1.A simulation study of the reliability and accuracy of Cox-TEL method for estimating hazard ratio and difference in proportions for long-term survival data containing cured patients
Biqing ZOU ; Lishan XU ; Keke LI ; Shengli AN
Journal of Southern Medical University 2024;44(6):1182-1187
Objective To explore the applicable conditions of the Cox-TEL(Cox PH-Taylor expansion adjustment for long-term survival data)method for analysis of survival data that contain cured patients.Methods The simulated survival data method based on Weibull distribution was used to simulate and generate the survival data with different cure rates,censored rates,and cure rate differences.The Cox-TEL method was used for analysis of the generated simulation data,and its performance was evaluated by calculating its type I error and power.Results Almost all the type I error of the hazard ratios(HRs)obtained by the Cox-TEL method under different conditions were slightly greater than 0.05,and this method showed a good test power for estimating the HRs for data with a large sample size and a large difference in proportions(DPs).For the data of cured patients,the type I error of the DPs obtained by the Cox-TEL method was well around 0.05,and its test power was robust in most of the scenarios.Conclusion The Cox-TEL method is effective for analyzing data of uncured patients and obtaining reliable HRs for most of the survival data with a sample size,a low censored rates,and a large difference in cure rates.The method is capable of accurately estimating the DPs regardless of the sample size,censored rates,or the cure rates.
2.Analysis of cognitive status of spiritual care in 741 neurosurgical nurses
Hongbo YAN ; Yuxian GUAN ; Chuanhui XU ; Qingmei LEI ; Lishan OU
Modern Hospital 2024;24(11):1797-1800,1804
Objective To examine the cognitive status and influencing factors of spiritual care among neurosurgery nur-ses,providing a basis for developing a spiritual care management plan for neurosurgery nurses.Methods A convenience sam-pling method was used to select 741 neurosurgical nurses from 35 tertiary hospitals across 14 prefecture-level cities in Guangdong Province from October 2022 to March 2023.A self-developed general information questionnaire and the Chinese version of the Spiritual Care-Giving Scale(C-SCGS)were utilized for the questionnaire survey.Results The average cognitive score for spirit-ual care among neurosurgery nurses was 169.07±27.66.Factors influencing the total score and various dimensions of spiritual care cognition included educational background,receipt of spiritual care education,position,number of night shifts,marital sta-tus,and employment type(P<0.05).Conclusion Neurosurgical nurses'spiritual care cognition is at a moderate level,indi-cating a need for targeted training programs to enhance their understanding and practice of spiritual care based on their status and characteristics.
3.A simulation study of the reliability and accuracy of Cox-TEL method for estimating hazard ratio and difference in proportions for long-term survival data containing cured patients
Biqing ZOU ; Lishan XU ; Keke LI ; Shengli AN
Journal of Southern Medical University 2024;44(6):1182-1187
Objective To explore the applicable conditions of the Cox-TEL(Cox PH-Taylor expansion adjustment for long-term survival data)method for analysis of survival data that contain cured patients.Methods The simulated survival data method based on Weibull distribution was used to simulate and generate the survival data with different cure rates,censored rates,and cure rate differences.The Cox-TEL method was used for analysis of the generated simulation data,and its performance was evaluated by calculating its type I error and power.Results Almost all the type I error of the hazard ratios(HRs)obtained by the Cox-TEL method under different conditions were slightly greater than 0.05,and this method showed a good test power for estimating the HRs for data with a large sample size and a large difference in proportions(DPs).For the data of cured patients,the type I error of the DPs obtained by the Cox-TEL method was well around 0.05,and its test power was robust in most of the scenarios.Conclusion The Cox-TEL method is effective for analyzing data of uncured patients and obtaining reliable HRs for most of the survival data with a sample size,a low censored rates,and a large difference in cure rates.The method is capable of accurately estimating the DPs regardless of the sample size,censored rates,or the cure rates.
4.Comparative analysis of homogeneous phase and vertical auto profile separation phase methods for detecting low-density lipo-protein cholesterol levels
Xiufen XU ; Jihua ZOU ; Kaiyun CHEN ; Wei HU ; Lishan WU ; Xuefeng YU ; Weifeng XU ; Yong XU ; Zhanke WANG
Chinese Journal of Clinical Laboratory Science 2024;42(6):411-415
Objective To investigate the reasons for the inconsistent results between the vertical auto profile(VAP)method and bio-chemical homogeneous phase(BHP)method in detecting plasma low-density lipoprotein cholesterol(LDL-C),and provide experimen-tal basis for the accurate and quantitative detection of plasma LDL-C levels.Methods A total of 360 plasma samples from diabetes mellitus patients combined with carotid plaque admitted to the Department of Endocrinology of Ningbo Yinzhou Hospital of Traditional Chinese Medicine during January,2022 and January,2023 were collected.The LDL-C levels of these samples were detected by the VAP method and BHP method,respectively.The VAP method uses software to automatically calculate the area under the LDL-C curve after centrifugation of the sample as the LDL-C level(LDL-CVAP)and the BHP method directly detects the LDL-C level(LDL-CBHP)by the special surfactant method.360 samples were divided into the consistent group(group A)and inconsistent group(group B)ac-cording to the relative deviation between the LDL-CBHP and LDL-CVAP methods.Group B was further divided into the LDL-CBHP on the high side group(Group B1)and LDL-CBHP on the low side group(Group B2).Groups B1 and B2 were divided into B1-1,B1-2,B1-3 and B2-1 groups based on the degree of relative deviation.The percentages of samples and levels of lipoprotein a cholesterol[Lp(a)-C],intermediate-density lipoprotein cholesterol(IDL-C),Lp(a)-C and IDL-C[Lp(a)-C+IDL-C],very low-density lipo-protein cholesterol(VLDL-C),total cholesterol(TC)and total triglyceride(TG)in each group were compared.Results The LDL-CBHP levels of 360 samples were significantly higher than that of LDL-CVAP(P<0.01).The percentage of samples in group B was significantly higher than that in group A,and that of group B1 was significantly higher than that of group B2(P<0.05).The levels of Lp(a)-C,IDL-C and Lp(a)-C+IDL-C in groups B1-1,B1-2,and B1-3 were significantly higher than those in group A(P<0.01).The relative deviation between LDL-CBHP and LDL-CVAP in 360 samples was significantly positively correlated with the levels of Lp(a)-C,IDL-C,and Lp(a)-C+IDL-C(P<0.01).The maximum correlation coefficient was found in Lp(a)-C+IDL-C.Conclusion The results of plasma LDL-C in diabetes mellitus patients combined with carotid plaque detected by the BHP method are significantly different from those detected by the VAP method,which mainly shows that the results of the BHP method are on the high side.The higher the level of plasma Lp(a)-C+IDL-C,the greater the relative deviation between the BHP method and VAP method.The reason for the high results of LDL-C detected by the BHP method may be related to the fact that LDL-CBHP contains irremovable Lp(a)-C and cholesterol carried by IDL-C.The VAP method can be used as an accurate method for detecting real LDL-C without Lp(a)-C and IDL-C.
5.Mechanism of "Sanyang" combined therapy of traditional Chinese medicine in alleviating colonic injury in mice induced by influenza virus based on transcriptome sequencing technique
Yanan ZHANG ; Jun YAN ; Liqiong SONG ; Yuanming HUANG ; Chang LIU ; Guoxing LIU ; Jintong LI ; Yue ZHANG ; Mingzhe WANG ; Zhiguang ZHAI ; Chengxiang WANG ; Lishan ZHANG ; Chengjun BAN ; Wenbo XU ; Miao CHENG
Chinese Journal of Experimental and Clinical Virology 2023;37(2):159-167
Objective:To explore the mechanism of Ma-Xing Shi-Gan decoction combined with Xiao-Chai-Hu decoction (hereinafter referred to as " Sanyang combined treatment" ) in alleviating colon injury in mice infected with influenza virus by transcriptome sequencing technique.Methods:The mouse model of colonic injury caused by influenza virus was induced by intranasal drip of influenza A virus H1N1 suspension. The mice were divided into Control group, Model group, and Sanyang combined treatment (SCT) group. Model group and SCT group were fed with PBS and Ma-Xing Shi-Gan decoction combined with Xiao-Chai-Hu decoction respectively. Seven days later, the colon tissues of each group were taken, the colon length and pathological damage were observed, and the transcriptome was sequenced to screen the significantly different genes between the SCT group and model group for Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Set Enrichment Analysis(GSEA).Results:After the therapy with SCT, the length of the colon of mice was significantly improved and the pathological injury of the colon was reduced. There are 92 differentially expressed genes between the SCT group and the model group. GO analysis indicated that the differential genes were enriched in biological processes such as regulation of cytokine and chemokine production, inflammatory response, defense response, immune response, regulation of NF-κB inducing kinase(NIK)/Nuclear factor-κB(NF-κB) signal and Mitogen-activated protein kinase(MAPK) cascade, as well as cell components related to intestinal barrier such as brush border membrane, brush border and microvilli. KEGG analysis indicated that the differential genes were enriched in Toll-like receptor signaling pathway, intestinal immune network for IgA production, complement and coagulation cascade, and Peroxisome proliferator-activated receptor(PPAR) signaling pathway. GSEA indicated that the intestinal immune network for IgA production, PPAR signaling pathway, propionic acid metabolism and butyrate metabolism were significantly up-regulated after the intervention with SCT, while apoptosis and MAPK signaling pathway were significantly down-regulated.Conclusions:Sanyang combined therapy can protect the intestinal tract of mice infected with influenza virus mainly through immunity, inflammation and metabolism pathways.
6.Investigation on the response to Ursodeoxycholic acid in primary biliary cholangitis patients with positive anti-hexokinase 1 antibodies and anti-kelch-like 12 antibodies
Zhaoyang LIU ; Lishan XU ; Bo ZANG ; Yifei YANG ; Bin LIU
Chinese Journal of Rheumatology 2021;25(2):85-89
Objective:To investigate the value of anti-hexokinase1 antibodies (anti-HK-1) and anti-kelch-like 1 antibodies (anti-KLHL12) antibody in evaluating ursodeoxycholic acid (UDCA) response in patients with primary biliary cholangitis (PBC).Methods:112 PBC patients who had been treated with UDCA for more than 12 months with relatively complete clinical data were analyzed. Serum was collected and the expression of anti-mitochondrial antibody (AMA), anti-HK-1 and anti-KLHL12 antibodies were detected by ELISA. The response to UDCA was based on Paris standard. According to the expression of new antibodies, the patients were divided into the new antibody positive group and negative group. In addition, PBC related baseline indicators were collected, and Spearman correlation analysis was used to study the correlation between antibody expression and baseline indicators in PBC patients.Results:Positivity of anti-HK1 and anti-KLHL12 antibody in AMA-positive PBC patients were 44.7% and 41.2% respectively. Positivity of anti-HK1 and anti-KLHL12 antibodies in AMA negative PBC patients were 33.3% and 22.2%. Anti-HK1 positive patients had higher serum levels of Alaninetransaminase (ALP), aspartate aminotransferase, (AST), γ-glutamyl transpeptidase (γ-GT) and total bilirubin (TBIL) compared with anti-HK1 negative patients, with statistical significant differences ( P<0.05). Notably, correlation analysis showed significantly positive correlation between anti-HK1 antibody expression and ALP, γ-GT and TBIL serum levels ( r=0.735, P<0.05; r=0.332, P<0.05; r=0.491, ( r=0.466, P<0.05). The UDCA response rate in anti-HK-1 antibody positive group was lower than that of the negative group (36.2% vs 60%; P<0.05). Conclusion:Anti-HK-1 and anti-KLHL12 antibody can help to diagnose PBC, and the expression of anti-HK-1 antibody is correlated with the severity of PBC, which could help to predict the reaction of PBC patients to UDCA.
7.Correlation between hyperuricemia and outcome in patients with acute ischemic stroke
Zhaohui XU ; Jiwei CHENG ; Zhizhen SHI ; Yuqing HOU ; Qian XIAO ; Biao LIANG ; Lishan CHENG ; Guoyi LI ; Qing ZHAO
International Journal of Cerebrovascular Diseases 2021;29(6):432-436
Objective:To investigate the relationship between hyperuricemia and outcome in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke admitted to Department of Neurology, Putuo Hospital, Shanghai University of Tranditional Chinese Medicine between January 2020 and September 2020 were enrolled retrospectively. The modified Rankin Scale (mRS) score was used to evaluate the clinical outcome 3 months after the onset. ≤2 was considered as good outcome, and >2 was considered as poor outcome. The demography and baseline characteristics were compared between the good outcome group and the poor outcome group. Multivariate logistic regression analysis was used to determine the independent influencing factors of the outcome. Results:A total of 210 patients were included, their age was 69.87±62.62 years. There were 125 males (59.52%) and 85 females (40.48%). The baseline median National Institutes of Health Stroke Scale (NIHSS) score was 4. The serum uric acid level in 169 patients (80.48%) was normal and 41 (19.52%) had hyperuricemia; 120 patients (57.14%) had a good outcome, and 90 (42.86%) had a poor outcome. Blood glucose level, serum uric acid level, baseline NIHSS score and the proportions of diabetes mellitus, history of stroke or transient ischemic attack, hyperuricemia in the poor outcome group were significantly higher than those in the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that diabetes mellitus (odds ratio [ OR] 2.735, 95% confidence interval [ CI] 1.461-5.121; P=0.002), hyperuricemia ( OR 2.400, 95% CI 1.102-5.228; P=0.027), and higher baseline NIHSS score ( OR 1.233, 95% CI 1.118-1.360; P<0.001) were the independent risk factors for poor outcome in patient with acute ischemic stroke. Conclusion:Hyperuricemia is an independent risk factor for poor outcome in patients with acute ischemic stroke.
8.Effect of Acupuncture plus Chinese Herbal Medication on ET-1 and CGRP in Child Patients with Mesenteric Lymphadenitis
Zongfu DING ; Renqiang SU ; Min WANG ; Yaoqin XU ; Feng LIU ; Dengyu SHI ; Weihua LI ; Lishan JIA
Shanghai Journal of Acupuncture and Moxibustion 2016;35(9):1087-1089
Objective To investigate the effect of acupuncture plus Chinese herbal medication on plasma endothelin (ET-1) and calcitonin gene-related peptide (CGRP) in child patients with mesenteric lymphadenitis.Methods One hundred and eighty child patients with mesenteric lymphadenitis were randomly allocated to groups A, B and C, 60 cases each. Group A received acupuncture at Zusanli and pricking Sifeng points plus oral administration of Wudang Babao Zijinding; group B, oral administration of amoxicillin and clavulanate potassium granules; group C, oral administration of Wudang Babao Zijinding alone. ET-1 and CGRP contents were measured in the three groups before and after treatment.Results There were statistically significant pre-/post-treatment differences in ET-1 and CGRP contents in group A (P<0.01). There were statistically significant post-treatment differences in ET-1 and CGRP contents between group A and group B or C (P<0.01).Conclusions Acupuncture plus Chinese herbal medication is an effective way to treat mesenteric lymphadenitis in children. It can regulate ET-1 and CGRP in the patients.
9.The function of miR-193b in hepatocellular carcinoma
Haijiang YAN ; Wei FENG ; Bo ZHAI ; Haopeng ZHANG ; Lishan XU
Cancer Research and Clinic 2016;28(1):11-14
Objective To investigate the significance of miR-193b to biological behaviors of hepatocellular carcinoma (HCC). Methods 48 cases of HCC specimens and corresponding adjacent tissues were collected, and the miR-193b expression levels in these specimens were measured by real-time quantitative PCR. The miR-193b expression was measured by the same way in HepG2 and SMMC-7721 cells. The HepG2 and SMMC-7721 were transfected with miR-193b mimics or negative control miRNA mimic with Lipofectamine 2000, and the non-transfected cells were taken as blank control. The proliferation ability of the HCC cells were detected by MTT method, and the apoptosis rate was tested by flow cytometry. Results The expression level of miR-193b in HCC tissues (2.441 ±0.569) was significantly lower than that in the corresponding adjacent tissues (15.488±4.326) (P < 0.05). Compared with normal liver cell line L-O2, the expression levels of miR-193b were significantly lower in HepG2 and SMMC-7721 cells. Transfected with miR-193b mimic, the proliferation ability of HepG2 and SMMC-7721 cells were reduced, while their apoptosis were increased. Conclusion miR-193b may be negative to regulate the proliferation of HCC and increase its apoptosis.
10.Cholangiocarcinoma of the hepatic hilum: surgical management and prognosis
Chinese Journal of Hepatobiliary Surgery 2011;17(10):829-832
Objective To analyze the surgical management and prognosis of hilar cholangiocarcinoma(HCC).MethodClinical data of 72 patients with HCC were retrospectively analyzed.Results There was a significant difference in the 3- and 5- year survival rates and median survivals among the groups treated with different surgical methods(x2 =28.1,P< 0.01 ).Univariate analyses conducted for the 16 factors which might affect prognosis showed the surgical method,lymphatic metastasis,positive margin,as well as the type of pathology and staging were of statistically significant prognostic value (P<0.05).On a multivariate analysis using the Cox proportional hazards model,surgical management,lymphatic metastasis and the type of pathology and staging were independent prognostic factors (regression coefficient 1.4157,1.1072,1.6435).ConclusionRadical excision is an important prognostic factor for HCCa and extended resection improved the long-term survival rates of radical surgery.

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