Category: Statistics

Minerva Gastroenterol (Torino). 2021 Apr 8. doi: 10.23736/S2724-5985.21.02809-9. Online ahead of print.

ABSTRACT

BACKGROUND: Metabolic-Associated Fatty Liver Disease (MAFLD), affects nearly one quarter of the world’s adult population creating large health loads and economic loads in society with no approved pharmacotherapy found yet. The number of studies showing the effect of nutrition on fibrosis accompanying MAFLD are insufficient. This study was planned with the aim of investigating the effect of nutritional treatment on liver injury.

METHODS: This research is a prospective, non-medication interventional study completed with 39 participants chosen from MAFLD patients with fibrosis. Post treatment lasting three months, patients had liver stiffness measurements (LSM), anthropometric measurements and biochemical tests repeated.

RESULTS: In pre- and post-treatment, there were statistically significant correlations found between LSM with serum gamma glutamyl transferase (GGT) values, and between controlled attenuation parameter (CAP) with body mass index (BMI) and fat mass (p<0.05). Post-treatment, statistically significant improvements were determined in the anthropometric measurements and biochemical findings. Moreover, post-treatment LSM and CAP values showed significant positive correlation compared to pre-treatment (p<0.05).

CONCLUSIONS: This study found dietary interventions have an important place within the scope of fibrosis treatment. Preparation and application of medical nutrition treatment suitable for the clinical features of patients and completing correct lifestyle changes has an ameliorating effect on disease prognosis. There is a need for advanced studies with larger sample groups to further enlighten this topic.

PMID:33829726 | DOI:10.23736/S2724-5985.21.02809-9

Sichuan Da Xue Xue Bao Yi Xue Ban. 2021 Mar;52(2):326-333. doi: 10.12182/20210360203.

ABSTRACT

OBJECTIVE: To explore the best treatment plan of intravesical instillation for patients with non-muscular invasive bladder cancer (NMIBC), to explore recurrence-related clinicopathological factors after intravesical instillation, and to evaluate the value of the prognosis and prediction models currently used for NMIBC patients.

METHODS: Starting from 2016, patients who underwent transurethral resection of bladder tumor (TURBT) in our hospital and who received post-surgery diagnosis of having intermediate or high risks for NMIBC were enrolled in the study. They were randomly assigned to different group sat a ratio of 2∶2∶1 for receiving intravesical instillation therapy of Bacillus Calmette-Guérin (BCG) for 19 times, BCG for 15 times, and epirubicin (EPI) for 18 times. The clinicopathological data of the patients were recorded before, during and after instillation therapy, and survival curves were drawn to evaluate the effects of the three regimens, using recurrence-free survival as the endpoint. Clinicopathological data were analyzed to study the associations between various factors and post-instillation recurrence. The consistency index (c-index) was used to evaluate the predictive accuracy of the scoring model of the Spanish Urological Club for Oncological Treatment (CUETO) and the risk tables of European Organization for Research and Treatment of Cancer (EORTC).

RESULTS: A total of 93 NMIBC patients (35 in the 19-time BCG group, 37 in the 15-time BCG group, and 21 in the EPI group) were included, with a median follow-up time of 33.46 months. Twenty-two patients experienced tumor recurrence and eight, tumor progression. The survival curve showed that the BCG group had better recurrence-free survival than the EPI group ( P=0.002), while the difference in recurrence-free survival between 19-time BCG and 15-time BCG groups was not statistically significant. Higher general complication rate was seen in the BCG groups compared with the EPI group (84.7% vs. 61.9%, P=0.022), but there was no grade 3-5 adverse events in any group. The c-index of CUETO scoring model and EORTC risk tables was higher than that of the prediction based solely on T stage, nuclear grade, or EAU risk stratification. In addition, the c-index in the BCG group was higher than that in the whole cohort.

CONCLUSION: Among the subjects of this study, the recurrence rate of bladder cancer in the intravesical BCG instillation groups was lower than that of the epirubicin group. EORTC risk tables and CUETO scoring model exhibited higher predictive accuracies in BCG-treated patients than its performance for the whole NMIBC cohort.

PMID:33829710 | DOI:10.12182/20210360203

Sichuan Da Xue Xue Bao Yi Xue Ban. 2021 Mar;52(2):340-344. doi: 10.12182/20210360603.

ABSTRACT

OBJECTIVE: To explore the relationship between abdominal obesity and diabetes among middle-aged and older adults with normal body mass index (BMI) and to provide reference information for formulating targeted diabetes prevention and control measures for this population.

METHODS: Data were extracted from the China Health and Retirement Longitudinal Study (CHARLS) done in 2015. Middle-aged and older adults who were aged 45 and older and had normal BMI were included in the study. According to their status of diabetes, the subjects were divided into two groups, non-diabetes and diabetes groups. χ ² test was used to investigate the difference between two groups. Logistic regression was used to do the multivariate analysis of factors influencing diabetes.

RESULTS: A total of 5 197 middle-aged and older adults with normal BMI ranging between 18.5 and 24 kg/m ² were included. The prevalence of diabetes was 11.26% (585/5 197) and the prevalence of abdominal obesity was 41.56% (2 160/5 197). Univariate analysis showed that the difference in age, residence, the status of hypertension, dyslipidemia and abdominal obesity between non-diabetic group and the diabetic group were statistically significant ( P<0.01). The prevalence of diabetes among adults with abdominal obesity was 14.2% (307/2 160) and that among people with no abdominal obesity was 9.2% (278/3 037). Compared with people with no abdominal obesity, the prevalence of diabetes among people with abdominal obesity was higher and the difference were statistically significant ( P<0.01). Multivariate logistic regression analysis showed that, among middle-aged and older adults with normal BMI, those with abdominal obesity, aged 60 years and older, living in urban areas, having hypertension and having dyslipidemia had higher probability of developing diabetes.

CONCLUSION: Abdominal obesity and diabetes are becoming a serious problem among middle-aged and older adults with normal BMI and abdominal obesity may be related to higher risks of diabetes. It is recommended that more attention is given to abdominal obesity in this population to reduce the possibilities of diabetes.

PMID:33829712 | DOI:10.12182/20210360603

Oral Health Prev Dent. 2021 Jan 7;19(1):229-233. doi: 10.3290/j.ohpd.b1179501.

ABSTRACT

PURPOSE: To assess the effectiveness of a 40% miswak compared to a 0.12% chlorhexidine mouthwash.

MATERIALS AND METHODS: A total of 60 patients aged 20-55 years who attended the Periodontics Clinics at the College of Dentistry, Al-Iraqia University, Baghdad, Iraq, were allocated into 2 groups to use either 40% miswak mouthwash or 0.12% chlorhexidine gluconate Kin Gingival (Laboratorios KIN) twice daily for 2 months. Gingival, bleeding, and plaque indices were assessed.

RESULTS: There were statistically significant differences between the effectiveness of miswak and chlorhexidine mouthwashes in terms of gingivitis. The means of gingival, bleeding, and plaque indices using miswak mouthwash were 1.2, 0.4, and 0.53, respectively, i.e. indicating lower effectiveness, than when 0.12% chlorhexidine mouthwash was used (0.87, 0.43, 0.23, respectively).

CONCLUSION: Miswak mouthwash is a good oral hygiene agent especially for long-term use even if its efficacy is lower than chlorhexidine mouthwash.

PMID:33829720 | DOI:10.3290/j.ohpd.b1179501

Sichuan Da Xue Xue Bao Yi Xue Ban. 2021 Mar;52(2):267-273. doi: 10.12182/20210360204.

ABSTRACT

OBJECTIVE: To investigate the potential association between multimorbidity and the handgrip strength of middle-aged and older adults.

METHODS: The baseline (2011) and second-round follow-up (2015) data of China Health and Retirement Longitudinal Study (CHARLS) were used. Adults≥40 were selected as the subjects of the study. Variables incorporated in the study included handgrip strength, chronic disease prevalence, demographic variables, and health behavior variables. Generalized estimating equations were used to analyze the longitudinal association between handgrip strength and multimorbidity.

RESULTS: A total of 28 368 middle-aged and older adults were included in the baseline and follow-up samples, with an average age of (59.1±9.7) years old, the oldest being 96 while the youngest being 40. Among them, 6 239 were male, accounting for 47.3%. In the second-round follow-up, 9 186 baseline respondents and 5 994 new respondents were covered, reaching a total of 15 180 respondents. Compared with the baseline, a higher proportion of the second-round follow-up respondents were female ( P=0.033) and were older ( P<0.001). From the baseline to the second-round follow-up, Q1, the lowest grip strength category, increased from 23.4% to 26.6%, while Q4, the highest grip strength category, decreased from 26.5% to 21.2%. The prevalence of having more than three chronic diseases increased from 18.2% to 24.2% and the prevalence of having more than five chronic diseases increased from 3.3% to 6.2%. After adjusting for confounding variables, the interaction items of handgrip strength and time showed statistical significance. After stratification by gender, the interaction items of male handgrip strength and follow-up time were statistically significant in both models ( P<0.05). The marginal effect graph of the interactive item showed that the multimorbidity prevalence of respondents with lower handgrip levels grew faster with age. Individual effect analysis showed that the correlation between handgrip strength and multimorbidity was not statistically significant at baseline, but the follow-up done four years afterwards showed statistical significant correlation between handgrip strength and multimorbidity.

CONCLUSION: Respondents with lower baseline handgrip strength are associated with increasingly higher risk of multimorbidity over time. Handgrip strength can be used as an effective screening tool for middle-aged and older adults in China to identify those at higher risks of multimorbidity of chronic diseases.

PMID:33829701 | DOI:10.12182/20210360204

Sichuan Da Xue Xue Bao Yi Xue Ban. 2021 Mar;52(2):286-292. doi: 10.12182/20210360506.

ABSTRACT

OBJECTIVE: To evaluate the noise reduction effect of deep learning-based reconstruction algorithms in thin-section chest CT images by analyzing images reconstructed with filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), and deep learning image reconstruction (DLIR) algorithms.

METHODS: The chest CT scan raw data of 47 patients were included in this study. Images of 0.625 mm were reconstructed using six reconstruction methods, including FBP, ASIR hybrid reconstruction (ASIR50%, ASIR70%), and deep learning low, medium and high modes (DL-L, DL-M, and DL-H). After the regions of interest were outlined in the aorta, skeletal muscle and lung tissue of each group of images, the CT values, SD values and signal-to-noise ratio (SNR) of the regions of interest were measured, and two radiologists evaluated the image quality.

RESULTS: CT values, SD values and SNR of the images obtained by the six reconstruction methods showed statistically significant difference ( P<0.001). There were statistically significant differences in the image quality scores of the six reconstruction methods ( P<0.001). Images reconstruced with DL-H have the lowest noise and the highest overall quality score.

CONCLUSION: The model based on deep learning can effectively reduce the noise of thin-section chest CT images and improve the image quality. Among the three deep-learning models, DL-H showed the best noise reduction effect.

PMID:33829704 | DOI:10.12182/20210360506

Sichuan Da Xue Xue Bao Yi Xue Ban. 2021 Mar;52(2):311-318. doi: 10.12182/20210360202.

ABSTRACT

OBEJECTIVE: To explore the clinical value of using radiomics models based on different MRI sequences in the assessment of hepatic metastasis of rectal cancer.

METHODS: 140 patients with pathologically confirm edrectal cancer were included in the study. They underwent baseline magnetic resonance imaging (MRI) between April 2015 and May 2018 before receiving any treatment. According to the results of liver biopsy, surgical pathology, and imaging, patients were put into two groups, the patients with hepatic metastasis and those without. T2 weighted images (T2WI), diffusion weighted images (DWI) and apparent diffusion coefficient (ADC) images were used to draw the region of interest (ROI) of primary lesions on consecutive slices on ITK-SNAP. 3-D ROIs were generated and loaded into Artificial Intelligent Kit for extraction of radiomics features and 396 features were extracted for each sequence. The feature data were preprocessed on Python and the samples were oversampled, using Support Vector Machine-Synthetic Minority Over-Sampling Technique (SVM-SMOTE) to balance the number of samples in the group with liver metastasis and the group with no liver metastasis at the end of the follow-up. Then, the samples were divided into the training cohort and the test cohort at a ratio of 2∶1. The logistic regression models were developed with selected radionomic features on R software. The receiver operating characteristics (ROC) curves and calibration curves were used to evaluate the performance of the models.

RESULTS: In total, 52 patients with liver metastasis and 88 patients without liver metastasis at the end of follow-up were enrolled. Carcinoembryonic antigen (CEA) and T stage and N stage evaluated on the MRI images showed statistically significant difference between the two groups ( P<0.05). After data preprocessing and selecting, except for 17 non-radiomic features, the model combining T2WI, DWI and ADC features, the model of T2WI features alone, the model of DWI features alone and the model of ADC features alone were developed with 32 features, 10 features, 30 features and 15 features, respectively. The combined model (T2WI+DWI+ADC), the T2WI model, and the ADC model can assess hepatic metastasis accurately, with the area under curve ( AUC) on the train set reaching 93.5%, 89.2%, 90.6% and that of the test set reaching 80.8%, 80.5%, 81.4%, respectively. The combined model did not show a higher AUC than those of the T2WI and ADC alone models. Model based on DWI features has a slightly insufficient AUC of 90.3% in the train set and 75.1% in the test set. The calibration curve showed the smallest fluctuation in the combined model, which is closest fit to the diagonal reference line. The fluctuation in the three independent data set models were similar. The calibration curves of all the four models showed that as the risk increased, the prediction of the models turned from an underestimation to an overestimating the risk. In brief, the combined model showed the best performance, with the best fit to the diagonal reference line in calibration curve and high AUC comparable to the AUC of the T2WI model and ADC model. The performance of T2WI and ADC alone models were second to that of the combined model, while the DWI alone model showed relatively poor performance.

CONCLUSION: Radiomics models based on MRI could be effectively used in assessing liver metastasis in rectal cancer, which may help determine clinical staging and treatment.

PMID:33829708 | DOI:10.12182/20210360202

Sichuan Da Xue Xue Bao Yi Xue Ban. 2021 Mar;52(2):248-258. doi: 10.12182/20210360205.

ABSTRACT

OBJECTIVE: To investigate the significance of stemness-related genes in the diagnosis and treatment of ovarian cancer.

METHODS: Key modules and genes were identified with weighted gene co-expression network analysis (WGCNA). The signal pathways of high expression of key genes were analyzed by gene set enrichment analysis (GSEA) and single cell sequencing data. The chemosensitivity of ovarian cancer to chemotherapy drugs was estimated with pRRophetic. Flow cytometry was used to examine the expression of CD44 ⁺CD117 ⁺in SKOV3 cells and cancer stem cells. The expression of key genes in ovarian cancer stem cells was confirmed by qRT-PCR. The core genes were identified by GeneMANIA analysis.

RESULTS: According to the WGCNA results, 15 key genes were identified at the transcription level, all being highly expressed in many kinds of tumors. They were involved in the cell cycle, DNA repair, E2 target and G2M checkpoint pathway, and had significant correlation with chemosensitivity. The proportion of CD44 ⁺ CD117 ⁺ cells in SKOV3 cells and ovarian cancer stem cells were (1.20±0.34)% and (37.17±1.80)% respectively, with statistically significant difference ( P<0.05). qRT-PCR confirmed that seven key genes ( BUB1, CDC20, CCNB2, DLGAP5, KIF4 A, NEK2, NUSAP1) in the WGCNA results were highly expressed in ovarian cancer stem cells, and BUB1 might have played a core role.

CONCLUSION: Seven hub genes, especially BUB1, were identified by constructing gene co-expression network, which may become potential biomarkers of ovarian cancer gene.

PMID:33829699 | DOI:10.12182/20210360205

Sichuan Da Xue Xue Bao Yi Xue Ban. 2021 Mar;52(2):259-266. doi: 10.12182/20210260302.

ABSTRACT

OBJECTIVE: To explore the individual or combined effects of adiponectin, leptin, and soluble leptin receptor (sOB-R) on risks for premenopausal and postmenopausal breast cancer, and to provide evidence for revealing the molecular mechanism between obesity and breast cancer.

METHODS: 469 newly-diagnosed breast cancer cases were sequentially recruited for the study and 469 age-frequency-matched healthy women were enrolled as the controls over the same period of time. The participant baseline information was collected with questionnaires, and plasmic levels of adiponectin, leptin and sOB-R were checked with ELISA. Multivariate unconditional logistic regression was conducted and the analyses were further stratified according to waist-to-hip ratio (WHR) and body mass index (BMI) to explore the effect of the indicators on the risks for premenopausal and postmenopausal breast cancer.

RESULTS: A total of 480 premenopausal and 458 postmenopausal women were included in the study. Among the premenopausal subjects, 249 were breast cancer patients and 231 were controls. The median BMI was 22.9 kg/m ²and 23.2 kg /m ², respectively, and the median WHR was 0.80 and 0.83, respectively. Among the postmenopausal subjects, 220 were breast cancer patients and 238 were controls. The median BMI was 23.4 kg/m ² and 23.7 kg/m ², respectively, and the median WHR was 0.82 and 0.86, respectively. Multivariate logistic regression analysis showed that before and after model adjustment, the increase in sOB-R and adiponectin levels was correlated to reduced risks of premenopausal and postmenopausal breast cancer ( P<0.05), while the increase in the leptin/sOB-R ratio (also known as free leptin index, FLI) and leptin/adiponectin (L/A) ratio was only correlated to increased risks of postmenopausal breast cancer. After further stratification by WHR and BMI, the association between adiponectin, FLI and postmenopausal breast cancer remained statistically significant in all subgroups. Among subjects with normal-BMI central obesity (18.5 kg/m ²≤BMI<24 kg/m ² & WHR≥0.85) , higher L/A ratio was associated with an increased risk of postmenopausal breast cancer. No clear association between leptin and premenopausal and risks for postmenopausal breast cancer was found in the study.

CONCLUSION: Postmenopausal women with decreased levels of sOB-R and adiponectin, and increased FLI and L/A, and premenopausal women with decreased levels of sOB-R and adiponectin were found to be at high risks for breast cancer.

PMID:33829700 | DOI:10.12182/20210260302

Sci Rep. 2021 Apr 7;11(1):7617. doi: 10.1038/s41598-021-87081-6.

ABSTRACT

Postbiotic RS5, produced by Lactiplantibacillus plantarum RS5, has been identified as a promising alternative feed supplement for various livestock. This study aimed to lower the production cost by enhancing the antimicrobial activity of the postbiotic RS5 by improving the culture density of L. plantarum RS5 and reducing the cost of growth medium. A combination of conventional and statistical-based approaches (Fractional Factorial Design and Central Composite Design of Response Surface Methodology) was employed to develop a refined medium for the enhancement of the antimicrobial activity of postbiotic RS5. A refined medium containing 20 g/L of glucose, 27.84 g/L of yeast extract, 5.75 g/L of sodium acetate, 1.12 g/L of Tween 80 and 0.05 g/L of manganese sulphate enhanced the antimicrobial activity of postbiotic RS5 by 108%. The cost of the production medium was reduced by 85% as compared to the commercially available de Man, Rogosa and Sharpe medium that is typically used for Lactobacillus cultivation. Hence, the refined medium has made the postbiotic RS5 more feasible and cost-effective to be adopted as a feed supplement for various livestock industries.

PMID:33828119 | DOI:10.1038/s41598-021-87081-6