1.An advanced machine learning method for simultaneous breast cancer risk prediction and risk ranking in Chinese population: A prospective cohort and modeling study
Liyuan LIU ; Yong HE ; Chunyu KAO ; Yeye FAN ; Fu YANG ; Fei WANG ; Lixiang YU ; Fei ZHOU ; Yujuan XIANG ; Shuya HUANG ; Chao ZHENG ; Han CAI ; Heling BAO ; Liwen FANG ; Linhong WANG ; Zengjing CHEN ; Zhigang YU
Chinese Medical Journal 2024;137(17):2084-2091
Background::Breast cancer (BC) risk-stratification tools for Asian women that are highly accurate and can provide improved interpretation ability are lacking. We aimed to develop risk-stratification models to predict long- and short-term BC risk among Chinese women and to simultaneously rank potential non-experimental risk factors.Methods::The Breast Cancer Cohort Study in Chinese Women, a large ongoing prospective dynamic cohort study, includes 122,058 women aged 25-70 years old from the eastern part of China. We developed multiple machine-learning risk prediction models using parametric models (penalized logistic regression, bootstrap, and ensemble learning), which were the short-term ensemble penalized logistic regression (EPLR) risk prediction model and the ensemble penalized long-term (EPLT) risk prediction model to estimate BC risk. The models were assessed based on calibration and discrimination, and following this assessment, they were externally validated in new study participants from 2017 to 2020.Results::The AUC values of the short-term EPLR risk prediction model were 0.800 for the internal validation and 0.751 for the external validation set. For the long-term EPLT risk prediction model, the area under the receiver operating characteristic curve was 0.692 and 0.760 in internal and external validations, respectively. The net reclassification improvement index of the EPLT relative to the Gail and the Han Chinese Breast Cancer Prediction Model (HCBCP) models for external validation was 0.193 and 0.233, respectively, indicating that the EPLT model has higher classification accuracy.Conclusions::We developed the EPLR and EPLT models to screen populations with a high risk of developing BC. These can serve as useful tools to aid in risk-stratified screening and BC prevention.
2.Research progress on inflammation and right ventricular failure
Hui ZHANG ; Yujuan BAO ; Xiangrong ZUO
Chinese Critical Care Medicine 2018;30(8):815-818
Right ventricular failure (RVF) is the main cause of death in patients with cardiopulmonary disease, such as pulmonary arterial hypertension (PAH), pulmonary embolism, acute respiratory distress syndrome, and right ventricular infarction. The exact cellular and molecular mechanisms underlying RVF remains unclear. Inflammation may play an important role during the development of RVF, as it does in left heart failure. Cardiac inflammation has been shown in RVF patients and animal models, which played a role in the impairment of the right ventricular contraction and in the maladaptive remodeling. Inflammation plays a dual role in the development of cardiopulmonary disease and its anti-inflammatory therapies may have double benefits for RVF patients. This review summarizes the evidence of inflammation in RVF and research progresses of inflammation in the development of RVF to provide a reference for further exploring the mechanism of inflammation in RVF.
3.Effects of delayed umbilical cord clamping on maternal and neonatal outcomes
Jialei FENG ; Jun LIU ; Airong BAO ; Ying LIAN ; Xuefei WANG ; Jing QI ; Lihong ZHAI ; Yujuan HAN
Chinese Journal of Nursing 2018;53(2):144-148
Objective To determine the effects of delayed umbilical cord clamping on the postpartum hemorrhage,instant and long-term newborn anemia,newborn jaundice.Methods In total,303 infants were selected during October 2016 to June 2017 in three hospitals in Beijing.They were randomly allocated into two groups receiving instant clamping of umbilical cord (less than 60s after delivery,n=158) and delayed clamping of umbilical cord(after cord pulsation ceased,n=145).Relevant indicators of maternal and neonatal outcomes are compared.Results There were significant differences between two groups in instant hemoglobin concentration and in 5~7 days (P<0.05).There were no differences between two groups in transcutaneous bilirubin,the risk of anemia in three months,the risk of jaundice in 5~7 days and the need of blue-light therapy (P>0.05).There were no differences between two groups of women in postpartum hemorrhage,the length of third stage of labor and the rate of breast feeding (P>0.05).Conclusion Clamping the umbilical cord when cord pulsation has ceased does not have negative effects on delivery process and postpartum hemorrhage,but it increases the instant hemoglobin concentration and hemoglobin concentration after delivery in 5~7 days.Still it is unclear whether it will affect the risk of jaundice.
4.Effect of VIM in EV71 infection in human microvascular endothelial cells
Yanyun ZHONG ; Bao ZHANG ; Mingliang HE ; Yujuan CAO ; Xianbo WU
The Journal of Practical Medicine 2016;32(10):1560-1563
Objectives To study the effect of VIM in Enterovirus 71 (EV71) infection of (human brain microvascular endothelial cells (HBMEC) and elaborating the mechanism of EV71 infection in the nervous system. Methods Knocked out the VIM by CRISPR technology , the differences in EV71 absorption , replication , release between wild VIM and VIM knocked-out (VIM-KO) HBMEC were detected by fluorescence quantitative PCR. Results 4 ℃ absorption experiment conformed that EV71 adsorption in VIM- KO is 40% less than in the normal HBMEC. After EV71 infect HBMEC for 48 h (48 h p. i.), the quantitative PCR result showed intracellular viral RNA in VIM-KO was only 1/12 of that in the normal HBMEC. Also the extracellular viral RNA was quantified, and the number of cells in VIM-KO had been reduced 1.4 times compared with the normal HBMEC. Conclusions Once VIM knocking out, EV71 attachment has been obviously reduced. Meanwhile, the level of viral RNA replication and release are decreased compared with the normal HBMEC. VIM may be an attachment receptor of EV71 in HBMEC , when the virus invades HBMEC with the binding of VIM. Moreover , VIM plays an important role in the replication and release of EV71.
5.Epidemiological characteristics and virulence of EV71 in Guangdong province
Xianbo WU ; Yanyun ZHONG ; Yujuan CAO ; Changwen KE ; Dawei GUAN ; Bao ZHANG
The Journal of Practical Medicine 2015;(6):999-1002
Objective To study the factors influencing epidemiological characteristics and virulence of Enterovirus 71 (EV71) in Guangdong province from 2008 to 2010. Methods RNA was extracted from collected samples or cultured virus , then reversing transcription into cDNA. We amplified full-length EV71-VP1 using poly-merase chain reaction technology , then conducted sequence alignment and established phylogenetic tree with MEGA software (version 5.0) to confirm the genotype of EV71. The association between severity of clinical symp-toms and sex, age, viral genotype and VP1 variation was also analyzed using Logistic regression. Results The genotype of the predominant epidemical strain was C4a in Guangdong from 2008 to 2010. However , this subtype had already differentiated into 4 subgroups (C4a1- C4a4). There was no correlation between clinical syndrome and sex or viral genotype; the severity of symptoms was negatively correlated with age: before 4 years old, varia-tion A289T can easily lead to severe cases, increasing the risk of infection (P<0.05, OR = 2.360, 95%CI:1.163~ 4.659). Conclusion The main epidemical EV71 strain is C4a1 in Guangdong province. The emerging differen-tiation and simultaneous prevalence should merit attention to strengthen relevant surveillance; and the protection of the susceptible population should be reinforced during EV71 prevalence.
6.Effect evaluation of family sickbed comprehensive nursing intervention on stroke patients
Huiling ZHANG ; Yingyi BAO ; Yujuan HUANG
Chinese Journal of Practical Nursing 2012;28(21):17-19
[Objective] To study the effect of family sickbed comprehensive nursing mode on patients with stroke.[Methods] 92 cases of discharged patients with cerebral apoplexy were selected between October 2010 and October 2011,and were divided into the observation group(52 cases)and the control group(40 cases).Among them,the observation group received the family sickbed comprehensive nursing intervention,which was conducted by community nurses.The control group received general discharge mode and did not accept community nursing intervention.As designed,patients were followed weekly or monthly after discharge.After three months the treatment efficacy and quality of life were assessed.[Results] After follow-up for 3 months,HAMD,NIHSS scores in the intervention group were lower than those of the control group,MMSE,FMA and BI scores were higher than those of the control group.The physical,psychological,social and environmental scorcs in the intervention group were higher than those in the control group.[Conclusions] Family sickbed comprehensive nursing of cerebral apoplexy patients during rehabilitation stage can not only save medical resources,but also facilitate to recovery of patients.

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