1.Dose-dependent associations between screen time, contents and adolescents' mental health
Longhui ZHOU ; Bin YU ; Chenchang XIAO ; Juan CHEN ; Yuanzhong ZHU ; Qingya YU ; Tinghui ZHANG ; Lu XIONG ; Nuo LI ; Yujie GONG ; Jinglei ZHANG ; Hong YAN
Chinese Journal of Epidemiology 2025;46(6):1030-1035
Objective:To investigate the relationship between screen time and content, and the mental health status of adolescents. The findings will inform the formulation of targeted intervention policies to enhance adolescent mental health.Methods:Between September and November 2023, 5 197 students from 64 junior high, senior high, and vocational schools across 13 districts in Wuhan were recruited, using the stratified whole-cluster random sampling to investigate their screen behavior and mental health status. Mental health status was measured using the Mental Health Inventory for Chinese Middle School Students (MMHI-60). A generalized additive model was used to explore the nonlinear association between screen time and mental health status. Additionally, a mixed-effects model was utilized to explore the dose-response associations between average daily total screen time, screen time for different content types, and adolescents' mental health status and the impact of the proportion of different screen contents on mental health outcomes.Results:The age of the participants was (14.40±1.48) years, with 56.07% being boys. The MMHI-60 score averaged 1.73±0.70. The M( Q1,Q3) for daily total screen time was 50.00 (0.00,128.57) minutes. The M( Q1,Q3) for screen time dedicated to gaming, studying, socializing, and watching videos were 0.00 (0.00, 20.00), 8.57 (1.64, 44.50), 4.28 (0.00, 30.00), and 0.00 (0.00, 25.71) minutes, respectively. A non-linear association was observed between average daily screen time and adolescent mental health problem score, 0-1 hour of daily screen time was beneficial for adolescent mental, compared to no screen time. However, screen time exceeding 1 hour was detrimental, with the negative impact increasing alongside screen time duration. When total daily screen time was held constant, the proportion of time spent on gaming ( β=0.14, 95% CI: 0.05-0.23, P=0.003) and video ( β=0.21, 95% CI: 0.09-0.28, P<0.001) was positively correlated with mental health problems, whereas the proportion of time spent on studying was negatively correlated with mental health problems ( β=-0.17, 95% CI: -0.24 - -0.11, P<0.001). Conclusions:Moderate screen time is advantageous for adolescent mental health. However, it is crucial to minimize the proportion of screen time dedicated to video and gaming activities to mitigate potential adverse effects.
2.Dose-dependent associations between screen time, contents and adolescents' mental health
Longhui ZHOU ; Bin YU ; Chenchang XIAO ; Juan CHEN ; Yuanzhong ZHU ; Qingya YU ; Tinghui ZHANG ; Lu XIONG ; Nuo LI ; Yujie GONG ; Jinglei ZHANG ; Hong YAN
Chinese Journal of Epidemiology 2025;46(6):1030-1035
Objective:To investigate the relationship between screen time and content, and the mental health status of adolescents. The findings will inform the formulation of targeted intervention policies to enhance adolescent mental health.Methods:Between September and November 2023, 5 197 students from 64 junior high, senior high, and vocational schools across 13 districts in Wuhan were recruited, using the stratified whole-cluster random sampling to investigate their screen behavior and mental health status. Mental health status was measured using the Mental Health Inventory for Chinese Middle School Students (MMHI-60). A generalized additive model was used to explore the nonlinear association between screen time and mental health status. Additionally, a mixed-effects model was utilized to explore the dose-response associations between average daily total screen time, screen time for different content types, and adolescents' mental health status and the impact of the proportion of different screen contents on mental health outcomes.Results:The age of the participants was (14.40±1.48) years, with 56.07% being boys. The MMHI-60 score averaged 1.73±0.70. The M( Q1,Q3) for daily total screen time was 50.00 (0.00,128.57) minutes. The M( Q1,Q3) for screen time dedicated to gaming, studying, socializing, and watching videos were 0.00 (0.00, 20.00), 8.57 (1.64, 44.50), 4.28 (0.00, 30.00), and 0.00 (0.00, 25.71) minutes, respectively. A non-linear association was observed between average daily screen time and adolescent mental health problem score, 0-1 hour of daily screen time was beneficial for adolescent mental, compared to no screen time. However, screen time exceeding 1 hour was detrimental, with the negative impact increasing alongside screen time duration. When total daily screen time was held constant, the proportion of time spent on gaming ( β=0.14, 95% CI: 0.05-0.23, P=0.003) and video ( β=0.21, 95% CI: 0.09-0.28, P<0.001) was positively correlated with mental health problems, whereas the proportion of time spent on studying was negatively correlated with mental health problems ( β=-0.17, 95% CI: -0.24 - -0.11, P<0.001). Conclusions:Moderate screen time is advantageous for adolescent mental health. However, it is crucial to minimize the proportion of screen time dedicated to video and gaming activities to mitigate potential adverse effects.
3.Detiction and drug resistance to commonly used antibiotics of Ureaplasma urealyticum and Mycoplasma hominis in chronic cervicitis patients
Ren YE ; Bin ZHANG ; Longhui SHEN ; Lian WU ; Xin LIU
Chinese Journal of Nosocomiology 2025;35(14):2140-2144
OBJECTIVE To explore the prevalence of Ureaplasma urealyticum and Mycoplasma hominis among the patients with chronic cervicitis(CC)and observe their drug resistance to commonly used antibiotics.METHODS A total of 91 patients with CC who were treated in gynecology department of Women and Children's Hospital Affiliated to Ningbo University from Jan.2022 to Jun.2024 were assigned as the CC group,meanwhile,91 healthy women who received physical examination were chosen as the control group.The genital tract secretions were collected from all of the research subjects for the culture of U.urealyticum and M.hominis and drug suscep-tibility testing.The isolation rates of U.urealyticum,M.hominis and U.urealyticum plus M.hominis were com-pared between the two groups.The isolation rates of U.urealyticum and M.hominis were compared among the different age groups of CC patients.The drug susceptibility testing of U.urealyticu m and M.hominis for doxycyc-line(DOX),josamycin(JOS),ofloxacin(OFL),clarithromycin(CLA),erythromycin(ERY),tetracycline(TET),azithromycin(AZI)and pristinamycin(PTN)were observed.RESULTS Totally 75(82.41%)genital tract secretion samples tested positive for Mycoplasma among the 91 samples,37 detected with U.urealyticum,25 were M.hominis,and 13 were U.urealyticum plus M.hominis.The isolation rates of U.urealyticum,M.hominis and U.urealyticum plus M.hominis of the CC group were 40.66%,24.47%and 14.29%,respective-ly,higher than 8.79%,4.40%and 5.49%of the control group(P<0.05).The total detection rate of U.urealyti-cum,M.hominis and U.urealyticum plus M.hominis was higher among the CC patients aged between 20 and 40 years old than among the CC patients aged more than 40 years old(P<0.05).The U.urealyticum strains from the positive specimens of the CC patients were highly sensitive to CL A and DOS but were resistant to OFL,CIP and PTN;the M.honinis and U.urealyticum plus M.hominis strains were sensitive to JOS and DOX but were resistant to OFL and CIP.CONCLUSIONS The detection rates of U.urealyticum plus M.hominis are higher a-mong the CC patients than among the normal population.The isolated U.urealyticum and M.hominis strains are highly resistant to quinolones and aminoglycosides.It is necessary for the hospital to empirically choose sensitive antibiotics based on the result of drug susceptibility testing.
4.Detiction and drug resistance to commonly used antibiotics of Ureaplasma urealyticum and Mycoplasma hominis in chronic cervicitis patients
Ren YE ; Bin ZHANG ; Longhui SHEN ; Lian WU ; Xin LIU
Chinese Journal of Nosocomiology 2025;35(14):2140-2144
OBJECTIVE To explore the prevalence of Ureaplasma urealyticum and Mycoplasma hominis among the patients with chronic cervicitis(CC)and observe their drug resistance to commonly used antibiotics.METHODS A total of 91 patients with CC who were treated in gynecology department of Women and Children's Hospital Affiliated to Ningbo University from Jan.2022 to Jun.2024 were assigned as the CC group,meanwhile,91 healthy women who received physical examination were chosen as the control group.The genital tract secretions were collected from all of the research subjects for the culture of U.urealyticum and M.hominis and drug suscep-tibility testing.The isolation rates of U.urealyticum,M.hominis and U.urealyticum plus M.hominis were com-pared between the two groups.The isolation rates of U.urealyticum and M.hominis were compared among the different age groups of CC patients.The drug susceptibility testing of U.urealyticu m and M.hominis for doxycyc-line(DOX),josamycin(JOS),ofloxacin(OFL),clarithromycin(CLA),erythromycin(ERY),tetracycline(TET),azithromycin(AZI)and pristinamycin(PTN)were observed.RESULTS Totally 75(82.41%)genital tract secretion samples tested positive for Mycoplasma among the 91 samples,37 detected with U.urealyticum,25 were M.hominis,and 13 were U.urealyticum plus M.hominis.The isolation rates of U.urealyticum,M.hominis and U.urealyticum plus M.hominis of the CC group were 40.66%,24.47%and 14.29%,respective-ly,higher than 8.79%,4.40%and 5.49%of the control group(P<0.05).The total detection rate of U.urealyti-cum,M.hominis and U.urealyticum plus M.hominis was higher among the CC patients aged between 20 and 40 years old than among the CC patients aged more than 40 years old(P<0.05).The U.urealyticum strains from the positive specimens of the CC patients were highly sensitive to CL A and DOS but were resistant to OFL,CIP and PTN;the M.honinis and U.urealyticum plus M.hominis strains were sensitive to JOS and DOX but were resistant to OFL and CIP.CONCLUSIONS The detection rates of U.urealyticum plus M.hominis are higher a-mong the CC patients than among the normal population.The isolated U.urealyticum and M.hominis strains are highly resistant to quinolones and aminoglycosides.It is necessary for the hospital to empirically choose sensitive antibiotics based on the result of drug susceptibility testing.
5.Investigating the Mechanistic Insights of Limonene's Anti-non-small Cell Lung Cancer Effect Through Metabolomics Analysis
Huamin ZHANG ; Longhui CHENG ; Xueman DONG ; Lu YE ; Yuxin XU ; Lin CHEN ; Pu WU ; Jianliang ZHOU
Chinese Journal of Modern Applied Pharmacy 2024;41(2):192-202
OBJECTIVE
To elucidate the mechanisms responsible for the inhibitory effects of limonene on the proliferation of non-small cell lung cancer(NSCLC) by non-targeted metabolomics and additional approaches.
METHODS
The CCK-8 assay was utilized to evaluate the inhibitory effects of limonene on NSCLC A549 cell viability and to ascertain the IC50. In vitro experiments, encompassing colony formation, flow cytometry, iron content assessment, and mitochondrial staining, were conducted to assess the anti-lung cancer and iron-induced cell death effects of limonene. Metabolomic analysis was employed to identify potential pathways influenced by limonene, and Western blotting was carried out to validate pivotal proteins within these pathways.
RESULTS
In comparison to the control group, the limonene-treated group demonstrated a significant, dose-dependent reduction in A549 cell proliferation and colony formation. Optical microscopy revealed cellular detachment and pronounced changes in cellular morphology following exposure to limonene. Limonene induced apoptosis in A549 cells and arrested them in the G0-G1 phase of the cell cycle. Confocal microscopy unveiled diminished mitochondrial fluorescence and an augmented intracellular iron content, indicative of the classical phenomenon of ferroptosis. Metabolomic investigations unveiled divergent metabolic pathways, including glutathione(GSH) metabolism, arginine biosynthesis, D-glutamine and D-glutamate metabolism, as well as cysteine and methionine metabolism, with many of them intricately linked to intracellular GSH synthesis. Western blotting experiments underscored a marked reduction in the levels of SLC40A1, SLC7A11(xCT), and GPX4 proteins within the cells post-limonene treatment.
CONCLUSION
Limonene may induce ferroptosis in lung cancer cells by reducing GSH synthesis and increasing Fe2+ levels.
6.Mechanism of Modified Guizhi Fulingwan in Regulating Mitochondrial Apoptosis Pathway Through PTEN/PI3K/Akt Pathway to Prevent Colorectal Adenoma in Mice
Sujie JIA ; Longhui LIU ; Yifan ZHANG ; Xiaomeng LANG ; Jianping LIU ; Xin KANG ; Chaodi SUN ; Jingyuan LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(19):10-20
ObjectiveTo investigate the effect and mechanism of modified Guizhi Fulingwan in preventing colorectal adenoma (CRA) in mice by regulating mitochondrial apoptosis pathway through the regulation of the phosphatase and tensin homolog (PTEN)/phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) pathway. MethodSixty SPF-grade male C57BL/6 mice were randomly divided into six groups: Normal group, model group, low, medium, and high dose groups of modified Guizhi Fulingwan (13, 26, 52 g·kg-1·d-1), and positive control aspirin group (0.015 g·kg-1·d-1). A mouse model of CRA was chemically induced using azoxymethane (AOM) and dextran sulfate sodium (DSS). During the modeling process, mice received modified Guizhi Fulingwan or aspirin. Body weight of mice was measured weekly during the treatment. After 9 weeks, the number of adenomas formed was observed. Serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β) were determined by enzyme-linked immunosorbent assay (ELISA). Hematoxylin-eosin (HE) staining was used to observe the histopathologic changes in adenoma tissues. The expression of Cyclin D1 and proliferative nuclear antigen (Ki67) was detected by immunohistochemistry (IHC). Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) was used to assess the apoptosis in adenoma tissues. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot were used to observe the mRNA and protein expression levels of PTEN, PI3K, Akt, phosphorylated PI3K (p-PI3K), phosphorylated Akt (p-Akt), B-cell lymphoma-2 (Bcl-2), Bcl-2 associated X protein (Bax), cytochrome C (Cyt C), Caspase-9, and caspase-3. ResultCompared with the normal group, the model group showed no significant change in body weight from week 1 to week 2, but a significant decrease from week 3 to week 9 (P<0.05,P<0.01). The colorectal length was significantly shortened, and the colorectal weight increased with visible varying sized tumor-like protrusions on the mucosal surface (P<0.01). Serum levels of TNF-α, IL-6, and IL-1β were elevated (P<0.01). Histopathology showed disordered epithelial gland structure, elongated nuclei with pathological mitosis, and numerous lymphocytic infiltrations in the lamina propria. The positive expression rates of Cyclin D1 and Ki67 were significantly increased (P<0.01), while the apoptosis rate of adenoma cells was significantly decreased (P<0.01). Expression levels of PI3K, Akt, Bcl-2 mRNA and proteins, as well as p-PI3K and p-Akt proteins, were significantly increased (P<0.01), whereas PTEN, Bax, Cyt C, Caspase-9, and Caspase-3 mRNA and protein levels were significantly decreased (P<0.05, P<0.01). Compared with the model group, all drug treatment groups showed an increase in body weight (P<0.01), decreased intestinal weight, increased colorectal length, reduced number of adenomas significantly (P<0.05, P<0.01), and significantly lowered serum levels of TNF-α, IL-6, and IL-1β (P<0.01). Histopathology indicated improved glandular structure and reduced neutrophil infiltration in the mucosal lamina propria. The positive expression rates of Cyclin D1 and Ki67 significantly decreased (P<0.01), while the apoptosis rate of adenoma cells significantly increased (P<0.05, P<0.01). Expression levels of PI3K, Akt, Bcl-2 mRNA and proteins, and p-PI3K and p-Akt proteins were significantly reduced (P<0.05, P<0.01), while PTEN, Bax, Cyt C, Caspase-9, and Caspase-3 mRNA and protein levels significantly increased (P<0.05, P<0.01). The high-dose modified Guizhi Fulingwan group exhibited the most significant intervention effects. ConclusionModified Guizhi Fulingwan may prevent CRA in mice by regulating the PTEN/PI3K/Akt signaling pathway and inducing the mitochondrial apoptosis pathway.
7.Comparison of the efficacy and safety of ShuoTong ureteroscopy and flexible ureteroscopy in the treatment of upper ureteral calculi with CT numberical value greater than 1000 HU
Longhui LAI ; Wenzhao ZHANG ; Dawei LIN ; Peide BAI ; Zhengsheng LIU ; Tao WANG ; Shu CUI ; Zhiping WANG ; Jinchun XING ; Bin CHEN
Chinese Journal of Urology 2023;44(2):115-120
Objective:To compare the clinical efficacy and safety of Shuo Tong ureteroscopy(ST-URS) and flexible ureteroscope(FURS)combined with holmium laser lithotripsy in the treatment of upper ureteral calculi with CT numerical value ≥ 1000 HU.Methods:A retrospective analysis of the clinical data of patients of upper ureteral calculi with CT numberical value≥1000 HU in the First Affiliated Hospital of Xiamen University was made from January 2018 to November 2020.There were 61 cases treated with ShuoTong ureteroscopy holmium laser lithotripsy (ST-URS group), including 45 males and 16 females, with 40 on the left and 21 on the right, age of(48.3±12.7) years, body mass index of(24.7±2.7)kg/m 2, the diameter of stone of(1.50±0.45)cm, and the CT numberical value of(1 288.8±179.0)(1 017-1 738)HU. There were 87 cases were treated with flexible ureteroscopy holmium laser lithotripsy (FURS group), including 58 males and 29 females, with 56 on the left and 31 on the right, age of(48.5±13.0) years, body mass index of(24.1±3.8)kg/m 2, the stone diameter of(1.45±0.40)cm, and the CT numberical value of(1 311.3±188.9)(1 009-1 817)HU. There were no significant differences in gender, age, body mass index, the location of stone, the diameter of stone and the CT numberical value of stone( P>0.05)between the two groups. For ST-URS group, a rigid ureteral channel sheath and standard mirror(F7.5/11.5)were placed under direct vision, exiting the standard mirror, leaving the channel sheath, inserting a lithotripsy mirror(F4.5/6.5)and a holmium laser[Power: 8-30 W(0.4-1.0 J/20-30 Hz)], and withdrawing the stone fragments after crushing the stone by "nibbling method" . For FURS group, a hard ureteroscope(F8/9.8)was used to explore the lesion side of the ureter, inserting a guide wire and placing a soft ureteral sheath, then inserting a flexible ureteroscope(F8)for holmium laser lithotripsy, and useing a stone basket to remove larger stone fragments. Ureteral stent was routinely indwelled after the operation. On the day 1 and 1 month after the operation, imaging examinations were performed to evaluate the stone-free rate. No residual stones or the diameter of stone was ≤0.4 cm and no urinary tract infection or any symptoms were defined as stone free. The operation time, blood loss, success rate of stage Ⅰ ureteral access sheath placement, incidence of postoperative complications, stone-free rate(SFR) at 1 day after operation, SFR at 1 month after operation, postoperative hospital stay and hospitalization costs were compared between the two groups. According to the size of calculi, the 2 groups were divided into 2 subgroups(≥1.5 cm and <1.5 cm)in order to make further analysis. The operation time, stone-free rate(SFR) at day 1 after operation and SFR at 1 month after operation were compared between the two groups. Results:The operation time of the ST-URS group was shorter than the FURS group(40.10 min vs. 49.43 min, P=0.020), and the incidence of postoperative complications was lower than the FURS group[3.28%(2/61)vs. 13.79%(12/87), P=0.031]. The SFR at day 1 after operation was significantly higher than the FURS group[60.7%(37/61)vs. 25.3%(22/87), P<0.01], and the hospitalization cost was lower than that of the FURS group(27 686 yuan vs. 32 281 yuan, P<0.010). There were no significant differences in the blood loss[(4.92±9.51)ml vs.(3.95±6.04)ml, P=0.452], success rate of stageⅠureteral access sheath placement[ 96.7%(59/61)vs. 96.6%(84/87), P=1.000], SFR at 1 month after operation[81.97%(50/61) vs. 75.86%(66/87), P=0.375] and postoperative hospital stay[(2.5±1.4)d vs.(2.4±0.8)d, P=0.543] between the two groups. When the size of calculi was ≥1.5cm, the operation time of the ST-URS group was shorter than the FURS group (43.67 min vs 55.00 min), the SFR at 1 day after operation was higher than the FURS group[40.00%(12/30)vs. 9.38%(3/32)], and the above differences are all statistically significant ( P<0.05). Conclusions:Compared with the FURS, for the treatment of upper ureteral calculi with CT numerical value ≥1000 HU, the ST-URS has shorter in operative time, lower in hospitalization cost and incidence of postoperative complications and higher SFR at day 1 after operation. The ST-URS is a safe and effective surgical technique, which is superior in the treatment of larger(≥1.5 cm) stones.
8.Discussion on Pharmacopoeia Standard and Drug Site of Amomi Fructus Based on Quality Investigation of Commercial Samples
Jun ZHANG ; Qi LU ; Xiaofan ZHANG ; Yanpeng DAI ; Longhui ZU ; Zhaoshuang ZHAN ; Dianhua SHI
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(15):139-144
ObjectiveTo investigate the quality of Amomi Fructus in the market, and to compare the difference between the seed mass and shell, so as to provide a basis for standardizing the usage of Amomi Fructus. MethodThe properties, thin layer identification, moisture, the content of bornyl acetate were determined by the methods in the 2020 edition of Chinese Pharmacopoeia, and the ash and extract content were determined according to the collection method of the 2020 edition of Chinese Pharmacopoeia. ResultAmong the 17 batches of samples, except the content of bornyl acetate in 2 batches of Amomum longiligulare, 2 batches of A. longiligulare and A. villosum mixture was lower than the standard, the quality of other samples all met the standard of the 2020 edition of Chinese Pharmacopoeia, but there were two specifications with shell and without shell. The husk rate, volatile oil, extract and bornyl acetate contents of the seed mass and shell were tested. It was found that the content of volatile oil in three kinds of Amomi Fructus seed mass was 1.8-5.3 times that of the corresponding shell, and the content of bornyl acetate in the seed mass was 8.8-62.1 times that of the corresponding shell, but there was little difference in the extract content. ConclusionBased on the above research, it is considered that the content of bornyl acetate in A. longiligulare contained in the 2020 edition of Chinese Pharmacopoeia remains to be discussed. It is tentatively determined that the total ash content of Amomi Fructus should not be more than 10.0%, and the extract content should not be less than 15.0%. At the same time, it is suggested that when Amomi Fructus is used as medicine, the dosage of Amomi Fructus should be calculated according to the removal rate of 20%-30% of shell, and it should be crushed regardless of whether it is used in shell or not.
9.Diagnosis and treatment of genetically related urinary calculi
Wenzhao ZHANG ; Longhui LAI ; Peide BAI ; Tao WANG ; Anran SUN ; Yu LUO ; Kai ZHU ; Jinchun XING ; Zhangqun YE ; Bin CHEN
Chinese Journal of Urology 2022;43(6):477-480
In recent years, the incidence of single-gene nephrolithiasis has been increasing year by year. With the application of whole-genome analysis and whole-exome sequencing technology, the etiology of single-gene mutations leading to the development of urinary calculi has been extensively verified. Therefore, this article reviews the research on urinary calculi-related genetic diseases at home and abroad, and introduces transport proteins and channels; ions, protons and amino acids. The role of urinary calculi in the majority of clinicians realizes the significance of genetic testing in such diseases, thereby increasing the understanding of genetically related urinary calculi and improving the level of clinical diagnosis and treatment.
10.Survival evaluation and external validation of prognostic scores in postoperative patients with spinal metastasis of lung cancer
Guoqing ZHONG ; Xiaolan WANG ; Jielong ZHOU ; Yue HE ; Longhui ZENG ; Juning XIE ; Huahao LAI ; Yuan YAN ; Mengyu YAO ; Shi CHENG ; Yu ZHANG
Chinese Journal of Orthopaedics 2022;42(24):1605-1614
Objective:To analyze the prognostic factors and evaluate the accuracy of existing survival prediction models in patients with lung cancer-derived spinal metastases who have undergone open surgery.Methods:According to the inclusion criteria, the data of 76 patients with spinal metastasis of lung cancer who underwent open surgery in the department of Orthopedics in Guangdong Provincial People's Hospital were collected from January 2019 to November 2021. The relationship between the number of bone metastasis, pathological type, visceral metastasis, epidermal growth factor receptor mutation, serum alkaline phosphatase (ALP), hemoglobin (Hb), Frankel grade and postoperative survival time in 76 cases was analyzed by Cox logical regression analysis and Kaplan-Meier method to determine the potential prognostic factors. The accuracy of Tomita score, Tokuhashi revised score, Katagiri New score, New England Spinal Metastasis Score score (NESMS) and Skeletal Oncology Research Group (SORG) machine learning algorithm in predicting postoperative survival time was verified by drawing receiver operating characteristic (ROC) curve.Results:The median follow-up time of the patients was 18.0 months (2.3-36.0 months). The median survival time was 12.6 months [95% CI (10.8, 14.4)]. The survival rates at 6 and 12 months after operation were 71.6% and 52.0%, respectively. Multivariate regression analysis showed that ALP [ HR=0.23, 95% CI (0.11, 0.48), P<0.001], Hb [ HR=4.48, 95% CI (2.07, 9.70), P< 0.001] and EGFR mutation [ HR=2.22, 95% CI (1.04, 4.76), P=0.040] were independent predictors of prognosis. The accuracy of Tomita score, Tokuhashi revised score (2005), Katagiri New score and NESMS score in predicting 1-year mortality was 58.7%, 65.7%, 70.5% and 65% respectively, and the accuracy in predicting 6-month mortality was 63.7%, 62.2%, 61.2% and 56.8% respectively. The accuracy of SORG machine learning algorithm in predicting 1-year and 90 d mortality was 81.1%, 67.5%, respectively. Conclusion:No EGFR mutation, ALP>164 U/L and Hb≤125 g/L were risk factors affecting the survival of patients with spinal metastasis of lung cancer. SORG machine learning algorithm has good accuracy in predicting the postoperative survival rate of patients with lung cancer spinal metastasis.


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