Background:Non-Hodgkin T/NK cell lymphoma is a rare and widely variable type of lymphoma with the most dismal prognosis.This study aimed to investigate varied impact of the clinical indicators to the overall survival(...Background:Non-Hodgkin T/NK cell lymphoma is a rare and widely variable type of lymphoma with the most dismal prognosis.This study aimed to investigate varied impact of the clinical indicators to the overall survival(OS).Methods:We conducted a retrospective study to identify the non-invasive clinical features of T cell lymphoma that can predict prognosis with an innovative analysis method using quantile regression.A total of 183 patients who visited a top-tier hospital in Beijing,China,were enrolled from January 2006 to December 2015.Demographic information and main clinical indicators were collected including age,erythrocyte sedimentation rate(ESR),survival status,and international prognostic index(IPI)score.Results:The median age of the patients at diagnosis was 45 years.Approximately 80%of patients were at an advanced stage,and the median survival time after diagnosis was 5.1 months.Multivariable analysis of the prognostic factors for inferior OS associated with advanced clinical staging[HR=3.16,95%CI(1.39-7.2)],lower platelet count[HR=2.57,95%CI(1.57-4.19),P<0.001]and higher IPI score[HR=1.29,95%CI(1.01-1.66),P=0.043].Meanwhile,T cell lymphoblastic lymphoma[HR=0.40,95%CI(0.20-0.80),P=0.010],higher white blood cell counts[HR=0.57,95%CI(0.34-0.96),P=0.033],higher serum albumin level[HR=0.6,95%CI(0.37-0.97),P=0.039],and higher ESR[HR=0.53,95%CI(0.33-0.87),P=0.011]were protective factors for OS when stratified by hemophagocytic lymphohistiocytosis(HLH).Multivariable quantile regression between the OS rate and each predictor at quartiles 0.25,0.5,0.75,and 0.95 showed that the coefficients of serumβ2-microglobulin level and serum ESR were statistically significant in the middle of the coefficient curve(quartile 0.25-0.75).The coefficient of IPI was negatively associated with OS.The coefficients of hematopoietic stem cell transplantation(HSCT)and no clinical symptoms were higher at the middle of the quartile level curve but were not statistically significant.Conclusions:The IPI score is a comparatively robust indicator of prognosis at 3 quartiles,and serum ESR is stable at the middle 2 quartiles section when adjusted for HLH.Quantile regression can be used to observe detailed impacts of the predictors on OS.展开更多
Based on the quarterly economic,social and financial development data of 39 poverty-stricken counties in Henan Province during 2016-2018,this paper utilized the entropy-based TOPSIS method to objectively measure the r...Based on the quarterly economic,social and financial development data of 39 poverty-stricken counties in Henan Province during 2016-2018,this paper utilized the entropy-based TOPSIS method to objectively measure the rural revitalization index,and then built the quantile regression model to study the effects of various elements of inclusive finance on different stages of rural revitalization.Research results show that industrial development,agricultural modernization,targeted poverty alleviation,endogenous demand,and rural governance are the main points of inclusive finance in poverty-stricken areas to support rural revitalization;the rural revitalization index indicates that compared with the Dabie Mountain area and the non-contiguous poverty-stricken areas,the rural revitalization of the Qinba Mountain area is slower;for inclusive finance supporting rural revitalization,it is necessary to bring into play the role of monetary policy tools in re-lending,functions of credit in supporting industrial development,and role of insurance in risk protection;furthermore,inclusive finance solves problems such as the diminishing marginal effect of physical machinery investment in rural revitalization support,financial support for the coordinated development of small farmers and new agricultural business entities,financial support for the development of the entire industry chain,and the"siphon effect"of capital.展开更多
Background:Six epidemic waves of human infection with avian influenza A(H7N9)virus have emerged in China with high mortality.However,study on quantitative relationship between clinical indices in ill persons and H7N9 ...Background:Six epidemic waves of human infection with avian influenza A(H7N9)virus have emerged in China with high mortality.However,study on quantitative relationship between clinical indices in ill persons and H7N9 outcome(fatal and nonfatal)is still unclear.A retrospective cohort study was conducted to collect laboratory-confirmed cases with H7N9 viral infection from 2013 to 2015 in 23 hospitals across 13 cities in Guangdong Province,China.Methods:Multivariable logistic regression model and classification tree model analyses were used to detect the threshold of selected clinical indices and risk factors for H7N9 death.The receiver operating characteristic curve(ROC)and analyses were used to compare survival and death distributions and differences between indices.A total of 143 cases with 90 survivors and 53 deaths were investigated.Results:Average age(Odds Ratio(OR)=1.036,95%Confidence Interval(CI)=1.016-1.057),interval days between dates of onset and confirmation(OR=1.078,95%CI=1.004-1.157),interval days between onset and oseltamivir treatment(OR=5.923,95%CI=1.877-18.687),body temperature(BT)(OR=3.612,95%CI=1.914-6.815),white blood cell count(WBC)(OR=1.212,95%CI=1.092-1.346)were significantly associated with H7N9 death after adjusting for confounders.The chance of death from H7N9 infection was 80.0%if BT was over 38.1°C,and chance of death is 67.4%if WBC count was higher than 9.5(109/L).Only 27.1%of patients who began oseltamivir treatment less than 9.5 days after disease onset died,compared to 68.8%of those who started treatment more than 15.5 days after onset.Conclusions:The intervals between date of onset and confirmation of diagnosis,between date of onset to oseltamivir treatment,age,BT and WBC are found to be the best predictors of H7N9 mortality.展开更多
基金grants from the National Natural Science Foundation of China(No.81673232)the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding(No.ZYLX201702)+1 种基金the Beijing Municipal Science and Technology Plan of Capital Characteristics Project(No.Z151100004015172)the Capital Health Research and Medical Development Foundation(No.2016-2-2027).
文摘Background:Non-Hodgkin T/NK cell lymphoma is a rare and widely variable type of lymphoma with the most dismal prognosis.This study aimed to investigate varied impact of the clinical indicators to the overall survival(OS).Methods:We conducted a retrospective study to identify the non-invasive clinical features of T cell lymphoma that can predict prognosis with an innovative analysis method using quantile regression.A total of 183 patients who visited a top-tier hospital in Beijing,China,were enrolled from January 2006 to December 2015.Demographic information and main clinical indicators were collected including age,erythrocyte sedimentation rate(ESR),survival status,and international prognostic index(IPI)score.Results:The median age of the patients at diagnosis was 45 years.Approximately 80%of patients were at an advanced stage,and the median survival time after diagnosis was 5.1 months.Multivariable analysis of the prognostic factors for inferior OS associated with advanced clinical staging[HR=3.16,95%CI(1.39-7.2)],lower platelet count[HR=2.57,95%CI(1.57-4.19),P<0.001]and higher IPI score[HR=1.29,95%CI(1.01-1.66),P=0.043].Meanwhile,T cell lymphoblastic lymphoma[HR=0.40,95%CI(0.20-0.80),P=0.010],higher white blood cell counts[HR=0.57,95%CI(0.34-0.96),P=0.033],higher serum albumin level[HR=0.6,95%CI(0.37-0.97),P=0.039],and higher ESR[HR=0.53,95%CI(0.33-0.87),P=0.011]were protective factors for OS when stratified by hemophagocytic lymphohistiocytosis(HLH).Multivariable quantile regression between the OS rate and each predictor at quartiles 0.25,0.5,0.75,and 0.95 showed that the coefficients of serumβ2-microglobulin level and serum ESR were statistically significant in the middle of the coefficient curve(quartile 0.25-0.75).The coefficient of IPI was negatively associated with OS.The coefficients of hematopoietic stem cell transplantation(HSCT)and no clinical symptoms were higher at the middle of the quartile level curve but were not statistically significant.Conclusions:The IPI score is a comparatively robust indicator of prognosis at 3 quartiles,and serum ESR is stable at the middle 2 quartiles section when adjusted for HLH.Quantile regression can be used to observe detailed impacts of the predictors on OS.
基金Western Project of National Social Science Foundation of China:Research on Governance Mechanism Optimization and Risk Prevention and Control of Credit Cooperation of Farmers'Cooperatives in China(16XJY021).
文摘Based on the quarterly economic,social and financial development data of 39 poverty-stricken counties in Henan Province during 2016-2018,this paper utilized the entropy-based TOPSIS method to objectively measure the rural revitalization index,and then built the quantile regression model to study the effects of various elements of inclusive finance on different stages of rural revitalization.Research results show that industrial development,agricultural modernization,targeted poverty alleviation,endogenous demand,and rural governance are the main points of inclusive finance in poverty-stricken areas to support rural revitalization;the rural revitalization index indicates that compared with the Dabie Mountain area and the non-contiguous poverty-stricken areas,the rural revitalization of the Qinba Mountain area is slower;for inclusive finance supporting rural revitalization,it is necessary to bring into play the role of monetary policy tools in re-lending,functions of credit in supporting industrial development,and role of insurance in risk protection;furthermore,inclusive finance solves problems such as the diminishing marginal effect of physical machinery investment in rural revitalization support,financial support for the coordinated development of small farmers and new agricultural business entities,financial support for the development of the entire industry chain,and the"siphon effect"of capital.
基金supported by grants from the National Science and Technology Major Project of China(No.2018ZX10101002-001-001)National Key Research and Development Program of China(No.2018YFD0500500).
文摘Background:Six epidemic waves of human infection with avian influenza A(H7N9)virus have emerged in China with high mortality.However,study on quantitative relationship between clinical indices in ill persons and H7N9 outcome(fatal and nonfatal)is still unclear.A retrospective cohort study was conducted to collect laboratory-confirmed cases with H7N9 viral infection from 2013 to 2015 in 23 hospitals across 13 cities in Guangdong Province,China.Methods:Multivariable logistic regression model and classification tree model analyses were used to detect the threshold of selected clinical indices and risk factors for H7N9 death.The receiver operating characteristic curve(ROC)and analyses were used to compare survival and death distributions and differences between indices.A total of 143 cases with 90 survivors and 53 deaths were investigated.Results:Average age(Odds Ratio(OR)=1.036,95%Confidence Interval(CI)=1.016-1.057),interval days between dates of onset and confirmation(OR=1.078,95%CI=1.004-1.157),interval days between onset and oseltamivir treatment(OR=5.923,95%CI=1.877-18.687),body temperature(BT)(OR=3.612,95%CI=1.914-6.815),white blood cell count(WBC)(OR=1.212,95%CI=1.092-1.346)were significantly associated with H7N9 death after adjusting for confounders.The chance of death from H7N9 infection was 80.0%if BT was over 38.1°C,and chance of death is 67.4%if WBC count was higher than 9.5(109/L).Only 27.1%of patients who began oseltamivir treatment less than 9.5 days after disease onset died,compared to 68.8%of those who started treatment more than 15.5 days after onset.Conclusions:The intervals between date of onset and confirmation of diagnosis,between date of onset to oseltamivir treatment,age,BT and WBC are found to be the best predictors of H7N9 mortality.
