Risk assessment of nosocomial infection in patients with multiple myeloma in the first hospitalization / 公共卫生与预防医学

Objective To assess the risk of nosocomial infection in patients with multiple myeloma during their first hospitalization. Methods Totally 480 patients with multiple myeloma who were hospitalized for the first time in department of hematology of West China Hospital, Sichuan University from August 2021 to August 2022 were included, and the nosocomial infection during treatment was statistically analyzed. The patients were divided into infected group and uninfected group. The independent influencing factors of nosocomial infection were analyzed and a prediction model was established. The reliability of the prediction model was analyzed by receiver operating characteristic curve (ROC). Results The incidence rate of nosocomial infection was 31.2% among 480 patients hospitalized for the first time. There were statistically significant differences in age, ISS staging, controlling nutritional status (CONUT) score, agranulocytosis, hemoglobin, and albumin between the infected group and the uninfected group (P<0.05). Logistic multivariate regression analysis showed that age, ISS staging, CONUT score, agranulocytosis, hemoglobin level, and albumin level were all independent correlated factors of nosocomial infection in patients with multiple myeloma hospitalized for the first time (P<0.05). The area under the ROC curve (AUC), sensitivity and specificity of multivariate logistic regression prediction model were 0.88 (95%CI: 0.840-0.920), 85.00% and 76.36%, respectively. Conclusion The incidence rate of nosocomial infection is high among patients with multiple myeloma in the first hospitalization. The prediction model established according to independent correlated factors of nosocomial infection has high predictive value on the occurrence of nosocomial infection.

Development and evaluation of a mortality risk prediction model for severe bacterial infections in children / 中华急诊医学杂志

Objective:To establish a mortality risk prediction model of severe bacterial infection in children and compare it with the pediatric early warning score (PEWS), pediatric critical illness score (PCIS) and pediatric risk of mortality score Ⅲ (PRISM Ⅲ).Methods:A total of 178 critically ill children were selected from the PICU of the Children's Hospital of Nanjing Medical University from May 2017 to June 2022. After obtaining the informed consent of the parents/guardians, basic information such as sex, age, height and weight, as well as indicators such as heart rate, systolic blood pressure and respiratory rate were collected from all children. A standard questionnaire was used to score the child 24 h after admission to the PICU. The children were divided into the survival and death groups according to their survival status at 28 d after admission. A mortality risk prediction model was constructed and nomogram was drawn. The value of the mortality risk prediction model, PEWS, PCIS and PRISM in predicting the risk of death was assessed and compared using the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC).Results:Among the 178 critically ill children, 11 cases were excluded due to severe data deficiencies and hospitalization not exceeding 24 h. A total of 167 children were included in the analysis, including 134 in the survival group and 33 in the death group. A mortality risk prediction model for children with severe bacterial infection was constructed using pupillary changes, state of consciousness, skin color, mechanical ventilation, total cholesterol and prothrombin time. ROC curve analysis showed that the AUCs of mortality risk prediction model was 0.888 ( P<0.05). The AUCs of PEWS, PCIS and PRISM Ⅲ in predicting death in children with severe bacterial infection were 0.769 ( P< 0.05), 0.575 ( P< 0.05) and 0.759 ( P< 0.05), respectively. Hosmer-Lemeshow goodness-of-fit test showed the best agreement between risk of death and PEWS predicted morbidity and mortality and actual morbidity and mortality (χ 2 = 5.180, P = 0.738; χ 2 = 4.939, P = 0.764), and the PCIS and PRISM Ⅲ predicted mortality rates fitted reasonably well with actual mortality rates (χ 2= 9.110, P= 0333; χ 2 = 8.943, P= 0.347). Conclusions:The mortality risk prediction model for predicting the death risk has better prognostic value than PEWS, PCIS and PRISM Ⅲ for children with severe bacterial infection.

Death-Related Factors in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Treated by Sequential Mechanical Ventilation / 中国医学科学院学报

Objective To analyze the death-related factors of elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) treated by sequential mechanical ventilation,so as to provide evidence for clinical practice. Methods The clinical data of 1204 elderly patients (≥60 years old) with AECOPD treated by sequential mechanical ventilation from June 2015 to June 2021 were retrospectively analyzed.The probability and influencing factors of death were analyzed. Results Among the 1204 elderly patients with AECOPD treated by sequential mechanical ventilation,167 (13.87%) died.Multivariate analysis showed that plasma procalcitonin ≥0.5 μg/L (OR=2.762, 95%CI=1.920-3.972, P<0.001),daily invasive ventilation time ≥12 h (OR=2.202, 95%CI=1.487-3.262,P<0.001),multi-drug resistant bacterial infection (OR=1.790,95%CI=1.237-2.591,P=0.002),oxygenation index<39.90 kPa (OR=2.447,95%CI=1.625-3.685,P<0.001),glycosylated hemoglobin >6% (OR=2.288,95%CI=1.509-3.470,P<0.001),and acute physiology and chronic health evaluation Ⅱ score ≥25 points (OR=2.126,95%CI=1.432-3.156,P<0.001) were independent risk factors for death in patients with AECOPD treated by sequential mechanical ventilation.Oral care>twice/d (OR=0.676,95%CI=0.457-1.000,P=0.048) and sputum excretion>twice/d (OR=0.492, 95%CI=0.311-0.776, P=0.002) were independent protective factors for death in elderly patients with AECOPD treated by sequential mechanical ventilation. Conclusions The outcomes of sequential mechanical ventilation in the treatment of elderly patients with AECOPD are affected by a variety of factors.To reduce the mortality,we put forward the following measures:attaching great importance to severe patients,restoring oxygenation function,shortening unnecessary invasive ventilation time,controlling blood glucose,preventing multidrug resistant bacterial infection,oral care twice a day,and sputum excretion twice a day.

Establishment and evaluation of predictive models of platelet transfusion effect in multi-center tumor patients / 中国输血杂志

【Objective】 To study the platelet transfusion predictive models in tumor patients and evaluate its application effect. 【Methods】 A retrospective study was conducted on 944 tumor patients, including 533 males and 411 females who received platelet transfusion in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University, the Affiliated Cancer Hospital of Xinjiang Medical University and Kailuan General Hospital from August 2022 to January 2023. Multivariate Logistic regression analysis was used to establish the platelet transfusion predictive models, and Medcalc15.8 software was used to draw the receiver operating curve (ROC) to evaluate the application effect of the prediction model. The actual application effect of models was verified through 162 female clinical cases and 172 male clinical cases. 【Results】 The incidence of platelet transfusion refractoriness in tumor patients was 28.9% (273/944), with 33.2% (177/533) in males, significantly higher than that in females [23.4% (96/411)] (P<0.05). Platelet transfusion predictive models: Y1 (female) =-8.546+ (0.581×number of pregnancies) + (0.964×number of inpatient transfusion bags) + number of previous platelet transfusion bags (5-9 bags: 1.259, ≥20 bags: 1.959) + clinical diagnosis (lymphoma: 2.562, leukemia: 3.214); Y2 (male) =-7.600+ (1.150×inpatient transfusion bags) + previous platelet transfusion bags (10-19 bags: 1.015, ≥20 bags: 0.979) + clinical diagnosis (lymphoma: 1.81, leukemia: 3.208, liver cancer: 1.714). Application effect evaluation: The AUC (area under the curve), cut-off point, corresponding sensitivity and specificity of female and male platelet transfusion effect prediction models were 0.868, -0.354, 68.75%, 89.84% and 0.854, -0.942, 81.36%, 77.53%, respectively. Actual application results showed that the sensitivity, specificity, and accuracy of female and male model were 89.47%, 92.74%, 91.98% and 83.72%, 91.47%, 89.53%, respectively. 【Conclusion】 There is high incidence of platelet transfusion refractoriness in tumor patients, and the predictive model has good prediction effect on platelet transfusion refractoriness in tumor patients, which can provide reliable basis for accurate platelet transfusion in tumor patients.

Risk factors for anti-tuberculosis drug-induced liver injury in treatment-naive tuberculosis patients / 中华传染病杂志

Objective:To investigate the risk factors for anti-tuberculosis drug-induced liver injury (ATB-DILI) in treatment-naive tuberculosis patients, and to provide evidence to avoid the occurrence of ATB-DILI in treatment-naive tuberculosis patients receiving anti-tuberculosis drug treatment.Methods:A retrospective case-control study was carried out in 177 treatment-naive tuberculosis patients admitted to the Third Hospital of Hebei Medical University from January 2014 to December 2019. According to whether developed ATB-DILI during anti-tuberculosis treatment, the patients were divided into non-ATB-DILI group and ATB-DILI group. General basic data of sex, age and body mass index, hepatic biological parameters, prothrombin time, serum ferritin level, basic liver condition and the number of first line hepatotoxic anti-tuberculosis drugs were collected. Mann-Whitney U test and chi-square test were used for statistical analysis, and multi-factor logistic regression analysis was adopted to analyze risk factors for ATB-DILI in treatment-naive tuberculosis patients. Results:The incidence of ATB-DILI was 20.3%(36/177) in the 177 treatment-naive tuberculosis patients. Alanine aminotransferase (ALT), aspartate aminotransferase, incidence of high serum ferritin and the number of first line hepatotoxic anti-tuberculosis drugs were significantly different between non-ATB-DILI group and ATB-DILI group ( Z=-2.13, Z=-2.08, χ2=9.08 and Z=-2.79, respectively, all P<0.050). Multivariate logistic regression analysis showed that chronic viral liver disease (odds ratio ( OR)=9.675, P<0.001), the number of first line hepatotoxic anti-tuberculosis drugs ( OR=4.863, P=0.001), baseline ALT level ( OR=1.016, P=0.011) and high serum ferritin level ( OR=3.336, P=0.018) were the independent risk factors for ATB-DILI. The number of first line hepatotoxic anti-tuberculosis drugs (regression coefficient was 1.582) and baseline ALT level (regression coefficient was 0.016) were both positively correlated with the occurrence of ATB-DILI. Conclusions:Chronic viral liver disease, the number of first line hepatotoxic anti-tuberculosis drugs, higher baseline ALT level and high serum ferritin level are the independent risk factors for ATB-DILI.

Prediction scale of cerebrovascular disease subtypes for high-risk population / 中南大学学报(医学版)

Objective: Cerebrovascular disease can be roughly divided into 2 subtypes: Cerebral ischemia (CI) and cerebral hemorrhage (CH). No scale currently exist that can predict the subtypes of cerebrovascular diseases. This study aims to establish a prediction scale for the subtypes of cerebrovascular diseases. Methods:A total of 1200 cerebrovascular disease patients were included in this study, data from 1081 (90％) patients were used to establish the CI-CH risk scale, and data from 119 (10％) patients were used to test it. Risk factors for the CI-CH risk scale were identified by 2 screens, with two-tailed student ' s t-test and two-tailed Fisher ' s exact test preliminarily and with logistic regression analysis further. The scores of each risk factor for CI-CH risk scale were determined according to the odds rate, and the cut-off point was determined by Youden index. Results: Nine risk factors were ultimately selected for score system, including age (≥75 years old was ?1, <75 years old was 0), BMI (<24 kg/m2 was 0, 24?28 kg/m2 was ?1,>28 kg/m2 was?2), hypertension grade (grade 1 was 1, grade 2 was 2, and grade 3 was 3), diabetes status (no was 0, yes was?1), antihypertensive drug use (no was 0, yes was?2), alcohol consumption (<60 g/d was 1, ≥60 g/d was 2), uric acid (less than normal was 0, normal was?1, high than normal was?2), LDL cholesterol (<2 mmol/L was 0, 2?4 mmol/L was?1, and>4 mmol/L was?2), and HDL cholesterol (<1.55 mmol/L was 0,≥1.55 mmol/L was 2). Patients with a score more than 0 were classified as the CH group, Conversely, they were assigned to the CI group;its sensitivity, specificity, and accuracy were 74.5％, 77.9％, and 76.4％, respectively. Conclusion: The CI-CH risk scale can help the clinician predict the subtypes of cerebrovascular diseases.

Reasonably conduct the multiple Logistic regression analysis combined with the ROC curve analysis / 四川精神卫生

The purpose of this paper was to introduce how to reasonably carry out the method of the multiple Logistic regression analysis by combining the ROC curve analysis. Firstly， it introduced two groups of the basic concepts related to the ROC curve analysis， that was， the statistical description of common diagnostic indicators and the ROC curve analysis method of the diagnostic data. Secondly， it introduced the core contents of the ROC curve analysis， that was， the calculation of the area under the ROC curve and the comparison of the area under multiple ROC curves. Thirdly， through an example of a diagnostic test， the whole process of how to use SAS software for the analysis was introduced， the contents were as follows： ① the analysis using only multiple Logistic regression analysis； ② the multiple Logistic regression analysis combined with the ROC curve analysis. The conclusion was that， for the diagnostic test data， combining the multiple Logistic regression analysis with the ROC curve analysis could obtain richer and more reasonable statistical analysis results.

The influence of duration of intra-abdominal hypertension on the prognosis of critically ill patients / 中华急诊医学杂志

Background:In the clinical setting, the effect of intra-abdominal hypertension on the human body is dependent on time, but its role is not yet clear.Objective:To investigate the effect of the duration of intra-abdominal hypertension (IAH) on the prognosis of critically ill patients.Methods:This prospective cohort study enrolled 256 IAH patients who were admitted to the Surgical ICU of 10 Grade A hospitals in Fujian Province from January 2018 to December 2020. The duration of IAH (DIAH) was obtained after monitoring IAP, and ICU length of stay, duration of mechanical ventilation, duration of continuous renal replacement therapy (CRRT) and average daily energy intake from enteral nutrition during ICU stay were observed and recorded. The correlation was analyzed by Spearman rank correlation. The patients were divided into the survival group and the death group according to their survival state at 60 days after enrollment. Thereafter, clinical characteristics between the two groups were compared. Multivariable logistic regression was used to study and validate the relationship between DIAH and 60-day mortality. The receiver operating characteristics (ROC) curve was established to evaluate the predictive abilities of DIAH on the mortality risk.Results:In critically ill patients, DIAH was positively correlated with duration of mechanical ventilation ( r=0.679, P<0.001), duration of CRRT ( r=0.541, P<0.001) and ICU length of stay ( r=0.794, P<0.001), respectively. In addition, there was a negative correlation between DIAH and average daily energy intake from enteral nutrition ( r=-0.669, P<0.001). After multivariable adjustment, DIAH was an independent risk factor for 60-day mortality in critically patients with IAH ( OR=1.05, 95% CI: 1.01-1.12; P = 0.012), and exhibited a linearity change trend relationship with mortality risk. The ROC curve analysis of DIAH showed that the area under ROC curve (AUC) was 0.825 (95% CI: 0.763~0.886, P<0.01). When the cut-off value was 16.5 days, the sensitivity was 78.4% and the specificity was 75.4%. Conclusions:DIAH is an important risk factor for prognosis in critically ill patients. Early identification and rapid intervention for the etiology of IAH should be performed to shorten DIAH.

Clinical effectiveness of a pneumatic compression device combined with low-molecular-weight heparin for the prevention of deep vein thrombosis in trauma patients: A single-center retrospective cohort study / 世界急诊医学杂志（英文）

@#BACKGROUND: To investigate the clinical effectiveness of a pneumatic compression device (PCD) combined with low-molecular-weight heparin (LMWH) for the prevention and treatment of deep vein thrombosis (DVT) in trauma patients. METHODS: This study retrospectively analyzed 286 patients with mild craniocerebral injury and clavicular fractures admitted to our department from January 2016 to February 2020. Patients treated with only LMWH served as the control group, and patients treated with a PCD combined with LMWH as the observation group. The incidence of DVT, postoperative changes in the visual analogue scale (VAS) score, and coagulation function were observed and compared between the two groups. Excluding the influence of other single factors, binary logistic regression analysis was used to evaluate the use of a PCD in the patient's postoperative coagulation function. RESULTS: After excluding 34 patients who did not meet the inclusion criteria, 252 patients were were included. The incidence of DVT in the observation group was significantly lower than that in the control group (5.6% vs. 15.1%, χ2=4.605, P<0.05). The postoperative VAS scores of the two groups were lower than those before surgery (P<0.05). The coagulation function of the observation group was significantly higher than that of the control group, with a better combined anticoagulant effect (P<0.05). There were no significant differences between the two groups in preoperative or postoperative Glasgow Coma Scale scores, intraoperative blood loss, postoperative infection rate, or length of hospital stay (P>0.05). According to logistic regression analysis, the postoperative risk of DVT in patients who received LMWH alone was 1.764 times that of patients who received LMWH+PCD (P<0.05). The area under the receiver operating characteristic (AUROC) curve of partial thromboplastin time (APTT) and platelet (PLT) were greater than 0.5, indicating that they were the influence indicators of adding PCD to prevent DVT. Excluding the influence of other variables, LMWH+PCD effectively improved the coagulation function of patients. CONCLUSIONS: Compared with LMWH alone, LMWH+PCD could improve blood rheology and coagulation function in patients with traumatic brain injury and clavicular fracture, reduce the incidence of DVT, shorten the length of hospital stay, and improve the clinical effectiveness of treatment.

Effects of overall planning on staff burnout and group blood donation errors / 中国输血杂志

【Objective】 To analyze the causes of staff burnout and various errors during group blood donation in blood centers, and to explore the significance of overall planning to improve above problems. 【Methods】 Various errors occurred during group blood donation from January 2016 to December 2020 in a blood center were selected as the research object. Job burnout related survey data including emotional exhaustion (MBI-EE), work attitude (MBI-DP), sense of achievement (MBI-PA) etc. were collected. The influence of six variables, including blood collection quantity, staff, order control, plan compliance, overload blood collection and over-stock blood collection, on the occurrence of errors was analyzed, and an ordered logistic regression model was established. After optimizing overall planning measures, the occurrence of errors and the improvement of burnout were compared. 【Results】 In addition to the volume of blood collected (P>0.05), the other five variables had significant influence on the occurrence of errors (P0.05). 【Conclusion】 Scientific inventory management and effective blood collection assessment measures are helpful to improve work quality, and the ordered Logistic regression model has a good fitting degree for error rectification. Analyzing the occurrence of errors during blood collection and supply from the influencing factors is conducive to formulate corrective and preventive measures and promote the continuous improvement of work quality.

Analysis of risk factors of stone escape in elderly patients with upper urinary tract stones treated with flexible ureteroscope lithotripsy / 国际外科学杂志

Objective:To analyze the risk factors of the elderly patients with upper urinary tract stones treated by flexible ureteroscope lithotripsy affect the patients′ stone escape.Methods:A retrospective study of 160 patients with upper urinary tract calculi admitted to Baise People′s Hospital from January 2015 to January 2021, all patients were treated with flexible ureteroscopic lithotripsy, and they were 60-85 years old. According to whether the patients had escaped stones, the patients were divided into stone escape group ( n=53) and stone non-escape group ( n=107). Chi-square test was used for comparison of count data between groups. Multivariate Logistic regression analysis was used to analyze the independent risk factors for stone escape in patients; Use R3.3.2 software and software package rms to build a nomogram prediction model; receiver operating characteristic curve (ROC) was used to evaluate the discrimination of the nomogram model in predicting patients with stone escape, and the results were expressed as the area under the curve (AUC) and the 95% confidence interval (95% CI) of the area. Results:Flexible ureteroscope lithotripsy for the treatment of elderly patients with upper urinary tract stones has been found to have good efficacy, low risk of bleeding and fewer complications. In univariate analysis, compared with the stone not-escape group, in the stone escape group, the proportion of patients with mild or moderate preoperative hydronephrosis, the ureteral tube occluder was not used during the operation, intraoperative pump injection pressure of 0.9% sodium chloride injection >200 mmHg, number of stones >1, the location of the stones in the upper and lower calyces of the kidney were significantly increased ( P<0.05). Multivariate Logistic regression analysis found that the preoperative hydronephrosis was mild or moderate, the ureteral tube occluder was not used during the operation, and the intraoperative pump injection pressure of 0.9% sodium chloride injection >200 mmHg were independent risk factors for stone escape in patients. The consistency index (C-index) of the nomogram prediction model and the AUC of the ROC were 0.804 (95% CI: 0.746-0.862) and 0.821 (95% CI: 0.763-0.879), respectively, indicating that the model has good discrimination. Conclusion:Mild or moderate preoperative hydronephrosis, no ureteral tube occluder during operation, and intraoperative pump injection pressure of 0.9% sodium chloride injection >200 mmHg are all risk factors for stone escape in patients.

Analysis of related factors for undertaking the NSFC project among faculties with master and doctor degrees in a tertiary hospital / 中华医学科研管理杂志

Objective:To analyze the main related factors for undertaking the NSFC project among the in-service master and doctor in a third-grade First-class hospital in 2020.Methods:By collecting and comparing the age of the target population, the type of education and degree, SCI papers publication and experience as principal investigator of scientific research projects and other variables, the factors affecting the commitment of the NSFC project were analyzed.Results:A total of 743 feedbacks from the people with master′s degree and doctor′s degree in this survey, 69 of whom had undertaken the NSFC project (accounting for 9.3% of the total number). By the univariate analysis, age, education, age more than 55 years old, professional Dr. and academic Dr., published SCI paper publication, JCR1/JCR2/JCR3/JCR4 publication and experience as principal investigator of scientific research project should significantly improve the opportunity of undertaking the NSFC project. The multivariate analysis results show that the main factors influencing the commitment of the NSFC project are the professional Dr., the academic Dr. and having hosted projects.Conclusions:Professional or academic doctors and experience as principal investigator of scientific research projects have significant advantages in undertaking the NSFC project. Medical institutions should fully consider the advantages of different types of scientific research personnel and make clear their differences in professional fields, in order to develop more targeted programs to improve the capacity for scientific research.

Prevalence and influencing factors of mental violence in intimate partner violence / 中华行为医学与脑科学杂志

Objective:To explore the prevalence and influencing factors of mental violence in intimate partner violence.Methods:A total of 900 people, who aged 18 to 65 with marriage or love experience, were selected from Xinjiang Uygur Autonomous Region using stratification cluster method. A self-designed questionnaire for general information, the brief conflict tactics scale 2 (CTS-2), perceived stress scales (PSS) and personality diagnostic questionnaire-4+ (PDQ-4+ ) were used for questionnaire investigation. The influencing factors of mental violence were analyzed by binary logistic regression analysis model using SPSS 17.0 software.Results:The scores of CTS-2, PPS and PDQ-4+ were (21.46±6.38), (42.48±18.91), and (3.05±0.62), respectively. In the past one year, the incidence of abusing partners, emotional violence, destroying each other's goods and threatening to hit each other in mental violence were 41.67% (375/900), 33.44% (301/900), and 8.44% (76/900), respectively. Based on the scores of three items, the incidence of mental violence was 55.44% (499/900). Multi-factor logistic regression analysis showed age≤29 ( β=0.57, OR=2.53, 95% CI=1.11-5.99), male ( β=0.64, OR=3.68, 95% CI=1.22-4.56), rural ( β=0.12, OR=2.49, 95% CI=1.17-5.36), moderate and severe drinking ( β=0.33, OR=2.87, 95% CI=2.57-6.63), higher perceived stress level ( β=0.51, OR=1.05, 95% CI=1.03-1.09), personality factors deviate ( β=0.43, OR=2.26, 95% CI=2.13-2.39), lower marital satisfaction ( β=0.18, OR=2.05, 95% CI=1.03-8.76), behavior control over partner ( β=0.16, OR=2.55, 95% CI=1.68-3.69), economic control over partners ( β=0.19, OR=1.36, 95% CI=1.28-1.55) were risk factors of mental violence in intimate partner violence, while individual opposed attitude towards violence ( β=0.29, OR=0.88, 95% CI=0.80-0.94) was the protective factor of mental violence in intimate partner violence. Conclusion:The annual incidence of mental violence is high. Therefore, it is necessary to focus on the young, male, rural and personality deviant people. The incidence of mental violence may be reduced by reducing the individual's perceived stress level, drinking level, behavior control and economic control over partners, and strengthening the marital satisfaction and the individual's opposition to violence.

Logistic regression analysis of the relationship between abnormal dental occlusion and temporomandibular disorders in lower grade college students / 口腔疾病防治

Objective @#To investigate the influence of abnormal occlusion factors on the incidence of temporomandibular disorders (TMDs) in junior college students and to provide an etiological basis for the prevention and treatment of TMDs.@*Methods @# We examined the temporomandibular joint (TMJ) and dental occlusion in 754 lower grade college students (male 354, female 400) at Zunyi Medical University (Zhuhai campus). A questionnaire was also administered. We analyzed the correlation between TMD and the other three factors (static abnormal occlusion, dynamical abnormal occlusion and oral parafunctional activity) from the perspective of multivariate unconditioned logistic regression and univariate unconditioned logistic regression with dummy variables.@*Results @#The prevalence of TMD was 31.7%. The incidence of TMD was significantly (P<0.05) associated with sleep bruxism (OR=2.070), clenching (OR=2.553), diurnal (OR=2.642) and anterior teeth overbite (OR=1.228). Univariate unconditioned logistics regression analysis by dummy variables was used to analyze the incidence of TMD at different deep overbites (mild, OR=1.558; moderate, OR=2.189; severe, OR=3.236; P<0.05). @*Conclusion@#The risk factors for TMD in lower grade college students included anterior teeth occlusion, sleep bruxism, clenching, and diurnal treatment. Worse deep overbite might increase the risk of TMD.

Application of the logistic regression model for the analysis of accuracy related influencing factors on HPLC measurement of preservatives / 公共卫生与预防医学

Objective To employ Logistic regression modeling to analyze the related factors influencing the accuracy of the high performance liquid chromatography (HPLC) determination of preservatives in beverages. Methods The HPLC separation was performed on a Zorbax Eclipse Plus C18 column with methanol-ammonium acetate solution as mobile phase. The external standard method was used to determine 5 beverage preservatives. The influencing factors on the measurement accuracy were statistically evaluated with univariate and multivariate analysis. Results Univariate analysis showed that the recovery rate of the added standard in the determination of coffee beverage preservatives by HPLC was affected by the pretreatment method, and the difference was statistically significant (P<0.05). Multivariate analysis showed that the main influencing factors on the accuracy of determination of sorbic acid was the pretreatment method (OR=5.406, P<0.05), while the sample type was a protective factor (OR=0.134, P<0.05). For the determination of benzoic acid, the main factor influencing the accuracy was the sample type (OR=1.112, P<0.05), while the pretreatment method was a protective factor (OR=0.447, P<0.05). Conclusion Logistic regression analysis can identify risk factors for the accuracy of the determination, and provide statistical modeling support for the experimental optimization.

Syndrome Distribution of 9 323 Cough Cases in Ancient Chinese Medical Books Based on Latent Structure Model and Logistic Regression Analysis / 中国实验方剂学杂志

Objective:To explore the syndrome distribution of cough cases in ancient Chinese medical books. Method:A total of 9 323 cough cases in the database of lung diseases in ancient Chinese medical books were extracted. Lantern 5.0 was used to construct the latent structure model for the 100 manifest variables based on the first 50 symptoms and 50 Chinese herbal medicines， and different latent nodes were interpreted. The syndrome differentiation patterns of syndromes with symptoms and Chinese herbal medicine （formula） were quantitatively revealed by the comprehensive clustering weights of latent structure. The correlation of diseases with syndromes was fitted through the binary Logistic regression analysis. Result:There were 204 syndromes involved in 9 323 cough cases with 18 syndromes showing a frequency higher than 100. As demonstrated by the model established on the first 50 symptoms and 50 Chinese herbal medicines， 35 latent variables， 98 latent classes， and 10 comprehensive clustering models were obtained， where <italic>Z</italic>5<italic> </italic>was the highest in the threshold value （6.7）， <italic>Z</italic>6 in the information coverage of productive cough （52%）， and <italic>Z</italic>7 in the score （19）. The binary Logistic regression model fitted the correlation between different disease types and five syndromes， where the dominance ratio of external wind to the syndrome of wind-heat invading lung reaching up to 88.919， those of syndrome of phlegm-heat accumulating in lung to diseased heat and sputum 51.594 and 15.861， and those of the syndrome of phlegm-dampness obstructing lung to dampness， phlegm， and fluid retention 31.415， 34.370， and 4.936， respectively. Conclusion:The newly discovered cough syndromes included lung heat and yin deficiency， external cold and internal fluid retention， weakness of spleen and stomach， and phlegm and blood stasis in lung. In most cases， multiple syndromes were observed clinically， such as syndrome of deficiency of both Qi and Yin in lung combined with yin deficiency in lung and kidney. Since differentiation of traditional Chinese medicine （TCM） syndrome is subjective， the weight can indicate the difference in the contributions of different symptoms to the syndrome， which is of guiding significance for syndrome inference. The latent structure model combined with Logistic regression analysis can solve the problem of quantification in TCM syndrome differentiation and can be used to explore the syndrome distribution of diseases.

Influencing factors of medical college students′ participation in voluntary blood donation: Logistic regression analysis / 中国输血杂志

【Objective】 To analyze the status and influencing factors of blood donation among medical college on going students, so as toassist in implementing targeted measures to expand and stabilize the group of college blood donors. 【Methods】 The cross-sectional survey method was used to carry out the field questionnaire survey. 【Results】 128 people participated in blood donation, and the blood donation rate was 16%. Gender, the knowledge and intention towards blood donation, and behavior of peers were the influencing factors revealed by the logistic regression analysis (P<0.05). In addition, the publicity and service provided by blood stations were also important factors. 【Conclusion】 The publicity of voluntary blood donation should be improved in colleges to raise the donation intention of college students.Service provided by blood centers should also be improved to ease donation fear, so as to expand the college donor population.

Usefulness of the TG/HDL Ratio in Predicting Cardiovascular Risk: A MMIMSR Experience

The present study was aimed to compare traditional lipid measures with the lipid ratios to establish a bettermarker for the assessment of coronary artery disease (CAD) risk. The comparison of traditional lipid parametersand lipid ratios were made in terms of independent ‘t’ test, area under receiver operating characteristic(AUROC) curve and logistic regression analysis. LDL-C and HDL-C could not correlate well with CAD riskprediction. Strikingly, TG/HDL ratio was found to be more significantly associated in comparison to any ofthe individual lipid parameters as well as TC/HDL and LDL/HDL ratios when compared in terms of AUROCand logistic regression analysis, while LDL/HDL ratio could not correlate. Altogether, these findings infer thatTG/HDL ratio is a better parameter in CAD risk prediction. Additionally, the TG/HDL ratio being calculatedparameter incurs no additional cost to the patients and health care system. Henceforth, the authors suggest theincorporation of the TG/HDL ratio in the routine lipid panel for the better diagnosis and treatment of dyslipidemia.

Factors Associated with Common Mental Disorders in Truck Drivers / Fatores Associados aos Transtornos Mentais Comuns em Caminhoneiros

Abstract This study aimed to identify the risk factors of Common Mental Disorders (CMD) using a sample of 565 Brazilian truck drivers. For data capture were applied the Self-Reporting Questionnaire (SRQ-20), Scale subscale of Psychosocial risks and questionnaire with socio-demographic, working and occupational stressors. The results obtained by multivariate binary logistic regression analysis, have explained the 39.9% of variation on CMD. The occupational stressor working hours is the predictor variable with highest impact, may implying in an increase of 5.41 times more chance of the trucker to present CMD. The results indicate actions by management level as work organization and public authorities with regard to the external work conditions.

Resumo Este estudo objetivou identificar os fatores de risco dos Transtornos Mentais Comuns (TMC) em uma amostra de 565 caminhoneiros brasileiros. Para a coleta de dados, foram utilizados o Self-Reporting Questionnaire (SRQ-20), Subescalas da Escala de Riscos Psicossociais e questionários sociodemográfico, laboral e de estressores ocupacionais. Os resultados obtidos por meio da análise de Regressão Logística Binária Multivariada explicaram 39,9% das variações dos TMC. A variável preditora de maior impacto foi o estressor ocupacional jornada de trabalho que implicou em um aumento de 5,41 vezes mais chance do caminhoneiro apresentar TMC. Os resultados sugerem ações por parte dos gestores quanto à organização do trabalho e por parte do poder público no que diz respeito às condições externas de trabalho.

Researches on the illness risk of essential hypertension complicated with coronary heart disease based on machine learning algorithm / 解放军医学杂志

[Abstract] Objective To study a model of screening the risk factors of essential hypertension complicated with coronary heart disease and establishing the individual risk classification, and provide a computer-aided diagnostic methods for disease occurrence. Methods To collect 70 clinical information including 2791 patients with essential hypertension complicated with coronary heart disease and 2135 patients with simple essential hypertension diagnosed from January 1, 2014 to May 31, 2019 in Chongqing Medical University medical big data platform, screen out the indicators with statistical differences in single factor analysis. With R3.6.1 to construct logistic regression classification model and 3 machine learning models of BP neural network, random forest and extreme gradient rise (XGBoost), then compare the relevant parameters of various models and select the optimal classification model. Results According to the univariate analysis, 44 indexes with statistical difference were selected and included in logistic regression classification model and machine learning model. The classification accuracy in test set of logistic regression classification model, BP neural network model, random forest model, XGBoost model was 0.852, 0.968, 0.966 and 0.976, respectively, and the area under the work characteristic curve (AUC) of the subjects was 0.853, 0.970, 0.967 and 0.977, respectively. Applying XGBoost model with optimal performance to clinical practice of cardiology in the University Town Hospital of Chongqing Medical University. The diagnostic sensitivity was 1.000, specificity was 0.912, accuracy was 0.926, and AUC was 0.956. Conclusion Establishment of XGBoost model has a good auxiliary diagnostic function for essential hypertension complicated with coronary heart disease, and has achieved good results in clinical practice.