目的探讨儿童上尿路结石术后复发现状,分析结石术后复发的危险因素,并建立列线图预测儿童上尿路结石复发风险。方法回顾性分析2014年6月至2020年12月在首都医科大学附属北京友谊医院泌尿外科接受手术治疗的218例上尿路结石患儿临床资料...目的探讨儿童上尿路结石术后复发现状,分析结石术后复发的危险因素,并建立列线图预测儿童上尿路结石复发风险。方法回顾性分析2014年6月至2020年12月在首都医科大学附属北京友谊医院泌尿外科接受手术治疗的218例上尿路结石患儿临床资料,采用多因素Cox回归模型筛选患儿的临床资料及随访资料,使用Kaplan-Meier法绘制结石复发曲线,依据独立危险因素构建列线图预测模型,并评价模型的预测效能。结果218例中,男157例、女61例,年龄(4.1±3.4)岁,随访(48.3±21.8)个月,总体复发率为16.1%(35/218)。Cox多因素回归分析结果显示:3岁以上较1岁以下患儿的复发风险高(HR=8.685,95%CI:1.144~65.930);肥胖较消瘦患儿复发风险高(HR=7.903,95%CI:1.046~59.684);结石质量>2000 Hu·cm^(2)较结石质量<1000 Hu·cm^(2)患儿复发风险高(HR=2.842,95%CI:1.171~6.895);术前尿白细胞阳性较术前尿白细胞阴性患儿复发风险高(HR=5.172,95%CI:1.681~15.913)。以上述4项独立危险因素为输入变量建立列线图预测模型,经计算该模型C-index为0.853,1年未复发率预测模型的受试者操作特征曲线下面积(area under curve,AUC)为0.98,3年未复发率预测模型的AUC为0.96,5年未复发率预测模型的AUC为0.84,校正曲线贴近于理想曲线。结论儿童上尿路结石术后具有较高的复发率,高龄、肥胖、结石质量大及术前尿白细胞阳性患儿具有较高的复发风险。本研究建立的儿童上尿路结石术后复发风险列线图模型有助于临床医师更精准地识别高危患儿,制定个性化结石防治方案。展开更多
Newspapers can preserve vast amount of first-hand historical information for research.They are reliable and valuable primary sources for studies on politics,economy,society,humanities,science and technology,culture,fo...Newspapers can preserve vast amount of first-hand historical information for research.They are reliable and valuable primary sources for studies on politics,economy,society,humanities,science and technology,culture,folkways and customs of a country for a specific period of history.Accordingly,these authors in this paper support that a Chinese Newspaper Digital Repository(CNDR)initiative led by National Library of China(NLC)be firmly established and put into operation in quick order.These authors' conviction and assertion are made only after they have given a careful study and analysis of the problems of current newspaper preservation methods,including print newspapers preservation,preserving newspapers by microfilming technology,and digital publication of newspapers.These authors also have taken into consideration of the legal issues involved about such an undertaking.Based on the review of the efforts and achievements on long-term preservation of newspapers home and abroad,these authors have critiqued the technical scheme of the NLC' Chinese Newspaper Digital Repository,including such important factors as system design,metadata schema,system structure,and the achievements of this project in Phase I.Finally,these authors have recommended that a collaborative operation mechanism and also a new comprehensive service paradigm in the realm of information delivery be established in CNDR's overall strategic planning.展开更多
文摘目的探讨儿童上尿路结石术后复发现状,分析结石术后复发的危险因素,并建立列线图预测儿童上尿路结石复发风险。方法回顾性分析2014年6月至2020年12月在首都医科大学附属北京友谊医院泌尿外科接受手术治疗的218例上尿路结石患儿临床资料,采用多因素Cox回归模型筛选患儿的临床资料及随访资料,使用Kaplan-Meier法绘制结石复发曲线,依据独立危险因素构建列线图预测模型,并评价模型的预测效能。结果218例中,男157例、女61例,年龄(4.1±3.4)岁,随访(48.3±21.8)个月,总体复发率为16.1%(35/218)。Cox多因素回归分析结果显示:3岁以上较1岁以下患儿的复发风险高(HR=8.685,95%CI:1.144~65.930);肥胖较消瘦患儿复发风险高(HR=7.903,95%CI:1.046~59.684);结石质量>2000 Hu·cm^(2)较结石质量<1000 Hu·cm^(2)患儿复发风险高(HR=2.842,95%CI:1.171~6.895);术前尿白细胞阳性较术前尿白细胞阴性患儿复发风险高(HR=5.172,95%CI:1.681~15.913)。以上述4项独立危险因素为输入变量建立列线图预测模型,经计算该模型C-index为0.853,1年未复发率预测模型的受试者操作特征曲线下面积(area under curve,AUC)为0.98,3年未复发率预测模型的AUC为0.96,5年未复发率预测模型的AUC为0.84,校正曲线贴近于理想曲线。结论儿童上尿路结石术后具有较高的复发率,高龄、肥胖、结石质量大及术前尿白细胞阳性患儿具有较高的复发风险。本研究建立的儿童上尿路结石术后复发风险列线图模型有助于临床医师更精准地识别高危患儿,制定个性化结石防治方案。
文摘Newspapers can preserve vast amount of first-hand historical information for research.They are reliable and valuable primary sources for studies on politics,economy,society,humanities,science and technology,culture,folkways and customs of a country for a specific period of history.Accordingly,these authors in this paper support that a Chinese Newspaper Digital Repository(CNDR)initiative led by National Library of China(NLC)be firmly established and put into operation in quick order.These authors' conviction and assertion are made only after they have given a careful study and analysis of the problems of current newspaper preservation methods,including print newspapers preservation,preserving newspapers by microfilming technology,and digital publication of newspapers.These authors also have taken into consideration of the legal issues involved about such an undertaking.Based on the review of the efforts and achievements on long-term preservation of newspapers home and abroad,these authors have critiqued the technical scheme of the NLC' Chinese Newspaper Digital Repository,including such important factors as system design,metadata schema,system structure,and the achievements of this project in Phase I.Finally,these authors have recommended that a collaborative operation mechanism and also a new comprehensive service paradigm in the realm of information delivery be established in CNDR's overall strategic planning.
