Hyponatremia is frequently seen in patients with ascites secondary to advanced cirrhosis and portal hypertension.The development of ascites in patients with cirrhosis is multi-factorial.Portal hypertension and the ass...Hyponatremia is frequently seen in patients with ascites secondary to advanced cirrhosis and portal hypertension.The development of ascites in patients with cirrhosis is multi-factorial.Portal hypertension and the associated systemic vasodilation lead to activation of the sodium-retaining neurohumoral mechanisms which include the renin-angiotensin-aldosterone system,sympathetic nervous system and antidiuretic hormone(ADH).The net effect is the avid retention of sodium and water to compensate for the low effective circulatory volume resulting in the development of ascites.Although not apparent in the early stages of cirrhosis,the progression of cirrhosis and ascites leads to impairment of the kidneys to eliminate solutefree water.This leads to additional compensatory mechanisms including non-osmotic secretion of ADH,also known as arginine vasopressin,further worsening excess water retention and thereby hyponatremia.Hyponatremia is associated with increased morbidity and mortality in patients with cirrhosis,and is an important prognostic marker both before and after liver transplant.The management of hyponatremia in this setting is a challenge as conventional therapy for hyponatremia including fluid restriction and loop diuretics are frequently inefficacious.In this review,we discuss the pathophysiology and various treatment modalities,including selective vasopressin receptor antagonists,for the management of hyponatremia in patients with cirrhosis.展开更多
AIM: To report the 3mo outcomes of collagen crosslinking(CXL) with a hypo-osmolar riboflavin in thin corneas with the thinnest thickness less than 400 μm without epithelium.METHODS: Eight eyes in 6 patients with age ...AIM: To report the 3mo outcomes of collagen crosslinking(CXL) with a hypo-osmolar riboflavin in thin corneas with the thinnest thickness less than 400 μm without epithelium.METHODS: Eight eyes in 6 patients with age 26.2±4.8y were included in the study. All patients underwent CXL using a hypo-osmolar riboflavin solution after its de-epithelization. Best corrected visual acuity, manifest refraction, the thinnest corneal thickness, and endothelial cell density were evaluated before and 3mo after the procedure.RESULTS: The mean thinnest thickness of the cornea was 408.5 ±29.0 μm before treatment and reduced to369.8 ±24.8 μm after the removal of epithelium. With the application of the hypo-osmolar riboflavin solution, the thickness increased to 445.0 ±26.5 μm before CXL and recover to 412.5 ±22.7 μm at 3mo after treatment, P =0.659). Before surgery, the mean K-value of the apex of the keratoconus corneas was 57.6 ±4.0 diopters, and slightly decreased(54.7±4.9 diopters) after surgery(P =0.085). Mean best-corrected visual acuity was 0.55 ±0.23 logarithm of the minimal angle of resolution, and increased to 0.53±0.26 logarithm after surgery(P =0.879).The endothelial cell density was 2706.4 ±201.6 cells/mm2 before treatment, and slightly decreased( 2641. 2 ±218.2 cells/mm2) at last fellow up(P =0.002).CONCLUSION: Corneal collagen cross-linking with a hypo-osmolar riboflavin in thin corneas seems to be a promising treatment. Further study should be done to evaluate the safety and efficiency of CXL in thin corneas for the long-term.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
Mold fluxes having adaptable properties were developed in the laboratory to solve quality defects, such as depressions and longitudinal cracks when casting hypo-peritectic steel at high casting speed. Firstly, the eff...Mold fluxes having adaptable properties were developed in the laboratory to solve quality defects, such as depressions and longitudinal cracks when casting hypo-peritectic steel at high casting speed. Firstly, the effect of components on the high basicity mold flux properties was first studied using the orthogonal method. In the scope of the studied content, Li2O has the largest effect on the melting temperature, and the least effect on the viscosity; CaF2 has the largest effect on the viscosity, and the least effect on the melting temperature; Na2O and CaO/SiO2 have no obvious influence on the melting temperature and viscosity. Secondly, two powders （Z1 and Z6） have reasonable viscosity-temperature curves, higher solidification temperatures, and porous structure after solidification, but the crystal property of Z6 is worse than that of Z1, and thus Z1 is more suitable for continuous casting hypo-peritectic steel at high casting speed. Thirdly, a higher basicity of powder, a less free enthalpy of crystal compound, and a lower baffle energy are good for a higher tendentiousness of crystal.展开更多
For 100 patients with gastric cancer, intraoperative intraperitoneal perfusion(IOIPP)using double-distilled water(D.D.W)with hibitane 37℃ for 5 minutes was performed.The anticancer effects were assessed cytologically...For 100 patients with gastric cancer, intraoperative intraperitoneal perfusion(IOIPP)using double-distilled water(D.D.W)with hibitane 37℃ for 5 minutes was performed.The anticancer effects were assessed cytologically in pre-IOIPP and post-IOPP specimens of the abdominal effusion and/or lavaged peritoneal fluid.The radical gastrectomy was performed in 65 of 93 cases with advanced gastric cancer, shed cancer cells in peritoneal cavity were detected in 16 of 65 cases with pre-IOIPP(24.62%)and to 3 of post-IOIPP cases(4.62%).There was significant difference between the two groups(P<0.01) . Shed cancer cells were inactivated in vivo estimated by the trypan-blue staining technique in 7 cases with radical surgery.But the effect of the IOIPP on shed cancer calls was not significant in cases with peritoneal metastasis. Also there were shed cancer cells in peritoneal cavity of patients with SS cancer histologically before the IOIPP(15. 56%)and iatrogenic diffusion of cancer cells during operation(7/24)in thisarticle.The above results indicated that the IOIPP with hypo-osmolar solution containing hibitane, 37℃ for 5 min was indispensable and useful for the killing of peritoneal shed cancer cells in order to prevent postoperative peritoneal recurrence in patients with radical surgery of advanced gastric cancer regardless of conditions of serosal invasion.展开更多
Turbot harbor a relatively remarkable ability to adapt to opposing osmotic challenges and are an excellent model species to study the physiological adaptations of flounder associated with osmoregulatory plasticity.The...Turbot harbor a relatively remarkable ability to adapt to opposing osmotic challenges and are an excellent model species to study the physiological adaptations of flounder associated with osmoregulatory plasticity.The kidney transcriptome of turbot treated 24 h in water of hypo-salinity(salinity 5)and seawater(salinity 30)was sequenced and characterized.In silico analysis indicated that all unigenes had significant hits in seven databases.The functional annotation analysis of the transcriptome showed that the immune system and biological processes associated with digestion,absorption,and metabolism played an important role in the osmoregulation of turbot in response to hypo-salinity.Analysis of biological processes associated with inorganic channels and transporters indicated that mineral absorption and bile secretion contributed to iono-osmoregulation resulting in cell volume regulation and cell phenotypic plasticity.Moreover,we analyzed and predicted the mechanisms of canonical signaling transduction.Biological processes involved in renin secretion,ECM-receptor interaction,adherens junction,and focal adhesion played an important role in the plasticity phenotype in hypo-stress,while the signal transduction network composed of the MAPK signaling pathway and PI3K-Akt signaling pathway with GABAergic synapse,worked in hypoosmoregulation signal transduction in the turbot.In addition,analysis of the tissue specificity of targeted gene expression using qPCR during salinity stress was carried out.The results showed that the kidney,gill,and spleen were vital regulating organs of osmotic pressure,and the osmoregulation pattern of euryhaline fish dif fered among species.展开更多
The aim of this study was to investigate the inter-fraction variations, patient comfort and knowledge at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). The differences in set-up that occurred between treatme...The aim of this study was to investigate the inter-fraction variations, patient comfort and knowledge at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). The differences in set-up that occurred between treatment sessions for the left sided breast patients were observed and recorded. Measurements of routine set-up variation for 24 patients were performed by matching the cone beam computed tomography (CBCT) and the planning computed tomography (CT). Scans of all five fractions per patient were used to quantify the setup variations with standard deviation (SD) in all the three directions (anterior posterior, left right, and superior inferior). The patients DIBH comfort and knowledge was also evaluated. The average translational errors for the anterior posterior (AP, z), left-right (LR, x), and Superior-inferior (SI, y) directions were 0.40 cm, 0.40 cm, and 0.40 cm, respectively. The translation variation of the three directions showed statistical significance (P < 0.05). On comfort and knowledge investigation, among all participants, 80% moderately agreed that the therapist’s instructions for operating the deep inspiration breath hold (DIBH) technique were easy to understand, and 63.33% indicated that their comfort with the DIBH technique was neutral or average. The inter-fraction variations in patients with left-sided breast cancer were qualitatively analyzed. Significant shifts between CBCT and planning CT images were observed. The daily treatment verification could assist accurate dose delivery.展开更多
This paper attempts to analyze the functions of hypo-cities in the context of regional economic integration and further studies how hypo-cities with different characteristics exploit their advantages to the full,putti...This paper attempts to analyze the functions of hypo-cities in the context of regional economic integration and further studies how hypo-cities with different characteristics exploit their advantages to the full,putting forward the development strategy of hypo-cities in the transportation integration.展开更多
Background：Karoshi,or death due to overwork,has now become a serious social problem in China.Worsening of cardiovascular risks by stress might initiate karoshi.Many studies have examined the relationship between job ...Background：Karoshi,or death due to overwork,has now become a serious social problem in China.Worsening of cardiovascular risks by stress might initiate karoshi.Many studies have examined the relationship between job stress and obesity,hypertension,and type 2 diabetes mellitus,but less evidence exists for dyslipidemia like hypo-high-density lipoproteinemia （hypo-HDL）.The aim of this study was to investigate the relationship between job stress and hypo-HDL of Chinese workers in Shanghai.Methods：We studied 2219 Chinese workers in Shanghai,who participated in the Japan-China cooperative study for the prevention of karoshi.A questionnaire was administered to examine the lifestyle characteristics,job category,weekly working hours,and job stress.Job demand and job control were quantified using the National Institute for Occupational Safety and Health questionnaire.Modified job strain measure was defined by the combination of low job control and high demand.Hypo-HDL was defined as plasma high-density lipoprotein cholesterol concentration of〈1.04 mmol/L （40 mg/dl）.Multivariate logistic regression analysis was performed for hypo-HDL as a dependent variable.Results：Modified job strain was not related to hypo-HDL either in men or women.In men,multivariate adjusted odds ratio （OR） for having hypo-HDL was significantly higher in the lowest job control tertile compared with the highest job control tertile （OR =1.39,95% confidence interval [CI] 1.03-1.87,P =0.034）.In the same model,a similar trend was observed for women,but it did not reach a statistically significant level （OR =1.51,95% CI,0.88-2.56,P =0.132）.Conclusion：A low level of job control but not modified job strain was significantly related to higher prevalence ofhypo-HDL of Chinese workers in Shanghai.展开更多
目的基于机器学习算法,构建太原市乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阳性母亲婴儿乙型肝炎疫苗无/弱应答的风险预测模型,为此类高风险婴儿的早期识别和预防提供参考。方法选取2019年11月—2023年10月在太原市第三人...目的基于机器学习算法,构建太原市乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阳性母亲婴儿乙型肝炎疫苗无/弱应答的风险预测模型,为此类高风险婴儿的早期识别和预防提供参考。方法选取2019年11月—2023年10月在太原市第三人民医院妇产科分娩的HBsAg阳性产妇及其分娩的婴儿作为研究对象,采用问卷调查和病历查阅方式收集数据。采用多因素logistic回归分析模型筛选危险因素,采用5折交叉验证划分数据集,采用合成少数样本过采样方法对训练集数据进行重采样处理后,分别构建logistic回归、极端梯度提升(extreme gradient boosting,XGBoost)、决策树、随机森林模型,并采用受试者工作特性曲线下面积(area under the curve,AUC)评价模型预测性能。结果共收集到HBsAg阳性母婴253对,其中无/弱应答率为10.28%(26/253)。Logistic回归分析模型结果显示,母亲乙型肝炎病毒DNA载量、新生儿髓样分化因子88蛋白百分比、磷酸化核因子κB蛋白百分比、浆细胞百分比是婴儿乙型肝炎疫苗无/弱应答的影响因素。将以上因素纳入预测模型,在验证集中各模型AUC均>0.800,其中以XGBoost算法构建的预测模型效能最佳(AUC=0.919)。结论基于机器学习算法,尤其是XGBoost算法,建立的太原市HBsAg阳性母亲婴儿乙型肝炎疫苗无/弱应答风险预测模型具有较好的效能,有助于预测婴儿乙型肝炎疫苗无/弱应答发生。展开更多
文摘Hyponatremia is frequently seen in patients with ascites secondary to advanced cirrhosis and portal hypertension.The development of ascites in patients with cirrhosis is multi-factorial.Portal hypertension and the associated systemic vasodilation lead to activation of the sodium-retaining neurohumoral mechanisms which include the renin-angiotensin-aldosterone system,sympathetic nervous system and antidiuretic hormone(ADH).The net effect is the avid retention of sodium and water to compensate for the low effective circulatory volume resulting in the development of ascites.Although not apparent in the early stages of cirrhosis,the progression of cirrhosis and ascites leads to impairment of the kidneys to eliminate solutefree water.This leads to additional compensatory mechanisms including non-osmotic secretion of ADH,also known as arginine vasopressin,further worsening excess water retention and thereby hyponatremia.Hyponatremia is associated with increased morbidity and mortality in patients with cirrhosis,and is an important prognostic marker both before and after liver transplant.The management of hyponatremia in this setting is a challenge as conventional therapy for hyponatremia including fluid restriction and loop diuretics are frequently inefficacious.In this review,we discuss the pathophysiology and various treatment modalities,including selective vasopressin receptor antagonists,for the management of hyponatremia in patients with cirrhosis.
文摘AIM: To report the 3mo outcomes of collagen crosslinking(CXL) with a hypo-osmolar riboflavin in thin corneas with the thinnest thickness less than 400 μm without epithelium.METHODS: Eight eyes in 6 patients with age 26.2±4.8y were included in the study. All patients underwent CXL using a hypo-osmolar riboflavin solution after its de-epithelization. Best corrected visual acuity, manifest refraction, the thinnest corneal thickness, and endothelial cell density were evaluated before and 3mo after the procedure.RESULTS: The mean thinnest thickness of the cornea was 408.5 ±29.0 μm before treatment and reduced to369.8 ±24.8 μm after the removal of epithelium. With the application of the hypo-osmolar riboflavin solution, the thickness increased to 445.0 ±26.5 μm before CXL and recover to 412.5 ±22.7 μm at 3mo after treatment, P =0.659). Before surgery, the mean K-value of the apex of the keratoconus corneas was 57.6 ±4.0 diopters, and slightly decreased(54.7±4.9 diopters) after surgery(P =0.085). Mean best-corrected visual acuity was 0.55 ±0.23 logarithm of the minimal angle of resolution, and increased to 0.53±0.26 logarithm after surgery(P =0.879).The endothelial cell density was 2706.4 ±201.6 cells/mm2 before treatment, and slightly decreased( 2641. 2 ±218.2 cells/mm2) at last fellow up(P =0.002).CONCLUSION: Corneal collagen cross-linking with a hypo-osmolar riboflavin in thin corneas seems to be a promising treatment. Further study should be done to evaluate the safety and efficiency of CXL in thin corneas for the long-term.
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Mold fluxes having adaptable properties were developed in the laboratory to solve quality defects, such as depressions and longitudinal cracks when casting hypo-peritectic steel at high casting speed. Firstly, the effect of components on the high basicity mold flux properties was first studied using the orthogonal method. In the scope of the studied content, Li2O has the largest effect on the melting temperature, and the least effect on the viscosity; CaF2 has the largest effect on the viscosity, and the least effect on the melting temperature; Na2O and CaO/SiO2 have no obvious influence on the melting temperature and viscosity. Secondly, two powders （Z1 and Z6） have reasonable viscosity-temperature curves, higher solidification temperatures, and porous structure after solidification, but the crystal property of Z6 is worse than that of Z1, and thus Z1 is more suitable for continuous casting hypo-peritectic steel at high casting speed. Thirdly, a higher basicity of powder, a less free enthalpy of crystal compound, and a lower baffle energy are good for a higher tendentiousness of crystal.
文摘For 100 patients with gastric cancer, intraoperative intraperitoneal perfusion(IOIPP)using double-distilled water(D.D.W)with hibitane 37℃ for 5 minutes was performed.The anticancer effects were assessed cytologically in pre-IOIPP and post-IOPP specimens of the abdominal effusion and/or lavaged peritoneal fluid.The radical gastrectomy was performed in 65 of 93 cases with advanced gastric cancer, shed cancer cells in peritoneal cavity were detected in 16 of 65 cases with pre-IOIPP(24.62%)and to 3 of post-IOIPP cases(4.62%).There was significant difference between the two groups(P<0.01) . Shed cancer cells were inactivated in vivo estimated by the trypan-blue staining technique in 7 cases with radical surgery.But the effect of the IOIPP on shed cancer calls was not significant in cases with peritoneal metastasis. Also there were shed cancer cells in peritoneal cavity of patients with SS cancer histologically before the IOIPP(15. 56%)and iatrogenic diffusion of cancer cells during operation(7/24)in thisarticle.The above results indicated that the IOIPP with hypo-osmolar solution containing hibitane, 37℃ for 5 min was indispensable and useful for the killing of peritoneal shed cancer cells in order to prevent postoperative peritoneal recurrence in patients with radical surgery of advanced gastric cancer regardless of conditions of serosal invasion.
基金Supported by the Earmarked Fund for Modern Agro-Industry Technology Research System(No.CARS-47-G01)the Ao Shan Talents Cultivation Program supported by Qingdao National Laboratory for Marine Science and Technology(No.2017ASTCP-OS04)+3 种基金the National Natural Science Foundation of China(No.41706168)the Agricultural Fine Breed Project of Shandong(No.2019LZGC013)the Basal Research Fund,Chinese Academy of Fishery Sciences(No.2016HY-JC0301)the Yantai Science and Technology Project(No.2018ZDCX021)
文摘Turbot harbor a relatively remarkable ability to adapt to opposing osmotic challenges and are an excellent model species to study the physiological adaptations of flounder associated with osmoregulatory plasticity.The kidney transcriptome of turbot treated 24 h in water of hypo-salinity(salinity 5)and seawater(salinity 30)was sequenced and characterized.In silico analysis indicated that all unigenes had significant hits in seven databases.The functional annotation analysis of the transcriptome showed that the immune system and biological processes associated with digestion,absorption,and metabolism played an important role in the osmoregulation of turbot in response to hypo-salinity.Analysis of biological processes associated with inorganic channels and transporters indicated that mineral absorption and bile secretion contributed to iono-osmoregulation resulting in cell volume regulation and cell phenotypic plasticity.Moreover,we analyzed and predicted the mechanisms of canonical signaling transduction.Biological processes involved in renin secretion,ECM-receptor interaction,adherens junction,and focal adhesion played an important role in the plasticity phenotype in hypo-stress,while the signal transduction network composed of the MAPK signaling pathway and PI3K-Akt signaling pathway with GABAergic synapse,worked in hypoosmoregulation signal transduction in the turbot.In addition,analysis of the tissue specificity of targeted gene expression using qPCR during salinity stress was carried out.The results showed that the kidney,gill,and spleen were vital regulating organs of osmotic pressure,and the osmoregulation pattern of euryhaline fish dif fered among species.
文摘The aim of this study was to investigate the inter-fraction variations, patient comfort and knowledge at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). The differences in set-up that occurred between treatment sessions for the left sided breast patients were observed and recorded. Measurements of routine set-up variation for 24 patients were performed by matching the cone beam computed tomography (CBCT) and the planning computed tomography (CT). Scans of all five fractions per patient were used to quantify the setup variations with standard deviation (SD) in all the three directions (anterior posterior, left right, and superior inferior). The patients DIBH comfort and knowledge was also evaluated. The average translational errors for the anterior posterior (AP, z), left-right (LR, x), and Superior-inferior (SI, y) directions were 0.40 cm, 0.40 cm, and 0.40 cm, respectively. The translation variation of the three directions showed statistical significance (P < 0.05). On comfort and knowledge investigation, among all participants, 80% moderately agreed that the therapist’s instructions for operating the deep inspiration breath hold (DIBH) technique were easy to understand, and 63.33% indicated that their comfort with the DIBH technique was neutral or average. The inter-fraction variations in patients with left-sided breast cancer were qualitatively analyzed. Significant shifts between CBCT and planning CT images were observed. The daily treatment verification could assist accurate dose delivery.
文摘This paper attempts to analyze the functions of hypo-cities in the context of regional economic integration and further studies how hypo-cities with different characteristics exploit their advantages to the full,putting forward the development strategy of hypo-cities in the transportation integration.
文摘Background：Karoshi,or death due to overwork,has now become a serious social problem in China.Worsening of cardiovascular risks by stress might initiate karoshi.Many studies have examined the relationship between job stress and obesity,hypertension,and type 2 diabetes mellitus,but less evidence exists for dyslipidemia like hypo-high-density lipoproteinemia （hypo-HDL）.The aim of this study was to investigate the relationship between job stress and hypo-HDL of Chinese workers in Shanghai.Methods：We studied 2219 Chinese workers in Shanghai,who participated in the Japan-China cooperative study for the prevention of karoshi.A questionnaire was administered to examine the lifestyle characteristics,job category,weekly working hours,and job stress.Job demand and job control were quantified using the National Institute for Occupational Safety and Health questionnaire.Modified job strain measure was defined by the combination of low job control and high demand.Hypo-HDL was defined as plasma high-density lipoprotein cholesterol concentration of〈1.04 mmol/L （40 mg/dl）.Multivariate logistic regression analysis was performed for hypo-HDL as a dependent variable.Results：Modified job strain was not related to hypo-HDL either in men or women.In men,multivariate adjusted odds ratio （OR） for having hypo-HDL was significantly higher in the lowest job control tertile compared with the highest job control tertile （OR =1.39,95% confidence interval [CI] 1.03-1.87,P =0.034）.In the same model,a similar trend was observed for women,but it did not reach a statistically significant level （OR =1.51,95% CI,0.88-2.56,P =0.132）.Conclusion：A low level of job control but not modified job strain was significantly related to higher prevalence ofhypo-HDL of Chinese workers in Shanghai.
文摘目的基于机器学习算法,构建太原市乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阳性母亲婴儿乙型肝炎疫苗无/弱应答的风险预测模型,为此类高风险婴儿的早期识别和预防提供参考。方法选取2019年11月—2023年10月在太原市第三人民医院妇产科分娩的HBsAg阳性产妇及其分娩的婴儿作为研究对象,采用问卷调查和病历查阅方式收集数据。采用多因素logistic回归分析模型筛选危险因素,采用5折交叉验证划分数据集,采用合成少数样本过采样方法对训练集数据进行重采样处理后,分别构建logistic回归、极端梯度提升(extreme gradient boosting,XGBoost)、决策树、随机森林模型,并采用受试者工作特性曲线下面积(area under the curve,AUC)评价模型预测性能。结果共收集到HBsAg阳性母婴253对,其中无/弱应答率为10.28%(26/253)。Logistic回归分析模型结果显示,母亲乙型肝炎病毒DNA载量、新生儿髓样分化因子88蛋白百分比、磷酸化核因子κB蛋白百分比、浆细胞百分比是婴儿乙型肝炎疫苗无/弱应答的影响因素。将以上因素纳入预测模型,在验证集中各模型AUC均>0.800,其中以XGBoost算法构建的预测模型效能最佳(AUC=0.919)。结论基于机器学习算法,尤其是XGBoost算法,建立的太原市HBsAg阳性母亲婴儿乙型肝炎疫苗无/弱应答风险预测模型具有较好的效能,有助于预测婴儿乙型肝炎疫苗无/弱应答发生。
