1.Roles of lncRNA in the crosstalk between osteogenesis and angiogenesis in the bone microenvironment.
Shihua ZHANG ; Jianmin GUO ; Yuting HE ; Zhi'ang SU ; Yao FENG ; Lan ZHANG ; Zou JUN ; Xiquan WENG ; Yu YUAN
Journal of Zhejiang University. Science. B 2025;26(2):107-123
Bone is a highly calcified and vascularized tissue. The vascular system plays a vital role in supporting bone growth and repair, such as the provision of nutrients, growth factors, and metabolic waste transfer. Moreover, the additional functions of the bone vasculature, such as the secretion of various factors and the regulation of bone-related signaling pathways, are essential for maintaining bone health. In the bone microenvironment, bone tissue cells play a critical role in regulating angiogenesis, including osteoblasts, bone marrow mesenchymal stem cells (BMSCs), and osteoclasts. Osteogenesis and bone angiogenesis are closely linked. The decrease in osteogenesis and bone angiogenesis caused by aging leads to osteoporosis. Long noncoding RNAs (lncRNAs) are involved in various physiological processes, including osteogenesis and angiogenesis. Recent studies have shown that lncRNAs could mediate the crosstalk between angiogenesis and osteogenesis. However, the mechanism by which lncRNAs regulate angiogenesis‒osteogenesis crosstalk remains unclear. In this review, we describe in detail the ways in which lncRNAs regulate the crosstalk between osteogenesis and angiogenesis to promote bone health, aiming to provide new directions for the study of the mechanism by which lncRNAs regulate bone metabolism.
RNA, Long Noncoding/physiology*
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Osteogenesis/physiology*
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Humans
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Neovascularization, Physiologic/genetics*
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Bone and Bones/metabolism*
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Animals
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Mesenchymal Stem Cells
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Signal Transduction
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Osteoblasts
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Osteoclasts
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Angiogenesis
2.Exploration and validation of optimal cut-off values for tPSA and fPSA/tPSA screening of prostate cancer at different ages
Xiaomin LIU ; Hongyuan DUAN ; Dongqi ZHANG ; Chong CHEN ; Yuting JI ; Yunmeng ZHANG ; Zhuowei FENG ; Ya LIU ; Jingjing LI ; Yu ZHANG ; Chenyang LI ; Yacong ZHANG ; Lei YANG ; Zhangyan LYU ; Fangfang SONG ; Fengju SONG ; Yubei HUANG
Chinese Journal of Oncology 2024;46(4):354-364
Objective:To determine the total and age-specific cut-off values of total prostate specific antigen (tPSA) and the ratio of free PSA divided total PSA (fPSA/tPSA) for screening prostate cancer in China.Methods:Based on the Chinese Colorectal, Breast, Lung, Liver, and Stomach cancer Screening Trial (C-BLAST) and the Tianjin Common Cancer Case Cohort (TJ4C), males who were not diagnosed with any cancers at baseline since 2017 and received both tPSA and fPSA testes were selected. Based on Cox regression, the overall and age-specific (<60, 60-<70, and ≥70 years) accuracy and optimal cut-off values of tPSA and fPSA/tPSA ratio for screening prostate cancer were evaluated with time-dependent receiver operating characteristic curve (tdROC) and area under curve (AUC). Bootstrap resampling was used to internally validate the stability of the optimal cut-off value, and the PLCO study was used to externally validate the accuracy under different cut-off values.Results:A total of 5 180 participants were included in the study, and after a median follow-up of 1.48 years, a total of 332 prostate cancer patients were included. In the total population, the tdAUC of tPSA and fPSA/tPSA screening for prostate cancer were 0.852 and 0.748, respectively, with the optimal cut-off values of 5.08 ng/ml and 0.173, respectively. After age stratification, the age specific cut-off values of tPSA in the <60, 60-<70, and ≥70 age groups were 3.13, 4.82, and 11.54 ng/ml, respectively, while the age-specific cut-off values of fPSA/tPSA were 0.153, 0.135, and 0.130, respectively. Under the age-specific cut-off values, the sensitivities of tPSA screening for prostate cancer in males <60, 60-70, and ≥70 years old were 92.3%, 82.0%, and 77.6%, respectively, while the specificities were 84.7%, 81.3%, and 75.4%, respectively. The age-specific sensitivities of fPSA/tPSA for screening prostate cancer were 74.4%, 53.3%, and 55.9%, respectively, while the specificities were 83.8%, 83.7%, and 83.7%, respectively. Both bootstrap's internal validation and PLCO external validation provided similar results. The combination of tPSA and fPSA/tPSA could further improve the accuracy of screening.Conclusion:To improve the screening effects, it is recommended that age-specific cut-off values of tPSA and fPSA/tPSA should be used to screen for prostate cancer in the general risk population.
3.Comparison of the latest cancer statistics, cancer epidemic trends and determinants between China and the United States
Yuting JI ; Siwen LIU ; Yunmeng ZHANG ; Hongyuan DUAN ; Xiaomin LIU ; Zhuowei FENG ; Jingjing LI ; Zhangyan LYU ; Yubei HUANG
Chinese Journal of Oncology 2024;46(7):646-656
Objective:To provide supports for the cancer prevention and control strategies in China by comparing the disease burden, epidemic trends, 5-year relative survival rate and major determinants of common cancers between China and the United States.Methods:A descriptive secondary analysis was conducted using data extracted from the GLOBOCAN database, the Surveillance, Epidemiology, and End Results database, Global Burden of disease 2019 database, and previous studies. The main indicators included the cases of malignant tumors in different sites, the cases of deaths, the age-standardized incidence (world standard incidence) and mortality (world standard mortality), the 5-year relative survival rate, and population attributable fraction (PAF).Results:In 2022, an estimated 4.825 million new cases and 2.574 million deaths of malignant neoplasms in China. The world standard incidence rate (201.6/100 000) in China was lower than that in the United States (367.0/100 000), and the world standard mortality rate (96.5/100 000) was higher than that in the United States (82.3/100 000). Lung cancer ranked first in the disease burden of malignant tumors in China, the new cases and deaths accounted for 22.0% and 28.5% of all malignant tumors, respectively. The top three malignant tumors in China were breast cancer (11.5%), prostate cancer (9.7%) and lung cancer (9.5%), which were also among the top five causes of death. However, the second to fifth leading causes of death from malignant tumors in China were digestive system tumors (liver cancer 12.3%, stomach cancer 10.1%, colorectal cancer 9.3%, and esophageal cancer 7.3%). From 2000 to 2018, the world standard incidence of malignant tumors showed an increasing trend and the world standard mortality of malignant tumors showed a decreasing trend in China, while the world standard incidence and mortality of malignant tumors in the United States showed a significant decreasing trend after 2000. The incidence of breast cancer, colorectal cancer and thyroid cancer increased rapidly in China, while the incidence and mortality of stomach cancer, liver cancer and esophageal cancer decreased, but they still had a heavy disease burden. From 2003 to 2015, the overall 5-year relative survival rate of malignant tumors increased from 30.9% to 40.5% in China. However, with the exception of esophageal cancer, the 5-year relative survival rates of other major malignant tumors were lower than those in the United States. In 2019, the PAF of malignant tumors death attributable to potential modifiable risk factors was 48.3% in China, which was similar to the United States (49.8%). Of these, smoking was the most important attributable risk factor, and the PAF was more than 30% both in China and the United States. In addition, about 18.8% of malignant tumors were caused by preventable chronic infections, such as hepatitis B virus and Helicobacter pylori, while less than 4% of malignant tumors in the United States were caused by infection.Conclusions:China has made great progress in the prevention and treatment of malignant tumors, but it still faces a serious disease burden. The cancer spectrum is changing from developing countries to developed countries. We should pay attention to modifiable factors, take comprehensive measures, and prevent cancer scientifically.
4.Exploration and validation of optimal cut-off values for tPSA and fPSA/tPSA screening of prostate cancer at different ages
Xiaomin LIU ; Hongyuan DUAN ; Dongqi ZHANG ; Chong CHEN ; Yuting JI ; Yunmeng ZHANG ; Zhuowei FENG ; Ya LIU ; Jingjing LI ; Yu ZHANG ; Chenyang LI ; Yacong ZHANG ; Lei YANG ; Zhangyan LYU ; Fangfang SONG ; Fengju SONG ; Yubei HUANG
Chinese Journal of Oncology 2024;46(4):354-364
Objective:To determine the total and age-specific cut-off values of total prostate specific antigen (tPSA) and the ratio of free PSA divided total PSA (fPSA/tPSA) for screening prostate cancer in China.Methods:Based on the Chinese Colorectal, Breast, Lung, Liver, and Stomach cancer Screening Trial (C-BLAST) and the Tianjin Common Cancer Case Cohort (TJ4C), males who were not diagnosed with any cancers at baseline since 2017 and received both tPSA and fPSA testes were selected. Based on Cox regression, the overall and age-specific (<60, 60-<70, and ≥70 years) accuracy and optimal cut-off values of tPSA and fPSA/tPSA ratio for screening prostate cancer were evaluated with time-dependent receiver operating characteristic curve (tdROC) and area under curve (AUC). Bootstrap resampling was used to internally validate the stability of the optimal cut-off value, and the PLCO study was used to externally validate the accuracy under different cut-off values.Results:A total of 5 180 participants were included in the study, and after a median follow-up of 1.48 years, a total of 332 prostate cancer patients were included. In the total population, the tdAUC of tPSA and fPSA/tPSA screening for prostate cancer were 0.852 and 0.748, respectively, with the optimal cut-off values of 5.08 ng/ml and 0.173, respectively. After age stratification, the age specific cut-off values of tPSA in the <60, 60-<70, and ≥70 age groups were 3.13, 4.82, and 11.54 ng/ml, respectively, while the age-specific cut-off values of fPSA/tPSA were 0.153, 0.135, and 0.130, respectively. Under the age-specific cut-off values, the sensitivities of tPSA screening for prostate cancer in males <60, 60-70, and ≥70 years old were 92.3%, 82.0%, and 77.6%, respectively, while the specificities were 84.7%, 81.3%, and 75.4%, respectively. The age-specific sensitivities of fPSA/tPSA for screening prostate cancer were 74.4%, 53.3%, and 55.9%, respectively, while the specificities were 83.8%, 83.7%, and 83.7%, respectively. Both bootstrap's internal validation and PLCO external validation provided similar results. The combination of tPSA and fPSA/tPSA could further improve the accuracy of screening.Conclusion:To improve the screening effects, it is recommended that age-specific cut-off values of tPSA and fPSA/tPSA should be used to screen for prostate cancer in the general risk population.
5.Comparison of the latest cancer statistics, cancer epidemic trends and determinants between China and the United States
Yuting JI ; Siwen LIU ; Yunmeng ZHANG ; Hongyuan DUAN ; Xiaomin LIU ; Zhuowei FENG ; Jingjing LI ; Zhangyan LYU ; Yubei HUANG
Chinese Journal of Oncology 2024;46(7):646-656
Objective:To provide supports for the cancer prevention and control strategies in China by comparing the disease burden, epidemic trends, 5-year relative survival rate and major determinants of common cancers between China and the United States.Methods:A descriptive secondary analysis was conducted using data extracted from the GLOBOCAN database, the Surveillance, Epidemiology, and End Results database, Global Burden of disease 2019 database, and previous studies. The main indicators included the cases of malignant tumors in different sites, the cases of deaths, the age-standardized incidence (world standard incidence) and mortality (world standard mortality), the 5-year relative survival rate, and population attributable fraction (PAF).Results:In 2022, an estimated 4.825 million new cases and 2.574 million deaths of malignant neoplasms in China. The world standard incidence rate (201.6/100 000) in China was lower than that in the United States (367.0/100 000), and the world standard mortality rate (96.5/100 000) was higher than that in the United States (82.3/100 000). Lung cancer ranked first in the disease burden of malignant tumors in China, the new cases and deaths accounted for 22.0% and 28.5% of all malignant tumors, respectively. The top three malignant tumors in China were breast cancer (11.5%), prostate cancer (9.7%) and lung cancer (9.5%), which were also among the top five causes of death. However, the second to fifth leading causes of death from malignant tumors in China were digestive system tumors (liver cancer 12.3%, stomach cancer 10.1%, colorectal cancer 9.3%, and esophageal cancer 7.3%). From 2000 to 2018, the world standard incidence of malignant tumors showed an increasing trend and the world standard mortality of malignant tumors showed a decreasing trend in China, while the world standard incidence and mortality of malignant tumors in the United States showed a significant decreasing trend after 2000. The incidence of breast cancer, colorectal cancer and thyroid cancer increased rapidly in China, while the incidence and mortality of stomach cancer, liver cancer and esophageal cancer decreased, but they still had a heavy disease burden. From 2003 to 2015, the overall 5-year relative survival rate of malignant tumors increased from 30.9% to 40.5% in China. However, with the exception of esophageal cancer, the 5-year relative survival rates of other major malignant tumors were lower than those in the United States. In 2019, the PAF of malignant tumors death attributable to potential modifiable risk factors was 48.3% in China, which was similar to the United States (49.8%). Of these, smoking was the most important attributable risk factor, and the PAF was more than 30% both in China and the United States. In addition, about 18.8% of malignant tumors were caused by preventable chronic infections, such as hepatitis B virus and Helicobacter pylori, while less than 4% of malignant tumors in the United States were caused by infection.Conclusions:China has made great progress in the prevention and treatment of malignant tumors, but it still faces a serious disease burden. The cancer spectrum is changing from developing countries to developed countries. We should pay attention to modifiable factors, take comprehensive measures, and prevent cancer scientifically.
6.Correlation between the distribution of airborne pollen and the positive sIgE test in patients with allergic rhinitis in Taiyuan City in spring from 2022 to 2023
Jing ZHANG ; Yuting JIANG ; Lu GAO ; Dongdong YU ; Chan HE ; Huliang CUI ; Haojiang WANG ; Yan FENG
Chinese Journal of Preventive Medicine 2024;58(6):823-829
This study was to investigate the relationship between spring pollen distribution concentration, species and the detection results of air-borne pollen allergens in Taiyuan City, Shanxi Province during March to May 2022 and March to May 2023.A retrospective study was conducted in the Otorhinolaryngology Head and Neck Surgery Clinic of the First Hospital of Shanxi Medical University.Pollen particles will be monitored by gravity sedimentation method on the roof of the outpatient department of the First Hospital of Shanxi Medical University in downtown Taiyuan from March to May 2022-2023, and pollen species and quantity will be observed and recorded under an optical microscope.The air-borne pollen allergen detection results of all allergic rhinitis patients in the otolaryngology Head and Neck surgery Department of the First Hospital of Shanxi Medical University were extracted from the relevant outpatient system. SPSS software and Pearson correlation analysis were used to compare the correlation between the allergens and the dominant air-borne pollen monitoring results. Results are as follows: (1)A total of 18 species of spring pollen in Taiyuan City were monitored in 2022-2023, with 101 177.5 grains, and the dominant airborne pollen was poplar (16.69%) and pine (29.06%) pollen. The pollen of poplar (11.96%), elm (7.89%) and cypress (8.68%) were dominant in early spring; Pine (25.16%) pollen predominated in late spring. The two peaks of pollen dispersal in Taiyuan were in late March (15 479 grains) and early and mid May (15 094/15 343 grains).(2) The positive rates of allergens in serum specific IgE detection were: wormwood (46%, 248/541 cases), tree combination (26%, 143/541 cases), ragweed (19%, 101/541 cases), humulus scandens (9%, 49/541 cases).(3)There was a linear positive correlation between the positive rate of air-borne pollen allergens in allergic rhinitis patients in the Department of Otolaryngology Head and Neck Surgery in the First Hospital of Shanxi Medical University and the dominant air-borne pollen concentration in the same period ( P<0.05, r=0.999). In conclusion, two spring pollen dispersal peaks were formed in late March and early to mid May in Taiyuan City, and the dominant air-borne pollens were poplar and pine pollens. The positive rate of air borne pollen allergen sIgE showed that wormwood allergy was the highest.There was a positive correlation between the concentration of air-borne pollen and the positive rate of air-borne pollen allergens in patients with allergic rhinitis in the Department of otorhinolaryngology and head and neck surgery in Taiyuan in 2022 and 2023.The monitoring of pollen distribution in spring can provide an important scientific basis for clinical workers to formulate prevention and treatment plans for patients with allergic rhinitis in the season, and provide data reference for the epidemiological investigation of allergic diseases in Taiyuan in the future.
7.Correlation between the distribution of airborne pollen and the positive sIgE test in patients with allergic rhinitis in Taiyuan City in spring from 2022 to 2023
Jing ZHANG ; Yuting JIANG ; Lu GAO ; Dongdong YU ; Chan HE ; Huliang CUI ; Haojiang WANG ; Yan FENG
Chinese Journal of Preventive Medicine 2024;58(6):823-829
This study was to investigate the relationship between spring pollen distribution concentration, species and the detection results of air-borne pollen allergens in Taiyuan City, Shanxi Province during March to May 2022 and March to May 2023.A retrospective study was conducted in the Otorhinolaryngology Head and Neck Surgery Clinic of the First Hospital of Shanxi Medical University.Pollen particles will be monitored by gravity sedimentation method on the roof of the outpatient department of the First Hospital of Shanxi Medical University in downtown Taiyuan from March to May 2022-2023, and pollen species and quantity will be observed and recorded under an optical microscope.The air-borne pollen allergen detection results of all allergic rhinitis patients in the otolaryngology Head and Neck surgery Department of the First Hospital of Shanxi Medical University were extracted from the relevant outpatient system. SPSS software and Pearson correlation analysis were used to compare the correlation between the allergens and the dominant air-borne pollen monitoring results. Results are as follows: (1)A total of 18 species of spring pollen in Taiyuan City were monitored in 2022-2023, with 101 177.5 grains, and the dominant airborne pollen was poplar (16.69%) and pine (29.06%) pollen. The pollen of poplar (11.96%), elm (7.89%) and cypress (8.68%) were dominant in early spring; Pine (25.16%) pollen predominated in late spring. The two peaks of pollen dispersal in Taiyuan were in late March (15 479 grains) and early and mid May (15 094/15 343 grains).(2) The positive rates of allergens in serum specific IgE detection were: wormwood (46%, 248/541 cases), tree combination (26%, 143/541 cases), ragweed (19%, 101/541 cases), humulus scandens (9%, 49/541 cases).(3)There was a linear positive correlation between the positive rate of air-borne pollen allergens in allergic rhinitis patients in the Department of Otolaryngology Head and Neck Surgery in the First Hospital of Shanxi Medical University and the dominant air-borne pollen concentration in the same period ( P<0.05, r=0.999). In conclusion, two spring pollen dispersal peaks were formed in late March and early to mid May in Taiyuan City, and the dominant air-borne pollens were poplar and pine pollens. The positive rate of air borne pollen allergen sIgE showed that wormwood allergy was the highest.There was a positive correlation between the concentration of air-borne pollen and the positive rate of air-borne pollen allergens in patients with allergic rhinitis in the Department of otorhinolaryngology and head and neck surgery in Taiyuan in 2022 and 2023.The monitoring of pollen distribution in spring can provide an important scientific basis for clinical workers to formulate prevention and treatment plans for patients with allergic rhinitis in the season, and provide data reference for the epidemiological investigation of allergic diseases in Taiyuan in the future.
8.Cognitive function change characteristics and diagnostic efficiency analysis of related indexes after white matter lesions in patients with asymptomatic middle cerebral artery stenosis
Shiyi ZUO ; Yong LIU ; Yuting FENG
Chongqing Medicine 2024;53(12):1778-1783
Objective To explore the characteristics of white matter lesions(WMLs)causing cognitive function change in the patients with asymptomatic middle cerebral artery(MCA)stenosis,and to analyze the diagnostic efficiency of related indexes.Methods Thirty-nine patients diagnosed with asymptomatic MCA ste-nosis and presenting with WMLs in the department of neurology of the hospital from 2021 to 2022 were in-cluded as the observation group,and 34 healthy people were included as the control group.The two groups conducted the behavioral assessment of cognitive function,such as the Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),Test of Connectivity Type A(TMT),Digit Symbol Test(SDMT),Digit Breadth Test(DST),Drawing the Clock Test(CDT),and Verbal Fluency Test(VFT).The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of related indica-tors.Results In the single cognitive function assessment scales,the scores of TMT in the observation group were significantly higher than those in the control group(P<0.01),the scores of SDMT,DST,CDT and VFT in the observation group were significantly lower than those in the control group and the differences were sta-tistically significant(P<0.01).In the comprehensive cognitive function assessment scales,the total scores of MMSE and MoCA in the observation group were significantly lower than those in the control group(P<0.01).In the scores of each factor of the MMSE scale,the verbal ability in the observation group was signifi-cantly lower than that in the control group(P<0.01),but the scores of orientation,memory,attention,calcu-lation and recall were had no statistically significant differences between the two groups(P>0.05).In the scores of each factor of MoCA,the visuospatial and executive ability,delayed memory,attention and abstrac-tion ability in the observation group were significantly lower than those in the control group(P<0.01),but the scores of naming ability,attention ability and orientation ability had no statistically difference(P>0.05).The area under the ROC curve(AUC),sensitivity and specificity of MoCA and MMSE were 0.80,0.73,0.52,0.71,0.92 and 0.74 respectively.The efficiency of MoCA for diagnosing cognitive function disorders caused by asymptomatic MCA stenosis was higher.Conclusion Compared with single cognitive function assessment scale,the comprehensive cognitive function assessment scales could more comprehensively and accurately screen the cognitive function disorders caused by WMLs in the patients with asymptomatic MCA stenosis,in which the diagnostic efficiency of MoCA is the highest.
9.Antiretroviral therapy attrition and its influencing factors among HIV-infected patients in Hainan
FENG Yuting ; XU Yujun ; ZHU Kaokao ; ZHANG Wenting
China Tropical Medicine 2024;24(3):304-
Objective To investigate the current status and attrition among HIV-infected persons receiving antiretroviral therapy (ART), and to analyze factors affecting attrition in Hainan. Methods In this study, HIV-infected patients who started ART treatment in Hainan Province from 2005 to 2022 were selected from the antiviral treatment submodule of China Disease Prevention and Control Information System.According to the inclusion and exclusion criteria,a total of 4 286 HIV-infected persons were receiving . A Cox proportional hazards regression model was used to analyze factors affecting attrition. Results Among the 4 286 study subjects, 3 718 were males (86.7%), with a sex ratio of 6.55∶1. Unmarried individuals accounted for 58.4%, and the average age was (39.68±13.17) years. Transmission through homosexual contact accounted for 49.8%, and 84.3% were in WHO clinical stage I. Treatment regimens containing Efavirenz (EFV) accounted for 71.7%. During a follow-up of 19 677.44 person-years, the overall attrition rate was 0.80 per 100 person-years, with the first-year post-ART initiation attrition rate being 21.10 per 100 person-years. The results of Cox regression analysis showed that the time of treatment initiation in 2016-2022 (AHR=2.40, 95%CI: 1.40-4.10), and the last HIV viral load (VL) 20-<1 000 copies/mL (AHR=3.69, 95%CI: 2.08-6.54), the last HIV-1 VL≥1 000 copies/mL (AHR=15.98, 95%CI: 9.46-27.01), and no last HIV-1 VL test (AHR=92.90, 95%CI: 57.68-149.62), the time interval from diagnosis to treatment for 1-12 months (AHR=1.62, 95%CI: 1.12-2.36), and an interval longer than 12 months (AHR=1.68, 95%CI: 1.07-2.62) were the main factors that increased the risk of attrition. Treatment regimens containing Lopinavir/ritonavir (Lpv/r) (AHR=0.34, 95%CI:0.18-0.66) and treatment regimens containing integrase strand transfer inhibitors (INSTIs) (AHR=0.24, 95%CI: 0.09-0.58) were the factors that reduced the risk of attrition after antiretroviral therapy. Conclusions The attrition of ART in HIV/AIDS patients in Hainan Province is related to a longer interval from diagnosis to treatment, treatment plan, and abnormal HIV viral load test results. Case-based measures should be taken to address factors influencing antiretroviral treatment attrition, while improving the timeliness of antiviral treatment and treatment management service quality to further improve the efficacy of antiviral treatment.
10.Research of predictive factors of axillary lymph node metastasis in breast cancer under the context of DIP payment of medical insurance
Haoran XIE ; Yihao LI ; Cheng LIU ; Yuting XIA ; Shenglei QIU ; Bin XIONG ; Qizhen FENG
Tianjin Medical Journal 2024;52(11):1193-1197
Objective To explore the predictive factors of axillary lymph node metastasis in breast cancer,and to provide a basis for clinical decision-making under the DIP payment mode of medical insurance.Methods A total of 715 patients with breast cancer were divided into the metastasis group(n=309)and the non-metastasis group(n=406)according to the postoperative paraffin pathological results.Data of age>60 years old,menopausal status,body mass index(BMI)>24 kg/m2,hyperglycemia(GLU>6.1 mmol/L),high triglycerides(TG>1.7 mmol/L),maximum diameter of the tumor,the distance between the tumor and nipple and the quadrant where the tumor located were compared between the two groups.The expression levels of estrogen receptor(ER),progesterone receptor(PR),nuclear proliferation antigen(Ki-67)and human epidermal growth factor receptor-2(Her-2)in breast cancer tissue samples were detected by histological grading and immunohistochemistry.The consistency,sensitivity and specificity of chest CT and breast ultrasound were examined,taken the pathological diagnosis as the gold standard.Results Compared with the non-metastatic group,the proportion of maximum diameter of tumor>2 cm,histological grade Ⅲ,high Ki-67 and high ER expression,tumor located in the outer upper quadrant,the distance>3 cm between tumor and nipple were increased in the metastatic group,and the proportion of high level of TG was decreased in the metastatic group(P<0.05).The consistency between chest CT and pathological diagnosis was better than that of breast ultrasound(Kappa was 0.493 and 0.353 respectively,P<0.05).Logistic regression analysis showed that histological grade Ⅲ,high expression of ER,maximum diameter of tumor>2 cm,and chest CT diagnosis were risk factors for axillary lymph node metastasis(P<0.05).Conclusion The combined application of the predictive factors of axillary lymph node metastasis of breast cancer could provide certain reference for clinical decision-making under the background of DIP payment mode of medical insurance.

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