Existing Case of Transportation System in Turkey and Transportation Trends in Istanbul

Transportation sector is one of the most important elements of a country’s economy with its highway,railway,airway and seaway modes,besides the information and communication infrastructure.Transportation sector has a pattern that affects the society continuously with its economic and social inputs that has a significant role in economies of countries in terms of being an important part of manufacturing process and effects of sizable investments on economy.Demands of more comfortable,more reliable,more safe and more punctual transport in developing economy is an arising trend worldwide and this shows an increase the importance of the transportation sector.Establishment of an efficient and functional transportation system is closely related with traffic safety,intermodal integration and balanced modal distribution.In Turkey,an important improvement has been achieved in these issues,but also some basic constitutive problems are still continuing.These constitutional problems can be summarized as providing traffic safety,integration of innovative implementations to transportation system,enhancing of infrastructure and an effective usage of existing infrastructure.

Association of the glycemic background patterns and the diabetes management efficacy in poorly controlled type 2 diabetes

BACKGROUND Inadequate glycemic control in patients with type 2 diabetes(T2DM)is a major public health problem and a significant risk factor for the progression of diabetic complications.AIM To evaluate the effects of intensive and supportive glycemic management strategies over a 12-month period in individuals with T2DM with glycated hemoglobin(HbA1c)≥10%and varying backgrounds of glycemic control.METHODS This prospective observational study investigated glycemic control in patients with poorly controlled T2DM over 12 months.Participants were categorized into four groups based on prior glycemic history:Newly diagnosed,previously well controlled with recent worsening,previously off-target but now worsening,and HbA1c consistently above 10%.HbA1c levels were monitored quarterly,and patients received medical,educational,and dietary support as needed.The analysis focused on the success rates of good glycemic control and the associated factors within each group.RESULTS The study showed significant improvements in HbA1c levels in all participants.The most significant improvement was observed in individuals newly diagnosed with diabetes:65%achieved an HbA1c target of≤7%.The results varied between participants with different glycemic control histories,followed by decreasing success rates:39%in participants with previously good glycemic control,21%in participants whose glycemic control had deteriorated compared to before,and only 10%in participants with persistently poor control,with mean HbA1c levels of 6.3%,7.7%,8.2%,and 9.7%,respectively.After one year,65.2%of the“newly diagnosed patients”,39.3%in the“previously controlled group”,21.9%in the“previously off-target but now worsened'”group and 10%in the“poorly controlled from the start”group had achieved HbA1c levels of 7 and below.CONCLUSION In poorly controlled diabetes,the rate at which treatment goals are achieved is associated with the glycemic background characteristics,emphasizing the need for tailored strategies.Therefore,different and comprehensive treatment approaches are needed for patients with persistent uncontrolled diabetes.

Duplicated gallbladder with acute cholecystitis:a case of unusual presentation and diagnostic challenges

Anomalies in the gallbladder can lead to misidentifying anatomical structures,heightening the risk of complications in laparoscopic and open cholecystectomy procedures.Failure to recognize these variations increases the chances of iatrogenic bile duct injuries and other complications.

An Affordable and Easily Accessible Approach for Acrylonitrile Monomer Purification through a Simple Column Technique

This manuscript presents a dataset detailing a method for purifying monomers. Purification plays a crucial role in every chemical process, as it leads to an improvement in product quality through the removal of impurities. The primary method for monomer purification, like acrylonitrile (AN), is the distillation technique. However, this technique is unsafe and hard to set up or handle. A straightforward, risk-free, low-cost method like the column technique resolves these issues. A simple column technique demonstrated the successful execution of purifying AN. Fourier transform infrared (FTIR) and nuclear magnetic resonance (NMR) analyses confirmed that AN was successfully purified, with purity reaching 99.8%. FTIR spectra revealed changes in the position and intensity of the stretching vibration peaks after purification. Also, the functional groups of the inhibitor monomethyl ether of hydroquinone (MeHQ) were undetected after purification. Furthermore, after purification, NMR spectra revealed the absence of aromatic protons and carbons associated with MeHQ. In conclusion, the column technique is a successful and inexpensive way to purify AN monomers. This makes it useful for a wide range of applications, especially in polymerization reactions where MeHQ needs to be removed to prevent self-polymerization during the initiation process.

Hepatitis C virus associated glomerulopathies

Hepatitis C virus (HCV) infection is a systemic disorder which is often associated with a number of extrahepatic manifestations including glomerulopathies. Patients with HCV infection were found to have a higher risk of end-stage renal disease. HCV positivity has also been linked to lower graft and patient survivals after kidney transplantation. Various histological types of renal diseases are reported in association with HCV infection including membranoproliferative glomerulonephritis (MPGN), membranous nephropathy, focal segmental glomerulosclerosis, fibrillary glomerulonephritis, immunotactoid glomerulopathy, IgA nephropathy, renal thrombotic microangiopathy, vasculitic renal involvement and interstitial nephritis. The most common type of HCV associated glomerulopathy is type I MPGN associated with type II mixed cryoglobulinemia. Clinically, typical renal manifestations in HCV-infected patients include proteinuria, microscopic hematuria, hypertension, acute nephritis and nephrotic syndrome. Three approaches may be suggested for the treatment of HCV-associated glomerulopathies and cryoglobulinemic renal disease: (1) antiviral therapy to prevent the further direct damage of HCV on kidneys and synthesis of immune-complexes; (2) B-cell depletion therapy to prevent formation of immune-complexes and cryoglobulins; and (3) nonspecific immunosuppressive therapy targeting inflammatory cells to prevent the synthesis of immune-complexes and to treat cryoglobulin associated vasculitis. In patients with moderate proteinuria and stable renal functions, anti-HCV therapy is advised to be started as pegylated interferon-α plus ribavirin. However in patients with nephrotic-range proteinuria and/or progressive kidney injury and other serious extra-renal manifestations, immunosuppressive therapy with cyclophosphamide, rituximab, steroid pulses and plasmapheresis should be administrated.

Effect of Helicobacter pylori eradication on serum ghrelin and obestatin levels

AIM: To investigate changes in serum ghrelin and obestatin levels before and after Helicobacter pylori (H. pylori ) eradication. METHODS: A total of 92 patients presenting with symptoms of dyspepsia were enrolled in the study. Upper endoscopy was performed on all patients and used to diagnose H. pylori infection according to the presence of characteristic histopathological findings; seventy patients were diagnosed with H. pylori infection and the remaining 22 non-infected patients were classified as healthy controls. H. pylori eradication was accomplished by administering the classical triple therapy drug regimen, consisting of lansoprazole 30 mg bid , amoxicillin 1 g bid , and clarithromycin 500 mg tid for 14 d. The eradication of H. pylori was assessed with C14-urea breath test, which was performed at eight weeks after treatment. Levels of serum active ghrelin and obestatin were assessed at beginning of the study (prior to treatment) and after eight weeks. The levels were comparatively analyzed between the H. pylori negative control group, the H. pylori eradicated group, and the H. pylori non-eradicated group. RESULTS: A total of 92 patients, 50 females and 42 males with a mean age of 38.2 ± 11.9 years (range: 19-64), were analyzed. H. pylori eradication success was achieved in 74.3% (52/70) of H. pylori positive patients. The initial levels of ghrelin in the H. pylori positive and control cases were 63.6 ± 19.8 pg/mL and 65.1 ± 19.2 pg/mL (P=0.78), respectively, and initial obestatin levels were 771±427 pg/mL and 830 ± 296 pg/mL (P=0.19), respectively. The difference between the initial levels and the week 8 levels of ghrelin and obestatin in the control group was insignificant [4.5% (P=0.30) and -0.9% (P=0.65), respectively]. The difference between the initial and week 8 levels of ghrelin and obestatin in the H. pylori non-eradicated group were also insignificant [0.9% (P=0.64) and 5.3% (P=0.32), respectively]. The H. pylori eradicated group had a greater change in obestatin levels when compared to the control and the non-eradicated groups (148 ± 381 pg/mL vs -12±138 pg/mL and -72.8±203 pg/mL, respectively, P=0.015), while decreases in ghrelin levels were insignificant (-7.2 pg/mL vs -1.4 pg/mL and -1.9 pg/mL, respectively, P=0.52). The ghrelin/obestatin ratio for the initial and week 8 levels changed significantly in only the H. pylori eradicated group (0.11 vs 0.08, respectively, P=0.015). For overweight patients (as designated by body mass index), we observed significant increases in obestatin levels in the eradicated group as compared to non-eradicated group (201 ± 458 pg/mL vs -5 ± 81 pg/mL, respectively, P=0.02). In the H. pylori-eradicated group, the levels did not differ between the sexes for ghrelin (-6.3 ± 26.9 pg/mL vs -8.0 ± 24.0 pg/mL, respectively, P=0.97) or obestatin (210 ± 390 pg/mL vs 96 ± 372 pg/mL, respectively, P=0.23).CONCLUSION: Serum levels of ghrelin decreased while obestatin levels increased in H. pylori eradicated subjects, especially in overweight and male patients.

Increased expression of YAP1 in prostate cancer correlates with extraprostatic extension

Objective:Yes associated protein 1(YAP1)is a member of the Hippo pathway,acting as a transcriptional coactivator.To elucidate the role of YAP1 and phosphorylated(p)YAP1 in prostate cancer(PCa)tumorigenesis,we investigated their expression in clinical samples of PCa and cell lines.Methods:Fifty-four tumor,adjacent nontumor,and prostate intraepithelial neoplasia(PIN)tissues from patients with PCa after radical prostatectomy were selected from a retrospective cohort and studied using immunohistochemistry(IHC).Protein and m RNA expression levels of YAP1 were evaluated by Western blot analysis and quantitative real-time reverse transcription PCR,respectively,in cancer cell lines.Publicly available gene expression datasets were downloaded to analyze YAP1 m RNA and protein levels in PCa tissue samples.Results:IHC analysis of PCa tissues revealed that YAP1 staining intensities were moderate to weak in the nucleus and cytoplasm of tumor cells,whereas adjacent normal epithelia showed strong staining.We observed that benign prostates were characterized by higher expression levels of both nuclear(P=0.004)and cytosolic(P=0.005)YAP1.p YAP1 staining was weak in the cytoplasm and absent in the nucleus of all the tissues investigated.YAP1 expression was an indicator of extraprostatic extension(EPE).The level of YAP1 was negatively correlated with the level of the androgen receptor(AR)in The Cancer Genome Atlas dataset and Western blot analysis of cell lines.Conclusions:Our study suggested that YAP1 expression is heterogeneous in PCa tissue samples;therefore,YAP1 might play different roles in different aspects of PCa progression.This might involve AR–YAP1 interplay in PCa.

Contrast-induced acute kidney injury:A review of practical points

Contrast-induced acute kidney injury(CI-AKI) is oneof the most common causes of AKI in clinical practice.CI-AKI has been found to be strongly associated with morbidity and mortality of the patients.Furthermore,CI-AKI may not be always reversible and it may be associated with the development of chronic kidney disease.Pathophysiology of CI-AKI is not exactly understood and there is no consensus on the preventive strategies.CI-AKI is an active research area thus clinicians should be updated periodically about this topic.In this review,we aimed to discuss the indications of contrastenhanced imaging,types of contrast media and their impact on nephrotoxicity,major pathophysiological mechanisms,risk factors and preventive strategies of CI-AKI and alternative non-contrast-enhanced imaging methods.

Metastasis in renal cell carcinoma:Biology and implications for therapy

Although multiple advances have been made in systemic therapy for renal cell carcinoma(RCC),metastatic RCC remains incurable.In the current review,we focus on the underlying biology of RCC and plausible mechanisms of metastasis.We further outline evolving strategies to combat metastasis through adjuvant therapy.Finally,we discuss clinical patterns of metastasis in RCC and how distinct systemic therapy approaches may be considered based on the anatomic location of metastasis.

Effects of body mass index on intraocular pressure and ocular pulse amplitude

AIM: To investigate the effects of body mass index (BMI) on intraocular pressure (IOP) and ocular pulse amplitude(OPA). METHODS: Totally 140 healthy individuals without any systemic diseases were included in the study. BMI (kg/m2) was calculated for every individual. IOP and OPA were measured with Pascal Dynamic contour tonometer (DCT). Blood pressure was also measured along with the DCT. The patients were divided into three groups according to BMI as: Group1, BMI<25; Group2, 25≤BMI<30; Group3, BMI≥30. Mean values of IOP, OPA, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were used in statistical analysis.RESULTS: In Group1, the means of IOP, OPA, were 16.8±2.3mmHg, 2.7±0.7mmHg respectively; and SBP, DBP were 120.0±6.1mmHg, and 77.4±5.6mmHg respectively. In group2, the mean IOP, OPA, SBP, and DBP were found to be 16.6±2.1mmHg, 2.4±0.7mmHg, 121.7±5.3mmHg, and 79.5±4.9mmHg respectively. In group3, the mean IOP, OPA, SBP, and DBP were found to be 17.3±1.7mmHg, 2.1±0.7mmHg, 122.4±5.7mmHg, and 79.7±5.2mmHg respectively. There were no statistically significant difference between groups in terms of IOP, SBP and DBP, while OPA values were significantly lower in group3 (P=0.001). CONCLUSION: Decreased OPA values in individuals with higher BMI may indicate that subjects with higher BMI have lower choroidal perfusion and lower ocular blood flow.

New approach: removal of silicone oil and trocar assisted sutureless scleral fixated intraocular lens implantation at the same session

Dear Sir,Iam Dr.Remzi Karadag,from the Department of Ophthalmology,Istanbul Medeniyet University School of Medicine,Istanbul,Turkey.I write to present two case reports of removal of silicone oil and trocar assisted sutureless scleral fixated intraocular lens implantation at the same session.

Relationship between diabetic polyneuropathy, serum visfatin, and oxidative stress biomarkers

BACKGROUND Diabetic polyneuropathy is a very common complication of diabetes.Numerous studies are available in terms of pathogenesis.But examination methods with low reliability are still not standardized and generally time consuming.Highsensitive,easy-to-access methods are expected.Biochemical markers are one of the subjects of research.We aimed to discover a potential biomarker that can be used for this purpose in patients with diabetes who have not yet developed symptoms of neuropathy.AIM To determine the place and availability of visfatin and thiol-disulfide homeostasis in this disorder.METHODS A total of 392 patients with type 2 diabetes mellitus were included in the study.The polyneuropathy clinical signs were evaluated with the Subjective Peripheral Neuropathy Screen Questionnaire and Michigan Neuropathy Screening Instrument questionnaire and examination.The biochemical parameters,oxidative stress markers,visfatin,and thiol-disulfide homeostasis were analyzed and correlated with each other and clinical signs.RESULTS Subjective Peripheral Neuropathy Screen Questionnaire and Michigan Neuropathy Screening Instrument questionnaire with examination scores were correlated with each other and diabetes duration(P<0.005).Neuropathy related symptoms were present in 20.7%of the patients,but neuropathy related findings were observed in 43.9%of the patients.Serum glucose,glycated hemoglobin,and visfatin were positively correlated with each other.Also,these parameters were positively correlated with the total oxidative stress index.Total and native thiol was positively correlated with total antioxidant status and negatively with oxidant status.Inversely thiol-disulfide positively correlated with higher glucose and oxidant status and negatively with total antioxidant status(P<0.005).There was no correlation between visfatin and thiol-disulphide(P=0.092,r=0.086).However,a significant negative correlation was observed between visfatin and total with native thiol(P<0.005,r=-0.338),(P<0.005,r=-0.448).CONCLUSION Diagnosis of neuropathy is one of the issues studied in patients with diabetes.Visfatin and thiol-disulfide balance were analyzed for the first time in this study with inspiring results.

Laser in situ keratomileusis in adult patients with anisometropic amblyopia

AIM: To evaluate the increase in corrected distance visual acuity (CDVA) after laser in situ keratomileusis (LASIK) in adults with anisometropic amblyopia. · METHODS: The medical records of consecutive patients diagnosed with anisometropic amblyopia at the time of refractive evaluation who underwent LASIK were retrospectively reviewed. Patients with at least a two-line difference of visual acuity (VA) between the eyes with a spherical refractive error difference of at least 3.00 diopters (D) or an astigmatic difference of at least 2.00D were included. Patients with any other possible reason for amblyopia other than anisometropia or those who had undergone previous amblyopia treatment were excluded. Amblyopic eyes with myopia or myopic astigmatism were considered as group 1, hypermetropia or hypermetropic astigmatism constituted group 2, and mixed astigmatism patients comprised group 3. Uncorrected distance visual acuity (UDVA), subjective manifest refraction, and CDVA were analyzed at 1 week and 1 month, 3, and 6 months. ·RESULTS: The study included 57 eyes of 57 patients. There were 33 eyes in group 1, 12 eyes in group 2, and 12 eyes in group 3. The preoperative mean values for spherical equivalent of subjective manifest refraction (SE) in groups 1, 2, and 3 were (-4.66±1.97)D, (4.40±1.00)D, and (0.15±1.05)D, respectively. Mean CDVA improved 0.1 log units (1 line LogMAR) at 6 months (P 【0.05). Sixteen eyes (28%) exhibited an improvement in CDVA in week 1. Fourteen eyes (25% ) experienced two or more lines of CDVA improvement at month 6. There were no statistically significant differences among the groups in terms of CDVA (P 】0.05). Moreover, age, the amount ofpreoperative refractive error, and the levels of preoperative corrected and UDVA had no effect on postoperative CDVA improvement (P 】0.05). · CONCLUSION: Correction of refractive errors with LASIK produced significant CDVA improvement in adult patients with anisometropic amblyopia and no previous amblyopia treatment.

Are radiological modalities really necessary for the long-term follow-up of patients having blunt solid organ injuries? A single center study

Dear editor, During the past two decades, management of blunt solid organ injuries had shifted from conventional surgery to more conservative approach, namely nonoperative management (NOM).[1] The non-operative approach mainly depends on the trauma experience of surgeons and the institution, quality of radiographic imaging and its interpretation.[2-5] If the surgeon decides to observe the patients by NOM, close monitoring of vital signs and frequent physical examinations must be done accordingly with radiological evaluations if needed.

Are suspicious activity reporting requirements for cryptocurrency exchanges effective?

This study analyzes the impact of a newly emerging type of anti-money laundering regulation that obligates cryptocurrency exchanges to report suspicious transactions to financial authorities.We build a theoretical model for the reporting decision structure of a private bank or cryptocurrency exchange and show that an inferior ability to detect money laundering(ML)increases the ratio of reported transactions to unreported transactions.If a representative money launderer makes an optimal portfolio choice,then this ratio increases further.Our findings suggest that cryptocurrency exchanges will exhibit more excessive reporting behavior under this regulation than private banks.We attribute this result to cryptocurrency exchanges’inferior ML detection abilities and their proximity to the underground economy.

Consumer choices under new payment methods

This study suggests a payment portfolio model that includes new payment methods that have emerged from the development of cryptocurrency markets and central bank digital currencies(CBDCs).Our model analyzes the optimal payment choice for consumers under various macroeconomic conditions.We determine that an individual economic agent chooses payment methods under specific conditions by incorporating policy interest rates on CBDCs and stablecoins used on cryptocurrency exchanges.We analyze the impacts of CBDCs and stablecoins on the choice of whether to use cash or deposits.We also examine how the agent changes her portfolio compositions in response to exogenous macroeconomic policies.If a government replaces cash with a CBDC,the convenience of digital currency would not affect consumer choices.The higher the government’s interest rate on CBDCs,the more consumers will use CBDCs than deposits.

Minimally invasive surgery for gastric cancer: A comparison between robotic, laparoscopic and open surgery

AIM To investigate the role of minimally invasive surgery for gastric cancer and determine surgical, clinical, and oncological outcomes.METHODS This is a propensity score-matched case-control study, comparing three treatment arms: robotic gastrectomy(RG), laparoscopic gastrectomy(LG), open gastrectomy(OG). Data collection started after sharing a specific study protocol. Data were recorded through a tailored and protected web-based system. Primary outcomes: harvested lymph nodes, estimated blood loss, hospital stay, complications rate. Among the secondary outcomes, there are: operative time, R0 resections, POD of mobilization, POD of starting liquid diet and soft solid diet. The analysis includes the evaluation of type and grade of postoperative complications. Detailed information of anastomotic leakages is also provided.RESULTS The present analysis was carried out of 1026 gastrectomies. To guarantee homogenous distribution of cases, patients in the RG, LG and OG groups were 1:1:2 matched using a propensity score analysis with a caliper = 0.2. The successful matching resulted in a total sample of 604 patients(RG = 151; LG = 151; OG = 302). The three groups showed no differences in all baseline patients characteristics, type of surgery(P = 0.42) and stage of the disease(P = 0.16). Intraoperative blood loss was significantly lower in the LG(95.93 ± 119.22) and RG(117.91 ± 68.11) groups compared to the OG(127.26 ± 79.50, P = 0.002). The mean number of retrieved lymph nodes was similar between the RG(27.78 ± 11.45), LG(24.58 ± 13.56) and OG(25.82 ± 12.07) approach. A benefit in favor of the minimally invasive approaches was found in the length of hospital stay(P < 0.0001). A similar complications rate was found(P = 0.13). The leakage rate was not different(P = 0.78) between groups.CONCLUSION Laparoscopic and robotic surgery can be safely performed and proposed as possible alternative to open surgery. The main highlighted benefit is a faster postoperative functional recovery.

Internet and social media usage of orthopaedic patients:A questionnaire-based survey

AIM To evaluate social media usage of orthopaedic patients to search for solutions to their health problems. METHODS The study data were collected using face-to-face questionnaire with randomly selected 1890 patients aged over 18 years who had been admitted to the orthopaedic clinics in different cities and provinces across Turkey. The questionnaire consists of a total of 16 questions pertaining to internet and social media usage and demographics of patients, patients' choice of institution for treatment, patient complaints on admission, online hospital and physician ratings, communication between the patient and the physician and its effects.RESULTS It was found that 34.2%(n = 647) of the participants consulted with an orthopaedist using the internet and 48.7%(n = 315) of them preferred websites that allow users to ask questions to a physician. Of all questionaskers, 48.5%(n = 314) reported having found the answers helpful. Based on the educational level of the participants, there was a highly significant difference between the rates of asking questions to an orthopaedist using the internet(P = 0.001). The rate of questionasking was significantly lower in patients with an elementary education than that in those with secondary, high school and undergraduate education(P = 0.001) The rate of reporting that the answers given was helpful was significantly higher in participants with an undergraduate degree compared to those who were illiterate, those with primary, elementary or high school education(P = 0.001). It was also found that the usage of the internet for health problems was higher among managers-qualified participants than unemployed-housewives, officers, workers-intermediate staff(P < 0.05).CONCLUSION We concluded that patients have been increasingly using the internet and social media to select a specific physician or to seek solution to their health problems in an effective way. Even though the internet and social media offer beneficial effects for physicians or patients, there is still much obscurity regarding their harms and further studies are warranted for necessary arrangements to be made.

Greater occipital nerve blocks in the treatment of refractory chronic migraine: An observational report of nine cases

AIM To report the effects of greater occipital nerve(GON) blocks on refractory chronic migraine headache.METHODS Nine patients who were receiving the conventionally accepted preventive therapies underwent treatment with repeated GON block to control chronic migraine resistant to other treatments. GON blocking with lidocaine and normal saline mixture was administered by the same physician at hospital once a month(for three times in total). Patients were assessed before the injection and every month thereafter for pain frequency and severity, number of times analgesics were used and any appearant side effects during a 6 mo follow-up.RESULTS Eight of nine patients reported a marked decrease in frequency and severity of migraine attacks in comparison to their baseline symptoms; one reported no significant change(not more than 50%) from baseline and did not accept the second injection. GON block resulted in considerable reduction in pain frequency and severity and need to use analgesics up to three months after the injection in the present cases. The patients did not report any adverse effects. CONCLUSION Hereby we noticed a remarkable success with refractory chronic migraine patients. We believe that this intervention can result in rapid relief of pain with the effects lasting for perhaps several weeks or even months. Further controlled clinical trials are warranted to evaluate the effect of GON block in the treatment of refractory migraine cases.

Increased serum soluble lectin-like oxidized low-density lipoprotein receptor-1 levels in patients with biopsy-proven nonalcoholic fatty liver disease

AIM: To analyze the relationship between the serum lectin-like oxidized low-density lipoprotein receptor-1(LOX-1) levels and clinical and histopathological features of biopsy-confirmed nonalcoholic fatty liver disease(NAFLD) patients.METHODS: Fifty-three consecutive,biopsy-proven NAFLD patients(31 males and 22 females,mean age 42.5 ± 9.6 years) and 26 age- and gender-matched,healthy controls(14 males and 12 females,mean age 39 ± 10.7 years) were included.The patientswith NAFLD were consecutive patients who had been admitted to the hepatology outpatient clinic within the last year and had been diagnosed with NAFLD as the result of liver biopsy.The healthy controls were individuals who attended the outpatient clinic for routine health control and had no known chronic illnesses.The histological evaluation was conducted according t o t he N AF LD ac t ivi ty scoring syst em recommended by The National Institute of Diabetes and Digestive and Kidney Diseases Nonalcoholic Steatohepatitis Clinical Research Network.The serum LOX-1 levels were measured using an ELISA kit(Life Science Inc.USCN.Wuhan,Catalog No.E1859Hu) in both patients and healthy controls.A receiver operating characteristic(ROC) curve analysis was used to identify the optimal cutoff value of LOX-1 and thereby distinguish between patients with nonalcoholic steatohepatitis(NASH) and healthy controls.A P-value < 0.05 was considered statistically significant.RESULTS: NAFLD and healthy control groups were similar in terms of age and sex.NAFLD patients consisted of 8 patients with simple steatosis(15%),27 with borderline NASH(51%) and 18 with definitive NASH(34%).Metabolic syndrome was found in 62.2% of the patients with NAFLD.The mean serum LOX-1 level in biopsy-proven NAFLD patients was 8.49 ± 6.43 ng/m L compared to 4.08 ± 4.32 ng/m L in healthy controls(P = 0.001).The LOX-1 levels were significantly different between controls,simple steatosis and NASH(borderline+definite) cases(4.08 ± 4.32 ng/m L,6.1 ± 6.16 ng/m L,8.92 ± 6.45 ng/m L,respectively,P = 0.004).When the cut-off value for the serum LOX-1 level was set at 5.35 ng/m L,and a ROC curve analysis was performed to distinguish between steatohepatitis patients and controls; the sensitivity and specificity of the serum LOX-1 level were 69.8% and 69.2%,respectively.CONCLUSION: The serum LOX-1 levels were significantly higher in NAFLD patients than in healthy controls.Additionally,the serum LOX-1 levels could differentiate between steatohepatitis patients and healthy controls.