背景:在许多观察性研究中表明,血浆凝血因子与慢性肾脏病密切相关。尽管如此,血浆凝血因子与慢性肾脏病之间的因果关系仍尚未完全揭示清楚。目的:采用双样本孟德尔随机化方法评估和探讨血浆凝血因子与慢性肾脏病风险之间的关联。方法:从...背景:在许多观察性研究中表明,血浆凝血因子与慢性肾脏病密切相关。尽管如此,血浆凝血因子与慢性肾脏病之间的因果关系仍尚未完全揭示清楚。目的:采用双样本孟德尔随机化方法评估和探讨血浆凝血因子与慢性肾脏病风险之间的关联。方法:从GWAS Catalog数据库中获取不同ID号的39种血浆凝血因子的全基因组关联研究数据,从开放全基因组关联研究数据库(IEU Open GWAS)中获取慢性肾脏病全基因组关联分析数据(ebi-a-GCST003374),其中慢性肾脏病数据集的样本量为117165例,单核苷酸多态性位点数量为2179497个。使用逆方差加权法、MR-Egger回归法、加权中位数法、加权模式法和简单模式法来探讨因果关系;同时,使用CochranQ检验来评估单核苷酸多态性位点的差异性。通过孟德尔随机化-Egger截距测试来验证单核苷酸多态性位点的水平多效性。利用“留一法”进行敏感性分析,以确定孟德尔随机化结果是否会受到单一单核苷酸多态性位点的干扰。结果与结论:(1)通过对39种血浆凝血因子和慢性肾脏病的孟德尔随机化分析,总共发现4种血浆凝血因子与慢性肾脏病相关。血浆凝血因子(FⅤ)水平(OR=0.922,95%CI:0.875-0.971,P=0.002)、血浆FⅦ水平(OR=0.719,95%CI:0.521-0.991,P=0.044)、血浆FⅩa水平(OR=1.113,95%CI:1.009-1.227,P=0.032)、血浆抗凝血Ⅲ水平(OR=0.849,95%CI:0.739-0.975,P=0.020)与慢性肾脏病之间均有显著性意义,P均<0.05;未检测到水平多效性和异质性。(2)基于遗传流行病学方法中双样本孟德尔随机化分析,凝血因子中血浆FⅦ水平、血浆抗凝血酶Ⅲ水平、血浆FⅤ水平是慢性肾脏病发生风险的保护因素,凝血因子中血浆FⅩa水平是慢性肾脏病发生风险的危险因素。(3)上述结果证实,血浆凝血因子与慢性肾脏病之间存在显著的潜在因果关系,虽然文章的数据分析研究的是国际数据库的欧洲人群,但这些数据分析对中国慢性肾脏病与凝血因子的研究有参考价值,对慢性肾脏病的遗传流行病学研究提供了创新的见解,也可为中国相关数据库的深入研究提供一定的参考价值,包括中国健康与养老追踪调查数据库等;未来研究可以重点关注相关凝血因子对慢性肾脏病患者体内低凝或高凝状态的评估。展开更多
本文测量了25例(♂9,♀16)成年太行山猕猴下颌骨的17项变量。通过运用SPSS for win-dows 10.0的单因子方差分析显示,有3项变量达到了显著差异水平。运用多变量判别分析方法对有关变量建立性别判别函数式,结果显示:采用全部进入法和逐步...本文测量了25例(♂9,♀16)成年太行山猕猴下颌骨的17项变量。通过运用SPSS for win-dows 10.0的单因子方差分析显示,有3项变量达到了显著差异水平。运用多变量判别分析方法对有关变量建立性别判别函数式,结果显示:采用全部进入法和逐步判别法,判别率分别为100.0%和88.0％。展开更多
Objective: To identify the prognostic factors of bullous pemphigoid (BP). Design: Prospective study of patients with BP included in a randomized, controlled trial. Setting: Twenty dermatology departments in France. Pa...Objective: To identify the prognostic factors of bullous pemphigoid (BP). Design: Prospective study of patients with BP included in a randomized, controlled trial. Setting: Twenty dermatology departments in France. Patients: One hundred seventy patients with BP initially treated with a 40-g/d dosage of clobetasol propionate cream (testing sample) and 171 patients initially treated with oral corticosteroids at a dosage of 0.5 or of 1.0 mg/kg per day, depending on the extent of BP (validation samples). Main Outcome Measures: The end point was overall survival during the first year after BP diagnosis. From the testing sample, associations of clinical and biological variables with overall survival were assessed using univariate and multivariate analyses. Selected predictors were included in a prognostic model. To verify that these predictors were not dependent on the treatment used, the model was then validated independently on the 2 series of BP patients treated with oral corticosteroids. Results: Median age of the BP patients included in the testing sample was 83 years. The 1-year Kaplan-Mei er survival rate was 74%. From univariate analysis, the main deleterious predictorswere demographic factors (ie, older age and female sex), associated medical conditions (ie, cardiac insufficiency, history of stroke, and dementia), and low Karnofsky score, which is a measure of the patient’s general condition. No factors directly related to BP, in particular extent of cutaneous lesions, were shown to be related to the patients’ prognosis. From multivariate analysis, only older age (P=.02) and low Karnofsky score (P<.001) appeared independently predictive of death. From the Cox model including these 2 predictors, the predicted 1-year survival rates were 90%(95%confidence interval [CI], 85%-96%) for patients 83 years or younger with Karnofsky score greater than 40, 79%(95%CI, 69%-90%) for patients older than 83 years with Karnofsky score greater than 40, 65%(95%CI, 50%-86%) for patients 83 years or younger with Karnofsky score of 40 or less, and 38%(95%CI, 26%-57%) for patients older than 83 years with Karnofsky score of 40 or less. Kaplan-Meier survival distributions of patients from the validation samples appeared clearly separated according to these 4 categories and were in close agreement with corresponding predicted 1-year survival rates obtained from the testing sample. Conclusions: The prognosis of patients with BP is influenced by age and Karnofsky score. These predictors are easy to use and should facilitate the management of BP. m anagem entofBP.展开更多
Cutaneous melanoma is rare among Chinese people. The clinicopathologic features and prognostic factors of 63 Hong Kong ethnic Chinese cases were analysed. We found that the mean age of onset was 65.5 years with a fema...Cutaneous melanoma is rare among Chinese people. The clinicopathologic features and prognostic factors of 63 Hong Kong ethnic Chinese cases were analysed. We found that the mean age of onset was 65.5 years with a female: male ratio of 1 ∶ 1.33. Forty- two (66.7% ) patients had their tumours on their feet. More than 50% had the acral lentiginous histologic subtype. The mean tumour thickness was 5.73 mm with 92.1% (n=58) having a Clark’ s level of III or more. Of the tumours, 57.1% were ulcerated. Stage I and II tumours comprised 73% (n=46) while stage III and IV tumours made up of 26% (n=17). The 1- , 3- and 5- year survival rates were 75% , 30% and 17% , respectively. Univariate analysis for overall survival showed that advanced clinical staging (stage III and IV), tumour ulceration and thicker tumour ( > 4 mm) had a significantly poorer prognosis. Multivariate analysis demonstrated that advanced clinical staging was the most decisive prognostic factor followed by tumour ulceration. Our study showed that cutaneous melanoma in Chinese people is a disease predominantly of an older age group with the acral lentiginous histologic type located mainly on the feet. The prognosis depends on clinical staging and ulceration status.展开更多
文摘背景:在许多观察性研究中表明,血浆凝血因子与慢性肾脏病密切相关。尽管如此,血浆凝血因子与慢性肾脏病之间的因果关系仍尚未完全揭示清楚。目的:采用双样本孟德尔随机化方法评估和探讨血浆凝血因子与慢性肾脏病风险之间的关联。方法:从GWAS Catalog数据库中获取不同ID号的39种血浆凝血因子的全基因组关联研究数据,从开放全基因组关联研究数据库(IEU Open GWAS)中获取慢性肾脏病全基因组关联分析数据(ebi-a-GCST003374),其中慢性肾脏病数据集的样本量为117165例,单核苷酸多态性位点数量为2179497个。使用逆方差加权法、MR-Egger回归法、加权中位数法、加权模式法和简单模式法来探讨因果关系;同时,使用CochranQ检验来评估单核苷酸多态性位点的差异性。通过孟德尔随机化-Egger截距测试来验证单核苷酸多态性位点的水平多效性。利用“留一法”进行敏感性分析,以确定孟德尔随机化结果是否会受到单一单核苷酸多态性位点的干扰。结果与结论:(1)通过对39种血浆凝血因子和慢性肾脏病的孟德尔随机化分析,总共发现4种血浆凝血因子与慢性肾脏病相关。血浆凝血因子(FⅤ)水平(OR=0.922,95%CI:0.875-0.971,P=0.002)、血浆FⅦ水平(OR=0.719,95%CI:0.521-0.991,P=0.044)、血浆FⅩa水平(OR=1.113,95%CI:1.009-1.227,P=0.032)、血浆抗凝血Ⅲ水平(OR=0.849,95%CI:0.739-0.975,P=0.020)与慢性肾脏病之间均有显著性意义,P均<0.05;未检测到水平多效性和异质性。(2)基于遗传流行病学方法中双样本孟德尔随机化分析,凝血因子中血浆FⅦ水平、血浆抗凝血酶Ⅲ水平、血浆FⅤ水平是慢性肾脏病发生风险的保护因素,凝血因子中血浆FⅩa水平是慢性肾脏病发生风险的危险因素。(3)上述结果证实,血浆凝血因子与慢性肾脏病之间存在显著的潜在因果关系,虽然文章的数据分析研究的是国际数据库的欧洲人群,但这些数据分析对中国慢性肾脏病与凝血因子的研究有参考价值,对慢性肾脏病的遗传流行病学研究提供了创新的见解,也可为中国相关数据库的深入研究提供一定的参考价值,包括中国健康与养老追踪调查数据库等;未来研究可以重点关注相关凝血因子对慢性肾脏病患者体内低凝或高凝状态的评估。
文摘本文测量了25例(♂9,♀16)成年太行山猕猴下颌骨的17项变量。通过运用SPSS for win-dows 10.0的单因子方差分析显示,有3项变量达到了显著差异水平。运用多变量判别分析方法对有关变量建立性别判别函数式,结果显示:采用全部进入法和逐步判别法,判别率分别为100.0%和88.0％。
文摘Objective: To identify the prognostic factors of bullous pemphigoid (BP). Design: Prospective study of patients with BP included in a randomized, controlled trial. Setting: Twenty dermatology departments in France. Patients: One hundred seventy patients with BP initially treated with a 40-g/d dosage of clobetasol propionate cream (testing sample) and 171 patients initially treated with oral corticosteroids at a dosage of 0.5 or of 1.0 mg/kg per day, depending on the extent of BP (validation samples). Main Outcome Measures: The end point was overall survival during the first year after BP diagnosis. From the testing sample, associations of clinical and biological variables with overall survival were assessed using univariate and multivariate analyses. Selected predictors were included in a prognostic model. To verify that these predictors were not dependent on the treatment used, the model was then validated independently on the 2 series of BP patients treated with oral corticosteroids. Results: Median age of the BP patients included in the testing sample was 83 years. The 1-year Kaplan-Mei er survival rate was 74%. From univariate analysis, the main deleterious predictorswere demographic factors (ie, older age and female sex), associated medical conditions (ie, cardiac insufficiency, history of stroke, and dementia), and low Karnofsky score, which is a measure of the patient’s general condition. No factors directly related to BP, in particular extent of cutaneous lesions, were shown to be related to the patients’ prognosis. From multivariate analysis, only older age (P=.02) and low Karnofsky score (P<.001) appeared independently predictive of death. From the Cox model including these 2 predictors, the predicted 1-year survival rates were 90%(95%confidence interval [CI], 85%-96%) for patients 83 years or younger with Karnofsky score greater than 40, 79%(95%CI, 69%-90%) for patients older than 83 years with Karnofsky score greater than 40, 65%(95%CI, 50%-86%) for patients 83 years or younger with Karnofsky score of 40 or less, and 38%(95%CI, 26%-57%) for patients older than 83 years with Karnofsky score of 40 or less. Kaplan-Meier survival distributions of patients from the validation samples appeared clearly separated according to these 4 categories and were in close agreement with corresponding predicted 1-year survival rates obtained from the testing sample. Conclusions: The prognosis of patients with BP is influenced by age and Karnofsky score. These predictors are easy to use and should facilitate the management of BP. m anagem entofBP.
文摘Cutaneous melanoma is rare among Chinese people. The clinicopathologic features and prognostic factors of 63 Hong Kong ethnic Chinese cases were analysed. We found that the mean age of onset was 65.5 years with a female: male ratio of 1 ∶ 1.33. Forty- two (66.7% ) patients had their tumours on their feet. More than 50% had the acral lentiginous histologic subtype. The mean tumour thickness was 5.73 mm with 92.1% (n=58) having a Clark’ s level of III or more. Of the tumours, 57.1% were ulcerated. Stage I and II tumours comprised 73% (n=46) while stage III and IV tumours made up of 26% (n=17). The 1- , 3- and 5- year survival rates were 75% , 30% and 17% , respectively. Univariate analysis for overall survival showed that advanced clinical staging (stage III and IV), tumour ulceration and thicker tumour ( > 4 mm) had a significantly poorer prognosis. Multivariate analysis demonstrated that advanced clinical staging was the most decisive prognostic factor followed by tumour ulceration. Our study showed that cutaneous melanoma in Chinese people is a disease predominantly of an older age group with the acral lentiginous histologic type located mainly on the feet. The prognosis depends on clinical staging and ulceration status.
