A Receiver Operating Characteristic(ROC)analysis of a power is important and useful in clinical trials.A Classical Conditional Power(CCP)is a probability of a classical rejection region given values of true treatment ...A Receiver Operating Characteristic(ROC)analysis of a power is important and useful in clinical trials.A Classical Conditional Power(CCP)is a probability of a classical rejection region given values of true treatment effect and interim result.For hypotheses and reversed hypotheses under normal models,we obtain analytical expressions of the ROC curves of the CCP,find optimal ROC curves of the CCP,investigate the superiority of the ROC curves of the CCP,calculate critical values of the False Positive Rate(FPR),True Positive Rate(TPR),and cutoff of the optimal CCP,and give go/no go decisions at the interim of the optimal CCP.In addition,extensive numerical experiments are carried out to exemplify our theoretical results.Finally,a real data example is performed to illustrate the go/no go decisions of the optimal CCP.展开更多
Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR wer...Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific factor. 4) Among subjects with BMI≥28 kg/m2 or WC≥95 cm, 95% of men and 90% of women appeared to have abdominal visceral obesity. Conclusion Measurements of BMI, WC, and WHR can be used in the prediction of abdominal visceral obesity, of which WC was the one with better accuracy.展开更多
BACKGROUND： The various combination of multiphase enhancement multislice spiral CT （MSCT） makes the diagno- sis of a small hepatocellular carcinoma （sHCC） on the back- ground of liver cirrhosis possible. This stu...BACKGROUND： The various combination of multiphase enhancement multislice spiral CT （MSCT） makes the diagno- sis of a small hepatocellular carcinoma （sHCC） on the back- ground of liver cirrhosis possible. This study was to explore whether the combination of MSCT enhancement scan and alpha-fetoprotein （AFP） level ficiency for sHCC. could increase the diagnostic ef- METHODS： This study included 35 sHCC patients and 52 cir- rhotic patients without image evidence of HCC as a control group. The diagnoses were made by three radiologists em- ploying a 5-point rating scale, with postoperative pathologic results as the gold standard. Receiver operating characteristic （ROC） curve analysis was performed to evaluate the diag- nostic value of the three MSCT combination modes （arterial phase＋portal-venous phase, arterial phase＋delayed phase, arterial phase＋portal-venous phase＋delayed phase） and AFP levels for sHCC on the background of liver cirrhosis. RESULTS： The area under ROC curve （AUC）, sensitivity, and specificity of the combination of arterial phase＋portal- venous phase＋delayed phase were 0.93, 93%, and 82%, respectively. The average AUC of the arterial phase＋portal- venous phase＋delayed phase combination was significantly greater than that of the arterial phase＋portal-venous phase （AUC=0.84, P=0.01） and arterial phase＋delayed phase （AUC=0.85, P=0.03）. Arterial phase＋portal-venous phase had a smaller AUC （0.84） than arterial phase＋delayed phase （0.85）, but the difference was insignificant （P=0.15）. After combining MSCT enhancement scan with AFP, the AUC, sensitivity, and specificity were 0.95, 94%, and 83%, respectively, indicating a greatly increased diagnostic efficiency for sHCC. CONCLUSIONS： The combination of AFP and 3 phases MSCT enhancement scan could increase the diagnostic efficiency for sHCC on the background of liver cirrhosis. The application of ROC curve analysis has provided a new method and reference in HCC diagnosis.展开更多
Aim： To assess that metabolic status of spermatozoa could provide a useful tool for evaluation of semen quality. Methods： The accuracy of the spectrophotometric application of the resazurin reduction assay was asses...Aim： To assess that metabolic status of spermatozoa could provide a useful tool for evaluation of semen quality. Methods： The accuracy of the spectrophotometric application of the resazurin reduction assay was assessed using receiver operating characteristic （ROC） analysis. Results： Areas under ROC curves （AUC） for motile sperm concentration and sperm index （SI） （sperm concentration multiplied by the square root of percentage sperm motility multiplied by the percentage normal sperm morphology） were 0.922. The best discrimination between poor and good semen samples according to the SI was achieved at a cut-off point of A610 = 0.209, where high sensitivity （94.1%） and specificity （91.7%） were calculated. The assay was less accurate when motile sperm concentration was used as the criterion value, yielding sensitivity of 88.2% and specificity of 87.5%, respectively. Likelihood ratios （LR） indicate that absorbances lower than 0.209 were at least 11.3 times as likely to be found in good semen samples than those in poor according to the SI, whereas in the case of motile sperm concentration, the LR was calculated to be 7.06. Conclusion： These results show that the resazurin reduction assay combined with spectrophotometry is an accurate method of assessing the quality of boar semen.展开更多
Objective： To establish the diagnostic quantitative criteria for fire-heat syndrome （FHS） of Chinese medicine （CM） based on the receiver operating characteristic （ROC） curve and principal component analysis （...Objective： To establish the diagnostic quantitative criteria for fire-heat syndrome （FHS） of Chinese medicine （CM） based on the receiver operating characteristic （ROC） curve and principal component analysis （PCA）. Methods： The symptoms and signs of FHS cases and healthy subjects from Guangzhou, Henan and Hunan of China were collected through questionnaire, and the diagnostic quantitative score tables were established for the three regions, respectively, with the method of maximum likelihood analysis. The homogeneity test was then performed on the diagnostic score tables for the three regions with ROC curve, and the diagnostic efficiency of diagnostic score tables for the three regions was compared with the prospective test and retrospective test. The method of PCA was adopted to obtain the analysis matrix for classifying the tapes of FHS. Results： Twenty-seven elements of FHS were confirmed through Chi-square test, and the diagnostic score tables for the three regions were established with the method of maximum likelihood analysis on the basis of the collected case data. According to the ROC curve test, the areas under ROC curve of Guangzhou diagnostic score table assessment with candidates in Guangzhou, Henan and Hunan were 0.998, 0.961 and 0.956, respectively. It showed that the diagnostic efficiency of Guangzhou diagnostic score tables was the highest one. With the prospective test, the area under ROC of Guangzhou diagnostic score table was 0.949, and more than any other diagnostic score table. By PCA, FHS was classified into excess fire and deficiency fire, and then classified into syndrome of flaring up of Heart （Xin） fire, syndrome of Lung （Fei）-Stomach （Wei） excess fire, syndrome of deficiency of Liver （Gan）-yin and Kidney （Shen）-yin, and syndrome of deficiency of Lung-yin from the view of viscera. In the retrospective test, the consistency with clinicians＇ diagnosis was 69.4%, and in the prospective test, it was 70.1%. Conclusions： The Guangzhou diagnostic score table could be used as the recommended criteria for the diagnosis of FHS. The classification of FHS was basically in conformity with the clinical situation.展开更多
Along with the development of digital X-ray imaging technology, a new, economical and practicalpaper-based output system gradually emerged. To reduce cost, more and more radiologic institutions began to change from fi...Along with the development of digital X-ray imaging technology, a new, economical and practicalpaper-based output system gradually emerged. To reduce cost, more and more radiologic institutions began to change from film copies to lower-priced paper prints for documenting radiologic findings.Therefore, laser paper printers are frequently used as an alternative to duplicating film though the use of printed images is not yet widespread. The aim of this study was to compare the practical value of high-resolution paper printer with dry film copies for detecting small solitary pulmonary nodules （SPNs）.展开更多
Aim:To assess that metabolic status of spermatozoa could provide a useful tool for evaluation of semen quality. Methods:The accuracy of the spectrophotometric application of the resazurm reduction assay was assessed u...Aim:To assess that metabolic status of spermatozoa could provide a useful tool for evaluation of semen quality. Methods:The accuracy of the spectrophotometric application of the resazurm reduction assay was assessed using receiver operating characteristic(ROC)analysis.Results:Areas under ROC curves(AUC)for motile sperm concen- tration and sperm index(SI)(sperm concentration multiplied by the square root of percentage sperm motility multi- plied by the percentage normal sperm morphology)were 0.922.The best discrimination between poor and good semen samples according to the SI was achieved at a cut-off point of A_(610)=0.209,where high sensitivity(94.1%)and specificity(91.7%)were calculated.The assay was less accurate when motile sperm concentration was used as the criterion value,vielding sensitivity of 88.2% and specificity of 87.5%,respectively,Likelihood ratios(LR)indicate that absorbances lower than 0.209 were at least 11.3 times as likely to be found in good semen samples than those in poor according to the SI,whereas in the case of motile sperm concentration,the LR was calculated to be 7.06.Conclusion: These results show that the resazurin reduction assay combined with spectrophotometry is an accurate method of assessing the quality of boar semen.展开更多
Freezing of gait is a significant and debilitating motor symptom often observed in individuals with Parkinson's disease.Resting-state functional magnetic resonance imaging,along with its multi-level feature indice...Freezing of gait is a significant and debilitating motor symptom often observed in individuals with Parkinson's disease.Resting-state functional magnetic resonance imaging,along with its multi-level feature indices,has provided a fresh perspective and valuable insight into the study of freezing of gait in Parkinson's disease.It has been revealed that Parkinson's disease is accompanied by widespread irregularities in inherent brain network activity.However,the effective integration of the multi-level indices of resting-state functional magnetic resonance imaging into clinical settings for the diagnosis of freezing of gait in Parkinson's disease remains a challenge.Although previous studies have demonstrated that radiomics can extract optimal features as biomarkers to identify or predict diseases,a knowledge gap still exists in the field of freezing of gait in Parkinson's disease.This cross-sectional study aimed to evaluate the ability of radiomics features based on multi-level indices of resting-state functional magnetic resonance imaging,along with clinical features,to distinguish between Parkinson's disease patients with and without freezing of gait.We recruited 28 patients with Parkinson's disease who had freezing of gait(15 men and 13 women,average age 63 years)and 30 patients with Parkinson's disease who had no freezing of gait(16 men and 14 women,average age 64 years).Magnetic resonance imaging scans were obtained using a 3.0T scanner to extract the mean amplitude of low-frequency fluctuations,mean regional homogeneity,and degree centrality.Neurological and clinical characteristics were also evaluated.We used the least absolute shrinkage and selection operator algorithm to extract features and established feedforward neural network models based solely on resting-state functional magnetic resonance imaging indicators.We then performed predictive analysis of three distinct groups based on resting-state functional magnetic resonance imaging indicators indicators combined with clinical features.Subsequently,we conducted 100 additional five-fold cross-validations to determine the most effective model for each classification task and evaluated the performance of the model using the area under the receiver operating characteristic curve.The results showed that when differentiating patients with Parkinson's disease who had freezing of gait from those who did not have freezing of gait,or from healthy controls,the models using only the mean regional homogeneity values achieved the highest area under the receiver operating characteristic curve values of 0.750(with an accuracy of 70.9%)and 0.759(with an accuracy of 65.3%),respectively.When classifying patients with Parkinson's disease who had freezing of gait from those who had no freezing of gait,the model using the mean amplitude of low-frequency fluctuation values combined with two clinical features achieved the highest area under the receiver operating characteristic curve of 0.847(with an accuracy of 74.3%).The most significant features for patients with Parkinson's disease who had freezing of gait were amplitude of low-frequency fluctuation alterations in the left parahippocampal gyrus and two clinical characteristics:Montreal Cognitive Assessment and Hamilton Depression Scale scores.Our findings suggest that radiomics features derived from resting-state functional magnetic resonance imaging indices and clinical information can serve as valuable indices for the identification of freezing of gait in Parkinson's disease.展开更多
Background： To combine dinicopathological characteristics associated with lymph node metastasis for submucosal gastric cancer into a nomogram. Methods： We retrospectively analyzed 262 patients with submucosal gastri...Background： To combine dinicopathological characteristics associated with lymph node metastasis for submucosal gastric cancer into a nomogram. Methods： We retrospectively analyzed 262 patients with submucosal gastric cancer who underwent D2 gastrectomy between 1996 and 2012. The relationship between lymph node metastasis and clinicopathological features was statistically analyzed. With multivariate logistic regression analysis, we made a nomogram to predict the possibility of lymph node metastasis. Receiver operating characteristic （ROC） analysis was also performed to assess the predictive value of the model. Discrimination and calibration were performed using internal validation. Results： A total number of 48 （18.3%） patients with submucosal gastric cancer have pathologically lymph node metastasis. For submucosal gastric carcinoma, lymph node metastasis was associated with age, tumor location, macroscopic type, size, differentiation, histology, the existence of ulcer and lymphovascular invasion in univariate analysis （all P〈0.05）. The multivariate logistic old, macroscopic type III or mixed, undifferentiated type, regression analysis identified that age _〈50 years and presence of lymphovascular invasion were independent risk factors of lymph node metastasis in submucosal gastric cancer （all P〈0.05）. We constructed a predicting nomogram with all these factors for lymph node metastasis in submucosal gastric cancer with good discrimination [area under the curve （AUC） =0.844]. Internal validation demonstrated a good discrimination power that the actual probability corresponds closely with the predicted probability. Conclusions： We developed a nomogram to predict the rate of lymph node metastasis for submucosal gastric cancer. With good discrimination and internal validation, the nomogram improved individualized predictions for assisting clinicians to make appropriated treatment decision for submucosal gastric cancer patients.展开更多
BACKGROUND Contrast-enhanced ultrasonography(CEUS)is utilized to assess the therapeutic efficacy of interventional therapy in liver cancer patients,offering insights into tumor blood flow changes,angiogenesis,and tumo...BACKGROUND Contrast-enhanced ultrasonography(CEUS)is utilized to assess the therapeutic efficacy of interventional therapy in liver cancer patients,offering insights into tumor blood flow changes,angiogenesis,and tumor markers.AIM To evaluate the use of CEUS in examining the effectiveness of interventional therapy for liver cancer,we aim to investigate its diagnostic utility for tumor perfusion patterns,microvessel density,perfusion recovery,blood flow enhancement response,and alterations in tumor markers among patients receiving interventional therapy for liver cancer.METHODS The study involved 124 patients who underwent interventional therapy for liver cancer at Guangzhou First People’s Hospital from January 2022 to February 2024.All patients were examined using CEUS before treatment and at 1 month,3 months,and 6 months,and the concentrations of tumor markers were collected and statistically analyzed using Statistical Package for the Social Sciences 25.0.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic efficacy of CEUS and analyze its sensitivity,specificity,and correlation with clinical indicators.RESULTS Before treatment,tumor blood flow was primarily enhanced.After treatment,enhanced perfusion declined,while uniform and non-uniform perfusion increased,indicating reduced tumor activity.Enhanced perfusion decreased from 68.25%before treatment to 53.75%at 6 months post-treatment(F=6.123,P=0.016),indicating reduced tumor activity.The microvessel density of the tumors decreased significantly after treatment(P<0.05),and the proportion of low microvessel density increased.After treatment,perfusion recovery in the tumor area improved,the proportion of complete and partial responses gradually increased,and the proportion of stable lesions decreased(P<0.05).The levels of alphafetoprotein,carcinoembryonic antigen,and carbohydrate antigen 19-9 decreased by 68.7%,30.4%,and 41.6%,respectively,at 6 months post-treatment(P<0.05).CEUS showed a sensitivity of 85.72%,specificity of 92.31%,and area under the curve of 0.911(95%CI:0.883–0.939)for evaluating treatment response.ROC curve analysis showed that CEUS had high sensitivity and specificity and could effectively evaluate the efficacy of interventional therapy for liver cancer.CONCLUSION CEUS has high diagnostic value in evaluating therapeutic effects in patients with liver cancer following interventional therapy.It can reflect changes in tumor blood flow,angiogenesis,and tumor marker levels,providing an effective basis for real-time monitoring of treatment outcomes.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is the most common pathological type of liver cancer and was the third leading cause of cancer-related deaths worldwide in 2020.AIM To evaluate the diagnostic potential of key t...BACKGROUND Hepatocellular carcinoma(HCC)is the most common pathological type of liver cancer and was the third leading cause of cancer-related deaths worldwide in 2020.AIM To evaluate the diagnostic potential of key tumor markers in serum,bile,and fecal samples for detecting HCC.METHODS Blood,bile,and fecal samples were collected from patients(n=265)with HCC and cholecystitis from Guangxi Medical University’s First Affiliated Hospital.Immunohistochemistry was performed on 69 HCC samples,and 16S ribosomal RNA sequencing was conducted on 166 fecal samples.Tumor marker cut-off values in bile and feces were determined using the Youden index,while serum biomarkers followed hospital standards.Diagnostic performance was evaluated using receiver operating characteristic analysis.RESULTS The areas under the curve(AUCs)for distinguishing HCC were 0.898,0.904,and 0.859 for serum alpha-fetoprotein(AFP),prothrombin induced by vitamin K absence-II(PIVKA-II),and bile AFP,respectively.Serum AFP had the highest diagnostic value(80%)for early-stage HCC.Combination analysis found that bile AFP and serum PIVKAII achieved the highest AUC of 0.965(P<0.001),suggesting that bile AFP may serve as a valuable complementary biomarker,particularly in cases where serum AFP is not significantly elevated.Additionally,bile AFP was positively correlated with Actinomyces,which plays a significant role in promoting tumorigenesis;and was negatively correlated with Faecalibacterium,which was associated with robust anticancer immune responses(P<0.05).These findings suggest the potential role of gut microbiota in modulating AFP levels and HCC progression.CONCLUSION Bile AFP improved the sensitivity of HCC detection,with the combination of bile AFP and PIVKA-II demonstrating the highest AUC for HCC diagnosis.AFP is associated with poorer clinical outcomes.展开更多
BACKGROUND With the increasing global incidence of mental illness,depression has become a serious problem among college students.AIM To investigate the relationship between depression and its correlates in Chinese ado...BACKGROUND With the increasing global incidence of mental illness,depression has become a serious problem among college students.AIM To investigate the relationship between depression and its correlates in Chinese adolescents and to identify diagnostic predictors of depression,examine the effects of binge eating,physical activity,and body dissatisfaction on depression among college students and to determine a diagnostic cutoff value for depression based on body dissatisfaction.METHODS We conducted a cross-sectional survey of 1286 college students in South China.Physical activity level,depressive symptoms,and binge eating behavior were assessed using the Physical Activity Scale-3,Zung Self-Rating Depression Scale,and Dutch Eating Behavior Questionnaire,respectively.The absolute difference between actual body mass index(BMI)and ideal BMI was used to indicate the level of body dissatisfaction.Structural equation modeling(SEM)and receiver operating characteristic(ROC)curve analysis were used to examine the relationships between these variables and depression.RESULTS The findings showed that female college students reported higher levels of depression.Physical activity,body dissatisfaction,and binge eating behavior were significantly associated with depression.SEM revealed that body dissatisfaction played a mediating role.A body dissatisfaction score of 1.73 was identified as the diagnostic cutoff value for predicting depression,with an area under the ROC curve of 70.0%,providing a basis for targeted interventions.CONCLUSION This study demonstrated a significant positive correlation between body dissatisfaction and depression.Low levels of physical activity and binge eating behaviors were found to heighten the risk of depression.Therefore,promoting physical activity and healthy eating habits among adolescents is essential.Additionally,the identification of a diagnostic threshold for body dissatisfaction represents a novel finding with important implications for early screening.Future longitudinal studies are recommended to further refine this diagnostic criterion.展开更多
BACKGROUND Syngeneic orthotopic tumor models offer an optimal functional tumor–immune interface for hepatocellular carcinoma research.Yet,unpredictable growth kinetics and spontaneous regression pose major obstacles....BACKGROUND Syngeneic orthotopic tumor models offer an optimal functional tumor–immune interface for hepatocellular carcinoma research.Yet,unpredictable growth kinetics and spontaneous regression pose major obstacles.Efficient induction protocols and continuous monitoring are therefore essential.Routine exploratory surgeries are ethically untenable,making non-invasive imaging modalities attractive alternatives.High-resolution magnetic resonance imaging and microcomputed tomography deliver detailed insights but incur substantial equipment costs,radiation risks,time demands,and require specialized expertise—challenges that limit their routine use.In contrast,ultrasound(US)imaging emerges as a cost-effective,radiation-free,and rapid approach,facilitating practical and ethical longitudinal assessment of tumor progression in preclinical studies.AIM To optimize the orthotopic hepatocellular carcinoma model and evaluate the potential of US imaging for accurate and cost-effective tumor monitoring.METHODS Hepatocellular carcinoma was induced in 28 Sprague Dawley rats by implanting 5×10^(6) N1S1 cells into the left lateral hepatic lobe.Tumor progression was monitored weekly via US.Upon reaching 100-150 mm^(3),an experimental group(n=14)received Sorafenib(40 mg/kg)orally on alternate days for 28 days;efficacy was compared to untreated controls.US accuracy was validated against micro-computed tomography,gross caliper measurements and histopathological analysis.Reliability and operator proficiency in US assessment were also evaluated.RESULTS US images procured 7-day post-surgery revealed a well-defined hypoechoic nodule at the left liver lobe tip,confirming successful tumor induction(mean volume 130±39 mm^(3)).Only three animals exhibited spontaneous regression by week 2,underscoring the model’s stability.Sorafenib treatment elicited a marked tumor reduction(678±103 mm^(3))vs untreated control(6005±1760 mm^(3)).US assessment demonstrated robust intra and interobserver reproducibility with high sensitivity and specificity for tumor detection.Moreover,US derived volumes correlated strongly with gross caliper measurements,histopathological analysis,and microcomputed tomography imaging,validating its reliability as a non-invasive monitoring tool in preclinical hepatocellular carcinoma studies.CONCLUSION The results demonstrate that US imaging is a reliable,cost-effective,and animal sparing approach with an easy tomaster protocol,enabling monitoring of tumor progression and therapeutic response in orthotopic liver tumor models.展开更多
To the Editor:We read with great interest the recent article by Shi et al.pub-lished in Hepatobiliary Pancreatic Diseases International[1].Shi’s study was based on radiological features and clinical factors to constr...To the Editor:We read with great interest the recent article by Shi et al.pub-lished in Hepatobiliary Pancreatic Diseases International[1].Shi’s study was based on radiological features and clinical factors to construct a model to predict the effectiveness of first transarterial chemoembolization(TACE)treatment for hepatocellular carcinoma(HCC)in prolonging patient survival.The results showed that area under the receiver operating characteristic curve was 0.964 for the training cohort and 0.949 for the validation cohort.展开更多
BACKGROUND Emerging evidence suggests that serum levels of pepsinogen(PG),gastrin-17(G17),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),and CA72-4 may aid in distinguishing gastric cancer(GC)from gas...BACKGROUND Emerging evidence suggests that serum levels of pepsinogen(PG),gastrin-17(G17),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),and CA72-4 may aid in distinguishing gastric cancer(GC)from gastric ulcer(GU).AIM To assess serum PG,G17,CEA,CA19-9,and CA72-4 in diagnosing GU and optimizing GC detection.METHODS A retrospective analysis was conducted from 263 patients treated at the Third People’s Hospital of Hefei,who were classified into three groups:Chronic non-atrophic gastritis(CG),GU,and GC.Fasting serum levels of PG,G17,CEA,CA19-9,and CA72-4 were measured and compared across the groups.RESULTS Serum levels of PGII and G17 were significantly elevated in both the GU and GC groups compared to the CG group(P<0.01),whereas the PGI/PGII ratio was markedly decreased(P<0.01).Levels of CEA,CA19-9,and CA72-4 were significantly higher in the GC group than in the CG and GU groups(P<0.01).Receiver operating characteristic curve analysis identified the optimal diagnostic cut-off values for GU and GC as follows:PGI(169.855 pmol/L),PGII(30.555μg/L),PGI/PGII ratio(16.529),G17(6.435 pmol/L),CEA(2.005 ng/mL),CA19-9(16.65 U/mL),and CA72-4(2.075 U/mL).The area under the curve for combined detection was 0.826(P<0.001),indicating good diagnostic performance.CONCLUSION Serological biomarkers effectively distinguish GC from GU,with combined detection of PGII,PGI/PGII ratio,G17,and tumor markers enhancing diagnostic accuracy.展开更多
目的分析乳腺癌术后患者并发上肢淋巴水肿的影响因素,并构建预测模型。方法回顾性纳入浙江省嘉兴市第一医院2023年10月至2024年3月收治的102例乳腺癌术后患者,根据术后6个月是否发生上肢淋巴水肿分为对照组(未发生上肢淋巴水肿患者,71例...目的分析乳腺癌术后患者并发上肢淋巴水肿的影响因素,并构建预测模型。方法回顾性纳入浙江省嘉兴市第一医院2023年10月至2024年3月收治的102例乳腺癌术后患者,根据术后6个月是否发生上肢淋巴水肿分为对照组(未发生上肢淋巴水肿患者,71例)、研究组(发生上肢淋巴水肿患者,31例)。通过多因素Logistic回归分析确定乳腺癌相关淋巴水肿(breast cancer-related lymphedema,BCRL)的独立预测因子,并据此建立风险预测模型。结果多因素Logistic分析结果显示,身体质量指数(body mass index,BMI)水平高、清扫淋巴结个数多、肿瘤淋巴结转移(tumor node metastasis,TNM)分期Ⅲ期是影响乳腺癌术后患者上肢淋巴水肿的危险因素,术后功能锻炼是保护因素(P<0.05)。所建模型预测BCRL的效能良好,药时曲线下面积(area under the curve,AUC)达0.893。结论高BMI、广泛淋巴结清扫、晚期TNM分期是乳腺癌术后上肢淋巴水肿的危险因素,而术后功能锻炼具有保护作用。在影响因素基础上构建的预测模型具有良好的预测价值。展开更多
BACKGROUND Metabolic dysfunction-associated fatty liver disease(MASLD)is a chronic liver disease characterized by hepatocellular steatosis,which is closely related to metabolic syndrome,with annually increasing morbid...BACKGROUND Metabolic dysfunction-associated fatty liver disease(MASLD)is a chronic liver disease characterized by hepatocellular steatosis,which is closely related to metabolic syndrome,with annually increasing morbidity in recent years.Gynecomastia(GYN),an abnormal proliferation of breast tissue in males,is common in males with sex hormone imbalance.Currently,there is insufficient research on the morbidity of GYN and its correlation among MASLD patients.AIM To investigate the prevalence of GYN and its associated clinical features in patients with MASLD and determine the prevalence of GYN in patients with MASLD and analyze the predictive effect of sex hormones on GYN using receiver operating characteristic(ROC)curves.METHODS A cross-sectional study was conducted in a tertiary care hospital.Among them,997 patients met the inclusion criteria and underwent breast ultrasonography to determine the presence of GYN.Anthropometric data,laboratory test data[estradiol(E2),androgens,liver function,glucose,lipids,low-density lipoprotein,high-density lipoprotein,creatinine,and uric acid,etc.],as well as information on medical history,severity of fatty liver(mild,moderate,and severe),and duration of the disease were collected.Package for the Social Sciences version 27 and R software(version 4.3.1)were used for data analysis.RESULTS The prevalence of GYN increased with the severity of fatty liver(27.6%for mild,33.5%for moderate,and 58%for severe,P<0.001);compared with non-GYN patients,GYN patients were older(54.11±9.71 years vs 47.89±9.92 years,P<0.001),with significantly higher E2 levels,higher estrogen to androgen ratio(P<0.001)and significantly lower androgen levels(P<0.001).In ROC curve analysis,the combined model of testosterone and E2 had a high diagnostic value in predicting GYN in MASLD patients,surpassing a single indicator.CONCLUSION The presence of GYN may suggest more severe metabolic abnormalities in patients with MASLD.Therefore,early recognition of GYN may be crucial for early intervention in metabolic syndrome and endocrine abnormalities in patients with MASLD.展开更多
Objectives:SocialNetworkAddiction(SNA)is becoming increasingly prevalent among college students;however,there remains a lack of consensus regarding the measurement tools and their optimal cutoff score.This study aims ...Objectives:SocialNetworkAddiction(SNA)is becoming increasingly prevalent among college students;however,there remains a lack of consensus regarding the measurement tools and their optimal cutoff score.This study aims to validate the 21-item SocialNetwork Addiction Scale-Chinese(SNAS-C)in its Chinese version and to determine its optimal cutoff score for identifying potential SNA cases within the college student population.Methods:A crosssectional survey was conducted,recruiting 3387 college students.Latent profile analysis(LPA)and receiver operating characteristic(ROC)curve analysis were employed to establish the optimal cutoff score for the validated 21-item SNAS-C.Results:Three profile models were selected based on multiple statistical criteria,classifying participants into low-risk,moderate-risk,and high-risk groups.The highest-risk group was defined as“positive”for SNA,while the remaining groups were considered“negative”,serving as the reference standard for ROC analysis.The optimal cutoff score was determined to be 72(sensitivity:98.2%,specificity:96.86%),with an overall classification accuracy of 97.0%.The“positive”group reported significantly higher frequency of social network usage,greater digitalmedia dependence scores,and a higher incidence of network addiction.Conclusion:This study identified the optimal cutoff score for the SNAS-C as≥72,demonstrating high sensitivity,specificity,and diagnostic accuracy.This threshold effectively distinguishes between high-risk and low-risk SNA.展开更多
In order to assist the design of short interfering ribonucleic acids （siRNA）, 573 non-redundant siRNAs were collected from published literatures and the relationship between siRNAs sequences and RNA interference （R...In order to assist the design of short interfering ribonucleic acids （siRNA）, 573 non-redundant siRNAs were collected from published literatures and the relationship between siRNAs sequences and RNA interference （RNAi） effect is analyzed by a support vector machine （SVM） based algorithm relied on a basebase correlation （BBC） feature. The results show that the proposed algorithm has the highest area under curve （AUC） value （0. 73） of the receive operating characteristic （ROC） curve and the greatest r value （0. 43） of the Pearson＇s correlation coefficient. This indicates that the proposed algorithm is better than the published algorithms on the collected datasets and that more attention should be paid to the base-base correlation information in future siRNA design.展开更多
Objective： To determine the clinical serum levels of carcinoembryonic antigen （CEA） and carbohydrate antigen 19-9 （CA19-9）, individually and in combination, for the diagnosis of 50 healthy subjects and 150 cases ...Objective： To determine the clinical serum levels of carcinoembryonic antigen （CEA） and carbohydrate antigen 19-9 （CA19-9）, individually and in combination, for the diagnosis of 50 healthy subjects and 150 cases of esophageal, gastric, and colon cancers. Methods： The sensitivities of the two markers were compared individually and in combination, with specificity set at 100%. Receiver operating characteristic （ROC） curves were plotted. Results： Serum CEA levels were significantly higher in cancer patients than in the control group. The sensitivity of CEA was determined： in esophageal cancer, sensitivity=28%, negative predictive value （NPV）=61.72%, and AUC=0.742 （SE=0.05）, with a significance level of P〈0.0001; in gastric cancer, sensitivity=30%, NPV=58.82%, and AUC=0.734 （SE=0.0S）, with a significance level of P〈0.0001; in colon cancer, sensitivity=74%, NPV=79.36%, and AUC=0.856 （SE=0.04）, with a significance level of P〈0.0001. The sensitivity of CA19-9 was also evaluated： in esophageal cancer, sensitivity=18%, NPV=54.94%, and AUC=0.573 （SE=0.05）, with a significance level of P=0.2054. In gastric cancer, sensitivity=42%, NPV=63.29%, and AUC=0.679 （SE=0.05）, with a significance level of P〈0.0011. In colon cancer, sensitivity=26%, NPV=57.47%, and AUC=0.S80 （SE=0.05）, with a significance level ofP=0.1670. The following were the sensitivities of CEA/CA19-9 combined： in esophageal cancer, sensitivity=42%, NPV=63.29%, SE=0.078 （95% CI： 0.0159-0.322）; gastric cancer, sensitivity=S8%, NPV=70.42%, SE=0.072 （9$% CI： -0.0866-0.198）; and colon cancer, sensitivity=72%, NPV=78.12%, SE=0.070 （9S% CI： 0.137-0.415）. Conclusion： CEA exhibited the highest sensitivity for colon cancer, and CA19-9 exhibited the highest sensitivity for gastric cancer. Combined analysis indicated an increase in diagnostic sensitivity in esophageal and gastric cancer compared with that in colon cancer.展开更多
基金supported by the National Social Science Fund of China(Grand No.21XTJ001).
文摘A Receiver Operating Characteristic(ROC)analysis of a power is important and useful in clinical trials.A Classical Conditional Power(CCP)is a probability of a classical rejection region given values of true treatment effect and interim result.For hypotheses and reversed hypotheses under normal models,we obtain analytical expressions of the ROC curves of the CCP,find optimal ROC curves of the CCP,investigate the superiority of the ROC curves of the CCP,calculate critical values of the False Positive Rate(FPR),True Positive Rate(TPR),and cutoff of the optimal CCP,and give go/no go decisions at the interim of the optimal CCP.In addition,extensive numerical experiments are carried out to exemplify our theoretical results.Finally,a real data example is performed to illustrate the go/no go decisions of the optimal CCP.
文摘Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific factor. 4) Among subjects with BMI≥28 kg/m2 or WC≥95 cm, 95% of men and 90% of women appeared to have abdominal visceral obesity. Conclusion Measurements of BMI, WC, and WHR can be used in the prediction of abdominal visceral obesity, of which WC was the one with better accuracy.
基金supported by grants from the National Natural Science Foundation of China(81301275,81471736 and 81671760)the National Science and Technology Pillar Program during the Twelfth Five-Year Plan Period(2015BAI01B09)Heilongjiang Province Foundation for Returness(LC2013C38)
文摘BACKGROUND： The various combination of multiphase enhancement multislice spiral CT （MSCT） makes the diagno- sis of a small hepatocellular carcinoma （sHCC） on the back- ground of liver cirrhosis possible. This study was to explore whether the combination of MSCT enhancement scan and alpha-fetoprotein （AFP） level ficiency for sHCC. could increase the diagnostic ef- METHODS： This study included 35 sHCC patients and 52 cir- rhotic patients without image evidence of HCC as a control group. The diagnoses were made by three radiologists em- ploying a 5-point rating scale, with postoperative pathologic results as the gold standard. Receiver operating characteristic （ROC） curve analysis was performed to evaluate the diag- nostic value of the three MSCT combination modes （arterial phase＋portal-venous phase, arterial phase＋delayed phase, arterial phase＋portal-venous phase＋delayed phase） and AFP levels for sHCC on the background of liver cirrhosis. RESULTS： The area under ROC curve （AUC）, sensitivity, and specificity of the combination of arterial phase＋portal- venous phase＋delayed phase were 0.93, 93%, and 82%, respectively. The average AUC of the arterial phase＋portal- venous phase＋delayed phase combination was significantly greater than that of the arterial phase＋portal-venous phase （AUC=0.84, P=0.01） and arterial phase＋delayed phase （AUC=0.85, P=0.03）. Arterial phase＋portal-venous phase had a smaller AUC （0.84） than arterial phase＋delayed phase （0.85）, but the difference was insignificant （P=0.15）. After combining MSCT enhancement scan with AFP, the AUC, sensitivity, and specificity were 0.95, 94%, and 83%, respectively, indicating a greatly increased diagnostic efficiency for sHCC. CONCLUSIONS： The combination of AFP and 3 phases MSCT enhancement scan could increase the diagnostic efficiency for sHCC on the background of liver cirrhosis. The application of ROC curve analysis has provided a new method and reference in HCC diagnosis.
文摘Aim： To assess that metabolic status of spermatozoa could provide a useful tool for evaluation of semen quality. Methods： The accuracy of the spectrophotometric application of the resazurin reduction assay was assessed using receiver operating characteristic （ROC） analysis. Results： Areas under ROC curves （AUC） for motile sperm concentration and sperm index （SI） （sperm concentration multiplied by the square root of percentage sperm motility multiplied by the percentage normal sperm morphology） were 0.922. The best discrimination between poor and good semen samples according to the SI was achieved at a cut-off point of A610 = 0.209, where high sensitivity （94.1%） and specificity （91.7%） were calculated. The assay was less accurate when motile sperm concentration was used as the criterion value, yielding sensitivity of 88.2% and specificity of 87.5%, respectively. Likelihood ratios （LR） indicate that absorbances lower than 0.209 were at least 11.3 times as likely to be found in good semen samples than those in poor according to the SI, whereas in the case of motile sperm concentration, the LR was calculated to be 7.06. Conclusion： These results show that the resazurin reduction assay combined with spectrophotometry is an accurate method of assessing the quality of boar semen.
基金Supported by the National Natural Science Foundation of China(No.81273817)the Program of Guangdong Province Administration of Traditional Chinese Medicine(No.20121225)
文摘Objective： To establish the diagnostic quantitative criteria for fire-heat syndrome （FHS） of Chinese medicine （CM） based on the receiver operating characteristic （ROC） curve and principal component analysis （PCA）. Methods： The symptoms and signs of FHS cases and healthy subjects from Guangzhou, Henan and Hunan of China were collected through questionnaire, and the diagnostic quantitative score tables were established for the three regions, respectively, with the method of maximum likelihood analysis. The homogeneity test was then performed on the diagnostic score tables for the three regions with ROC curve, and the diagnostic efficiency of diagnostic score tables for the three regions was compared with the prospective test and retrospective test. The method of PCA was adopted to obtain the analysis matrix for classifying the tapes of FHS. Results： Twenty-seven elements of FHS were confirmed through Chi-square test, and the diagnostic score tables for the three regions were established with the method of maximum likelihood analysis on the basis of the collected case data. According to the ROC curve test, the areas under ROC curve of Guangzhou diagnostic score table assessment with candidates in Guangzhou, Henan and Hunan were 0.998, 0.961 and 0.956, respectively. It showed that the diagnostic efficiency of Guangzhou diagnostic score tables was the highest one. With the prospective test, the area under ROC of Guangzhou diagnostic score table was 0.949, and more than any other diagnostic score table. By PCA, FHS was classified into excess fire and deficiency fire, and then classified into syndrome of flaring up of Heart （Xin） fire, syndrome of Lung （Fei）-Stomach （Wei） excess fire, syndrome of deficiency of Liver （Gan）-yin and Kidney （Shen）-yin, and syndrome of deficiency of Lung-yin from the view of viscera. In the retrospective test, the consistency with clinicians＇ diagnosis was 69.4%, and in the prospective test, it was 70.1%. Conclusions： The Guangzhou diagnostic score table could be used as the recommended criteria for the diagnosis of FHS. The classification of FHS was basically in conformity with the clinical situation.
基金This study was supported by grants from the National Natural Science Foundation of China （No. 81101043）, Natural Science Foundation of Jiangsu Province （No. BK2011178）, and the Priority Academic Program Development of Jiangsu Higher Education institutions.
文摘Along with the development of digital X-ray imaging technology, a new, economical and practicalpaper-based output system gradually emerged. To reduce cost, more and more radiologic institutions began to change from film copies to lower-priced paper prints for documenting radiologic findings.Therefore, laser paper printers are frequently used as an alternative to duplicating film though the use of printed images is not yet widespread. The aim of this study was to compare the practical value of high-resolution paper printer with dry film copies for detecting small solitary pulmonary nodules （SPNs）.
文摘Aim:To assess that metabolic status of spermatozoa could provide a useful tool for evaluation of semen quality. Methods:The accuracy of the spectrophotometric application of the resazurm reduction assay was assessed using receiver operating characteristic(ROC)analysis.Results:Areas under ROC curves(AUC)for motile sperm concen- tration and sperm index(SI)(sperm concentration multiplied by the square root of percentage sperm motility multi- plied by the percentage normal sperm morphology)were 0.922.The best discrimination between poor and good semen samples according to the SI was achieved at a cut-off point of A_(610)=0.209,where high sensitivity(94.1%)and specificity(91.7%)were calculated.The assay was less accurate when motile sperm concentration was used as the criterion value,vielding sensitivity of 88.2% and specificity of 87.5%,respectively,Likelihood ratios(LR)indicate that absorbances lower than 0.209 were at least 11.3 times as likely to be found in good semen samples than those in poor according to the SI,whereas in the case of motile sperm concentration,the LR was calculated to be 7.06.Conclusion: These results show that the resazurin reduction assay combined with spectrophotometry is an accurate method of assessing the quality of boar semen.
基金supported by the National Natural Science Foundation of China,No.82071909(to GF)the Natural Science Foundation of Liaoning Province,No.2023-MS-07(to HL)。
文摘Freezing of gait is a significant and debilitating motor symptom often observed in individuals with Parkinson's disease.Resting-state functional magnetic resonance imaging,along with its multi-level feature indices,has provided a fresh perspective and valuable insight into the study of freezing of gait in Parkinson's disease.It has been revealed that Parkinson's disease is accompanied by widespread irregularities in inherent brain network activity.However,the effective integration of the multi-level indices of resting-state functional magnetic resonance imaging into clinical settings for the diagnosis of freezing of gait in Parkinson's disease remains a challenge.Although previous studies have demonstrated that radiomics can extract optimal features as biomarkers to identify or predict diseases,a knowledge gap still exists in the field of freezing of gait in Parkinson's disease.This cross-sectional study aimed to evaluate the ability of radiomics features based on multi-level indices of resting-state functional magnetic resonance imaging,along with clinical features,to distinguish between Parkinson's disease patients with and without freezing of gait.We recruited 28 patients with Parkinson's disease who had freezing of gait(15 men and 13 women,average age 63 years)and 30 patients with Parkinson's disease who had no freezing of gait(16 men and 14 women,average age 64 years).Magnetic resonance imaging scans were obtained using a 3.0T scanner to extract the mean amplitude of low-frequency fluctuations,mean regional homogeneity,and degree centrality.Neurological and clinical characteristics were also evaluated.We used the least absolute shrinkage and selection operator algorithm to extract features and established feedforward neural network models based solely on resting-state functional magnetic resonance imaging indicators.We then performed predictive analysis of three distinct groups based on resting-state functional magnetic resonance imaging indicators indicators combined with clinical features.Subsequently,we conducted 100 additional five-fold cross-validations to determine the most effective model for each classification task and evaluated the performance of the model using the area under the receiver operating characteristic curve.The results showed that when differentiating patients with Parkinson's disease who had freezing of gait from those who did not have freezing of gait,or from healthy controls,the models using only the mean regional homogeneity values achieved the highest area under the receiver operating characteristic curve values of 0.750(with an accuracy of 70.9%)and 0.759(with an accuracy of 65.3%),respectively.When classifying patients with Parkinson's disease who had freezing of gait from those who had no freezing of gait,the model using the mean amplitude of low-frequency fluctuation values combined with two clinical features achieved the highest area under the receiver operating characteristic curve of 0.847(with an accuracy of 74.3%).The most significant features for patients with Parkinson's disease who had freezing of gait were amplitude of low-frequency fluctuation alterations in the left parahippocampal gyrus and two clinical characteristics:Montreal Cognitive Assessment and Hamilton Depression Scale scores.Our findings suggest that radiomics features derived from resting-state functional magnetic resonance imaging indices and clinical information can serve as valuable indices for the identification of freezing of gait in Parkinson's disease.
文摘Background： To combine dinicopathological characteristics associated with lymph node metastasis for submucosal gastric cancer into a nomogram. Methods： We retrospectively analyzed 262 patients with submucosal gastric cancer who underwent D2 gastrectomy between 1996 and 2012. The relationship between lymph node metastasis and clinicopathological features was statistically analyzed. With multivariate logistic regression analysis, we made a nomogram to predict the possibility of lymph node metastasis. Receiver operating characteristic （ROC） analysis was also performed to assess the predictive value of the model. Discrimination and calibration were performed using internal validation. Results： A total number of 48 （18.3%） patients with submucosal gastric cancer have pathologically lymph node metastasis. For submucosal gastric carcinoma, lymph node metastasis was associated with age, tumor location, macroscopic type, size, differentiation, histology, the existence of ulcer and lymphovascular invasion in univariate analysis （all P〈0.05）. The multivariate logistic old, macroscopic type III or mixed, undifferentiated type, regression analysis identified that age _〈50 years and presence of lymphovascular invasion were independent risk factors of lymph node metastasis in submucosal gastric cancer （all P〈0.05）. We constructed a predicting nomogram with all these factors for lymph node metastasis in submucosal gastric cancer with good discrimination [area under the curve （AUC） =0.844]. Internal validation demonstrated a good discrimination power that the actual probability corresponds closely with the predicted probability. Conclusions： We developed a nomogram to predict the rate of lymph node metastasis for submucosal gastric cancer. With good discrimination and internal validation, the nomogram improved individualized predictions for assisting clinicians to make appropriated treatment decision for submucosal gastric cancer patients.
基金Supported by Science and Technology Program of Guangzhou,No.2024A03J1029Science and Technology Program of Chinese Medicine and Integrated Chinese and Western Medicine in Guangzhou,No.20252A010001.
文摘BACKGROUND Contrast-enhanced ultrasonography(CEUS)is utilized to assess the therapeutic efficacy of interventional therapy in liver cancer patients,offering insights into tumor blood flow changes,angiogenesis,and tumor markers.AIM To evaluate the use of CEUS in examining the effectiveness of interventional therapy for liver cancer,we aim to investigate its diagnostic utility for tumor perfusion patterns,microvessel density,perfusion recovery,blood flow enhancement response,and alterations in tumor markers among patients receiving interventional therapy for liver cancer.METHODS The study involved 124 patients who underwent interventional therapy for liver cancer at Guangzhou First People’s Hospital from January 2022 to February 2024.All patients were examined using CEUS before treatment and at 1 month,3 months,and 6 months,and the concentrations of tumor markers were collected and statistically analyzed using Statistical Package for the Social Sciences 25.0.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic efficacy of CEUS and analyze its sensitivity,specificity,and correlation with clinical indicators.RESULTS Before treatment,tumor blood flow was primarily enhanced.After treatment,enhanced perfusion declined,while uniform and non-uniform perfusion increased,indicating reduced tumor activity.Enhanced perfusion decreased from 68.25%before treatment to 53.75%at 6 months post-treatment(F=6.123,P=0.016),indicating reduced tumor activity.The microvessel density of the tumors decreased significantly after treatment(P<0.05),and the proportion of low microvessel density increased.After treatment,perfusion recovery in the tumor area improved,the proportion of complete and partial responses gradually increased,and the proportion of stable lesions decreased(P<0.05).The levels of alphafetoprotein,carcinoembryonic antigen,and carbohydrate antigen 19-9 decreased by 68.7%,30.4%,and 41.6%,respectively,at 6 months post-treatment(P<0.05).CEUS showed a sensitivity of 85.72%,specificity of 92.31%,and area under the curve of 0.911(95%CI:0.883–0.939)for evaluating treatment response.ROC curve analysis showed that CEUS had high sensitivity and specificity and could effectively evaluate the efficacy of interventional therapy for liver cancer.CONCLUSION CEUS has high diagnostic value in evaluating therapeutic effects in patients with liver cancer following interventional therapy.It can reflect changes in tumor blood flow,angiogenesis,and tumor marker levels,providing an effective basis for real-time monitoring of treatment outcomes.
文摘BACKGROUND Hepatocellular carcinoma(HCC)is the most common pathological type of liver cancer and was the third leading cause of cancer-related deaths worldwide in 2020.AIM To evaluate the diagnostic potential of key tumor markers in serum,bile,and fecal samples for detecting HCC.METHODS Blood,bile,and fecal samples were collected from patients(n=265)with HCC and cholecystitis from Guangxi Medical University’s First Affiliated Hospital.Immunohistochemistry was performed on 69 HCC samples,and 16S ribosomal RNA sequencing was conducted on 166 fecal samples.Tumor marker cut-off values in bile and feces were determined using the Youden index,while serum biomarkers followed hospital standards.Diagnostic performance was evaluated using receiver operating characteristic analysis.RESULTS The areas under the curve(AUCs)for distinguishing HCC were 0.898,0.904,and 0.859 for serum alpha-fetoprotein(AFP),prothrombin induced by vitamin K absence-II(PIVKA-II),and bile AFP,respectively.Serum AFP had the highest diagnostic value(80%)for early-stage HCC.Combination analysis found that bile AFP and serum PIVKAII achieved the highest AUC of 0.965(P<0.001),suggesting that bile AFP may serve as a valuable complementary biomarker,particularly in cases where serum AFP is not significantly elevated.Additionally,bile AFP was positively correlated with Actinomyces,which plays a significant role in promoting tumorigenesis;and was negatively correlated with Faecalibacterium,which was associated with robust anticancer immune responses(P<0.05).These findings suggest the potential role of gut microbiota in modulating AFP levels and HCC progression.CONCLUSION Bile AFP improved the sensitivity of HCC detection,with the combination of bile AFP and PIVKA-II demonstrating the highest AUC for HCC diagnosis.AFP is associated with poorer clinical outcomes.
基金Supported by Starting Research Fund from the Gannan Medical University,No.QD202121。
文摘BACKGROUND With the increasing global incidence of mental illness,depression has become a serious problem among college students.AIM To investigate the relationship between depression and its correlates in Chinese adolescents and to identify diagnostic predictors of depression,examine the effects of binge eating,physical activity,and body dissatisfaction on depression among college students and to determine a diagnostic cutoff value for depression based on body dissatisfaction.METHODS We conducted a cross-sectional survey of 1286 college students in South China.Physical activity level,depressive symptoms,and binge eating behavior were assessed using the Physical Activity Scale-3,Zung Self-Rating Depression Scale,and Dutch Eating Behavior Questionnaire,respectively.The absolute difference between actual body mass index(BMI)and ideal BMI was used to indicate the level of body dissatisfaction.Structural equation modeling(SEM)and receiver operating characteristic(ROC)curve analysis were used to examine the relationships between these variables and depression.RESULTS The findings showed that female college students reported higher levels of depression.Physical activity,body dissatisfaction,and binge eating behavior were significantly associated with depression.SEM revealed that body dissatisfaction played a mediating role.A body dissatisfaction score of 1.73 was identified as the diagnostic cutoff value for predicting depression,with an area under the ROC curve of 70.0%,providing a basis for targeted interventions.CONCLUSION This study demonstrated a significant positive correlation between body dissatisfaction and depression.Low levels of physical activity and binge eating behaviors were found to heighten the risk of depression.Therefore,promoting physical activity and healthy eating habits among adolescents is essential.Additionally,the identification of a diagnostic threshold for body dissatisfaction represents a novel finding with important implications for early screening.Future longitudinal studies are recommended to further refine this diagnostic criterion.
基金Supported by Amrita Vishwa Vidyapeetham Seed Grant,No.K-PHAR-24-722DST INSPIRE Fellowship,No.IF190226.
文摘BACKGROUND Syngeneic orthotopic tumor models offer an optimal functional tumor–immune interface for hepatocellular carcinoma research.Yet,unpredictable growth kinetics and spontaneous regression pose major obstacles.Efficient induction protocols and continuous monitoring are therefore essential.Routine exploratory surgeries are ethically untenable,making non-invasive imaging modalities attractive alternatives.High-resolution magnetic resonance imaging and microcomputed tomography deliver detailed insights but incur substantial equipment costs,radiation risks,time demands,and require specialized expertise—challenges that limit their routine use.In contrast,ultrasound(US)imaging emerges as a cost-effective,radiation-free,and rapid approach,facilitating practical and ethical longitudinal assessment of tumor progression in preclinical studies.AIM To optimize the orthotopic hepatocellular carcinoma model and evaluate the potential of US imaging for accurate and cost-effective tumor monitoring.METHODS Hepatocellular carcinoma was induced in 28 Sprague Dawley rats by implanting 5×10^(6) N1S1 cells into the left lateral hepatic lobe.Tumor progression was monitored weekly via US.Upon reaching 100-150 mm^(3),an experimental group(n=14)received Sorafenib(40 mg/kg)orally on alternate days for 28 days;efficacy was compared to untreated controls.US accuracy was validated against micro-computed tomography,gross caliper measurements and histopathological analysis.Reliability and operator proficiency in US assessment were also evaluated.RESULTS US images procured 7-day post-surgery revealed a well-defined hypoechoic nodule at the left liver lobe tip,confirming successful tumor induction(mean volume 130±39 mm^(3)).Only three animals exhibited spontaneous regression by week 2,underscoring the model’s stability.Sorafenib treatment elicited a marked tumor reduction(678±103 mm^(3))vs untreated control(6005±1760 mm^(3)).US assessment demonstrated robust intra and interobserver reproducibility with high sensitivity and specificity for tumor detection.Moreover,US derived volumes correlated strongly with gross caliper measurements,histopathological analysis,and microcomputed tomography imaging,validating its reliability as a non-invasive monitoring tool in preclinical hepatocellular carcinoma studies.CONCLUSION The results demonstrate that US imaging is a reliable,cost-effective,and animal sparing approach with an easy tomaster protocol,enabling monitoring of tumor progression and therapeutic response in orthotopic liver tumor models.
基金supported by a grant from the Nursing Re-search Program of the First Affiliated Hospital of Zhejiang Univer-sity School of Medicine(No.2022ZYHL045).
文摘To the Editor:We read with great interest the recent article by Shi et al.pub-lished in Hepatobiliary Pancreatic Diseases International[1].Shi’s study was based on radiological features and clinical factors to construct a model to predict the effectiveness of first transarterial chemoembolization(TACE)treatment for hepatocellular carcinoma(HCC)in prolonging patient survival.The results showed that area under the receiver operating characteristic curve was 0.964 for the training cohort and 0.949 for the validation cohort.
基金Supported by Chinese Medicine Research Project of Anhui Chinese Medicine Society,No.2024ZYYXH135.
文摘BACKGROUND Emerging evidence suggests that serum levels of pepsinogen(PG),gastrin-17(G17),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),and CA72-4 may aid in distinguishing gastric cancer(GC)from gastric ulcer(GU).AIM To assess serum PG,G17,CEA,CA19-9,and CA72-4 in diagnosing GU and optimizing GC detection.METHODS A retrospective analysis was conducted from 263 patients treated at the Third People’s Hospital of Hefei,who were classified into three groups:Chronic non-atrophic gastritis(CG),GU,and GC.Fasting serum levels of PG,G17,CEA,CA19-9,and CA72-4 were measured and compared across the groups.RESULTS Serum levels of PGII and G17 were significantly elevated in both the GU and GC groups compared to the CG group(P<0.01),whereas the PGI/PGII ratio was markedly decreased(P<0.01).Levels of CEA,CA19-9,and CA72-4 were significantly higher in the GC group than in the CG and GU groups(P<0.01).Receiver operating characteristic curve analysis identified the optimal diagnostic cut-off values for GU and GC as follows:PGI(169.855 pmol/L),PGII(30.555μg/L),PGI/PGII ratio(16.529),G17(6.435 pmol/L),CEA(2.005 ng/mL),CA19-9(16.65 U/mL),and CA72-4(2.075 U/mL).The area under the curve for combined detection was 0.826(P<0.001),indicating good diagnostic performance.CONCLUSION Serological biomarkers effectively distinguish GC from GU,with combined detection of PGII,PGI/PGII ratio,G17,and tumor markers enhancing diagnostic accuracy.
文摘目的分析乳腺癌术后患者并发上肢淋巴水肿的影响因素,并构建预测模型。方法回顾性纳入浙江省嘉兴市第一医院2023年10月至2024年3月收治的102例乳腺癌术后患者,根据术后6个月是否发生上肢淋巴水肿分为对照组(未发生上肢淋巴水肿患者,71例)、研究组(发生上肢淋巴水肿患者,31例)。通过多因素Logistic回归分析确定乳腺癌相关淋巴水肿(breast cancer-related lymphedema,BCRL)的独立预测因子,并据此建立风险预测模型。结果多因素Logistic分析结果显示,身体质量指数(body mass index,BMI)水平高、清扫淋巴结个数多、肿瘤淋巴结转移(tumor node metastasis,TNM)分期Ⅲ期是影响乳腺癌术后患者上肢淋巴水肿的危险因素,术后功能锻炼是保护因素(P<0.05)。所建模型预测BCRL的效能良好,药时曲线下面积(area under the curve,AUC)达0.893。结论高BMI、广泛淋巴结清扫、晚期TNM分期是乳腺癌术后上肢淋巴水肿的危险因素,而术后功能锻炼具有保护作用。在影响因素基础上构建的预测模型具有良好的预测价值。
文摘BACKGROUND Metabolic dysfunction-associated fatty liver disease(MASLD)is a chronic liver disease characterized by hepatocellular steatosis,which is closely related to metabolic syndrome,with annually increasing morbidity in recent years.Gynecomastia(GYN),an abnormal proliferation of breast tissue in males,is common in males with sex hormone imbalance.Currently,there is insufficient research on the morbidity of GYN and its correlation among MASLD patients.AIM To investigate the prevalence of GYN and its associated clinical features in patients with MASLD and determine the prevalence of GYN in patients with MASLD and analyze the predictive effect of sex hormones on GYN using receiver operating characteristic(ROC)curves.METHODS A cross-sectional study was conducted in a tertiary care hospital.Among them,997 patients met the inclusion criteria and underwent breast ultrasonography to determine the presence of GYN.Anthropometric data,laboratory test data[estradiol(E2),androgens,liver function,glucose,lipids,low-density lipoprotein,high-density lipoprotein,creatinine,and uric acid,etc.],as well as information on medical history,severity of fatty liver(mild,moderate,and severe),and duration of the disease were collected.Package for the Social Sciences version 27 and R software(version 4.3.1)were used for data analysis.RESULTS The prevalence of GYN increased with the severity of fatty liver(27.6%for mild,33.5%for moderate,and 58%for severe,P<0.001);compared with non-GYN patients,GYN patients were older(54.11±9.71 years vs 47.89±9.92 years,P<0.001),with significantly higher E2 levels,higher estrogen to androgen ratio(P<0.001)and significantly lower androgen levels(P<0.001).In ROC curve analysis,the combined model of testosterone and E2 had a high diagnostic value in predicting GYN in MASLD patients,surpassing a single indicator.CONCLUSION The presence of GYN may suggest more severe metabolic abnormalities in patients with MASLD.Therefore,early recognition of GYN may be crucial for early intervention in metabolic syndrome and endocrine abnormalities in patients with MASLD.
基金supported by the National Natural Science Foundation of China(Grant No.72364006).
文摘Objectives:SocialNetworkAddiction(SNA)is becoming increasingly prevalent among college students;however,there remains a lack of consensus regarding the measurement tools and their optimal cutoff score.This study aims to validate the 21-item SocialNetwork Addiction Scale-Chinese(SNAS-C)in its Chinese version and to determine its optimal cutoff score for identifying potential SNA cases within the college student population.Methods:A crosssectional survey was conducted,recruiting 3387 college students.Latent profile analysis(LPA)and receiver operating characteristic(ROC)curve analysis were employed to establish the optimal cutoff score for the validated 21-item SNAS-C.Results:Three profile models were selected based on multiple statistical criteria,classifying participants into low-risk,moderate-risk,and high-risk groups.The highest-risk group was defined as“positive”for SNA,while the remaining groups were considered“negative”,serving as the reference standard for ROC analysis.The optimal cutoff score was determined to be 72(sensitivity:98.2%,specificity:96.86%),with an overall classification accuracy of 97.0%.The“positive”group reported significantly higher frequency of social network usage,greater digitalmedia dependence scores,and a higher incidence of network addiction.Conclusion:This study identified the optimal cutoff score for the SNAS-C as≥72,demonstrating high sensitivity,specificity,and diagnostic accuracy.This threshold effectively distinguishes between high-risk and low-risk SNA.
基金The National Natural Science Foundation of China(No60671018,60121101)
文摘In order to assist the design of short interfering ribonucleic acids （siRNA）, 573 non-redundant siRNAs were collected from published literatures and the relationship between siRNAs sequences and RNA interference （RNAi） effect is analyzed by a support vector machine （SVM） based algorithm relied on a basebase correlation （BBC） feature. The results show that the proposed algorithm has the highest area under curve （AUC） value （0. 73） of the receive operating characteristic （ROC） curve and the greatest r value （0. 43） of the Pearson＇s correlation coefficient. This indicates that the proposed algorithm is better than the published algorithms on the collected datasets and that more attention should be paid to the base-base correlation information in future siRNA design.
基金the financial support provided by the Biotechnology Information Service–Sub-Distributed Information Centre(supported by the Department of Biotechnology,Government of India)Advanced Bioinformatics Centre(supported by the Government of Rajasthan)at Birla Institute of Scientific Research for the infrastructure and facilities for conducting statistical work
文摘Objective： To determine the clinical serum levels of carcinoembryonic antigen （CEA） and carbohydrate antigen 19-9 （CA19-9）, individually and in combination, for the diagnosis of 50 healthy subjects and 150 cases of esophageal, gastric, and colon cancers. Methods： The sensitivities of the two markers were compared individually and in combination, with specificity set at 100%. Receiver operating characteristic （ROC） curves were plotted. Results： Serum CEA levels were significantly higher in cancer patients than in the control group. The sensitivity of CEA was determined： in esophageal cancer, sensitivity=28%, negative predictive value （NPV）=61.72%, and AUC=0.742 （SE=0.05）, with a significance level of P〈0.0001; in gastric cancer, sensitivity=30%, NPV=58.82%, and AUC=0.734 （SE=0.0S）, with a significance level of P〈0.0001; in colon cancer, sensitivity=74%, NPV=79.36%, and AUC=0.856 （SE=0.04）, with a significance level of P〈0.0001. The sensitivity of CA19-9 was also evaluated： in esophageal cancer, sensitivity=18%, NPV=54.94%, and AUC=0.573 （SE=0.05）, with a significance level of P=0.2054. In gastric cancer, sensitivity=42%, NPV=63.29%, and AUC=0.679 （SE=0.05）, with a significance level of P〈0.0011. In colon cancer, sensitivity=26%, NPV=57.47%, and AUC=0.S80 （SE=0.05）, with a significance level ofP=0.1670. The following were the sensitivities of CEA/CA19-9 combined： in esophageal cancer, sensitivity=42%, NPV=63.29%, SE=0.078 （95% CI： 0.0159-0.322）; gastric cancer, sensitivity=S8%, NPV=70.42%, SE=0.072 （9$% CI： -0.0866-0.198）; and colon cancer, sensitivity=72%, NPV=78.12%, SE=0.070 （9S% CI： 0.137-0.415）. Conclusion： CEA exhibited the highest sensitivity for colon cancer, and CA19-9 exhibited the highest sensitivity for gastric cancer. Combined analysis indicated an increase in diagnostic sensitivity in esophageal and gastric cancer compared with that in colon cancer.
