目的探讨血清C-反应蛋白(CRP)、降钙素原(PCT)、金属基质蛋白酶-9(MMP-9)在胃癌患者术后吻合口瘘早期的诊断价值。方法收集进行肿瘤切除手术的胃癌患者310例研究对象,根据术后早期是否发生吻合口瘘分为未口瘘组(40例)、口瘘组(270例)。...目的探讨血清C-反应蛋白(CRP)、降钙素原(PCT)、金属基质蛋白酶-9(MMP-9)在胃癌患者术后吻合口瘘早期的诊断价值。方法收集进行肿瘤切除手术的胃癌患者310例研究对象,根据术后早期是否发生吻合口瘘分为未口瘘组(40例)、口瘘组(270例)。采集患者术前,术后1、3、5、7 d血清,采用酶联免疫法检测CRP、PCT、MMP-9表达,制作受试者工作特征曲线(ROC)评估CRP、PCT及MMP-9在胃癌术后吻合口瘘中最佳截断值,以组织病理结果作为金标准,评估三项指标单项检测以及联合检测诊断效能。结果与未口瘘组相比,口瘘组术前、术后1 d CRP、PCT、MMP-9水平比较差异无统计学意义(P>0.05),术后3、5、7 d三项指标水平均升高(P<0.05)。ROC曲线分析显示,术后3 d CRP、PCT、MMP-9诊断胃癌术后吻合口瘘的AUC分别为0.784、0.712、0.827(P<0.05),截断值分别为28.16、5.42、65.32,敏感性分别为72.50%、70.00%、75.00%,特异性分别为78.89%、82.22%、84.81%;与单项检测相比,联合检测在胃癌术后吻合口瘘中准确度、灵敏度、特异度均升高(P<0.05)。结论血清CRP、PCT、MMP-9在胃癌术后吻合口瘘中均具有诊断价值,三项联合诊断后诊断效能进一步提高,为临床胃癌术后吻合口瘘诊断提供一定的参考。展开更多
This paper aims to the debate on the nexus between informal economies and the environment by investigating the long-term dynamic impacts of China’s informal economies on pollution and considering regional differences...This paper aims to the debate on the nexus between informal economies and the environment by investigating the long-term dynamic impacts of China’s informal economies on pollution and considering regional differences in informal economies’ pollution.This paper uses the Multiple Indicators Multiple Causes(MIMIC) model to estimate the size of informal economies and employs econometric models to examine their relationships to pollution based on provincial-level panel data from 2000 to 2017. The results indicate that informal economies’ effects on environmental pollution are not purely positive or negative. Rather, our model indicates that there is an inverted U-shaped relationship between informal economies and pollution in the long run in China;this means that the level of environmental pollution increases at first and then decreases with the growth of informal economies. Further analysis shows that while this inverted, U-shaped relationship is significant in different regions of China, it is affected by different environmental impact factors. The paper concludes by discussing the policy implications for environmental protection and sustainable development.展开更多
文摘目的探讨血清C-反应蛋白(CRP)、降钙素原(PCT)、金属基质蛋白酶-9(MMP-9)在胃癌患者术后吻合口瘘早期的诊断价值。方法收集进行肿瘤切除手术的胃癌患者310例研究对象,根据术后早期是否发生吻合口瘘分为未口瘘组(40例)、口瘘组(270例)。采集患者术前,术后1、3、5、7 d血清,采用酶联免疫法检测CRP、PCT、MMP-9表达,制作受试者工作特征曲线(ROC)评估CRP、PCT及MMP-9在胃癌术后吻合口瘘中最佳截断值,以组织病理结果作为金标准,评估三项指标单项检测以及联合检测诊断效能。结果与未口瘘组相比,口瘘组术前、术后1 d CRP、PCT、MMP-9水平比较差异无统计学意义(P>0.05),术后3、5、7 d三项指标水平均升高(P<0.05)。ROC曲线分析显示,术后3 d CRP、PCT、MMP-9诊断胃癌术后吻合口瘘的AUC分别为0.784、0.712、0.827(P<0.05),截断值分别为28.16、5.42、65.32,敏感性分别为72.50%、70.00%、75.00%,特异性分别为78.89%、82.22%、84.81%;与单项检测相比,联合检测在胃癌术后吻合口瘘中准确度、灵敏度、特异度均升高(P<0.05)。结论血清CRP、PCT、MMP-9在胃癌术后吻合口瘘中均具有诊断价值,三项联合诊断后诊断效能进一步提高,为临床胃癌术后吻合口瘘诊断提供一定的参考。
基金Under the auspices of the National Natural Science Foundation of China(No.41930646,41771137)the Guangdong Academy of Sciences(GDAS)Project of Science and Technology Development(No.2019GDASYL-0104004)Fundamental Research Funds for the Central Universities(No.20lgpy31)。
文摘This paper aims to the debate on the nexus between informal economies and the environment by investigating the long-term dynamic impacts of China’s informal economies on pollution and considering regional differences in informal economies’ pollution.This paper uses the Multiple Indicators Multiple Causes(MIMIC) model to estimate the size of informal economies and employs econometric models to examine their relationships to pollution based on provincial-level panel data from 2000 to 2017. The results indicate that informal economies’ effects on environmental pollution are not purely positive or negative. Rather, our model indicates that there is an inverted U-shaped relationship between informal economies and pollution in the long run in China;this means that the level of environmental pollution increases at first and then decreases with the growth of informal economies. Further analysis shows that while this inverted, U-shaped relationship is significant in different regions of China, it is affected by different environmental impact factors. The paper concludes by discussing the policy implications for environmental protection and sustainable development.
