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SUMMARY: This article has two aims: (a) first aim was to determine what is the most applicable and the simplest alternative for recommended BMI categories for underweight, overweight and obesity related to IOTF references, from the practical standpoint; (b) second aim was to determine the prevalence of the nutritional status in Montenegro on this representative sample of school children aged 9-13 years and compare them with peers from relevant and similar studies from both the local region and globally. A total sample of 1478 healthy children from Montenegro participated in this study divided into two sub-samples of 732 girls and 746 boys. According to the IOTF body mass index (BMI) reference values were used through ROC curve analysis to evaluate potential alternatives for estimation of the nutritional status of this sample of children. Only WHtR did not show significant age-related differences in the case of both genders. Considering the nutritional status of children from this study it has been found that boys have a considerably higher prevalence of being overweight (22.7 % vs. 16.4 %) and obese (7.5 % vs. 3.3 %) compared to girls. On the other hand, girls were more prevalent to be underweight (10.5 % vs. 7.5 %). WHtR seems like the best alternative for the estimation of obesity and being overweight due to simplicity and the equipment needed.
Este artículo tiene dos objetivos: (a) el primero fue determinar cuál es la alternativa más aplicable y más sencilla para las categorías de IMC recomendadas para bajo peso, sobrepeso y obesidad relacionadas con las referencias de la IOTF, desde el punto de vista práctico; (b) el segundo objetivo fue determinar la prevalencia del estado nutricional en Montenegro en esta muestra representativa de escolares de 9 a 13 años y compararlos con pares de estudios relevantes y similares tanto de la región local como a nivel mundial. En el estudio participaron 1478 niños sanos de Montenegro divididos en dos submuestras de 732 niñas y 746 niños. De acuerdo con el índice de masa corporal (IMC) de la IOTF, se utilizaron valores de referencia mediante análisis de curvas ROC para evaluar posibles alternativas para la estimación del estado nutricional de esta muestra en niños. Sólo el ICT no mostró diferencias significativas relacionadas con la edad en el caso de ambos sexos. Teniendo en consideración el estado nutricional de los niños, se determinó que los éstos tenían una prevalencia considerablemente mayor de sobrepeso (22,7 % frente a 16,4 %) y obesidad (7,5 % frente a 3,3 %) en comparación con las niñas. Por otro lado, las niñas tenían más prevalencia de bajo peso (10,5 % frente a 7,5 %). El WHtR parece la mejor alternativa para la estimación de la obesidad y el sobrepeso por su sencillez y equipamiento necesario.
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Humanos , Masculino , Femenino , Niño , Adolescente , Estudiantes , Composición Corporal , Estado Nutricional , Grosor de los Pliegues Cutáneos , Peso Corporal , Montenegro , Relación Cintura-EstaturaRESUMEN
SUMMARY: The identification of children and adolescents who are at risk of sarcopenic obesity development often requires specialized equipment and expensive test procedures. Therefore, the establishment of cheaper and faster methods would be greatly useful, especially if they could be applied in the field. The study's objective was to establish if identification of female adolescents who suffer the risk of developing sarcopenic obesity can be obtained through the standing-long-jump test application. To achieve the research objectives, various anthropometric and body composition measurements were performed and lower limb explosive strength was assessed using the standing long jump fitness test. The research was conducted on a sample of 535 female respondents randomly selected from 9 elementary schools in the Skopje region of the Republic of North Macedonia. The respondents were divided into quintiles according to BMI z-scores, and the arithmetic means and SD about muscle-to-fat ratio were calculated for each quintile. The cutoff was determined based on the mean and standard deviation of the muscle-to-fat ratio for the 3rd quintile of BMI and the percentage of respondents with sarcopenic obesity was examined. The optimal cut-off value of the long jump fitness test results for predicting sarcopenic obesity in an adolescent girl showed that the area under the ROC curve was 0.781 (95 % CI 0.743-0.815). The standing-long-jump test values, on grounds of odds ratio (OR 95 % CI) about the girls at risk of sarcopenic obesity development, which was identified on muscle-to-fat ratio base, were 8.76 (4.39 - 17.54, p 0.001). It can be used to predict sarcopenic obesity presence in female adolescents, which can be vital in case of health intervention.
La identificación de niños y adolescentes que corren riesgo de desarrollar obesidad sarcopénica a menudo requiere equipos especializados y procedimientos de pruebas costosos. Por lo tanto, el establecimiento de métodos más baratos y rápidos sería de gran utilidad, especialmente si pudieran aplicarse en el campo. El objetivo del estudio fue establecer si la identificación de mujeres adolescentes que sufren riesgo de desarrollar obesidad sarcopénica se puede obtener mediante la aplicación de la prueba de salto de longitud de pie. Para lograr los objetivos de la investigación, se realizaron diversas mediciones antropométricas y de composición corporal y se evaluó la fuerza explosiva de los miembros inferiores mediante la prueba de aptitud de salto de longitud de pie. La investigación se realizó con una muestra de 535 mujeres encuestadas seleccionadas al azar de 9 escuelas primarias de la región de Skopje, en la República de Macedonia del Norte. Los encuestados se dividieron en quintiles según las puntuaciones z del IMC, y se calcularon las medias aritméticas y la DE sobre la relación músculo-grasa para cada quintil. El límite se determinó en función de la media y la desviación estándar de la relación músculo-grasa para el tercer quintil del IMC y se examinó el porcentaje de encuestados con obesidad sarcopénica. El valor de corte óptimo de los resultados de la prueba de condición física de salto de longitud para predecir la obesidad sarcopénica en una adolescente mostró que el área bajo la curva ROC fue 0,781 (IC del 95 %: 0,743-0,815). Los valores de la prueba de salto de longitud de pie, sobre la base del odds ratio (OR IC del 95 %) sobre las niñas en riesgo de desarrollar obesidad sarcopénica, que se identificó sobre la base del ratio músculo-grasa, fueron 8,76 (4,39 - 17,54, p. 0,001). Puede utilizarse para predecir la presencia de obesidad sarcopénica en adolescentes, lo que puede ser vital en caso de intervención sanitaria.
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Humanos , Femenino , Niño , Adolescente , Prueba de Esfuerzo , Sarcopenia/diagnóstico , Obesidad/diagnóstico , Composición Corporal , Antropometría , Tejido Adiposo , Encuestas y Cuestionarios , Análisis de Regresión , Impedancia Eléctrica , Medición de Riesgo , Músculo Esquelético , Posición de PieRESUMEN
RESUMEN Objetivo: Evaluar la asociación y el riesgo de hipercolesterolemia en pacientes adultos prediabéticos atendidos en un centro médico del distrito de Villa El Salvador en Lima, Perú. Materiales y métodos: Estudio analítico, prospectivo y transversal, con datos de historias clínicas de consultas médicas de 749 pacientes atendidos en un policlínico del distrito de Villa El Salvador, Lima, Perú. Se incluyó a pacientes adultos asintomáticos que asistieron a evaluaciones de rutina y preventivas. Se excluyó a pacientes con enfermedades endocrino-metabólicas o en tratamiento con fármacos hipoglucemiantes. Las variables de estudio fueron sexo, hipercolesterolemia y prediabetes. El análisis de asociación se realizó por medio de la prueba de chi cuadrado y el riesgo fue evaluado por medio de la oportunidad relativa; asimismo, se realizó el análisis multivariado por medio de regresión logística binaria y se consideró como punto de corte en decisión de significancia estadística el valor alfa igual a 0,05 y un nivel de confianza de 95 %. Resultados: Hubo asociación estadísticamente significativa entre prediabetes e hipercolesterolemia. Las mujeres prediabéticas tuvieron 1,66 veces más riesgo de desarrollar hipercolesterolemia que las mujeres con niveles de glucosa basal normales, mientras que los hombres con prediabetes tuvieron 2,37 veces más riesgo de tener colesterol alto que los hombres con niveles de glucemia basal normales. Conclusiones: La prediabetes se asocia con la hipercolesterolemia, lo cual aumenta su riesgo. Es justificable realizar la medición conjunta del colesterol total en ayunas junto con la medición de la glucosa basal en campañas preventivo-promocionales de salud y en consultas periódicas, así como durante el seguimiento de pacientes con factores de riesgo de diabetes, prediabetes e hipercolesterolemia, a fin de reducir las consecuencias hemodinámicas y cardiovasculares del colesterol elevado en la sangre y el agravamiento de la morbimortalidad conjunta de la hiperglucemia crónica.
ABSTRACT Objective: To evaluate the association and risk of hypercholesterolemia among adult patients with prediabetes treated at a medical center in the district of Villa El Salvador in Lima, Peru. Materials and methods: An analytical, prospective and cross-sectional study conducted with data from medical consultation records of 749 patients treated at a polyclinic in the district of Villa El Salvador in Lima, Peru. Asymptomatic adult patients who had routine and preventive checkups were included in the research. Patients with endocrine and metabolic disorders or being treated with hypoglycemic drugs were excluded. The study variables were sex, hypercholesterolemia and prediabetes. The association analysis was performed using the chi-square test and the risk was evaluated by means of the odds ratio. In addition, the multivariate analysis was conducted through a binary logistic regression, and an alpha value of 0.05 and a confidence level of 95 % were considered as the cut-off point to determine the statistical significance. Results: There was a statistically significant association between prediabetes and hypercholesterolemia. Females with prediabetes were 1.66 times more likely to develop hypercholesterolemia than females with normal baseline glucose levels, while males with prediabetes were 2.37 times more likely to have high cholesterol than males with normal baseline blood glucose levels. Conclusions: Prediabetes is associated with hypercholesterolemia, thus increasing its risk. It is justifiable to carry out the joint measurement of fasting total cholesterol and baseline glucose in disease prevention and health promotion campaigns, regular checkups and follow-up of patients with risk factors for diabetes, prediabetes and hypercholesterolemia. This helps reduce the hemodynamic and cardiovascular consequences of high cholesterol levels and the worsening of the joint morbidity and mortality of chronic hyperglycemia.
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Introducción: Los indicadores demográficos básicos constituyen una operación estadística, conformada por una colección de indicadores que permiten analizar la incidencia de los fenómenos demográficos básicos en una sociedad. Objetivo: Diseñar un indicador, a partir del índice de masculinidad, para la evaluación del envejecimiento poblacional a través de una escala jerárquica. Métodos: Se realizó un estudio ecológico, que incluyó a cualquier población con información existente desde la edad 0 hasta un grupo abierto final de 75 y más años, subdivididos por grupos quinquenales y sexo. La muestra fue seleccionada por muestreo simple aleatorio. Entre las medidas descriptivas figuraron la media aritmética, la mediana, la desviación típica y los percentiles; asimismo, fueron aplicadas la prueba de bondad de ajuste de Kolmogorov-Smirnov, la curva de la característica operativa del receptor, el índice de Youden, el coeficiente de correlación de Pearson, el coeficiente kappa como medida de concordancia y la prueba de la Χ2 de independencia. Resultados: Existió una concordancia buena o elevada con el índice de Sundbarg y una alta correlación con todos los indicadores de envejecimiento, excepto con el índice de dependencia. Conclusiones: La razón de masculinidad ponderada proporciona una excelente medición del grado de envejecimiento de una población, siempre que el intervalo de edad final sea de 75 años y más.
Introduction: Basic demographic indicators constitute a statistical operation, conformed by a collection of indicators that allow analyzing the incidence of the basic demographic phenomena in a society. Objective: To design an indicator, taking the masculinity index as a starting point, for the evaluation of population ageing through a hierarchical scale. Methods: An ecological study was carried out that included any population with existent information, from the age 0 to a final open group of 75 years and over, subdivided by five-year groups and sex. The sample was selected by random simple sampling. The mean arithmetic, medium arithmetic, typical deviation and percentiles were among the descriptive measures; also, the Kolmogorov-Smirnov test for goodness of fit, the receiver operating characteristic curve, Youden index, Pearson correlation coefficient, kappa coefficient as a measure of concordance and chi-square test of independence were applied. Results: A good or high concordance existed with the Sundbarg index and a high correlation with all the aging indicators, except the dependence index. Conclusion: The pondered masculinity ratio provides an excellent measuring of the aging degree in a population, whenever the final age interval is 75 years and over.
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Objective To observe the changes of laboratory blood indexes in patients with intrahepatic cholestasis of pregnancy(ICP),and analyze the value of blood inflammation indexes and liver function indexes in the diagnosis of ICP and the prediction of delivery mode.Methods A total of 251 patients diagnosed with ICP in this hospital from January 2021 to December 2022 were selected as the ICP group,and another 200 healthy pregnant women were selected as the control group.The patients with ICP were further divided into the severe ICP group(n=47)and the mild ICP group(n=204),the vaginal delivery group(n=113)and the cesarean section group(n=138)according to the severity of ICP and delivery mode.Mann-Whitney U test was used for comparison of parameters between groups,and Spearman method was used for correlation analy-sis.Receiver operating characteristic(ROC)curves were used to evaluate the efficacy of laboratory indicators in diagnosing ICP and predicting delivery mode.Results Neutrophil/lymphocyte ratio(NLR)[6.01(4.45,8.37)vs.3.36(4.12,3.51)]and aspartate transaminase(AST)level[20.00(16.00,33.00)U/L vs.15.00(13.00,18.00)U/L]in the ICP group were significantly higher than those in the control group(P<0.05),and NLR in the severe ICP group was significantly higher than that in the mild ICP group[4.93(3.87,7.35)vs.4.14(3.12,5.17),P<0.05].Correlation analysis showed that NLR was positively correlated with AST level(r=0.279,P<0.001)and ICP severity(r=0.139,P=0.028)in patients with ICP.The area under ROC curve(AUC)of NLR combined with AST for ICP diagnosis was 0.882(95%CI:0.851-0.913).In ad-dition,cholinesterase(CHE)[6 020.00(5 499.50,6 703.50)U/L vs.5 341.50(4 651.75,6 259.25)U/L]and prealbumin(PA)[199.00(177.71,225.20)mg/Lvs.169.17(139.18,204.40)mg/L]levels in the va-ginal delivery group were significantly higher than those in the cesarean section group(P<0.05),and the AUC of CHE combined with PA for predicting vaginal delivery in ICP patients was 0.727(95%CI:0.664-0.789).Conclusion NLR and AST have potential value in the diagnosis of ICP,and CHE and PA have poten-tial value in predicting delivery mode of ICP patients.
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Objective To investigate the correlation and predictive effect of serum CD4+/CD8+T lympho-cyte ratio combined with magnetic resonance angiography(MRA)on recurrence of cerebral infarction.Meth-ods A total of 153 patients with acute cerebral infarction admitted to the Zhenjiang First People's Hospital from January 2021 to February 2022 were selected.CD4+/CD8+T lymphocyte ratio of patients was deter-mined,vascular stenosis score and collateral circulation filling score were evaluated by MRA.The patients were followed up for 1 year,including 34 patients with recurrent cerebral infarction as recurrent cerebral in-farction group,107 patients without recurrent cerebral infarction as the non-recurrent cerebral infarction group,12 patients were excluded due to other causes of loss of follow-up,and the receiver operating character-istic(ROC)curve for using the indicators to predict the recurrent cerebral infarction was drawn.Results The CD4+/CD8+T lymphocyte ratio in recurrent cerebral infarction group was significantly higher than that in non-recurrent cerebral infarction group(P<0.05).Vascular stenosis score and collateral circulation filling score in recurrent cerebral infarction group were lower than those in non-recurrent cerebral infarction group(P<0.05).The recurrence of cerebral infarction was correlated with CD4+/CD8+T lymphocyte ratio,vascu-lar stenosis score and collateral circulation filling score(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of CD4+/CD8+T lymphocyte ratio,vascular stenosis score,and collateral circulation filling score to predict recurrent cerebral infarction was 0.975,0.889,and 0.935,respectively,and the AUC of recurrent cerebral infarction was 0.994 when combined with the three factors.The AUC of cerebral infarction recurrence was significantly higher than that of each index alone.Conclusion Serum CD4+/CD8+T lympho-cyte ratio combined with MRA vascular stenosis score and collateral circulation filling score have high efficacy in the diagnosis of recurrent cerebral infarction,which have predictive value for recurrent cerebral infarction.
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Objective To study the construction of risk prediction model for postoperative recurrence of ad-vanced epithelial ovarian cancer based on serum human epididymis protein 4(HE4),platelet count/lymphocyte count ratio(PLR),relaxin(RLX),karyopherin α2(KPNA2).Methods 124 patients with advanced epithelial o-varian cancer diagnosed and treated in Suzhou Municipal Hospital(East District)from January 2016 to January 2019 were selected as the study objects,patients with advanced epithelial ovarian cancer were divided into re-currence group and the non-recurrence group based on whether they had recurred or not.The level of HE4 was detected by electrochemical luminescence immunoassay,PLR was calculated according to the blood routine re-sults,and RLX and KPNA2 levels were detected by enzyme-related immunosorbent assay.Multivariate Logis-tic regression analysis was used to analyze the influencing factors of postoperative recurrence in patients with advanced epithelial ovarian cancer,and establish a risk prediction model for postoperative recurrence of ad-vanced epithelial ovarian cancer.Receiver operating characteristic(ROC)curve was used to evaluate the pre-dictive efficacy of the model for postoperative recurrence of advanced epithelial ovarian cancer,and Hosmer-Lemeshow test was used to analyze the fitting of recurrence risk prediction model for patients with advanced epithelial ovarian cancer.Results There was a statistically significant difference in International Federation of Gynecology and Obstetrics(FIGO)staging and serum levels of carbohydrate antigen 125,HE4,PLR,RLX and KPNA2 between the recurrence group and the non-recurrence group(P<0.05).FIGO staging Ⅳ of cancer and elevated serum HE4,PLR,RLX and KPNA2 were risk factors for postoperative recurrence in patients with advanced epithelial ovarian cancer(P<0.05).ROC curve analysis showed that,the area under the curve of the recurrence risk prediction model for postoperative recurrence risk of advanced epithelial ovarian cancer was 0.859,which was significantly higher than that single indicator detected by HE4,PLR,RLX and KP-NA2.Hosmer-Lemeshow test showed that the recurrence risk prediction model of advanced epithelial ovarian cancer had a good fitting(x2=7.869,P=0.437).Conclusion The risk prediction model for postoperative re-currence of advanced epithelial ovarian cancer based on serum HE4,PLR,RLX,KPNA2 and FIGO staging of cancer has high predictive value for evaluating postoperative recurrence of advanced epithelial ovarian cancer,and deserves clinical attention.
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Objective To investigate the relationship between mean platelet volume/lymphocyte ratio(MPVLR)and left atrial thrombosis in elderly patients with non-valvular atrial fibrillation(NVAF).Methods A total of 178 elderly patients with NVAF admitted to the hospital from January 2019 to December 2022 were enrolled in the study.The patients were divided into thrombosis group(28 cases)and non-throm-bosis group(150 cases)according to the left atrial thrombosis judged by using esophageal echocardiography(TEE).The white blood cell count(WBC),red blood cell count(RBC),lymphocyte count,lymphocyte pro-portion,platelet count(PLT)and mean platelet volume(MPV)were detected by automatic blood cell analy-zer,and MPVLR was calculated.The liver and kidney function indicators and blood lipid indicators were detec-ted by automatic biochemical analyzer.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of MPV,lymphocyte ratio and MPVLR for left atrial thrombosis in NVAF patients.Multiva-riate Logistic regression was used to analyze the influencing factors of left atrial thrombosis in elderly NVAF patients.Results MPV,lymphocyte proportion and MPVLR in the thrombosis group were higher than those in the non-thrombosis group,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of MPV,lymphocyte ratio and MPVLR for predicting left atrial thrombosis in NVAF patients were 0.821(95%CI:0.764-0.882),0.771(95%CI:0.714-0.842)and 0.901(95%CI:0.861-0.949).respectively.The course of disease in the thrombosis group was longer than that in the non-thrombosis group,the proportion of patients with chronic heart failure,the proportion of patients with stroke,CH A2DS2-VASc score,LAEF,LAD,LVEDV,MPVLR,serum uric acid,MPV,lymphocyte proportion and MPVLR were higher than those in the non-thrombosis group,and LVEF was lower than that in the non-thrombosis group,the differences were statistically significant(P<0.05).Multivariate Logistic regression a-nalysis showed that disease duration ≥1.93 years(OR=3.050,95%CI:1.928-4.824),chronic heart failure(OR=3.333,95%CI:1.808-6.144),MPVLR≥3.10(OR=3.873,95%CI:1.734-8.650)were independ-ent risk factors for left atrial thrombosis in elderly NVAF patients(P<0.05).Conclusion The increase of MPVLR is associated with left atrial thrombosis in elderly patients with NVAF,and it can be used as a an in-dicator to predict left atrial thrombosis in patients with NVAF.
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Objective:To explore the predictive value of early serum tumor markers (STM) , neutrophil to lymphocyte ratio (NLR) , platelet to lymphocyte ratio (PLR) combination score on the efficacy of gastric cancer immunotherapy.Methods:A total of 76 patients with gastric cancer who received immunotherapy at Second Affiliated Hospital of Shandong First Medical University from January 1, 2020 to June 30, 2022 were selected. Patients' leading STM, NLR, PLR were collected. Optimal cut-off value of NLR and PLR were determined by the receiver operating characteristic (ROC) curve. The clinical efficacy and prognosis of different leading STM, NLR, PLR and combined scores in gastric cancer patients received immunotherapy were analyzed. ROC curve was used to evaluate the predictive efficiency of each index and the combined score. Cox regression model was used to analyze the factors affecting patients' survival.Results:The best truncation value for NLR was 2.75, and the best truncation value for PLR was 175.9. All patients completed at least 2 cycles of immunotherapy, the objective response rate (ORR) was 23.7% (18/76) , and the disease control rate (DCR) was 88.2% (67/76) . There were no significant differences in ORR [ (20.9% (9/43) vs. 27.3% (9/33) ], DCR [83.7% (36/43) vs. 93.9% (31/33) ] between the high NLR group ( n=43) and low NLR group ( n=33) ( χ2=0.42, P=0.519; χ2=1.02, P=0.313) . There were no significant differences in ORR [27.3% (12/44) vs. 18.8% (6/32) ], DCR [81.8% (36/44) vs. 96.9% (31/32) ] between the high PLR group ( n=44) and low PLR group ( n=32) ( χ2=0.75, P=0.388; χ2=2.71, P=0.555) . The ORR for the high combined score group ( n=39) and low combined score group ( n=37) was 17.9% (7/39) and 29.7% (11/37) , respectively, with no statistically significant difference ( χ2=1.46, P=0.230) ; the DCR was 79.5% (31/39) and 97.3% (36/37) , respectively, with a statistically significant difference ( χ2=4.19, P=0.041) . The median progression free survival (PFS) and overall survival (OS) of 76 patients were 8.0 and 12.0 months. The median PFS in the high NLR group and low NLR group was 7.0 and 10.0 months, respectively, with a statistically significant difference ( χ2=7.95, P=0.005) ; the median OS was 12.0 and 14.0 months, respectively, with no statistically significant difference ( χ2=1.04, P=0.307) . The median PFS in the high PLR group and low PLR group was 8.0 and 10.0 months, respectively, with a statistically significant difference ( χ2=3.90, P=0.048) ; the median OS was 13.0 and 13.0 months, respectively, with no significant difference ( χ2=0.02, P=0.896) . The median PFS in the high combined score group and low combined score group was 7.0 and 10.0 months, respectively, with a statistically significant difference ( χ2=13.52, P<0.001) ; the median OS was 12.0 and 14.0 months, respectively, with a statistically significant difference ( χ2=5.02, P=0.025) . ROC curve analysis showed that the area under curve (AUC) of leading STM, NLR, PLR and combined score to predict the efficacy of gastric cancer immunotherapy was 0.662, 0.697, 0.601 and 0.773. Univariate analysis showed that, surgery ( HR=0.59, 95% CI: 0.36-0.95, P=0.031) , leading STM ( HR=0.57, 95% CI: 0.34-0.93, P=0.026) , NLR ( HR=0.54, 95% CI: 0.34-0.87, P=0.011) , combined score ( HR=0.42, 95% CI: 0.26-0.68, P<0.001) were all influencing factors for PFS in gastric cancer patients received immunotherapy; tumor stage ( HR=0.30, 95% CI: 0.12-0.75, P=0.011) , leading STM ( HR=0.28, 95% CI: 0.15-0.50, P<0.001) , combined score ( HR=0.55, 95% CI: 0.31-0.96, P=0.036) were all influencing factors for OS in gastric cancer patients received immunotherapy. Multivariate analysis showed that, leading STM ( HR=0.56, 95% CI: 0.33-0.98, P=0.041) was an independent influencing factor for PFS in gastric cancer patients received immunotherapy; tumor stage ( HR=0.29, 95% CI: 0.11-0.76, P=0.012) , leading STM ( HR=0.32, 95% CI: 0.17-0.58, P<0.001) , combined score ( HR=0.46, 95% CI: 0.25-0.82, P=0.009) were all independent influencing factors for OS in gastric cancer patients received immunotherapy. Conclusion:The combined score of leading STM, NLR and PLR is an independent factor influencing OS in patients receiving immunotherapy for gastric cancer, and can predict the efficacy of immunotherapy for gastric cancer.
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Objective To investigate the association of 13 single nucleotide polymorphism(SNP)sites in 6 phalange-bone development related genes[fibroblast growth factor receptor 2(FGFR2),indian hedgehog signaling molecule(IHH),Msh homeobox 1(MSX1),Runx family transcription factor 2(RUNX2),SRY-box transcription factor 9(SOX9),Wnt family member 5A(WNT5A)]with human index-ring finger length ratio(2D∶4D).Methods Digital cameras were used to take frontal photographs of the hands of 731 college students(358 males and 373 females)in Ningxia,and image analysis software was used to mark anatomical points and measure finger lengths of index(2th)and ring(4th);genotyping of 13 SNP sites(rs1047057,rs755793,rs41258305,rs3731881,rs3100776,rs12532,rs3821949,rs45585135,rs3749863,rs1042667,rs12601701,rs1829556,rs3732750)for 6 genes by multiplex PCR;One-Way ANOVA or independent sample t-test indirectly assessed the association between 2D∶4D and 13 SNP sites.Results Both left and right hand 2D∶4D were significantly higher in females than males in Ningxia college students(all P<0.01);no statistically significant differences in genotype and allele frequencies of the 13 SNP sites among different sexes(all P>0.05);among different sexes,male left hand 2D∶4D was significantly associated with the genotype of SOX9 gene rs12601701 site(P<0.05)and right hand 2D∶4D was significantly associated with the genotype of WNT5A gene rs1829556 site(P<0.05);the female right hand 2D∶4D was significantly associated with the MSX1 gene rs12532(P<0.01)and rs3821949(P<0.05)sites genotypes.Conclusion SOX9(rs12601701),WNT5A(rs1829556)and MSX1(rs12532 and rs3821949)gene polymorphisms may be associated with the formation of 2D∶4D in Ningxia population.
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Objective To investigate the relationship between aspartate aminotransferase-platelet ratio index(APRI)and hepatocellular carcinoma(HCC)recurrence after radiofrequency ablation(RFA),and to construct a nomogram model for predicting the prognosis.Methods The clinical data of a total of 204 patients,whose initial diagnosis was HCC and received RFA at the Wujin Hospital Affiliated to Jiangsu University of China between January 2017 and December 2020,were retrospectively analyzed.The optimal cut-off value of APRI was determined using receiver operating characteristic(ROC)curve.Kaplan-Meier curves were plotted to estimate the recurrence-free survival(RFS)of high-APRI group patients and low-APRI group patients.The independent predictors of HCC recurrence after RFA were identified by using univariate and multivariate Cox regression analysis,and significant variables were selected to construct a nomogram model.The predictive ability of the nomogram model for HCC recurrence was evaluated by the consistency index(C-index)and calibration curves.Results The incidence of HCC recurrence after RFA was 57.4%(117/204),the optimal cut-off value of APRI for predicting HCC recurrence was 0.501,and the area under curve(AUC)value was 0.678(95%CI=0.603-0.752).High-APRI group(≥0.501)had 121 patients and low-APRI group(<0.501)had 83 patients.High APRI index was significantly correlated with low RFS(χ2=12.929,P<0.01).The univariate and multivariate Cox regression analysis revealed that the number of tumors(HR=1.541,95%CI=1.039-2.286,P=0.031),maximum tumor diameter(HR=1.461,95%CI=1.011-2.112,P=0.044),serum AFP level(HR=2.286,95%CI=1.576-3.318,P<0.01)and APRI index(HR=1.873,95%CI=1.257-2.790,P=0.002)were the independent risk factors for HCC recurrence.Based on the above four variables,a nomogram model for predicting HCC recurrence after RFA was constructed,the C-index was 0.769(95%CI=0.676-0.862),and the AUC values for 1-,2-,and 3-year RFS prediction were 0.707,0.719,and 0.707,respectively.The calibration curves showed that a good consistency existed between the predicted probability and actual probability.Conclusion The nomogram model based on APRI and tumor biological characteristics has an excellent predictive ability for HCC recurrence after RFA.(J Intervent Radiol,2024,32:38-43)
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Objective To study the correlation between the changes of matrix metalloproteinase-9(MMP-9)and neutrophil/lymphocyte ratio(NLR)before and after the revascularization of acute ischemic stroke(AIS),so as to find biomarkers to predict the bleeding transformation risk of AIS patients.Methods From February 2022 to December 2022,161 patients admitted to the Stroke Center of Qujing Hospital Affiliated to Kunming Medical University with AIS werre divided in to the hemorrhagic transformation group and the non-hemorrhagic transfor-mation groupand treated with revascularization(intravenous thrombolysis,endovascular treatment,combined the intravenous thrombolysis with endovascular treatment).Among them,there were 46 cases in the hemorrhagic transformation group and 115 cases in the non hemorrhagic transformation group.And the general data,NLR value and MMP-9 before and after the revascularization were compared between the two groups.Results There was no statistical difference in general data between the two groups(all P>0.05)except for C-reactive protein in hemorrhagic transformation group and in non-hemorrhagic transformation group(P<0.001).The white blood cells,neutrophils,neutrophil percentage,neutrophil absolute value,lymphocyte absolute value,NLR and MMP-9 value in hemorrhagic transformation group were significantly higher than those in non-hemorrhagic transformation group before the treatment and there was a statistical significance(P<0.05).After revascularization,the indexes of blood routine and MMP-9 were significantly higher than those before the revascularization,and the increase in hemorrhagic transformation group was more obvious than that in non-hemorrhagic transformation group and there was a statistical significance(P<0.001),The ROC curve showed that the area under the curve(AUC)of NLR and MMP-9 predicting bleeding transformation after AIS revascularization were 0.74 and 0.90.Conclusion NLR,MMP-9 are associated with the risk of bleeding transformation in AIS patients after the revascularization and can they can be used as the predictive factors for bleeding transformation risk.
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Objective To investigate the correlation of triacylglycerol glucose(TyG)index,monocyte to high-density lipoprotein cholesterol ratio(MHR)with coronary artery disease and myocardial ischemia degree in coronary heart disease(CHD),and to analyze the two Predictive value of coronary artery disease and myocardial ischemia degree.Methods CHD patients from the 920th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force from January 2019 to January 2022 were selected as the study group(n = 150),and healthy physical examination subjects from the same period were selected as the control group(n = 75).The TyG index and MHR of the two groups were compared and analyzed.The extent of coronary artery disease was evaluated based on the Gensini score,and the TyG index and MHR of patients with different coronary lesions and myocardial ischemia were compared,and their correlation with Gensini score and myocardial ischemia was analyzed.The predictive value of TyG index,MHR,and the combined detection of both for coronary lesions and myocardial ischemia was evaluated using receiver operating characteristic(ROC)curves and area under the curve(AUC).Results The TyG index and MHR of the study group were(4.12±0.35)and(0.26±0.08)×109,respectively,which were higher than those of the control group(4.94±0.55)and(0.43±0.12)×109,and the TyG index and MHR of severe coronary artery disease>moderate coronary artery disease>mild coronary artery disease,acute myocardial infarction TyG index,MHR>unstable angina pectoris>stable angina pectoris(P<0.05);TyG index and MHR were positively correlated with Gensini score(r = 0.621,0.635,P<0.05),and positively correlated with the severity of myocardial ischemia(r = 0.617,0.642,P<0.05).The AUC of TyG index and MHR for the joint identification of mild coronary artery disease and moderate coronary artery disease was 0.917,which was greater than the AUCs of 0.749 and 0.832 for the two conditions individually.The AUC of TyG index and MHR for the joint identification of mild to moderate coronary artery disease and severe coronary artery disease was 0.935,which was greater than the AUCs of 0.770 and 0.767 for the two conditions individually(P<0.05).The AUC of TyG index and MHR for the joint identification of stable angina pectoris and unstable angina pectoris was 0.922,which was greater than the AUCs of 0.812 and 0.824 for the two conditions individually.The AUC of TyG index and MHR for the joint identification of stable angina pectoris,unstable angina pectoris,and acute myocardial infarction was 0.913,which was greater than the AUCs of 0.708 and 0.714 for the two conditions individually(P<0.05).Conclusions TyG index and MHR are positively correlated with Gensini score and myocardial ischemia degree.The combined detection of the two has a higher application value in the evaluation of coronary artery disease and myocardial ischemia degree.
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Objective To analyze the influence of medication compliance of chronic type 2 diabetes management patients on disease control in two communities in Kunming.Methods A total of 138 patients with type 2 diabetes who were included in chronic disease management in Guandu and Xiaobanqiao communities of Kunming were selected from December 2021 to September 2022.Basic information collection and HbAlc and other related tests were improved.A questionnaire survey of 8-item Morisliy medication adherence scale(MMAS-8)was conducted to analyze the levels of HbAlc and other indexes of three groups with high(group A),medium(group B),and low(group C)adherence,and to conduct statistical analysis.Results Group A accounted for 22.5%,group B for 44.9%,and group C for 32.6%.There were significance differences in urinary albumin creatinine ratio(UACR),HbA1c and blood creatinine among the three groups(P<0.05).The levels of UACR,HbAlc and serum creatinine in group A were lower than those in group B and group C,and there was a negative correlation between UACR,HbAlc and serum creatinine and medication compliance rate(P<0.05).Conclusion In the Guandu Community and Xiaobanqiao community of Kunming,only 22.5%of patients with chronic type 2 diabetes had high medication compliance.The higher the compliance,the lower the level of UACR,HbAlc and serum creatinine,there is a correlation between the two,suggesting that medication compliance should be regarded as one of the key points in the management of chronic diabetes mellitus in the community,and the intervention of patients'medication compliance should be strengthened.
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Objective To explore the predictive value of inflammatory markers for stroke-associated pneumonia(SAP)in patients with acute ischemic stroke(AIS)based on the nomogram model.Methods According to whether pneumonia occurred,259 AIS patients were divided into SAP group(81 cases)and non-SAP group(178 cases).The clinical data of the two groups were compared.The systemic inflammatory response index(SIRI),systemic immunoinflammatory index(SII)and neutrophil to lymphocyte ratio(NLR)were calculated according to the formula.The variables with statistically significant differences were included in the multivariate binary Logistic regression model to screen out the independent risk factors for SAP in AIS patients.The independent risk factors were used to construct a predictive model,and the predictive ability of the two models,which only included traditional factors and included inflammatory indicators at the same time,was further compared from the aspects of discrimination,calibration,clinical practicability and so on.Reclassification analysis was used to evaluate the extent to which the nomogram model improved the predictive value of SAP risk in AIS patients.Results Compared with those in the non-SAP group,the rates of smoking,diabetes,dysphagia,leukocytes,neutrophils,lymphocytes,triglyceride level,NIHSS score on admission,SIRI,SII and NLR were significantly increased in the SAP group,and the rate of hypertension was decreased(all P<0.05).Diabetes mellitus(OR =2.505,95%CI:1.070-5.850,P =0.034),dysphagia(OR =3.492,95%CI:1.501-8.119,P =0.004),NIHSS score on admission(OR = 1.310,95%CI:1.188-1.446,P<0.001),SIRI(OR =2.417,95%CI:1.327-4.401,P =0.008),NLR(OR =1.434,95%CI:1.101-1.860,P =0.007)were independent risk factors for SAP in AIS patients.The area under the curve was 0.788(95%CI:0.725-0.852,P<0.001)for the prediction model without inflammatory factors and 0.884(95%CI:0.838-0.930,P<0.001)for the prediction model with independent risk factors.The calibration curve showed a good consistency between the predicted risk and the observed results.The decision curve showed that the model had a significant net benefit for predicting SAP.In addition,by calculating the net reclassification index(NRI)and the comprehensive discriminant improvement index(IDI),it was found that the nomogram model had a significant improvement in predicting the risk of SAP in AIS patients.Internal verification also proves the reliability of the nomogram model.Conclusions SIRI and NLR are independent predictors of SAP in AIS patients on admission.Adding SIRI and NLR to the traditional model can significantly improve the ability to identify the risk of SAP occurrence in AIS patients.
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Objective To explore the value of cytokines,procalcitonin(PCT)and neutrophil-lymphocyte ratio(NLR)in the early diagnosis and prognosis evaluation in the patients with sepsis.Methods 98 patients with sepsis admitted to the First Affiliated Hospital of Air Force Medical University from January 2020 to January 2023 were selected as research objects,including 82 patients in the sepsis non-shock group and 16 patients in the sepsis shock group.According to the death within 28 days,the patients was divided into survival group(n=82)and death group(n=16).Meantime,95 cases of non-septic infection group were included as control.The expression of interleukin(IL)-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-17,tumor necrosis factor(TNF)-α,interferon(IFN)-γ,IFN-α,PCT,and NLR were detected within 24h after admission,and their relationship with sepsis was analyzed by ROC curve.Results ①The IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-17,TNF-α,IFN-α,NLR and PCT in patients with sepsis were significantly higher than those in healthy subjects(Z=0.43~30.54,all P<0.05)except IL-1β,IFN-γ.Further analysis of ROC showed that IL-8,NLR,PCT and IL-17 had strong predictive ability,with area under curve(AUC)of 0.78(95%CI:0.71~0.84),0.81(95%CI:0.75~0.87),0.83(95%CI:0.78~0.88),0.86(95%CI:0.81~0.92),respectively.Combined detection of the four indicators can effectively improve the diagnostic efficiency of sepsis,with the AUC of 0.90(95%CI:0.85~0.93).② There were no significant differences in cytokines,PCT and NLR concentration between positive and negative blood culture groups(P>0.05),suggesting that these indexes were not affected by blood culture detection results.③Among the patients in the shock group,IL-6[122.10(10.77~10 000.00)ng/L]was significantly higher than that in non-shock group[25.56(1.02~9 096.74)ng/L],the difference was statistically significant(Z=74.55,P=0.01),with the AUC of 0.73(95%CI:0.59~0.87).The levels of IL-10[10.69(1.12~1 338.00)ng/L],IL-2[12.52(0.86~280.42)ng/L]and IL-5[9.55(0.93~259.57)ng/L]in sepsis death group were higher than those[2.55(0.34~695.13)ng/L,4.46(0.13~625.43)ng/L,2.75(0.01~117.88)ng/L]in survival group,the differences were statistically significant(Z=3.64,6.37,4.74,all P<0.05),and the AUC were 0.69(95%CI:0.53~0.85),0.71(95%CI:0.56~0.85)and 0.72(95%CI:0.58~0.87),respectively.Conclusion The combined detection of IL-8,NLR,PCT and IL-17 is helpful for the early diagnosis of sepsis.The increase of IL-6 level can effectively predict the occurrence of septic shock,and the high expression of IL-10,IL-2 and IL-5 has a good predictive value for the death of sepsis patients.
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Objective:To evaluate the efficacy of cerebral-placental-uterine ratio(CPUR)in predicting late-on-set fetal growth restriction(FGR).Methods:From May 2020 to May 2021,1255 women with singleton pregnancy who underwent prenatal examinations at the University of Hong Kong Shenzhen Hospital were selected for fetal growth and Doppler measurements at 35-37 +6 weeks of gestation.Pregnant women with birth weight of newbo-rns<the 10th percentile were the FGR group.The pulsatility index(PI)of uterine artery(UtA),umbilical artery(UA)and fetal middle cerebral artery(MCA)were analyzed separately and in combination.ROC curve was used to analyze the cerebral-placental-uterine ratio(CPUR),cerebral-placental ratio(CPR),cerebral-uterine ratio(C-UtA)for predicting late-onset FGR;and to evaluate the sensitivity,positive and negative predictive value and of CPUR in the prediction of late-onset FGR.Results:The area under the curve(AUC)of CPUR,CPR,C-UtA and mean UtA-PI for FGR grope were 0.88,0.86,0.84 and 0.72.Under certain cut-off values and 87% specificity,the specificity of CPUR,CPR,C-UtA and mean UtA-Pifor predicting FGR group was 43.2%,46.6%,39.8% and 23.9%,respectively.The positive predictive values of CPUR,CPR,C-UtA and mean UtA-PI,UA-PI for predicting FGR group were 90.5%,71.9%,83.3%,63.6%and 5.2%,respectively.Conclusions:CPUR is more effective in predicting late onset FGR than CPR,C-UtA and mean UtA-PI.It can effectively increase the detection rate of fetal growth restrictionand reduce the FGR risk.
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Objective To investigate the value of short diameter of lymph nodes combined with neutrophil to lymphocyte ratio(NLR)in evaluating lymph node metastasis of cervical cancer by enhanced CT.Methods A total of 82 patients with cervical cancer were selected and divided into metastatic group(n=13)and non-metastatic group(n=69)according to whether lymph node metas-tasis occurred.The clinicopathological features of the two groups were compared,and the relationship between NLR and clinicopath-ology was analyzed.Logistic regression was used to analyze the influencing factors of lymph node metastasis of cervical cancer.The short diameter of lymph nodes and serum NLR were compared between the two groups.Receiver operating characteristic(ROC)curve,DeLong test and compare the area under the curve(AUC)analysis was used to evaluate the value of lymph node metastasis in cervical cancer.The diagnostic efficacy of the above indexes were compared between the two groups.Results The short diameter of lymph nodes and NLR in the metastatic group were(0.686±0.120)cm and 2.23±0.41 respectively,while thosein the non-metastatic group were(0.602±0.106)cm and 1.76±0.30 respectively.The difference between the two groups was statistically signifi-cant(P<0.05);There was no significant difference in age,growth pattern and vascular infiltration between the metastatic group and the non-metastatic group(P>0.05).There were significant differences in clinical stage,maximum diameter of tumor,NLR and short diameter of enhanced CT lymph nodes(P<0.05);The NLR was related to clinical stage,pelvic lymph node metastasis,and the short diameter of lymph nodes on enhanced CT scan(P<0.05);Clinical stage Ⅲ,maximum diameter of tumor≥4 cm,NLR>1.80 and short diameter of enhanced CT lymph nodes≥0.632 cm were independent risk factors for cervical cancer lymph node metastasis(P<0.05);The ROC curve analysis showed that the AUC of the combined detection of cervical cancer was 0.871,higher than that of the enhanced CT lymph nodes short diameter and serum NLR(0.645,0.795),and its specificity was better than that of the independent detection.The best cutoff values of the enhanced CT lymph nodes short diameter and serum NLR were 0.630 cm and 1.91,respectively.Conclusion The short diameter of lymph nodes and the serum NLR can predict lymph node metastasis of cervical cancer,and the combined detection can improve the evaluation efficiency.
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Objective To investigate the diagnostic value of the T2WI gray scale ratio for Hashimoto's thyroiditis(HT).Methods The T2WI-iterative decomposition of water and fat with echo asymmetry and least square estimation(IDEAL)quantitation sequence water images of 22 HT cases were analyzed retrospectively.The gray scale ratio of the thyroid,sternocleidomastoid muscle,trachea cavity,and subcutaneous fat at the same layer were measured on the picture archiving and communication systems(PACS).The gray scale ratios of thyroid/sternocleidomastoid muscle(T/M),thyroid/trachea cavity(T/Tr),and thyroid/lipid(T/L)were calculated.The intraclass correlation coefficient(ICC)was used to evaluate the consistency among the measurements,and the optimal threshold for distinguishing HT from non-HT was determined via the receiver operating characteristic(ROC)curve.The Spearman correlation analysis was used to analyze the correlation between T/M,T/Tr,T/L ratios,and titers of thyroid peroxidase antibody(TPO-Ab)and thyroglobulin antibody(Tg-Ab),respectively.Results On the T2WI-IDEAL quantitation sequence water images,the(x)±s of T/M,T/Tr,T/L ratios for HT and non-HT were 2.17±0.47 and 1.62±0.21(t=14.90,P<0.001),9.40±3.24 and 4.87±2.93(t=11.42,P<0.001),1.66±0.32 and 1.21±0.31(t=7.51,P<0.001),respectively.The area under the curve(AUC)of T/M,T/Tr,and T/L ratios for diagnosing HT were 0.89,0.86,and 0.85,respectively;the optimal thresholds were 1.90,3.50,and 1.36,and the sensitivity and specificity were 72.7%and 100%,100%and 40.5%,95.5%and 29.7%,respectively.The T/M ratio had a moderate correlation with TPO-Ab(r=0.513,P<0.05),and T/Tr,T/L ratios had a mild correlation with TPO-Ab,respectively.Conclusion The T/M ratio in the T2WI gray scale ratio can quantitatively and objectively distinguish HT from non-HT to some extent and is correlated with TPO-Ab.It has extremely high specificity and holds promise as a non-invasive imaging method for the diagnosis of incidental HT.
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Objective To noninvasively predict isocitrate dehydrogenase(IDH)status of glioma via combining imaging and clini-cal features before surgery,so as to provide basis for individualized clinical treatment decision.Methods A total of 47 patients with glioma confirmed by pathological and molecular genetic tests were included,including 20 with IDH mutant type and 27 with IDH wild type.After diffusion tensor imaging(DTI)scanning,fractional anisotropy(FA)and mean diffusivity(MD)values of tumor paren-chyma were calculated.Combining DTI parameters with MRI morphological features of tumor,blood neutrophil/lymphocyte ratio(NLR)and patient's age,binary logistic regression model was established to effectively predict IDH status of glioma patients before surgery.Results There were significant differences in FAmean/FANAWM,MDmin,NLR,tumor location and age between IDH mutant type and IDH wild type groups(P<0.05).The binary logistic regression model concluding,FAmean/FANAWM,MDmin,cystic degeneration,NLR and age,predicted IDH status of glioma with area under the curve(AUC)of 0.961 and 95%confidence interval(CI)of 0.914-1.00.Conclusion The regression model established via combining DTI,MRI morphological features and blood NLR has great performance in classifying IDH status of glioma,and can help predict IDH status noninvasively before surgery,so as to assist clinical individualized treatment.