ABSTRACT
BACKGROUND@#Computed tomography images are easy to misjudge because of their complexity, especially images of solitary pulmonary nodules, of which diagnosis as benign or malignant is extremely important in lung cancer treatment. Therefore, there is an urgent need for a more effective strategy in lung cancer diagnosis. In our study, we aimed to externally validate and revise the Mayo model, and a new model was established.@*METHODS@#A total of 1450 patients from three centers with solitary pulmonary nodules who underwent surgery were included in the study and were divided into training, internal validation, and external validation sets (n = 849, 365, and 236, respectively). External verification and recalibration of the Mayo model and establishment of new logistic regression model were performed on the training set. Overall performance of each model was evaluated using area under receiver operating characteristic curve (AUC). Finally, the model validation was completed on the validation data set.@*RESULTS@#The AUC of the Mayo model on the training set was 0.653 (95% confidence interval [CI]: 0.613-0.694). After re-estimation of the coefficients of all covariates included in the original Mayo model, the revised Mayo model achieved an AUC of 0.671 (95% CI: 0.635-0.706). We then developed a new model that achieved a higher AUC of 0.891 (95% CI: 0.865-0.917). It had an AUC of 0.888 (95% CI: 0.842-0.934) on the internal validation set, which was significantly higher than that of the revised Mayo model (AUC: 0.577, 95% CI: 0.509-0.646) and the Mayo model (AUC: 0.609, 95% CI, 0.544-0.675) (P < 0.001). The AUC of the new model was 0.876 (95% CI: 0.831-0.920) on the external verification set, which was higher than the corresponding value of the Mayo model (AUC: 0.705, 95% CI: 0.639-0.772) and revised Mayo model (AUC: 0.706, 95% CI: 0.640-0.772) (P < 0.001). Then the prediction model was presented as a nomogram, which is easier to generalize.@*CONCLUSIONS@#After external verification and recalibration of the Mayo model, the results show that they are not suitable for the prediction of malignant pulmonary nodules in the Chinese population. Therefore, a new model was established by a backward stepwise process. The new model was constructed to rapidly discriminate benign from malignant pulmonary nodules, which could achieve accurate diagnosis of potential patients with lung cancer.
Subject(s)
Humans , Lung , Lung Neoplasms/diagnostic imaging , Multiple Pulmonary Nodules , Risk Assessment , Solitary Pulmonary Nodule/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
BACKGROUND:The artificial joint has gone through nearly a century of history from the beginning of design to the clinical application. The forerunner of artificial joints is artificial hip joint. With the skiled technological application in clinic, the design, application and improvement of wrist, shoulder, knee and other artificial joints have been promoted. OBJECTIVE: To summarize the application progress and performance characteristics of artificial joint materials in exercise-induced articular cartilage injury. METHODS: PubMed (http://www.ncbi.nlm.nih.gov/PubMed), Wanfang database (http://wanfangdata.com.cn/) and China National Knowledge Infrastructure (http://www.cnki.net/) during 1980 to 2015 were retrieved by the first author. “Sports; Cartilage Injury; Artificial Joint” were taken as the key words in English and Chinese, respectively. Retrieved data were analyzed and summarized. The artificial joint materials commonly used at home and abroad were introduced and analyzed one by one. The clinical advantages and disadvantages of various materials were analyzed from the view of materials science. The surface treatment methods commonly used for artificial joints were described. The direction of the artificial joint research was pointed out from a development perspective. RESULTS AND CONCLUSION:The surface modification of titanium aloys can obtain surface ceramic layer with good performance, and can effectively improve the anti-wear properties of titanium aloys. The filing and modification of ultra-high molecular weight polyethylene can obtain joint composites with good anti-wear properties that can effectively reduce the production of ultra-high molecular weight polyethylene wear particles and the biological response induced by ultra-high molecular weight polyethylene wear particles. Further research and improvement of ceramic artificial joints wil be the future direction of development of artificial joints.
ABSTRACT
In order to investigate the role of MMP-9 and TIMP-1 in the pathogenesis of systemic sclerosis, the expression of MMP-9 and TIMP-1 was immunohistochemically detected in skin lesions of the patients with diffuse cutaneous systemic sclerosis, skin lesions of the patients with limited cutaneous systemic sclerosis, and skin tissues of normal subjects. The results showed that the expression of MMP-9 in lesions of diffuse cutaneous systemic sclerosis was significantly lower than that of normal skins (P＜0.05). However, no significant difference in the level of MMP-9 in the limited cutaneous systemic sclerosis and normal skin was found. Meanwhile, the expression of TIMP-1 in lesions of diffuse cutaneous systemic sclerosis and limited cutaneous systemic sclerosis were significantly higher than that of normal skins (both P＜0.05). It was suggested that the expression of MMP-9 and TIMP-1 might play an important role in the development of systemic sclerosis.