Search

Objective To explore the diagnostic value of combining pediatric appendicitis score (PAS) with high-frequency ultrasound for appendicitis types in children over 5 years of age. Methods Retrospective analysis was performed for 394 hospitalized appendicitis children fulfilling the inclusion criteria from January 2018 to December 2020. There were 270 boys and 124 girls with a mean age of (8. 94 ± 2. 28) years. Depending on intraoperative finding and the final histology, patients were classified into two groups of simple appendicitis (n = 113) and non-simple appendicitis (n = 281). The effects of general data, PAS and ultrasonic images were compared between two groups. Fisher's stepwise discriminant analysis was employed for establishing a discriminant function by applying significant variables. Then the diagnostic efficacy of this model was verified by self-test, cross-validation and validation group. Results Univariate analysis indicated that 13 factors were statistically different between two group (P < 0. 05) . Seven parameters of PAS, illegibility of wall layers, count of leucocyte, duration of symptoms, periappendiceal fluid, enlarged appendix and thickened periappendiceal fat were crnsidered ultimately. The discriminant function equation was Y1 = - 14. 446 - 1. 312X3 + 1. 102X5 + 0. 481X2 + 0. 065X1 - 1. 884X6 + 4. 046X4 + 3. 878X7, Y2 = - 36. 834 + 1. 509X3 + 4. 297 X5 + 0. 687 X2 + 0. 110X1 -0. 167X6 + 3. 432X4 + 0. 874X7. The results obtained by self-test and cross-validation all indicated that the accuracy rate of discriminant function was 94. 7% (373/394); The results verified by validation group showed that the accuracy rate of discriminant function was 94. 4% (84/89). Conclusion Combining PAS with high-frequency ultrasound is useful in distinguishing the types of appendicitis in children aged above 5 years. Thus clinicians may formulate re111onahle treatments for acute appendicitis in children. [ABSTRACT FROM AUTHOR]

Objective To establish a clinical anatomic composite grading system and to evaluate the combined effects of the European Heart Surgery Risk Scoring System (EuroSCORE) Ⅱ and SYNTAX scoring system in predicting the prognosis of patients undergoing coronary artery bypass grafting (CABG). Methods The perioperative data of CABG patients in Tianjin chest hospital from July 2017 to December 2018 were retrospectively analyzed. EuroSCOREⅡ and SYNTAX were used to stratify the cardiovascular risk of patients. According to the classification of the two systems, they were arranged and redistributed to construct the clinical anatomy composite grading system. The discrimination and calibration of the system were evaluated compared by EuroSCOREⅡ and SYNTAX. Results The actual hospital mortality for 301 patients was 1.54% (20/1 301). According to the comparison of baseline data after grading by scoring system, there were significant differences between EuroSCORE Ⅱ groups except unstable angina pectoris and SYNTAX. There were significant differences in age, unstable angina pectoris and 30-day death between SYNTAX groups. There were significant differences in other variables except unstable angina pectoris, NYHA and peripheral arterial disease between composite grading system groups. The results of H-L goodness of fit test showed that EuroSCORE Ⅱ, SYNTAX and composite grading system had good fitting degree. ROC curve analysis showed that the accuracy of composite classification system was the best, (AUC=0.862). AUC of EuroSCORE Ⅱ and SYNTAX were 0.849 and 0.732 (P＜0.01). This indicates that the composite grading system can significantly improve the predictive ability of 30-day mortality after operation. Compared with EuroSCORE Ⅱ, NRI of composite grading system was 14.05% (Z=7.205, P＜0.01), compared with SYNTAX, NRI=37.85% (Z=4.240, P＜0.01). Conclusion The composite classification system of EuroSCORE Ⅱ and SYNTAX can improve the ability of single type scoring system to predict the short-term mortality of CABG. [ABSTRACT FROM AUTHOR]

BACKGROUND: Nerve root compression of lumbar disc herniation is difficult to diagnose. Pattern recognition technology combined with surface electromyography will provide new ideas for improving the diagnostic accuracy of compressed nerve roots. OBJECTIVE: To establish the recognition model of the nerve root compression of lumbar disc herniation through three kinds of pattern recognition methods, and to analyze the diagnostic accuracy of the models. METHODS: Twenty-four cases of disc herniation at L4/L5 segments combined with L5 nerve root compression and 23 cases of disc herniation at L5/S1 segments combined with S1 nerve root compression from October 2015 to October 2016 were enrolled. The surface electromyography parameters were collected and the Logistic regression equation, decision tree and artificial neural network were used to establish the identification model of compressed nerve roots. The sensitivity, specificity and diagnosis accuracy of the three models were calculated. The diagnosis accuracy was compared by receiver operating characteristic curve. REEULTS AND CONCLUSSION: (1) The logistic regression model had established the three models and the accuracy increased from 85.7% to 100%, with an average of 93.6%, and the sensitivity and specificity of the model was 0.98 and 0.92, respectively. (2) The Chi-squared Automatic Interaction Detector showed an accuracy of 42.86%-85.71%, with an average of 66.43%, the sensitivity and specificity of the model was 0.77 and 0.56, respectively. (3) The Classification and Regression Tree showed an accuracy of 57.14%-85.71%, with an average of 72.14%, the sensitivity and specificity of the model was 0.71 and 0.73, respectively. (4) The neural network model showed an accuracy of 85.7%-100%, with an average of 92.14%, and the sensitivity and specificity of the model were 0.93 and 0.92, respectively. (5) The area under the Receiver Operating Characteristic Curve was used to evaluate the three models, and the neural network was 0.98, the logistic regression was 0.97, and the decision tree was 0.90. (6) These results indicate that both neural network model and the logic regression model show satisfactory results in recognition of the compressed nerve roots, which are superior to MRI. The neural network model is more stable and it may be a more suitable auxiliary method for the diagnosis of nerve root compression. The Logistic regression model is suitable when no neural network diagnostic model is established. The decision tree shows a good performance in the screening of risk factors, and which can be combined with other methods to improve the recognition accuracy. [ABSTRACT FROM AUTHOR]

Objective: To explore the application of the RCOG (Royal College of Obstetricians and Gynaecologists) model of thrombosis risk assessment in the prevention of maternity venous thromboembolism (VTE). Methods: A total of 2 089 puerperas delivered in our hospital were included from May 2015 to June 2016. They were randomly divided into the control group and the observation group. Puerperas in the control group were treated by traditional nursing to prevent VTE. Based on the RCOG model, those puerperas in the observation group were classified and treated by corresponding intervention. The levels of prenatal and postnatal blood D -dim er in two groups, and the morbidity of VTE, were compared. Results: There was not significant difference in the level of prenatal blood D-dim er between two groups (P> 0.05). The level and the positive rate of postnatal D-dim er in the observation group were significantly lower than those in the control group (P< 0.05). The ratio of puerperas with the increased postnatal D -dim er level in the observation group was much lower than that in the control group (P〈 0.05). No puerpera in the observation group had VTE during the 6-week follow-up period, while 4 puerperas with the high VTE risk in the control groups had VTE, who were classified into the high risk or highest risk group following RCOG assessment model. The morbidity of VTE in the control group was higher than it in the observation group, but the difference was not significant (P> 0.05). Conclusions: The RCOG model of thrombosis risk assessment was effective in the classification of puerperas VTE risk, the decreased D -dim er level, and the prevention of VTE by corresponding intervention. [ABSTRACT FROM AUTHOR]