1.Application value of machine learning prediction model for neural invasion in gallbladder cancer based on enhanced CT and clinical characteristics
Bing ZHOU ; Sheng ZHANG ; Hao LI ; Binjie ZHOU ; Yang JIAO ; Qingwu WU ; Junyan YUE ; Shaoying LI
Chinese Journal of Digestive Surgery 2025;24(4):535-542
Objective:To explore the application value of machine learning prediction model for neural invasion in gallbladder cancer based on enhanced computed tomography (CT) and clinical characteristics.Methods:The retrospective cohort study was conducted. The clinical and imaging data of 502 patients with gallbladder cancer who were admitted to The First Affiliated Hospital of Xinxiang Medical University from January 2010 to June 2024 were collected. There were 171 males and 331 females, aged 65(range, 35?91)years. All patients underwent preoperative abdominal enhanced CT and radical resection. The 502 patients were randomly divided into a training set of 351 cases and a test set of 151 cases at a 7:3 ratio. The training set was used to construct prediction model, and the test set was used to validate prediction model. Observation indicators: (1)neural invasion in gallbladder cancer and influencing factor analysis; (2) construction and validation of machine learning prediction models for neural invasion in gallbladder cancer. Comparison of count data between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the Mann-Whitney U test. Logistic regression model was performed for univariate and multivariate analyses. Independent influencing factors were incor-porated to construct machine learning models using the standard library modules based on Python 3.9. Receiver operating characteristic (ROC) curves were plotted, and the accuracy, sensitivity, specificity, area under the curve (AUC), precision, F1 score, positive predictive value, negative predic-tive value, and Kappa value were calculated to evaluate the predictive performance of the models. The Delong test was used to assess the differences in AUC among different models in the test set. The Hosmer-Lemeshow test and Brier score were used to evaluate the calibration of the models. Results:(1) Neural invasion in gallbladder cancer and influencing factor analysis. Of the 502 patients with gallbladder cancer, 131 cases had neural invasion, and 371 cases had no neural invasion. Results of multivariate analysis showed that total bilirubin, carcinoembryonic antigen, CA199, CA125, neutrophil-lymphocyte ratio, liver invasion detected by CT, vascular invasion detected by CT, hilar or retroperi-toneal lymph node metastasis detected by CT, and tumor stages T3 and T4 were independent influencing factors for neural invasion in patients with gallbladder cancer [ odds ratios=3.747, 2.395, 3.917, 3.596, 2.805, 2.377, 3.523, 2.774, 5.080, 6.809, 95% confidence interval ( CI) as 1.890?7.430, 1.154?4.971, 2.054?7.472, 1.807?7.155, 1.506?5.225, 1.241?4.553, 1.666?7.449, 1.483?5.189, 2.050?12.589, 2.552?18.168, P<0.05]. (2) Construction and validation of machine learning predic-tion models for neural invasion in gallbladder cancer. Based on the independent influencing factors, seven machine learning models were constructed, including logistic regression, K-nearest neighbors, support vector machine, random forest, decision tree, back-propagation neural network, and gradient boosting machine. The ROC curves of seven machine learning models in the test set were plotted, and the AUC were 0.900(95% CI as 0.851?0.948), 0.741(95% CI as 0.646?0.829), 0.836(95% CI as 0.762?0.895), 0.782(95% CI as 0.701?0.855), 0.839(95% CI as 0.770?0.901), 0.817(95% CI as 0.738?0.887), 0.843(95% CI as 0.770?0.909), respectively. Results of Delong test showed that the logistic regression model had the highest AUC. The sensitivity and specificity of the logistic regression model were 0.868 and 0.805 respectively, indicating the best balance. Results of Hosmer-Lemeshow test showed that the logistic regression model had a good goodness-of-fit ( χ2=5.320, P>0.05). The Brier score of the logistic regression model was relatively low, as 0.168, which verified its calibration advantage. Conclusion:Total bilirubin, carcinoembryonic antigen, CA199, CA125, neutrophil-to-lymphocyte ratio, liver invasion detected by enhanced CT, vascular invasion detected by enhanced CT, hilar or retroperitoneal lymph node metastasis detected by enhanced CT, and tumor stages T3 and T4 are independent influencing factors for nerve invasion in patients with gallbladder cancer. Seven machine learning models are constructed based on enhanced CT and clinical characteristics to predict neural invasion in gallbladder cancer, of which the logistic regression model demonstrates good predictive performance.
2.Correlation between SⅡ and early neurological deterioration in patients with branch atheromatous disease
Debiao GAN ; Juntao LI ; Bing LIU ; Junyan DUAN ; Bo ZHANG ; Zonghan JIA ; Huiyong HUO
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(1):72-75
Objective To explore the relationship between systemic immune-inflammation index(SⅡ)at admission and occurrence of early neurological deterioration(END)in patients with branch atheromatous disease(BAD).Methods A retrospective analysis was performed on 326 BAD patients admitted in Department of Neurology of Handan Central Hospital from October 2021 to February 2024.Based on occurrence of END or not,they were divided into END group(97 cases)and non-END group(229 cases).Clinical data of the patients were collected,and multivari-ate logistic regression analysis was used to identify the END risk variables in BAD patients.ROC curve was plotted to evaluate the value of NIHSS score,hs-CRP and SⅡ in predicting the inci-dence of END in the patients.Results Significantly advanced age,higher NIHSS score at admis-sion,and elevated hs-CRP level,neutrophil count and SⅡ,but lower platelet and lymphocyte counts were observed in the END group than the non-END group(P<0.05,P<0.01).Multi vari-ate logistic regression analysis indicated that NIHSS score at admission(OR=1.134,95%CI:1.050-1.226,P=0.001),hs-CRP(OR=1.131,95%CI:1.024-1.249,P=0.015),and SⅡ(OR=1.001,95%CI:1.001-1.002,P=0.003)were independent risk factors for END in BAD patients.The AUC value of SⅡ in the prediction of END was 0.660,which was significantly higher than that of NIHSS score and hs-CRP in BAD patients(P<0.05).Conclusion SⅡ is an independent risk factor for END in BAD patients,and SⅡ at admission has a certain predictive value for the oc-currence of END in these patients.
3.Two-sample Mendelian randomization study on the causal association between air pollution and Alzheimer's disease
Yingying ZHANG ; Junyao ZHANG ; Jiwei SONG ; Shengjie WANG ; Junyan YAO
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(1):87-94
Objective·To explore the causal relationship between air pollution and the risk of Alzheimer's disease(AD)by using two-sample Mendelian randomization(MR).Methods·Based on the data from the genome-wide association study(GWAS),a two-sample MR analysis was conducted to evaluate the causal relationship between air pollution and the risk of AD.Air pollution indicators,including particulate matter 2.5(PM2.5),particulate matter 2.5-10(PM2.5-10),particulate matter 10(PM10),nitrogen dioxide and nitrogen oxides,were used as exposure factors,and summarized data were aggregated from the UK Biobank database.The PM2.5 dataset included 423 796 cases,with correlation analysis conducted on 9 851 867 single nucleotide polymorphisms(SNPs);the PM2.5-10 dataset included 423 796 cases,with correlation analysis conducted on 9 851 867 SNPs;the PM10 dataset included 455 314 cases,with correlation analysis conducted on 9 851 867 SNPs;the nitrogen dioxide dataset included 456 380 cases,with correlation analysis conducted on 9 851 867 SNPs;the nitrogen oxides dataset included 456 380 cases,with correlation analysis conducted on 9 851 867 SNPs.AD was used as the outcome factor,and data were obtained from the International Genomics of Alzheimer's Project(IGAP).The AD dataset included 25 580 cases and 48 466 controls,with correlation analysis of 7 067 513 SNPs.SNPs significantly associated with AD were used as instrumental variables.The main analysis was conducted by using the inverse variance weighted(IVW)method,and four methods including weighted median,MR-Egger regression,mode-based simple estimation and mode-based weighted estimation were used for quality control.Heterogeneity testing,gene pleiotropy testing and sensitivity analysis were conducted to assess the reliability of the study results.Results·Heterogeneity testing indicated no evidence of heterogeneity among SNPs associated with air pollution indicators and AD(both IVW and MR-Egger results,P>0.05).Gene pleiotropy testing did not detect any pleiotropic effects(MR-Egger results,P>0.05).Sensitivity analysis confirmed the stability of the PM2.5 results.IVW analysis revealed a statistically significant association between PM2.5 and AD in European populations(P<0.001),while no statistically significant associations were observed between PM2.5-10(P=0.664),PM10(P=0.664),nitrogen dioxide(P=0.284),nitrogen oxides(P=0.567)and AD.Conclusion·There is a significant causal relationship between PM2.5 exposure and the risk of AD,with PM2.5 exposure increasing the incidence of AD.However,no evidence has been found to suggest that PM2.5-10,PM10,nitrogen dioxide or nitrogen oxides cause an increased risk of AD.
4.Application value of machine learning prediction model for neural invasion in gallbladder cancer based on enhanced CT and clinical characteristics
Bing ZHOU ; Sheng ZHANG ; Hao LI ; Binjie ZHOU ; Yang JIAO ; Qingwu WU ; Junyan YUE ; Shaoying LI
Chinese Journal of Digestive Surgery 2025;24(4):535-542
Objective:To explore the application value of machine learning prediction model for neural invasion in gallbladder cancer based on enhanced computed tomography (CT) and clinical characteristics.Methods:The retrospective cohort study was conducted. The clinical and imaging data of 502 patients with gallbladder cancer who were admitted to The First Affiliated Hospital of Xinxiang Medical University from January 2010 to June 2024 were collected. There were 171 males and 331 females, aged 65(range, 35?91)years. All patients underwent preoperative abdominal enhanced CT and radical resection. The 502 patients were randomly divided into a training set of 351 cases and a test set of 151 cases at a 7:3 ratio. The training set was used to construct prediction model, and the test set was used to validate prediction model. Observation indicators: (1)neural invasion in gallbladder cancer and influencing factor analysis; (2) construction and validation of machine learning prediction models for neural invasion in gallbladder cancer. Comparison of count data between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the Mann-Whitney U test. Logistic regression model was performed for univariate and multivariate analyses. Independent influencing factors were incor-porated to construct machine learning models using the standard library modules based on Python 3.9. Receiver operating characteristic (ROC) curves were plotted, and the accuracy, sensitivity, specificity, area under the curve (AUC), precision, F1 score, positive predictive value, negative predic-tive value, and Kappa value were calculated to evaluate the predictive performance of the models. The Delong test was used to assess the differences in AUC among different models in the test set. The Hosmer-Lemeshow test and Brier score were used to evaluate the calibration of the models. Results:(1) Neural invasion in gallbladder cancer and influencing factor analysis. Of the 502 patients with gallbladder cancer, 131 cases had neural invasion, and 371 cases had no neural invasion. Results of multivariate analysis showed that total bilirubin, carcinoembryonic antigen, CA199, CA125, neutrophil-lymphocyte ratio, liver invasion detected by CT, vascular invasion detected by CT, hilar or retroperi-toneal lymph node metastasis detected by CT, and tumor stages T3 and T4 were independent influencing factors for neural invasion in patients with gallbladder cancer [ odds ratios=3.747, 2.395, 3.917, 3.596, 2.805, 2.377, 3.523, 2.774, 5.080, 6.809, 95% confidence interval ( CI) as 1.890?7.430, 1.154?4.971, 2.054?7.472, 1.807?7.155, 1.506?5.225, 1.241?4.553, 1.666?7.449, 1.483?5.189, 2.050?12.589, 2.552?18.168, P<0.05]. (2) Construction and validation of machine learning predic-tion models for neural invasion in gallbladder cancer. Based on the independent influencing factors, seven machine learning models were constructed, including logistic regression, K-nearest neighbors, support vector machine, random forest, decision tree, back-propagation neural network, and gradient boosting machine. The ROC curves of seven machine learning models in the test set were plotted, and the AUC were 0.900(95% CI as 0.851?0.948), 0.741(95% CI as 0.646?0.829), 0.836(95% CI as 0.762?0.895), 0.782(95% CI as 0.701?0.855), 0.839(95% CI as 0.770?0.901), 0.817(95% CI as 0.738?0.887), 0.843(95% CI as 0.770?0.909), respectively. Results of Delong test showed that the logistic regression model had the highest AUC. The sensitivity and specificity of the logistic regression model were 0.868 and 0.805 respectively, indicating the best balance. Results of Hosmer-Lemeshow test showed that the logistic regression model had a good goodness-of-fit ( χ2=5.320, P>0.05). The Brier score of the logistic regression model was relatively low, as 0.168, which verified its calibration advantage. Conclusion:Total bilirubin, carcinoembryonic antigen, CA199, CA125, neutrophil-to-lymphocyte ratio, liver invasion detected by enhanced CT, vascular invasion detected by enhanced CT, hilar or retroperitoneal lymph node metastasis detected by enhanced CT, and tumor stages T3 and T4 are independent influencing factors for nerve invasion in patients with gallbladder cancer. Seven machine learning models are constructed based on enhanced CT and clinical characteristics to predict neural invasion in gallbladder cancer, of which the logistic regression model demonstrates good predictive performance.
5.Validation of the atopic dermatitis control tool in assessing disease control
Yani LIU ; Qian ZHAO ; Yuan LIU ; Junyan ZHANG ; Huiping WANG
Chinese Journal of Dermatology 2025;58(2):154-160
Objective:To verify the validity of the atopic dermatitis control tool (ADCT) in assessing disease control in patients with atopic dermatitis (AD) .Methods:Based on a cross - sectional study, demographic data, comorbidities and information on disease assessment - related scales such as the ADCT, the pruritus numerical rating scale (NRS), the patient-oriented eczema measure (POEM), and the dermatological life quality index (DLQI) were collected from patients with AD at Tianjin Medical University General Hospital from June 2021 to March 2023. The reliability and validity of the ADCT were assessed using these data. The discrimination power of the ADCT total score was evaluated by comparing the differences in the mean ADCT total scores among adjacent POEM/DLQI subgroups based on POEM/DLQI response classifications (POEM: clear or almost absent, mild, moderate, severe, very severe; DLQI: no effect, mild effect, moderate effect, serious effect, very serious effect). According to the ADCT scores, the AD patients were divided into an uncontrolled AD group (ADCT scores ≥ 7 points) and a controlled AD group (ADCT scores < 7 points). Differences between the above two groups were analyzed in terms of ADCT item scores, mean pruritus NRS scores, POEM total scores, DLQI total scores, and DLQI dimension scores to evaluate the validity of the ADCT in assessing AD disease control.Results:A total of 338 patients with AD were included, comprising 170 (50.30%) males and 168 (49.70%) females, and they were aged 17 to 89 (41.36 ± 17.63) years. Reliability analysis showed that the Cronbach′s α coefficient and split-half reliability coefficient of the ADCT were 0.886 and 0.878 respectively (both > 0.70), and the test- retest reliability coefficient was 0.977 (> 0.70, P < 0.001). Content validity analysis showed that the Pearson correlation coefficients between the ADCT item scores and the ADCT total score ranged from 0.753 to 0.852 (all P < 0.001) ; confirmatory factor analysis revealed that the Chi-square to degree of freedom ratio ( χ2/df) was 2.896 (< 5), the Tucker-Lewis index was 0.976 (> 0.9), the comparative fit index was 0.991 (> 0.9), the standardized root mean square residual was 0.026 (< 0.08), and the root-mean-square error of approximation was 0.075 (< 0.08) ; convergent validity analysis showed that the standardized factor loadings of all observed variables ranged from 0.689 to 0.905 (all > 0.500), combined reliability coefficient was 0.896 (> 0.700), and the average extracted variance value was 0.591 (> 0.500) ; criterion validity analysis showed that the correlation coefficients of the ADCT total score with other patient - reported outcome measures (the mean pruritus NRS scores, peak pruritus NRS scores, POEM total scores, and DLQI total scores) and DLQI dimension scores ranged from 0.649 to 0.730 and from 0.303 to 0.647, respectively (all P < 0.001). Analysis of the discrimination power of the ADCT total score showed significant differences in the mean ADCT total scores among adjacent POEM/DLQI subgroups (all P ≤ 0.001). The uncontrolled AD group (287 cases) showed significantly increased ADCT item scores, mean pruritus NRS score, POEM total score, DLQI total score, and DLQI dimension scores compared with the controlled AD group (51 cases, all P<0.001) . Conclusion:The ADCT exhibited good reliability, validity and discriminability based on the cross-sectional study, and can efficiently and reliably assess disease control in AD patients.
6.Retrospective analysis of adverse events associated with traditional Chinese medicine formula granules and decoction pieces in hospitalized patients using the global trigger tool
Yaxiong LI ; Fusang WANG ; Mei ZHANG ; Jiawei LIN ; Wenge CHEN ; Min HUANG ; Junyan WU
China Pharmacy 2025;36(5):606-611
OBJECTIVE To provide technical support for improving recognition rate of adverse drug events (ADEs) related to traditional Chinese medicine (TCM) formula granules and decoction pieces among inpatient patients. METHODS By referencing the global trigger tool (GTT) whitepaper, literature on adverse reactions to TCM, and expert review opinions, ADE trigger items for TCM formula granules and decoction pieces used in the inpatients were established. GTT was applied to analyze ADEs in inpatients who had used TCM formula granules and decoction pieces in our hospital from August 2013 to August 2023, utilizing the Chinese Hospital Pharmacovigilance System. The effectiveness of GTT and the characteristics of these ADEs were analyzed. RESULTS A total of forty-eight triggers were established, including thirty-two laboratory test indexes, thirteen clinical symptoms, and three antidotes. Among the 1 682 patients included, GTT identified 652 potential ADEs, 284 true positive ADEs,with a trigger rate of 38.76% and a positive predictive value of 43.56%. After review by the auditor, 278 cases of ADEs were finally confirmed, with an incidence rate of 16.53%, significantly higher than the number of spontaneously reported ADEs during the same period (0). The 278 cases of ADEs were mostly grade 1 (223 cases), mainly involving hepatobiliary system, gastrointestinal system, blood- lymphatic system, etc;a total of 219 types of TCMs are involved,and the top five suspected TCMs used at a frequency higher than 1% were Poria cocos, Codonopsis pilosula, Atractylodes macrocephala, fried Glycyrrhiza uralensis, and Scutellaria baicalensis. CONCLUSIONS The established GTT can improve the recognition rate of ADEs for hospitalized patients using traditional Chinese medicine formula granules and decoction pieces.
7.Correlation between SⅡ and early neurological deterioration in patients with branch atheromatous disease
Debiao GAN ; Juntao LI ; Bing LIU ; Junyan DUAN ; Bo ZHANG ; Zonghan JIA ; Huiyong HUO
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(1):72-75
Objective To explore the relationship between systemic immune-inflammation index(SⅡ)at admission and occurrence of early neurological deterioration(END)in patients with branch atheromatous disease(BAD).Methods A retrospective analysis was performed on 326 BAD patients admitted in Department of Neurology of Handan Central Hospital from October 2021 to February 2024.Based on occurrence of END or not,they were divided into END group(97 cases)and non-END group(229 cases).Clinical data of the patients were collected,and multivari-ate logistic regression analysis was used to identify the END risk variables in BAD patients.ROC curve was plotted to evaluate the value of NIHSS score,hs-CRP and SⅡ in predicting the inci-dence of END in the patients.Results Significantly advanced age,higher NIHSS score at admis-sion,and elevated hs-CRP level,neutrophil count and SⅡ,but lower platelet and lymphocyte counts were observed in the END group than the non-END group(P<0.05,P<0.01).Multi vari-ate logistic regression analysis indicated that NIHSS score at admission(OR=1.134,95%CI:1.050-1.226,P=0.001),hs-CRP(OR=1.131,95%CI:1.024-1.249,P=0.015),and SⅡ(OR=1.001,95%CI:1.001-1.002,P=0.003)were independent risk factors for END in BAD patients.The AUC value of SⅡ in the prediction of END was 0.660,which was significantly higher than that of NIHSS score and hs-CRP in BAD patients(P<0.05).Conclusion SⅡ is an independent risk factor for END in BAD patients,and SⅡ at admission has a certain predictive value for the oc-currence of END in these patients.
8.Effects of peiminine B on Streptococcus pneumoniae-induced alveolar epithelial cell injury and its mechanism
Rui ZHANG ; Cuihong LI ; Youqin WANG ; Junyan GUAN
China Pharmacy 2025;36(7):820-825
OBJECTIVE To investigate the effects of peiminine B (PEI) on Streptococcus pneumoniae (SP)-induced alveolar epithelial cell injury by regulating the Ras-related C3 botulinum toxin substrate 1 in nucleus accumbens (Rac1)/protein kinase B (Akt)/nuclear factor κB (NF-κB) signaling pathway. METHODS Human alveolar epithelial cells (HPAEpiC) were taken and randomly divided into the Control group, SP group (1×108 cfu/mL SP bacterial solution), low-, medium-, and high-concentration PEI groups (1×108 cfu/mL SP bacterial solution+0.05, 0.10, 0.20 mmol/L PEI), and high-concentration PEI+Akt activator group (P-H+SC79 group, 1×108 cfu/mL SP bacterial solution+0.20 mmol/L PEI+10 μmol/L SC79). Except for the Control group, the other groups of cells were treated with SP bacterial solution and/or corresponding drug solution. After 24 h of treatment, the levels of inflammatory factors (interleukin-6, -18, -1β) in the supernatant solution, the contents of oxidative stress indexes [lactate dehydrogenase (LDH), reactive oxygen species (ROS) and superoxide dismutase (SOD)], apoptosis rate, as well as the expressions of proliferation/apoptosis-related proteins [cyclin-dependent kinase 1 (CDK1), B cell lymphoma-2 related X protein (Bax)] and pathway-related proteins (Rac1, Akt, phosphorylated Akt, NF-κB and phosphorylated NF-κB) were detected in each group. RESULTS Compared with the Control group, the levels of inflammatory factors in supernatant solution, LDH and ROS contents, apoptosis rate, the protein expressions of Bax and Rac1 and the phosphorylation levels of Akt and NF-κB in the SP group were significantly increased or up-regulated, while SOD content and the protein expression of CDK1 were significantly decreased or down-regulated (P<0.05). Compared with the SP group, the above indexes in PEI groups were significantly improved in a concentration-dependent manner (P<0.05). SC79 could significantly reverse the improvement effect of the high concentration of PEI (P<0.05). CONCLUSIONS PEI can alleviate SP-induced inflammation and oxidative stress damage of alveolar epithelial cells and inhibit apoptosis, which may be achieved by inhibiting Rac1/Akt/NF-κB signaling pathway.
9.Persistent HPV Infection Among Women in Zhengzhou, China: A Prevalence Study
Haixia DUAN ; Jin QIAN ; Yao ZHANG ; Zhimin REN ; Guohong ZHAO ; Junyan HONG ; Xinmin LI
Cancer Research on Prevention and Treatment 2025;52(9):770-775
Objective To analyze the status of persistent human papillomavirus (HPV) infection and the distribution of viral subtypes in the Zhengzhou region. Methods Clinical data of
10.Validation of the atopic dermatitis control tool in assessing disease control
Yani LIU ; Qian ZHAO ; Yuan LIU ; Junyan ZHANG ; Huiping WANG
Chinese Journal of Dermatology 2025;58(2):154-160
Objective:To verify the validity of the atopic dermatitis control tool (ADCT) in assessing disease control in patients with atopic dermatitis (AD) .Methods:Based on a cross - sectional study, demographic data, comorbidities and information on disease assessment - related scales such as the ADCT, the pruritus numerical rating scale (NRS), the patient-oriented eczema measure (POEM), and the dermatological life quality index (DLQI) were collected from patients with AD at Tianjin Medical University General Hospital from June 2021 to March 2023. The reliability and validity of the ADCT were assessed using these data. The discrimination power of the ADCT total score was evaluated by comparing the differences in the mean ADCT total scores among adjacent POEM/DLQI subgroups based on POEM/DLQI response classifications (POEM: clear or almost absent, mild, moderate, severe, very severe; DLQI: no effect, mild effect, moderate effect, serious effect, very serious effect). According to the ADCT scores, the AD patients were divided into an uncontrolled AD group (ADCT scores ≥ 7 points) and a controlled AD group (ADCT scores < 7 points). Differences between the above two groups were analyzed in terms of ADCT item scores, mean pruritus NRS scores, POEM total scores, DLQI total scores, and DLQI dimension scores to evaluate the validity of the ADCT in assessing AD disease control.Results:A total of 338 patients with AD were included, comprising 170 (50.30%) males and 168 (49.70%) females, and they were aged 17 to 89 (41.36 ± 17.63) years. Reliability analysis showed that the Cronbach′s α coefficient and split-half reliability coefficient of the ADCT were 0.886 and 0.878 respectively (both > 0.70), and the test- retest reliability coefficient was 0.977 (> 0.70, P < 0.001). Content validity analysis showed that the Pearson correlation coefficients between the ADCT item scores and the ADCT total score ranged from 0.753 to 0.852 (all P < 0.001) ; confirmatory factor analysis revealed that the Chi-square to degree of freedom ratio ( χ2/df) was 2.896 (< 5), the Tucker-Lewis index was 0.976 (> 0.9), the comparative fit index was 0.991 (> 0.9), the standardized root mean square residual was 0.026 (< 0.08), and the root-mean-square error of approximation was 0.075 (< 0.08) ; convergent validity analysis showed that the standardized factor loadings of all observed variables ranged from 0.689 to 0.905 (all > 0.500), combined reliability coefficient was 0.896 (> 0.700), and the average extracted variance value was 0.591 (> 0.500) ; criterion validity analysis showed that the correlation coefficients of the ADCT total score with other patient - reported outcome measures (the mean pruritus NRS scores, peak pruritus NRS scores, POEM total scores, and DLQI total scores) and DLQI dimension scores ranged from 0.649 to 0.730 and from 0.303 to 0.647, respectively (all P < 0.001). Analysis of the discrimination power of the ADCT total score showed significant differences in the mean ADCT total scores among adjacent POEM/DLQI subgroups (all P ≤ 0.001). The uncontrolled AD group (287 cases) showed significantly increased ADCT item scores, mean pruritus NRS score, POEM total score, DLQI total score, and DLQI dimension scores compared with the controlled AD group (51 cases, all P<0.001) . Conclusion:The ADCT exhibited good reliability, validity and discriminability based on the cross-sectional study, and can efficiently and reliably assess disease control in AD patients.

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