Significance of leukocyte-specific transcript 1 levels in nasal mucosal tissue to predict recurrence of nasal polyps

Abstract Objective: Chronic Rhinosinusitis with Polyps (CRSwNP) is characterized by high heterogeneity and postoperative recurrence rate. This study aims to explore the clinical significance of tissue Leukocyte-Specific Transcript 1 (LST1) in predicting CRSwNP recurrence. Methods: We enrolled 62 CRSwNP patients including 30 primary CRSwNP and 32 recurrent CRSwNP patients, and 40 Healthy Controls (HC). Tissue samples were collected. Tissue LST1 expression was assessed by Reverse Transcription-Polymerase Chain Reaction (RT-PCR), Western Blotting (WB) and Immunofluorescence (IF) staining. The predictive values of LST1 expression for CRSwNP postoperative recurrence were assessed through the Receiver Operating Characteristic (ROC) curves. Results: The tissue levels of LST1 were significantly increased in the CRSwNP group than the HC group, especially in the recurrent group, and the elevated LST1 mRNA levels were positively correlated with the peripheral eosinophil percentages, tissue eosinophil counts and percentages. IF staining results showed that the LST1 protein levels were higher in CRSwNP patients, especially in the recurrent patients than in the HC group. ROC curves highlighted that tissue LST1 levels were associated with recurrent CRSwNP and exhibited a higher predictive ability for postoperative CRSwNP recurrence. Conclusion: This was the first report suggesting that LST1 expression was upregulated and associated with mucosal eosinophil infiltration and CRSwNP recurrence. Tissue LST1 could be a promising biomarker for predicting postoperative recurrence in CRwNP patients.

Dynamic monitoring of plasma Epstein-Barr Virus DNA load can predict the occurrence of lymphoproliferative disorders after haploidentical hematopoietic stem cell transplantation / 中华血液学杂志

Objective: To determine the optimal cutoff value of Epstein-Barr virus (EBV) DNA load that can assist in the diagnosis of post-transplant lymphoproliferative disease (PTLD) after haploidentical hematopoietic stem cell transplantation (haplo-HSCT) . Methods: The data of patients with EBV infection after haplo-HSCT from January to December 2016 were retrospectively analyzed. Through constructing the receiver operating characteristic (ROC) curve and calculating the Youden index to determine the cutoff value of EBV-DNA load and its duration of diagnostic significance for PTLD. Results: A total of 94 patients were included, of whom 20 (21.3% ) developed PTLD, with a median onset time of 56 (40-309) d after transplantation. The median EBV value at the time of diagnosis of PTLD was 70,400 (1,710-1,370,000) copies/ml, and the median duration of EBV viremia was 23.5 (4-490) d. Binary logistic regression was used to analyze the peak EBV-DNA load (the EBV-DNA load at the time of diagnosis in the PTLD group) and duration of EBV viremia between the PTLD and non-PTLD groups. The results showed that the difference between the two groups was statistically significant (P=0.018 and P=0.001) . The ROC curve was constructed to calculate the Youden index, and it was concluded that the EBV-DNA load ≥ 41 850 copies/ml after allogeneic hematopoietic stem cell transplantation had diagnostic significance for PTLD (AUC=0.847) , and the sensitivity and specificity were 0.611 and 0.932, respectively. The duration of EBV viremia of ≥20.5 d had diagnostic significance for PTLD (AUC=0.833) , with a sensitivity and specificity of 0.778 and 0.795, respectively. Conclusion: Dynamic monitoring of EBV load in high-risk patients with PTLD after haplo-HSCT and attention to its duration have important clinical significance, which can help clinically predict the occurrence of PTLD in advance and take early intervention measures.

Evaluation of Screening Model for Advanced Colorectal Adenoma and Traditional Chinese Medicine Tongue Image Analysis Based on Real World Data / 中医杂志

ObjectiveTo evaluate the effectiveness and consistency of three commonly used early colorectal cancer screening models for advanced colorectal adenoma as a noninvasive means， and to assess the predictive value of traditional Chinese medicine （TCM） tongue images in the models. MethodsPatients diagnosed with colorectal adenoma who underwent colonoscopy and pathological examination were selected as the study participants. Basic clinical data and tongue image were collected. The prediction models of Asia-Pacific colorectal screening （APCS） model， its revision （M-APCS） and colorectal neoplasia predict （CNP） model were applied to compare the predictive effects of the three models on advanced stage adenomas of the colon， the differences in clinical data and traditional Chinese medicine tongue characteristics among patients with different degrees of adenomas， and the similarities and differences in tongue characteristics among the models. The discriminative ability of the three risk models was evaluated using the area under the curve （AUC） and receiver operating characteristic （ROC） curves. The calibration was assessed using the Kuder-Richardson coefficient and the Hosmer-Lemeshow test for consistency analysis. ResultsA total of 227 patients with adenoma were analyzed， including 104 patients （45.82%） with advanced adenoma. In the detection of advanced adenoma， those with greasy coating （70 cases， 67.3%） were higher than those without greasy coating （34 cases， 32.7%， P＜0.05）. After multivariate analysis， the odds ratio （OR） value of non-greasy coating was 0.371 （0.204~0.673， P＜0.01）， indicating that non-greasy coating was a protective factor for advanced adenomas. Among the three risk models， the detection rate of advanced adenoma in the high-risk group with APCS was the highest （63.3%）， which was 1.49 times and 2.04 times that of the medium-risk group （42.6%） and the low-risk group （31.1%， P＜0.01）. The detection rate of advanced adenomas in high-risk groups of M-APCS and CNP was slightly higher than that in moderate or low risk groups （P＞0.05）. The proportion of yellow and greasy coating in high-risk group was higher than that in the medium-risk or low-risk group （P＜0.05）. For the ability to distinguish advanced and non-advanced adenomas， the AUC of APCS was 0.629 （95% CI： 0.556~0.702） and was higher than that of M-APCS （0.591） and CNP （0.586）. In calibration evaluation， Cronbach's alpha was 0.919 （＞0.7）， which indicated that the three models were consistent. In the correlation matrix， the correlation coefficients between APCS model and M-APCS model， and CNP model were 0.794 and 0.717， respectively， and the correlation coefficients between M-APCS model and CNP model were 0.873， Hosmer-Lemeshow χ2 =2.552， P＞0.05， which suggested that the three models had good calibration ability. ConclusionAll three models demonstrate the efficiency to identify advanced colorectal adenoma， and their calibration ability is considered to be good. Among the three models， the APCS exhibits the highest recognition efficiency， however， the recognition accuracy of the APCS model needs improvement. The presence of a greasy coating is identified as one of the potential predictors of advanced adenoma. Consequently， it can be considered for inclusion in the risk model of advanced colorectal adenoma to enhance the accuracy.

Prediction of concentration immediately dangerous to life or health of benzene and its derivatives based on quantitative structure-activity relationship / 环境与职业医学

Background With the increasing exposure to hazardous chemicals in the workplace and frequency of occupational injuries and occupational safety accidents, the acquisition of occupational exposure limits of hazardous chemicals is imminent. Objective To obtain more unknown immediately dangerous to life or health (IDLH) concentrations of hazardous chemicals in the workplace by exploring the application of quantitative structure-activity relationship (QSAR) prediction method to IDLH concentrations, and to provide a theoretical basis and technical support for the assessment and prevention of occupational injuries. Methods QSAR was used to correlate the IDLH values of 50 benzene and its derivatives with the molecular structures of target compounds. Firstly, affinity propagation algorithm was applied to cluster sample sets. Secondly, Dragon 2.1 software was used to calculate and pre-screen 537 molecular descriptors. Thirdly, the genetic algorithm was used to select six characteristic molecular descriptors as dependent variables and to construct a multiple linear regression model (MLR) and two nonlinear models using support vector machine (SVM) and artificial neural network (ANN) respectively. Finally, model performance was evaluated by internal and external validation and Williams diagram was drawn to determine the scopes of selected models. Results The ANN model results showed that \begin{document}$ {R}_{\mathrm{t}\mathrm{r}\mathrm{a}\mathrm{i}\mathrm{n}}

Validation of the online PREDICT tool in a cohort of early breast cancer in Brazil

PREDICT is a tool designed to estimate the benefits of adjuvant therapy and the overall survival of women with early breast cancer. The model uses clinical, histological, and immunohistochemical variables. This study aimed to evaluate the model's performance in a Brazilian population. We assessed the discrimination and calibration of the PREDICT model to estimate overall survival (OS) in five and ten years of follow-up in a cohort of 873 women with early breast cancer diagnosed from January 2001 to December 2016. A total of 743 patients had estrogen receptor (ER)-positive and 130 had ER-negative tumors. The area under the receiver operating characteristic (ROC) curve (AUC) for discrimination was 0.72 (95%CI: 0.66-0.78) at five years and 0.67 (95%CI: 0.61-0.72) at ten years for women with ER-positive tumors. The AUC was 0.72 (95%CI: 0.62-0.81) at five years and 0.67 (95%CI: 0.54-0.77) at ten years for women with ER-negative tumors. The predicted survival in ER-positive tumors was 91.0% (95%CI: 90.2-91.6%) at five years and 79.3% (95%CI: 77.7-81.0%) at ten years, and the observed survival 90.7% (95%CI: 88.6-92.9%) and 77.2% (95%CI: 73.4-81.4%), respectively. The predicted survival in ER-negative tumors was 84.5% (95%CI: 82.5-86.6%) at five years and 75.0% (95%CI: 71.6-78.5%) at ten years, and the observed survival 76.3% (95%CI: 69.1-84.3%) and 67.9% (95%CI: 58.6-78.6%), respectively. In conclusion, PREDICT was accurate to estimate OS in women with ER-positive tumors and overestimated the OS in women with ER-negative tumors.

The prognostic value of PI combined with Pv-aCO 2 /Ca-vO 2 in patients with septic shock / 中华急诊医学杂志

Objective:To explore the predictive value of peripheral perfusion index (PI) combined with central venous-arterial carbon dioxide tension to arterial-venous oxygen content ratio(Pv-aCO 2/Ca-vO 2)for prognosis after initial resuscitation of septic shock. Methods:A total of 76 cases of patients with septic shock from January 2019 to January 2021 in emergency intensive care unit (EICU) of Harrson international peace hospital affiliated to Hebei Medical University were enrolled. All recovered according to 2016 Severe Sepsis and Septic Shock Treatment International Guidelines 2016 (SSC 2016) , and PI was monitored, central vein and arterial blood gas analysis was performed, and the ratio of Pv-aCO 2/Ca-vO 2 was calculated.The PI and Pv-aCO 2/Ca-vO 2 at 3 h,hemodynamic variables,oxygen metabolism indexes,APACHEⅡ and SOFA score were recorded.Patients were divided into survival group and death group according to 28 d survival condition, the dfferences in demographics and clinical data were compared between two groups.The Kaplan-Meier urviving curve was created and the survival of the patients was analyzed by the Log-rank test. Risk factors associated with the prognosis were analyzed using the Cox regression analysis. The role of PI and Pv-aCO 2/Ca-vO 2 in prediting death was evaluated by receiver operating characteristic curves(ROC). Results:There were 37 cases in survival group and 39 cases in death group.Compared with death group, PI in survival group [(1.77±0.63) vs. (0.89±0.69)]was significantly higher,and Pv-aCO 2/Ca-vO 2[(1.52±0.52) vs. (2.57±0.86)] was significantly lower ( P<0.05). Kaplan-Meier survival curve showed that the median survival time in the high PI group [20.09 d (95% CI:16.95-23.24) vs.11.00d (95% CI:7.14-14.86)] was longer than that in the low PI group(χ 2=12.424, P=0.000),and that in low Pv-aCO 2/Ca-vO 2 group [23.74 d (95% CI:20.35-27.13) vs.12.85d (95% CI:9.75-15.95)] was longer than that in the high Pv-aCO 2/Ca-vO 2 group (χ 2=12.200, P=0.000) .Cox regression analysis showed that both PI ( RR=0.397, 95% CI: 0.230-0.687, P =0.001) and Pv-aCO 2/Ca-vO 2 ( RR=1.878, 95% CI: 1.169-3.019, P =0.009) were predictors of 28 d mortality.The area under the ROC curve of PI and Pv-aCO 2/Ca-vO 2 for predicting 28 d death in patients with septic shock were 0.828 (95% CI: 0.732-0.923) and 0.785 (95% CI: 0.6777-0.893)respectively. The optimal cutoff values were 0.52 (sensitivity 58.3% and specificity 94.4%) and 0.35 (sensitivity 88.9% and specificity 63.9%)respectively, and the AUC of the combined prediction of the two indicators was 0.903 (95% CI: 0.835-0.971). Conclusions:Combination of PI and Pv-aCO 2/Ca-vO 2 is better to predict the risk of adverse outcomes of septie shock patients,and may provide useful information for the resuscitation at early stage.

Predictive value of baseline CRP, NLR, and LER for aspiration pneumonia in patients with acute cerebral infarction / 中华急诊医学杂志

Objective:To investigate the predictive value of C-reactive protein (CRP), neutrophils-lymphocytes ratio (NLR) and leukocyte-erythrocyte ratio (LER) for aspiration pneumonia (AP) in patients with acute cerebral infarction (ACI).Methods:Retrospective analysis was performed on 989 consecutive hospitalized ACI patients in 2021 who were free of infection within 48 h after ACI onset. General information, past medical history, CRP and complete blood count within 24 h after admission were collected. NLR and LER were calculated based on neutrophil, lymphocyte, leukocyte and erythrocyte count. ACI patients were divided into two groups: non-AP group ( n = 883) and AP group ( n = 106) according to whether they had AP 48 h after admission. Spearman correlations of CRP, NLR and LER with AP were analyzed. The receiver operator characteristic (ROC) curves were plotted to evaluate the predictive values of CRP, NLR and LER for the occurrence of AP in ACI patients, and the sensitivity and specificity at the optimal cut-off value were also calculated. Logistic regression analysis was used for further verification. Results:Compared with the non-AP group, CRP, NLR and LER were significantly higher in the AP group ( P<0.05). Spearman correlation analysis showed that AP was positively correlated with CRP, NLR and LER ( r = 0.42, 0.36 and 0.35, P<0.01). ROC curve analysis showed that CRP, NLR and LER had certain predictive value for AP in ACI patients ( P<0.05), and the area under the curve (AUC) was 0.8917, 0.8349 and 0.8269, respectively. The optimal cutoff values of CRP, NLR and LER were 12.70 mg/L, 4.40 and 1.89 ×10 -3, respectively, with the sensitivity and specificity of 79.25% and 86.41%, 71.70% and 84.94%, and 75.47% and 79.95%, respectively. Multivariate Logistic regression analysis showed that CRP ( OR=6.65, 95% CI: 3.70-11.98, β=1.90, P<0.001), NLR ( OR=2.84,95% CI: 1.60-5.03, β=1.04, P<0.001) and LER ( OR=3.51, 95% CI: 2.00-6.16, β=1.26, P<0.001) were independent risk factors for AP in ACI patients. Conclusions:CRP, NLR and LER at baseline show certain predictive value for the occurrence of AP in ACI patients, and CRP has the strongest predictive power.

Research on the Development Trend of Pharmaceutical Intermediates Application Technology in China from the Perspective of Patent / 中国药房

OBJECTIVE：To assist enterprises to understand the technical points a nd development trend of pharmaceutical intermediates industry ，and to provide new development ideas and technical support for pharmaceutical intermediates application technology. METHODS ：Taking the core technology involved in pharmaceutical intermediates as the research object and divided into four levels ，the patent data of pharmaceutical intermediates published （announced）before Feb. 2nd，2020 in State Intellectual Property Office （SIPO），INCOPAT and PatSnap patent databases were searched. Patent analysis method was used to analyze the patent application trend and patent applicants of pharmaceutical intermediates ，and the secondary and tertiary technologies of pharmaceutical intermediates were analyzed in detail. Finally ，SPSS 24.0 software was used for curve fitting prediction analysis of the number of patent applications for pharmaceutical intermediates in China. RESULTS ：A total of 12 103 related patents were retrieved. Under the secondary technology classification ，there were 331 patents for antibiotic drug intermediates ，474 patents for antipyretic and analgesic drug intermediates ，1 227 patents for cardiovascular drug intermediates ，and 1 550 patents for anticancer drug intermediates. The numbers of patent applications for pharmaceutical intermediates in the world and China were increasing year by year ，and Chinese mainland had the largest number of patent applications. The number of patent applications in Jiangsu ， Shanghai and Shandong ranked the top 3. Among the top 10 patent，8 were domestic enterprises or universities ，and they also ranked the top 2 in the composition of pharmaceutical intermediates applicants in China. Among the secondary technologies of pharmaceutical intermediates ，cardiovascular pharmaceutical intermediates accounted for the largest proportion of patent applications （32％），followed by anticancer pharmaceutical intermediates （30％）. Among the tertiary technologies ，there were patent applications for the products （35％），methods（35％）and uses （28％）of pharmaceutical intermediates. The curve fitting of the number of patent applications for pharmaceutical intermediates in China showed that the current trend of patent applications was the best fitted with the cubic curve model ，and it was predicted that the number of patent applications in 2020 and 2021 will be 688 and 781 respectively. CONCLUSIONS ：The technology of pharmaceutical intermediates has developed rapidly in China ，and universities and enterprises have considerable R&D strength. In addition to expanding in technological innovation ，enterprises can also consider the development idea of school-enterprise cooperation and patent cross licensing among enterprises to help the better deve lopment of China ’s pharmaceutical intermediates industry.

Pod production, and dasometric variables, of the tree Senna spectabilis (Fabaceae) in a tropical dry forest / Producción de vainas, y variables dasométricas, del árbol Senna spectabilis (Fabaceae) en un bosque seco tropical

Introduction: Senna spectabilis is a multipurpose pantropical tree, used in agroforestry systems. Objective: To determine pod production (Pp) and their relationship with dasometric variables in S. spectabilis in the tropical dry forest. Methods: From August 2016 to February 2017, thirty trees in production stage were randomly selected. The random selection was formed of the more isolated trees from the total dispersion. The trees were monitored at the beginning and end of the study period, to determine dasometric measurements such as total height (Th), height to the first branch (Hb), crown height (Ch), Stem diameter (at 0.2 m height from the ground) (Db), crown diameter (Cd), and crown volume (Cv) measured. Pods were harvested by the researcher with cutting and height cutting tongs when their color began to change. Pearson correlations and univariate and multivariate regression analyses were performed between the dasometric variables and pod production. The potential number of trees/ha (NPa) was calculated by determining the occlusion percentage (Op) and the shadow area/tree (Ca); to estimate the production potential of fruits/ha, the production of fruits/tree was multiplied by (NPa). Results: Th was 6.16 ± 1.23 m, Hb 2.75 ± 0.52 m, Ch 3.41 ± 0.98 m, Db 20.43 ± 4.80 cm, Cd 7.46 ± 1.20 m and Cv 108.43 ± 61.38 m3/tree. There was a significant positive correlation between Hb, Cd, Db, with Pp of 0.592**, 0.592**, and 0.446* respectively. Pp was 32.73 ± 16.13 kg/tree and the dry matter production (MSP) was 17.84 ± 8.80 kg/tree. The result of the multivariate regression indicated that the second-order polynomial model presented best goodness of fit. Op was 73.4 7.92 %, the cup area was 49.3 m2/tree, Ca was 36.2 m2/tree, and NPa was 83 trees. Conclusions: The production of fresh pods/ tree in the S. spectabilis presents a potential in its availability as feed for ruminant or seed production. The potential production of pods in silvopastoral with S. spectabilis could be 2.72 t/ ha, and 1.64 t/ ha of dry pods, this shows the importance of trees and of pods production and nutritional contribution obtained for dry ecosystems.

Introducción: Senna spectabilis es un árbol pantropical multipropósito, utilizado en sistemas agroforestales. Objetivo: Determinar la producción de vainas (Pv) y la relación con las variables dasométricas en S. spectabilis en el bosque seco tropical. El número potencial de árboles/ha (NPa) fue calculado determinando el porcentaje de oclusión (Po) y el área de sombra/árbol (As); para calcular la producción potencial de frutos/ha, la producción de frutos/árbol fue multiplicada por (NPa). Métodos: Desde agosto del 2016 hasta febrero de 2017, treinta árboles en etapa de producción fueron seleccionados al azar, los más aislados del total de árboles dispersos fueron seleccionados, y fueron monitoreados al inicio y al final del período de estudio, para determinar las mediciones dasométricas como la altura total (At), altura a la primera rama (Apr), altura de la copa (Ac), diámetro del tallo (a 0.2 m altura desde el suelo) (Dt), diámetro de la copa (Dc) y volumen de copa (Vc). Las vainas se cosecharon cuando su color comenzó a cambiar. Se realizaron correlaciones de Pearson y análisis de regresión univariada y multivariada entre las variables dasométricas y la producción de vainas. El número potencial de árboles/ha (NPa) se calculó determinando el porcentaje de oclusión (Po) y el área de sombra/árbol (Asa); para estimar el potencial de producción de las vainas/ha, la producción de vainas/árbol se multiplicó por NPa. Resultados: La At fue de 6.16 ± 1.23 m, Apr 2.75 ± 0.52 m, Ac 3.41 ± 0.98 m, Db 20.43 ± 4.80 cm, Dc 7.46 ± 1.20 m y Vc 108.43 ± 61.38 m3/árbol. Existió una correlación positiva significativa entre Apr, Dc, Db, Pv de 0.592**, 0.592 ** y 0.446 * respectivamente. La Pv fue de 32.73 ± 16.13 kg y la producción de materia seca (PMS) fue de 17.84 ± 8.80 kg/árbol. El resultado de la regresión multivariada indicó que el modelo polinomial de segundo orden presentó la mejor bondad de ajuste. El Po de los árboles fue de 73.4 % ± 7.92 %, el área de copa fue de 49.3 m2/árbol, el Asa fue de 36.2 m2/árbol, el NPa fue de 83 árboles. Conclusiones: La producción de vainas frescas/árbol en el S. spectabilis presenta un potencial en la disponibilidad de alimento para los rumiantes o la producción de semillas. El potencial de producción de vainas en u arreglos silvopastoriles podría ser de 2.72 t/ha, y 1.64 t/ha de vainas secas, esto muestra la importancia del árbol de producción de vainas y la contribución nutricional para los ecosistemas secos.

Clinical study on neutrophil to lymphocyte ratio and neutrophil extracellular traps with liver injury in patients with sepsis / 中华急诊医学杂志

Objective:To explore the clinical value of peripheral blood neutrophil-to-lymphocyte ratio (NLR) combined with neutrophil extracellular traps (NETs) in predicting liver injury in patients with sepsis.Methods:A prospective observational study was conducted. The patients who met the diagnostic criteria for sepsis 3.0 admitted to the Department of Intensive Care Unit in Wuxi People’s Hospital Affiliated to Nanjing Medical University from March 2019 to June 2020 were selected as the research objects. The basic informations of the patients were recorded. NLR based on blood routine at admission was calculated. PicoGreen fluorescence quantitative detection kit was used to detect the quantitative level of free DNA (cf-DNA/NETs) in the peripheral plasma of patients at admission. According to whether liver injury occurred, the patients were divided into the sepsis without liver injury group and sepsis with liver injury group. Binary Logistics regression analysis was used to predict the risk factors of sepsis with liver injury. The receiver operating characteristic (ROC) curve was drawn. The value of NLR, NETs, NLR combined with NETs in predicting liver injury in patients with sepsis was analyzed.Results:A total of 122 patients with sepsis were enrolled, of which 45 patients suffered from septic liver injury, with an incidence rate of 36.89%. The NLR of the sepsis wth liver injury group was (21.63 ± 4.71), the NLR of the sepsis without injury injury group was (15.03 ± 4.71), and the NETs level of the sepsis with liver injury group was (505.86 ± 250.05) μg/L, the level of NETs in the sepsis without liver injury group was (179.27 ± 67.20) μg/L, and the differences between the two groups were statistically significant (all P<0.05). Binary logistic regression analysis found that NLR ( OR=1.470, 95% CI: 1.121-1.926, P<0.05) and NETs ( OR=1.018, 95% CI: 1.005-1.030, P<0.05) at admission were the independent risk factors for liver injury in patients with sepsis. The best cut-off value of NLR was 16.68, and the best cut-off value of NETs was 317 μg/L. The sensitivity of combined application of NLR and NETs to predict liver injury in patients with sepsis was 77.78%, specificity was 98.70%, the area under the curve was 0.930, and the Youden Index was 0.765. Conclusions:The peripheral blood NLR and NETs levels are independent risk factors for liver injury in patients with sepsis. The combined application of NLR and NETs has a certain predictive value for liver injury in patients with sepsis. Taking NLR of 16.68 and NETs of 317 μg/L as the cut-off values, they can be used as early warning indicators to predict liver injury in patients with sepsis.

The novel fibrosis index at diagnosis may predict all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis without substantial liver diseases

OBJECTIVES: Antineutrophil cyto plasmic antibody-associated vasculitis (AAV) is a fatal disease. Currently, predictors of mortality due to AAV are based on the distribution of organ involvement. The novel fibrosis index (NFI) is an index composed of laboratory results that reflect the degree of liver fibrosis. This study aimed to evaluate whether NFI can predict poor outcomes in patients with AAV without substantial liver disease. METHODS: A total of 210 patients with immunosuppressive drug-naïve AAV were retrospectively reviewed. NFI was calculated as follows: NFI=(serum bilirubin × (alkaline phosphatase)2)/(platelet count×(serum albumin)2). NFI cut-off was set at 1.24 (the highest quartile). Poor outcomes were defined as all-cause mortality, relapse, and end-stage renal disease (ESRD). RESULTS: During the median 34.5 months of follow-up, 21 patients (10%) died, 72 patients (34.3%) relapsed, and 38 patients (18.1%) had ESRD due to AAV progression. The median calculated NFI was 0.61, and it was higher in AAV patients with all-cause mortality than in those without mortality, but the difference was not statistically significant (1.26 vs. 0.59). AAV patients with NFI at diagnosis ≥1.24 exhibited a significantly lower cumulative patient survival rate than those with NFI at diagnosis <1.24 (p=0.002). Multivariate Cox hazard model analysis showed that NFI at diagnosis ≥1.24 was an independent predictor of all-cause mortality in AAV (hazard ratios [HR] 2.850, 95% confidence interval [CI] 1.026, 7.910). CONCLUSIONS: NFI ≥1.24, which may be an independent predictive marker for all-cause mortality in AAV patients without substantial liver disease.

SARS-CoV-2 viremia may predict rapid deterioration of COVID-19 patients

ABSTRACT COVID-19 has raised worldwide concern as spiraling into a pandemic. Reports about comprehensive investigation of COVID-19 viremia are extremely scanty. Herein, we present four COVID-19 patients with positive SARS-CoV-2 nucleic acid test in blood, accounting for 12.12% of 33 detected cases. Rapid deterioration of these cases with septic shock, accompanying with lung CT images enlarged rapidly, decrease of blood oxygen, heart rate drop (with asynchrony of hypoxemia) accompanied with SARS-CoV-2 viremia. It indicates that massive replication and releasing into blood of SARS-CoV-2 and secondary inflammation storm may lead to injury of multiple organs and poor prognosis. So, positive COVID-19 nucleic acid test in blood may be a good forecasting marker of rapid deterioration of COVID-19 pneumonia. In addition, clearance of viremia may indicate tendency for recovery.

Role of microRNA in predictingclinical efficacy of neoadjuvant chemoradiotherapy for rectal cancer / 中华放射肿瘤学杂志

Neoadjuvant chemoradiotherapy (NCRT) has become the standard treatment for patients with locally advanced rectal cancer (LARC).However,the response to NCRT varies among LARC patients and a subset of patients show resistance to NCRT.NCRT may delay the timing of surgery and even reduce the overall survival.Therefore,it is of significance to identify biomarkers for predicting the clinical efficacy of NCRT,screen patients who are resistant to NCRT and perform surgery as early as possible,eventually establishing an individualized therapeutic strategy.MicroRNAs are a class of small non-coding RNAs that post-transcriptionally regulate gene expression,which areinvolved in multiple signaling pathways and DNA damage repair process and affect the radiosensitivity of rectal cancer cells.Many recent studies have evaluated the role of microRNA in predicting the response to NCRT.The purpose of this article is to review the research progress and validate the role of microRNA in predicting the clinical efficacy of NCRT for rectal cancer.

Body mass index, obstruction of the airflow, dyspnea, and exercise capacity index as predictor of the severity of exacerbations and systemic involvement in patients with COPD

Background: Allocation of the limited resources to the needed patients and decision making regarding timely interventions demand development of a reliable, cost effective, simple assessment tool. Several studies propose body-mass index, airflow obstruction, dyspnea, and exercise (BODE) index for this purpose in patients with Chronic obstructive pulmonary disease (COPD). The objective of this study was to assess the utility of BODE index to predict the severity of exacerbations and systemic involvement in COPD.Methods: A Present hospital based cross sectional study was carried out among 100 COPD patients. BODE index was used to assess the patients and its association was studied with various variables. The data was analyzed using one-way analysis of variance (ANOVA) test.Results: As the body index class of severity increases, the number of hospitalizations required in the past also increases and this association is statistically significant. As the severity of the disease increased as indicated by the class the mean number of exacerbations in the past increased and this association was found out to be statistically significant. As the severity of the disease increased as indicated by the class level, the mean number of days of hospitalization increased. But this increase was of small difference and hence on one-way ANOVA test was not found out to be statistically significant. As the pack years increases, the BODE index increases significantly (p value <0.001). As the severity of the disease increased, the mean body mass index decreased. Haemoglobin level was found to decrease with increase in BODE index class of severity. This association was statistically significant.Conclusions: The BODE index has been found to be a very good tool to assess the prognosis of COPD as well as severity of acute exacerbations.

A retrospective study of endoscopic ultrasonography for predicting progression of esophageal varices in patients with hepatitis B virus-related hepatocirrhosis / 中华消化内镜杂志

Objective To assess the clinical value of endoscopic ultrasonography ( EUS ) for predicting esophageal varices ( EV ) progression in patients with hepatitis B virus ( HBV )-related hepatocirrhosis. Methods A retrospective cohort study was performed on 299 HBV-related hepatocirrhosis patients with light EV in Tianjin Second People′s Hospital admitted from September 2014 to September 2015. The diameter and number of peri-esophageal collateral veins ( ECV ) and para-ECV were measured and described by EUS. The first EUS examination time was the starting point, and the follow-up of 24 months or EV progression was the end. Risk factors of EV progression were evaluated by multivariate Cox regression model, and the predictive value of EUS for EV progression was analyzed by receiver operating characteristic ( ROC) curve. Results The cumulative incidence of EV progression was 2. 3％ ( 7/299 ) , 14. 8％( 44/297) , 33. 7％ ( 96/285) and 40. 0％ ( 120/273) at 6 months, 12 months, 18 months and 24 months of follow-up, respectively. The results of multivariate Cox regression analysis showed that the diameter of peri-ECV ( P=0. 0112, HR=1. 3232, 95％CI: 1. 0656-1. 6429 ) , the number of peri-ECV ( P=0. 0001, HR=1. 3666, 95％CI:1. 1634-1. 6052) and para-ECV diameter ( P=0. 0002, HR=1. 3641, 95％CI:1. 1558-1. 6100) were risk factors for EV progression. The use of nucleoside analogues treating HBV (P=0. 0020, HR=0. 4969, 95％CI: 0. 3186-0. 7751) and non-selective β-blockers descending portal venous pressure ( P=0. 0765, HR=0. 5732, 95％CI:0. 3097-1. 0611) were the protective factors for EV progression. The results of ROC curve analysis showed that the diameter of peri-ECV[ P<0. 001, area under the curve (AUC)= 0. 850, 95％CI: 0. 804-0. 895], the number of peri-ECV (P<0. 001, AUC=0. 831, 95％CI: 0. 784-0. 878), the diameter of para-ECV (P<0. 001, AUC=0. 924, 95％CI: 0. 895-0. 954) , and the number of para-ECV ( P<0. 001, AUC=0. 761, 95％CI: 0. 704-0. 817 ) had higher predictive value for EV progression;and the optimum cut-off values of each index were 1. 85 mm, 3. 5, 3. 35 mm, and 4. 5, respectively. The accuracies of prediction for EV progression were 76. 60％, 75. 19％, 84. 48％ and 70. 29％, respectively. Conclusion EUS can be used to predict EV progression in HBV-related hepatocirrhosis patients. Peri-ECV diameter>1. 85 mm, number>3. 5, and para-ECV diameter>3. 35 mm, number>4. 5 suggest a high risk of EV progression. For patients with HBV-related hepatocirrhosis complicated with mild EV, nucleoside analogues to anti-HBV and non-selective β-blockers to reduce portal hypertension can prevent EV progression.

Assessment of the feasibility of transperineal ultrasound combined with clinical factors in predicting female stress urinary incontinence factors / 中华超声影像学杂志

Objective@#To investigate the feasibility and accuracy of transperineal real-time three-dimensional ultrasound combined with clinical factors in predicting the risk of female stress urinary incontinence(SUI).@*Methods@#Three hundred and forty-eight female patients with SUI diagnosed were selected as the case group, and 102 healthy people in the same period were selected as the control group. All subjects underwent transperineal real-time three-dimensional ultrasound. The ultrasonic parameters of resting state, contraction and Valsalva were measured, and the clinical parameters such as age, height, weight, history of pregnancy and childbirth were collected. According to the time sequence, all the subjcets were divided into derivation cohort and verification cohort inproportion to 2∶1, single factor screening and logistic multiple regression analysis were carried out on 24 factors, and the risk model was established. The cut-off value of the disease probability P was determined by the ROC curve of the subjects, and then the accuracy of the cut-off value in predicting SUI was verified in the verification group.@*Results@#Single factor analysis showed that 13 parameters were associated with SUI(all P<0.05). Logit P=2.014+ 1.870×Z1 was established by multivariate logistic regression analysis. The cut-off value of the disease probability P determined by ROC curve was 0.823. The predictive sensitivity of the model was 68.1% (95%CI: 59.6%-76.6%), specificity was 91.2% (95%CI: 86.0%-96.4%), positive predictive value was 64.3% (95%CI: 55.6%-73.0%) and negative predictive value was 92.5% (95%CI: 86.2%-98.8%).@*Conclusions@#It is feasible to predict the risk of female stress urinary incontinence by transperineal real-time three-dimensional ultrasound combined with clinical factors. Although, some limitations with the prediction model, it has accuracy in predicting SUI with obvious symptoms.

Assessment of the feasibility of transperineal ultrasound combined with clinical factors in predicting female stress urinary incontinence factors / 中华超声影像学杂志

Objective To investigate the feasibility and accuracy of transperineal real‐time three‐dimensional ultrasound combined with clinical factors in predicting the risk of female stress urinary incontinence( SUI ) . Methods T hree hundred and forty‐eight female patients with SUI diagnosed were selected as the case group ,and 102 healthy people in the same period were selected as the control group . All subjects underwent transperineal real‐time three‐dimensional ultrasound . T he ultrasonic parameters of resting state ,contraction and Valsalva were measured ,and the clinical parameters such as age ,height , weight ,history of pregnancy and childbirth were collected . According to the time sequence ,all the subjcets were divided into derivation cohort and verification cohort inproportion to 2∶1 ,single factor screening and logistic multiple regression analysis were carried out on 24 factors ,and the risk model was established . T he cut‐off value of the disease probability P was determined by the ROC curve of the subjects ,and then the accuracy of the cut‐off value in predicting SUI was verified in the verification group . Results Single factor analysis showed that 13 parameters were associated with SUI( all P ＜0 .05) . Logit P＝2 .014+1 .870× Z1 was established by multivariate logistic regression analysis . T he cut‐off value of the disease probability P determined by ROC curve was 0 .823 . T he predictive sensitivity of the model was 68 .1% ( 95% CI : 59 .6% －76 .6% ) ,specificity was 91 .2% ( 95% CI :86 .0% －96 .4% ) ,positive predictive value was 64 .3%( 95% CI : 55 .6% － 73 .0% ) and negative predictive value was 92 .5% ( 95% CI : 86 .2% － 98 .8% ) . Conclusions It is feasible to predict the risk of female stress urinary incontinence by transperineal real‐time three‐dimensional ultrasound combined with clinical factors . Although ,some limitations with the prediction model ,it has accuracy in predicting SUI with obvious symptoms .

Drainage in the first postoperative days predicts intra-abdominopelvic complications / 国际外科学杂志

Objective To explore the feasibility of early predicting intra-abdominopelvic infectious complications by closer observation of abdominal drainage.Methods Prospectively collected and evaluated the first-three-postoperative-day drainage samples of 207 up-to-standard patients underwent gastrointestinal surgery between April and September 2017 in Peking University Cancer Hospital.Among them,159 males (76.8％) and 48 females (23.2％) were included,the average age was (59.9 ± 10.6) years and the average body mass index was (23.7 ± 3.2) kg/m2.Characteristics of the samples were daily recorded and later on matched with the clinical outcomes,including complications recorded and graded according to the Clavien-Dindo classification.The measurement data with normal distribution were presented as mean and standard deviation,the enumeration data were recorded in the form of quantity and percentage,using the x2 test and Fisher accurate test.Results One hundred and ninty-nine patients (96.1％) were recorded as normal in the drainage samples,while the other 8 cases (3.9％) as abnormal (including pungent odor,purulent color etc.).There were 53 patients (25.6％) were diagnosed with postoperative complications.Among the patients with normal samples,the complication rate was 22.6％,while the eight abnormal ones were all diagnosed with postoperative complications (complication rate:100.00％,P =O.000 012).Notably,among those 8 cases,complications were diagnosed much later than 3 days after surgery in 7 (87.5％) patients.In 1 (12.5％) case,the drainage abnormality was the only abnormal signs and there was no complications detected during the postoperative period of hospitalization.The intra-abdominal infectious complication occurred within 30 days after discharge and the patient re-admitted two times.Conclusions Early change of basic characteristics of postoperative drainage is a promising candidate for detection of postoperative complications with strong specificity.Clinical practice should be further regulated to ensure in-time recording and following interventions of those signs.

A quantitative study on the epidemic situation of tuberculosis based on the transmission disease dynamics in 14 prefectures of Xinjiang from 2005 to 2017 / 中国感染控制杂志

Objective To quantitatively analyze the epidemic situation of tuberculosis(TB)by modeling the data of tuberculosis in prefectures of Xinjiang,and predict the new cases of tuberculosis in prefectures of Xinjiang.Methods A dynamic model was used to fit the data of TB in 14 prefectures in Xinjiang from 2005 to 2014,the results of the fitting were verified by tuberculosis data in 2015－2017,verified results were evaluated,estimated values and basic reproductive numbers (R0)of parameters in each region were obtained,data of new TB in 2018－2022 were predic-ted.Results The verification of TB data in 2015－2017 showed that the actual values fell within the 95% confidence interval of the predictive value curve,model was fit well.R0in Southern Kashgar was 1 1.38 (95%CI:1 1.33－11.50),R0in Urumqi City in Eastern Xinjiang and Ili Kazak Autonomous Prefecture in Northern Xinjiang were 5.46 (95% CI :5.28－5.50)and 2.22 (95% CI :2.18－2.28)respectively.The epidemic situation of TB in Southern Xinjiang was more serious than that in Northern and Eastern Xinjiang,epidemic situation of TB in Kash- gar Prefecture was most serious.The predicted results showed that the number of new TB from 2018 to 2022 will slowly grow in most prefectures.Conclusion The dynamical model of TB fits well and is feasible in this study,it can be used for prediction of new TB cases,intervention and management in Southern Xinjiang should be strength-ened to control the prevalence of TB.

Agrupación de técnicas inteligentes para predecir Reacción Adversa a Medicamentos / Grouping smart techniques to predict Adverse Drug Reaction

Las Reacciones Adversas a Medicamentos (RAM) pueden causar incapacidad temporal o permanente al paciente, incluso tener un desenlace fatal. La ocurrencia de las RAM, presentan costos directos teniendo en cuenta: salario de la persona, gasto de material y costo de los medicamentos, los cuales aumentan la cuantía al tratarla. Con el objetivo de predecir que RAM le puede causar a un paciente, teniendo en cuenta: las características de los pacientes, la interacción entre medicamentos y las propias RAM; se crean y agrupan algunas técnicas de inteligencia artificial, donde cada una de ellas resuelve un problema determinado, pero en conjunto logran predecir una Reacción Adversa a Medicamentos. Entre las técnicas aplicadas se encuentra: razonamiento basado en caso, razonamiento basado en reglas y reconocimiento de patrones. La validación de cada una de estas técnicas se realiza de forma independiente, demostrando que el uso de estas, permite a los profesionales de salud contar con un apoyo informático en el momento de la consulta médica(AU)

Adverse Drug Reactions (ADRs) can cause temporary or permanent disability to the patient, even resulting in a fatal outcome. The occurrence of ADRs present direct costs taking into account: salary of the person, expenditure of material and cost of medicines, which increase the amount when dealing with it. With the aim of predicting which RAM can cause a patient, taking into account: the characteristics of patients, the interaction between medications and the RAM itself; Some artificial intelligence techniques are created and grouped, where each one solves a specific problem, but together they can predict an Adverse Drug Reaction. Among the applied techniques is: case-based reasoning, rule-based reasoning, and pattern recognition. The validation of each of these techniques is performed independently, demonstrating that the use of these, allows health professionals to have a computer support at the time of medical consultation(AU)