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【Objective】 To explore the factors influencing the survival and prognosis of patients with bladder urothelial carcinoma (BUC) after surgical treatment, and to establish an artificial intelligence algorithm to predict the effects of different surgical regimens. 【Methods】 BUC patients treated with surgery during Jan.2007 and Jan.2019 in The Second Hospital of Dalian Medical University and Nanfang Hospital of Southern Medical University were enrolled. The complete clinical and follow-up data were collected. Deep neural network (DNN) was used to establish an artificial intelligence algorithm model. A prediction model of survival and prognosis was established, and the influencing factors of survival were explored and ranked by the artificial intelligence algorithm. 【Results】 A total of 832 patients were involved, including 438 (52.64%) treated in The Second Hospital of Dalian Medical University, and 394 (47.36%) treated in Nanfang Hospital of Southern Medical University. Of all cases, 579 (69.6%) were non-muscle invasive bladder cancer, and 253 (30.4%) were muscle invasive bladder cancer. Transurethral resection of bladder tumor was conducted in 539 (64.8%) cases, partial cystectomy in 66 (7.9%) cases, and total cystectomy in 227 (27.3%) cases. The data of patients treated in Second Hospital of Dalian Medical University were used for DNN modeling, and the data of patients treated in Nanfang Hospital of Southern Medical University were used for external verification after modeling. Finally, it was concluded that the factors affecting survival and prognosis were T stage, pathological grade, hypertension or cardiovascular and cerebrovascular disease, hemoglobin, blood calcium, smoking, albumin, lymphocytes, age, ratio of albumin/globulin, operation method, N stage, and creatinine clearance rate in descending order. The model could be used for preoperative prediction. 【Conclusion】 Through DNN modeling and external verification, the influencing factors of postoperative survival can be predicted for patients with bladder cancer, and the surgical effects can also be predicted before operation. The model can provide artificial intelligence algorithm support for the selection of surgical methods and postoperative follow-up plans.
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Objective:To compare the influence of single and staged percutaneous coronary intervention (PCI) on long-term prognosis in patients with multi-vessel coronary artery disease.Methods:Using prospective research methods, 1 832 patients with multi-vessel coronary artery disease from January to December 2013 in Fuwai Hospital, Chinese Academy of Medical Sciences were selected. According to the time of PCI, the patients were divided into single PCI group (1 218 cases) and staged PCI group (614 cases). The patients were followed up for 2 years, the primary endpoint was major cardiovascular and cerebrovascular event (MACCE), including target vessel-related myocardial infarction (TV-MI), target vessel-related revascularization (TVR), cardiogenic death and stroke, and the secondary endpoint was stent thrombosis. The propensity score matching (PSM) was applied to balance the discrepancies between 2 groups, and the baseline and follow-up data were compared. The Kaplan-Meier survival curves were drawn to evaluate the survival rates events; multifactor Cox proportional risk regression was used to analyze whether staged PCI was an independent risk factor for the endpoint events.Results:The in-hospital stay, duration of procedure and synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score in single PCI group were significantly lower than those in staged PCI group: (5.54±3.09) d vs. (9.50±4.06) d, (43.12±28.55) min vs. (79.54±44.35) min, (14.04±7.63) scores vs. (18.51±7.79) scores, and there were statistical differences ( P<0.01); there were no statistical difference in complete revascularization rate and SYNTAX score after PCI between 2 groups ( P>0.05). Based on 2-year follow-up, the incidences of TV-MI and stent thrombosis in staged PCI group were significantly higher than those in single PCI group: 2.1% (13/614) vs. 0.5% (6/1 218) and 2.0% (12/614) vs. 0.4% (5/1 218), and there were statistical differences ( P<0.01). Kaplan-Meier survival curves analysis results showed that the event-free survival rates of TV-MI and stent thrombosis in single PCI group were better than those in staged PCI group (99.5% vs. 97.9% and 99.6% vs. 98.0%, P<0.01). Multifactor Cox proportional risk regression analysis results showed that staged PCI was an independent risk factor for stent thrombosis ( HR = 3.91, 95% CI 1.25 to 12.18, P = 0.019). After PSM, the incidences of TV-MI and stent thrombosis in staged PCI group were significantly higher than those in single PCI group: 2.1% (13/614) vs. 0.7% (4/614) and 2.0% (12/614) vs. 0.5% (3/614), and there were statistical differences ( P<0.05); Kaplan-Meier survival curve analysis results showed that the event-free survival rates of TV-MI and stent thrombosis in single PCI group were significantly higher than those in staged PCI group: (99.3% vs. 97.9% and 99.5% vs. 98.0%, P<0.05); multifactor Cox proportional risk regression analysis results showed that staged PCI was not an independent risk factor of stent thrombosis ( HR = 2.29, 95% CI 0.58 to 9.00, P = 0.234). Both before and after PSM, there were no evidences for interaction between the type of angina pectoris and staged PCI ( P>0.05). Conclusions:Although a seemingly increase exists in the incidence of TV-MI and stent thrombosis in the staged PCI group, staged PCI is an independent risk factor neither for MACCE and its components, nor for stent thrombosis. In addition single PCI reduces the in-hospital days and duration of PCI procedure, which may be a relatively reasonable approach to clinical practice.
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OBJECTIVE：To provide reference for clinical decision-making related to chemotherapy-induced nausea and vomiting（CINV）. METHODS ：The medical records of patients diagnosed as malignant tumor receiving multi-day cisplatin-containing chemotherapy in our hospital were collected by hospital information system from Jan.-Dec. 2012. The medical records were divided into tropisetron group ，ramosetron group and palonosetron group according to different schemes of 5-hydroxytryptamine-3 receptor antagonist. The covariates of 3 groups were balanced by propensity score matching method ；cost-utility analysis was conducted for the 3 matched antiemetic schemes ；one-way sensitivity analysis and sampling uncertainty analysis were also conducted. RESULTS ： The results of cost-utility analysis showed that treatment cost of one observation period of tropisetron group was 237.71 yuan and utility were 0.054 68 QALYs；that of ramosetron group was 242.37 yuan and utility were 0.055 26 QALYs，and that of palonosetron group was 319.24 yuan and utility were 0.055 76 QALYs. Compared with tropisetron group ，the ICER of palonosetron group was 75 155.69 yuan/QALY；Compared with ramosetron group ，the ICER of palonosetron group was 152 062.07 yuan/QALY. Both of them were lower than 3 times of China ’s 2020 per capita GDP （217 341 yuan/QALY）. The results of sensitivity analysis and sampling uncertainty analysis demonstrated that the results of basic analysis were robust. CONCLUSIONS ：Under the current drug price，the antiemetic regimen based on palonosetron is more economical for the prevention of CINV caused by multi-day chemotherapy containing cisplatin.
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Objective:To study the diagnosis and treatment of osteoporotic fractures in the elderly in two third Grade A hospitals in Shenyang and Dalian, and to provide scientific basis for prevention and treatment of osteoporotic fractures in Dalian and Shenyang.Methods:Patients of osteoporotic fractures over 60 years old from January 2015 to December 2015 in the Second Hospital of Dalian Medical University and the People′s Hospital of Liaoning Province were chosen, and the basic characteristics, fracture site, the number of fracture site, diagnosis treatment and secondary prevention of osteoporosis fractures of them were analyzed.Results:Among the patients of osteoporotic fractures over 60 years old in the hospitals of Shenyang and Dalian, women were more than men ( P = 0.00). The predilection sites of elderly osteoporotic fractures in two hospitals were both followed by the hip, spine, ulnar and radial distal, proximal humerus. The rates respectively were 38.26%(295/771), 34.63% (267/771), 9.34%(72/771), 5.71%(44/771). The rate of fracture-again was 10.89%(84/771). The rates of in-hospital diagnosis, in-hospital treatment and treatment of discharged medical advice among osteoporosis were 13.88%(107/771), 24.64%(190/771) and 18.81%(145/771). There were 0.65% (5/771) patients who had diagnosis of osteoporosis, basic osteoporosis treatment (vitamin D 3 and calcium) and anti-osteoporosis treatment in both in-hospital and discharged medical advice. Conclusions:The rates of in-hospital diagnosis, in-hospital osteoporosis treatment and anti-osteoporosis treatment in discharged medical advice are both very low in the two third Grade A hospitals. The secondary prevention of osteoporosis fractures in the elderly has not been taken attention, and the situation of prevention and treatment are serious.
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Objective@#To explore data mining methods and tools for the activity paths of confirmed patients, and provide data analysis tools for epidemic control.@*Methods@#The data used came from the trajectory data of confirmed cases collected by Tencent. The jieba word segmentation and word cloud map function of Python 3.6 were used to calculate the high-frequency vocabulary in the trajectory of confirmed patients. The epidemic prevention and control strategy was developed based on the high-frequency vocabulary.@*Results@#Taking Guangdong Province, the second most confirmed patients in the country, as an example, the key areas of epidemic control obtained through data mining involve Wuhan (epidemiological history), Zhuhai and Guangzhou. The key control activities include family visiting, traveling and shopping. Means of transportation include self-driving, trains and airplanes; the key patients studied were Li and Ding; the symptoms of this patient group were mainly fever and cough.@*Conclusions@#The data mining algorithm in this paper can provide an advantageous tool for epidemic prevention and control, also assist frontline personnel to adjust the deployment of epidemic prevention and control according to their priorities.
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Objective:To explore data mining methods and tools for the activity paths of confirmed patients, and provide data analysis tools for epidemic control.Methods:The data used came from the trajectory data of confirmed cases collected by Tencent. The jieba word segmentation and word cloud map function of Python 3.6 were used to calculate the high-frequency vocabulary in the trajectory of confirmed patients. The epidemic prevention and control strategy was developed based on the high-frequency vocabulary.Results:Taking Guangdong Province, the second most confirmed patients in the country, as an example, the key areas of epidemic control obtained through data mining involve Wuhan (epidemiological history), Zhuhai and Guangzhou. The key control activities include family visiting, traveling and shopping. Means of transportation include self-driving, trains and airplanes; the key patients studied were Li and Ding; the symptoms of this patient group were mainly fever and cough.Conclusions:The data mining algorithm in this paper can provide an advantageous tool for epidemic prevention and control, also assist frontline personnel to adjust the deployment of epidemic prevention and control according to their priorities.
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Objective@#To study the characteristics of sentinel vein (SV) and middle temporal vein (MTV) and influence in surgery of periorbital and temporal areas.@*Methods@#From January 2018 to August 2019, 20 donated fresh/frozen head specimens (12 males and 8 females) were collected in various regions of China, with an average age of 47.2 (21 to 88) years. Temporal region of 29 hemi-facial area was dissected in layers, and the occurrence rate, route, geometric parameters, branchesand correlation of SV and MTV were observed and measured.@*Results@#Occurrence rate of SV was 96.6% (28/29), the subcutaneous subordinate branches of SV were 2.5±1.0 in average, with both joining together in 6 kinds of mode. The horizontal section length was (5.8±3.8) mm, and outside diameter was (1.0±0.1) mm. The vertical section length was (8.2±4.3) mm, and outside diameter was (1.2±0.4) mm, steering vertically to the deep through the superficial temporal fascia, middle temporal fascia (MTF) and superficial layer of deep temporal fascia (SDTF), continuing to the MTV. The minimal average distance between the SV and TFN was (6.0±2.7) mm. Occurrence rate of MTV was 96.6% (28/29). The first half of MTV was parallel to the zygomatic arch and ran across the superficial temporal fat pad, then turned down near the upper pole of the external ear wheel, and run vertically in front of the ear, and 5.9±2.7 peripheral branches were collected along the way. The length of temporal middle vein was (82.3±8.6) mm, and outer diameter of the thickest point was (3.6±0.7) mm.@*Conclusions@#Sentinel vein is the main branch of middle temporal vein. It passes through several layers of soft tissue vertically and directly into the MTV. Position of sentinel vein is relatively constant, which is an important localization marker in the operation of the temporal region. The middle temporal vein has large diameter, fixing in the superficial temporal fat pad, collecting the venous reflux of the temporal area at both superficial and deep, which may be the main cause of pulmonary infarction produced by the temporal fat transplantation, and injury should be avoided.
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Objective To summarize and analyze the Logistic and linear regression modeling of medical research papers in 2018,to propose a general modeling strategy.Methods Search 2018 China Knowledge Network medical research related papers,extract some papers for evaluation,identify and analyze possible modeling defects in the paper writing process,provide the general method of modeling.Results In the China Knowledge Network database,1 319 medical research papers were detected in 2018,and 125 papers were randomly selected for evaluation.Identified issues include no data cleaning before modeling,insufficient attention to modeling,and model evaluation after modeling.Conclusions There are defects in the modeling process of medical research papers,and further attention and enhancement are needed in the writing process.
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OBJECTIVE@#Identification of new risk factors is needed to improve prediction of adverse outcomes in patients with three-vessel disease (TVD). The present study aimed to evaluate the prognostic values of serum chloride and sodium levels in patients with TVD.@*METHODS@#We used data from a prospective cohort of consecutive patients with angiographically confirmed TVD. The primary endpoint was all-cause death. Cox proportional hazard regression was used to analyze the relationship of serum chloride and sodium levels with long-term outcomes of TVD patients.@*RESULTS@#A total of 8,318 participants with available serum chloride and sodium data were included in this analysis. At baseline, patients in the low tertiles group of serum chloride level (⪕ 102.0 mmol/L) or serum sodium level (⪕ 139.0 mmol/L) had more severe disease conditions. During a median follow-up of 7.5-year, both low serum chloride level and low serum sodium level were found to be associated with an increased risk for mortality in univariate analysis. However, when both parameters were incorporated into a multivariate model, only low serum sodium level remained to be an independent predictor of all-cause death (hazard ratio: 1.16, 95% confidence interval: 1.01-1.34, P = 0.041). Modest but significant improvement of discrimination was observed after incorporating serum sodium level into the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery score.@*CONCLUSION@#Serum sodium level is more strongly associated with long-term outcomes of TVD patients compared with serum chloride level. Low serum sodium level is an independent risk factor for mortality, but only provides modest prognostic information beyond an established risk model.
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Aged , Female , Humans , Male , Middle Aged , China , Epidemiology , Chlorides , Blood , Coronary Artery Disease , Blood , Diagnosis , Mortality , Prognosis , Prospective Studies , Sodium , BloodABSTRACT
With the evolution of medical techniques and technology, an increasing number of infants, neonates, and fetuses are exposed to general anesthesia for clinical diagnostic and therapeutic process. The neurotoxic effects of general anesthetics on developing brain have been a subject of concern and considerable research interest. Population-based study confirmed that single short-term general anesthetic exposure does not affect nervous system function, but multiple exposures to general anesthesia could damage cognitive function. Animal studies further discovered the underlying mechanisms. Nervous system is most susceptible to general anesthetics during the brain growth spurt. The time-point is more critical than the duration of exposure to general anesthetics. General anesthetics can induce intracellular calcium overload, disturb energy metabolism, promote cell apoptosis and lead to cell loss. General anesthetics can damage synaptic structure, transmission and plasticity, and impair brain function. High throughput omics technologies have been used to screen the differentially expressed genes induced by general anesthetics, which provide further understanding of the mechanism of general anesthetics affecting cognitive function. This review provides an update on the pathophysiologic mechanisms underlying the anesthesia-neurotoxicity, which will be helpful to provide instructions for the clinical use of general anesthesia in children.
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Animals , Female , Humans , Infant , Infant, Newborn , Pregnancy , Anesthesia, General , Anesthetics, General , Brain , Cognition , Prenatal Exposure Delayed EffectsABSTRACT
Objective The research aims to optimize the hospital research performance appraisal ,clarify the scientific characteristics and possible shortages of different clinic departments in various types ,to enhance the effectiveness of research performance appraisal .Methods Descriptive statistics were used to generalize hospital research performance appraisal in 2017 . Hierarchical clustering was used to cluster and analyze performance appraisal characteristics of 75 clinic departments .Results SCI papers (405) ,National projects (181) and National core journal papers (106) took 75 .2％ of total average score .The op-timal solution of the cluster was 6 types for 75 departments and the dendrogram illustrated significant varieties among the 6 types .Six departments' types were academic-conference-oriented ,national-paper-oriented ,SCI-paper-oriented ,advanced-pro-ject-oriented ,provincial/horizontal-project-oriented and attending-conference-oriented .The percentages of the oriented indica-tors that took their total average scores were 59 .4％ ,42 .0％ ,66 .7％ ,57 .0％ ,61 .8％ ,52 .3％ .Conclusions Compared with K-means method ,the results of hierarchical clustering equipped with better characteristics and interpretative power .Research performance appraisal has been further optimized .Departments in different types showed significant characteristics and weak-nesses ,which provides managers with effective guidance on countermeasures .
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Objective To evaluate the effects of the pulsed-dye laser (PDL) at a wave length of 595 nm in treatment of scar after cosmetic suturing.Methods Twenty patients after cosmetic suturing were randomly assigned to the treatment group and control group.Each group had ten patients.The scar of patient was evaluated with the Vancouver scar scale (VSS).The treatment group was treated with 595 nm PDL for three times,and the control group did not receive any treatment.Follow-up was arranged at one mouth after the last treatment.Acquired score was compared with paired T-test transversely and longitudinally.Results Pre-operation VSS was 3.80± 1.48 and post-operation VSS was 5.20±2.66 in control group,which had no statistic difference (P ＜ 0.05).Pre-operation VSS was 4.10 ± 1.20 and post-operation VSS was 2.80±1.23 in treatment group,which showed statistic difference (P＞0.05);scars were much normal in treatment group,including less vasculature,more flatter and softer.VSS in the control group postoperatively had no statistic difference as compared with the treatment group (4.10±1.20 vs.3.80±1.48,P＞0.05).VSS in the treatment group showed significant statistic difference between pre-operation and post-operation (2.80 ± 1.23 vs.5.20 ± 2.66,P ＜ 0.05).Conclusions 595nm PDL is a safe and effective treatment in improving the appearance of scars after cosmetic suturing.
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Objective To analyze the shortcomings of statistical methods of journal articles and propose solutions.Methods Information All the literature of "Basic Science" and "Medical Science and Technology" database in CNKI database was used as sampling source,and the limited time was retrieved from November 10,2014 to November 10,2017.A total number of 1 456 417 articles were found,of which 100 were sampled each year by random number method.300 articles were used to examine the application of statistical methods one by one,identifying the statistical defects and providing solutions.Results 126 out of the 300 papers analyzed used statistical methods,of which there were statistical defects.Most of the articles focused on statistics and P values without detailed annotation.The applicable conditions of statistical methods Mishandled and other issues,in view of these problems,this paper developed a statistical path map and question-answer computer system for clinical applications.Conclusions There are a lot of statistical flaws in the randomized papers.The statistical path map and the question-answering computer system proposed in this paper provide a solution to the clinical statistical problems.
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Objective To investigate the effect of maternal psychological status and family structure on the social emotional development of toddlers.Methods The study was conducted in January 2016,50 toddlers aged 12 to 36 months from one kindergarten in Dalian were selected with cluster random sampling.The parents of toddlers were interviewed,and the questionnaire for background condition,the socialemotional assessment scale for children and SCL-90 for maternal psychological status were applied.The effect of maternal psychological status and family structure on the social-emotion development of toddlers was analyzed.Results The positive rates of externalizing,internalizing,deregulation and competence in 50 toddlers were 24％ (12/50),14％ (7/50),20％ (10/50) and 22％ (11/50),respectively.The scores of obsession and anxiety in high school and college graduate mother group were higher than junior high school group(F =6.488,5.834,all P ＜ 0.05).The scores of obsession,interpersonal relationship,depression and anxiety in unhappy mother group were higher than those in happy mother group (t =7.812,3.860,5.871,6.843,all P ＜ 0.05).Compared to happy mother group,the abnormality rates of externalizing behavior [42％ (10/24)vs.8％ (2/26),x2 =10.667,P =0.001],internalization behavior [25％ (6/24) vs.4％ (1/26),x2 =0.000,P =0.008] and behavior disorder [33％ (8/24)vs.8％ (2/26),x2 =7.200,P =0.007] were significantly higher in unhappy mother group.There were significant differences in positive rate of externalized behavior among mothers with different educational levels (junior high school,high school and college graduate) (8/15,3/17 and 1/18,F =9.757,P ＜0.05).There were significant differences in respond ability of children among families with different structure (single-parent family,joint family,direct family and nuclear family) (3/5,1/4,7/28 and 0/13,F =8.134,P =0.026).Conclusion The abnormal rates of children's externalization,internalization and deregulation behavior are higher for mothers with emotional unhappiness,and the abnormal rate of children's competence in single-parent family,joint family and direct family are higher than that in nuclear family.
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AIM: To analyze the value of 24 - hour intraocular pressure ( IOP) monitoring in suspected glaucoma patients. METHODS: Totally 48 suspected glaucoma (96 eyes) were selected for 24 - hour IOP monitoring by using Accupen tonometer (24 - 3000) and non - contact tonometer (NCT, CT-80A) from 9 30 to 7 30 next day (once in 2h). During 07 30 to 21 30, patients were measured in sitting position,while during 23 30 to 05 30 in both sitting and supine position. RESULTS:A morning peak of IOP was shown at 7 30 in traditional position by using two measures with 22.05士3 608mmHg of NCT and 19.79士4.147mmHg of Accupen tonometer. The peak IOP in habitual position appeared in 5 30 with 21.64士4.814mmHg. The lowest IOP occurred in both position at 21 30 with 15. 73士3. 649mmHg. Both positions showed IOP trend of going up at night and then declining in the morning. CONCLUSION: The peak IOP in suspected glaucoma occurs mostly at early morning. Supine IOP of sleeping time is higher than that of sitting position.
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Objective To analyze the SCI papers output and its impact factors of a hospital during 2013-2017,to provide supports and proofs for scientific research administrators to update incentive policies for stimulate growth of SCI Paper publication.Methods Dynamic sequence and Optimal Scaling Regression methods were used to conduct statistical analysis of the output and impact factors of hospital-published SCI papers.Results The average increased number per year of hospital-published SCI papers output was 30.3 with an annual increase rate of 37.5％,which was 9.5％ higher than the national average.In 2017,the growth rate of a fixed base of hospital-published SCI papers was increased to 257.4 ％,which was 89％ higher than the national rate during the same period.The model was statistically significant (F =10.513,P＜ 0.001,adjusted R2 =0.409) according to the Optimal Scaling Regression analysis of 180 first/corresponding authors out of 516 SCI papers.We found that authors' status as tutor of post-graduate student (P＜0.001),average project fundings (P=0.001),professional titles (P=0.048) and genders (P=0.005) have significant impacts on the output of hospital-published SCI papers (P＜0.05).The sum of the importance of the four factors above was 0.961,namely account for 96.1％ of the whole model.The quantitative score conversion chart shows that doctoral tutors,high average project funding,senior professional titles,and male authors of the SCI papers have higher quantitative scores.Conclusions Tutor status,average project fundings,professional titles and genders could impact the output of SCI papers.Scientific research administrators could adjust incentive policies of SCI papers,based on the science platform construction inclining to doctor tutors,adding matching funds for science and research,bonding professional title appraisals and rising incentives for female researchers on SCI papers,to promote SCI papers output.
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OBJECTIVE@#To compare the application among intensity-modulated radiotherapy (IMRT), three-dimensional conformal radiotherapy(3D-CRT) and conventional radiotherapy (CRT) for locally advanced middle-low rectal cancer.@*METHODS@#From January 2015 to December 2016, 93 locally advanced middle-low rectal cancer patients with clinical stage cT3N+M0 or cT4N0/+M0 who underwent preoperative concurrent chemoradiotherapy at Department of Colorectal Surgery, the Third Affiliated Hospital of Kunming Medical University and had complete data were enrolled in this retrospective cohort study. Patients were divided into IMRT group (17 cases), 3D-CRT group (28 cases) and CRT group (48 cases) according to different radiotherapy methods. The frequency and dose of CRT were 1 time/day, 5 times/week, for a total of 5 weeks, with a single dose of 2.0 Gy, the total dose was 50 Gy. Frequency and dose of 3D-CRT and IMRT were 1 time/day, 5 times/week, for a total of 23 to 28 times, with a single dose of 1.8 to 2.0 Gy, and a total dose of 45.0 to 50.4 Gy. The chemotherapy regimen was performed with capecitabine tablets at a dose of 825 mg/m twice a day for 5 days every week, at the same time during radiotherapy. The efficacy, chemotherapy adverse reactions and immune function of the three groups were compared.@*RESULTS@#There was no significant difference in the baseline data among the three groups (all P>0.05). The proportion of patients receiving permanent ostomy in the IMRT group and the 3D-CRT group was 29.4%(5/17) and 32.1%(9/28) respectively, which was lower than 58.3%(28/48) in CRT group, and the difference was statistically significant (χ²=7.982, P=0.030), while this proportion was not significantly different between IMRT and 3D-CRT group(χ²=0.037, P=0.848). The pathologic complete response(pCR) rate was 23.7%(22/93) in the whole study, and the pCR rate was 39.3%(11/28) in the 3D-CRT group, which was higher than that of CRT group and IMRT group [12.5%(6/48) and 29.4%(5/17)], and the difference was statistically significant (χ²=7.407, P=0.025), while there was no significant difference in pCR rate between CRT group and IMRT group (χ²=2.554, P=0.110). There was no adverse reaction of grade 3 or above in all three groups. No significant difference in the incidence of bone marrow suppression, abnormal liver and kidney function markers, digestive tract reaction or radiation dermatitis was found(all P>0.05). After receiving concurrent chemoradiotherapy, the proportion of CD3/CD4 cells in the IMRT group and the CRT group decreased compared with that before treatment(23.1±9.3 vs. 31.1±10.9, 27.4±10.7 vs. 33.6±7.2, respectively); the proportion of CD3/CD8 cells was up-regulated (36.1±15.2 vs. 24.8±10.9, 30.9±14.4 vs. 24.0±8.3,respectively), and the differences were statistically significant (both P0.05). After treatment, the proportion of CD4/CD8 cells in IMRT group decreased (0.8±0.6 vs. 1.6±1.0, t=3.838, P=0.003), while this proportion was not significantly different in CRT group and 3D-CRT group(all P>0.05).@*CONCLUSIONS@#IMRT and 3D-CRT can reduce the rate of permanent stoma. 3D-CRT can increase pCR rate. No obvious advantage is shown in IMRT as compared with 3D-CRT in the short-term efficacy. On the contrary, an immunosuppressive status may occur. Therefore, 3D-CRT is recommended as the best preoperative treatment strategy for patients with locally advanced middle-low rectal cancer, especially for those with immunosuppression status.
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Humans , Radiotherapy , Methods , Reference Standards , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted , Radiotherapy, Conformal , Reference Standards , Radiotherapy, Intensity-Modulated , Reference Standards , Rectal Neoplasms , Radiotherapy , Retrospective StudiesABSTRACT
Objective To explore the application of Propensity Score Matching Methods in medical scientific research,and demonstrate the operation process of SPSS.Methods This article summarized and discussed the principle and application of PSM through the literature,a real example was adopted to introduce the operation procedures of SPSS.Results We can use PSM process to control confounding factors between the retrospective study groups effectively through SPSS.Conclusions PSM is an efficient tool to conduct retrospective study.It can provide necessary help for clinical data mining.
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Objective To analyze the correlation of different antiphospholipid antibody isotypes in female infertility.Methods Selected 296 patients with female infertility and 31 normal female between May 2015 to August 2015 in Dalian Women’s and Children’s Medical Centre.All the antibodies were detected by chemilumininescence.The positiverate of antipholipid an-tibodies in female infertility patients and health controls were calculated.The concentrations of antiphospholipid antibodies in different groups were compared with Mann-Whitney U test.Results The positive rate of aCL IgG of female infertility and normal female were 0.34% and 0.00%.The positive rate of aCL IgM of female infertility and normal female were 1.35%and 0.00%.The positive rate ofβ2 GPⅠ IgG of female infertility and normal female were 0.00% and 0.00%.The positive rate ofβ2 GPⅠ IgM of female infertility and normal female were 0.34% and 0.00%.aCL IgG were differet beween female infertility and normal female (P=0.013),others had on significant difference.Conclusion Need to detect LA,combined with aCL and anti-β2 GPⅠ,exclusively diagnose APS,layed the foundation of sequential treatment.
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<p><b>OBJECTIVE</b>To investigate and analyze the characteristics of Meridian Sinew (Jingjin) syndrome in patients with whiplash-associated disorders (WAD).</p><p><b>METHODS</b>From August 2010 to September 2011, 313 WAD cases from New York and California states were collected. The survey mostly collects the information of "Sinew Knotted Points" and symptoms of four types of Meridian Sinew differentiation-Taiyang, Shaoyin, Shaoyang and Yangming.</p><p><b>RESULTS</b>Among the cases which are on the average of medium injury level, the higher frequency of "Sinew Knotted Points" tenderness were found on Jianwaishu (SI 14), Jianzhongshu (SI 15), Tianchuang (SI 16), C3-6 Spinous Process, Dazhui (GV 14), Fengchi (GB 20), Tianliao (SJ 15) and Tianding (LI 17). The most commonly presented symptoms were widespread spasm and tenderness in the neck (Taiyang), difficulty in lateral flexion (Shaoyang), problems of extension and flexion (Taiyang), and stiffness and pain during neck movement (Yangming). Among the cases, 237 cases (75.72%) were related to Taiyang Meridian Sinew syndrome, 82 cases (26.20%) to Shaoyin syndrome and 175 (55.91%) and 176 (56.23%) cases to Shaoyang and Yangming syndrome respectively. The most of cases presented in a combination format. The syndrome distribution under Grade I, II and III reflected that more combination of the Meridian Sinew syndromes in the whiplash injury patients which is resulted from more severity of injury.</p><p><b>CONCLUSION</b>It is practical to identify the location of abnormality through Meridian Sinew differentiation, considering both "Sinew Knotted Points" tenderness and corresponding symptoms, for the local neck symptoms of WAD.</p>