术前白蛋白与纤维蛋白原比值对三阴性乳腺癌患者的预后影响和临床意义

目的:探讨术前白蛋白与纤维蛋白原比值（albumin to fibrinogen,AFR）对三阴性乳腺癌患者的预后影响和临床意义。方法:回顾性分析我院自2010年1月至2013年12月间就诊的195例三阴性乳腺癌患者。用受试者工作特性曲线（ROC）确定AFR的最佳临界值。采用卡方检验或Fisher精确检验分析比较计数资料。Kaplan-Meier方法和Log rank方法用于分析生存曲线。单因素和多因素分析（Cox比例风险回归模型）用于评估独立的预后因素。结果:ROC曲线确定AFR最佳临界值为15.00，依此分两组，即低AFR组（AFR＜15.00）和高AFR组（AFR≥15.00）。单因素和多因素分析显示AFR是三阴性乳腺癌DFS（P=0.045，HR:0.627，95%CI:0.397~0.990；P=0.026，HR:0.595，95%CI:0.377~0.940）和OS（P=0.039，HR:0.238，95%CI:0.061~0.927；P=0.001，HR:0.385，95%CI:0.221~0.670）的独立预后因素。高AFR组患者术后中位DFS和OS显著高于低AFR组患者，差异具有显著统计学意义（χ2=8.190，P=0.004；χ2=8.720，P=0.003）。散点图分析显示，AFR与ALB呈显著正相关（R2=0.028，P=0.020），AFR与FIB呈显著负相关（R2=0.516，P＜0.000 1）。此外，对伴有淋巴管侵犯的患者，高AFR组患者比低AFR组患者术后生存时间长，预后更好。结论:术前AFR是影响患者预后的独立因素。AFR具有操作简单、易于推广、成本低、可重复性好等优点，具有潜在的临床应用价值。     

Bone hierarchical structure in three dimensions

Bone is a complex hierarchically structured family of materials that includes a network of cells and their interconnected cell processes. New insights into the 3-D structure of various bone materials (mainly rat and human lamellar bone and minipig fibrolamellar bone) were obtained using a focused ion beam electron microscope and the serial surface view method. These studies revealed the presence of two different materials, the major material being the well-known ordered arrays of mineralized collagen fibrils and associated macromolecules, and the minor component being a relatively disordered material composed of individual collagen fibrils with no preferred orientation, with crystals inside and possibly between fibrils, and extensive ground mass. Significantly, the canaliculi and their cell processes are confined within the disordered material. Here we present a new hierarchical scheme for several bone tissue types that incorporates these two materials. The new scheme updates the hierarchical scheme presented by Weiner and Wagner (1998). We discuss the structures at different hierarchical levels with the aim of obtaining further insights into structure–function-related questions, as well as defining some remaining unanswered questions.     

MPV、FIB、ApoAⅠ检测在老年高血压脑梗死患者中的临床意义

目的 探讨MPV、FIB、ApoAⅠ等指标在高血压脑梗死患者中的临床意义. 方法 回顾性分析高血压脑梗死组、单纯高血压组及对照组MPV、FIB、ApoAⅠ、ApoAⅠ/B指标的变化. 结果 高血压脑梗死组MPV、FIB分别为(13.82±0.73)、(4.19±0.75),明显高于单纯高血压组的(13.22±0.38)、(3.66±0.61)及对照组的(12.41±0.51)、(3.27±0.61),P＜0.05;HDL、ApoAⅠ、 ApoAⅠ/B分别为(1.02±0.23)、(0.92±0.22)、(0.91±0.24),明显低于单纯高血压组的(1.43±0.31)、(1.26±0.32)、(1.39±0.16)及对照组的(1.61±0.12)、(1.37±0.36)、(1.46±0.21),P＜0.05,三组比较具有统计学意义. 结论高血压脑梗死患者存在凝血及血脂的异常,早期干预治疗,可减少致残率.     

Validation of a machine learning approach using FIB-4 and APRI scores assessed by the metavir scoring system: A cohort study

Background and Study AimThe study aim was to improve and validate the accuracy of the fibrosis-4 (FIB-4) and aspartate aminotransferase-to-platelet ratio index (APRI) scores for use in a potential machine-learning (ML) method that accurately predicts the extent of liver fibrosis.Patients and MethodsThis retrospective multicenter study included 69,106 patients with chronic hepatitis C planned for antiviral therapy from January 2010–December 2014 with liver biopsy results. FIB-4 and APRI scores were calculated and their performance for predicting significant liver fibrosis (F3–F4) assessed against the Metavir scoring system. ML was used for feature selection and reduction to identify the most relevant attributes (CfsSubseteval/best first) for prediction.ResultsIn this study, 57,492 (83.2%) patients were F0–F2, and 11,615 (16.8%) patients were F3–F4. The revalidation of FIB-4 and APRI showed lower accuracy and higher disagreement with the biopsy results, with AUCs of 0.68 and 0.58, respectively. FIB-4 diagnosed fewer (14%) F3–F4 patients, and the high specificity and negative predictive values of FIB-4 and APRI reflected the low prevalence of F3–F4 in the study population. Out of 15 attributes, age (>35 years), AFP (>6.5 ng/ml), and platelet count (<150,000/mm³) were the most relevant risk attributes, and patients with one or more of these risk factors were likely to be F3–F4, with a classification accuracy of ≤ 92% and receiver operating characteristics area of 0.74.ConclusionFIB-4 and APRI scores were not very accurate and missed diagnosing most of the F3–F4 patients. ML implementation improved medical decisions and minimized the required clinical data to three risk factors.     

In Vitro Evaluation of Structural Factors Favouring Bacterial Adhesion on Orthodontic Adhesive Resins

Bacterial adhesion to the surface of orthodontic materials is an important step in the formation and proliferation of plaque bacteria, which is responsible for enamel demineralization and periodontium pathologies. With the intent of investigating if adhesive resins used for bracket bonding are prone to bacteria colonization, the surface roughness of these materials has been analyzed, combining information with a novel methodology to observe the internal structures of orthodontic composites. Scanning electron microscopy, combined with focus ion bean micromachining and stylus profilometry analyses, were performed to evaluate the compositional factors that can influence specific pivotal properties facilitating the adhesion of bacteria to the surface, such as surface roughness and robustness of three orthodontic adhesive composite resins. To confirm these findings, contact angle measurements and bacteria incubation on resin slide have been performed, evaluating similarities and differences in the final achievement. In particular, the morphological features that determine an increase in the resins surface wettability and influence the bacterial adhesion are the subject of speculation. Finally, the focused ion beam technique has been proposed as a valuable tool to combine information coming from surface roughness with specific the internal structures of the polymers.     

三种凝血功能指标改变与肝硬化相关性讨论

目的:研究三项凝血功能指标改变与肝硬化及分级程度是否具有相关性.方法:观察100例不同Child pugh分级肝硬化患者凝血功能改变,以及55例正常健康体检人员为对照,研究凝血指标与肝硬化Child pugh评分相关性.结果:肝硬化组及对照组凝血酶原(PT)活化部分凝血活酶时间(APTT)纤维蛋白原(FIB)比较差异有统计学意义(P<0.05);肝硬化组不同Child pugh分级的PT比较差异有统计学意义(P<0.05),C级的APTT、FIB均高于A级及B级;PT与Child pugh评分呈正相关.结论:PT、APTT、FIB三项凝血指标的改变能够反映出肝硬化病程改变,两者之间有相关性.