Is the neutrophil to lymphocyte ratio associated with liver fibrosis in patients with chronic hepatitis B?

AIM: To determine the association between the neutrophil to lymphocyte(N/L) ratio and the degree of liver fibrosis in patients with chronic hepatitis B(CHB) infection. METHODS: Between December 2011 and February 2013, 129 consecutive CHB patients who were admitted to the study hospitals for histological evaluation of chronic hepatitis B-related liver fibrosis were included in this retrospective study. The patients were divided into two groups based on the fibrosis score: individuals with a fibrosis score of F0 or F1 were included in the "no/minimal liver fibrosis" group, whereas patients with a fibrosis score of F2, F3, or F4 were included in the "advanced liver fibrosis" group. The Statistical Package for Social Sciences 18.0 for Windows was used to analyze the data. A P value of < 0.05 was accepted as statistically significant.RESULTS: Three experienced and blinded pathologists evaluated the fibrotic status and inflammatory activity of 129 liver biopsy samples from the CHB patients. Following histopathological examination, the "no/minimal fibrosis" group included 79 individuals, while the "advanced fibrosis" group included 50 individuals. Mean(N/L) ratio levels were notably lower in patients with advanced fibrosis when compared with patients with no/minimal fibrosis. The mean value of the aspartate aminotransferase-platelet ratio index was markedly higher in cases with advanced fibrosis compared to those with no/minimal fibrosis.CONCLUSION: Reduced levels of the peripheral blood N/L ratio were found to give high sensitivity, specificity and predictive values in CHB patients with significant fibrosis. The prominent finding of our research suggests that the N/L ratio can be used as a novel noninvasive marker of fibrosis in patients with CHB.

Clinical importance of serum procalcitonin in ulcerative colitis patients

We have read with interest the recently published article entitled &#x0201c;Clinical significance of serum procalcitonin in patients with ulcerative colitis&#x0201d; by Koido et al. They aimed to investigate the association of procalcitonin with ulcerative colitis (UC) activity. They concluded that elevated procalcitonin levels were significantly correlated with UC activity. We would like to thank the authors for their comprehensive contribution.

Values of high-resolution computed tomography and pulmonary function tests in managements of patients with chronic hepatitis C virus infection

AIM:To investigate pulmonary involvement via pulmonary function tests (PFT) and high-resolution computed tomocjraphy (HRCT) in patients with chronic hepatitis C virus (HCV) infection. METHODS:Thirty-four patients with chronic HCV infection without diagnosis of any pulmonary diseases and 10 healthy cases were enrolled in the study,PFT and HRCT were performed in all cases. RESULTS:A decrease lower than 80% of the predicted value was detected in vital capacity in 9/34 patients,in forced expiratory volume in one second in 8/34 patients,and in forced expiratory flow 25-75 in 15/34 patients,respectively.Carbon monoxide diffusing capacity (DLCO) was decreased in 26/34 patients.Findings of interstitial pulmonary involvement were detected in the HRCT of 16/34 patients.Significant difference was found between controls and patients with HCV infection in findings of HRCT (X^2=4.7,P=0.003).Knodell histological activity index (KHAI) of 28/34 patients in whom liver biopsy was applied was 9.0±4.7.HRCT findings,PFT values and DLCO were not affected by KHAI in patients with HCV infection.In these patients,all the parameters were related with age. CONCLUSION:We suggest that chronic hepatitis C virus infection may cause pulmonary interstitial involvement without evident respiratory symptoms.

Comparison of the effects of first and second generation silicone hydrogel contact lens wear on tear film osmolarity

AIM:To compare the effects of first and second generation silicone hydrogel(SiH) contact lens wear on tear film osmolarity.METHODS:The healthy subjects who have never used contact lenses before were enrolled in the study.Tear film osmolarity values of 16 eyes(group 1) who wore first generation SiH contact lenses were compared with those of 18 eyes(group 2) who wore second generation SiH contact lenses after three months follow-up.RESULTS:Beforecontactlenswear,tearfilmosmolarity of groups 1 and 2 were 305.02±49.08 milliosmole(mOsm) and 284.66±30.18mOsm,respectively.After three months of contact lens wear,osmolarity values were found 317.74±60.23mOsm in group 1 and 298.40±37.77mOsm in group 2.Although osmolarity values for both groups of SiH contact lens wear after three months periods were slightly higher than before the contact lens wear,the difference was not statistically significant. CONCLUSION:Contact lens wear may cause evaporation from the tear film and can increase tear film osmolarity leading to symptoms of dry eye disease.In the current study,there is a tendency to increase tear film osmolarity for both groups of SiH contact lens wear,but the difference is not statistically significant.

Healing Effects of Omalizumab in a Patient with Cholinergic Urticaria Associated Severe Dyspeptic Complaints

To the Editor： Cholinergic urticaria （CU） is a type of physical urticaria characterized by a number of short-lasting, highly pruritic weals. The underlying pathological mechanism of CU is not fully understood. Omalizumab is a humanized, monoclonal IgG anti-lgE antibody that binds specifically to circulating lgE molecules, thus interrupting the allergic cascade, The efficacy of anti-lgE treatment has been shown in many disorders with complex and unclear etiology, comprising physical urticarias, chronic idiopathic urticaria, angioedema and eosinophil-associated gastrointestinal disorders.