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Objective:To develop a machine model to predict the risk of postoperative distant metastasis recurrence in serous ovarian cancer (SOC) based on routine clinical data.Methods:Participants included 687 patients with recurrent SOC who underwent surgery at Yunnan Cancer Hospital from January 2010 to December 2020. According to the recurrence status, the patients were divided into the distant metastasis group ( n=105) and the non-distant metastasis group ( n=582). Logistic regression was used to screen the variables related to distant metastasis of SOC. Based on these selected variables, five machine learning methods including K-nearest neighbor (KNN), logistic regression (LR), random forest (RF), support vector machine (SVM) and extreme gradient boosting (XGBoost) were used to develop the postoperative distant metastasis risk prediction model of SOC. For model validation, the 10-fold cross-validation method was used for internal validation. The performance of the models was evaluated using the receiver operating characteristic curve. Results:There were statistically significant differences in International Federation of Gynecology and Obstetrics (FIGO) stage ( Z=-3.81, P<0.001), perioperative chemotherapy cycle ( t=-5.11, P<0.001), lymph node metastasis ( χ2=5.98, P=0.014), peritoneal effusion cytology ( Z=-2.22, P=0.026), and neoadjuvant chemotherapy ( χ2=5.29, P=0.021) between patients in the distant metastasis group and the non-distant metastasis group. Multivariate regression analysis showed that the FIGO stage ( OR=1.54, 95% CI: 1.07-2.22, P=0.019) and perioperative chemotherapy cycle ( OR=1.22, 95% CI: 0.09-0.36, P<0.001) were independent influencing factors for postoperative distant metastasis recurrence in SOC. Peritoneal effusion cytology ( OR=1.20, 95% CI: 0.71-1.89, P=0.180) was not an independent influencing factor for distant metastasis of SOC. It was ultimately included in the construction of the model, for its inclusion could improve the area under the curve (AUC) of the model. Among the five machine learning models constructed based on the above three variables, the KNN-based model had the best performance in identifying distant metastasis of SOC, with the AUC of 0.750, sensitivity of 0.591, specificity of 0.786, and accuracy of 85.0%. The AUC of the LR model was 0.679, the sensitivity was 0.545, the specificity was 0.765, and the accuracy was 84.3%. The AUC of SVM model was 0.634, the sensitivity was 0.240, the specificity was 0.968, and the accuracy was 84.7%. The AUC of RF model was 0.575, the sensitivity was 0.905, the specificity was 0.245, and the accuracy was 84.7%. The AUC of XGBoost model was 0.704, the sensitivity was 0.567, the specificity was 0.745, and the accuracy was 84.9%. Conclusion:FIGO stage and perioperative chemotherapy cycle are independent influencing factors for postoperative distant metastasis recurrence in SOC. The KNN model established based on FIGO stage, perioperative chemotherapy cycle and peritoneal effusion cytology has high discrimination degree and accuracy rate in predicting postoperative distant metastasis recurrence of SOC.
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Objective:To evaluate the efficacy and safety of pharyngeal spraying recombinant human interfe-ron alpha 2b (rhIFNα2b) in the treatment of herpangina in children.Method:s A prospective, multicenter, rando-mized, opened and controlled study was carried out in 11 hospitals in Anhui province from August 2018 to March 2019.According to the time of admission, 180 patients diagnosed as herpangina were prospectively and randomly divided into rhIFNα2b treatment group and Ribavirin control group.On the basis of giving both groups the heat-clearing, detoxifying and anti-infection treatment, the patients in treatment group received pharyngeal spraying rhIFNα2b 9 g/L saline solution[1 million IU/mL, 0.1 million IU/(0.1 mL·press)], and the patients in control group were treated by pharyngeal spraying Ribavirin (0.5 mg RBV/press, 150 press), 3 presses per time, 4 times per day, continuous administration for 5 days for both groups.Those who recovered in advance were no longer given medication.All patients were observed to fully recover.The clinical efficacy and the disappearing time of symptoms and signs between two groups were compared, and the safety of pharyngeal spraying rhIFNα2b for patients was evaluated.Result:s All of the 180 patients completed the study, including 90 cases in the treatment group and 90 cases in the control group.There was no statistically significant difference in terms of gender, age, weight and course of illness before treatment between the two groups (all P>0.05), which had clinical comparability.The apparent efficiency of the treatment group [63.3% (57/90 cases)] was significantly higher than that in the control group [38.9% (35/90 cases)] and the difference was statistically significant( χ2=10.934, P=0.004); no significant difference in the total efficiency between the treatment group [96.7% (87/90 cases)]and the control group [92.2% (83/90 cases)]was observed ( χ2=2.924, P=0.169). The duration of fever[(32.59±20.73) h vs.(45.72±26.96) h], hyperemia[(76.48±23.12) h vs.(92.44±24.31) h], herpes[(72.99±25.77) h vs.(85.09± 26.62) h], salivation[(45.44±24.96) h vs.(54.42±31.20) h] and anorexia[(62.70±23.99) h vs.(78.71±30.54) h] in the treatment group were significantly shorter than those in the control group, and the differences were statistically significant(all P<0.05). Before treatment, the serum levels of tumor necrosis factor α(TNF-α) [(13.02±4.41) ng/L vs.(13.57±9.27) ng/L], interleukin-6(IL-6) [(26.48±11.31) ng/L vs.(30.15±15.55) ng/L] and C-reactive protein(CRP)[(19.34±14.11) mg/L vs.(19.83±14.57) mg/L]were not significantly different between the two groups (all P>0.05). After treatment, the serum levels of TNF-α and IL-6 were(7.26±1.99) ng/L and (2.42±0.73) ng/L in the treatment group, which were significantly lower than those in the control group [(12.09±6.39) ng/L and (7.32±11.51) ng/L](all P<0.05), but no significant difference in serum levels of CRP between the two groups was observed ( P>0.05). The comparison on positive rate of virus in pharyngeal swab between the treatment group [65.3% (32/49 cases) and 40.6% (13/32 cases) respectively] and the control group[66.7%(36/54 cases) and 41.0% (16/39 cases), respectively]before and after therapy showed no significant difference (all P>0.05). During the treatment, no serious adverse reactions were observed in the two groups.The incidence of adverse reactions was 1.1% (1/90 cases) in the treatment group and 5.6% (5/90 cases) in the control group.In addition, the serum hemoglobin level of children in the control group after treatment was significantly lower than that before treatment and that in the treatment group (all P<0.05). Conclusions:Compared with pharyngeal spraying ribavirin, pharyngeal spraying rhIFNα2b can greatly improve the clinical efficiency, accelerate the disappearance of clinical symptoms and signs, and shorten the total course of disease, and is more safe and worthy of clinical application.
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Objective To explore the effects of first-degree relatives' anxious traits on the anxious emotion in children with Tic disorders ( TD) . Methods A total of 31 children with TD and 32 normal chil-dren were assessed by The Screen for Child Anxiety Related Emotional Disorders ( SCARED) ,and their first-degree relatives were assessed by State-Trait Anxiety Inventory ( STAI) . The differences of first-degree rela-tives' personality traits between two groups were compared,and the effects of these personality traits on chil-dren's anxious emotion were further analyzed. Results Compared with the control group(36. 66±8. 24),the first-degree relatives of children with TD had higher scores in trait anxiety (40. 10±8. 24,P<0. 05),but there was no significant difference in state anxiety between TD group and control group((35. 00±9. 09) vs (40. 90 ±10. 21),P>0. 05). The school phobia in children with TD was positively correlated with the education lev-els of their mothers(r=0. 407,P<0. 05). Conclusion The first-degree relatives of children with TD are more anxious emotion than normal children. Children with TD are more likely to have school phobia if their mothers have better education.
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Objective To compare the difference between C-WISC and WISC-Ⅳ in the diagnosis of IQ in the children diagnosed with mental retardation(MR) or borderline intellectual funcition(BIF).Methods 80 children aged 6-16 years were enrolled in this study.All of them were diagnosed with MR or BIF based on the criteria of DSM-Ⅳ-R.Then,C-WISC and WISC-Ⅳ were used to measure the IQ.Results There was no significant difference in the scores of full IQ between C-WISC and WISC-Ⅳ in these children ((65.49±12.83) vs (64.86±10.10),t=-0.591,P＞0.05).The score of verbal intelligence quotient in the C-WISC was significantly lower than the corresponding score in the WISC-Ⅳ ((64.96± 13.14) vs (68.26 ± 10.99),t=3.029,P＜0.05).The score of performance intelligence quotient in the C-WISC was significantly higher than the corresponding score in the WISC-Ⅳ ((72.48±14.04) vs (69.35±11.75),t=-2.488,P＜0.05).The scores of similarities,coding,and block design in the C-WISC were significantly higher than the corresponding score in the WISC-Ⅳ (P＜0.05)).There was no significant difference in the scores of comprehension and digit span between the two methods (P＞0.05).There was also no significant difference in MR hierarchical diagnosis between the two methods (x2=0.427,P9＞0.05).Conclusion There is no significant difference between C-WISC and WISC-Ⅳ in the diagnosis of IQ in the children aged 6-16 years who were diagnosed with MR or BIF.Both C-WISC and WISC-Ⅳ can be used to diagnose the MR and marginal intelligence for the children aged 6-16 years.
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Objective To investigate the relationship between plasma homocysteine on admission and the outcome at discharge of acute ischemic stroke.Methods A non-concurrent cohort study was performed and a total of 1 3 1 9 patients with acute is-chemic stroke were continuously included in this study.According to tertile range of plasma homocysteine,patients were di-vided into three group.Logistic regression analysis was used to assess the independent association between plasma homocys-teine on admission and poor outcome at discharge of acute ischemic stroke.Results The difference of plasma homocysteine on admission between the poor outcome and those with good outcome had statistical significance (P<0.000 1).Without the adj ustment of multiple factors,when comparing to the first group,the second and third tertile seemed to have a tendency of increasing the risk of poor outcome at discharge,the OR (95%CI)was 2.111 (1.297~3.437,P<0.05),2.113 (1.361~3.279,P<0.05).After adjustment for multivariate,the second and third tertile also seemed to have a tendency of increasing the risk of poor outcome at discharge,the OR (95%CI)was 1.876 (1.160~3.036,P<0.05),2.396 (1.414~4.062,P<0.05).Conclusion The current study indicated that higher plasma homocysteine level was an independent risk factor for poor outcome at discharge in ischemic stroke patients.It would increase the risk of the outcome at discharge in patients with acute ischemic stroke,and suggests that there is a dose-response relationship between plasma homocysteine level on admis-sion and the poor outcome at discharge.
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OBJECTIVE:To investigate the clinical efficacy and safety of aerosol inhalation of magnesium sulfate and salbuta-mol sulfate in the treatment of acute attack of severe bronchial asthma in children. METHODS:85 children with acute attack of se-vere bronchial asthma were divided into control group(45 cases)and intervention group(40 cases)in accordance to even and odd number of hospitalization time. Based on routine treatment of glucocorticoid intravenous injection,oxygen uptake,sedation and nu-tritional support,control group was given aerosol inhalation of salbutamol sulfate,0.6 ml each time,once every 20 min,for 1 h;intervention group was additionally given aerosol inhalation of magnesium sulfate,0.6 ml each time,once every 20 min,for 1 h, on the basis of control group. Therapeutic efficacy,improvement time of shortness of physical examination indexes (breath, wheeze,coughing),lung function indicators and ADR were observed in 2 groups,and discharge time was recorded in 2 groups. RESULTS:The total effective rate of clinical efficacy of intervention group was 95.00%after 1 h treatment,which was significant-ly higher than 77.78% in control group,with statistical significance (P0.05). CONCLUSIONS:On the basis of conventional treatment,the aerosol inhalation of magnesium sulfate and salbutamol sulfate shows good clinical efficacy and safety in the treatment of acute attack of severe bronchi-al asthma in children.
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Objective To examine the association between uric acid (UA)levels of patients with acute ischemic stroke at ad-mission and discharged outcome.Methods The acute ischemic stroke patients of Xinganmeng People’s Hospital in Inner Mongolia,from June 1,2009 to May 31,2012 were continuity included in the present study,the included analysis sample size were 3 440 cases.Poor discharged outcome was defined as the occurrence of disability or death.With reference to the Modi-fied Rankin's Scale (MRs)Stroke Scale,Scores were recorded in the questionnaires,score of 3 or more (MRs≥3)was de-fined as disability.The patients were all grouped by P20,P60,P90 of UA,binary logistic regression were used in studying of risk factors,calculated the odds ratios (Odds ratio,OR)and 95% confidence interval (95% Confident interval,95%CI).All tests were two-sided test and a significance level of 0.05.Results A total of 359 people occurred poor outcomes in the stud-y,accounting for 10.44%.Univariate logistic regression analysis of poor outcome occurred showed that relative to the lowest group(P20,UA≤222.6 mmol/L),the second and third group (UA:222.7 ~ 310.9 mmol/L and 311.0~419.7 mmol/L) OR (95% CI)were:0.70(0.53~0.91)(P <0.05)and 0.66(0.49~0.88)(P <0.05).After adjusted age,body tempera-ture,high blood pressure,hyperglycemia,history of stroke,high triglycerides,high LDL-C and smoking,relative to the low-est level group,the second and third group occurred poor outcoming OR (95% CI)were:0.70(0.53~0.93)(P <0.05)and 0.66(0.48~0.90)(P <0.05).Conclusion Higher levels of uric acid levels in patients with acute ischemic stroke may inde-pendently related with occurred poor discharged outcome.
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Objective To explore the adverse effects of recurrence of acute ischemic stroke at discharge.Methods Continuously including 3 440 acute ischemic stroke patients from June 1,2009 to May 31, 2012 in Department of Neurology of the People's Hospital of Xinganmeng of Inner Mongoha Autonomous Region were esearch objects.Poor outcome was defined as the occurrence of disability or death at discharge.Disability was defined as the Modified Rankin ' s Scale (MRs), when MRs was 3 or more.Binary logistic regression was used to analysis the risk factors ,calculated the odds ratios(OR) and 95％ confidence interval (95％CI).Results A total of 359 (10.44％) patients occurred poor outcomes, of whom 136 (37.88％) patients occurred the recurrence of ischemic stroke.Multiple logistic regression analysis showed that age (OR=1.24,95％CI 1.09-1.41), body temperature (OR =1.92,95 ％ CI 1.43-2.57), hypertension (OR =1.73,95 ％ CI 1.33-2.24), high blood sugar (OR=1.67,95％CI 1.26-2.20) ,glycerin trilaurate(OR=0.41,95％CI0.27-0.62) ,smoking (OR =1.37,95％CI 1.01-1.85) and recmrrence(OR=1.49,95％CI 1.15-1.95) were independent risk factors of poor outcome at discharge.The recurrence of acute ischemic stroke can increase the risk of the occurrence of poor outcome at discharge up to 49％.Conclusion Recurrence is an independent risk factor for the poor outcome of acute ischemic stroke, we should focus on secondary prevention of stroke patients at the clinical work and health education to reduce the recurrence of ischemic stroke.
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Objective To observe the therapeutic effect of anti-inflammatory combined with cedilanid and diuretic therapy for treatment of patients with senile pneumonia and lung cancer accompanied by pleural effusion and to investigate the changes of concentrations in plasma levels of B-type natriuretic peptide(BNP)and C-reactive protein(CRP),procalcitonin(PCT)before and after treatment. Methods From July 2012 to January 2013, a prospective study was carried out to investigate 57 emergently hospitalized patients with pleural effusion,and according to the etiology,they were divided into two groups:a senile pneumonia group(30 cases)and a lung cancer group(27 cases). The same therapeutic measures were taken in the two groups,such as anti-infection,enhancement of cardiac function,diuresis,and limitation of the amount of liquid intake. Respectively,all the patients took the CT scan of the chest before treatment and on the 7th day after treatment,and at the same time,plasma concentrations of BNP,CRP and PCT were detected. Results ①According to the gradation of the New York Heart Association (NYHA),before treatment most of the cardiac function of patients in pneumonia group was at the Ⅲ grade,while that in the lung cancer group was at theⅠgrade,and the incidence of congestive heart failure(CHF)in pneumonia group was significantly higher than that in lung cancer group(86.7% vs. 14.8%,P0.05〕. Anti-inflammatory effect in pneumonia group was much superior to that in lung cancer group〔basically cured:86.7%(26 cases)vs. 0(0),P<0.05〕. In pneumonia group,the decrease of the above two indexes after treatment was consistent with the pneumonia shadow dissipation,while in the lung cancer group,no such consistency was found,apparently,the latter phenomenon was associated with the tumor invasive occupation. Conclusion To detect the concentration changes of plasma BNP, CRP and PCT has important clinical significance in screening the cardiac insufficiency and evaluating the curative effect of anti-inflammatory combined with cedilanid and diuretic therapy in patients of lung diseases complicated by pleural effusion.
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Objective To investigate the status quo of the assurance and subsidy for severe diseases acquired by juvenile in rural areas in Qinghai, and provide evidences for building a subsidy system for such population. Methods Quantitative surveys were made to collect data on medical expenses and the compensation practice for such expenses for severe diseases of juvenile in the area, for a knowledge of the present medication and disease load in question; specialists in two hospitals were interviewed to learn the present treatnents for such a population, and their expenditures in case of such diseases. Results Juveniles in rural Qinghai rely on the new rural cooperative medical scheme, under which however the reimbursement rate was only 26% ～35%. Families with juvenile patients of severe diseases were found to suffer heavy burdens. As a result, a high percentage of the patients give up treatment. To make things worse, as only two hospitals in the provincial capital city can provide professional treatment for children with severe diseases, rural children have to pay heavy indirect costs other than medication such as heavy travel expenses. Conclusion It is critical to build a medical assurance system for juvenile with severe diseases. It is also imperative to build and strengthen the capacity of medical centers for such a population in Qinghai, and upgrade the diagnosis and treatment competence of local health providers, ensuring adequate medical resources for juvenile with severe diseases upon joint development of both healthcare providers and the medical insurance system.
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BACKGROUND: Studies have shown that 160 mg/L tramethylpyrazine (TMP) can inhibit the proliferation of endothelial cells cultured in vitro,but whether TMP also inhibits vascular endothelial growth factor (VEGF)induced proliferation of vascular endothelial cells remains unkown. OBJECTIVE: To study the effect of rat serum containing TMP on vascular endothelial cell proliferation and its proliferation induced by VEGF. DESIGN: Randomized controlled experiment. SETTING: College of Traditional Chinese Medicine, Chongqing University of Medical Sciences. MATERIALS: The experiment was carried out in the Institute of Pediatrics, Chongqing University of Medical Sciences from March, 2002 to March, 2003 using human umbilical vein endothelial cell (HUVEC) line ECV304 and 30 female Wistar rats. METHODS: Thirty rats were randomly divided into 3 equal groups to receive intraperitoneal TMP injection at 143.0 mg/kg and 71.5 mg/kg and 0.8 mL normal saline (blank control group). All the injections were performed once a day for consecutive 7 days, then blood was collected from the intraperitoneal artery and diluted to 20％, 10％, and 5％ in triplicate.Effect of TMP-containing serum on the proliferation of ECV304 cells was observed by means of in vitro culture and 3H-TdR incorporation as well as methyl thiazolyl tetrazolium (MTT) methods. MAIN OUTCOME MEASURES: ① Effect of TMP-containing serum on proliferation of ECV304 cells in in vitro culture and VEGF-induced proliferation of the cells.RESULTS:All the 30 rats survived the experiment without losses. The absorbance (A) and scintillation counting (minute-1) of the cells were significantly lower in 143.0 mg/kg TMP group than those in the control group treated with rat serum at the dilution of 5％ (0.720±0.024 vs 0.816±0.068,3340.45±567.7 vs 5120.84±301.49), 10％ (0.630±0.017 vs 0.798±0.015,2430.06±265.98 vs 5225.83±100.10), and 20％ (0.765±0.027 vs 0.823±0.031,3570.45±130.52 vs 5256.82±183.18), and those in 71.5 mg/kg TMP group were also significantly lower than those in the control group after treatment with the serum of 10％ (0.775±0.023, 4571.14±275.39) and 20％(0.749±0.012, 3287.25±144.82). In the experiment evaluating the effect of TMP serum on VEGF-induced proliferation of ECV304 cells, the A value and scintillation counting in the 143.0 mg/kg TMP group were significantly lower than those in the control group after the cells were treated with the serum of 5％ (0.726 ±0.004 vs 0.964 ±0.004, 5760.46 ±49.64 vs 9821.82±128.05), 10％ (0.712±0.004 vs 0.933±0.014, 5024.48±100.57 vs 9052.76±65.19), and 20％ (0.717±0.003 vs 0.924±0.004, 5405.45±140.90vs 9197.07±169.92], and those of the cells treated with 71.5 mg/kg TMP serum of 10％ and 20％ were also significantly lower than those in the control group (0.703±0.005 and 7526.47±169.21 for 10％ serum, and 0.693±0.006 and 5720.09±279.03 for 20％ serum). CONCLUSION: The sera at the concentrations of 5％,10％, and 20％from rats treated with 143 mg/kg TMP and at higher concentrations from 71.5 mg/kg TMP-treated rats can inhibit the proliferation of ECV 304 in in vitro culture as well as VEGF-induced proliferation of the cells.
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Aim To study the effect of tetramethylpyrazine(TMP) on binding of 125I-VEGF to VEGF receptor. Methods The mice sera were collected after peritoneal injection with big-dose TMP,low-dose TMP,protamine and NS. A reversed-phase high performance liquid chromatography(RP-HPLC) method was used to determine the TMP in mice serum. The culture medium of ECV304 was treated with the mice sera in different groups. Radioligand binding assay(RBA) of receptor and Scatchard pot were performed to observe the changes of the maximum binding capacity(B_ max) and dissociation constant(K_d).Results The sera of big-dose TMP inhibited 125I-VEGF binding to its receptor, K_d=343.30?36.64 pmol?L-1,B_ max=46.26?5.85 fmol/2?10~5 cells(P0.05),but B_ max decreased(P
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OBJECTIVE:To study the effect of ligustrazine injection(LTZ)on DNA synthesis of vascular endothelial cell.METHODS:In vitro cultured cell line of human umbilical vein endothelial cells,ECV304,were adopted to measure the ef?fects of LTZ on DNA synthesis by 3 H-TdR incorporation.RESULTS:LTZ could inhibit DNA synthesis of ECV304in a dose-dependent manner.CONCLUSION:The mechanism of anti-angiogenesis of LTS might be associated with inhibiting DNA synthesis of vascular endothelial cell.
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ICU is a special department for critically ill person.For the reasons of the closed-type of administration and the peculiar psychological state of patient,some ethics issues came out.The patients and their relative can't receive the due respect and humanism care,and the ethics issue hasn't drawn enough attention.The author holds that to solve the ethical problems in the administration,we should pay attention to the basic principle of ethics of life,reinforce the humanistic morals of the medical personnel in ICU,and apply the principle of people first in clinic.