OBJECTIVE： To determine the risk factors for progressive ischemic stroke, and to prevent onset and make a prognosis of disease, the present study systemically evaluated 19 cohort studies and 10 case-controlled studie...OBJECTIVE： To determine the risk factors for progressive ischemic stroke, and to prevent onset and make a prognosis of disease, the present study systemically evaluated 19 cohort studies and 10 case-controlled studies of progressive ischemic stroke. SEARCH STRATEGY： A computer-based, online, literature search of PubMed （1966/2007）, China Biological Medicine Database （CBM-disc, 1979/2007） and CNKI （www.cnki.net, 1979/2007） was performed to screen for related studies. DATA SELECTION： Cohort or case-controlled studies that focused on risk factors of progressive ischemic stroke were selected for review. Two reviewers independently extracted data and assessed study quality according to Cochrane Collaboration guidelines. Statistical analysis was performed using RevMan software. MAIN OUTCOME MEASUREMENT： Risk factors for progressive ischemic stroke. RESULTS： Using the inclusion criteria, 29/781 studies published in English and Chinese were initially reviewed, including 19 cohort studies and 10 case-control studies. Despite variations in determination of progressive ischemic stroke and the intervals between 2 evaluations, all studies described the diagnostic criteria for progressive ischemic stroke. Logistic analysis was employed in 20 of the studies. Meta-analysis of primary data in the related studies determined that the following factors that significantly correlated with progressive ischemic stroke： fever [risk ratio （RR） = 2.26, 95% confidence interval （CO： 1.20-4.26, P = 0.01; odds ratio （OR） = 2.85, 95% CI： 1.64-4.98, P 〈 0.01 ）]; diabetes （RR = 1.38, 95% CI： 1.18-1.61, P 〈 0.01 ; OR = 2.48, 95% Ch 1.93-3.19, P 〈 0.01 ）; coronary heart disease （RR = 1.22, 95% CI： 1.08-1.38, P 〈 0.01）; neuroimaging transformation （RR= 1.55, 95%CI： 1.34-1.80, P〈 0.01; OR= 2.29, 95% CI： 1.47-3.58, P〈 0.01）; and hyperglycemia （RR = 2.62, 95% CI： 1.86-3.68, P 〈 0.01 ; OR = 3.49, 95% CI： 1.92-6.35, P 〈 0.01）. CONCLUSION： Fever, diabetes, coronary heart disease, neuroimaging transformation, and hyperglycemia are important risk factors for progressive ischemic stroke. Interventions for these risk factors could effectively prevent occurrence of progressive ischemic stroke.展开更多
Traditional occupational disease control and prevention has remained prevalent in China over recent decades. There are appropriately 30,000 new case reports of occupational diseases annually. Although China has alread...Traditional occupational disease control and prevention has remained prevalent in China over recent decades. There are appropriately 30,000 new case reports of occupational diseases annually. Although China has already established a series of occupational disease prevention programs, occupational health risk assessment （OHRA） strategies continue to be a limitation.展开更多
BACKGROUND： Progressive ischemic stroke has higher fatality rate and disability rate than common cerebral infarction, thus it is very significant to investigate the early predicting factors related to the occurrence ...BACKGROUND： Progressive ischemic stroke has higher fatality rate and disability rate than common cerebral infarction, thus it is very significant to investigate the early predicting factors related to the occurrence of progressive ischemic stroke, the potential pathological mechanism and the risk factors of early intervention for preventing the occurrence of progressive ischemic stroke and ameliorating its outcome. OBJECTIVE： To analyze the possible related risk factors in patients with progressive ishcemic stroke, so as to provide reference for the prevention and treatment of progressive ishcemic stroke. DESIGN： A retrospective analysis. SETTING： Department of Neurology, General Hospital of Beijing Coal Mining Group. PARTICIPANTS： Totally 280 patients with progressive ischemic stroke were selected from the Department of Neurology, General Hospital of Beijing Coal Mining Group from March 2002 to June 2006, including 192 males and 88 females, with a mean age of （62±7） years old. They were all accorded with the diagnostic standards for cerebral infarction set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1995, and confired by CT or MRI, admitted within 24 hours after attack, and the neurological defect progressed gradually or aggravated in gradients within 72 hours after attack, and the aggravation of neurological defect was defined as the neurological deficit score decreased by more than 2 points. Meanwhile, 200 inpatients with non-progressive ischemic stroke （135 males and 65 females） were selected as the control group. METHODS： After admission, a univariate analysis of variance was conducted using the factors of blood pressure, history of diabetes mellitus, fever, leukocytosis, levels of blood lipids, fibrinogen, blood glucose and plasma homocysteine, cerebral arterial stenosis, and CT symptoms of early infarction, and the significant factors were involved in the multivariate non-conditional Logistic regression analysis. MAIN OUTCOME MEASURES： Results of the univariate analysis of variance of the factors related to progressive ischemic stroke; Results of the multivariate regression analysis. RESULTS： All the 480 patients were involved in the analysis of results. ① Results of the univariate analysis variance： There were significantly more patients with fever, leukocytosis, history of diabetes mellitus, cerebral arterial stenosis and CT symptoms of early infarction in the progressive ischemic stroke group than in the control group （P 〈 0.01）; The levels of blood glucose and fibrinogen in the progressive ischemic stroke group were significantly higher than those in the control group, while the level of blood pressure was significantly lower than that in the control group （P 〈 0.05 - 0.01）. ② Results of the multivariate Logistic regression analysis： The independent predicting factors for progressive ischemic stroke were history of diabetes mellitus, fever, leukocytosis, cerebral arterial stenosis, CT symptoms of early infarction, blood glucose and blood pressure （OR =2.61,2.96, 3.79, 1.03, 3.57, 2.68, 95% CI 0.92 - 3.59, P 〈 0.05 - 0.01）. CONCLUSION： History of diabetes mellitus, fever, leukocytosis, levels of blood pressure, blood glucose, cerebral arterial stenosis and CT symptoms of early infarction are the risk factors for progress ischemic stroke展开更多
Inference are considered for the dependence competing risks model by using the Marshal-Olkin bivariate exponential distribution. Under generalized progressively hybrid censoring with partially observed failure causes,...Inference are considered for the dependence competing risks model by using the Marshal-Olkin bivariate exponential distribution. Under generalized progressively hybrid censoring with partially observed failure causes, the maximum likelihood estimators are established, and the approximate confidence intervals are also constructed via the observed Fisher information matrix.Moreover, Bayes estimates and highest probability density credible intervals are presented and the importance sampling technique is used to compute corresponding results. Finally, the numerical analysis is proposed for illustration.展开更多
Nowadays, bladder cancer is the fourth most common cancer in adults and the second most frequent urogenital tumor. Predicting recurrence and progression of superficial bladder tumors, with available clinical informati...Nowadays, bladder cancer is the fourth most common cancer in adults and the second most frequent urogenital tumor. Predicting recurrence and progression of superficial bladder tumors, with available clinical information to decide the therapy to be used is a difficult task. In this work, two mathematical models were developed to help specialists on the decision process. The mathematical tool used to formulate the model was the fuzzy sets theory, due to its capacity in dealing with uncertainties inherent in medical concepts. In the first model, Stage, Grade and Size of the tumor were also considered input variables and Risk of Recurrence of a superficial bladder tumor as output variable of the first Fuzzy Rule-Based Systems (FRBS). In the second model, in addition to the Stage, Grade and Size of the tumor, it was also considered as input variable of a second FRBS Carcinoma in situ and, the Risk of Progression of superficial tumors as an output variable. For each model, simulations were made with data originated from of patients of the Clinics Hospital/ UNICAMP and A. C. Camargo Hospital of São Paulo, with the aim to verify the reliability of results generated by the two systems. From a database and the possibility found by FRBS, after the possibility-probability transformation, we can generate the real probability of each fuzzy output set.展开更多
In this paper, we construct a Bayesian framework combining Type-Ⅰ progressively hybrid censoring scheme and competing risks which are independently distributed as exponentiated Weibull distribution with one scale par...In this paper, we construct a Bayesian framework combining Type-Ⅰ progressively hybrid censoring scheme and competing risks which are independently distributed as exponentiated Weibull distribution with one scale parameter and two shape parameters. Since there exist unknown hyper-parameters in prior density functions of shape parameters, we consider the hierarchical priors to obtain the individual marginal posterior density functions,Bayesian estimates and highest posterior density credible intervals. As explicit expressions of estimates cannot be obtained, the componentwise updating algorithm of Metropolis-Hastings method is employed to compute the numerical results. Finally, it is concluded that Bayesian estimates have a good performance.展开更多
To determine the risk, malignant degree and clinical progression of prostate cancer （PCa） associated with mouse double-minute 2 protein （MDM2） T309G variants, a meta-analysis was performed on all eligible publishe...To determine the risk, malignant degree and clinical progression of prostate cancer （PCa） associated with mouse double-minute 2 protein （MDM2） T309G variants, a meta-analysis was performed on all eligible published studies. Odds ratios （ORs） with 95% confidence intervals （CIs） were estimated to assess these associations in seven studies that included 5151 cases and 1003 controls. In the overall analysis, the 309G allele was significantly associated with a decreased PCa risk （0R=0.85, 95% CI： 0.74-0.97）; this was also the case for the homozygous comparison （0R--0.72, 95% Ch 0.55-0.95） and the dominant genetic model （0R=0.79, 95% Ch 0.65-0.96）. The 309G allele was also found to be significantly associated with lower degrees of PCa malignancy （0R=0.85, 95% Ch 0.75-0.96） in the overall analysis, as well as in the heterozygous comparison （0R=0.79, 95% Ch 0.65-0.96）, homozygous comparison （0R=0.76, 95% Ch 0.58-0.98） and dominant genetic model （0R=0.81, 95% CI： 0.68-0.96）. Furthermore, grouping analysis showed that the 309G allele in Caucasians was significantly correlated with a decreased PCa risk （0R=0.77, 95% Ch 0.61-0.96）; this was also the case in the homozygous comparison （0R=0.51, 95% Ch 0.31-0.86）. The grouping analysis also showed that the 309G variant in Caucasians was significantly associated with a lower degree of PCa malignancy in all of the genetic models. In addition, we found that the 309G variant in Caucasians was significantly associated with a slower PCa clinical progression in all of the genetic models. In summary, our meta-analysis showed that the MDM2 309G variant was significantly associated with a decreased PCa risk, lower malignant degree and slower clinical progression in Caucasians, but there was no obvious association in the Asian population.展开更多
目的探讨胎龄<32周的早产儿发生脑室周围-脑室内出血(periventricular-intraventricular hemorrhage,PIVH)进展的潜在危险因素。方法回顾性收集2020年1月1日至2022年12月31日,江苏省新生儿围产期协作网20家医疗机构新生儿重症监护室...目的探讨胎龄<32周的早产儿发生脑室周围-脑室内出血(periventricular-intraventricular hemorrhage,PIVH)进展的潜在危险因素。方法回顾性收集2020年1月1日至2022年12月31日,江苏省新生儿围产期协作网20家医疗机构新生儿重症监护室收治的胎龄<32周、生后3 d内第一次头颅B超提示Ⅰ、Ⅱ度PIVH,且10天内复查第二次头颅B超的早产儿临床资料。排除先天畸形、基因异常、信息不全的早产儿。采用多因素Logistic回归分析生后早期PIVH进展的危险因素。结果共纳入3347例早产儿资料,其中胎龄小于32周者551例,将"自Ⅰ、Ⅱ度发展为Ⅲ、Ⅳ度"的患儿纳入进展组(共29例),其余522例纳入未进展组。单因素Logistic回归分析结果显示,胎龄、是否多胎、1 min Apgar评分、分娩前母亲体温超过38℃、新生儿危重病例评分、新生儿急性生理学评分-Ⅱ(Score for Neonatal Acute Physiology-Ⅱ,SNAP-Ⅱ)、新生儿急性生理学评分围产期补充评分Ⅱ(Score for Neonatal Acute Physiology,Perinatal Extension,VersionⅡ,SNAPPE-Ⅱ)、早发败血症、新生儿窒息、新生儿肺动脉高压、休克、早产儿贫血、血小板减少症、生后有创机械通气、使用肺泡表面活性物质、输入血小板和血浆是早期PIVH进展的相关因素(P<0.05)。多因素Logistic回归分析显示,胎龄<28周(OR=6.346,95%CI:2.914~13.824)、分娩前母亲体温超过38℃(OR=2.454,95%CI:1.153~5.225)是早期PIVH进展的危险因素(P<0.05)结论胎龄<32周的早产儿出现PIVH早期进展的危险因素是胎龄<28周和分娩前母亲体温超过38℃。展开更多
基金Supported by Science and Technology Development Projects of Henan Province Science and Technology Department, No. 102102310124Special Fund for Medical Science and Technology Innovation Talents of Henan Province
文摘OBJECTIVE： To determine the risk factors for progressive ischemic stroke, and to prevent onset and make a prognosis of disease, the present study systemically evaluated 19 cohort studies and 10 case-controlled studies of progressive ischemic stroke. SEARCH STRATEGY： A computer-based, online, literature search of PubMed （1966/2007）, China Biological Medicine Database （CBM-disc, 1979/2007） and CNKI （www.cnki.net, 1979/2007） was performed to screen for related studies. DATA SELECTION： Cohort or case-controlled studies that focused on risk factors of progressive ischemic stroke were selected for review. Two reviewers independently extracted data and assessed study quality according to Cochrane Collaboration guidelines. Statistical analysis was performed using RevMan software. MAIN OUTCOME MEASUREMENT： Risk factors for progressive ischemic stroke. RESULTS： Using the inclusion criteria, 29/781 studies published in English and Chinese were initially reviewed, including 19 cohort studies and 10 case-control studies. Despite variations in determination of progressive ischemic stroke and the intervals between 2 evaluations, all studies described the diagnostic criteria for progressive ischemic stroke. Logistic analysis was employed in 20 of the studies. Meta-analysis of primary data in the related studies determined that the following factors that significantly correlated with progressive ischemic stroke： fever [risk ratio （RR） = 2.26, 95% confidence interval （CO： 1.20-4.26, P = 0.01; odds ratio （OR） = 2.85, 95% CI： 1.64-4.98, P 〈 0.01 ）]; diabetes （RR = 1.38, 95% CI： 1.18-1.61, P 〈 0.01 ; OR = 2.48, 95% Ch 1.93-3.19, P 〈 0.01 ）; coronary heart disease （RR = 1.22, 95% CI： 1.08-1.38, P 〈 0.01）; neuroimaging transformation （RR= 1.55, 95%CI： 1.34-1.80, P〈 0.01; OR= 2.29, 95% CI： 1.47-3.58, P〈 0.01）; and hyperglycemia （RR = 2.62, 95% CI： 1.86-3.68, P 〈 0.01 ; OR = 3.49, 95% CI： 1.92-6.35, P 〈 0.01）. CONCLUSION： Fever, diabetes, coronary heart disease, neuroimaging transformation, and hyperglycemia are important risk factors for progressive ischemic stroke. Interventions for these risk factors could effectively prevent occurrence of progressive ischemic stroke.
基金supported by the Natural Science Foundation of China(81472961)the Joint Projects of the National Health and Family Planning Commission of China and the Health Bureau of Zhejiang Province(No.WSK 2014-2-004)the Zhejiang Provincial Program for the Cultivation of High-Level Innovative Health Talents
文摘Traditional occupational disease control and prevention has remained prevalent in China over recent decades. There are appropriately 30,000 new case reports of occupational diseases annually. Although China has already established a series of occupational disease prevention programs, occupational health risk assessment （OHRA） strategies continue to be a limitation.
文摘BACKGROUND： Progressive ischemic stroke has higher fatality rate and disability rate than common cerebral infarction, thus it is very significant to investigate the early predicting factors related to the occurrence of progressive ischemic stroke, the potential pathological mechanism and the risk factors of early intervention for preventing the occurrence of progressive ischemic stroke and ameliorating its outcome. OBJECTIVE： To analyze the possible related risk factors in patients with progressive ishcemic stroke, so as to provide reference for the prevention and treatment of progressive ishcemic stroke. DESIGN： A retrospective analysis. SETTING： Department of Neurology, General Hospital of Beijing Coal Mining Group. PARTICIPANTS： Totally 280 patients with progressive ischemic stroke were selected from the Department of Neurology, General Hospital of Beijing Coal Mining Group from March 2002 to June 2006, including 192 males and 88 females, with a mean age of （62±7） years old. They were all accorded with the diagnostic standards for cerebral infarction set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1995, and confired by CT or MRI, admitted within 24 hours after attack, and the neurological defect progressed gradually or aggravated in gradients within 72 hours after attack, and the aggravation of neurological defect was defined as the neurological deficit score decreased by more than 2 points. Meanwhile, 200 inpatients with non-progressive ischemic stroke （135 males and 65 females） were selected as the control group. METHODS： After admission, a univariate analysis of variance was conducted using the factors of blood pressure, history of diabetes mellitus, fever, leukocytosis, levels of blood lipids, fibrinogen, blood glucose and plasma homocysteine, cerebral arterial stenosis, and CT symptoms of early infarction, and the significant factors were involved in the multivariate non-conditional Logistic regression analysis. MAIN OUTCOME MEASURES： Results of the univariate analysis of variance of the factors related to progressive ischemic stroke; Results of the multivariate regression analysis. RESULTS： All the 480 patients were involved in the analysis of results. ① Results of the univariate analysis variance： There were significantly more patients with fever, leukocytosis, history of diabetes mellitus, cerebral arterial stenosis and CT symptoms of early infarction in the progressive ischemic stroke group than in the control group （P 〈 0.01）; The levels of blood glucose and fibrinogen in the progressive ischemic stroke group were significantly higher than those in the control group, while the level of blood pressure was significantly lower than that in the control group （P 〈 0.05 - 0.01）. ② Results of the multivariate Logistic regression analysis： The independent predicting factors for progressive ischemic stroke were history of diabetes mellitus, fever, leukocytosis, cerebral arterial stenosis, CT symptoms of early infarction, blood glucose and blood pressure （OR =2.61,2.96, 3.79, 1.03, 3.57, 2.68, 95% CI 0.92 - 3.59, P 〈 0.05 - 0.01）. CONCLUSION： History of diabetes mellitus, fever, leukocytosis, levels of blood pressure, blood glucose, cerebral arterial stenosis and CT symptoms of early infarction are the risk factors for progress ischemic stroke
基金supported by the National Natural Science Foundation of China(11501433)the Fundamental Research Funds for the Central Universities(JB180711)
文摘Inference are considered for the dependence competing risks model by using the Marshal-Olkin bivariate exponential distribution. Under generalized progressively hybrid censoring with partially observed failure causes, the maximum likelihood estimators are established, and the approximate confidence intervals are also constructed via the observed Fisher information matrix.Moreover, Bayes estimates and highest probability density credible intervals are presented and the importance sampling technique is used to compute corresponding results. Finally, the numerical analysis is proposed for illustration.
文摘Nowadays, bladder cancer is the fourth most common cancer in adults and the second most frequent urogenital tumor. Predicting recurrence and progression of superficial bladder tumors, with available clinical information to decide the therapy to be used is a difficult task. In this work, two mathematical models were developed to help specialists on the decision process. The mathematical tool used to formulate the model was the fuzzy sets theory, due to its capacity in dealing with uncertainties inherent in medical concepts. In the first model, Stage, Grade and Size of the tumor were also considered input variables and Risk of Recurrence of a superficial bladder tumor as output variable of the first Fuzzy Rule-Based Systems (FRBS). In the second model, in addition to the Stage, Grade and Size of the tumor, it was also considered as input variable of a second FRBS Carcinoma in situ and, the Risk of Progression of superficial tumors as an output variable. For each model, simulations were made with data originated from of patients of the Clinics Hospital/ UNICAMP and A. C. Camargo Hospital of São Paulo, with the aim to verify the reliability of results generated by the two systems. From a database and the possibility found by FRBS, after the possibility-probability transformation, we can generate the real probability of each fuzzy output set.
基金Supported by the National Natural Science Foundation of China（71571144,71401134,71171164,11701406） Supported by the International Cooperation and Exchanges in Science and Technology Program of Shaanxi Province（2016KW-033）
文摘In this paper, we construct a Bayesian framework combining Type-Ⅰ progressively hybrid censoring scheme and competing risks which are independently distributed as exponentiated Weibull distribution with one scale parameter and two shape parameters. Since there exist unknown hyper-parameters in prior density functions of shape parameters, we consider the hierarchical priors to obtain the individual marginal posterior density functions,Bayesian estimates and highest posterior density credible intervals. As explicit expressions of estimates cannot be obtained, the componentwise updating algorithm of Metropolis-Hastings method is employed to compute the numerical results. Finally, it is concluded that Bayesian estimates have a good performance.
文摘To determine the risk, malignant degree and clinical progression of prostate cancer （PCa） associated with mouse double-minute 2 protein （MDM2） T309G variants, a meta-analysis was performed on all eligible published studies. Odds ratios （ORs） with 95% confidence intervals （CIs） were estimated to assess these associations in seven studies that included 5151 cases and 1003 controls. In the overall analysis, the 309G allele was significantly associated with a decreased PCa risk （0R=0.85, 95% CI： 0.74-0.97）; this was also the case for the homozygous comparison （0R--0.72, 95% Ch 0.55-0.95） and the dominant genetic model （0R=0.79, 95% Ch 0.65-0.96）. The 309G allele was also found to be significantly associated with lower degrees of PCa malignancy （0R=0.85, 95% Ch 0.75-0.96） in the overall analysis, as well as in the heterozygous comparison （0R=0.79, 95% Ch 0.65-0.96）, homozygous comparison （0R=0.76, 95% Ch 0.58-0.98） and dominant genetic model （0R=0.81, 95% CI： 0.68-0.96）. Furthermore, grouping analysis showed that the 309G allele in Caucasians was significantly correlated with a decreased PCa risk （0R=0.77, 95% Ch 0.61-0.96）; this was also the case in the homozygous comparison （0R=0.51, 95% Ch 0.31-0.86）. The grouping analysis also showed that the 309G variant in Caucasians was significantly associated with a lower degree of PCa malignancy in all of the genetic models. In addition, we found that the 309G variant in Caucasians was significantly associated with a slower PCa clinical progression in all of the genetic models. In summary, our meta-analysis showed that the MDM2 309G variant was significantly associated with a decreased PCa risk, lower malignant degree and slower clinical progression in Caucasians, but there was no obvious association in the Asian population.
文摘目的探讨胎龄<32周的早产儿发生脑室周围-脑室内出血(periventricular-intraventricular hemorrhage,PIVH)进展的潜在危险因素。方法回顾性收集2020年1月1日至2022年12月31日,江苏省新生儿围产期协作网20家医疗机构新生儿重症监护室收治的胎龄<32周、生后3 d内第一次头颅B超提示Ⅰ、Ⅱ度PIVH,且10天内复查第二次头颅B超的早产儿临床资料。排除先天畸形、基因异常、信息不全的早产儿。采用多因素Logistic回归分析生后早期PIVH进展的危险因素。结果共纳入3347例早产儿资料,其中胎龄小于32周者551例,将"自Ⅰ、Ⅱ度发展为Ⅲ、Ⅳ度"的患儿纳入进展组(共29例),其余522例纳入未进展组。单因素Logistic回归分析结果显示,胎龄、是否多胎、1 min Apgar评分、分娩前母亲体温超过38℃、新生儿危重病例评分、新生儿急性生理学评分-Ⅱ(Score for Neonatal Acute Physiology-Ⅱ,SNAP-Ⅱ)、新生儿急性生理学评分围产期补充评分Ⅱ(Score for Neonatal Acute Physiology,Perinatal Extension,VersionⅡ,SNAPPE-Ⅱ)、早发败血症、新生儿窒息、新生儿肺动脉高压、休克、早产儿贫血、血小板减少症、生后有创机械通气、使用肺泡表面活性物质、输入血小板和血浆是早期PIVH进展的相关因素(P<0.05)。多因素Logistic回归分析显示,胎龄<28周(OR=6.346,95%CI:2.914~13.824)、分娩前母亲体温超过38℃(OR=2.454,95%CI:1.153~5.225)是早期PIVH进展的危险因素(P<0.05)结论胎龄<32周的早产儿出现PIVH早期进展的危险因素是胎龄<28周和分娩前母亲体温超过38℃。
