1.Development and validation of a nomogram model for preoperative prediction of hepatocellular carcinoma with microvascular invasion
Kangkang WAN ; Shubo PAN ; Liangping NI ; Qiru XIONG ; Shengxue XIE ; Longsheng WANG ; Tao LIU ; Haonan SUN ; Ju MA ; Huimin WANG ; Zongfan YU
Chinese Journal of Hepatobiliary Surgery 2023;29(8):561-566
Objective:To develop and validate a nomogram model for predicting microvascular invasion (MVI) in hepatocellular carcinoma (HCC) based on preoperative enhanced computed tomography imaging features and clinical data.Methods:The clinical data of 210 patients with HCC undergoing surgery in the Second Affiliated Hospital of Anhui Medical University from May 2018 to May 2022 were retrospectively analyzed, including 172 males and 38 females, aged (59±10) years old. Patients were randomly divided into the training group ( n=147) and validation group ( n=63) by systematic sampling at a ratio of 7∶3. Preoperative enhanced computed tomography imaging features and clinical data of the patients were collected. Logistic regression was conducted to analyze the risk factors for HCC with MVI, and a nomogram model containing the risk factors was established and validated. The diagnostic efficacy of predicting MVI status in patients with HCC was assessed by receiver operating characteristic (ROC) curve, calibration curves, decision curve analysis (DCA), and clinical impact curve (CIC) of the subjects in the training and validation groups. Results:The results of multifactorial analysis showed that alpha fetoprotein ≥400 μg/ml, intra-tumor necrosis, tumor length diameter ≥3 cm, unclear tumor border, and subfoci around the tumor were independent risk factors predicting MVI in HCC. A nomogram model was established based on the above factors, in which the area under the curve (AUC) of ROC were 0.866 (95% CI: 0.807-0.924) and 0.834 (95% CI: 0.729-0.939) in the training and validation groups, respectively. The DCA results showed that the predictive model thresholds when the net return is >0 ranging from 7% to 93% and 12% to 87% in the training and validation groups, respectively. The CIC results showed that the group of patients with predictive MVI by the nomogram model are highly matched with the group of patients with confirmed MVI. Conclusion:The nomogram model based on the imaging features and clinical data could predict the MVI in HCC patients prior to surgery.
2. Influencing factors of health literacy among college students in a university
Miaomiao CHEN ; Xin SHI ; Jiaolong MA ; Haifeng YUE ; Bingyao WANG ; Aimin JIANG ; Haonan JU ; Qiang DENG ; Jiaming LIU
China Occupational Medicine 2020;47(04):451-455
OBJECTIVE: To analyze the status and influencing factors of the health literacy(HL) of college students in a comprehensive university. METHODS: A total of 3 360 students from in a comprehensive university of Xinjiang Production and Construction Corps was selected using multi-stage stratified cluster random sampling method. The HL level of college students was investigated and evaluated with self-edited Xinjiang Construction Corps College Students Health Literacy Questionnaire. RESULTS: The HL level of college students was 17.1%. The HL level of medical students was higher than that of non-medical students(35.4% vs 10.0%, P<0.01). Logistic regression analysis results showed that among the medical students in grade three or four, those with medium and excellent academic achievement, and Han nationality had a positive effect on their HL level(P<0.01). Among the non-medical students, female and medicine related optional courses had a positive effect on their HL level(P<0.05). Students in the sophomore year had a negative effect on their HL level(P<0.05). CONCLUSION: There is a big difference in the level of HL between medical students and non-medical students. Medical college students and non-medical college students have different factors affecting HL, medical education is related to improving HL.