ABSTRACT
Objective:To establish a risk prediction model for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) using regression analysis and verify the model.Methods:The risk factors and acute exacerbation of 1 326 patients with chronic obstructive pulmonary disease (COPD) who entered the stable phase and followed up for 6 months in the four completed multi-center large-sample randomized controlled trials were retrospectively analyzed. Using the conversion-random number generator, about 80% of the 1 326 cases were randomly selected as the model group ( n = 1 074), and about 20% were the verification group ( n = 252). The data from the model group were selected, and Logistic regression analysis was used to screen independent risk factors for AECOPD, and an AECOPD risk prediction model was established; the model group and validation group data were substituted into the model, respectively, and the receiver operating characteristic (ROC) curve was drawn to verify the effectiveness of the risk prediction model in predicting AECOPD. Results:There were no statistically significant differences in general information (gender, smoking status, comorbidities, education level, etc.), body mass index (BMI) classification, lung function [forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), etc.], disease status (the number and duration of acute exacerbation in the past year, duration of disease, etc.), quality of life scale [COPD assessment test (CAT), etc.] and clinical symptoms (cough, chest tightness, etc.) between the model group and the validation group. It showed that the two sets of data had good homogeneity, and the cases in the validation group could be used to verify the effectiveness of the risk prediction model established through the model group data to predict AECOPD. Logistic regression analysis showed that gender [odds ratio ( OR) = 1.679, 95% confidence interval (95% CI) was 1.221-2.308, P = 0.001], BMI classification ( OR = 0.576, 95% CI was 0.331-1.000, P = 0.050), FEV1 ( OR = 0.551, 95% CI was 0.352-0.863, P = 0.009), number of acute exacerbation ( OR = 1.344, 95% CI was 1.245-1.451, P = 0.000) and duration of acute exacerbation ( OR = 1.018, 95% CI was 1.002-1.034, P = 0.024) were independent risk factors for AECOPD. A risk prediction model for AECOPD was constructed based on the results of regression analysis: probability of acute exacerbation ( P) = 1/(1+ e- x), x = -3.274 + 0.518×gender-0.552×BMI classification + 0.296×number of acute exacerbation + 0.018×duration of acute exacerbation-0.596×FEV1. The ROC curve analysis verified that the area under ROC curve (AUC) of the model group was 0.740, the AUC of the verification group was 0.688; the maximum Youden index of the model was 0.371, the corresponding best cut-off value of prediction probability was 0.197, the sensitivity was 80.1%, and the specificity was 57.0%. Conclusion:The AECOPD risk prediction model based on the regression analysis method had a moderate predictive power for the acute exacerbation risk of COPD patients, and could assist clinical diagnosis and treatment decision in a certain degree.
ABSTRACT
Objective@#To explore the clinical effect of artificial dermis on partial nail bed defects.@*Methods@#From May 2013 to September 2016, 16 cases of 21 fingers with partial nail bed defect and bone exposure received primary repair with artificial dermis after debridement. Then the outer dressing was changed 3 days after the operation, and the dressing was changed once every 3 to 5 days. The pink dermis like tissue was placed on the wound surface 2 to 3 weeks after the operation. The wound surface was naturally epithelialized.@*Results@#All the fingers were survived after artificial dermis repair, and the fingertip surface of nail bed defect was epithelialized naturally and healed well. Postoperative follow-up was 5 to 16 months, with an average of 8.2 months. The growth of fingernails was smooth with symmetrical appearance, natural toughness, good adhesion between the nail body and the nail bed, and no pain or hyperesthesia at the tip. Results of curative effect evaluation showed excellent in 18 fingers, good in 3 fingers. Results of patient′s satisfaction with postoperative finger appearance showed very satisfactory in 13 cases and satisfactory in 3 cases.@*Conclusions@#The method of repairing partial defect of nail bed using artificial dermis is simple with minimal damage and a good clinical effect.
ABSTRACT
Objective: To determine the transdermal absorption of phloretin and ligustilide in Fufang phloretin cream.Methods: In vitro percutaneous absorption test using the Franz intelligent transdermal absorption apparatus was adopted, an HPLC method was used to determine the contents of phloretin and ligustilide in the accepting solution at different time points, and then the cumulative release amount and the total penetration amount were calculated to evaluate the percutaneous absorption behavior.Results: Phloretin and ligustilide showed a good linearity within the range of 0.044 2-4.42 μg·ml-1(r=0.999 9) and 0.048 7-4.87 μg·ml-1(r=0.999 9), respectively, the average recovery was 99.85% and 99.92%, and RSD was 0.67% and 0.66% (n=9), respectively.The in vitro permeation behavior of phloretin and ligustilide through the skin of rats fit Higuchi equations(r>0.9), suggesting a good linear correlation between the cumulatine penetration amount (Qn) and (time).Conclusion: Fufang phloretin cream has a good percutaneous permeation property in vitro.
ABSTRACT
Choriocarcinoma is a highly malignant trophoblastic tumor and is propagated by blood -borne.The diagnosis of choriocarcinoma is based on its histopathologic appearance and a high serum level of hu -man chorionic gonadotropin(HCG).To report a case on multiple organ metastasis of choriocarcinoma ,we retro-spectively analyzed the treatment by reviewing the interrelated articles to analyse the clinical characteristics and treatment of choriocarcinoma .