Analysis of risk factors for steroid resistance in children with primary nephritic syndrome and discussion on the prediction model of steroid resistance

Objective To seek the risk factors of steroid resistance in children with primary nephritic syndrome, and construct the predicting model of steroid resistance. Methods The clinical indicators of 185 patients with primary nephrotic syndrome (PNS) were collected, including clinical data, laboratory and imaging examination. The risk factors of steroid resistance were found using single factor analysis, receiver operator characteristic (ROC) and logistic regression test. The predicting model of steroid resistance was constructed based on integral method model. Results The results of single factor analysis, receiver operating characteristic curve (ROC) and logistic regression analysis showed that the age more than 6.5 years old, having microscopic hematuria and the 24 h urine protein content (24 hUP) more than 177.49 mg•kg-1•d-1 were the significant risk factors of steroid resistant nephrotic syndrome (SRNS). Logistic regression prediction model was Y=6.761-2.947X1-3.336X2-2.669X3. The result of receiver operator characteristic showed that when the score was 0.95, the sensitivity and specificity was 56.56%, 96.62% respectively and the area under ROC was 0.86, P＜0.05). Conclusions The age more than 6.5 years old, having microscopic hematuria and 24 h urine protein content more than 177.49 mg•kg-1•d-1 are the significant risk factors of SRNS.     

生物信息学方法在预测蛋白质相互作用中的应用

生物信息学是一门数学、统计学、计算机与生物交叉结合的新兴学科.随着后基因组时代的来临,生物信息学的研究重点从基因组测序工作逐渐转移到对已测序基因组的功能进行注释,尤其是蛋白质与蛋白质之间相互作用的研究.以下将重点介绍生物信息学在蛋白质相互作用预测中的应用,以及不同的预测方法各自的优缺点及发展状况.     

生殖激素水平测定对早期先兆流产妊娠预后的判断价值

目的:总结在多种生殖激素在早期先兆流产妊娠预后的预测价值。方法:回顾性分析50例正常妊娠分娩者、50例先兆流产继续妊娠者及50例先兆流产难免流产者的临床资料,以正常妊娠分娩者为A组,以先兆流产继续妊娠者为B组,以先兆流产难免流产者为C组。分析三组间多种生殖激素含量差异,并探讨多种生殖激素与早期先兆流产妊娠结节的相关性。结果:三组间孕6周时P、E2及β-HCG含量存在显著差异(P0.05),而LH、PRL及FSH无统计学差异(P0.05)。C组P、E2及β-HCG明显低于A组及B组(P0.05),B组P、E2及β-HCG明显低于A组(P0.05)。同时P、E2及β-HCG含量与早期先兆流产妊娠预后存在显著的相关性(P0.05)。结论:P、E2及β-HCG含量对早期先兆流产的妊娠预后有着显著的预测价值。     

Clinical significance of melatonin concentrations in predicting the severity of acute pancreatitis

AIM: To assess the value of plasma melatonin in pre-dicting acute pancreatitis when combined with the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and bedside index for severity in acute pancreatitis (BISAP) scoring systems. METHODS: APACHEⅡ and BISAP scores were calculated for 55 patients with acute physiology (AP) in the first 24 h of admission to the hospital. Additionally, morning (6:00 AM) serum melatonin concentrations were measured on the first day after admission. According to the diagnosis and treatment guidelines for acute pancreatitis in China, 42 patients suffered mild AP (MAP). The other 13 patients developed severe AP (SAP). A total of 45 healthy volunteers were used in this study as controls. The ability of melatonin and the APACHEⅡ and BISAP scoring systems to predict SAP was evaluated using a receiver operating characteristic (ROC) curve. The optimal melatonin cutoff concentration for SAP patients, based on the ROC curve, was used to classify the patients into either a high concen-tration group (34 cases) or a low concentration group (21 cases). Differences in the incidence of high scores, according to the APACHEⅡ and BISAP scoring sys- tems, were compared between the two groups. RESULTS: The MAP patients had increased melatonin levels compared to the SAP (38.34 ng/L vs 26.77 ng/L) (P = 0.021) and control patients (38.34 ng/L vs 30.73 ng/L) (P = 0.003). There was no significant difference inmelatoninconcentrations between the SAP group and the control group. The accuracy of determining SAP based on the melatonin level, the APACHEⅡ score and the BISAP score was 0.758, 0.872, and 0.906, respectively, according to the ROC curve. A melatonin concentration ≤ 28.74 ng/L was associated with an increased risk of developing SAP. The incidence of high scores (≥ 3) using the BISAP system was significantly higher in patients with low melatonin concentration (≤ 28.74 ng/L) compared to patients with high melatonin concentration (> 28.74 ng/L) (42.9% vs 14.7%, P = 0.02). The     

急性缺血性脑卒中患者血清miR-103,miR-29b的表达水平变化及其临床意义

目的 探讨急性缺血性脑卒中(AIS)患者血清miR-103,miR-29b的表达水平变化及其临床意义。方法 收集2016年1月-2019年12月本院神经内科收治的126例AIS患者(AIS组),根据美国国立卫生研究院卒中量表(NIHSS)评分将其分为轻度组(45例)、中度组(57例)和重度组(24例),根据改良Rankin量表(mRS)评分将其分为预后良好组(78例)和预后不良组(48例),另选择56例同期于本院门诊体检健康者为对照组,检测血清miR-103,miR-29b表达水平,Spearman秩相关性分析miR-103,miR-29b表达水平与NIHSS,mRS评分的相关性,受试者工作特征曲线(ROC)分析miR-103,miR-29b表达水平对神经功能预后的预测价值。结果 AIS组血清miR-103表达水平高于对照组(P<0.05),miR-29b表达水平低于对照组(P<0.05),血清miR-103表达水平随着AIS患者神经缺损程度加重而升高(P<0.05),miR-29b表达水平则降低(P<0.05)。预后不良组血清miR-103表达水平高于预后良好组(P<0.05),miR-29b表达水平低于预后良好组(P<0.05)。Spearman秩相关性分析显示AIS患者血清miR-103表达水平与NIHSS评分、mRS评分呈正相关(r₂=0.636、0.794,P<0.05),miR-29b表达水平与NIHSS评分、mRS评分呈负相关(r₂=-0.664、-0.659,P<0.05)。ROC分析显示miR-103,miR-29b表达水平预测AIS患者神经功能预后的曲线下面积(AUC)为0.713、0.741,联合miR-103,miR-29b表达水平预测AIS患者神经功能预后的AUC为0.918,高于单独miR-103,miR-29b表达水平(P<0.05)。结论 AIS患者血清miR-103表达水平升高,miR-29b表达水平降低,miR-103表达上调、miR-29b表达缺失均与AIS患者神经功能缺损程度和神经功能恶化有关,可以为患者神经功能预后评估提供参考。     

最小二乘法预测门诊人数

目的建立趋势线性模型,预测2011-2012年门诊就诊人数。方法采用最小二乘法对模型进行回归分析。结果 2011和2012年的预测门诊人数分别为162.25万、170.68万人次,2011年门诊人数实际值为165.77万人次,误差仅为2.17%。结论应用最小二乘法对门诊人数预测,效果较理想,可为医院工作计划和决策提供了理论依据。     

阴道超声监测先兆早产孕妇的宫颈对早产预测的价值

目的：评价阴道超声监测宫颈对早产的预测价值。方法：采用阴道超声监测189例先兆早产孕妇的宫颈,并追踪妊娠结局,评价对早产的预测价值。超声监测指标为宫颈长度、漏斗形成、漏斗长度、漏斗宽度及宫颈指数[（漏斗长度＋1）/宫颈长度]。结果：189例先兆早产孕妇中早产率为34.4%（65/189）。各项超声监测指标均与先兆早产预后有关,而宫颈长度是预测早产的最佳超声指标。ROC曲线结果显示宫颈长度25 mm是预测早产的最佳工作点。宫颈长度≤25 mm时预测早产的敏感度为67.7%,特异度为75.0%,阳性预测值为58.7%,阴性预测值为81.6%。结论：应用阴道超声监测宫颈,可客观、准确地预测早产。     

非小细胞肺癌转移预测指标的研究

目的 :研究非小细胞肺癌 (NSCLC)淋巴结和远处转移的预测指标 ,并建立Logistic回归模型。　 方法 :通过免疫组化、ELISA、酶谱电泳等方法 ,对NSCLC肿瘤病理标本、血清、尿液和骨髓等进行检查 ,并通过Logistic回归分析建立预测概率模型。　结果 :免疫组化指标肿瘤组织内微血管密度 (IMVD)、血管内皮细胞生长因子(VEGF)、碱性成纤维细胞生长因子 (b FGF)、白细胞分化抗原变异型 (CD4 4v6 )、基质金属蛋白酶 2 (MMP 2 )与NSCLC淋巴结转移危险有关 (P <0 .0 5 ) ,组织金属蛋白酶抑制物 (TIMP 2 )、上皮型钙粘素 (E cad)与NSCLC淋巴结转移危险下降有关 (P <0 .0 5 )。血清MMP 2、MMP 9,尿液MMP 2、MMP 9及骨髓上皮膜抗原 (EMA)阳性细胞与NSCLC远处转移危险有关 (P <0 .0 5 )。其中免疫组化指标CD4 4v6、IMVD、E cad及尿液MMP 2、骨髓EMA阳性细胞对NSCLC转移有显著回归效果而分别被选入概率模型 1和 2 ,其预测准确率分别为 81.1%和 72 .7%。　结论 :组织标本中CD4 4v6、IMVD、E cad以及尿液中MMP 2及骨髓EMA阳性细胞检查 ,可预测绝大多数NSCLC的淋巴结转移和远处转移状况 ,为NSCLC转移的早期诊断提供重要信息 ,有助于NSCLC的个体化治疗和改善预后     

护理干预对MP妊高症检测仪预测阳性的效果观察

目的:通过对采用MP妊高症检测仪进行桡动脉脉搏波预测妊高症阳性孕妇的护理干预,观察预测妊高症阳性的改善效果。方法:抽取2006年1月至2006年8月在我院作产检的孕妇120例,将体重偏重、下肢轻微水肿、测量血压接近120/80mmHg的孕妇进行MP妊高症预测阳性的32例为基线组;预测阴性的68例分为观察组。对基线组进行护理干预后复查MP妊高症预测(2~4周一次);对观察组则定期测量血压、体重和检查下肢水肿情况,观察MP复查,发现预测阳性也及时给予护理干预,观察其效果。结果:基线组:在给以护理干预后复查MP明显转为阴性和MP预测各项指标均呈下降趋势的29例,有效率90.6%,(P<0.5);观察组:MP妊高症预测阳性的36例,且都在孕晚期出现了体重异常增加(2周增加体重≥2kg)和下肢水肿,并及时给予护理干预,复查MP预测明显好转的26例,有效率72.2%。结论:使用MP妊高征检测系统可预测妊高征发生的可能,而且尽早地给予健康宣教和生活指导,能够有效地降低MP妊高征预测阳性的各项指标,对妊高症的发病有明显的预防作用。且MP妊高症检测仪监测方法简单,无创,耗时短。