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Objective To evaluate predictive factors affecting the short-term efficacy of PD-1 inhibitors in non-small cell lung cancer (NSCLC) and to construct a prediction model. Methods From October 2019 to November 2021, 221 patients with advanced NSCLC who met the inclusion criteria and were treated with PD-1 inhibitors were prospectively enrolled. Patients who were enrolled before May 1st, 2021 were included inthe modeling group (n=149), whereas those who enrolled thereafter were included in the validation group (n=72). The general clinical data of patients, information of the four TCM diagnoses were collected, and TCM syndrome elements were identified. R software version 4.0.4 was used in constructing a nomogram clinical prediction model of objective response rate. The predictive ability and discrimination of the model were evaluated and externally validated by using a validation group. Results After two to four cycles of PD-1 inhibitor therapy in 221 patients, the overall objective response rate was 44.80%. Multivariate logistic regression analysis of the modeling group showed that the TPS score (OR=0.261, P=0.001), number of treatment lines (OR=3.749, P=0.002), treatment mode (OR=2.796, P=0.019), qi deficiency disease syndrome elements (OR=2.296, P=0.043), and syndrome elements of yin deficiency disease (OR=3.228, P=0.005) were the independent predictors of the short-term efficacy of PD-1 inhibitors. Based on the above five independent predictors, a nomogram prediction model for the short-term efficacy of PD-1 inhibitors was constructed. The AUC values of the modeling and validation groups were 0.8317 and 0.7535, respectively. The calibration curves of the two groups showed good agreement between the predicted and true values. The mean absolute errors were 0.053 and 0.039, indicating that the model has good predictive performance. Conclusion The nomogram model constructed on the basis of the syndrome elements of Qi-deficiency disease and Yin-deficiency syndrome of TCM, as well as TPS score, number of treatment lines and treatment mode, is a stable and effective tool for predicting the short-term efficacy of PD-1 inhibitors in advanced non-small cell lung cancer.
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Objective To construct a nomogram prediction model for the treatment effect of anlotinib with the participation of traditional Chinese medicine syndrome elements on the patients with extensive-stage small cell lung cancer (ES-SCLC) who previously received multiple lines of chemotherapy. Methods The clinical data of 127 patients with ES-SCLC who received at least two cycles of anlotinib treatment were retrospectively studied. Kaplan-Meier method was used to analyze the relationship between each factor and the overall survival time. Cox regression analysis was applied to screen the independent influencing factors of the prognosis of patients with ES-SCLC. R language was employed to build a nomogram prediction model, C-index was used to evaluate the model, and calibration curve was adopted to verify the accuracy of the model. Results Age, PS score, brain metastases, qi deficiency syndrome, yin deficiency syndrome, and blood stasis syndrome were related risk factors for ES-SCLC treated with anlotinib. PS score, brain metastasis, and blood stasis syndrome were independent prognostic factors. On the basis of these three independent influencing factors, a nomogram model was established to predict the prognosis of patients with ES-SCLC treated with anlotinib. The predicted risk was close to the actual risk, showing a high degree of coincidence. Conclusion The nomogram model established with PS score, blood stasis syndrome elements, and brain metastasis as independent factors can predict the prognosis of patients with ES-SCLC receiving second- and third-line treatment of anlotinib.
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Objective:To explore the relationship between cardiac radiation dose and prognosis of patients with non-small cell lung cancer (NSCLC).Methods:From August 2015 to September 2018, the clinical data and cardiac dose parameters of 180 patients with locally advanced NSCLC who received radiotherapy in Tangshan people′s Hospital of Hebei Province were analyzed retrospectively.The relationship between cardiac dose parameters and overall survival rate was analyzed by K-M analysis, and the prognostic factors of NSCLC patients were identified by multivariate Cox regression.Results:The median survival time of NSCLC patients was 33.4 months.Univariate analysis indicated prescription dose≥56Gy ( HR 1.54, 95% CI1.28-2.86, P=0.011), hypertension ( HR 1.42, 95% CI1.34-1.89, P=0.012), mean cardiac dose≥13.9Gy ( HR 1.12, 95% CI1.05-2.61, P=0.031), V5≥70% ( HR 1.08, 95% CI1.01-2.16, P=0.044), and V30≥40% ( HR 1.16, 95% CI1.04-3.01, P=0.041), V50≥20% ( HR 1.23, 95% CI1.11-2.81, P<0.001), and V60≥5% ( HR 1.03, 95% CI1.00-1.89, P=0.037) were the prognostic factors of NSCLC patients.After multi-factor adjustments, receiving chemotherapy was a favorable factor for the prognosis of NSCLC patients ( HR 0.711, 95% CI0.35-0.89, P=0.005); hypertension was a factor of poor prognosis ( HR 1.641, 95% CI1.56-1.86, P=0.034); V50≥20% in cardiac dose ( HR 1.161, 95% CI1.13-3.82, P=0.002) was a poor prognostic factor in NSCLC patients. Conclusion:The cardiac dose V50 is an independent predictor of prognosis in patients with advanced NSCLC.The increase of cardiac radiation dose may increase the potential risk of death.In clinical practice, the prognosis of patients may be improved by reducing the cardiac radiation dose.
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A wearable wireless health monitoring system for drug addicts in compulsory rehabilitation centers was proposed. The system can continuously monitor multiple physiological parameters of drug addicts in real time, and issue early warning information when abnormal physiological parameters occur, so as to play the role of timely medical practice. In addition, this study proposes a convolutional neural network (CNN)model, which can evaluate the health status of drug addicts based on multiple physiological parameters. Experiments show that the model can be applied to the task of body state recognition in the open physiological parameter data set, and the recognition accuracy can reach up to 100% in a single physiological parameter data set; when the whole physiological data set is used, the recognition accuracy can reach 99.1%. The recognition accuracy exceeds the performance of the traditional pattern recognition method on this task, which verifies the superiority of the model.
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Algoritmos , Electrocardiografía , Monitoreo Fisiológico , Redes Neurales de la Computación , Dispositivos Electrónicos VestiblesRESUMEN
Because the huge number of images of the digestive tract by Wireless Capsule Endoscopy (WCE) are left to the medical personnels detected by their eyes, huge burden leaves to doctors. This article provides a classification of method based on SVM (Support Vector Machine) for the capsule endoscopy bleeding intelligent recognition. We created a new kind of feature parameter, and the experiment result can reach 83% specificity and 94% sensitivity.
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Humanos , Endoscopía Capsular , Tracto Gastrointestinal , Patología , Hemorragia , Diagnóstico , Sensibilidad y Especificidad , Máquina de Vectores de SoporteRESUMEN
Objective To evaluate the role of thoracic three-dimensional conformal radiotherapy (3DCRT) in patients with extensive-stage small cell lung cancer (ES-SCLC).Methods A total of 171 patients with ES-SCLC admitted from 2004 to 2009 were included in the study.Eighty-six patients received thoracic 3DCRT and systemic chemotherapy (CT),while 85 patients received systemic CT alone.3DCRT was delivered at 1.5 Gy/fraction twice daily or 2.0 Gy/fraction once daily,with a total dose ranging from 40 to 62 Gy.The CT regimen consisted of carboplatin/cisplatin and etoposide.The survival time and survival rate were calculated by the Kaplan-Meier method,and the log-rank test was used for univariate prognostic analysis;the Cox model was used for multivariate prognostic analysis.Results The follow-up rate was 100%.The median overall survival (OS) time and the 2-and 5-year OS rates were 15 months,31.5%,and 2.4%,respectively,for all patients;they were 18 months,35.3%,and 2.4%,respectively,for the CT/3DCRT group,versus 12 months,14.5%,and 2.4% for the CT group (P =0.023).The median progression-free survival (PFS) time and the 1-and 2-year PFS rates were 8 months,27.5%,and 2.4%,respectively,for all patients;they were 9 months,35.4%,and 6.0%,respectively,for the CT/3DCRT group,versus 6 months,20.5%,and 6.0% for the CT group (P =0.004).In the CT/3DCRT group,the 22 patients who received 45 Gy at 1.5 Gy/fraction twice daily had a median PFS time of 11 months,versus 9 months for the 26 patients who received 60 Gy at 2.0 Gy/fraction once daily (P =0.037).Multivariate analysis revealed that receiving ≥ 4 cycles of CT (P =0.001) and 3DCRT (P =0.008) were favorable prognostic factors for OS.Conclusions Thoracic 3DCRT can improve the OS and PFS in patients with EDSCLC,and it has good efficacy when delivered with a total dose of 45 Gy at 1.5 Gy/fraction twice daily.Thoracic 3DCRT and receiving ≥4 cycles of CT are independent favorable prognostic factors for OS.
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BACKGROUND: Colonic manometry is a widely used method to assess digestive tract function and is of crucial importanoe in evaluating colonic activity disorder.OBJECTIVE: To analyze the kinematic and kinetic eatures f intestinal tract pressure signal of healthy volunteers and patients with abnormal colonic pressure.DESIGN: Contrast observation experiment.SETTING: People's Hospital of Shanghai Pudong New Area.PARTICIPANTS: Two groups of participants were organized. The patient group consisted of six patients ith abnormal colonic function. They received treatment in the People's Hospital, Shanghai Pudong New Area etween January 2000 and August 2001. These patients were not allowed to take any medicine or foods that ould affect intestinal motility within two weeks prior to the study. The control group consisted of nother 2 healthy volunteers who received health examination homeochronously. Informed consents were btained from all the participants. Gastrointestinal tract functionamonitor manufactured by CTD2SYNETICS ompany (Sweden) was employed.METHODS: Participants were asked to lie down on their left sides for 30 inutes quietly before the manometer entered the ileum with the help of an enteroscope. A water bag was ttached to the end of manometer and was filled with water to increase the end weight. The enteroscope was sed to inhale the intra-intestinal gas while it was pulled out. Afterwards, the water bag was emptied. Easurement began after the participant was asked to lie down for another 30 minutes to deplete the bnormal contraction of intestinal tract caused by enteroscope. Every inspection took about 20 minutes. Ubsequently, the water bag was filled with 50 mL water and the gas bag with 50 mL air to simulate the timulation of faeces. The simulation inspection also lasted about 20 minutes. During the measurement rocess, the precise position was determined by a B-type ultrasonic inspection system. The manometer was hen pulled out 20 cm and the same inspection process was repeated. Fractal dimension of intestinal tract ressure was calculated with the method from Higuchi to distinguish normal and abnormal colonic pressure ignal.MAIN OUTCOME MEASURES: Fractal dimension analysis of intestinal tract pressure signals.RESULTS: xtensive analysis was conducted for pressure signals of two healthy volunteers and six patients. The racta dimensions of intestinal tract pressure data from normal subjects basically kept around a certain alue, while those from patients varied greatly. There was something wrong with colonic contractions of ntestinal tract of the patients, as the associated fractal dimensions, were around "1".CONCLUSION: ractal imension of intestinal tract pressure signals is calculated, and the resultant fractal dimension can be sed as an index to distinguish normal and abnormal colonic pressure signals.
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Objective:To study the interaction between the SARS-S1 protein and the SARS-sensitive cells.Methods:The SARS-S1 expression in the E.coli was purified and the anti-SARS-S1 was produced.After incubate with the SARS-S1 protein,cells was staining by the mouse-anti-SARS-S1 antibody and the anti-mouse antibody labeled by FITC.The result was determined by FACS.Results:After incubate with the SARS-S1 protein,different cell line have a different reaction to the SARS-S1 antibody.Conclusion:The SARS-S1 protein expressed by E.coli has a specific binding ability to the SARS-sensitive cells.