1.Development of Sample Size Formulas for Least Square Regression-Based Consistency Evaluation of Quantitative Indicators
Feilong CHEN ; Miao YU ; Tao XU
Acta Academiae Medicinae Sinicae 2024;46(2):225-231
Objective To develop and verify the sample size formulas for quantitative data consistency e-valuation based on the least square regression method.Methods According to the principle of least square regres-sion-based quantitative consistency evaluation,statistical inference,and formula derivation,we developed the for-mulas for calculating sample size based on regression constant and regression coefficient.Furthermore,the accuracy of the formulas was verified by the data of three examples,and the results were compared with those of the sample size formula established based on the Bland-Altman(BA)method.Results The sample size formulas for regres-sion-based quantitative consistency evaluation were deduced,and the accuracy of the formulas was verified by three examples.In addition,the results obtained with this formula had differences compared with those of the sample size formula established based on the BA method.Furthermore,consistent conclusions could be obtained by regression analysis and BA analysis with the sample size calculated with the regression method.However,with the sample size calculated based on the BA method,the consistency conclusion of regression analysis and BA analysis was some-times not valid.Conclusion A sample size formula for quantitative consistency evaluation based on the regression method was proposed for the first time,which provided methodological support for the research in this field.
2.Trastuzumab Combined with Irinotecan in Patients with HER2-Positive Metastatic Colorectal Cancer: A Phase II Single-Arm Study and Exploratory Biomarker Analysis
Ting XU ; Xicheng WANG ; Ying XIN ; Zhenghang WANG ; Jifang GONG ; Xiaotian ZHANG ; Yanyan LI ; Congcong JI ; Yu SUN ; Feilong ZHAO ; Depei HUANG ; Yuezong BAI ; Jian LI ; Lin SHEN
Cancer Research and Treatment 2023;55(2):626-635
Purpose:
The human epidermal growth factor receptor 2 (HER2) is an established therapeutic target for various kinds of solid tumors. HER2 amplification occurs in approximately 1% to 6% of colorectal cancer. In this study, we aimed to assess the efficacy and safety of trastuzumab in combination with chemotherapy in HER2-positive metastatic colorectal cancer (mCRC).
Materials and Methods:
An open-label, phase II trial (Clinicaltrials.gov: NCT03185988) was designed to evaluate the antitumor activity of trastuzumab and chemotherapy in HER2-positive digestive cancers excluding gastric cancer in 2017. Patients from this trial with HER2-positive, KRAS/BRAF wild-type, unresectable mCRC were analyzed in this manuscript. Eligible patients were treated with trastuzumab (8 mg/kg loading dose and then 6 mg/kg every 3 weeks) and irinotecan (120 mg/m2 days 1 and 8 every 3 weeks). The primary endpoint was the objective response rate.
Results:
Twenty-one HER2-positive mCRC patients were enrolled in this study. Seven patients (33.3%) achieved an objective res-ponse, and 11 patients (52.4%) had stable disease as their best response. The median progression-free survival (PFS) was 4.3 months (95% confidence interval, 2.7 to 5.9). Four of the 21 patients (19.0%) had grade 3 adverse events, including leukopenia, neutropenia, urinary tract infection, and diarrhea. No treatment-related death was reported. Exploratory analyses revealed that high tumor tissue HER2 copy number was associated with better therapeutic response and PFS. Alterations in the mitogen-activated protein kinase pathway, HER2 gene, phosphoinositide 3-kinase/AKT pathway, and cell cycle control genes were potential drivers of trastuzumab resistance in mCRC.
Conclusion
Trastuzumab combined with chemotherapy is a potentially effective and well-tolerated therapeutic regimen in mCRC with a high HER2 copy number.
3.Predictive model of fecal or urinary incontinence among older adults in China
Lin LI ; Feilong CHEN ; Xiaoyan LI ; Yiyuan GAO ; Silin ZHU ; Xiyezi DIAO ; Ning WANG ; Tao XU
Chinese Journal of Geriatrics 2023;42(6):726-732
Objective:To construct and validate a predictive model of fecal/urinary incontinence among older adults in China.Methods:Data was obtained from the Seventh Chinese Longitudinal Healthy Longevity Survey in 2018.In the questionnaire, "Are you able to control your bowel and urine" , was regarded as the main effect indicator.Receiver operating curves(ROC)were used to find the best cut-off values of calf circumference for predicting fecal/urinary incontinence, and univariate Logistic model method was used to explore the potential factors associated with fecal/urinary incontinence among community-living older adults in China.A random sampling method was used to extract 70% of the survey data as the training set, and the remaining 30% of the survey data as the test set.A multivariate Logistic regression analysis was conducted in the training set to build a prediction model that encompassed all predictors, and a nomogram was plotted.Results:Logistic regression analysis showed that age, small calf circumference(male <28.5 cm, female <26.5 cm), inability to walk 1 km continuously, inability to lift 5 kg items, inability to do three consecutive squats, limited daily activities, and a history of urinary system disorders, nervous system disorders, and cerebrovascular disorders were all risk factors for fecal/urinary incontinence for older adults in China.Female, better socioeconomic status, and normal body mass index were protective factors for fecal/urinary incontinence.The Logistic regression model for predicting fecal/urinary incontinence among Chinese older adults was constructed using the above twelve factors.The consistency index(C-index)value of the model was 0.907, indicating that the model had good predictive ability.The area under the ROC curve(AUC)of the overall sample, training set and test set were 0.906(95% CI: 0.896-0.917), 0.907(95 % CI: 0.894-0.921)and 0.910(95% CI: 0.892-0.928), respectively, indicating that the model had high prediction ability and good discrimination. Conclusions:Age, sex, calf circumference, ability to walk 1 km continuously, ability to lift 5 kg items, ability to do three consecutive squats, daily activities, history of urinary system disorders, nervous system disorders and cerebrovascular disorders, socioeconomic status, and body mass index were independent predictors for fecal/urinary incontinence among older adults in China.The nomogram based on the above indicators has a good predictive effect on fecal/urinary incontinence for older adults.
4.Anzhen hospital expert experience on perioperative treatment principles of cardiovascular surgery for patients infected with COVID-19
Haiyang LI ; Ran DONG ; Ming GONG ; Feilong HEI ; Ming JIA ; Yongqiang LAI ; Nan LIU ; Yongmin LIU ; Sheng WANG ; Jiangang WANG ; Qiang WANG ; Bin XU ; Bin YOU ; Dong ZHAO ; Junming ZHU ; Xiaotong HOU ; Hongjia ZHANG ; Lizhong SUN
Chinese Journal of Thoracic and Cardiovascular Surgery 2023;39(7):385-392
The end of the COVID-19 infection peak in 2022 prompts a backlog of cardiovascular surgical patients to gradually return to the hospital, resulting in a surge in cardiovascular surgeries. However, against the backdrop of the COVID-19 pandemic, the clinical practice of cardiovascular surgery faces many problems. Therefore, organized by Beijing Anzhen Hospital, experts in cardiovascular surgery and related fields have formulated hospital expert experience on perioperative treatment principles of cardiovascular surgery for patients infected with COVID-19. This article summarizes the clinical decision-making of patients requiring cardiovascular surgery after COVID-19 infection, and advises on the corresponding recommendations according to the existing evidence-based medical evidence as well as the actual clinical practice experience of relevant experts. The main content of the article includes special requirements for cardiovascular surgical treatment indications in patients with COVID-19 infection, selection of surgical timing, special requirements of preoperative, intraoperative and postoperative management, etc., which aims to provide COVID-19-infected patients with guidance on rational decision-making when receiving cardiovascular surgery.
5.Relationship between depression and lifestyle factors in Chinese adults using multi-level generalized estimation equation model.
Li YUAN ; Feilong CHEN ; Shaomei HAN ; Tao XU
Chinese Medical Journal 2023;136(7):871-873
Adult
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Humans
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Depression
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East Asian People
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Life Style
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Asian People
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China
6.Design and Implementation of the Scientific Data Management Platform of Traditional Chinese Medicine
Feilong XU ; Jia LYU ; Jiarong WU ; Yuping ZENG ; Haoyang FU
Journal of Medical Informatics 2023;44(12):78-82
Purpose/Significance To address the challenge of low willingness to share scientific data among stakeholders in the tradi-tional Chinese medicine(TCM)industry,and to promote standardization,aggregation,sharing,and application of scientific data in the field of TCM.Method/Process By adhering to national standards for scientific data submission and management,integrating technologies such as blockchain and digital watermarking,the study aims to establish atrusted process for the exchange of scientific data in the field of TCM and build a TCM scientific data management platform.Result/Conclusion This platform will provide information technology support for regional TCM scientific data exchange,and effectively improve the efficiency and willingness of scientific data exchange within the region.
7.Clinical features of acquired immunodeficiency syndrome patients complicated with peripulmonary occupational lesions
Feilong XU ; Xizi DENG ; Xiejie CHEN ; Linghua LI ; Yun LAN ; Qingqing LI ; Kaiyin HE
Chinese Journal of Infectious Diseases 2021;39(3):152-156
Objective:To analyze the clinical features of acquired immunodeficiency syndrome (AIDS) patients complicated with peripulmonary occupational lesions.Methods:Fifty-five AIDS patients with peripulmonary occupational lesions treated in Guangzhou Eighth People′s Hospital from January 2012 to January 2019 were included, and the clinical data of patients were retrospectively analyzed. According to the results of lung biopsy, the patients were divided into Mycobacterium infection group, fungal infection group and tumor group. The clinical characteristics, the proportion of different CD4 + T lymphocyte counts and chest computed tomography (CT) features of the three groups were compared. Chi square test was used for comparison among the three groups, and Bonferroni method was used to correct the test level for pairwise comparison. The significance level was 0.016 7 because of three pairwise comparisons. Results:Among 55 AIDS patients complicated with peripulmonary occupational lesions, pulmonary biopsy showed 14 cases with Mycobacterium infection, 12 cases with fungal infection and 15 cases with tumor lesions. Mixed diseases were found in 11 patients, including seven cases with Mycobacterium and fungus coinfection, four with tumor complicated with fungus and (or) Mycobacterium. Three with chronic interstitial pneumonia. The main clinical manifestations of 55 patients were fever, expectoration, fatigue, weight loss and superficial lymph node enlargement. There were no significant differences in symptoms/signs, white blood cell counts, hemoglobin levels, alanine transaminase and creatinine among Mycobacterium infection group, fungal infection group and tumor group (all P>0.05). There was significant difference in anti-retroviral therapy (ART) acceptance among the three groups ( χ2=15.165, P<0.01). However, the results of pairwise comparison between groups showed that there was significant difference between fungal infection group and tumor group ( χ2=7.514, P<0.016 7), while there was no significant difference between Mycobacterium infection group and tumor group, Mycobacterium infection group and fungal infection group ( χ2=0.255 and 5.306, respectively, both P>0.016 7). There were significant differences in clinical outcomes among the three groups ( χ2=15.119, P<0.01), and the pairwise comparison between the Mycobacterium infection group and the tumor group, and the fungal infection group and the tumor group showed significant differences ( χ2 =10.311 and 9.095, respectively, both P<0.016 7). The cases with CD4 + T lymphocyte count ≤50/μL, 51-<200/μL and ≥200/μL in Mycobacterium infection group were three cases, one case and 10 cases, respectively; those in fungal infection group were 10 cases, two cases and 0 case, respectively, and those in tumor group were one case, two cases and 12 cases, respectively. The difference was statistically significant ( χ2=21.284, P<0.01). Chest CT showed that there was significant difference in the types of space occupying lesions among the three groups ( χ2=13.308, P=0.003), and pairwise comparison between the two groups showed that there was significant difference between the Mycobacterium infection group and the tumor group ( χ2=11.312, P<0.016 7), while there were no significant differences between the Mycobacterium infection group and fungal infection group ( χ2=0.931, P>0.016 7), and the fungal infection group and the tumor group ( χ2=7.053, P>0.016 7). There was significant difference among the three groups in calcification focus ( χ2=8.524, P=0.004), while there was no difference between the Mycobacterium infection group and fungal infection+ tumor group ( χ2=10.982, P<0.016 7). Conclusions:Mycobacterium infection, fungal infection and tumor are the main types of peripulmonary occupational lesions in AIDS patients. The differential diagnosis could be made by combining with chest CT features, ART acceptance and CD4 + T lymphocyte level.
8.Risk factors for postoperative acute kidney injury in patients undergoing off-pump coronary artery bypass grafting
Yuan HE ; Hongdang XU ; Hongqi LIN ; Feilong HEI
Chinese Journal of Anesthesiology 2021;41(9):1079-1082
Objective:To identify the risk factors for postoperative acute kidney injury (AKI) in patients undergoing off-pump coronary artery bypass grafting (OPCABG).Methods:The medical records of patients who underwent elective OPCABG from January 1, 2018 to December 31, 2020 from the Heart Center of Henan Provincial People′s Hospital, were retrospectively collected.The patient′s gender, age, body mass index, history of diabetes, history of hypertension, history of hyperlipidemia, history of chronic obstructive pulmonary disease, history of cerebrovascular disease, history of myocardial infarction, New York Heart Association classification of cardiac function, Killip classification, values of last left ventricular ejection fraction measured by transthoracic echocardiography before operation, glycosylated hemoglobin, glucose and serum creatinine, duration of operation, intraoperative fluid intake and output such as red blood cell infusion, crystal fluid, colloid fluid, autologous blood, blood loss and urine volume, intraoperative hypotension, perioperative maximal blood glucose difference (MGD) and serum creatinine concentrations within 48 h and 7 days were recorded.Postoperative AKI was defined according to the Kidney Disease Improving Global Outcomes criteria and the patients were divided into AKI group and non-AKI group according to whether AKI occurred after surgery.Logistic regression analysis was used to identify the risk factors for AKI after OPCABG.Results:A total of 1 203 patients were included in this study, and the incidence of AKI after OPCABG was 28.1%.Logistic regression analysis showed that body mass index, history of hypertension and perioperative MGD were risk factors for AKI after OPCABG ( P<0.05). Conclusion:Body mass index, history of hypertension and perioperative MGD are risk factors for AKI after OPCABG.
9.Expression of hepatoma-derived growth factor in tumor and its related signaling pathway
Feilong YANG ; Dawei LI ; Juchao REN ; Lei YAN ; Zunlin ZHOU ; Hainan LIU ; Zhonghua XU
Journal of International Oncology 2017;44(3):193-195
Recent studies find that the expression of hepatoma-derived growth factor (HDGF) is closely correlated with the tumorigenesis,progression,metastasis,therapy and prognosis of various malignancies.Though the mechanism of the interaction of HDGF and tumors is still unclear,the research of HDGF serving as a tumor marker in malignancies and a new target for tumor treatment has become a hotspot in the research of tumor.
10.Analysis on disease spectrum among hospitalized children in Chongqing City during 2015
Feilong XU ; Xiaolan XU ; Leming ZHOU ; Yiwei HUANG ; Yuchen XU ; Kaiming WU
Chongqing Medicine 2017;46(17):2389-2391,2395
Objective To study the characteristics of the diseases spectrum in hospitalized children.Methods The items of main diagnosis,gender,age,etc.in the inpatients medical records home page data aged 0? 12 years old in second-level and above hospitals of Chongqing City during 2015 were performed the disease spectrum sequence and constituent ratio analysis for deeply digging the relation between the disease change trend with the age and sex.Results The top 5 main system diseases affecting children's health were respiratory system diseases (male 43.84%,female 45.74%),some conditions originated from prenatal period (male 12.01 %,female 13.87 %),infectious diseases and parasites diseases (male 9.48 %,female 9.88 %),digestive system diseases (male 9.09 %,female 6.95 %),injury,poisoning and some other consequences of external causes(male 6.86 %,female 5.27 %).Respiratory system diseases always ranked the first place,the sexual difference among various system disease was unobvious,the sequence of injury,poisoning and some other consequence of external causes was increased with the age increasing;in the ranking of respiratory system diseases,pneumonia(38.73 %),acute bronchitis(17.29 %) and acute tonsillitis(13.83%) were the top 3 diseases affecting children's health.Conclusion Respiratory system diseases are the concerned key point for children health promotion.The health and epidemic prevention departments should provide effective methods and measures for preventing respiratory system diseases in children.Furthermore,the targeted prevention and treatment measures should be proposed aiming at the difference of disease sequence in different age groups.

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