RESUMO
This study aimed to establish and validate the efficacy of a nomogram model, synthesized through the integration of multi-parametric magnetic resonance radiomics and clinical risk factors, for forecasting perineural invasion in rectal cancer. We retrospectively collected data from 108 patients with pathologically confirmed rectal adenocarcinoma who underwent preoperative multiparametric MRI at the First Affiliated Hospital of Bengbu Medical College between April 2019 and August 2023. This dataset was subsequently divided into training and validation sets following a ratio of 7:3. Both univariate and multivariate logistic regression analyses were implemented to identify independent clinical risk factors associated with perineural invasion (PNI) in rectal cancer. We manually delineated the region of interest (ROI) layer-by-layer on T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) sequences and extracted the image features. Five machine learning algorithms were used to construct radiomics model with the features selected by least absolute shrinkage and selection operator (LASSO) method. The optimal radiomics model was then selected and combined with clinical features to formulate a nomogram model. The model performance was evaluated using receiver operating characteristic (ROC) curve analysis, and its clinical value was assessed via decision curve analysis (DCA). Our final selection comprised 10 optimal radiological features and the SVM model showcased superior predictive efficiency and robustness among the five classifiers. The area under the curve (AUC) values of the nomogram model were 0.945 (0.899, 0.991) and 0.846 (0.703, 0.99) for the training and validation sets, respectively. The nomogram model developed in this study exhibited excellent predictive performance in foretelling PNI of rectal cancer, thereby offering valuable guidance for clinical decision-making. The nomogram could predict the perineural invasion status of rectal cancer in early stage.
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The fibrinolytic system is involved in many physiological functions, among which the important members can interact with each other, either synergistically or antagonistically to participate in the pathogenesis of many diseases. Plasminogen activator inhibitor 1 (PAI-1) acts as a crucial element of the fibrinolytic system and functions in an anti-fibrinolytic manner in the normal coagulation process. It inhibits plasminogen activator, and affects the relationship between cells and extracellular matrix. PAI-1 not only involved in blood diseases, inflammation, obesity and metabolic syndrome but also in tumor pathology. Especially PAI-1 plays a different role in different digestive tumors as an oncogene or cancer suppressor, even a dual role for the same cancer. We term this phenomenon "PAI-1 paradox". PAI-1 is acknowledged to have both uPA-dependent and -independent effects, and its different actions can result in both beneficial and adverse consequences. Therefore, this review will elaborate on PAI-1 structure, the dual value of PAI-1 in different digestive system tumors, gene polymorphisms, the uPA-dependent and -independent mechanisms of regulatory networks, and the drugs targeted by PAI-1 to deepen the comprehensive understanding of PAI-1 in digestive system tumors.
Assuntos
Neoplasias do Sistema Digestório , Neoplasias Gastrointestinais , Humanos , Neoplasias do Sistema Digestório/genética , Inflamação , Inibidor 1 de Ativador de Plasminogênio/genética , Inibidor 1 de Ativador de Plasminogênio/metabolismo , Ativador de Plasminogênio Tipo Uroquinase/química , Ativador de Plasminogênio Tipo Uroquinase/genética , Ativador de Plasminogênio Tipo Uroquinase/metabolismoRESUMO
AIM: To examine the association of life-style factors, including second-hand smoke, with dental caries among 3-year-old children in Wuxi, China. METHODS: A multi-stage stratified random cluster sampling method was used, and 283 children were recruited. The prevalence of dental caries was 29.3% (83/283). RESULTS: Univariate analysis indicated that the possible related factors of dental caries included sleep duration, interest in snacks, candy, exposure to second-hand smoke and weight of birth (all P < 0.05). Meanwhile, multivariate logistic regression analysis suggested that children who had used fluoride were less susceptible to dental caries than those who had not used fluoride before (P < 0.05). Moreover, the risk of dental caries in children who were very interested in snacks was greater than those with little interest in snacks (P < 0.05). CONCLUSIONS: Life-style behaviours are crucial factors and should attract enough attention. There might be a potential negative effect of second-hand smoke on the deciduous caries, but it still requires further studies. A co-ordinated effort by health-care providers, policymakers and health institutions has successfully improved children's oral health and the awareness of hygiene knowledge among citizens in Wuxi city.
Assuntos
Cárie Dentária , Poluição por Fumaça de Tabaco , Pré-Escolar , China/epidemiologia , Estudos Transversais , Índice CPO , Cárie Dentária/epidemiologia , Cárie Dentária/etiologia , Humanos , Estilo de Vida , Prevalência , Fatores de Risco , Poluição por Fumaça de Tabaco/efeitos adversosRESUMO
Informed by the Situational Theory of Problem Solving (STOPS), this study used data from the Health Information National Trends Survey, a large and representative national sample, to examine predictors of information seeking and information accessing of health information, including cancer-related information. We found that the independent variables in STOPS-problem recognition, involvement recognition, and referent criterion- well predicted people's information seeking of cancer-related information and accessing of health information on line. However, the impact of trust in online health information was more complicated than anticipated. Our study demonstrated the utility of the STOPS in the health information context. Theoretical and practical implications are discussed.
Assuntos
Informação de Saúde ao Consumidor , Comportamento de Busca de Informação , Neoplasias , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resolução de Problemas , Teoria Psicológica , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To examine the extent to which local health department (LHD) assurance of select services known to promote and protect the health of older adults is associated with more favorable population health indicators among seniors. DESIGN: Data from the California Health Interview Survey (CHIS: 2003, 2005, and 2007) were linked with the 2005 wave of the National Association of County and City Health Officials profile survey and the Area Resource File to assess the association of LHD assurance and senior health indicators. Assurance was measured by an index of 5 services, either directly provided or contracted by LHDs: cancer screening, injury prevention, comprehensive primary care, home health care, and chronic disease prevention. Multilevel regression models estimated the association of LHD assurance of services and each of 6 older adult health indicators, controlling for individual, LHD, and county characteristics that included key social determinants of health, such as poverty. SETTING: Fifty-seven California counties. PARTICIPANTS: 33,154 older adults (age 65 and older). MAIN OUTCOME MEASURES: Colorectal cancer screening, mammography, healthy eating, physical activity, and multiple falls among older adults. RESULTS: Local health departments provided or contracted a median of 2 of the 5 services. In adjusted analyses, LHD assurance of services was generally unassociated with the seniors' health behaviors, screening, and falls. Greater LHD expenditures per capita were associated with significantly better mammography screening rates (adjusted odds ratio [AOR] = 1.22, P < 0.01) compared to jurisdictions in the bottom one-third of per capita LHD spending. Greater county-level poverty (a social determinant of health) was associated with greater junk food consumption (AOR = 1.14, P < 0.01) and worse fruit and vegetable consumption (AOR = 0.97, P < 0.01). Highly impoverished counties were consistently in the bottom quartile of performance across all indicators. CONCLUSIONS: The LHD's assurance of select services known to promote and protect the health of older adults does not appear to translate into higher rates of colorectal cancer screening, mammography, healthy eating, physical activity, and fewer falls among seniors. County-level poverty is most strongly associated with older adult health, underscoring a key barrier to address in local senior health improvement efforts.