Computed tomography features and prediction model of stage-IA solitary nodular invasive mucinous lung adenocarcinoma / 中国辐射卫生

@#<b>Objective</b> To investigate the computed tomography (CT) features of solitary nodular invasive mucinous lung adenocarcinoma (IMA) in stage IA and establish its prediction model. <b>Methods</b> We included 53 lesions of 53 patients with stage-IA IMA and 141 control lesions of 141 patients with invasive non-mucinous lung adenocarcinoma (NIMA) that were confirmed by surgical pathology in our hospital from January 2017 to December 2019. Univariable analysis was used to compare the demographics and CT signs of the two groups. Multivariable logistic regression analysis was performed to determine the main factors influencing solitary nodular IMA. A risk score prediction model was constructed based on the regression coefficients of the main influencing factors. A receiver operating characteristic (ROC) curve was used to assess the performance of the model. <b>Results</b> The univariable analysis showed significant differences between the two groups in age, largest nodule diameter, tumor-lung interface, lobulation, spiculation, air-bronchogram or vacuole sign, vessel abnormalities (<i>P</i> < 0.05). The spiculation sign was different between the two groups, which was longer and softer in the IMA group while shorter and harder in the NIMA group. There was no significant difference in sex, nodule shape, or pleural retraction (<i>P</i> > 0.05), but irregular shapes were slightly more frequent in the IMA group. The multivariable logistic regression analysis showed that obscure tumor-lung interface (odds ratio (<i>OR</i> = 20.930, <i>P</i> < 0.05), air-bronchogram or vacuole sign (<i>OR</i> = 7.126, <i>P</i> < 0.05), spiculation sign (<i>OR</i> = 4.207, <i>P</i> < 0.05), and vessel abnormalities (<i>OR</i> = 0.147, <i>P</i> < 0.05) were the main influencing factors. The prediction model based on those factors’ regression coefficients had an area under the ROC curve of 0.829 (<i>P</i> < 0.05). <b>Conclusion</b> Compared with those with NIMA, patients with solitary nodular IMA in stage IA were older and more likely to have the CT features of obscure tumor-lung interface, air-bronchogram or vacuole sign, and longer and softer spiculation. Based on the regression coefficients of tumor-lung interface, air-bronchogram or vacuole sign, spiculation, and vessel abnormalities, the risk score prediction model showed good predictive performance for solitary nodular IMA.

Reasonably conduct the multiple Logistic regression analysis combined with the average treatment effect analysis / 四川精神卫生

The purpose of the paper was to introduce how to reasonably carry out multiple Logistic regression analysis combined with the average treatment effect analysis. Firstly， it introduced 4 basic concepts related to the average treatment effect analysis. Secondly， it presented the core contents in the average treatment effect analysis， that was， six estimation methods. Thirdly， through a hypothetical drug clinical trial example， it gave the whole process of how to use SAS software for the analysis. The contests were as follows： ① the traditional multiple Logistic regression model was used for the analysis； ② the propensity score model was used to calculate the inverse probability weights； ③ six estimation methods were used to estimate the potential outcome mean and the average treatment effect.

A risk score model for predicting cardiac rupture after acute myocardial infarction / 中华医学杂志(英文版)

Background:@#Cardiac rupture (CR) is a major lethal complication of acute myocardial infarction (AMI). However, no valid risk score model was found to predict CR after AMI in previous researches. This study aimed to establish a simple model to assess risk of CR after AMI, which could be easily used in a clinical environment.@*Methods:@#This was a retrospective case-control study that included 53 consecutive patients with CR after AMI during a period from January 1, 2010 to December 31, 2017. The controls included 524 patients who were selected randomly from 7932 AMI patients without CR at a 1:10 ratio. Risk factors for CR were identified using univariate analysis and multivariate logistic regression. Risk score model was developed based on multiple regression coefficients. Performance of risk model was evaluated using receiveroperating characteristic (ROC) curves and internal validity was explored using bootstrap analysis.@*Results:@#Among all 7985 AMI patients, 53 (0.67%) had CR (free wall rupture, n=39; ventricular septal rupture, n=14). Hospital mortalities were 92.5% and 4.01% in patients with and without CR (P < 0.001). Independent variables associated with CR included: older age, female gender, higher heart rate at admission, body mass index (BMI) <25 kg/m2, lower left ventricular ejection fraction (LVEF) and no primary percutaneous coronary intervention (pPCI) treatment. In ROC analysis, our CR risk assess model demonstrated a very good discriminate power (area under the curve [AUC]= 0.895, 95% confidence interval: 0.845–0.944, optimism-corrected AUC= 0.821, P < 0.001).@*Conclusion:@#This study developed a novel risk score model to help predict CR after AMI, which had high accuracy and was very simple to use.

The application and prospect for the tumor marker score model in clinical diagnosis and therapy / 中华检验医学杂志

Single tumor marker(TM)for cancer diagnosis with both satisfactory sensitivity and specificity has not been found.Therefore, it is necessary to identify the biomarkers to make the TM panel and establish the corresponding multiparameter predictive model through fuzzy mathematics methods.Recent studies using the big data technology showed that the integration of the biomarkers panel and prediction score model could provide the effective and accurate diagnosis for the cancer patients and be in favor of making the scheme for personalized therapy,treatment-monitoring and prognosis prediction.A reliable and efficient TM score prediction model will provide the novel perspectives and procedures for the diagnosis and treatment of cancer patients.

Empirical Study on Financial Status of Listed Chinese Pharmaceutical Companies Evaluated by Using Z-score Model / 中国药房

OBJECTIVE:To find out potential financial risk in the listed Chinese pharmaceutical companies and to provide rec-ommendations. METHODS:The Z-score established with Altman E was adopted to classiy and analyzed empirically 143 listed phar-maceutical companies in China during 1998-2013 by sub-sectors(medical devices,pharmaceutical commercial,biological products chemical raw medicine,traditional TCM). The effects of some data in annual reports on Z-score were validated by using stepwise regression. RESULTS:The result showed that the average Z-score values percentage of the best 3 companies were 90.95%,47.96%and 41.25%,respectively,from 1998-2013;while for the worst 3 companies,the values were 0.80%,1.14%and 1.21%,respective-ly. At the same time,the financial situations of chemical raw medicine companies were the worst among 5 sub-sectors,of which dur-ing 2004-2006,the constituent ratios of companies in“Distress”zones went over 50.00%,which were 60.00%,55.20% and 53.60%,respectively. If counted by calendar year,the market value per share of 10 years and float of 9 years significantly affected the Z-score values(P<0.05);if counted by listed year,the market value per share of 15 years significantly affected the Z-score val-ues. CONCLUSIONS:Although major pharmaceutical companies have good financial status,financial crisis still exists in some companies. Especially,the financial situations of chemical raw medicine companies should not be neglected. The government should pay more attention to share price in order to prevent financial crisis which was induced by stock bubbles;at the same time,supervi-sion system should be established to evaluate the financial situation of listed pharmaceutical companies,even for all listed companies.

Post-treatment prognostic score model establishment and stratified therapy for newly diagnosed metastatic nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective To establish a post?treatment prognostic score model for newly diagnosed metastatic nasopharyngeal carcinoma, and to investigate the feasibility of stratified therapy. Methods A total of 263 eligible patients with newly diagnosed metastatic nasopharyngeal carcinoma from 2002 to 2010 were enrolled as subjects. The primary tumor was treated with conventional radiotherapy, three?dimensional conformal radiotherapy, or intensity?modulated radiotherapy, and radiation areas included nasopharyngeal tumor and cervical lymphatic drainage region. The metastatic bone tumor was mainly treated with conventional external radiotherapy, while the metastatic liver or lung tumor was mainly treated with surgical resection, radiotherapy, or radiofrequency ablation. The first?line therapy for most of patients was cisplatin?based combination chemotherapy. Factors including the general characteristics, tumor status, and therapy for patients were involved in multivariate analysis, and a prognostic model was established based on the n value (HR=en ) of the prognostic factors. Results The factors influencing the overall survival (OS) in patients were a Karnofsky performance score (KPS) not higher than 70(P= 0?? 00), multiple organ metastases (P=0?? 00), combination with liver metastasis (P= 0?? 00), a number of metastases not less than 2(P= 0?? 00), a level of lactate dehydrogenase (LDH) higher than 245 IU/ L (P= 0?? 00), a number of chemotherapy cycles ranging between 1 and 3( P= 0?? 00), a poor response for metastatic tumor ( stable disease or progressive disease)(P= 0?? 00), and primary tumor not treated with radiotherapy (P= 0?? 01). Based on the prognostic score, patients were divided into low?risk group (0?1?? 5 points), intermediate?risk group (2?? 0?6?? 5 points), and high?risk group (≥7?? 0 points), and the 5?year OS rates in the three groups were 59?? 0%, 25?? 1%, and 0%, respectively. Conclusions The prognostic score model based on the KPS, serum level of LDH, multiple organ metastases, combination with liver metastasis, and number of metastases can effectively predict the survival in patients. Active treatment including at least 4 chemotherapy cycles and radiotherapy for primary tumor can prolong the survival time of patients in the low?and intermediate?risk groups. However, patients in the high?risk group were mainly treated with palliative radiotherapy due to no improvement in the survival by radiotherapy for primary tumor.

Estratificación de riesgo cardiovascular en enfermedades autoinmunes en un hospital universitario / Cardiovascular risk stratification in autoimmune diseases in a university hospital

Introducción: las enfermedades autoinmunes (EAI) han sido consideradas como no fatales; sin embargo, la mayoría de éstas tienen una historia natural de mortalidad prematura. Algunas como el lupus eritematoso sistémico (LES), artritis reumatoidea (AR), esclerosis sistémica (ES), polimiositis, vasculitis y otras, están asociadas a una mortalidad temprana comparable a las enfermedades cardiovasculares y neoplásicas. Objetivos: 1- identificar las EAI con mayor riesgo cardiovascular previamente diagnosticadas en pacientes que sean atendidos en un servicio de reumatología de un hospital universitario. 2- comparar el riesgo cardiovascular calculado según la escala de Framingham y el modelo SCORE en pacientes con diagnóstico previo de enfermedad autoinmune. Material y métodos: estudio analítico de corte transversal, en un servicio de reumatología de un hospital universitario donde se reclutaron 129 historias clínicas de pacientes que acudieron espontáneamente entre el 1 de noviembre de 2010 y el 31 de mayo de 2011. Se elaboraron tablas de cruces de variables y su posterior cálculo con Chi Cuadrado y coeficiente de Pearson. Resultados: las EAI con mayor riesgo cardiovascular fueron AR, vasculitis y EASN. La escala de Framingham mostró solo un paciente con AR que tenía RCV muy elevado. Las vasculitis encabezó el RCV elevado con el 16,7%, pero esto corresponde solo a un paciente. El segundo lugar estaba representado por AR (10.7%), luego EASN (10%) y LES (4,5%). El modelo SCORE demostró que el 3,1% de las enfermedades tenía muy elevado RCV, porcentaje que estaba comprendido por 3 pacientes con AR y 1 con vasculitis. El RCV elevado estuvo representado sólo por AR en un 13.3%. Al comparar ambas escalas de riesgo cardiovascular, el 70,5% de 129 pacientes presentaron bajo RCV. Sólo un paciente (0,8%) con bajo RCV en la escala de Framingham tenía muy elevado RCV en el SCORE.

Introduction :Autoimmune diseases (AID) have been considered asnon-fatal; however, most of these have a natural history of premature mortality. Some such as lupus erythematosus (SLE), rheumatoid arthri-tis (RA), systemic sclerosis (SS), polymyositis, vasculitis and others are associated with early mortality comparable to cardiovascular and neo-plastic diseases. Objectives: 1- Identify autoimmune diseases with increased cardiovascular risk in previously diagnosed patients who are treated at a rheumatology service of an university hospital. 2- To compare the cardiovascular risk calculated according to the Framingham and the SCORE modelin patients with a previous diagnosis of autoimmune disease treated ata rheumatology service of a public hospital.

Application of "fingers pain score model" in pain evaluation / 中国实用护理杂志

Objective To investigate the characteristic and satisfaction degree of clinical applica-tion of "fingers pain score model" from the aspects of nurses and patients in order to evaluated the fea- sibility and pragmatism of the model. Methods "Fingers pain score model" was designed and to-gether with the NRS- 10 scale were applied in clinic for 2 years. Evaluation from both nurses and patients were in-vestigated after two-year probation, and the results underwent χ<'2> test. Results Evaluation from nurses on convenience, fidelity, communication and satisfaction of "fingers pain score model"were all sig-nificantly higher compared with the control. And evaluation from patients on direct-viewing,accuracy,re-ception and satisfaction of "fingers pain score model"were different from the NRS- 10 control, except for the fidelity. Conclusions Outweighing the NRS- 10 scale, the "fingers pain score model" is a better choice to meet the needs of the nurses and patients in pain evaluation in clinic.