Improvement of the Prediction Power of the CoMFA and CoMSIA Models on Histamine H3 Antagonists by Different Variable Selection Methods

The aim of this study is to enhance the predictivity power of CoMFA and CoMSIA models by means of different variable selection algorithms. The genetic algorithm (GA), successive projection algorithm (SPA), stepwise multiple linear regression (SW-MLR), and the enhanced replacement method (ERM) were used and tested as variable selection algorithms. Then, the selected variables were used to generate a simple and predictive model by the multilinear regression algorithm. A set of 74 histamine H₃ antagonists were split into 40 compounds as a training set, and 17 compounds as a test set, by the Kennard-Stone algorithm. Before splitting the data, 17 compounds were randomly selected from the pool of the whole data set as an evaluation set without any supervision, pretreatment, or visual inspection. Among applied variable selection algorithms, ERM had noticeable improvement on the statistical parameters. The r² values of training, test, and evaluation sets for the ERM-MLR model using CoMFA fields were 0.9560, 0.8630, and 0.8460 and using the CoMSIA fields were 0.9800, 0.8521, and 0.9080, respectively. In this study, the principles of organization for economic cooperation and development (OECD) for regulatory acceptability of QSARs are considered.     

主观认知障碍的相关危险因素分析及预防

目的 探讨主观认知障碍(SCI)的危险因素及预防措施.方法 选取2016年3~9月在上海长征医院痴呆门诊就诊患者54例,进行简易智力状况检查量表和SCI调查问卷调查.然后采用单因素和多因素条件Logistic回归分析对数据进行处理以筛查影响因素.结果 经单因素和多因素条件Logistic回归分析,筛选出3个有意义的独立因素:年龄(OR=1.243,95%CI=1.072~1.442)、脑血管疾病史(OR=130.466,95%CI=1.688~3630.660)是SCI发生的独立危险因素;文化程度是独立保护因素(OR=0.016,95%CI=0.007~0.607).结论 年龄与脑血管疾病史是SCI发病的危险因素,在该病防治上需主要加强危险因素的防治.文化程度是发病保护因素,因此应该倡导和鼓励老年人多思考、勤用脑.     

From the Horse’s Mouth: Perceptions of the Management of the 2007 Equine Influenza Outbreak in Australia

In August 2007, Australia experienced its first‐ever outbreak of equine influenza, a highly infectious respiratory disease of horses. Although the outbreak spread over a large geographic area, it was eradicated within 5 months following a substantial disease control effort led by federal and state animal health authorities. Despite its timely control, this large‐scale outbreak caused severe impacts on horse owners and industry participants. This study aimed to describe the perceptions of horse owners and managers, impacted by outbreak control measures, regarding the state government’s animal health authority outbreak management. Participants were interviewed face‐to‐face. Factors associated with ordinal ratings of perception (‘well managed’, ‘adequately managed’ and ‘poorly managed’) were identified using ordinal logistic regression. Factors significantly associated with a reduced likelihood of ‘well‐managed’ outbreak response ratings, adjusted for age and gender, were being involved in horse competitions/sporting events (OR = 0.48; 95% CI: 0.25–0.91), managing a horse stud (OR = 0.09; 95% CI: 0.03–0.28) and believing that another outbreak of equine influenza was highly likely in the next 5 years (OR = 0.29; 95% CI: 0.12–0.68). Possible reasons for these ratings were further investigated using content analyses. Outbreak communications and government efficiency/support were mentioned most frequently as both strengths (30% and 28%, respectively) and weaknesses (40% and 30%, respectively) of the outbreak management. To promote manager–government rapport and future compliance with disease control regulations, we recommend that outbreak communications and outbreak information systems be reviewed.     

A Cox Regression Analysis of Covariates for Asthma Hospital Readmissions

Background.?Asthma hospital admissions and readmissions are unacceptably high, thus, a method to identify those at greatest risk could be helpful. Methods.?An observational retrospective study using a Cox regression to determine the relationship between the time interval between admissions and possible covariates of a readmission. The covariates were age, sex, ethnicity, smoking habit, history of allergy or eczema/hay fever, age of onset, Townsend index (TI), Jarman score (JS), and drugs on discharge. Those with p<0.2, together with interacting covariates, from the preliminary analysis were eligible for the multivariate Cox regression analysis. Results.?Of the 523 patients admitted between 1994 and 1998 because of their asthma, complete data were available for 440. Of these, 112 were readmitted. Eligible covariates for the multivariate Cox regression analysis were sex, allergy status, history of eczema/hay fever, the JS and TI together with interactions between JS and TI, JS and allergy, and allergy with eczema/hay fever. There were 278 subjects (71 with a readmission) with complete data for these eligible covariates. The multivariate analysis revealed that female sex (odds ratio [OR] = 2.65, 95% confidence interval [CI] 1.42, 4.92), high JS (OR = 2.03, 95% CI 1.13–3.65), and history of allergy (OR = 1.88, 95% CI 1.06–3.32) formed the final model as significant predictors of readmission. Conclusion.?Females with a history of allergy that were registered at a practice with a high workload (JS) had a higher risk of readmission. The analysis method used highlights how those at risk of readmission can be identified so that they can be targeted post discharge.     

Bone Marrow Examination

Bone marrow examination is of inestimable diagnostic value in selected cases. It is particularly indicated in pancytopenia to establish or exclude leukemia or in conditions in which characteristic evidence of disease is likely to be found in the marrow but rarely or never in the blood. However, in many cases it adds little to data obtained from history, physical examination, and peripheral blood smears.     

Statistical analysis of the results of heart valve replacement

A variety of statistical methods can be used to analyze the results of heart valve replacement. In this review, we illustrate the methodology and the application of the techniques that are most widely used. For early events, univariate analysis and multivariate logistic regression are illustrated. For late (time-related) events, nonparametric methods (Kaplan–Meier and cumulative incidence or ‘actual’ analysis), parametric methods (based on the exponential, Gompertz and Weibull distributions) and semiparametric methods (Cox proportional hazards) are illustrated.     

术前区域性动脉灌注化疗对进展期胃癌预后的影响

目的　探讨术前区域性动脉灌注化疗对进展期胃癌预后的影响。方法　对 80例行根治性手术切除的进展期胃癌患者 (其中 3 3例术前行介入化疗 )的临床资料进行分析 ,并应用Cox比例风险模型对可能影响胃癌患者预后的临床病理、治疗措施及分子生物学等 11项指标进行多因素回归分析。结果　术前介入化疗组患者 5年生存率为 59.3 % ,显著高于对照组术后 5年生存率的 47.6% (P<0 .0 5)。Cox多因素回归分析显示 ,术前动脉插管介入化疗为影响进展期胃癌患者术后长期存活的独立预后因素之一。结论　术前区域性动脉灌注化疗对改善胃癌患者预后具有重要价值     

High Physical Activity is Associated with an Improved Lipid Profile and Resting Heart Rate among Healthy Middle-aged Chinese People

Objective To investigate the effects of physical activity (PA) on dyslipidemia and elevated resting heart rate (RHR) in a large-scale cross-sectional study in China. Methods We recruited community-based individuals who were 40-60 years old using a cluster sampling method. The PA levels of the participants were classified as low, moderate, or high, using the International Physical Activity Questionnaire. Dyslipidemia was defined as the detection of abnormalities in lipid indicators, and 4 lipid parameters were evaluated using fasting blood samples. Multivariate logistic regression analyses were used to evaluate the associations of PA with dyslipidemia and RHR. Results A total of 10,321 participants (38.88% men) were included in this study. The percentages of individuals with high, moderate, and low PA levels were 46.5%, 43.9%, and 9.6%, respectively. In both men and women, high PA provided odds ratios of 0.88 [95% confidence interval (CI): 0.83, 0.94] for dyslipidemia and 0.82 (95% CI: 0.73, 0.92) for elevated RHR, compared to participants with low PA. Conclusion Our data suggested that substantial health benefits (related to dyslipidemia and elevated RHR) occurred at higher intensity PA, with greater energy consumption, in middle-aged Chinese people, and particularly in men.     

某三甲教学医院手术病人手术部位感染危险因素及人工网络模型探讨

目的 统计某医院外科病人手术部位感染发生率,找出导致术后感染的相关因素,对外科病人发生术后感染的机率进行科学预测。方法 研究对象选取2012—2015年某三甲教学医院术后病人,发生275例手术部位感染的病人为病例组,另按照1∶1比例选取术后无感染266例病人为对照组,进行病例回顾性调查研究,统计检出致病菌和手术感染部位情况,探讨手术部位感染综合因素,结合术后感染统计分析数据构建人工网络模型。结果 手术部位感染率0.35％。多因素分析结果表明,手术部位感染的独立危险因素分别是手术类型、是否有原发疾病、切口类别、ASA病情分级、病人年龄、手术时长、手术例次(OR=11.043,9.587,2.136,1.818,1.299, 1.293,1.041,P<0.05)。最终确定网络模型运行结果如下,平均误差为0.040%,网络错分率 0.038% ;通过曲线下面积(ROC)大于0.9。结论 部位感染危险因素前三位是手术类型、是否患有原发疾病、切口类别。人工网络模型针对手术部位感染危险度的预测结果较理想,建立与其相关预报信息平台系统,为临床院感管控决策提供指导依据。     

原位肝移植术前危险因素分析

目的 分析与肝移植术后早期死亡率有密切关系的术前危险因素。方法 回顾性地收集50例成人肝移植病人的临床和实验室资料，对20种待筛选的术前危险因素与术后早期死亡率的关系进行多元回归分析。结果 经单因素和Logistic多元回归分析最终筛选出术前感染情况、急性生理，年龄和慢性健康（APACHE）Ⅲ评分和血浆肌酐（Cr）水平与术后早期死亡率有独立相关性。经受试者运算特征（ROC）曲线分析，APACHEⅢ的截断点为60分，Cr的截断点为140μmol/L。结论 术前APACHEⅢ≥60分、Cr水平≥140μmol/L术前存在感染灶，是肝移植受体的术前危险因素，提示预后不佳。