1.Identification of an immune-related risk signature and nomogram predicting the overall survival in patients with endometrial cancer
Yuan CHENG ; Xingchen LI ; Yibo DAI ; Yangyang DONG ; Xiao YANG ; Jianliu WANG
Journal of Gynecologic Oncology 2021;32(3):e30-
Objective:
Aimed to construct an immune-related risk signature and nomogram predicting endometrial cancer (EC) prognosis.
Methods:
An immune-related risk signature in EC was constructed using the least absolute shrinkage and selection operator regression analysis based on The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. A nomogram integrating the immune-related genes and the clinicopathological characteristics was established and validated using the Kaplan-Meier survival curve and receiver operating characteristic (ROC) curve to predict the overall survival (OS) of EC patients. The Estimation of STromal and Immune cells in MAlignant Tumor tissues using Expression data (ESTIMATE) R tool was used to explore the immune and stromal scores.
Results:
CCL17, CTLA4, GPI, HDGF, HFE2, ICOS, IFNG, IL21R, KAL1, NR3C1, S100A2, and S100A9 were used in developing an immune-related risk signature evaluation model. The Kaplan-Meier curve indicated that patients in the low-risk group had better OS (p<0.001).The area under the ROC curve (AUC) values of this model were 0.737, 0.764, and 0.782 for the 3-, 5-, and 7-year OS, respectively. A nomogram integrating the immune-related risk model and clinical features could accurately predict the OS (AUC=0.772, 0.786, and 0.817 at 3-, 5-, and 7-year OS, respectively). The 4 immune cell scores were lower in the high-risk group. Forkhead box P3 (FOXP3) and basic leucine zipper ATF-like transcription factor (BATF) showed a potential significant role in the immune-related risk signature.
Conclusion
Twelve immune-related genes signature and nomogram for assessing the OS of patients with EC had a good practical value.
2.Development and validation of a prognostic model based on metabolic risk score to predict overall survival of endometrial cancer in Chinese patients
Xingchen LI ; Xiao YANG ; Yuan CHENG ; Yangyang DONG ; Jingyuan WANG ; Jianliu WANG
Journal of Gynecologic Oncology 2023;34(6):e69-
Objective:
Metabolic syndrome (MetS) is closely related to the increased risk and poor prognosis of endometrial cancer (EC). The purpose of this study was to analyze the relationship between metabolic risk score (MRS) and EC, and establish a predictive model to predict the prognosis of EC.
Methods:
A retrospective study was designed of 834 patients admitted between January 2004 to December 2019. Univariate and multivariate Cox analysis were performed to screen independent prognostic factors for overall survival (OS). A predictive nomogram is built based on independent risk factors for OS. Consistency index (C-index), calibration plots and receiver operating characteristic curve were used to evaluate the predictive accuracy of the nomogram.
Results:
The patients were randomly divided into training cohort (n=556) and validation cohort (n=278). The MRS of EC patients, ranging from −8 to 15, was calculated. Univariate and multivariate Cox analysis indicated that age, MRS, FIGO stage, and tumor grade were independent risk factors for OS (p<0.05). The Kaplan–Meier analysis demonstrated that EC patients with low score showed a better prognosis in OS. Then, a nomogram was established and validated based on the above four variables. The C-index of nomogram were 0.819 and 0.829 in the training and validation cohorts, respectively. Patients with high-risk score had a worse OS according to the nomogram.
Conclusion
We constructed and validated a prognostic model based on MRS and clinical prognostic factors to predict the OS of EC patients accurately, which may help clinicians personalize prognostic assessments and effective clinical decisions.
3.Application of control charts in hospital data quality management
Qin LUO ; Mingju WANG ; Xingchen MING ; Jin ZHANG ; Ping FU ; Qiong DENG ; Xiao YANG
Chinese Journal of Hospital Administration 2022;38(10):790-796
Objective:To study the feasibility of control charts in the quality management of hospital statistical data as a reference for improving such management.Methods:Main business indicators of the main campus and some business indicators of the affiliated campus of a tertiary general hospital from January to May 2022 were selected. K-S test and chi-square goodness of fit test were used to test data in its statistical daily report, analyzing whether the data conform to the specific distributions. Then appropriat control chart were used according to the data type and distribution type. Minitab 21.1 software was used to draw the hospital data quality control chart, and data quality was monitored by analyzing the distribution of data points in the control chart.Results:The test found that the number of admissions, ultrasound examinations and emergency department visits in the main campus, and CT examinations in the affiliated campus, conformed to normal distribution, and single value control charts were applied. The number of ambulance trips in the main campus and the affiliated campus conform to Poisson distribution, and the defect number control chart was applied. The number of inpatient deaths in the main campus conform to a geometric distribution, and a rare event control chart was applied. The volume of admissions and ultrasound examinations in the main campus were mostly influenced by other factors, and the single-value selective control chart was used to further determine the cause of abnormal data distribution. The results of the control chart analysis showed that, there were no abnormal points in the data distribution of admissions, color ultrasound volume and in-hospital deaths in the main campus, two abnormal points in the CT examination volume in the affiliated campus. The control charts for the number of emergency department visits in the main campus and the number of ambulance trips in the main and affiliated campuses each had one outlier. It was verified that one anomaly in the volume of CT examinations in the affiliated campus and one anomaly in the number of ambulance trips in the affiliated campus were caused by data errors, while the other data were correct.Conclusions:It is feasible to use control charts to monitor the quality of hospital data, which can be used as a quality management tool to assist the quality management of hospital data.
4.Serum prealbumin predicts prognosis of hepatectomy in patients with hepatocellular carcinoma
Minjun LI ; Yuxian TENG ; Qing LI ; Xingchen XIAO ; Rongrui HUO ; Liang MA ; Bangde XIANG ; Lequn LI ; Jianhong ZHONG
Chinese Journal of Hepatobiliary Surgery 2020;26(1):27-31
Objective To study the correlation between serum prealbumin level before liver resection and prognosis of patients with primary hepatocellular carcinoma (HCC).Methods The clinical data of patients with HCC who underwent liver resection at the Affiliated Tumor Hospital of Guangxi Medical University from August 2007 to October 2016 were retrospectively analyzed.The previous albumin of 200 mg/L and the pre-albumin as predicted by the maximum selection rank statistic method were used as the bounding group,and reduced groups and the correlation between pre-operative serum pre-albumin levels and clinicopathological characteristics were analyzed.The Kaplan-Meier method was used to calculate the overall survival rate of patients with the different cutoff levels.The Cox proportional regression model was used to analyze,and cirrhosis,alpha-fetoprotein levels and Barcelona Clinic Liver Cancer staging were used to adjust the relationship between serum prealbumin and prognosis of liver resection for HCC patients.Analysis of stratified variables was performed and their interactions with serum prealbumin were analyzed.Results Of the 2 022 patients included in this study,there were 1 739 males and 283 females.Their age was 49.5 ± 11.2 years.The median follow-up was 37.4 months.The optimal cutoff value of prealbumin predicted by the maximum selection rank statistic method was 166 mg/L.Regardless of the cutoff values of previous albumin 200 mg/L or prealbumin 166 mg/L,multivariate analysis showed that preoperative serum prealbumin level was an independent prognostic risk factor for patients (P <0.05).The prognosis of patients with >200 mg/L (> 166 mg/L) serum prealbumin before surgery was significantly better than that of patients with ≤200 mg/L (≤166 mg/L) prealbumin,the differences were significant (all P < 0.05).After adjusting for confounding factors,the prealbumin level correlated with prognosis of patients with HCC [cutoff value 200 mg/L:HR (95% CI) was 1.59 (1.35-1.86),cutoff value 166 mg/L:HR (95% CI) was 1.69 (1.44-1.98),all P < 0.05].The results of stratified analysis showed that the relationship between prealbumin levels and the prognosis of HCC patients became more robust.Conclusions Preoperative serum prealbumin was an independent risk factor for prognosis of HCC patients,and it had predictive value on prognosis of HCC patients.
5.Analysis of the real situation of medication in the population with gout achieving T2T indicators: a multicentre real-world study
Weiqin GAO ; Xuezhong GONG ; Yuanyuan ZHANG ; Xingchen DU ; Ping JIANG ; Fengyuan GUAN ; Ying LU ; Xiao SU ; Hongze JIANG ; Hongbin LI ; Yongfei FANG ; Hengli ZHAO ; Jiangyun PENG ; Mingli GAO ; Li SU ; Fang HE ; Qingwen TAO ; Chunrong HU ; Peng LI ; Zeguang LI ; Yuelan ZHU ; Ying GU ; Ming ZHANG ; Rongsheng WANG ; Ting JIANG ; Xiaolin YANG ; Qi ZHU ; Quan JIANG ; Jianyong ZHANG ; Xiaolei FAN ; Yu XUE ; Dongyi HE
Chinese Journal of Rheumatology 2023;27(6):361-367
Objective:To explore the therapeutic characteristics of population with gout achieving treat-to-target (T2T) indicators through real-world research and evaluate their safety.Methods:A total of 3 287 patients diagnosed with gout by rheumatologists in 21 first-class tertiary hospitals in 10 provinces, municipalities, and autonomous regions in China from January 2015 to December 2021 were included in this polycentric cross-sectional study. The database included patients′ general information, disease characteristics, and clinical application of traditional Chinese and Western medicine treatment measures. SPSS and Excel software were used for data analysis. Frequency analysis, cluster analysis, and factor analysis were used to summarize the characteristics and rules of treatment measures for patients with gout who achieved the target after treatment. The occurrence of adverse events (AE) was recorded during treatment.Results:After treatment, 691 visits (7%) achieved the serum urate (SUA) target, and the most frequent use of urate-lowering therapy (ULT) was febuxostat, followed by benzbromarone. The most common treatment options were following: GroupⅠ: traditional Chinese medicine (TCM) decoction-TCM external treatment-physical exercise-proprietary Chinese medicine; GroupⅡ: ferulic acid-nonsteroidal anti-inflammatory drugs (NSAIDs); Group Ⅲ: allopurinol-sodium bicarbonate-benzbromarone; Group Ⅳ: glucocorticoid-colchicine; Group Ⅴ: febuxostat. A total of 5 898 visits (60%) chieved manifestations of joint pain VAS scores target, and the most frequently used drug to control joint symptoms was NSAIDs. The frequency of use of drugs to control joint symptoms were 2 118 times (usage rate reached 35.9%), while the frequency of ULT were 2 504 times (usage rate reached 42.5%), which was higher than the joint symptom control drug. The most common treatment options were following: Group Ⅰ: proprietary Chinese medicine-TCM decoction-TCM external treatment-physical exercise; Group Ⅱ: NSAIDs-colchicine hormones; Group Ⅲ: allopurinol, Group Ⅳ: benzbromarone; Group Ⅴ: febuxostat. A total of 59 adverse events occurred during treatment.Conclusion:The proportions of gout patients who reach target serum urate level & good control of joint symptoms are both very low, and ULT and anti-inflammatory prescription patterns are very different from international guidelines, so it is necessary to strengthen the standardized management of gout patients. At the same time, life intervention measures account for a certain proportion of the treatment plans for the T2T population, and further exploration is needed.
6.Investigation and suggestions on the smoothness of reporting channels for adverse drug reaction of pharmaceutical manufacturers in China based on the public perspective
Xiao LIN ; Hongyan WU ; Long WANG ; Yan HUANG ; Xingmin HAO ; Xingchen LI ; Jiangxia YU ; Liudan TIAN ; Yi RONG
China Pharmacy 2022;33(6):653-660
OBJECTIVE To provide the suggestions for improving t he enthusiasm of the public to report adverse drug reactions (ADRs),promoting pharmaceutical manufacturers to improve the smoothness of ADR reporting channels by the public and the enthusiasm of assuming the main responsibility for drug safety ,and to provide reference for the performance of drug safety supervision by regulatory departments in China. METHODS Taking 180 pharmaceutical manufacturers that had entered the top 1 000 in the world as the objects ,the questionnaire was prepared to investigate the smoothness of ADR reporting channels through 4 channels:contact number ,e-mail,official website and new media (including Wechat and microblog ) of enterprise . The questionnaire involved the establishment of public reporting channels ,the records and the feedback of enterprises. The existing problems were analyzed and suggestions were put forward. RESULTS & CONCLUSIONS More than 70% of pharmaceutical manufacturers in China had established the channels for reporting ADR by the public ,which were mainly regular channels such as contact numbers and e-mail ,and each channel had the phenomenon that ADR information couldn ’t be reported. More than 60% of the public channels established by manufactures lacked inquiry and supplement for the miss ing part of th e reported information ; only 24 pharmaceutical manufacturers provided feedback on ADR information ,and the feedback contents were monotonous. gywf2021-11It is suggested that pharmaceutical manufacturers should pay more attention to ADR monitoring among the public ,consider increasing multiple reporting channels while ensuring the smoothness of channels ,strengthen the training of employee ’s information collection ability to improve the quality of information ,timely feed back the ADR information reported by the public , and increase the feedback content concerned by the public.