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Novel non-invasive score to predict cirrhosis in the era of hepatitis C elimination: A population study of ex-substance users in Singapore

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Hepatobiliary & Pancreatic Diseases International 2019年第2期18卷 143-148页

作者： Yue Zhao Prem Harichander Thurairajah Rahul Kumar Jessica Tan Eng Kiong Teo John Chen Hsiang Department of Gastroenterology and Hepatology Changi General Hospital

Background: Chronic hepatitis C infection is common among people with history of substance use. Liver fibrosis assessment is a barrier to linkage to care, particularly among those with history of substance users. The use of non-invasive scores can be helpful in predicting liver cirrhosis in the era of HCV elimination, especially in countries where transient elastography(TE) is not available. We compared the commonly used non-invasive scores with a novel non-invasive score in predicting liver cirrhosis in this population. Methods: HCV patients with history of substance use between 2011 and 2016 were analyzed. All patients had TE for liver fibrosis assessment. Clinical performance of established non-invasive scores for fibrosis assessment and novel score were compared. Youden's index was used to determine optimal cut-off of the novel score. Results: A total of 579 patients were included. In multivariate logistic regression, cirrhosis on TE was associated with age( P = 0.002), aspartate aminotransferase(AST)( P = 0.004), and platelet count( P score. Modified APRI was superior to APRI in predicting cirrhosis(AUROC, 0.796 vs. 0.770, P = 0.007), but not fibrosis-4 score(FIB-4)( P = 1.00). Modified APRI at cut-off of 4 has sensitivity, specificity and negative predictive value(NPV) of 94.4%, 26.9% and 92.6%, respectively, and at 19, has sensitivity, specificity and positive predictive value(PPV) of 33.3%, 96.2% and 77.1%, respectively. FIB-4 has a NPV and PPV of 88.6%, 41.8% and 78.5%, 77.6%, at cut-off of 1.45 and 3.25, respectively. Using the cut-off of 4 and 14 for modified APRI, 32.5% of patients can be correctly classified and misses out only 5.6% of cirrhosis patients. Conclusions: Modified APRI score is superior in predicting cirrhosis in HCV population, with 32.5% of the population being correctly classified using cut-off of 4 and 14.

关键词： Hepatitis C Cirrhosis Fibrosis assessment AST-to-platelet ratio index Modified APRI Fibrosis-4 score

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Comparison of breast-conserving surgery and mastectomy in early breast cancer using observational data revisited:a propensity score-matched analysis

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Science China(Life Sciences) 2018年第12期61卷 1528-1536页

作者： Kai Chen Zihao Pan Liling Zhu Tingting Hu Min Peng Weijuan Jia Fengxi Su Shunrong Li Erwei Song Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhou 510120China Breast Tumor Center Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhou 510120China Department of Thoracic-Cardiac Surgery Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhou 510120China Fountain-Valley Institute for Life Sciences Guangzhou Institute of Biomedicine and HealthChinese Academy of SciencesGuangzhou 510530China

Recent observational studies showed that breast-conserving surgery(BCS) resulted in superior survival compared to mastectomy in breast cancer patients. This study compared the clinical outcomes of BCS and mastectomy using propensity score(PS)matching analysis, which had advantages over conventional methods in reducing bias. Nonmetastatic breast cancer patients who underwent BCS and mastectomy were matched 1:1 based on their PS. We used the Kaplan-Meier method and Cox-regression model to estimate the treatment effects. A total of 2,866 patients with a median follow-up time of 67 months were included in the original study population. Although the mastectomy cohort(N=1,219) had more advanced disease compared to the BCS cohort(N=1,647), LRFS was similar between the two groups(93.8% vs. 92.4%, P>0.05). BCS(vs. mastectomy) was associated with improved DFS(73.8% vs. 58.7%, P0.05) or CSS(87.5% vs. 84.9%, P>0.05). We found that PS methods reduce bias when estimating treatment effects using observational data. BCS and mastectomy show equivalent outcomes in nonmetastatic breast cancer patients.

关键词： breast-conserving surgery mastectomy breast cancer propensity score survival

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ADVISING score:a reliable grading scale based on injury and response for intracerebral haemorrhage

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Stroke & Vascular Neurology 2023年第2期8卷 111-118页

作者： Yan Wan Hongxiu Guo Shaoli Chen Jiang Chang David Wang Rentang Bi Man Li Ke Shi Zhaowei Wang Daokai Gong Jingwen Xu Quanwei He Bo Hu Department of Neurology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina School of Public Health Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Neurovascular Division Department of NeurologyBarrow Neurological Institute/Saint Joseph Hospital Medical CenterPhoenixArizonaUSA Department of Neurology Qianjiang Central HospitalQianjiangHubeiChina Department of Neurology Jingzhou Central HospitalJingzhouHubeiChina Department of Neurology Honghu People's HospitalHonghuHubeiChina

Background Intracerebral haemorrhage(ICH)is the most devastating form of stroke causing high morbidity and *** aimed to develop a novel clinical score incorporating multisystem markers to predict functional dependence at 90 days after *** We analysed data from Chinese Cerebral Hemorrhage:Mechanism and Intervention *** logistic regression analysis was used to identify the factors associated with 90-day functional dependency(the modified Rankin Scale≥3)after ICH and develop the ADVISING scoring *** test the scoring system,a total of 2111 patients from Hubei province were included as the training cohort,and 733 patients from other three provinces in China were included as an external validation *** We found nine variables to be significantly associated with functional dependency and included in the ADVISING score system:age,deep location of haematoma,volume of haematoma,National Institutes of Health Stroke Scale,aspartate transaminase,international normalised ratio,neutrophil-lymphocyte ratio,fasting blood glucose and glomerular filtration *** were divided into 12 different categories by using these nine potential *** proportion of patients who were functionally dependent increased with higher ADVISING scores,which showed good discrimination and calibration in both the training cohort(C-statistic,0.866;p value of Hosmer-Lemeshow test,0.195)and validation cohort(C-statistic,0.884;p value of Hosmer-Lemeshow test,0.853).The ADVISING score also showed better discriminative performance compared with the other five existing ICH scores(pscore is a reliable tool to predict functional dependency at 90 days after ICH.

关键词： score statistic reliable

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Outcomes of Medicare beneficiaries hospitalised with transient ischaemic attack and stratification using the ABCD^(2) score

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Stroke & Vascular Neurology 2021年第2期6卷 314-318页

作者： Shreyansh Shah Li Liang Durgesh Bhandary Saga Johansson Eric E Smith Deepak L Bhatt Gregg C Fonarow Naeem D Khan Eric Peterson Janet Prvu Bettger Department of Neurology Duke University School of MedicineDurhamNorth CarolinaUSA Duke Clinical Research Institute DurhamNorth CarolinaUSA AstraZeneca UK Ltd CambridgeUK Hotchkiss Brain Institute and Department of Clinical Neurosciences University of CalgaryCalgaryAlbertaCanada Division of Cardiology Brigham and Women's HospitalBostonMassachusettsUSA Division of Cardiology Ronald Reagan UCLA Medical CenterLos AngelesCaliforniaUSA

Background Long-term outcomes for Medicare beneficiaries hospitalised with transient ischaemic attack(TIA)and role of ABCD^(2) score in identifying high-risk individuals are not *** We identified 40825 Medicare beneficiaries hospitalised from 2011 to 2014 for a TIA to a Get With The Guidelines(GWTG)-Stroke hospital and classified them using ABCD^(2)s of mortality and rehospitalisation(all-cause,ischaemic stroke,haemorrhagic stroke,myocardial infarction,and gastrointestinal and intracranial haemorrhage)for high-risk versus low-risk groups adjusted for patient and hospital *** Of the 40825 patients,35118(86%)were high risk(ABCD^(2)≥4)and 5707(14%)were low risk(ABCD^(2)=0-3).Overall rate of mortality during 1-year follow-up after hospital discharge for the index TIA was 11.7%,44.3% were rehospitalised for any reason and 3.6%were readmitted due to *** with ABCD^(2) score≥4 had higher mortality at 1 year than not(adjusted HR 1.18,95%CI 1.07 to 1.30).Adjusted risks for ischaemic stroke,all-cause readmission and mortality/all-cause readmission at 1 year were also significantly higher for patients with ABCD^(2) score≥4 vs *** contrast,haemorrhagic stroke,myocardial infarction,gastrointestinal bleeding and intracranial haemorrhage risk were not significantly different by ABCD^(2) *** This study validates the use of ABCD^(2) score for long-term risk assessment after TIA in patients aged 65 years and *** efforts for community-based follow-up care after TIA are needed for ongoing prevention in Medicare beneficiaries who were hospitalised for TIA.

关键词： admitted score prevention

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Essen score in the prediction of cerebrovascular events compared with cardiovascular events after ischaemic stroke or transient ischaemic attack:a nationwide registry analysis

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Journal of Geriatric Cardiology 2022年第4期19卷 265-275页

作者： Long LI Ze-Ning JIN Yue-Song PAN Jing JING Xia MENG Yong JIANG Hao LI Cai-Xia GUO Yong-Jun WANG Department of Cardiology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Car-diology and Beijing Key Laboratory of Hypertension Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases BeijingChina Department of Cardiology Beijing Tongren HospitalCapital Medical UniversityBeijingChina

BACKGROUND The Essen risk score improves stratification of patients with acute ischemic stroke by early stroke *** study showed it could also predict myocardial infarction(MI).This study aimed to compare the Essen score’s ability to predict cerebrovascular events with compared cardiovascular *** We included patients with acute ischaemic stroke or transient ischaemic attack within seven days from the Third China National Stroke ***-year cumulative event rates of combined vascular events(a composite of MI,stroke recurrence or vascular death)and cardiac events(a composite of MI,heart failure or cardiac death)was estimated using the Kaplan-Meier *** predictive value of the Essen score was assessed with *** multivariate Cox regression analyses,we assessed whether Essen score,etiological subtype and imaging parameters were associated with *** Of 13,012 patients were included,the cumulative one-year event rates were 10.03%for combined vascular events and 0.77%for cardiac events,*** with those with an Essen scorescore≥3 were more likely to have a subsequent combined vascular event[hazard ratio(HR)=1.39,95%CI:1.24−1.55]and cardiac events(HR=2.30,95%CI:1.53−3.44).The score tended to be more predictive of the risk of MI(C-statistic=0.63,95%CI:0.55−0.71)and cardiac events(C-statistic=0.62,95%CI:0.56−0.67)than stroke recurrence(C-statistic=0.55,95%CI:0.54−0.57)and combined vascular events(C-statistic=0.56,95%CI:0.54−0.57).In multivariable analysis after adjusted Essen score,patients with multiple acute in-farctions or single acute infarctions and large artery atherosclerosis subtype were independently associated with an increased risk of combined vascular *** the cardioembolism subtype was associated with an increased risk of cardiac *** The Essen score is potentially more suitable for risk stratification of cardiovascular events than cerebrovasc

关键词： transient score statistic

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Comparison of diagnostic efficacy between transrectal and transperineal prostate biopsy:a propensity score-matched study

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Asian Journal of Andrology 2019年第6期21卷 612-617页

作者： Chen-Yi Jiang Peng-Fei Shen Cheng Wang Hao-Jun Gui Yuan Ruan Hao Zeng Shu-Jie Xia Qiang Wei Fu-Jun Zhao Department of Urology Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai 200080China Department of Urology West China HospitalSichuan UniversityWest China School of MedicineChengdu 610041China Department of Urology Shanghai General Hospital Affiliated to Nanjing Medical UniversityShanghai 200080China.

This study compared the diagnostic efficacy of transrectal ultrasound(TRUS)-guided prostate biopsy(TRBx)and transperineal prostate biopsy(TPBx)in patients with suspected prostate cancer(PCa).We enrolled 2962 men who underwent transrectal(n=1216)or transperineal(n=1746)systematic 12-core prostate *** data including age,prostate-specific antigen(PSA)level,and prostate volume(PV)were *** minimize confounding,we performed propensity score-matching analysis?We measured and compared PCa detection rates between TRBx and TPBx,which were stratified by clinical characteristics and Gleason *** effects of clinical characteristics on PCa detection rate were assessed by logistic *** all patients,TPBx detected a higher proportion of clinically significant PCa(Pscore-matching analysis showed that the detection rates in TRBx were higher than those in TPBx for patients aged≥80 years(80.4%vs 56.5%,P=0.004)and with PSA level 20.1-100.0 ng ml^-1(80.8%vs 69.1%,P=0.040).In conclusion,TPBx was associated with a higher detection rate of clinically significant PCa than TRBx was;however,because of the high detection rate at certain ages and PSA levels,biopsy approaches should be optimized according to patents'clinical characteristics.

关键词： biopsy demography Gleason score propensity score prostatic neoplasms

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Clinical risk score for invasive fungal diseases in patients with hematological malignancies undergoing chemotherapy:China Assessment of Antifungal Therapy in Hematological Diseases (CAESAR) study

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Frontiers of Medicine 2019年第3期13卷 365-377页

作者： Ling Wang Ying Wang Jiong Hu Yuqian Sun He Huang Jing Chen Jianyong Li Jun Ma Juan Li Yingmin Liang Jianmin Wang Yan Li Kang Yu Jianda Hu Jie Jin Chun Wang Depei Wu Yang Xiao Xiaojun Huang Blood & Marrow Transplantation Center Department of HematologyCollaborative Innovation Center of HematologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200025China Department of Hematology The First Affiliated Hospital of China Medical UniversityShenyang 110001China Department of Hematology The First Affiliated Hospital of Wenzhou Medical CollegeWenzhou 325000China Department of Hematology Fujian Medical University Union HospitalFuzhou 350001China Department of Hematology The First People's Hospital of ShanghaiShanghai 200080China Department of Hematology The First Affiliated Hospital of Soochow UniversitySuzhou 215006China Department of Hematology The General Hospital of Guangzhou Military Command of PLAGuangzhou 510010China Peking University Institute of Hematology Peking UniversityPeople's HospitalBeijing Key Laboratory of Hematopoietic Stem Cell TransplantationBeijing 100044China Department of Hematology The First Affiliated Hospital of Medical School of Zhejiang UniversityHangzhou 310003China Department of Hematology-Oncology Shanghai Children's Medical CenterShanghai 200127China Department of Hematology Jiangsu Province HospitalNanjing 210029China Harbin Hematologic Tumor Institution Harbin 150010China Department of Hematology The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080China Department of Hematology Tangdu HospitalFourth Military Medical UniversityXi'an 710032China Department of Hematology Changhai Hospital of the Second Military Medical UniversityShanghai 200082China

Invasive fungal disease (IFD) is a major infectious complication in patients with hematological *** this study,we examined 4889 courses of chemotherapy in patients with hematological diseases to establish a training dataset (n=3500) by simple random sampling to develop a weighted risk score for proven or probable IFD through multivariate regression,which included the following variables: male patients,induction chemotherapy for newly diagnosed or relapsed disease,neutropenia,neutropenia longer than 10 days,hypoalbuminemia,central-venous catheter,and history of *** patients were classified into three groups,which had low (0-10,~1.2%),intermediate (11-15,6.4%),and high risk (> 15,17.5%) of *** the validation set (n=1389),the IFD incidences of the groups were ~1.4%,5.0%,and 21.4%.In addition,we demonstrated that antifungal prophylaxis offered no benefits in low-risk patients,whereas benefits were documented in intermediate (2.1% vs.6.6%,P=0.007) and high-risk patients (8.4% vs.23.3%,P=0.007).To make the risk score applicable for clinical settings,a pre-chemo risk score that deleted all unpredictable factors before chemotherapy was established,and it confirmed that anti-fungal prophylaxis was beneficial in patients with intermediate and high risk of *** conclusion,an objective,weighted risk score for IFD was developed,and it may be useful in guiding antifungal prophylaxis.

关键词： invasive fungal diseases hematological malignancies chemotherapy risk score prophylaxis

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Body condition score prior to parturition is associated with plasma and adipose tissue biomarkers of lipid metabolism and inflammation in Holstein cows

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Journal of Animal Science and Biotechnology 2018年第2期9卷 439-450页

作者： Abdulrahman Alharthi Zheng Zhou Vincenzo Lopreiato Erminio Trevisi Juan J.Loor Mammalian Nutri Physio Genomics Department of Animal Sciences and Division of Nutritional Sciences University of Illinois Animal and Veterinary Sciences Clemson University 146 Poole Agricultural Center Department of Health Science Interdepartmental Services Centre of Veterinary for Human and Animal Health Magna Gr?cia University of Catanzaro Institute of Zootechnics Faculty of Agriculture Food and Environmental Science Università Cattolica del S.Cuore

Background: Previous research has revealed a strong inflammatory response within adipose(AT) tissue during the transition into lactation. Whether this effect is a result of oxidative stress induced by lipolysis and fatty acid oxidation associated with differences in prepartum body condition score remains to be determined. The objectives of this study were to investigate systemic biomarkers of energy balance and inflammation and the expression of lipid metabolismand inflammation-related genes in AT during the transition period in dairy ***: Twenty multiparous Holstein cows were retrospectively divided by body condition score(BCS) prior to parturition into two groups(10 cows/group): BCS ≤ 3.25(Lo BCS) and BCS ≥ 3.75(Hi BCS). Subcutaneous adipose tissue was biopsied from the tail-head region at d-10, 7 and 20 relative to parturition. Plasma was used to evaluate biomarkers of energy balance(EBAL) [free fatty acids(NEFA), glycerol, insulin] and inflammation [IL-1β, haptoglobin, myeloperoxidase, and reactive oxygen metabolites(ROM)]. Although insulin concentration was not affected by BCS, NEFA was overal greater and glycerol lower in HiB CS cows. Greater activity of myeloperoxidase in plasma coincided with increased haptoglobin and IL-1β postpartum in LoB CS *** genes related with oxidative stress, the expression of the cytosolic antioxidant enzyme SOD1 was greater in LoB CS compared to HiB CS. Cows in LoB CS compared with HiB CS had greater overal expression of ABDH5 and ATGL along with ADIPOQ, indicating enhanced basal lipolysis and secretion of adiponectin. Expression of CPT1 A, ACADVL, and ACOX1 was greater overal in HiB CS than LoB CS indicating enhanced NEFA oxidation. Although the temporal increase in plasma NEFA regardless of BCS coincided with the profile of CPT1 A, the gradual decrease in genes related with reesterification of NEFA(PCK1) and glycerol efflux(AQP7) coupled with an increase in glycerol kinase(GK) suggested some stimulation of NEFA u

关键词： Body condition score Lipid mobilization Transition cow

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Development and validation of a score predicting mortality for older patients with mitral regurgitation

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Journal of Geriatric Cardiology 2023年第8期20卷 577-585页

作者： De-Jing FENG Yun-Qing YE Zhe LI Bin ZHANG Qing-Rong LIU Wei-Wei WANG Zhen-Yan ZHAO Zheng ZHOU Qing-Hao ZHAO Zi-Kai YU Hai-Tong ZHANG Zhen-Ya DUAN Bin-Cheng WANG Jun-Xing LV Shuai GUO Run-Lin GAO Hai-Yan XU Yong-Jian WU on behalf of the China-DVD and China-VHD study investigators Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseaseChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina

OBJECTIVE To develop and validate a user-friendly risk score for older mitral regurgitation(MR)patients,referred to as the Elder-MR *** The China Senile Valvular Heart Disease(China-DVD)Cohort Study functioned as the development cohort,while the China Valvular Heart Disease(China-VHD)Study was employed for external *** included patients aged 60 years and above receiving medical treatment for moderate or severe MR(2274 patients in the development cohort and 1929 patients in the validation cohort).Candidate predictors were chosen using Cox’s proportional hazards model and stepwise selection with Akaike’s information *** Eight predictors were identified:age≥75 years,body mass indexscore=0.06)and the validation cohort(C-statistic=0.73,95%CI:0.68-0.78,Brier score=0.06).The Elder-MR score ranges from 0 to 15 *** a one-year follow-up,each point increase in the Elder-MR score represents a 1.27-fold risk of death(HR=1.27,95%CI:1.21-1.34,Pscore II,the Elder-MR score demonstrated superior predictive accuracy for one-year mortality in the validation cohort(C-statistic=0.71 vs.0.70,net reclassification improvement=0.320,Pscore may serve as an effective risk stratification tool to assist clinical decision-making in older MR patients.

关键词： patients mitral score

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A Risk score System for Myopia Symptom Warning

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Current Medical Science 2019年第3期39卷 455-462页

作者： Dan-dan DU Wen-long XU Li-hua YANG He-xin WANG Chang-mei GU Jia TANG Fang LI Ting XU Shi-qing WU Mei-xia LU Department of Epidemiology and Statistics and the Ministry of Education (MOE) Key Lab of Environment and Health School of Public Health Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China Wuhan Center for Adolescent Poor Vision Prevention & Control Wuhan 430015 China Wuhan Commission of Experts for the Prevention &. Control of Adolescent Poor Vision Wuhan 430015 China China Innovation and Research and Development Center Carl Zeiss (Shanghai) Co. Ltd. ZEISS Group Shanghai 200131 China Wuhan Academy of Educational Science Wuhan 430030China Wuhan Centers for Disease Prevention & Control Wuhan 430015 China

Myopia is the leading cause of visual impairments worldwide. Some studies revealed that visual experience in early life affected the final myopia, indicating that environmental factors play an impellent role in the development of myopia. However, risk factors of myopia are still not identified among adolescents in China. A total of 4104 cases of myopia symptom and 3306 emmetropia controls were selected from students in primary and middle schools in Wuhan in 2008. We identified the risk factors associated with myopia symptom by multivariate logistic regression in this cross-sectional study and constructed a risk score system for myopia symptom. The value of the area under the receiver operating characteristic curve (ROC) was 0.735. Furthermore, we followed up 93 students aged 7-9 years for one year and calculated the total points using the score system. We found no significant difference between the final myopia symptom and the results predicted by the total points by pair chi-square test (P>0.05). The score system had a modest ability to estimate the risk factors of myopia symptom. Using this score system, we could identify the students who are at risk of myopia symptom in the future according to their behaviors and environmental factors, and take measures to slow the progress of myopia symptom.

关键词： myopia symptom adolescents risk score system

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