Acute pancreatitis(AP)is a potentially life-threatening inflammatory disease of the pancreas,with clinical management determined by the severity of the disease.Diagnosis,severity prediction,and prognosis assessment of...Acute pancreatitis(AP)is a potentially life-threatening inflammatory disease of the pancreas,with clinical management determined by the severity of the disease.Diagnosis,severity prediction,and prognosis assessment of AP typically involve the use of imaging technologies,such as computed tomography,magnetic resonance imaging,and ultrasound,and scoring systems,including Ranson,Acute Physiology and Chronic Health Evaluation II,and Bedside Index for Severity in AP scores.Computed tomography is considered the gold standard imaging modality for AP due to its high sensitivity and specificity,while magnetic resonance imaging and ultrasound can provide additional information on biliary obstruction and vascular complications.Scoring systems utilize clinical and laboratory parameters to classify AP patients into mild,moderate,or severe categories,guiding treatment decisions,such as intensive care unit admission,early enteral feeding,and antibiotic use.Despite the central role of imaging technologies and scoring systems in AP management,these methods have limitations in terms of accuracy,reproducibility,practicality and economics.Recent advancements of artificial intelligence(AI)provide new opportunities to enhance their performance by analyzing vast amounts of clinical and imaging data.AI algorithms can analyze large amounts of clinical and imaging data,identify scoring system patterns,and predict the clinical course of disease.AI-based models have shown promising results in predicting the severity and mortality of AP,but further validation and standardization are required before widespread clinical application.In addition,understanding the correlation between these three technologies will aid in developing new methods that can accurately,sensitively,and specifically be used in the diagnosis,severity prediction,and prognosis assessment of AP through complementary advantages.展开更多
Introduction:Fluorine-18 fluorodeoxyglucose(18F-FDG)positron emission tomography/computed tomography(PET/CT)is a powerful tool for monitoring the response of diffuse large B-cell lymphoma(DLBCL)to therapy,but the crit...Introduction:Fluorine-18 fluorodeoxyglucose(18F-FDG)positron emission tomography/computed tomography(PET/CT)is a powerful tool for monitoring the response of diffuse large B-cell lymphoma(DLBCL)to therapy,but the criteria to interpret PET/CT results remain under debate.We investigated the value of post-treatment PET/CT in predicting the prognosis of DLBCL patients when interpreted according to qualitative visual trichotomous assessment(QVTA)criteria compared with the Deauvil e criteria.Methods:In this retrospective study,final PET/CT scans of DLBCL patients treated with rituximab-based regimens between October 2005 and November 2010 were interpreted using the Deauvil e and QVTA criteria.Survival curves were estimated using Kaplan-Meier analysis and compared using the log-rank test.Results:A total of 253 patients were enrol ed.The interpretation according to the Deauvil e criteria revealed that 181patients had negative PET/CT scan results and 72 had positive results.The 3 year overal survival(OS)rate was significantly higher in patients with negative scan results than in those with positive results(91.6%vs.57.5%,P<0.001).The72 patients with positive scan results according to the Deauville criteria were divided into two groups by the interpretation according to the QVTA criteria:29 had indeterminate results,and 43 had positive results.The 3 year OS rate was significantly higher in patients with indeterminate scan results than in those with positive results(91.2%vs.33.5%,P<0.001)but was similar between patients with negative and indeterminate scan results(91.6%vs.91.2%,P=0.921).Conclusions:Compared with the Deauvil e criteria,using the QVTA criteria for interpreting post-treatment PET/CT scans of DLBCL patients is likely to reduce the number of false positive results.The QVTA criteria are feasible for therapeutic outcome evaluation and can be used to guide risk-adapted therapy.展开更多
Objective:Fournier’s gangrene is a rare but life-threatening infection disease with high mortality rate.The quick Sepsis-related Organ Failure Assessment(qSOFA)is a new and simpler scoring system that may identify pa...Objective:Fournier’s gangrene is a rare but life-threatening infection disease with high mortality rate.The quick Sepsis-related Organ Failure Assessment(qSOFA)is a new and simpler scoring system that may identify patients with suspected infection who are at greater risk for a poor outcome.The purpose of this study was to find out role of qSOFA in determining prognosis of Fournier’s gangrene patients.Methods:This study is a case control with retrospective review of Fournier’s gangrene patients treated at Hasan Sadikin Hospital from January 2013 to December 2017 who met inclusion criteria.Participants were divided into two groups according to qSOFA score as high qSOFA(2-3)and low qSOFA(0-1).Results:From 69 patients,the mortality rate was 24.6%.The sensitivity of qSOFA score to predict mortality was 88.2%;the specificity was 94.2%;positive predictive value was 83.3%;negative predictive value was 96.1%;positive likelihood ratio was 15.2;negative likelihood ratio was 0.12;and the area under the receiver operating characteristic curve of qSOFA was 94.2%.There was significant association between qSOFA scale and mortality with p-value of 0.0001.The qSOFA score has strong positive correlation with Fournier’s Gangrene Severity Index(p<0.0001,r=0.704).Conclusion:qSOFA scoring system has a high prognostic value and can be used to determine prognosis of Fournier’s gangrene patients.展开更多
AIM: To establish a model for prognosis assessment of extranodal follicular dendritic cell (FDC) sarcoma.METHODS: Nine lesions were examined by routine and molecular approaches.Clinicopathological factors from the new...AIM: To establish a model for prognosis assessment of extranodal follicular dendritic cell (FDC) sarcoma.METHODS: Nine lesions were examined by routine and molecular approaches.Clinicopathological factors from the new cases and 97 reported cases were analyzed for their prognostic values.RESULTS: The current lesions were found in f ive male and four female patients,located mainly in the head and neck area and averaging 7.2 cm in size.Six patients had recurrence or metastasis and three remained free of disease.The 106 patients (male/female ratio,1.1:1) were aged from 9 to 82 years (median,44 years).The tumor sizes ranged from 1.5 to 21 cm (mean,7.4 cm).Abdominal/pelvic region was affected most frequently (43%).Surgical resection was performed in 100 patients,followed by radiation and/or chemotherapy in 35 of them.Follow-up data were available in 91 cases,covering a period of 3-324 mo (mean,27 mo;median,19 mo).Of the informative cases,38 (42%) had recurrence or metastasis,and 12 (13%) died of the disease.These tumors were classif ied histologically into lowand high-grade lesions.A size ≥ 5 cm (P = 0.003),highgrade histology (P = 0.046) and a mitotic count ≥ 5/10 HPF (P = 0.013) were associated with tumor recurrence.The lesions were def ined as low-,intermediateand high-risk tumors,and their recurrence rates were 16%,46% and 73%,and their mortality rates 0%,4% and 45%,respectively.CONCLUSION: Extranodal FDC tumors behave like soft tissue sarcomas.Their clinical outcomes are variable and can be evaluated according to their sizes and grades.展开更多
AIM To investigate the expression and clinical significance of B7 homolog 3(B7-H3) and β-1,3-galactosyltransferase-4(B3 GALT4) in colorectal cancer(CRC) patients.METHODS Using tissue microarray, we identified the exp...AIM To investigate the expression and clinical significance of B7 homolog 3(B7-H3) and β-1,3-galactosyltransferase-4(B3 GALT4) in colorectal cancer(CRC) patients.METHODS Using tissue microarray, we identified the expression of B7-H3 and B3 GALT4 in 223 CRC patient samples by immunohistochemistry and evaluated the possible correlation between B7-H3 and B3 GALT4 and clinicaloutcomes. Further, the m RNA and protein expression were identified to establish the regulatory relationship of B7-H3 with B3 GALT4 in vitro.RESULTS A significant positive correlation between B7-H3 and B3 GALT4 was observed in CRC specimens(r = 0.219, P = 0.001). High expression of B7-H3 was identified as a significant independent predictor of poor overall survival(OS) [hazard ratio(HR) = 1.781; 95%CI: 1.027-3.089; P = 0.040]. Moreover, high expression of B3 GALT4 was also recognized as an independent predictor of inferior OS(HR = 1.597; 95%CI: 1.007-2.533; P = 0.047). Additionally, CRC patients expressing both high B7-H3 and high B3 GALT4 contributed to a significant decrease in OS(HR = 2.283; 95%CI: 1.289-4.042; P = 0.005). In CRC cell lines with stable expression of high B7-H3, the m RNA and protein expressions of B3 GALT4 were significantly upregulated. Similarly, the expression of B3 GALT4 was significantly reduced when expression of B7-H3 was knocked down.CONCLUSION The expression of B3 GALT4 in CRC is positively correlated with B7-H3 expression in vitro. B7-H3/B3 GLAT4 may be used as dual prognostic biomarkers for CRC.展开更多
AIM To evaluate the importance of the CD34+CD38-cell population when compared to the CD34+CD38+/low and CD34+CD38+/high leukemic cell sub-populations and to determine its correlations with leukemia characteristics and...AIM To evaluate the importance of the CD34+CD38-cell population when compared to the CD34+CD38+/low and CD34+CD38+/high leukemic cell sub-populations and to determine its correlations with leukemia characteristics and known prognostic factors, as well as with response to therapy and survival.METHODS Two hundred bone marrow samples were obtained at diagnosis from 200 consecutive patients with newly diagnosed acute myeloid leukemia(AML) were studied between September 2008 and December 2010 at our Institution(Hematology Department, Lyon, France). The CD34/CD38 cell profile was analyzed by multiparameter flowcytometry approach using 8 C panels and FACS CANTO and Diva software(BD Bioscience).RESULTS We analyzed CD34 and CD38 expression in bone marrow samples of 200 AML patients at diagnosis, and investigated the prognostic value of the most immature CD34+CD38-population. Using a cut-off value of 1% of CD34+CD38-from total "bulk leukemic cells" we found that a high(> 1%) level of CD34+CD38-blasts at diagnosis was correlated with advanced age, adverse cytogenetics as well as with a lower rate of complete response after induction and shorter disease-free survival. In a multivariate analysis considering age, leukocytosis, the % of CD34+ blasts cells and the standardized cytogenetic and molecular risk subgroups, a percentage of CD34+CD38-leukemic cells > 1% was an independent predictor of DFS [HR = 2.8(1.02-7.73), P = 0.04] and OS [HR = 2.65(1.09-6.43), P = 0.03].CONCLUSION Taken together, these results show that a CD34/CD38 "backbone" for leukemic cell analysis by multicolour flowcytometry at diagnosis provides useful prognostic information.展开更多
Objective:To assess prognostic factors and validate the effectiveness of recursive partitioning analysis (RPA) classes and graded prognostic assessment (GPA) in 290 non-small cell lung cancer (NSCLC) patients with bra...Objective:To assess prognostic factors and validate the effectiveness of recursive partitioning analysis (RPA) classes and graded prognostic assessment (GPA) in 290 non-small cell lung cancer (NSCLC) patients with brain metastasis (BM).Methods:From Jan 2008 to Dec 2009,the clinical data of 290 NSCLC cases with BM treated with multiple modalities including brain irradiation,systemic chemotherapy and tyrosine kinase inhibitors (TKIs) in two institutes were analyzed.Survival was estimated by Kaplan-Meier method.The differences of survival rates in subgroups were assayed using log-rank test.Multivariate Cox's regression method was used to analyze the impact of prognostic factors on survival.Two prognostic indexes models (RPA and GPA) were validated respectively.Results:All patients were followed up for 1-44 months,the median survival time after brain irradiation and its corresponding 95% confidence interval (95% CI) was 14 (12.3-15.8) months.1-,2-and 3-year survival rates in the whole group were 56.0%,28.3%,and 12.0%,respectively.The survival curves of subgroups,stratified by both RPA and GPA,were significantly different (P<0.001).In the multivariate analysis as RPA and GPA entered Cox's regression model,Karnofsky performance status (KPS) ≥ 70,adenocarcinoma subtype,longer administration of TKIs remained their prognostic significance,RPA classes and GPA also appeared in the prognostic model.Conclusion:KPS ≥70,adenocarcinoma subtype,longer treatment of molecular targeted drug,and RPA classes and GPA are the independent prognostic factors affecting the survival rates of NSCLC patients with BM.展开更多
BACKGROUND The nutritional status is closely related to the prognosis of liver transplant re-cipients,but few studies have reported the role of preoperative objective nutri-tional indices in predicting liver transplan...BACKGROUND The nutritional status is closely related to the prognosis of liver transplant re-cipients,but few studies have reported the role of preoperative objective nutri-tional indices in predicting liver transplant outcomes.AIM To compare the predictive value of various preoperative objective nutritional indicators for determining 30-d mortality and complications following liver transplantation(LT).METHODS A retrospective analysis was conducted on 162 recipients who underwent LT at our institution from December 2019 to June 2022.RESULTS This study identified several independent risk factors associated with 30-d mor-tality,including blood loss,the prognostic nutritional index(PNI),the nutritional risk index(NRI),and the control nutritional status.The 30-d mortality rate was 8.6%.Blood loss,the NRI,and the PNI were found to be independent risk factors for the occurrence of severe postoperative complications.The NRI achieved the highest prediction values for 30-d mortality[area under the curve(AUC)=0.861,P<0.001]and severe complications(AUC=0.643,P=0.011).Compared to those in the high NRI group,the low patients in the NRI group had lower preoperative body mass index and prealbumin and albumin levels,as well as higher alanine aminotransferase and total bilirubin levels,Model for End-stage Liver Disease scores and prothrombin time(P<0.05).Furthermore,the group with a low NRI exhibited significantly greater incidences of intraabdominal bleeding,primary graft nonfunction,and mortality.CONCLUSION The NRI has good predictive value for 30-d mortality and severe complications following LT.The NRI could be an effective tool for transplant surgeons to evaluate perioperative nutritional risk and develop relevant nutritional therapy.展开更多
Primary PTCA is an effective performance to reopen the infarct-relatedartery,so as to limit infarct size and maintain left ventricular function.It is veryimportant to estimate infarct size for the management and progn...Primary PTCA is an effective performance to reopen the infarct-relatedartery,so as to limit infarct size and maintain left ventricular function.It is veryimportant to estimate infarct size for the management and prognosis after AMI.Infarct size can be assessed by serum creatinc phosphokinase （CK）.CK isoenzymeMB （CK-MB） or troponin T （TnT）,but reperfusion therapy such as primary PTCAhas a washout effect on these biochemical indexes.Whether or not thesebiochemical indexes are still useful in estimating infarct size after reperfusion isconfused.Objective:To detect the possibility of serum CK,CK-MB and TnT forassessing the infarct size after early successful reperfusion in acute myocardialinfarction （AMI）,and find a better method of these biochemical indexes toestimate infarct size.Methods:This study consisted of 29 AMI patients aftersuccessful primary PTCA.Serum CK,CK-MB and TnT were measuredsequentially within 72 hours after primary PTCA,and <sup>99m</sup>Tc-MIBI myocardialsingle photon emission computed tomography was performed within 30 days afterpermission to calculate the myocardial infarction score （ISI）.The peak,sum totaland area under curve within 16 hours of these biochemical indexes were comparedwith ISI with linear regression analysis and multiple stepwise regression analysis.Finally,the result were correlated with ISI to find its assessed value.sensitivity andspecificity.Results:Serum CK,CK-MB and TnT increased rapidly after primaryPTCA （p【0.05）;CK,CK-MB and TnT release curves were about monophasicwithin 24 hours;The peak,sum total and area under curve within 16 hours of CK,CK-MB and TnT correlated well with ISI;The area under curve within 16 hours ofTnT correlated best with ISI （r=0.58,p【0.01）,its regression equation was Y=1.39×10<sup>-4</sup>X+0.20.While patients were grouped by ISl as 30%.there wasobvious difference on the ISI between the 2 groups （p【0.01）.The assessing valueof TnT area under curve within 16 hours to infarct size was 85.2% （ISI=30%.TnTAUC=688μg.h/l）,the sensitivity was 100%,specificity was 84%.Two of thesepatients studied had a relative normal <sup>99m</sup>Tc-MIBI myocardial perfusion as healthypeople.Conclusion:The area under curve within 16 hours after primary PTCAcan be used to assess infarct size in AMI.Primary PTCA can reopen the infarct-related artery in time,and rescue the dying myocardium obviously.展开更多
Assessment exercises constitute a crucial component of the teaching and learning process,serving the purpose of gauging the degree to which learning objectives have been accomplished.This study aims to assess the math...Assessment exercises constitute a crucial component of the teaching and learning process,serving the purpose of gauging the degree to which learning objectives have been accomplished.This study aims to assess the mathematics performance of Grade 7 learners using the 50-30-20 exercise.Specifically,this study seeks to determine the learners’pre-test and post-test mean scores,identify significant differences between the pre-test and post-test results,evaluate learners’exercises,and propose enhanced exercises.The research employs a quasi-experimental design,with 40 Grade 7 learners in the school year 2023-2024 as participants,selected through purposive non-random sampling.Statistical data analysis involves the use of mean,standard deviation,paired t-test,and Cohen’s D effect size.Ethical considerations were paramount,as evidenced by a letter of authorization from the school head outlining the strict adherence to voluntary participation,informed parental consent,anonymity,confidentiality,risk mitigation,results-sharing protocols,and the commitment to keeping research data confidential.The data yielded a remarkable outcome:the experimental group exhibited improvement in both the pre-test and post-test.This result substantiates the initial objective of the study,showcasing a noteworthy and favorable performance among the participants.Consequently,it suggests that a majority of the participants strongly agree that the 50-30-20 exercises contribute to enhancing their understanding and problem-solving skills,as well as their ability to grasp mathematical concepts and improve their overall performance in mathematics.Therefore,the 50-30-20 exercises not only facilitated students in understanding mathematics lessons but were also aligned with the Department of Education’s development plan.展开更多
An accurate and objective assessment of the health status of EMU trains is of great importance.In order to make sure the trains are functional,reliable,and endurable in their full life cycle(FLC),health assessment met...An accurate and objective assessment of the health status of EMU trains is of great importance.In order to make sure the trains are functional,reliable,and endurable in their full life cycle(FLC),health assessment method for EMU trains after Level 3-5 maintenance and repair is studied.First,the element-selection principles and the assessment rules are defined;second,to present the complex topological relationship between the elements in assessment,a functional logical structure construction method is proposed;third,a health value calculation model is defined based on the element’s characteristics and their logical structures.The health variables of each element is calculated and fitted following the steps in the corresponding weight calculation methods.The assessment method is proved to be applicable and effective.展开更多
BACKGROUND Accurate assessment of the prognosis after colorectal cancer surgery is of great significance in patients with colorectal cancer.However,there is no systematic analysis of factors affecting the prognosis of...BACKGROUND Accurate assessment of the prognosis after colorectal cancer surgery is of great significance in patients with colorectal cancer.However,there is no systematic analysis of factors affecting the prognosis of colorectal cancer currently.AIM To systematically analyze the influence of clinical data and serological and histological indicators on the prognosis of patients with colorectal cancer,and to explore the indicators that can accurately assess the prognosis of patients with colorectal cancer.METHODS A total of 374 patients with colorectal cancer were enrolled.The clinical data,tumor-node-metastasis(TNM)stage,and Dukes stage were recorded.All patients received examinations including carcinoembryonic antigen(CEA),carbohydrate antigen 199,C-reactive protein,albumin,D-dimer,and fibrinogen as well as routine blood tests one week before surgery.The tumor location,size,depth of invasion,lymph node metastasis,and distant metastasis were recorded during surgery.The pathological tissue typing and expression of proliferating cell nuclear antigen(PCNA)and p53 were observed.All patients were followed for 3 years,and patients with endpoint events were defined as a poor prognosis group,and the remaining patients were defined as a good prognosis group.The differences in clinical data,serology,and histology were analyzed between the two groups.Multivariate COX regression was used to analyze the independent influencing factors for the prognosis of colorectal cancer.The receiver operating characteristic curve was used to evaluate the predictive value of each of the independent influencing factors and their combination for the prognosis of colorectal cancer.RESULTS The follow-up outcomes showed that 81 patients were in the good prognosis group and 274 patients in the poor prognosis group.The TNM stage,PCNA,Glasgow prognostic score(GPS),neutrophil-lymphocyte ratio(NLR),C-reactive protein/albumin ratio(CAR),D-dimer,and CEA were independent influencing factors for the prognosis of colorectal cancer(P=0.000).NLR had the highest predictive power for colorectal cancer prognosis[area under the receiver operating characteristic curve(AUC)=0.925],followed by D-dimer(AUC=0.879)and GPS(AUC=0.872).The accuracy of the combination of all indicators in predicting the prognosis of colorectal cancer was the highest(AUC=0.973),which was significantly higher than that of any of the indicators alone(P<0.05).The sensitivity and specificity of the combination were 92.59%and 90.51%,respectively.CONCLUSION The independent influence factors for the prognosis of colorectal cancer include TNM stage,PCNA,GPS,NLR,CAR,D-dimer,and CEA.The combined assessment of the independent factors is the most accurate predictor of the prognosis after colorectal cancer surgery.展开更多
AIM: To identify prognostic factors of patients with hepatocellular carcinoma (HCC), who were treated by orthotopic liver transplantation (OLT). METHODS: From January 2000 to October 2006, 165 patients with HCC underw...AIM: To identify prognostic factors of patients with hepatocellular carcinoma (HCC), who were treated by orthotopic liver transplantation (OLT). METHODS: From January 2000 to October 2006, 165 patients with HCC underwent OLT. Various clinicopathological risk factors for actuarial and recurrence-free survival were identified using the Kaplan-Meier method with the log-rank test. The Cox proportional hazards model was used to identify independently predictive factors for actuarial and recurrence-free survival, which were used to propose new selection criteria. We compared the outcome of the subgroup patients meeting different criteria. Survival analysis was performed using the Kaplan-Meier method with the log-rank test. RESULTS: The median follow-up was 13.0 mo (2.8-69.5 mo). Overall, 1-, 2-, 3-and 5-year actuarial survival was 73.3%, 45.6%, 35.4% and 32.1%, respectively. One-, 2-, 3-and 5-year overall recurrencefree survival was 67.0%, 44.3%, 34.5% and 34.5%, respectively. In univariate analysis, number of tumors, total tumor size, lobar distribution, differentiation, macrovascular invasion, microvascular invasion, capsulationof the tumor, and lymph node metastasis were found to be associated significantly with actuarial and tumor-free survival. By means of using the multivariate Cox proportional hazards model, total tumor size and macrovas-cular invasion were found to be independent predictors of actuarial and tumor-free survival. When the selection criteria were expanded into the proposed criteria, there was no significant difference in 1-, 2-, 3-and 5-year actuarial and tumor-free survival of the 49 patients who met the proposed criteria (97.6%, 82.8%, 82.8% and 82.8%, and 90.7%, 82.8%, 68.8% and 68.8%, respectively) compared with that of patients who met the Milan or University of California, San Francisco (UCSF) criteria. CONCLUSION: Macrovascular invasion and total tumor diameter are the strongest prognostic factors. The proposed criteria do not adversely affect the outcome of liver transplantation for HCC, compared with the Milan or UCSF criteria.展开更多
Gejiu Tin District is an old mine with a long exploitation history, but its resource is nearly used up at present. The research in mineral resources assessment based on GIS plays a more important and particular role i...Gejiu Tin District is an old mine with a long exploitation history, but its resource is nearly used up at present. The research in mineral resources assessment based on GIS plays a more important and particular role in development of Gejiu. Now mineral resources assessment has been guided by new theories. It makes full use of a large information data of geology, geophysics, geochemistry and remote sensing, which are obtained from current geology exploration, in order to carry out integration mineral analysis, assessment, and to research into the data farther in high levels. At present, the processing of data by computer technique has become more powerful, because GIS was developed in recent years. Particularly, GIS has opened up vast prospects for integrated processing of geoscience data and prognosis of ore resources. GIS can analyze, extract mineral information, quantitatively assess mineral resources, delineate tractes, construct variables, carry out prospecting targets selection and so on.展开更多
基金Fujian Provincial Health Technology Project,No.2020GGA079Natural Science Foundation of Fujian Province,No.2021J011380National Natural Science Foundation of China,No.62276146.
文摘Acute pancreatitis(AP)is a potentially life-threatening inflammatory disease of the pancreas,with clinical management determined by the severity of the disease.Diagnosis,severity prediction,and prognosis assessment of AP typically involve the use of imaging technologies,such as computed tomography,magnetic resonance imaging,and ultrasound,and scoring systems,including Ranson,Acute Physiology and Chronic Health Evaluation II,and Bedside Index for Severity in AP scores.Computed tomography is considered the gold standard imaging modality for AP due to its high sensitivity and specificity,while magnetic resonance imaging and ultrasound can provide additional information on biliary obstruction and vascular complications.Scoring systems utilize clinical and laboratory parameters to classify AP patients into mild,moderate,or severe categories,guiding treatment decisions,such as intensive care unit admission,early enteral feeding,and antibiotic use.Despite the central role of imaging technologies and scoring systems in AP management,these methods have limitations in terms of accuracy,reproducibility,practicality and economics.Recent advancements of artificial intelligence(AI)provide new opportunities to enhance their performance by analyzing vast amounts of clinical and imaging data.AI algorithms can analyze large amounts of clinical and imaging data,identify scoring system patterns,and predict the clinical course of disease.AI-based models have shown promising results in predicting the severity and mortality of AP,but further validation and standardization are required before widespread clinical application.In addition,understanding the correlation between these three technologies will aid in developing new methods that can accurately,sensitively,and specifically be used in the diagnosis,severity prediction,and prognosis assessment of AP through complementary advantages.
文摘Introduction:Fluorine-18 fluorodeoxyglucose(18F-FDG)positron emission tomography/computed tomography(PET/CT)is a powerful tool for monitoring the response of diffuse large B-cell lymphoma(DLBCL)to therapy,but the criteria to interpret PET/CT results remain under debate.We investigated the value of post-treatment PET/CT in predicting the prognosis of DLBCL patients when interpreted according to qualitative visual trichotomous assessment(QVTA)criteria compared with the Deauvil e criteria.Methods:In this retrospective study,final PET/CT scans of DLBCL patients treated with rituximab-based regimens between October 2005 and November 2010 were interpreted using the Deauvil e and QVTA criteria.Survival curves were estimated using Kaplan-Meier analysis and compared using the log-rank test.Results:A total of 253 patients were enrol ed.The interpretation according to the Deauvil e criteria revealed that 181patients had negative PET/CT scan results and 72 had positive results.The 3 year overal survival(OS)rate was significantly higher in patients with negative scan results than in those with positive results(91.6%vs.57.5%,P<0.001).The72 patients with positive scan results according to the Deauville criteria were divided into two groups by the interpretation according to the QVTA criteria:29 had indeterminate results,and 43 had positive results.The 3 year OS rate was significantly higher in patients with indeterminate scan results than in those with positive results(91.2%vs.33.5%,P<0.001)but was similar between patients with negative and indeterminate scan results(91.6%vs.91.2%,P=0.921).Conclusions:Compared with the Deauvil e criteria,using the QVTA criteria for interpreting post-treatment PET/CT scans of DLBCL patients is likely to reduce the number of false positive results.The QVTA criteria are feasible for therapeutic outcome evaluation and can be used to guide risk-adapted therapy.
文摘Objective:Fournier’s gangrene is a rare but life-threatening infection disease with high mortality rate.The quick Sepsis-related Organ Failure Assessment(qSOFA)is a new and simpler scoring system that may identify patients with suspected infection who are at greater risk for a poor outcome.The purpose of this study was to find out role of qSOFA in determining prognosis of Fournier’s gangrene patients.Methods:This study is a case control with retrospective review of Fournier’s gangrene patients treated at Hasan Sadikin Hospital from January 2013 to December 2017 who met inclusion criteria.Participants were divided into two groups according to qSOFA score as high qSOFA(2-3)and low qSOFA(0-1).Results:From 69 patients,the mortality rate was 24.6%.The sensitivity of qSOFA score to predict mortality was 88.2%;the specificity was 94.2%;positive predictive value was 83.3%;negative predictive value was 96.1%;positive likelihood ratio was 15.2;negative likelihood ratio was 0.12;and the area under the receiver operating characteristic curve of qSOFA was 94.2%.There was significant association between qSOFA scale and mortality with p-value of 0.0001.The qSOFA score has strong positive correlation with Fournier’s Gangrene Severity Index(p<0.0001,r=0.704).Conclusion:qSOFA scoring system has a high prognostic value and can be used to determine prognosis of Fournier’s gangrene patients.
基金Supported by Grants from National Natural Science Foundation of China,No.30171052,30572125 and 30772508
文摘AIM: To establish a model for prognosis assessment of extranodal follicular dendritic cell (FDC) sarcoma.METHODS: Nine lesions were examined by routine and molecular approaches.Clinicopathological factors from the new cases and 97 reported cases were analyzed for their prognostic values.RESULTS: The current lesions were found in f ive male and four female patients,located mainly in the head and neck area and averaging 7.2 cm in size.Six patients had recurrence or metastasis and three remained free of disease.The 106 patients (male/female ratio,1.1:1) were aged from 9 to 82 years (median,44 years).The tumor sizes ranged from 1.5 to 21 cm (mean,7.4 cm).Abdominal/pelvic region was affected most frequently (43%).Surgical resection was performed in 100 patients,followed by radiation and/or chemotherapy in 35 of them.Follow-up data were available in 91 cases,covering a period of 3-324 mo (mean,27 mo;median,19 mo).Of the informative cases,38 (42%) had recurrence or metastasis,and 12 (13%) died of the disease.These tumors were classif ied histologically into lowand high-grade lesions.A size ≥ 5 cm (P = 0.003),highgrade histology (P = 0.046) and a mitotic count ≥ 5/10 HPF (P = 0.013) were associated with tumor recurrence.The lesions were def ined as low-,intermediateand high-risk tumors,and their recurrence rates were 16%,46% and 73%,and their mortality rates 0%,4% and 45%,respectively.CONCLUSION: Extranodal FDC tumors behave like soft tissue sarcomas.Their clinical outcomes are variable and can be evaluated according to their sizes and grades.
基金Supported by the Natural Science Foundation of Jiangsu Province,No.BK20171150the National Natural Science Foundation of China,No.81502042
文摘AIM To investigate the expression and clinical significance of B7 homolog 3(B7-H3) and β-1,3-galactosyltransferase-4(B3 GALT4) in colorectal cancer(CRC) patients.METHODS Using tissue microarray, we identified the expression of B7-H3 and B3 GALT4 in 223 CRC patient samples by immunohistochemistry and evaluated the possible correlation between B7-H3 and B3 GALT4 and clinicaloutcomes. Further, the m RNA and protein expression were identified to establish the regulatory relationship of B7-H3 with B3 GALT4 in vitro.RESULTS A significant positive correlation between B7-H3 and B3 GALT4 was observed in CRC specimens(r = 0.219, P = 0.001). High expression of B7-H3 was identified as a significant independent predictor of poor overall survival(OS) [hazard ratio(HR) = 1.781; 95%CI: 1.027-3.089; P = 0.040]. Moreover, high expression of B3 GALT4 was also recognized as an independent predictor of inferior OS(HR = 1.597; 95%CI: 1.007-2.533; P = 0.047). Additionally, CRC patients expressing both high B7-H3 and high B3 GALT4 contributed to a significant decrease in OS(HR = 2.283; 95%CI: 1.289-4.042; P = 0.005). In CRC cell lines with stable expression of high B7-H3, the m RNA and protein expressions of B3 GALT4 were significantly upregulated. Similarly, the expression of B3 GALT4 was significantly reduced when expression of B7-H3 was knocked down.CONCLUSION The expression of B3 GALT4 in CRC is positively correlated with B7-H3 expression in vitro. B7-H3/B3 GLAT4 may be used as dual prognostic biomarkers for CRC.
文摘AIM To evaluate the importance of the CD34+CD38-cell population when compared to the CD34+CD38+/low and CD34+CD38+/high leukemic cell sub-populations and to determine its correlations with leukemia characteristics and known prognostic factors, as well as with response to therapy and survival.METHODS Two hundred bone marrow samples were obtained at diagnosis from 200 consecutive patients with newly diagnosed acute myeloid leukemia(AML) were studied between September 2008 and December 2010 at our Institution(Hematology Department, Lyon, France). The CD34/CD38 cell profile was analyzed by multiparameter flowcytometry approach using 8 C panels and FACS CANTO and Diva software(BD Bioscience).RESULTS We analyzed CD34 and CD38 expression in bone marrow samples of 200 AML patients at diagnosis, and investigated the prognostic value of the most immature CD34+CD38-population. Using a cut-off value of 1% of CD34+CD38-from total "bulk leukemic cells" we found that a high(> 1%) level of CD34+CD38-blasts at diagnosis was correlated with advanced age, adverse cytogenetics as well as with a lower rate of complete response after induction and shorter disease-free survival. In a multivariate analysis considering age, leukocytosis, the % of CD34+ blasts cells and the standardized cytogenetic and molecular risk subgroups, a percentage of CD34+CD38-leukemic cells > 1% was an independent predictor of DFS [HR = 2.8(1.02-7.73), P = 0.04] and OS [HR = 2.65(1.09-6.43), P = 0.03].CONCLUSION Taken together, these results show that a CD34/CD38 "backbone" for leukemic cell analysis by multicolour flowcytometry at diagnosis provides useful prognostic information.
文摘Objective:To assess prognostic factors and validate the effectiveness of recursive partitioning analysis (RPA) classes and graded prognostic assessment (GPA) in 290 non-small cell lung cancer (NSCLC) patients with brain metastasis (BM).Methods:From Jan 2008 to Dec 2009,the clinical data of 290 NSCLC cases with BM treated with multiple modalities including brain irradiation,systemic chemotherapy and tyrosine kinase inhibitors (TKIs) in two institutes were analyzed.Survival was estimated by Kaplan-Meier method.The differences of survival rates in subgroups were assayed using log-rank test.Multivariate Cox's regression method was used to analyze the impact of prognostic factors on survival.Two prognostic indexes models (RPA and GPA) were validated respectively.Results:All patients were followed up for 1-44 months,the median survival time after brain irradiation and its corresponding 95% confidence interval (95% CI) was 14 (12.3-15.8) months.1-,2-and 3-year survival rates in the whole group were 56.0%,28.3%,and 12.0%,respectively.The survival curves of subgroups,stratified by both RPA and GPA,were significantly different (P<0.001).In the multivariate analysis as RPA and GPA entered Cox's regression model,Karnofsky performance status (KPS) ≥ 70,adenocarcinoma subtype,longer administration of TKIs remained their prognostic significance,RPA classes and GPA also appeared in the prognostic model.Conclusion:KPS ≥70,adenocarcinoma subtype,longer treatment of molecular targeted drug,and RPA classes and GPA are the independent prognostic factors affecting the survival rates of NSCLC patients with BM.
基金Supported by The Self-Funded Research Project of the Health Commission of Guangxi Zhuang Autonomous Region,No.Z-A20230045.
文摘BACKGROUND The nutritional status is closely related to the prognosis of liver transplant re-cipients,but few studies have reported the role of preoperative objective nutri-tional indices in predicting liver transplant outcomes.AIM To compare the predictive value of various preoperative objective nutritional indicators for determining 30-d mortality and complications following liver transplantation(LT).METHODS A retrospective analysis was conducted on 162 recipients who underwent LT at our institution from December 2019 to June 2022.RESULTS This study identified several independent risk factors associated with 30-d mor-tality,including blood loss,the prognostic nutritional index(PNI),the nutritional risk index(NRI),and the control nutritional status.The 30-d mortality rate was 8.6%.Blood loss,the NRI,and the PNI were found to be independent risk factors for the occurrence of severe postoperative complications.The NRI achieved the highest prediction values for 30-d mortality[area under the curve(AUC)=0.861,P<0.001]and severe complications(AUC=0.643,P=0.011).Compared to those in the high NRI group,the low patients in the NRI group had lower preoperative body mass index and prealbumin and albumin levels,as well as higher alanine aminotransferase and total bilirubin levels,Model for End-stage Liver Disease scores and prothrombin time(P<0.05).Furthermore,the group with a low NRI exhibited significantly greater incidences of intraabdominal bleeding,primary graft nonfunction,and mortality.CONCLUSION The NRI has good predictive value for 30-d mortality and severe complications following LT.The NRI could be an effective tool for transplant surgeons to evaluate perioperative nutritional risk and develop relevant nutritional therapy.
文摘Primary PTCA is an effective performance to reopen the infarct-relatedartery,so as to limit infarct size and maintain left ventricular function.It is veryimportant to estimate infarct size for the management and prognosis after AMI.Infarct size can be assessed by serum creatinc phosphokinase （CK）.CK isoenzymeMB （CK-MB） or troponin T （TnT）,but reperfusion therapy such as primary PTCAhas a washout effect on these biochemical indexes.Whether or not thesebiochemical indexes are still useful in estimating infarct size after reperfusion isconfused.Objective:To detect the possibility of serum CK,CK-MB and TnT forassessing the infarct size after early successful reperfusion in acute myocardialinfarction （AMI）,and find a better method of these biochemical indexes toestimate infarct size.Methods:This study consisted of 29 AMI patients aftersuccessful primary PTCA.Serum CK,CK-MB and TnT were measuredsequentially within 72 hours after primary PTCA,and <sup>99m</sup>Tc-MIBI myocardialsingle photon emission computed tomography was performed within 30 days afterpermission to calculate the myocardial infarction score （ISI）.The peak,sum totaland area under curve within 16 hours of these biochemical indexes were comparedwith ISI with linear regression analysis and multiple stepwise regression analysis.Finally,the result were correlated with ISI to find its assessed value.sensitivity andspecificity.Results:Serum CK,CK-MB and TnT increased rapidly after primaryPTCA （p【0.05）;CK,CK-MB and TnT release curves were about monophasicwithin 24 hours;The peak,sum total and area under curve within 16 hours of CK,CK-MB and TnT correlated well with ISI;The area under curve within 16 hours ofTnT correlated best with ISI （r=0.58,p【0.01）,its regression equation was Y=1.39×10<sup>-4</sup>X+0.20.While patients were grouped by ISl as 30%.there wasobvious difference on the ISI between the 2 groups （p【0.01）.The assessing valueof TnT area under curve within 16 hours to infarct size was 85.2% （ISI=30%.TnTAUC=688μg.h/l）,the sensitivity was 100%,specificity was 84%.Two of thesepatients studied had a relative normal <sup>99m</sup>Tc-MIBI myocardial perfusion as healthypeople.Conclusion:The area under curve within 16 hours after primary PTCAcan be used to assess infarct size in AMI.Primary PTCA can reopen the infarct-related artery in time,and rescue the dying myocardium obviously.
文摘Assessment exercises constitute a crucial component of the teaching and learning process,serving the purpose of gauging the degree to which learning objectives have been accomplished.This study aims to assess the mathematics performance of Grade 7 learners using the 50-30-20 exercise.Specifically,this study seeks to determine the learners’pre-test and post-test mean scores,identify significant differences between the pre-test and post-test results,evaluate learners’exercises,and propose enhanced exercises.The research employs a quasi-experimental design,with 40 Grade 7 learners in the school year 2023-2024 as participants,selected through purposive non-random sampling.Statistical data analysis involves the use of mean,standard deviation,paired t-test,and Cohen’s D effect size.Ethical considerations were paramount,as evidenced by a letter of authorization from the school head outlining the strict adherence to voluntary participation,informed parental consent,anonymity,confidentiality,risk mitigation,results-sharing protocols,and the commitment to keeping research data confidential.The data yielded a remarkable outcome:the experimental group exhibited improvement in both the pre-test and post-test.This result substantiates the initial objective of the study,showcasing a noteworthy and favorable performance among the participants.Consequently,it suggests that a majority of the participants strongly agree that the 50-30-20 exercises contribute to enhancing their understanding and problem-solving skills,as well as their ability to grasp mathematical concepts and improve their overall performance in mathematics.Therefore,the 50-30-20 exercises not only facilitated students in understanding mathematics lessons but were also aligned with the Department of Education’s development plan.
文摘An accurate and objective assessment of the health status of EMU trains is of great importance.In order to make sure the trains are functional,reliable,and endurable in their full life cycle(FLC),health assessment method for EMU trains after Level 3-5 maintenance and repair is studied.First,the element-selection principles and the assessment rules are defined;second,to present the complex topological relationship between the elements in assessment,a functional logical structure construction method is proposed;third,a health value calculation model is defined based on the element’s characteristics and their logical structures.The health variables of each element is calculated and fitted following the steps in the corresponding weight calculation methods.The assessment method is proved to be applicable and effective.
文摘BACKGROUND Accurate assessment of the prognosis after colorectal cancer surgery is of great significance in patients with colorectal cancer.However,there is no systematic analysis of factors affecting the prognosis of colorectal cancer currently.AIM To systematically analyze the influence of clinical data and serological and histological indicators on the prognosis of patients with colorectal cancer,and to explore the indicators that can accurately assess the prognosis of patients with colorectal cancer.METHODS A total of 374 patients with colorectal cancer were enrolled.The clinical data,tumor-node-metastasis(TNM)stage,and Dukes stage were recorded.All patients received examinations including carcinoembryonic antigen(CEA),carbohydrate antigen 199,C-reactive protein,albumin,D-dimer,and fibrinogen as well as routine blood tests one week before surgery.The tumor location,size,depth of invasion,lymph node metastasis,and distant metastasis were recorded during surgery.The pathological tissue typing and expression of proliferating cell nuclear antigen(PCNA)and p53 were observed.All patients were followed for 3 years,and patients with endpoint events were defined as a poor prognosis group,and the remaining patients were defined as a good prognosis group.The differences in clinical data,serology,and histology were analyzed between the two groups.Multivariate COX regression was used to analyze the independent influencing factors for the prognosis of colorectal cancer.The receiver operating characteristic curve was used to evaluate the predictive value of each of the independent influencing factors and their combination for the prognosis of colorectal cancer.RESULTS The follow-up outcomes showed that 81 patients were in the good prognosis group and 274 patients in the poor prognosis group.The TNM stage,PCNA,Glasgow prognostic score(GPS),neutrophil-lymphocyte ratio(NLR),C-reactive protein/albumin ratio(CAR),D-dimer,and CEA were independent influencing factors for the prognosis of colorectal cancer(P=0.000).NLR had the highest predictive power for colorectal cancer prognosis[area under the receiver operating characteristic curve(AUC)=0.925],followed by D-dimer(AUC=0.879)and GPS(AUC=0.872).The accuracy of the combination of all indicators in predicting the prognosis of colorectal cancer was the highest(AUC=0.973),which was significantly higher than that of any of the indicators alone(P<0.05).The sensitivity and specificity of the combination were 92.59%and 90.51%,respectively.CONCLUSION The independent influence factors for the prognosis of colorectal cancer include TNM stage,PCNA,GPS,NLR,CAR,D-dimer,and CEA.The combined assessment of the independent factors is the most accurate predictor of the prognosis after colorectal cancer surgery.
文摘AIM: To identify prognostic factors of patients with hepatocellular carcinoma (HCC), who were treated by orthotopic liver transplantation (OLT). METHODS: From January 2000 to October 2006, 165 patients with HCC underwent OLT. Various clinicopathological risk factors for actuarial and recurrence-free survival were identified using the Kaplan-Meier method with the log-rank test. The Cox proportional hazards model was used to identify independently predictive factors for actuarial and recurrence-free survival, which were used to propose new selection criteria. We compared the outcome of the subgroup patients meeting different criteria. Survival analysis was performed using the Kaplan-Meier method with the log-rank test. RESULTS: The median follow-up was 13.0 mo (2.8-69.5 mo). Overall, 1-, 2-, 3-and 5-year actuarial survival was 73.3%, 45.6%, 35.4% and 32.1%, respectively. One-, 2-, 3-and 5-year overall recurrencefree survival was 67.0%, 44.3%, 34.5% and 34.5%, respectively. In univariate analysis, number of tumors, total tumor size, lobar distribution, differentiation, macrovascular invasion, microvascular invasion, capsulationof the tumor, and lymph node metastasis were found to be associated significantly with actuarial and tumor-free survival. By means of using the multivariate Cox proportional hazards model, total tumor size and macrovas-cular invasion were found to be independent predictors of actuarial and tumor-free survival. When the selection criteria were expanded into the proposed criteria, there was no significant difference in 1-, 2-, 3-and 5-year actuarial and tumor-free survival of the 49 patients who met the proposed criteria (97.6%, 82.8%, 82.8% and 82.8%, and 90.7%, 82.8%, 68.8% and 68.8%, respectively) compared with that of patients who met the Milan or University of California, San Francisco (UCSF) criteria. CONCLUSION: Macrovascular invasion and total tumor diameter are the strongest prognostic factors. The proposed criteria do not adversely affect the outcome of liver transplantation for HCC, compared with the Milan or UCSF criteria.
基金Foundatial itemProject (2000D0005Q) supported by the Natural Science Foundation of Yunnan Province , China
文摘Gejiu Tin District is an old mine with a long exploitation history, but its resource is nearly used up at present. The research in mineral resources assessment based on GIS plays a more important and particular role in development of Gejiu. Now mineral resources assessment has been guided by new theories. It makes full use of a large information data of geology, geophysics, geochemistry and remote sensing, which are obtained from current geology exploration, in order to carry out integration mineral analysis, assessment, and to research into the data farther in high levels. At present, the processing of data by computer technique has become more powerful, because GIS was developed in recent years. Particularly, GIS has opened up vast prospects for integrated processing of geoscience data and prognosis of ore resources. GIS can analyze, extract mineral information, quantitatively assess mineral resources, delineate tractes, construct variables, carry out prospecting targets selection and so on.
