摘要
Objective To build the early predictive model for chronic kidney disease(CKD)in hypertension and diabetes patients in the community.Methods The CKD patients were recruited from 4 health care centers in 4 urban areas in Kunming.The control group was residents without hypertension and diabetes(n = 1267).The disease group was residents with hypertension and/or diabetes(n = 566).The questionnaire survey,physical examination,laboratory testing,and 5 SNPs gene types in the PVT1 gene.The risk factors,which were filtered with logistics regression,were used to build predictive models.Four machine learning algorithms were built:support vector machine(SVM),random forest(RF),Na?ve Bayes(NB),and artificial neural network(ANN)models.Results Thirteen indicators included in the final diagnostic model:age,disease type,ethnicity,blood urea nitrogen,creatinine,eGFR from MDRD,ACR,eGFR from EPI2009,PAM13 score,sleep quality survey,staying-up late,PVT1 SNP rs11993333 and rs2720659.The accuracy,specificity,Kappa value,AUC of ROC,and PRC of ANN are greater than those of the other 3 models.The sensitivity of RF is the highest among 4 types of machine learning.Conclusions The ANN predictive model has a good ability of efficiency and classification to predict CKD with hypertension and/or diabetes patients in the community.
摘要
Objective To observe the effect of Dai medicine Yapan on TGF-β1/Smads signaling transduction pathway in unilateral ureteral obstruction (UUO) rats,and to explore its possible mechanism in rat renal interstitial fibrosis inhibitory effect.Methods The UUO rat model was established by conducting the unilateral ureteral obstruction(UUO) in 120 male rats.Normal saline gavage or medication were performed for 28 d and serum was collected for detecting BUN and Scr.Then the rats were killed for taking the renal tissue and conducting HE and Masson staining.The expression of TGF-β1,Smad2 and Smad7 in kidney tissues were detected by using the immunohistochemical method.The mRNA expression was detected by RT-PCR;the protein expression was detected by Western blot.Results Various Yapan doses groups could reduce the level of serum BUN and Scr in experimental rats,alleviated renal tubular interstitial inflammatory cells and renal interstitial fibrosis degree,meanwhile up-regulated the expression of TGF-β1,Smad2 mRNA and protein (P＜0.05),while down-regulated the expression of Smad7 mRNA and protein (P＜ 0.05).Conclusion Different concentrations groups of Dai medician Yapan may inhibit Smad2 mRNA expression in some extent,upregulates Smad7 mRNA expression,inhibits the expression of TGF-β1 in kidney tissues through interfering TGF-β1/Smads signaling transduction pathway,thus obtains a therapeutic effect for inhibiting kidney interstitial fibrosis in UUO rat.