Machine learning models identify predictive features of patient mortality across dementia types.

BACKGROUND: Dementia care is challenging due to the divergent trajectories in disease progression and outcomes. Predictive models are needed to flag patients at risk of near-term mortality and identify factors contributing to mortality risk across different dementia types. METHODS: Here, we developed machine-learning models predicting dementia patient mortality at four different survival thresholds using a dataset of 45,275 unique participants and 163,782 visit records from the U.S. National Alzheimer's Coordinating Center (NACC). We built multi-factorial XGBoost models using a small set of mortality predictors and conducted stratified analyses with dementiatype-specific models. RESULTS: Our models achieved an area under the receiver operating characteristic curve (AUC-ROC) of over 0.82 utilizing nine parsimonious features for all 1-, 3-, 5-, and 10-year thresholds. The trained models mainly consisted of dementia-related predictors such as specific neuropsychological tests and were minimally affected by other age-related causes of death, e.g., stroke and cardiovascular conditions. Notably, stratified analyses revealed shared and distinct predictors of mortality across eight dementia types. Unsupervised clustering of mortality predictors grouped vascular dementia with depression and Lewy body dementia with frontotemporal lobar dementia. CONCLUSIONS: This study demonstrates the feasibility of flagging dementia patients at risk of mortality for personalized clinical management. Parsimonious machine-learning models can be used to predict dementia patient mortality with a limited set of clinical features, and dementiatype-specific models can be applied to heterogeneous dementia patient populations.

Dementia has emerged as a major cause of death in societies with increasingly aging populations. However, predicting the exact timing of death in dementia cases is challenging, due to variations in the gradual process where cognitive decline interferes with the body's normal functions. In our study, we build machine-learning models to predict whether a patient diagnosed with dementia will survive or die within 1, 3, 5, or 10 years. We found that the prediction models can work well across patients from different parts of the US and across patients with different types of dementia. The key predictive factor was the information that is already used to diagnose and stage dementia, such as the results of memory tests. Interestingly, broader risk factors related to other causes of death, such as heart conditions, were less significant for predicting death in dementia patients. The ability of these models to identify dementia patients at a heightened risk of mortality could aid clinical practices, potentially allowing for earlier interventions and tailored treatment strategies to improve patient outcomes.

The effect of low-dose ropivacaine combined with sufentanil on the onset time of anesthesia and postoperative rectal traction reflectance in patients undergoing mixed hemorrhoid surgery / 中国医师杂志

Objective:To investigate the effects of low-dose ropivacaine combined with sufentanil on the onset time of anesthesia and postoperative rectal traction reflectance in patients undergoing mixed hemorrhoid surgery.Methods:A total of 96 patients who underwent mixed hemorrhoid surgery at the General Hospital of the Southern Theater Command of the Chinese People′s Liberation Army from January 2020 to June 2021 were selected. They were randomly divided into a control group and an observation group using a random number table method, with 48 cases in each group. The control group was anesthetized with low-dose ropivacaine; The observation group was anesthetized with low-dose ropivacaine combined with sufentanil. The anesthesia effect, hemodynamic changes, pain score, bleeding score, postoperative rectal traction reflectance, and incidence of adverse reactions were compared between two groups of patients.Results:Compared with the control group, the observation group had a shorter onset time of anesthesia ( P<0.05) and a longer duration of anesthesia maintenance ( P<0.05). Before surgery, there was no statistically significant difference in heart rate and mean arterial pressure between the two groups of mixed hemorrhoid patients (all P>0.05); After surgery, both groups of patients had an increase in heart rate, a decrease in mean arterial pressure, and a more significant change in the control group (all P<0.05). Before surgery, there was no statistically significant difference in Visual Analogue Scale (VAS) scores and bleeding scores between the two groups of mixed hemorrhoid surgery patients (all P>0.05); After 1 day of surgery, the VAS score and bleeding score of both groups of patients were significantly reduced (all P<0.05), and the observation group showed a more significant decrease (all P<0.05). The postoperative recovery rate of anal contraction in the observation group was higher than that in the control group ( P<0.05), and the rectal traction reflectance was lower than that in the control group ( P<0.05). The total incidence of adverse reactions in the observation group was significantly lower than that in the control group (χ 2=4.667, P<0.05). Conclusions:The combination of low-dose ropivacaine and sufentanil has a definite anesthetic effect on patients undergoing mixed hemorrhoid surgery. It can improve the onset time of anesthesia and postoperative rectal traction reflectivity, alleviate patient pain, and has high safety.

Application of case-based reverse teaching model based on micro-classes in Neurology teaching / 沈阳医学院学报

Objective:To investigate the advantages of case-based reverse teaching model based on micro-classes in Neurology teaching.Method:A total of 60 undergraduates of grade 2017 majoring in psychiatry from Bengbu Medical University were selected and divided into the control group and the experimental group according to random number table method,with 30 students in each group.The control group received the traditional teaching model to study Neurology.The experimental group received the case-based reverse teaching model based on micro-classes.At the end of the course,Neurology professional knowledge and case analysis ability were evaluated,and students'satisfaction with the teaching mode were compared by questionnaire scores.Results:The scores of Neurology professional knowledge and case analysis ability and the total score in the experimental group were higher than those in the control group(P＜0.05).The satisfaction score in the experimental group was also higher than that in the control group(P＜0.05).Conclusion:The case-based reverse teaching mode based on micro-classes in Neurology teaching can promote students'professional knowledge learning and mastering,and improve teaching satisfaction,which is worthy of promotion.

Predictive Models and Features of Patient Mortality across Dementia Types.

Dementia care is challenging due to the divergent trajectories in disease progression and outcomes. Predictive models are needed to identify patients at risk of near-term mortality. Here, we developed machine learning models predicting survival using a dataset of 45,275 unique participants and 163,782 visit records from the U.S. National Alzheimer's Coordinating Center (NACC). Our models achieved an AUC-ROC of over 0.82 utilizing nine parsimonious features for all one-, three-, five-, and ten-year thresholds. The trained models mainly consisted of dementia-related predictors such as specific neuropsychological tests and were minimally affected by other age-related causes of death, e.g., stroke and cardiovascular conditions. Notably, stratified analyses revealed shared and distinct predictors of mortality across eight dementia types. Unsupervised clustering of mortality predictors grouped vascular dementia with depression and Lewy body dementia with frontotemporal lobar dementia. This study demonstrates the feasibility of flagging dementia patients at risk of mortality for personalized clinical management.

Effect analysis of thoracic paravertebral nerve block combined with propofol intravenous anesthesia in radical treatment of lung cancer / 中国医师杂志

Objective:To investigate the effects of thoracic paravertebral nerve block combined with propofol intravenous anesthesia (PPA) on hemodynamic parameters, inflammatory stress indexes, postoperative analgesia and immune indexes in patients with lung cancer undergoing radical surgery.Methods:116 patients with lung cancer admitted to the Southern Theater General Hospital from January 2020 to December 2021 were randomly divided into observation group and control group, with 58 patients in each group. The observation group received PPA combined with general anesthesia, and the control group received sevoflurane inhalation combined with general anesthesia; the hemodynamic parameters, the amount of anesthetic and analgesic drugs used during and after the operation, the pain score of the patients after the operation, the serum interleukin-6 (IL-6), interleukin-10 (IL-10), cortisol (Cor), norepinephrine (NE), vascular cell growth factor-C (VEGF-C), transforming growth factor-β 1(TGF-β1) and T lymphocytes before and after the operation, adverse reactions of the two groups were monitored and compared.Results:The intraoperative dosage of remifentanil and postoperative dosage of sufentanil in the observation group were lower than those in the control group (all P<0.05). There was no statistically significant difference in cardiac output (CO), systemic vascular resistance index (SVRI) and extravascular lung water index (EVLWI) between the observation group and the control group at T 0 to T 3 (all P>0.05); The mean arterial pressure (MAP) at T 1 to T 2 in the observation group was higher than that in the control group, and the MAP at T 3 was lower than that in the control group (all P<0.05). There was no significant difference between observation group and control group in Visual Analogue Scale (VAS) scores at resting state and coughing state 2 h after surgery(all P>0.05). The VAS scores in the observation group at resting state were lower than those in the control group at 4 h and 12 h after surgery (all P<0.05), and the VAS scores in the observation group at coughing state were lower than those in the control group at 4 h, 12 h and 24 h after surgery (all P<0.05). Before surgery, there was no significant difference in serum levels of IL-6, IL-10, Cor, NE, VEGF-C and TGF-β1 between observation group and control group (all P>0.05). The serum levels of IL-6, NE and VEGF-C in observation group were lower than those in control group 24 h after surgery (all P<0.05). Before surgery, there was no significant difference in CD3 +, CD4 + and CD8 + between observation group and control group (all P>0.05). 24 h after operation, the CD3 + in observation group was higher than that in control group ( P<0.05). The incidence of adverse reactions in observation group (10.34%) was lower than that in control group (24.14%, P<0.05). Conclusions:PPA anesthesia for patients undergoing radical resection of lung cancer is conducive to maintaining the stability of hemodynamic parameters, reducing the inflammatory stress response of patients, the impact of surgery on patients′ immune function, and the amount of anesthetic drugs and postoperative analgesics during surgery.

2-Amino-1,3-benzothiazole-6-carboxamide Preferentially Binds the Tandem Mismatch Motif r(UY:GA).

RNA helices are often punctuated with non-Watson-Crick features that may be targeted by chemical compounds, but progress toward identifying such compounds has been slow. We embedded a tandem UU:GA mismatch motif (5'-UG-3':5'-AU-3') within an RNA hairpin stem to identify compounds that bind the motif specifically. The three-dimensional structure of the RNA hairpin and its interaction with a small molecule identified through virtual screening are presented. The G-A mismatch forms a sheared pair upon which the U-U base pair stacks. The hydrogen bond configuration of the U-U pair involves O2 of the U adjacent to the G and O4 of the U adjacent to the A. The G-A and U-U pairs are flanked by A-U and G-C base pairs, respectively, and the stability of the mismatch is greater than when the motif is within the context of other flanking base pairs or when the 5'-3' orientation of the G-A and U-U pairs is swapped. Residual dipolar coupling constants were used to generate an ensemble of structures against which a virtual screen of 64480 small molecules was performed. The tandem mismatch was found to be specific for one compound, 2-amino-1,3-benzothiazole-6-carboxamide, which binds with moderate affinity but extends the motif to include the flanking A-U and G-C base pairs. The finding that the affinity for the UU:GA mismatch is dependent on flanking sequence emphasizes the importance of the motif context and potentially increases the number of small noncanonical features within RNA that can be specifically targeted by small molecules.

Psychological morbidities and fatigue in patients with confirmed COVID-19 during disease outbreak: prevalence and associated biopsychosocial risk factors

ObjectiveThe coronavirus disease 2019 (COVID-19) - a novel and highly infectious pneumonia - has now spread across China and beyond for over four months. However, its psychological impact on patients is unclear. We aim to examine the prevalence and associated risk factors for psychological morbidities and fatigue in patients with confirmed COVID-19 infection. MethodsAmidst the disease outbreak, 41 out of 105 COVID-19 patients in a local designated hospital in China were successfully assessed using a constellation of psychometric questionnaires to determine their psychological morbidities and fatigue. Several potential biopsychosocial risk factors (including pre-existing disabilities, CT severity score of pneumonia, social support, coping strategies) were assessed through multivariable logistic regression analyses to clarify their association with mental health in patients. Results43.9% of 41 patients presented with impaired general mental health, 12.2% had post-traumatic stress disorder (PTSD) symptoms, 26.8% had anxiety and/or depression symptoms, and 53.6% had fatigue. We did not find any association between pneumonia severity and psychological morbidities or fatigue in COVID-19 patients. However, high perceived stigmatization was associated with an increased risk of impaired general mental health and high perceived social support was associated with decreased risk. Besides, negative coping inclination was associated with an increased risk of PTSD symptoms; high perceived social support was associated with a decreased risk of anxiety and/or depression symptoms. ConclusionsPsychological morbidities and chronic fatigue are common among COVID-19 patients. Negative coping inclination and being stigmatized are primary risk factors while perceived social support is the main protective factor.

Clinical observation of 6 severe COVID-19 patients treated with plasma exchange or tocilizumab / 浙江大学学报·医学版

OBJECTIVE@#To observe the clinical effect of plasma exchange and tocilizumab in treatment of patients with severe coronavirus disease 2019 (COVID-19).@*METHODS@#Six patients with severe COVID-19 admitted in First Affiliated Hospital of Bengbu Medical College from January 25 to February 25, 2020. Three patients were treated with plasma exchange and three patients were treated with tocilizumab. The effect on excessive inflammatory reaction of plasma exchange and tocilizumab was observed.@*RESULTS@#The C-reactive protein (CRP) and IL-6 levels were significantly decreased and the lymphocyte and prothrombin time were improved in 3 patients after treatment with plasma exchange; while inflammation level was not significantly decreased, and lymphocyte and prothrombin time did not improve in 3 patients treated with tocilizumab.@*CONCLUSIONS@#For severe COVID-19 patients with strong inflammatory reaction, plasma exchange may be preferred.

Comparison of hidden blood loss between minimally invasive percutaneous locking plate fixation and intramedullary nail fixation in the treatment of tibial shaft fracture / 中国骨伤

OBJECTIVE@#To analyze and compare the hidden blood loss of minimally invasive percutaneous plate osteosynthesis(MIPPO) combined with locking plate fixation and intramedullary nail fixation in the treatment of tibial shaft fracture.@*METHODS@#One hundred and ninety-one cases of tibial shaft fracture treated from January 2017 to January 2019 were analyzed retrospectively. The patients were all treated with closed reduction and divided into two groups:group A (110 cases) and group B (81 cases). In group A, 78 males and 32 females were treated with MIPPO combined with locking plate. The age ranged from 19 to 74 (45.32±11.79) years old. According to AO classification, 42cases were type 42-A, 45 were type 42-B and 23 were type 42-C fractures. Group B was treated with intramedullary nail, including 65 males and 16 females, aged 19 to 84 (45.44± 14.32) years old. According to AO classification, there were 39 cases of type 42-A, 29 cases of type 42-B and 13 cases of type 42-C. The operation time, intraoperative blood loss and hidden blood loss were observed and compared between the two groups.@*RESULTS@#On the first day, the hidden blood loss was (155.27±47.89) ml in group A and (160.43±131.42) ml in group B, the difference was statistically significant (0.05).@*CONCLUSION@#In the treatment of tibial shaft fracture with intramedullary nail, there is obvious hidden blood loss, which is much higher than expected.

Protective effect of TFB on serum induced injury of HUVECs in henoch-schonlein purpura children patients / 中国医师杂志

Objective:To investigate the protective effect and mechanism of total flavonoids of bidens bipinnata L (TFB) on vascular endothelial cell injury in children with henoch-schonlein purpura (HSP).Methods:Human umbilical vein endothelial cells (HUVECs) were cultured in vitro and intervened with normal and HSP children's serum. Then the HUVECs were divided into blank group, normal group, HSP group and TFB group. Levels of interleukin-8 (IL-8) and tumor necrosis factor α (TNF-α) in the supernatant were detected by enzyme-linked immunosorbent assay ( ELISA). The mRNA and protein expression of nuclear factor kappa B (NF-κB) and Fractalkine were detected by reverse polymerase chain reaction (RT-PCR) and Western blot in HUVECs. Results:ELISA results showed that the expression of IL-8 and TNF-α in HSP group were significantly higher than that in normal control group and blank group ( P<0.05), and the level of IL-8 and TNF-α in the TFB group was significantly lower than that in the HSP group ( P<0.05); the results of RT-PCR and Western blot showed that the expression levels of NF-κB, Fractalkine mRNA and protein in HSP group were significantly higher than those in normal group and blank group ( P<0.05). The expression levels of NF-κB, Fractalkine mRNA and protein in the TFB group were significantly lower than those in the HSP group ( P<0.05). Conclusions:TFB can inhibit the expression of NF-κB in children with Henoch-Schonlein purpura, reduce the secretion of IL-8 and TNF-α in HUVECs, and then relieve the occurrence of vascular injury.

Preventing Infection Measures of COVID-19 Patients during Mechanical Ventilation / 中国医疗器械杂志

OBJECTIVE@#To explore the preventing infection measures of new coronavirus disease 2019(COVID-19) patients during mechanical ventilation, and to provide reference for the safe application of mechanical ventilation.@*METHODS@#Retrieved from PubMed, Ovid and other databases, and combined with the application experience of mechanical ventilation were collected to explore the preventing infection measures of COVID-19 patients during mechanical ventilation.@*RESULTS@#This paper put forward the preventing infection measures of external circuit, internal circuit, outer surface, filter and special parts in ventilator. The preventing infection measures of sputum suction and nebulization were summarized.@*CONCLUSIONS@#The preventing infection measures of COVID-19 patients during mechanical ventilation are successfully completed, which can provide suggestions for the application and maintenance of mechanical ventilation.

Intracavitary electrocardiogram guidance for placement of peripherally inserted central catheters in premature infants.

This study evaluated the accuracy of intracavitary electrocardiogram (IC-ECG) guidance for placement of peripherally inserted central catheters (PICCs) in premature infants, relative to chest X-ray.Premature infants (n = 173) underwent placement of a PICC monitored by ECG, and a stable heart rhythm was shown. Changes in the P wave of the ECG reflected the position of the catheter tip, and a characterized P wave indicated the correct position. The P wave results were compared with a chest X-ray.P wave changes were observed in 157 (90.75%) of the premature infants on the ECG. Among them, the catheter tips of 148 (85.55%) and nine (5.20%) patients were in the correct and non-correct position, respectively, which was confirmed by chest X-ray. No characteristic P wave changes were observed in 16 (9.32%) patients on ECG, in which the catheter tips of eight (4.62%) patients each were in the correct and non-correct position, according to the chest X-ray. The accuracy of IC-ECG guidance for placement of the PICC was 90.17%. The PICC tip location results of the IC-ECGs were statistically similar to that of the chest X-rays.IC-ECG guidance is accurate for placement of PICC in premature infants, and provides an economical assessment without radiation.

Acupuncture in the treatment of chronic fatigue syndrome based on "interaction of brain and kidney" in TCM: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effects of acupuncture on the fatigue symptoms of chronic fatigue syndrome, the potential symptoms and cytokines on the base of the theory as "interaction of brain and kidney" and explore its clinical therapeutic effects and the potential mechanism.@*METHODS@#A total of 68 patients were randomized into an observation group and a control group, 34 cases in each one. In the control group, oryzanol and vitamin B1 were prescribed for oral administration and the patients were required to have a proper rest and physical exercise. In the observation group, on the base of the theory as "interaction of brain and kidney", acupuncture was added to Baihui (BL 20), Fengchi (GB 20), Pishu (BL 20), Shenshu (BL 23), Sanyinjiao (SP 6) and Taixi (KI 3). The treatment was given once a day, 5 treatments a week, with 2 days break. The consecutive treatment for 4 weeks was required. Before and after treatment, the score of the fatigue scale-14 (FS-14), the score of the somatic and psychological health report (SPHERE) and the score of the Pittsburgh sleep quality index (PSQI) were observed in the patients of the two groups separately. The enzyme-linked immunosorbent assay (ELISA) was adopted to determine the levels of serum interleukin-6 (IL-6) and interferon-γ (INF-γ) before and after treatment.@*RESULTS@#After treatment, FS-14 scores, SPHERE scores and PSQI scores were all reduced as compared with the scores before treatment in the two groups (<0.05, <0.01). After treatment, the levels of IL-6 and INF-γ in the serum in the observation group were reduced as compared with the levels before treatment (both <0.01). After treatment, the scores of FS-14, SPHERE and PSQI as well as the levels of serum IL-6 and INF-γ in the observation group were all lower than the results in the control group (<0.05, <0.01).@*CONCLUSION@#On the base of the theory as "interaction of brain and kidney", acupuncture therapy relieves the fatigue symptoms and the potential symptoms and improves the sleep quality in the patients of chronic fatigue syndrome. The effect mechanism is probably related to the decrease of the levels of IL-6 and INF-γ in serum.

The Non-Coding RNA Journal Club: Highlights on Recent Papers-6.

We are delighted to share with you our sixth Journal Club and highlight some of the most interesting papers published recently [...].

Imaging features of cerebral small vessel disease in systemic lupus erythematosus patients with impaired renal function and its associated risk factors / 中华放射学杂志

Objective@#To investigate the imaging features of cerebral small vessel disease(SVD) in systemic lupus erythematosus(SLE) patients with impaired renal function and their related risk factors.@*Methods@#Seventy-six SLE patients and forty age- and sex-matched healthy controls were recruited, and SLE patients were divided into the impaired renal function group [estimated glomerular filtration rate (eGFR) <90 ml/(min·1.73 m2)] (n=38) and the normal renal function group [eGFR≥90 ml/(min·1.73 m2)] (n=38) according to their eGFR. All subjects underwent brain MRI, cognitive and psychiatric testing. The SVD scores were measured, total white matter hyperintensity (WMH) and SVD scores were calculated, and the risk factors of SVD scores were analyzed by using ordinal logistic regression.@*Results@#SLE patients in the impaired renal function group showed higher basal ganglia PVS, centrum semiovale perivascular space (PVS), periventricular WMH, deep WMH and total SVD scores compared with normal controls or patients with normal renal function (H=44.568, 31.380, 31.172, 43.419, 24.317, P<0.001) . The ordinal logistic regression analysis showed that C-reactive protein was a risk factor for SVD in patients with SLE(OR=1.323, P<0.01).@*Conclusion@#SLE patients with impaired renal function had a higher SVD burden on MR imaging, particularly PVS in the basal ganglia and deep WMH, which was affected by the C-reactive protein level.

Simultaneous Determination of 5 Constituents in Xiao'er Magan Granule by HPLC-QAMS / 中国药师

Objective:To develop a method of quantitative analysis of multi-components by single marker(QAMS)for the determi-nation of five constituents(ephedrine hydrochloride,amygdalin,liquiritin, baicalin and ammonium glycyrrhizinate)in Xiao'er Magan granule. Methods:Amygdalin was used as the internal reference substance, and the relative correlation factors(RCF) of ephedrine hydrochloride,liquiritin,baicalin and ammonium glycyrrhizinate to amygdalin were calculated and evaluated. The contents of the five constituents were determined by the external standard method(ESM) and QAMS,respectively. The content results determined by the two methods were compared and the feasibility of QAMS method was verified. Results:The RCF between amygdalin and the other con-tents was 1.237,1.318,1.327 and 0.884,respectively. There were no significant differences in the results between QAMS and ESM with the relative errors less than 0.3%. Conclusion:The QAMS method is accurate and feasible for the simultaneous determination of Xiao'er Magan granule.

Diagnostic accuracy of dual-energy CT angiography in patients with intracranial aneurysm: Meta-analysis / 中国医学影像技术

Objective To explore the diagnostic value of dual-energy CTA in detection of intracrania[aneurysms by using Meta-analysis.Methods Taking "Dual energy"," intracranial aneurysms" or "subarachnoid hemorrhage" as key words,related literatures of diagnostic accuracy of intracrania[aneurysms by using dual-energy CTA compared with DSA were extracted from Wanfang database,CNKI,Chinese biomedical database and PubMed from January 2006 to January 2017.The quality of included literatures was assessed.MetaDISC1.4 was used for Meta-analysis to examine the heterogeneity among the studies and to analyze the diagnostic accuracy index.The forest map was drawn.The summary operating characteristic curve was analyzed.Results Fifteen studies without heterogeneity were considered for analysis.The pooled sensitivity,specificity,positive likelihood ratio and negative likelihood ratio was 0.97 (95 ％CI [0.96,0.99]),0.99 (95 ％ CI [0.97,1.00]),21.71 (95％CI [12.10,38.96]) and 0.04 (95％CI [0.03,0.07]),respectively.The value of OR was 703.4 (95％CI [303.96,1 627.74]).The area under the curve of summary ROC was 0.990 8.The maximum value (Q value) of sensitivity and specificity was 0.992 5.Conclusion Dual-energy CTA has high sensitivity and specificity in diagnosis of intracranial aneurysms,therefore can be taken as the first choice for patients with suspected intracranial aneurysms.

Clinical efficacy on anxiety , depression and sleep disorders in middle-aged and elderly patients with chronic subjective tinnitus / 中华老年医学杂志

Objective To evaluate the efficacy of tinnitus retraining therapy (TRT) on anxiety , depression , and symptoms of sleep disorders in patients with chronic subjective tinnitus. Methods Eighty patients with chronic subjective tinnitus visiting The Affiliated Hospital of Hangzhou Normal University from January 2016 to December 2017 were recruited ,and were divided into an observation group and a control group through computer generated random numbers. Patients in the control group were given drug treatment only ,while those in the observation group received TRT in addition to drug treatment. Clinical efficacy was evaluated using Tinnitus Handicap Inventory (THI) , Pittsburgh Sleep Quality Index (PSQI) ,Hamilton Depression Scale (SDS) ,and Hamilton Anxiety Scale (SAS ) for both groups. Results Patients in the observation group were associated with significantly lower scores of THI ,PSQI ,SAS and SDS ,compared with those in the control group 3 months after treatment (each P＜0.05). Furthermore ,the effectiveness rate was markedly higher (82.5% or 33 cases vs. 55.0% or 22 cases ,χ2＝7.040 ,P＜0.01) in the observation group than in the control group 6 months after treatment. Conclusion Tinnitus retraining therapy combined with conventional therapy can help to reduce the severity of tinnitus handicap ,ameliorate negative emotions such as anxiety and depression ,and improve sleep quality in patients with chronic subjective tinnitus.

Effect of age on prognosis of hepatocellular carcinoma patients with diabetes mellitus: A propensity-score matching analysis / 第二军医大学学报

Objective To explore the effect of age on prognosis of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) complicated with diabetes mellitus (DM) after radical resection. Methods The clinical data of 250 patients with HBV-related HCC complicated with DM who received radical resection were collected from the First Affiliated Hospital of Nanchang University and the Eastern Hepatobiliary Surgery Hospital and were retrospectively analyzed. The patients aged 30-80 years old and were divided into the elder group (≥60 years n=58) and the non-elder group (<60 years, n=192). Propensity score matching (PSM) method was used for covariate balance and the overall survival (OS) rates were compared between the two groups. Cox regression was used to analyze the risk factors influencing the prognosis of HCC. Results In the PSM cohort (n=53 in elder group, n=85 in non-elder group), the 1-, 3-, 5-year OS rates were not significantly different between the two groups (P =0. 15). The results of Cox multivariate regression analysis revealed that age was not significantly associated with OS of patients with HBV-related HCC complicated with DM. Conclusion Elder age seems not to decrease the OS of patients with HBV-related HCC complicated with DM after radical resection; elder patients can obtain similar survival as the non-elder ones.

Propensity score-matching method for evaluating the effect of anatomic liver resection and non-anatomic liver resection on prognosis of hepatocellular carcinoma patients / 第二军医大学学报

Objective To compare the prognoses of hepatocellular carcinoma (HCC) patientswho underwent anatomic liver resection (AR) or non-anatomic liver resection (NAR) using propensity score-matching methods. Methods We retrospectively analyzed the clinical data of 124 HCC patients who were treated in the First Affiliated Hospital of Nanchang University between Jan. 2010 and Dec. 2015. The patients included 64 undergoing AR (AR group), and 60 undergoing NAR (NAR group). Propensity score-matching methods were used to assess the overall survival (OS) of the patients in AR and NAR groups whle controlling the potential confounders, and the risk factors of prognosis of HCC patients were analyzed by Cox proportional hazardmodel. Results In the propensity score-matching cohort, the OS of the patients in AR group (n=29) was significantly longer than that in the NAR group (n=45) after propensity score-matching (52 [44. 83-59. 17] months vs 38 [31. 45-44. 55] months, P = 0. 005). The Cox proportional hazards model revealed that AR was associatedwith a superior OS (HR=0. 54, 95%CI 0. 30-0. 96, P =0. 04). Conclusion Propensity score-matching method has shown that AR can better improve the OS in HCC patients after liver resection compared withNAR.