1.Development and validation of a nomogram for predicting cervical lymph node metastasis based on hematological parameters and clinicopathological characteristics in patients with laryngeal squamous cell carcinoma.
Shanshan TIAN ; Yu SONG ; Ningyuan WANG ; Jianqiang LI ; Wenwen CHEN ; Deli WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(10):949-956
Objective:To explore the predictive value of preoperative peripheral hematological parameters combined with clinicopathological features for cervical lymph node metastasis(CLNM) in patients with laryngeal squamous cell carcinoma(LSCC), and to construct and validate a nomogram model for CLNM. Methods:A retrospective analysis was conducted on the clinical data of 264 LSCC patients who underwent surgical treatment and were pathologically confirmed, collected from the Second Affiliated Hospital of Shandong First Medical University and Taian 88 Hospital. Specifically, 161 patients from one hospital were allocated to the training cohort, while 103 patients from another hospital constituted the validation cohort. Based on postoperative pathological results, patients were categorized into CLNM-positive and CLNM-negative groups. The general clinical data, clinicopathological features, and hematological parameters of the two groups were analyzed and compared. A preoperative predictive model for CLNM was developed using logistic regression analysis, followed by validation and sensitivity analysis to evaluate the robustness of the model's predictive performance. Results:The results showed that there were significant differences in tumor location, tumor size, tumor differentiation, neutrophil percentage, lymphocyte count, lymphocyte percentage, c-reactive protein(CRP), fibrinogen, neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), systemic immune-inflammation index(SII), systemic inflammation response index(SIRI), and prognostic inflammatory index(PIV) between the CLNM-positive and CLNM-negative groups(P<0.05). Lasso regression identified tumor location, clinical T stage, tumor size, tumor differentiation degree, red blood cell distribution width(RDW) -coefficient of variation(RDW-CV), CRP, FIB, D-dimer, NLR, and lymphocyte-to-monocyte ratio(LMR) were the most predictive parameters. Multivariate logistic regression revealed that tumor location, tumor size, tumor differentiation degree, CRP, and NLR were independent risk factors for CLNM in LSCC patients(P<0.05). A nomogram was constructed based on these five factors. The model demonstrated excellent discrimination, with a C-index of 0.837(95%CI 0.766-0.908) in the training cohort and 0.809(95%CI 0.698-0.920) in the validation cohort. Calibration curves and DCA curves in both cohorts confirmed the clinical utility of the model. Sensitivity analysis further supported the robustness of the results, showing good discrimination and calibration across different age and BMI subgroups. Conclusion:Tumor location, tumor size, tumor differentiation degree, CRP, and NLR were independent risk factors for CLNM in LSCC patients. The nomogram based on these variables exhibits strong discrimination, calibration, and clinical applicability, and may serve as a valuable tool for preoperative risk assessment and individualized treatment planning.
Humans
;
Nomograms
;
Laryngeal Neoplasms/blood*
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Retrospective Studies
;
Lymphatic Metastasis
;
Carcinoma, Squamous Cell/blood*
;
Lymph Nodes/pathology*
;
Male
;
Female
;
Middle Aged
;
Neck
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C-Reactive Protein
;
Aged
;
Logistic Models
;
Neutrophils
;
Prognosis
2.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
3.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
4.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
5.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
6.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
7.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
8.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
9.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
10.Epidemiological characteristics of severe fever with thrombocytopenia syndrome in China, 2018-2021
Xiaoxia HUANG ; Shanshan DU ; Aqian LI ; Chuan LI ; Tingting TIAN ; Tiezhu LIU ; Qin WANG ; Mifang LIANG ; Shiwen WANG ; Jiandong LI ; Dexin LI
Chinese Journal of Epidemiology 2024;45(1):112-116
Objective:To understand the epidemiological characteristics and incidence trend of severe fever with thrombocytopenia syndrome (SFTS) in China.Methods:The incidence data of SFTS in China from 2018 to 2021 were collected from Chinese Disease Prevention and Control Information System for a statistical and descriptive epidemiological analysis by using software such as Excel 2016, Joinpoint 5.0.2, SPSS 26.0, and GraphPad Prism 8.0, especially, the SFTS cases reported monthly by key provinces were analyzed.Results:From 2018 to 2021, a total of 8 835 SFTS cases were reported in 25 provinces and the annual incidence showed an upward trend. The distribution of SFTS cases showed clustering, but the cases were mainly sporadic ones. The cases began to increase in March, mainly occurred during April to October (96.79%,8 551/8 835), and peaked during May to July. The cases were mainly distributed in middle-aged and old farmers, and slight more cases were women. The average case fatality rate was 5.38%, which varied greatly with areas. The case fatality rate tended to increase with age.Conclusion:From 2018 to 2021, the epidemiological characteristics of SFTS in China remained stable, but the number of reported cases gradually increased and the distribution showed an expanding trend, to which close attention should be paid.

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