ABSTRACT
Objective To establish a simple scoring system for the diagnosis of liver fibrosis in chronic hepatitis B (CHB), and to observe its sensitivity and specificity. Methods Two hundred and thirty-three patients diagnosed as CHB by liver biopsy were divided into model group (N = 154) and validation group (N = 79). The general information, biochemical parameters and imaging data of all patients were observed. With hepatic fibrosis being obvious or not as the end point of primary study in the model group, we established a simple scoring system for the diagnosis. The cut-off, sensitivity and specificity of the system were tested in the model group by ROC curve, and its diagnostic efficacy was tested in the validation group. Results(1) A simple scoring system for the diagnosis of liver fibrosis called MDFS was established in the model group, and the dimensions of the system included sex, HBV-DNA, Fibroscan (FS) value and splenomegaly. In MDFS, male, HBV-DNA≥ 107 U/mL,FS value≥7.3 kPa, and splenomegaly were assigned 1 point, -2 points, 3 points, and 2 points respectively. (2) The best cut-off value in MDFS was 2 points.(3) ROC curve of the model group indicated that the specificity and sensitivity were 92.86% and 54.76% respectively, the area under curve(AUC) was 0.790, and the Youden index was 0.4762. In the validation group, the diagnostic cut-off value was over 2 points, and the sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 52.17%, 82.35%, 2.96, and 0.58 respectively. (4) The scoring results of MDFS for different traditional Chinese medical syndromes of CHB showed that the scores of blood stasis blocking collaterals > damp-heat accumulation > deficiency of spleen and kidney yang> liver depression and spleen deficiency = stagnation of liver Qi. Conclusion The MDFS diagnostic scoring system has medium efficiency. The specificity of MDFS is relatively high and MDFs has a relatively low misdiagnosis rate for the diagnosis of obvious hepatic fibrosis in CHB. The MDFS is expected to be a noninvasive and simple diagnosing way for hepatic fibrosis in CHB.
ABSTRACT
Objective To investigate the effect of docetaxel combined capecitabine chemotherapy and psychological intervention after radical mastectomy. Methods 80 cases of radical mastectomy for breast cancer treated in our hospital from January 2015 to January 2017 were treated with docetaxel combined with capecitabine chemotherapy. According to different nursing methods, the patients were divided into 2 groups. The observation group was treated with psychological nursing, while the control group received routine nursing care. The anxiety and depression scores in two groups before and after nursing were observed and compared. Results There were no significant difference in the scores of anxiety and depression between the two groups before and after treatment. After the intervention group, patients in observation group were significantly improved, and better than the control group patients; The nursing satisfaction rate in the observation group was 97.5%,which was significantly higher than that in the control group (72.5%) (P<0.05). Conclusion After radical mastectomy of breast cancer with docetaxel combined with capecitabine chemotherapy and psychological clinical observation of dry pre found in breast cancer resection and chemotherapy as the basis, to patients with psychological intervention can improve the clinical situation of patients, promote their mental status improved, improve nursing satisfaction rate of patients, so it is worthy of reference.