to postoperative pathology,we compared tumor regression and complete response rate between the two groups.The primary outcome measure was the tumor regression grade(TRG)after chemotherapy.The difference in pathological complete response between the two groups was also investigated.RESULTS There were no tumor progression and distant metastasis in both groups during preoperative chemotherapy.Patients in the AFP risen group achieved better TRG 0/1 than those in the AFP normal group(61.5%vs 39.4%).The increase in AFP was a significant predictor for better tumor regression[χ2=4.144,odds ratio(OR)=2.666,P=0.04].In the AFP risen group,the complete response rate was 30.8%,which was higher than in the AFP normal group(30.8%vs 12.1%,χ2=4.542,OR=3.251,P=0.03).CONCLUSION Patients with a slight increase in serum AFP can achieve better tumor regression during preoperative chemotherapy,and are more likely to achieve pathological complete response.展开更多
BACKGROUND Irritable bowel syndrome(IBS)is a common functional bowel disease that shares features with many organic diseases and cannot be accurately diagnosed by symptom-based criteria.Alarm symptoms have long been a...BACKGROUND Irritable bowel syndrome(IBS)is a common functional bowel disease that shares features with many organic diseases and cannot be accurately diagnosed by symptom-based criteria.Alarm symptoms have long been applied in the clinical diagnosis of IBS.However,no study has explored the predictive value of alarm symptoms in suspected IBS patients based on the latest Rome IV criteria.AIM To investigate the predictive value of alarm symptoms in suspected IBS patients based on the Rome IV criteria.METHODS In this multicenter cross-sectional study,we collected data from 730 suspected IBS patients evaluated at 3 tertiary care centers from August 2018 to August 2019.Patients with IBS-like symptoms who completed colonoscopy during the study period were initially identified by investigators through medical records.Eligible patients completed questionnaires,underwent laboratory tests,and were assigned to the IBS or organic disease group according to colonoscopy findings and pathology results(if a biopsy was taken).Independent risk factors for organic disease were explored by logistic regression analysis,and the positive predictive value(PPV)and missed diagnosis rate were calculated.RESULTS The incidence of alarm symptoms in suspected IBS patients was 75.34%.Anemia[odds ratio(OR)=2.825,95%confidence interval(CI):1.273-6.267,P=0.011],fecal occult blood[OR=1.940(95%CI:1.041-3.613),P=0.037],unintended weight loss(P=0.009),female sex[OR=0.560(95%CI:0.330-0.949),P=0.031]and marital status(P=0.030)were independently correlated with organic disease.The prevalence of organic disease was 10.41%in suspected IBS patients.The PPV of alarm symptoms for organic disease was highest for anemia(22.92%),fecal occult blood(19.35%)and unintended weight loss(16.48%),and it was 100%when these three factors were combined.The PPV and missed diagnosis rate for diagnosing IBS were 91.67%and 74.77%when all alarm symptoms were combined with Rome IV and 92.09%and 34.10%when only fecal occult blood,unintended weight loss and anemia were combined with Rome IV,respectively.CONCLUSION Anemia,fecal occult blood and unintended weight loss have high predictive value for organic disease in suspected IBS patients and can help identify patients requiring further examination but are not recommended as exclusion criteria for IBS.展开更多
<strong>Objective:</strong> To assess the diagnostic accuracy and predictive values of clinical symptoms in patients with suspected mild COVID-19 to identify target groups for self-isolation and outpatient...<strong>Objective:</strong> To assess the diagnostic accuracy and predictive values of clinical symptoms in patients with suspected mild COVID-19 to identify target groups for self-isolation and outpatient treatment without additional testing. <strong>Methods:</strong> We conducted an open-label prospective study in patients aged 18 to 72 years with suspected mild COVID-19. The clinical diagnosis was based on the acute onset of such symptoms as olfactory dysfunction, hyperthermia, myalgia, nasal congestion, nasal discharge, cough, rhinolalia, sore throat, without pneumonia in persons in contact with a confirmed case of COVID-19. The physician assessed clinical symptoms using a 4-point scale. The patient self-assessed clinical symptoms using a ten-point visual analogue scale (VAS). All enrolled patients underwent laboratory testing to confirm the diagnosis of COVID-19. <strong>Results:</strong> Of the 120 patients underwent testing, the diagnosis of mild COVID-19 was confirmed in 96 patients and ruled out in 24 patients. When assessing symptoms by a physician according to the correlation analysis, hyperthermia, myalgia, nasal congestion and rhinolalia have a positive predictive value with a significance level of more than 0.6. When self-assessing symptoms by a patient, fever, myalgia and nasal congestion have a diagnostic accuracy with a significance level of more than 0.5. Nasal discharge, cough and sore throat have negative predictive values. <strong>Conclusion: </strong>The presence of these symptoms in patients with an acute onset of the disease can help to make a clinical diagnosis of coronavirus disease and identify target groups for self-isolation and outpatient treatment without additional testing. Highly suspect asymptomatic patients are not considered as those who have possible mild COVID-19 infection.展开更多
AIM:To determine which features of history and demographics predict a diagnosis of malignancy or peptic stricture in patients presenting with dysphagia.METHODS:A prospective case-control study of 2000 consecutive refe...AIM:To determine which features of history and demographics predict a diagnosis of malignancy or peptic stricture in patients presenting with dysphagia.METHODS:A prospective case-control study of 2000 consecutive referrals(1031 female,age range:17-103 years) to a rapid access service for dysphagia,based in a teaching hospital within the United Kingdom,over 7 years.The service consists of a nurse-led telephone triage followed by investigation(barium swallow or gastroscopy),if appropriate,within 2 wk.Logistic regression analysis of demographic and clinical variables was performed.This includes age,sex,duration of dysphagia,whether to liquids or solids,and whether there are associated features(reflux,odynophagia,weight loss,regurgitation).We determined odds ratio(OR) for these variables for the diagnoses of malignancy and peptic stricture.We determined the value of the Edinburgh Dysphagia Score(EDS) in predicting cancer in our cohort.Multivariate logistic regression was performed and P < 0.05 considered significant.The local ethics committee confirmed ethics approval was not required(audit).RESULTS:The commonest diagnosis is gastro-esophageal reflux disease(41.3%).Malignancy(11.0%) and peptic stricture(10.0%) were also relatively common.Malignancies were diagnosed by histology(97%) or on radiological criteria,either sequential barium swallows showing progression of disease or unequivocal evidence of malignancy on computed tomography.The majority of malignancies were esophago-gastric in origin but ear,nose and throat tumors,pancreatic cancer and extrinsic compression from lung or mediastinal metastatic cancer were also found.Malignancy was statistically more frequent in older patients(aged >73 years,OR 1.1-3.3,age < 60 years 6.5%,60-73 years 11.2%,> 73 years 11.8%,P < 0.05),males(OR 2.2-4.8,males 14.5%,females 5.6%,P < 0.0005),short duration of dysphagia(≤ 8 wk,OR 4.5-20.7,16.6%,8-26 wk 14.5%,> 26 wk 2.5%,P < 0.0005),progressive symptoms(OR 1.3-2.6:progressive 14.8%,intermittent 9.3%,P < 0.001),with weight loss of ≥ 2 kg(OR 2.5-5.1,weight loss 22.1%,without weight loss 6.4%,P < 0.0005) and without reflux(OR 1.2-2.5,reflux 7.2%,no reflux 15.5%,P < 0.0005).The likelihood of malignancy was greater in those who described true dysphagia(food or drink sticking within 5 s of swallowing than those who did not(15.1%vs 5.2% respectively,P < 0.001).The sensitivity,specificity,positive predictive value and negative predictive value of the EDS were 98.4%,9.3%,11.8% and 98.0% respectively.Three patients with an EDS of 3(high risk EDS ≥ 3.5) had malignancy.Unlike the original validation cohort,there was no difference in likelihood of malignancy based on level of dysphagia(pharyngeal level dysphagia 11.9% vs mid sternal or lower sternal dysphagia 12.4%).Peptic stricture was statistically more frequent in those with longer duration of symptoms(> 6 mo,OR 1.2-2.9,≤ 8 wk 9.8%,8-26 wk 10.6%,> 26 wk 15.7%,P < 0.05) and over 60 s(OR 1.2-3.0,age < 60 years 6.2%,60-73 years 10.2%,> 73 years 10.6%,P < 0.05).CONCLUSION:Malignancy and peptic stricture are frequent findings in those referred with dysphagia.The predictive value for associated features could help determine need for fast track investigation whilst reducing service pressures.展开更多
In this retrospective study, a total of 275 solid masses were examined for cytopathologic diagnosis. Twenty four percent (67/275) of these cytologic samples were followed by surgical biopsy and histopathologic diagnos...In this retrospective study, a total of 275 solid masses were examined for cytopathologic diagnosis. Twenty four percent (67/275) of these cytologic samples were followed by surgical biopsy and histopathologic diagnosis, allowing for comparisons. On average, the cutaneous and subcutaneous solid masses were recognized when the dogs were aged between 6 and 9 years old. The origins of the solid masses included connective tissue tumors 37.1% (23/62), epithelial tissue tumors 33.9% (21/62), round cell tumors 19.4% (12/62), masses of inflammatory lesions 4.8% (3/62) and lesions due to other causes 4.8% (3/62). The sensitivity and positive predictive value (PPV) of cytopathology in the diagnosis of solid masses were 93% (62/67) and 97% (62/64), respectively. Generally, neo-plasms were over diagnosed by cytopathology as was indicated by the positive predictive value. Both the sensitivity and the PPV of cytopathology comparative to histopathology in the diagnosis of inflammatory processes were 100% (3/3). The inflammatory lesions were eventually confirmed as necrotizing myositis, necro-suppurative cystitis and endocrine inflammatory dermatopathy based on histopathology. Less than 8% (5/67) of samples were incorrectly diagnosed by cytology. The study showed high accuracy between cytological and histopathological examination of solid masses in dogs, and thus a reliable diagnostic tool in patient care.展开更多
Objective:To study the predictive value of serum pregenomic RNA(pgRNA)on HBeAg clearance in patients with chronic hepatitis B with low HBeAg levels during pegylated interferon therapy.Methods:Twenty chronic hepatitis ...Objective:To study the predictive value of serum pregenomic RNA(pgRNA)on HBeAg clearance in patients with chronic hepatitis B with low HBeAg levels during pegylated interferon therapy.Methods:Twenty chronic hepatitis B patients with HBeAg positive and quantitative<50S/CO were selected for this study.The subjects underwent pegylated interferon therapy for 48-96 weeks and were followed up in the outpatient clinic after treatment.The patients were then divided into groups based on whether their HbeAg turned negative.The predictive ability of each indicator for HBeAg negative conversion was evaluated in the HBeAg negative group and the HBeAg positive group.Results:The results of logistic regression analysis suggested that pgRNA and HBcrAg were better indicators for predicting the clearance of HBeAg after treatment.Conclusion:For patients with chronic hepatitis B with low HBeAg levels,pgRNA is a good indicator in predicting HBeAg clearance during pegylated interferon therapy.展开更多
Objective: to investigate the predictive value of folic acid metabolism gene polymorphism in pregnancy for birth defects. Methods: a total of 2019 pregnant women were collected from our hospital from January 2020 to D...Objective: to investigate the predictive value of folic acid metabolism gene polymorphism in pregnancy for birth defects. Methods: a total of 2019 pregnant women were collected from our hospital from January 2020 to December 2020. The data of MTHFR, Hcy, vitamin B12, folic acid (FA) and other data of pregnant women were detected during the first pregnancy examination. According to the Results of Down's screening, the data of 2019 pregnant women were divided into two groups. Observation group: 1010 pregnant women with moderate and high down's disease risk;Control group: 1009 cases of pregnant women with low or no down's disease risk were given folic acid for 3 months, and then the statistics were collected. Meanwhile, the occurrence of birth defects in the two groups were compared, and the predictive value of folic acid metabolism gene polymorphism on birth defects was analyzed. Results: after intervention, folic acid increased significantly in both groups, Hcy decreased in both groups (P<0.05), but the comparison between groups (P>0.05);The incidence of birth defects in control group was slightly lower than that in observation group (P<0.05). Conclusion: polymorphism of folic acid metabolism gene can be used to preliminarily evaluate the risk of birth defects, and folic acid supplementation can be used to reduce the incidence of birth defects in pregnant women.展开更多
Objective To evaluate the performance of the Sino System for Coronary Operative Risk Evaluation (SinoSCORE) on in hospital mortality and postoperative complications in patients undergoing coronary artery bypass grafti...Objective To evaluate the performance of the Sino System for Coronary Operative Risk Evaluation (SinoSCORE) on in hospital mortality and postoperative complications in patients undergoing coronary artery bypass grafting (CABG) in a single heart center. Methods From January 2007 to December 2008,clinical information of 201 consecutive patients undergoing isolated CABG in our hospital was collected. The SinoSCORE was used to展开更多
Objective To investigate the correlation of Clq/tumor necrosis factor-related protein-6(CTRP6),Irisin and type 2 diabetes mellitus(T2DM).Methods A total of 80 T2DM patients who visited the Endocrinology Department of ...Objective To investigate the correlation of Clq/tumor necrosis factor-related protein-6(CTRP6),Irisin and type 2 diabetes mellitus(T2DM).Methods A total of 80 T2DM patients who visited the Endocrinology Department of Bayannur City Hospital from March 2022 to October 2022 were selected as the T2DM group,and 80 healthy subjects were selected as the normal control(NC)group.Serum CTRP6,Irisin,adiponectin(APN),tumor necrosis factor alpha(TNF-α),interleukin 6(IL-6),fasting plasma glucose(FPG),Blood glucose 2 h after 25 g glucose load(2 hPG),fasting insulin(FIns),insulin resistance index(HOMAIR),glycated hemoglobin(HbA,c),body mass index(BMI)and visceral fat area(VFA)were measured and compared between the two group.Results Compared with the NC group,the serum CTRP6 level in the study group was significantly increased[(150.69±29.57)us(116.05±29.06)pg/ml,P<0.05],and the Irisin level was significantly decreased[145.56(117.50,191.75)vs 205.19(142.15,334.69)pg/ml,P<0.05]in T2DM group.Spearman correlation analysis showed that serum CTRP6 was positively correlated with BMI,VFA,FPG,2 hPG,FIns,HOMA-IR,HbA_(1)c,IL-6,and TNF-α(r=0.255,0.243,0.500,0.434,0.237,0.456,0.470,0.284and0.222,P<0.05)and negatively correlated with age(r=-0.113,P<0.05).Serum Irisin was negatively correlated with BMI,FPG,2 hPG,HOMA-IR and HbA,c(r=-0.201,-0.295,-0.278,-0.234 and-0.352,P<0.05),and positively correlated with APN and IL-6(r=0.248,0.248,P<0.05).Multiple linear regression analysis showed that VFA,FIns,HOMA-IR,APN and IL-6 were independent influencing factors of CTRP6,and IL-6 was an independent influencing factor of Irisin.Logistic regression analysis showed that HOMA-IR,CTRP6 and Irisin were independent predictors of T2DM.Receiver operating characteristic curve analysis showed that the area under the curve(AUC)of serum CTRP6 for predicting T2DM was 0.795,the AUC of serum Irisin for predicting T2DM was 0.669,and the AUC of the combination predicting T2DM was 0.832.Conclusion Serum CTRP6 and Irisin are closely related to T2DM and have high predictive value for T2DM.展开更多
Objective To investigate the early predictive value of ECG PR interval for the risk of coronary heart disease(CHD) in patiens with T2DM.Methods A total of 7 886 participants from Guiyang enrolled in the REACTION study...Objective To investigate the early predictive value of ECG PR interval for the risk of coronary heart disease(CHD) in patiens with T2DM.Methods A total of 7 886 participants from Guiyang enrolled in the REACTION study between May and August 2011 were included.展开更多
blood cell derived inflammatory nmarker(including systemic immunoinflammatory index(SI),systemic inflammatory response index(SIRI),neutrophil count/lymphocyte count(NLR),platelet count/lymphocyte count(PLR),and monocy...blood cell derived inflammatory nmarker(including systemic immunoinflammatory index(SI),systemic inflammatory response index(SIRI),neutrophil count/lymphocyte count(NLR),platelet count/lymphocyte count(PLR),and monocyte count/lymphocyte count(MLR))and in combination with N-terminal pro-B-type natriuretic peptide(NT-proBNP)on the prognosis of patients with chronic heart failure.Methods This study was a retrospective cohort study.Patients with chronic heart failure hospitalized in the Department of Cardiovascular Medicine,Nanfang Hospital,Southern Medical University from January 2019 to August 2022 were enrolled.Patients were followed up and were divided into survival group and death group according to the follow-up results.Clinical characteristics of the two groups were compared.Receiver operating characteristic(ROC)curve was used to determine the optimal cut-off value of each whole blood cell derived inflammatory marker for predicting all-cause death in patients with chronic heart failure.Kaplan-Meier survival curve was drawn,and log-rank test was used to compare the difference in survival of chronic heart failure patients with different levels of whole blood cell derived inflammatory markers.Univariate and multivariate Cox proportional hazards models were used to analyze the effects of whole blood cell derived inflammatory markers and NT-proBNP on the all-cause death of patients with chronic heart failure.ROC curve was used to analyze the predictive value of whole blood cell derived inflammatory markers combined with NT-proBNP on the prognosis of patients with chronic heart failure.Results A total of 324 patients with heart failure aged(64.76±13.78)years were enrolled,with 212 males(65.43%).297 patients(91.67%)completed follow-up,27 patients(8.33%)were lost to follow-up.The follow-up time was 24.O(18.0,41.8)months.There were 258 patients in the survival group and 66 patients in the death group.The optimal cut-off values of SI,SIRI,NLR,PLR and MLR determined by R0C curve were 739.83,1.65,3.14,151.95 and 0.37,respectively.Kaplan-Meier survival curve analysis showed that patients with chronic heart failure with high levels of SII(≥739.83),SIRI(≥1.65),NLR(≥3.14),PLR(≥151.95)and MLR(≥0.37)had higher incidence of all-cause death than patients with low levels of inflammatory markers(all P<0.001).Multivariate Cox proportional hazard regression analysis showed that age(HR=1.04,95%CI 1.01-1.06,P=0.002),NT-proBNP(HR=2.93,95%CI 1.64-5.23,P<0.001),SII≥739.83(HR=3.27,95%CI 1.18-9.02,P=0.022)and PLR≥151.95(HR=2.67,95%CI 1.02-6.96,P=0.045)were independent predictors of all-cause death in patients with chronic heart failure.ROC curve analysis showed that the predictive value of SII and PLR combined with NTproBNP(AUC=0.850)for the prognosis of patients with chronic heart failure was better than that of SII(AUC=0.779)、PLR(AUC=0.782)、NT-proBNP(AUC=0.727)and CRP(AUC=0.668)alone(all P<0.001).Conclusion Whole blood cell derived inflammatory markers—SII,PLR,and NT-pro BNP are independently associated with all-cause death in patients with chronic heart failure.SII and PLR can independently predict the prognosis of patients with chronic heart failure,combination of SII and PLR with NT-pro BNP has better predictive value for the prognosis of patients with chronic heart failure.展开更多
Background: Studies have found that the ratio of total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) was associated with the development of chronic kidney disease (CKD). However, the relationship in d...Background: Studies have found that the ratio of total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) was associated with the development of chronic kidney disease (CKD). However, the relationship in different genders was rarely discussed. The aim of this study was to explore this relationship and assess its predictive power for both males and females.Methods: Based on a prospective cohort platform in northwest China, 32,351 participants without CKD were collected in the baseline and followed up for approximately 5 years. Cox proportional hazard model and restricted cubic spline regression analysis were performed to investigate the association between TC, HDL-C, TC/HDL-C and CKD in adult female and male. The clinical application value of the indicators in predicting CKD was evaluated by the receiver operator characteristic curve.Results: During a mean follow-up of 2.2 years, 484 males and 164 females developed CKD. After adjusted for relevant confounders, for every one standard deviation increase in TC, HDL-C and TC/HDL-C, the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for CKD were 1.17 (1.05-1.31), 0.84 (0.71-0.99), and 1.15 (1.06-1.25) for males, 0.94 (0.78-1.13), 0.58 (0.35-0.95), and 1.19 (1.01-1.40) for females, respectively. The results also showed that TC, HDL-C, and TC/HDL-C were associated with CKD in a linear dose-response relationship. The TC/HDL-C had the largest area under the curve (AUC) compared to TC and HDL-C, and the AUC among the females was larger than that among males.Conclusions: The TC/HDL-C was significantly associated with CKD in adult males and females and has better clinical value in predicting CKD than TC and HDL-C, especially in females.展开更多
文摘BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gastrectomy;however,post-surgical pancreatic fistula remain a serious issue.These fistulas can lead to abdominal infections,anastomotic leakage,increased costs,and pain;thus,early diagnosis and prevention are crucial for a better prognosis.Currently,C-reactive protein(CRP),procalcitonin(PCT),and total bilirubin(TBil)levels are used to predict post-operative infections and anastomotic leakage.However,their predictive value for pancreatic fistula after radical gastrectomy for gastric cancer remains unclear.The present study was conducted to determine their predictive value.AIM To determine the predictive value of CRP,PCT,and TBil levels for pancreatic fistula after gastric cancer surgery.METHODS In total,158 patients who underwent radical gastrectomy for gastric cancer at our hospital between January 2019 and January 2023 were included.The patients were assigned to a pancreatic fistula group or a non-pancreatic fistula group.Multivariate logistic analysis was conducted to assess the factors influencing development of a fistula.Receiver operating characteristic(ROC)curves were used to determine the predictive value of serum CRP,PCT,and TBil levels on day 1 postsurgery.RESULTS On day 1 post-surgery,the CRP,PCT,and TBil levels were significantly higher in the pancreatic fistula group than in the non-pancreatic fistula group(P<0.05).A higher fistula grade was associated with higher levels of the indices.Univariate analysis revealed significant differences in the presence of diabetes,hyperlipidemia,pancreatic injury,splenectomy,and the biomarker levels(P<0.05).Logistic multivariate analysis identified diabetes,hyperlipidemia,pancreatic injury,CRP level,and PCT level as independent risk factors.ROC curves yielded predictive values for CRP,PCT,and TBil levels,with the PCT level having the highest area under the curve(AUC)of 0.80[95%confidence interval(CI):0.72-0.90].Combined indicators improved the predictive value,with an AUC of 0.86(95%CI:0.78-0.93).CONCLUSION Elevated CRP,PCT,and TBil levels predict risk of pancreatic fistula post-gastrectomy for gastric cancer.
基金Medical Research Project of Xi’an Science and Technology Bureau“Molecular Mechanism of miR-1305 Competitive Endogenous circRNA in the Development of Liver Cancer”(Project No.22YXYJ0134)General Project of Key Research and Development Program of Shaanxi Provincial Department of Science and Technology“Mechanism Study on the Inhibition of Liver Cancer Invasion and Metastasis by Downregulating METTL3 and Reducing the m6A Modification Level of MMP3 with Honokiol”(Project No.2023-YBSF-631)。
文摘Objective:To evaluate the predictive value of secreted phosphoprotein 1(SPP1)gene expression for postoperative survival in patients with advanced liver cancer undergoing hepatic artery interventional chemoembolization treatment.Method:Bioinformatics methods,including gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis,were used to identify genes related to survival prognosis in hepatocellular carcinoma(HCC)patients.A retrospective analysis of 115 advanced liver cancer patients treated between January 2016 and October 2017 was conducted.Patients were categorized into SPP1 high-expression(n=89)and low-expression groups(n=26).Additionally,115 healthy individuals served as the control group.The relationship between SPP1 expression and clinical pathological features was analyzed.A 60-month follow-up and logistic regression analysis identified risk factors affecting survival.Results:SPP1 mRNA expression was significantly higher in liver cancer patients compared to healthy controls(P<0.05).SPP1 expression levels were significantly associated with tumor size,Child-Pugh grading,lymph node metastasis,and BCLC staging(P<0.05).High SPP1 expression,along with tumor size,Child-Pugh grading,lymph node metastasis,and BCLC staging,were independent risk factors for survival(P<0.05).The 60-month survival rate was 17.39%,with a median survival of 40 months in the low-expression group versus 18 months in the high-expression group(P<0.05).Conclusion:SPP1 expression is significantly upregulated in advanced liver cancer patients and has predictive value for postoperative survival following hepatic artery chemoembolization treatment.SPP1,combined with clinical indicators such as tumor size,Child-Pugh grading,lymph node metastasis,and BCLC staging,may serve as a prognostic biomarker for interventional treatment outcomes.
文摘BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is often combined with respiratory failure,which increases the patient's morbidity and mortality.Diaphragm ultrasound(DUS)has developed rapidly in the field of critical care in recent years.Studies with DUS monitoring diaphragm-related rapid shallow breathing index have demonstrated important results in guiding intensive care unit patients out of the ventilator.Early prediction of the indications for withdrawal of non-invasive ventilator and early evaluation of patients to avoid or reduce disease progression are very important.AIM To explore the predictive value of DUS indexes for non-invasive ventilation outcome in patients with AECOPD.METHODS Ninety-four patients with AECOPD who received mechanical ventilation in our hospital from January 2022 to December 2023 were retrospectively analyzed,and they were divided into a successful ventilation group(68 cases)and a failed ventilation group(26 cases)according to the outcome of ventilation.The clinical data of patients with successful and failed noninvasive ventilation were compared,and the independent predictors of noninvasive ventilation outcomes in AECOPD patients were identified by multivariate logistic regression analysis.RESULTS There were no significant differences in gender,age,body mass index,complications,systolic pressure,heart rate,mean arterial pressure,respiratory rate,oxygen saturation,partial pressure of oxygen,oxygenation index,or time of inspiration between patients with successful and failed mechanical ventilation(P>0.05).The patients with successful noninvasive ventilation had shorter hospital stays and lower partial pressure of carbon dioxide(PaCO_(2))than those with failed treatment,while potential of hydrogen(pH),diaphragm thickening fraction(DTF),diaphragm activity,and diaphragm movement time were significantly higher than those with failed treatment(P<0.05).pH[odds ratio(OR)=0.005,P<0.05],PaCO_(2)(OR=0.430,P<0.05),and DTF(OR=0.570,P<0.05)were identified to be independent factors influencing the outcome of mechanical ventilation in AECOPD patients.CONCLUSION The DUS index DTF can better predict the outcome of non-invasive ventilation in AECOPD patients.
文摘Background Acute myocarditis is a disease characterized by inflammation of the heart muscle, usually caused by viral infection, autoimmune reactions, or toxins, resulting in damage and dysfunction of cardiomyocytes. In recent years, the incidence of acute myocarditis has gradually increased, especially in young people and athletes, which can cause serious cardiac complications and even lead to heart failure, cardiac arrest or major adverse cardiovascular events(MACEs). Methods A total of 90 patients with acute myocarditis(acute myocarditis group) and 30 healthy subjects(control group) admitted to our hospital from November 2021 to November 2023 were selected. Cardiac magnetic resonance(CMR) T1 and T2 mapping sequence scanning and cardiac function parameter measurement was performed on all subjects. The acute myocarditis group was followed up for 12 months and divided into the MACEs group and the non-MACEs group according to whether MACEs occurred. The differences in CMR parameters were analyzed, and receiver operating characteristic(ROC) curve was applied to analyze the predictive value of cardiac CMR T1 and T2 techniques for the occurrence of MACEs in patients with acute myocarditis. Results Compared with the control group, the level of left ventricular ejection fraction(LVEF) in the acute myocarditis group was significantly decreased, while left ventricular end-diastole volume(LVEDV), left ventricular endsystolic volume(LVESV), lactate dehydrogenase(LDH) and creatine kinase MB isoenzyme(CK-MB) increased significantly(P<0.05);T1 and T2 values, late gadolinium enhancement(LGE) percentage of left ventricle, left ventricular entropy and extracellular volume(ECV) in acute myocarditis group were significantly higher than those in the control group(P<0.05). Pearson correlation analysis showed that T1 and T2 values were negatively correlated with LVEF, while T1 and T2 values were positively correlated with LVESV, CK-MB, left ventricular entropy and ECV in patients with acute myocarditis(P<0.05). Among patients with acute myocarditis, the values of T1 and T2, left ventricular entropy and ECV in MACEs group were higher than those in non-MACEs group(P<0.05). Further multivariate analysis also showed that T1 and T2 values had independent predictive capacity for MACEs in patients with acute myocarditis(P<0.05). The maximum area under ROC curve was 0.894 and 0.912, and the sensitivity was 89.35% and 90.40% in patients with acute myocarditis predicted by T1 and T2 mapping. The specificity was 80.34% and 84.25%. Conclusions CMR T1 and T2 mapping techniques can effectively evaluate the cardiac function status of patients with acute myocarditis, and provide an important reference for the prognosis assessment of acute myocarditis.
文摘BACKGROUND:The major issue with intraoperative cholangiography (IOC) is whether its diagnostic accuracy for common bile duct (CBD) stones matches that of other diagnostic procedures,and thus,whether it will become a routine diagnostic procedure.The current study aimed to address the main determinants of CBD stone diagnosis in IOC among an Iranian population.METHODS:In a retrospective review database-based study conducted in Taleghani Hospital in Tehran between 2006 and 2008,baseline data and perioperative information of 2060 patients (male to female ratio 542:1518,mean age 53.7 years) who were candidates for cholecystectomy and underwent concomitant IOC for confirming CBD stones were reviewed.The predictive power of this procedure for diagnosis of abnormal biliary ducts with the focus on biliary stones was determined.RESULTS:Overall mortality and morbidity following cholecystectomy in the study population were 0.6% and 2.6%,respectively.Both early mortality and morbidity due to cholecystectomy were higher in male than female.The prevalence of CBD stones in IOC was 3.4% (5.2% in male and 2.8% in female,P=0.008).Among those without gallstones,8.7% had CBD stones and only 3.1% had concomitant gallstones and CBD stones.The main predictors of stone appearance as an abnormal feature of IOC during cholecystectomy were:advanced age (OR=1.022,P=0.001),male gender (OR=1.498,P=0.050),history of abdominal surgery (OR=1.543,P=0.040) and preoperative endoscopic retrograde cholangiopancreatography (OR=5.400,P<0.001).CONCLUSIONS:IOC is a safe and accurate method for the assessment of bile duct anatomy and stones.Therefore,the routine use of IOC within cholecystectomy seems reasonable and is recommended.
文摘As one of the earliest markers for predicting pregnancy outcomes, human chorionic gonadotropin(h CG) values have been inconclusive on reliability of the prediction after frozen and fresh embryo transfer(ET). In this retrospective study, patients with positive h CG(day 12 after transfer) were included to examine the h CG levels and their predictive value for pregnancy outcomes following 214 fresh and 1513 vitrified-warmed single-blastocyst transfer cycles. For patients who got clinical pregnancy, the mean initial h CG value was significantly higher after frozen cycles than fresh cycles, and the similar result was demonstrated for patients with live births(LB). The difference in h CG value existed even after adjusting for the potential covariates. The area under curves(AUC) and threshold values calculated by receiver operator characteristic curves were 0.944 and 213.05 m IU/m L for clinical pregnancy after fresh ET, 0.894 and 399.50 m IU/m L for clinical pregnancy after frozen ET, 0.812 and 222.86 m IU/m L for LB after fresh ET, and 0.808 and 410.80 m IU/mL for LB after frozen ET with acceptable sensitivity and specificity, respectively. In conclusion, single frozen blastocyst transfer leads to higher initial h CG values than single fresh blastocyst transfer, and the initial h CG level is a reliable predictive factor for predicting IVF outcomes.
文摘Aim: To determine the predictive value of the hypo-osmotic swelling (HOS) test to identify viable, non-motile sperm. Methods: Semen samples from 20 men with severe asthenozoospermia underwent traditional seminal analysis, eosin-nigrosin (EN) staining and the HOS test. A further EN stain was then performed on a HOS pre-treated aliquot and a total of 2000 further sperm examined. Results: The median sperm density was 5.1 million/mL (IQR 4.3-13.1) and the median motility was 3.0 % (IQR 0-7). Seven samples showed complete asthenozoospermia. Initial EN staining showed 59 % viability (range 48-69) despite the poor standard parameters and 47 % (range 33-61) in the complete asthenozoospermia subgroup. The HOS test showed 49.9 % reacted overall (range 40-59) and 41.7 % (range 22-61) in the complete asthenozoospermia subgroup. The combined HOS/EN stain showed the positive predictive value of the HOS test to identify viable sperm was 84.2 % overall and 79.7 % in the complete asthenozoospermia subgroup. Conclusion: The HOS test can effectively predict sperm viability in patients with severe and complete asthenozoospermia.
文摘This study aimed to compare the predictive value of six selected anthropometric indicators for benign prostatic hyperplasia(BPH).Males over 50 years of age who underwent health examinations at the Health Management Center of the Second Xiangya Hospital,Central South University(Changsha,China)from June to December 2020 were enrolled in this study.The characteristic data were collected,including basic anthropometric indices,lipid parameters,six anthropometric indicators,prostate-specific antigen,and total prostate volume.The odds ratios(ORs)with 95%confidence intervals(95%CIs)for all anthropometric parameters and BPH were calculated using binary logistic regression.To assess the diagnostic capability of each indicator for BPH and identify the appropriate cutoff values,receiver operating characteristic(ROC)curves and the related areas under the curves(AUCs)were utilized.All six indicators had diagnostic value for BPH(all P≤0.001).The visceral adiposity index(VAI;AUC:0.797,95%CI:0.759–0.834)had the highest AUC and therefore the highest diagnostic value.This was followed by the cardiometabolic index(CMI;AUC:0.792,95%CI:0.753–0.831),lipid accumulation product(LAP;AUC:0.766,95%CI:0.723–0.809),waist-to-hip ratio(WHR;AUC:0.660,95%CI:0.609–0.712),waist-to-height ratio(WHtR;AUC:0.639,95%CI:0.587–0.691),and body mass index(BMI;AUC:0.592,95%CI:0.540–0.643).The sensitivity of CMI was the highest(92.1%),and WHtR had the highest specificity of 94.1%.CMI consistently showed the highest OR in the binary logistic regression analysis.BMI,WHtR,WHR,VAI,CMI,and LAP all influence the occurrence of BPH in middle-aged and older men(all P≤0.001),and CMI is the best predictor of BPH.
基金the China-Japan Friendship Hospital Institutional Review Board,No.2021-117-K75.Youth Foundation of China–Japan Friendship Hospital,No.2019-1-QN-42。
文摘BACKGROUND Preoperative therapy is widely used in locally advanced rectal cancer.It can improve local control of rectal cancer.However,there are few indicators that can predict the effect of preoperative chemotherapy accurately.AIM To investigate whether the increase in serumα-fetoprotein(AFP)can predict better efficacy of preoperative chemotherapy.METHODS This was a retrospective study.We analyzed 125 patients admitted between 2017 and 2019 with locally advanced rectal cancer.All patients received six cycles of preoperative chemotherapy(mFOLFOX6 every 2 wk).Serum AFP of 26 patients rose slightly after three or four cycles of chemotherapy,and fell to normal again within 2 mo.The other 99 patients had a normal level of serum AFP during chemotherapy.Patients were divided into two groups(AFP risen and AFP normal).According to postoperative pathology,we compared tumor regression and complete response rate between the two groups.The primary outcome measure was the tumor regression grade(TRG)after chemotherapy.The difference in pathological complete response between the two groups was also investigated.RESULTS There were no tumor progression and distant metastasis in both groups during preoperative chemotherapy.Patients in the AFP risen group achieved better TRG 0/1 than those in the AFP normal group(61.5%vs 39.4%).The increase in AFP was a significant predictor for better tumor regression[χ2=4.144,odds ratio(OR)=2.666,P=0.04].In the AFP risen group,the complete response rate was 30.8%,which was higher than in the AFP normal group(30.8%vs 12.1%,χ2=4.542,OR=3.251,P=0.03).CONCLUSION Patients with a slight increase in serum AFP can achieve better tumor regression during preoperative chemotherapy,and are more likely to achieve pathological complete response.
基金Supported by the Key Research and Development Program of Shaanxi Province,No.2017ZDXMSF-046.
文摘BACKGROUND Irritable bowel syndrome(IBS)is a common functional bowel disease that shares features with many organic diseases and cannot be accurately diagnosed by symptom-based criteria.Alarm symptoms have long been applied in the clinical diagnosis of IBS.However,no study has explored the predictive value of alarm symptoms in suspected IBS patients based on the latest Rome IV criteria.AIM To investigate the predictive value of alarm symptoms in suspected IBS patients based on the Rome IV criteria.METHODS In this multicenter cross-sectional study,we collected data from 730 suspected IBS patients evaluated at 3 tertiary care centers from August 2018 to August 2019.Patients with IBS-like symptoms who completed colonoscopy during the study period were initially identified by investigators through medical records.Eligible patients completed questionnaires,underwent laboratory tests,and were assigned to the IBS or organic disease group according to colonoscopy findings and pathology results(if a biopsy was taken).Independent risk factors for organic disease were explored by logistic regression analysis,and the positive predictive value(PPV)and missed diagnosis rate were calculated.RESULTS The incidence of alarm symptoms in suspected IBS patients was 75.34%.Anemia[odds ratio(OR)=2.825,95%confidence interval(CI):1.273-6.267,P=0.011],fecal occult blood[OR=1.940(95%CI:1.041-3.613),P=0.037],unintended weight loss(P=0.009),female sex[OR=0.560(95%CI:0.330-0.949),P=0.031]and marital status(P=0.030)were independently correlated with organic disease.The prevalence of organic disease was 10.41%in suspected IBS patients.The PPV of alarm symptoms for organic disease was highest for anemia(22.92%),fecal occult blood(19.35%)and unintended weight loss(16.48%),and it was 100%when these three factors were combined.The PPV and missed diagnosis rate for diagnosing IBS were 91.67%and 74.77%when all alarm symptoms were combined with Rome IV and 92.09%and 34.10%when only fecal occult blood,unintended weight loss and anemia were combined with Rome IV,respectively.CONCLUSION Anemia,fecal occult blood and unintended weight loss have high predictive value for organic disease in suspected IBS patients and can help identify patients requiring further examination but are not recommended as exclusion criteria for IBS.
文摘<strong>Objective:</strong> To assess the diagnostic accuracy and predictive values of clinical symptoms in patients with suspected mild COVID-19 to identify target groups for self-isolation and outpatient treatment without additional testing. <strong>Methods:</strong> We conducted an open-label prospective study in patients aged 18 to 72 years with suspected mild COVID-19. The clinical diagnosis was based on the acute onset of such symptoms as olfactory dysfunction, hyperthermia, myalgia, nasal congestion, nasal discharge, cough, rhinolalia, sore throat, without pneumonia in persons in contact with a confirmed case of COVID-19. The physician assessed clinical symptoms using a 4-point scale. The patient self-assessed clinical symptoms using a ten-point visual analogue scale (VAS). All enrolled patients underwent laboratory testing to confirm the diagnosis of COVID-19. <strong>Results:</strong> Of the 120 patients underwent testing, the diagnosis of mild COVID-19 was confirmed in 96 patients and ruled out in 24 patients. When assessing symptoms by a physician according to the correlation analysis, hyperthermia, myalgia, nasal congestion and rhinolalia have a positive predictive value with a significance level of more than 0.6. When self-assessing symptoms by a patient, fever, myalgia and nasal congestion have a diagnostic accuracy with a significance level of more than 0.5. Nasal discharge, cough and sore throat have negative predictive values. <strong>Conclusion: </strong>The presence of these symptoms in patients with an acute onset of the disease can help to make a clinical diagnosis of coronavirus disease and identify target groups for self-isolation and outpatient treatment without additional testing. Highly suspect asymptomatic patients are not considered as those who have possible mild COVID-19 infection.
文摘AIM:To determine which features of history and demographics predict a diagnosis of malignancy or peptic stricture in patients presenting with dysphagia.METHODS:A prospective case-control study of 2000 consecutive referrals(1031 female,age range:17-103 years) to a rapid access service for dysphagia,based in a teaching hospital within the United Kingdom,over 7 years.The service consists of a nurse-led telephone triage followed by investigation(barium swallow or gastroscopy),if appropriate,within 2 wk.Logistic regression analysis of demographic and clinical variables was performed.This includes age,sex,duration of dysphagia,whether to liquids or solids,and whether there are associated features(reflux,odynophagia,weight loss,regurgitation).We determined odds ratio(OR) for these variables for the diagnoses of malignancy and peptic stricture.We determined the value of the Edinburgh Dysphagia Score(EDS) in predicting cancer in our cohort.Multivariate logistic regression was performed and P < 0.05 considered significant.The local ethics committee confirmed ethics approval was not required(audit).RESULTS:The commonest diagnosis is gastro-esophageal reflux disease(41.3%).Malignancy(11.0%) and peptic stricture(10.0%) were also relatively common.Malignancies were diagnosed by histology(97%) or on radiological criteria,either sequential barium swallows showing progression of disease or unequivocal evidence of malignancy on computed tomography.The majority of malignancies were esophago-gastric in origin but ear,nose and throat tumors,pancreatic cancer and extrinsic compression from lung or mediastinal metastatic cancer were also found.Malignancy was statistically more frequent in older patients(aged >73 years,OR 1.1-3.3,age < 60 years 6.5%,60-73 years 11.2%,> 73 years 11.8%,P < 0.05),males(OR 2.2-4.8,males 14.5%,females 5.6%,P < 0.0005),short duration of dysphagia(≤ 8 wk,OR 4.5-20.7,16.6%,8-26 wk 14.5%,> 26 wk 2.5%,P < 0.0005),progressive symptoms(OR 1.3-2.6:progressive 14.8%,intermittent 9.3%,P < 0.001),with weight loss of ≥ 2 kg(OR 2.5-5.1,weight loss 22.1%,without weight loss 6.4%,P < 0.0005) and without reflux(OR 1.2-2.5,reflux 7.2%,no reflux 15.5%,P < 0.0005).The likelihood of malignancy was greater in those who described true dysphagia(food or drink sticking within 5 s of swallowing than those who did not(15.1%vs 5.2% respectively,P < 0.001).The sensitivity,specificity,positive predictive value and negative predictive value of the EDS were 98.4%,9.3%,11.8% and 98.0% respectively.Three patients with an EDS of 3(high risk EDS ≥ 3.5) had malignancy.Unlike the original validation cohort,there was no difference in likelihood of malignancy based on level of dysphagia(pharyngeal level dysphagia 11.9% vs mid sternal or lower sternal dysphagia 12.4%).Peptic stricture was statistically more frequent in those with longer duration of symptoms(> 6 mo,OR 1.2-2.9,≤ 8 wk 9.8%,8-26 wk 10.6%,> 26 wk 15.7%,P < 0.05) and over 60 s(OR 1.2-3.0,age < 60 years 6.2%,60-73 years 10.2%,> 73 years 10.6%,P < 0.05).CONCLUSION:Malignancy and peptic stricture are frequent findings in those referred with dysphagia.The predictive value for associated features could help determine need for fast track investigation whilst reducing service pressures.
文摘In this retrospective study, a total of 275 solid masses were examined for cytopathologic diagnosis. Twenty four percent (67/275) of these cytologic samples were followed by surgical biopsy and histopathologic diagnosis, allowing for comparisons. On average, the cutaneous and subcutaneous solid masses were recognized when the dogs were aged between 6 and 9 years old. The origins of the solid masses included connective tissue tumors 37.1% (23/62), epithelial tissue tumors 33.9% (21/62), round cell tumors 19.4% (12/62), masses of inflammatory lesions 4.8% (3/62) and lesions due to other causes 4.8% (3/62). The sensitivity and positive predictive value (PPV) of cytopathology in the diagnosis of solid masses were 93% (62/67) and 97% (62/64), respectively. Generally, neo-plasms were over diagnosed by cytopathology as was indicated by the positive predictive value. Both the sensitivity and the PPV of cytopathology comparative to histopathology in the diagnosis of inflammatory processes were 100% (3/3). The inflammatory lesions were eventually confirmed as necrotizing myositis, necro-suppurative cystitis and endocrine inflammatory dermatopathy based on histopathology. Less than 8% (5/67) of samples were incorrectly diagnosed by cytology. The study showed high accuracy between cytological and histopathological examination of solid masses in dogs, and thus a reliable diagnostic tool in patient care.
基金the grant from SPPH Incubator Fund for Development of Science and Technology(2021YJY-19)SPPH Foundation for Development of Science and Technology(2021BJ-26)International Science and Technology Cooperation Projects of Shaanxi Province(2022KW-14).
文摘Objective:To study the predictive value of serum pregenomic RNA(pgRNA)on HBeAg clearance in patients with chronic hepatitis B with low HBeAg levels during pegylated interferon therapy.Methods:Twenty chronic hepatitis B patients with HBeAg positive and quantitative<50S/CO were selected for this study.The subjects underwent pegylated interferon therapy for 48-96 weeks and were followed up in the outpatient clinic after treatment.The patients were then divided into groups based on whether their HbeAg turned negative.The predictive ability of each indicator for HBeAg negative conversion was evaluated in the HBeAg negative group and the HBeAg positive group.Results:The results of logistic regression analysis suggested that pgRNA and HBcrAg were better indicators for predicting the clearance of HBeAg after treatment.Conclusion:For patients with chronic hepatitis B with low HBeAg levels,pgRNA is a good indicator in predicting HBeAg clearance during pegylated interferon therapy.
文摘Objective: to investigate the predictive value of folic acid metabolism gene polymorphism in pregnancy for birth defects. Methods: a total of 2019 pregnant women were collected from our hospital from January 2020 to December 2020. The data of MTHFR, Hcy, vitamin B12, folic acid (FA) and other data of pregnant women were detected during the first pregnancy examination. According to the Results of Down's screening, the data of 2019 pregnant women were divided into two groups. Observation group: 1010 pregnant women with moderate and high down's disease risk;Control group: 1009 cases of pregnant women with low or no down's disease risk were given folic acid for 3 months, and then the statistics were collected. Meanwhile, the occurrence of birth defects in the two groups were compared, and the predictive value of folic acid metabolism gene polymorphism on birth defects was analyzed. Results: after intervention, folic acid increased significantly in both groups, Hcy decreased in both groups (P<0.05), but the comparison between groups (P>0.05);The incidence of birth defects in control group was slightly lower than that in observation group (P<0.05). Conclusion: polymorphism of folic acid metabolism gene can be used to preliminarily evaluate the risk of birth defects, and folic acid supplementation can be used to reduce the incidence of birth defects in pregnant women.
文摘Objective To evaluate the performance of the Sino System for Coronary Operative Risk Evaluation (SinoSCORE) on in hospital mortality and postoperative complications in patients undergoing coronary artery bypass grafting (CABG) in a single heart center. Methods From January 2007 to December 2008,clinical information of 201 consecutive patients undergoing isolated CABG in our hospital was collected. The SinoSCORE was used to
文摘Objective To investigate the correlation of Clq/tumor necrosis factor-related protein-6(CTRP6),Irisin and type 2 diabetes mellitus(T2DM).Methods A total of 80 T2DM patients who visited the Endocrinology Department of Bayannur City Hospital from March 2022 to October 2022 were selected as the T2DM group,and 80 healthy subjects were selected as the normal control(NC)group.Serum CTRP6,Irisin,adiponectin(APN),tumor necrosis factor alpha(TNF-α),interleukin 6(IL-6),fasting plasma glucose(FPG),Blood glucose 2 h after 25 g glucose load(2 hPG),fasting insulin(FIns),insulin resistance index(HOMAIR),glycated hemoglobin(HbA,c),body mass index(BMI)and visceral fat area(VFA)were measured and compared between the two group.Results Compared with the NC group,the serum CTRP6 level in the study group was significantly increased[(150.69±29.57)us(116.05±29.06)pg/ml,P<0.05],and the Irisin level was significantly decreased[145.56(117.50,191.75)vs 205.19(142.15,334.69)pg/ml,P<0.05]in T2DM group.Spearman correlation analysis showed that serum CTRP6 was positively correlated with BMI,VFA,FPG,2 hPG,FIns,HOMA-IR,HbA_(1)c,IL-6,and TNF-α(r=0.255,0.243,0.500,0.434,0.237,0.456,0.470,0.284and0.222,P<0.05)and negatively correlated with age(r=-0.113,P<0.05).Serum Irisin was negatively correlated with BMI,FPG,2 hPG,HOMA-IR and HbA,c(r=-0.201,-0.295,-0.278,-0.234 and-0.352,P<0.05),and positively correlated with APN and IL-6(r=0.248,0.248,P<0.05).Multiple linear regression analysis showed that VFA,FIns,HOMA-IR,APN and IL-6 were independent influencing factors of CTRP6,and IL-6 was an independent influencing factor of Irisin.Logistic regression analysis showed that HOMA-IR,CTRP6 and Irisin were independent predictors of T2DM.Receiver operating characteristic curve analysis showed that the area under the curve(AUC)of serum CTRP6 for predicting T2DM was 0.795,the AUC of serum Irisin for predicting T2DM was 0.669,and the AUC of the combination predicting T2DM was 0.832.Conclusion Serum CTRP6 and Irisin are closely related to T2DM and have high predictive value for T2DM.
文摘Objective To investigate the early predictive value of ECG PR interval for the risk of coronary heart disease(CHD) in patiens with T2DM.Methods A total of 7 886 participants from Guiyang enrolled in the REACTION study between May and August 2011 were included.
文摘blood cell derived inflammatory nmarker(including systemic immunoinflammatory index(SI),systemic inflammatory response index(SIRI),neutrophil count/lymphocyte count(NLR),platelet count/lymphocyte count(PLR),and monocyte count/lymphocyte count(MLR))and in combination with N-terminal pro-B-type natriuretic peptide(NT-proBNP)on the prognosis of patients with chronic heart failure.Methods This study was a retrospective cohort study.Patients with chronic heart failure hospitalized in the Department of Cardiovascular Medicine,Nanfang Hospital,Southern Medical University from January 2019 to August 2022 were enrolled.Patients were followed up and were divided into survival group and death group according to the follow-up results.Clinical characteristics of the two groups were compared.Receiver operating characteristic(ROC)curve was used to determine the optimal cut-off value of each whole blood cell derived inflammatory marker for predicting all-cause death in patients with chronic heart failure.Kaplan-Meier survival curve was drawn,and log-rank test was used to compare the difference in survival of chronic heart failure patients with different levels of whole blood cell derived inflammatory markers.Univariate and multivariate Cox proportional hazards models were used to analyze the effects of whole blood cell derived inflammatory markers and NT-proBNP on the all-cause death of patients with chronic heart failure.ROC curve was used to analyze the predictive value of whole blood cell derived inflammatory markers combined with NT-proBNP on the prognosis of patients with chronic heart failure.Results A total of 324 patients with heart failure aged(64.76±13.78)years were enrolled,with 212 males(65.43%).297 patients(91.67%)completed follow-up,27 patients(8.33%)were lost to follow-up.The follow-up time was 24.O(18.0,41.8)months.There were 258 patients in the survival group and 66 patients in the death group.The optimal cut-off values of SI,SIRI,NLR,PLR and MLR determined by R0C curve were 739.83,1.65,3.14,151.95 and 0.37,respectively.Kaplan-Meier survival curve analysis showed that patients with chronic heart failure with high levels of SII(≥739.83),SIRI(≥1.65),NLR(≥3.14),PLR(≥151.95)and MLR(≥0.37)had higher incidence of all-cause death than patients with low levels of inflammatory markers(all P<0.001).Multivariate Cox proportional hazard regression analysis showed that age(HR=1.04,95%CI 1.01-1.06,P=0.002),NT-proBNP(HR=2.93,95%CI 1.64-5.23,P<0.001),SII≥739.83(HR=3.27,95%CI 1.18-9.02,P=0.022)and PLR≥151.95(HR=2.67,95%CI 1.02-6.96,P=0.045)were independent predictors of all-cause death in patients with chronic heart failure.ROC curve analysis showed that the predictive value of SII and PLR combined with NTproBNP(AUC=0.850)for the prognosis of patients with chronic heart failure was better than that of SII(AUC=0.779)、PLR(AUC=0.782)、NT-proBNP(AUC=0.727)and CRP(AUC=0.668)alone(all P<0.001).Conclusion Whole blood cell derived inflammatory markers—SII,PLR,and NT-pro BNP are independently associated with all-cause death in patients with chronic heart failure.SII and PLR can independently predict the prognosis of patients with chronic heart failure,combination of SII and PLR with NT-pro BNP has better predictive value for the prognosis of patients with chronic heart failure.
基金Municipal Science and Technology Program of Wuwei City, China(Grant/Award Number: WW2202RPZ037)Fundamental Research Funds for the Central Universities in China(Grant/Award Number: lzujbky-2018-69)。
文摘Background: Studies have found that the ratio of total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) was associated with the development of chronic kidney disease (CKD). However, the relationship in different genders was rarely discussed. The aim of this study was to explore this relationship and assess its predictive power for both males and females.Methods: Based on a prospective cohort platform in northwest China, 32,351 participants without CKD were collected in the baseline and followed up for approximately 5 years. Cox proportional hazard model and restricted cubic spline regression analysis were performed to investigate the association between TC, HDL-C, TC/HDL-C and CKD in adult female and male. The clinical application value of the indicators in predicting CKD was evaluated by the receiver operator characteristic curve.Results: During a mean follow-up of 2.2 years, 484 males and 164 females developed CKD. After adjusted for relevant confounders, for every one standard deviation increase in TC, HDL-C and TC/HDL-C, the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for CKD were 1.17 (1.05-1.31), 0.84 (0.71-0.99), and 1.15 (1.06-1.25) for males, 0.94 (0.78-1.13), 0.58 (0.35-0.95), and 1.19 (1.01-1.40) for females, respectively. The results also showed that TC, HDL-C, and TC/HDL-C were associated with CKD in a linear dose-response relationship. The TC/HDL-C had the largest area under the curve (AUC) compared to TC and HDL-C, and the AUC among the females was larger than that among males.Conclusions: The TC/HDL-C was significantly associated with CKD in adult males and females and has better clinical value in predicting CKD than TC and HDL-C, especially in females.
