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Objective:To investigate the application value of establishing the differential diagnosis model of pulmonary tuberculosis using routine laboratory data.Methods:The retrospective study was conducted. The routine laboratory data of newly diagnosed patients with pulmonary tuberculosis and other pulmonary diseases in Beijng Jishuitan Hospital and Beijing Hepingli Hospital from May 2015 to November 2021were collected. According to the random numbers showed in the computer, all the 11516 patients were divided into training dataset and test dataset with a ratio of 9∶1. Four machine learning algorithms, Support Vector Machine, Random Forest, K-Nearest Neighbor and Logistic Regression, were used to build models and select features. The diagnostic accuracy of each model was verified by using the 10-fold cross-validation method and the performance of each model was evaluated by using the receptor operator of characteristic (ROC) curve.Results:Random Forest was selected as the optimal machine learning algorithm to build the best feature model in the study. According to importance scale of factors, the differential diagnosis model of pulmonary tuberculosis consisting of 37 non-specific test indexes. In the validation set and test set the accuracy and area under curve (AUC) of the models were 0.747 and 0.736, the sensitivity, specificity and accuracy were 68.03% and 68.75%, 70.91% and 67.90%, 70.30% and 68.12%, respectively.Conclusion:A key tool in the differential diagnosis model of pulmonary tuberculosis was established by routine laboratory data in combination with machine learning. The results of this study need to be further verified by more data from medical institutions.
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Objective:To investigate the expression and clinical significance of F0 ATP synthase C subunit (Csub) in patients with ischemic heart disease (IHD).Methods:The 101 patients with chest pain admitted to the department of emergency of the People's Hospital of Yuhuan from May 2019 to December 2020 were enrolled, including 59 patients with acute myocardial infarction (AMI) and 42 patients with unstable angina pectoris (UAP). At the same time, 50 age-matched healthy subjects in the health examination center were selected as the healthy control (HC). All patients had completed blood sampling before the intervention of drugs or other intervention measures in the emergency room. The content of serum Csub was detected by enzyme linked immunosorbent assay (ELISA), and the relationship between Csub and clinical characteristics was analyzed. At the same time, the contents of hypersensitivity cardiac troponin T (hs-cTnT) and MB isoenzyme of creatine kinase (CK-MB) in blood were detected by electrochemical luminescence. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the value of Csub, hs-cTnT, and CK-MB in the early diagnosis of IHD.Results:The baseline data such as age, gender, and history of the three groups were balanced. There were significant differences in low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), CK-MB, hs-cTnT and B-type natriuretic peptide (BNP), but there were no significant differences in other biochemical indexes. The Csub content in the AMI group and the UAP group were significantly higher than those in the HC group [8.96% (6.37%, 11.53%), 4.27% (3.23%, 6.49%) vs. 1.56% (1.07%, 2.33%), both P < 0.01]. Moreover, the Csub in the AMI group with more severe myocardial ischemia was higher than UAP group [8.96% (6.37%, 11.53%) vs. 4.27% (3.23%, 6.49%), P < 0.01]. A total of 59 patients with AMI were treated with percutaneous coronary intervention (PCI). According to the median of Csub, AMI patients were subdivided into above-median group (29 cases) and below-median group (30 cases). The results showed that there were no significant differences in the number of coronary artery lesion branches, the number of stent implantation and postoperative medication between the two groups. ROC curve analysis showed that the area under the curve (AUC) and 95% confidence interval (95% CI) of Csub, hs-cTnT and CK-MB in the diagnosis of IHD were 0.98 (0.95-1.00), 0.99 (0.99-1.00), 0.94 (0.89-0.99), respectively. The diagnostic efficacy of Csub was slightly lower than that of hs-cTnT but higher than that of CK-MB. When the cut-off value of Csub was 4.74%, the sensitivity and specificity for the diagnosis of IHD were 100% and 87.0%, respectively. Conclusions:Csub increased significantly in the serum of IHD patients, and further increased with the severity of ischemia. It can be used as a new diagnostic biomarker for the diagnosis and evaluation of the development of myocardial ischemia.
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Objective To explore the risk factors of coronary artery plaque progression and the clinical indexes that could predict plaque progression. Methods The 142 patients had twice coronary artery angiographs were enrolled in this study. Quantitative coronary angiography (QCA)was performed to evaluate angiographs at baseline and follow-up. Results According to the changes of minimum lumen diameter (MLD) in twice angiographs being or not more than 0.4 mm, the patients were divided into plaque progression group (n=54) and non-plaque progression group (n=88). The incidences of myocardial infarction (MI) and diabetes were significantly higher in plaque progression group than in non-plaque progression group [27.8% vs. 5.7%, 63.0% vs. 36.4%], and the serum levels of high-sensitivity C-reactive protein (hs-CRP, 14.5 mg/L vs. 6.3 mg/L) and neutrophil (6.6×109/L vs. 4.3×109/L) were also significantly higher. The incidence of coronary artery plaque progression in patients with high hs-CRP level was 2.52 times higher than in patients with low hs-CRP level, and the incidence in patients with myocardial infarction was 3.98 times as much as patients without MI. Conclusions The hs-CRP and myocardial infarction were the independent risk factors for coronary artery plaque progression.
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Objective:To study the change rule of rats'pulse waves after kidney resection.Methods:To collect the pulse waves of femoral artery in each side of rats in Drugged state.Then do one-side kidney resection operation,after fully recover from it,collect the pulse waves again.To average the pulse waves in the same cycle length and then do the LSQ regression by 6 harmonics which are correspond with the cycle lengths,analyze the phase and the amplitude of vibration of fundamental wave and harmonics by statistical method.Results:The amplitude of vibration of the 3rd harmonics of pulse waves of femoral artery in the same side with operation and the amplitude of vibration of the 1st to 5th harmonics of pulse waves of femoral artery in the other side with operation has reinforced, the phase of the 1st and 2nd harmonics also have changed regularly.Conclusion:There're some regular changes in the pulse waves of rats after one-side kidney resection operation,which shows that the pulse waves of artery on the body surface can reflect the splanchnic changes.This research can offer some scientific foundation to the pulse-diagnosis in TCM.