Improved LS+MAR hybrid method to UT1-UTC ultra-short-term prediction by using first-order-difference UT1-UTC

Accurate ultra-short-term prediction of the Earth rotation parameters(ERP)holds paramount impor-tance for real-time applications,particularly in reference frame conversion.Among them,diurnal rota-tion(UT1-UTC)which cannot be directly estimated through Global Navigation Satellite System(GNSS)techniques,significantly affects the rapid and ultra-rapid orbit determination of GNsS satellites.Pres-ently,the traditional LS(least squares)+AR(autoregressive)and LS+MAR(multivariate autoregressive)hybrid methods stand as primary approaches for UT1-UTC ultra-short-term predictions(1-10 days).The LS+MAR hybrid method relies on the UT1-UTC and LOD(length of day)series.However,the correlation between LOD and first-order-difference UT1-UTC is stronger than that between LOD and UT1-UTC.In light of this,and with the aid of the first-order-difference UT1-UTC,we propose an enhanced LS+MAR hybrid method to UT1-UTC ultra-short-term prediction.By using the UT1-UTC and LOD data series of the IERS(International Earth Rotation and Reference Systems Service)EOP 14 C04 product,we conducted a thorough analysis and evaluation of the improved method's prediction performance compared to the traditional LS+AR and LS+MAR hybrid methods.According to the numerical results over more than 210 days,they demonstrate that,when considering the correlation information between the LoD and the first-order-difference UT1-UTC,the mean absolute errors(MAEs)of the improved LS+MAR hybrid method range from 21 to 934μs in 1-10 days predictions.In comparison to the traditional LS+AR hybrid method,the MAEs show a reduction of 7-53μs in 1-10 days predictions,with corresponding improvement percentages ranging from 1 to 28%.Similarly,when compared to the traditional LS+MAR hybrid method,the MAEs have a reduction of 5-42μs in 1-10 days predictions,with corresponding improvement percentages ranging from 4-20%.Additionally,when aided by GNSS-derived LOD data series,the MAEs of improved LS+MAR hybrid method experience further reduction.

A modified stochastic model for LS+AR hybrid method and its application in polar motion short-term prediction

Short-term(up to 30 days)predictions of Earth Rotation Parameters(ERPs)such as Polar Motion(PM:PMX and PMY)play an essential role in real-time applications related to high-precision reference frame conversion.Currently,least squares(LS)+auto-regressive(AR)hybrid method is one of the main techniques of PM prediction.Besides,the weighted LS+AR hybrid method performs well for PM short-term prediction.However,the corresponding covariance information of LS fitting residuals deserves further exploration in the AR model.In this study,we have derived a modified stochastic model for the LS+AR hybrid method,namely the weighted LS+weighted AR hybrid method.By using the PM data products of IERS EOP 14 C04,the numerical results indicate that for PM short-term forecasting,the proposed weighted LS+weighted AR hybrid method shows an advantage over both the LS+AR hybrid method and the weighted LS+AR hybrid method.Compared to the mean absolute errors(MAEs)of PMX/PMY sho rt-term prediction of the LS+AR hybrid method and the weighted LS+AR hybrid method,the weighted LS+weighted AR hybrid method shows average improvements of 6.61%/12.08%and 0.24%/11.65%,respectively.Besides,for the slopes of the linear regression lines fitted to the errors of each method,the growth of the prediction error of the proposed method is slower than that of the other two methods.

An adaptive physics-informed deep learning method for pore pressure prediction using seismic data

Accurate prediction of formation pore pressure is essential to predict fluid flow and manage hydrocarbon production in petroleum engineering.Recent deep learning technique has been receiving more interest due to the great potential to deal with pore pressure prediction.However,most of the traditional deep learning models are less efficient to address generalization problems.To fill this technical gap,in this work,we developed a new adaptive physics-informed deep learning model with high generalization capability to predict pore pressure values directly from seismic data.Specifically,the new model,named CGP-NN,consists of a novel parametric features extraction approach(1DCPP),a stacked multilayer gated recurrent model(multilayer GRU),and an adaptive physics-informed loss function.Through machine training,the developed model can automatically select the optimal physical model to constrain the results for each pore pressure prediction.The CGP-NN model has the best generalization when the physicsrelated metricλ=0.5.A hybrid approach combining Eaton and Bowers methods is also proposed to build machine-learnable labels for solving the problem of few labels.To validate the developed model and methodology,a case study on a complex reservoir in Tarim Basin was further performed to demonstrate the high accuracy on the pore pressure prediction of new wells along with the strong generalization ability.The adaptive physics-informed deep learning approach presented here has potential application in the prediction of pore pressures coupled with multiple genesis mechanisms using seismic data.

Prediction of Potential Drug Activity and Therapeutic Targets of a Natural Compound Niga-ichigoside F1 Based on Network Pharmacology and Molecular Docking

Objective:To study the drug activity and therapeutic targets of Niga-ichigoside F1 predicted based on network pharmacology and molecular docking.Methods:Download the 2D and 3D structures of Niga-ichigoside F1 from the PubChem database for target prediction and molecular docking,respectively.Target information was predicted by PharmMapper and swiss ADME databases,target gene names were extracted and rechecked by Uniprot database,and disease information corresponding to target was queried by TTD database.The enrichment analysis of GO and KEGG signal pathway was conducted by Metascape database.AutoDuck Vina was used for molecular docking of Niga-ichigoside F1 3D structure with key proteins of related diseases and common pathways.Finally,the conformation of molecular docking was visualized by PyMOL.Results:A total of 34 targets and 69 related disease information were obtained from the database screening.The targets with high degree of acquisition of the association network between target and disease were AR,F2,VDR,PDE10A,mTOR,and NR3C2,etc..Diseases with a high degree of relief were solid tumour,breast cancer, acute myeloid leukemia, hypertension, and thrombocytopenia,etc..The items with significance in GO analysis included positive regulation of transferase activity,protein autophosphorylation,negative regulation of cGMP-mediated signaling,intracellular receptor signaling pathway,regulation of cellular response to stress,blood vessel development,reactive oxygen species metabolic process,negative regulation of immune response,regulation of transcription from RNA polymerase Ⅱ promoter in response to stress,and nucleobase-containing small molecule metabolic process,etc..The items with significance in KEGG enrichment analysis(P<0.01) included Pathways in cancer,Purine metabolism,Focal adhesion,MAPK signaling pathway,GnRH signaling pathway,AGE-RAGE signaling pathway in diabetic complications,Ras signaling pathway,Leukocyte transendothelial migration and Platelet activation,etc..Molecular docking suggested that the target of Niga-ichigoside F1 had good binding ability with related diseases and key proteins of common pathways.Conclusion:According to the results of network pharmacology and molecular docking,Niga-ichigoside F1 has rich drug activity and may act on a variety of diseases.After comprehensive analysis, we proposed for the first time the high correlation between Niga-ichigoside F1 and cancer,as well as the possible association with acute myeloid leukemia and hypertension.It has the characteristics of multi-target and multi-pathway,which is worthy of further research,development and utilization.

Influence of Angiotensin II on α1-Adrenergic Receptors Function in Rat Aorta and Expression in Vascular Smooth Muscle Cells

Angiotensin II (Ang II) is the main mediator of the Renin-Angiotensin-System acting on AT1 and other AT receptors. It is regarded as a pleiotropic agent that induces many actions, including functioning as a growth factor, and as a contractile hormone, among others. The aim of this work was to examine the impact of Ang II on the expression and function of α1-adrenergic receptors (α1-ARs) in cultured rat aorta, and aorta-derived smooth muscle cells. Isolated Wistar rat aorta was incubated for 24 h in DMEM at 37˚C, then subjected to isometric tension and to the action of added norepinephrine, in concentration-response curves. Ang II was added (1 × 10−5 M), and in some experiments, 5-Methylurapidil (α1A-AR antagonist), AH11110A (α1B-AR antagonist), or BMY-7378 (α1D-AR antagonist), were used to identify the α1-AR involved in the response. Desensitization of the contractile response to norepinephrine was observed due to incubation time, and by the Ang II action. α1D-AR was protected from desensitization by BMY-7378;while RS-100329 and prazosin partially mitigated desensitization. In another set of experiments, isolated aorta-derived smooth muscle cells were exposed to Ang II and α1-ARs proteins were evaluated. α1D-AR increased at 30 and 60 min post Ang II exposure, the α1A-AR diminished from 1 to 4 h, while α1B-AR remained unchanged over 24 h of Ang II exposure. Ang II induced an increase of α1D-AR at short times, and BMY-7378 protected α1D-AR from desensitization.

血清c5ar1、ALP及25(OH)D3的表达规律对股骨颈骨折术后骨折愈合情况的预测价值

目的:探讨血清补体成分5a受体1(Complement component 5a receptor,c5ar1)、碱性磷酸酶(Alkaline phosphatase,ALP)及25羟基维生素D(Vitamin D325-hydroxy monohydrate,25(OH)D3)的表达规律对股骨颈骨折术后骨折愈合情况的预测价值.方法:选取2019年1月至2022年12月本院治疗的股骨颈发生骨折且实施全髋关节置换术的98例患者作为研究对象.依据其术后6 m的影像学方面检查结果评估患者的骨折愈合情况,并将患者分成骨折愈合组(77例)和未愈合组(21例).于入院及术后42 d分别对两组的血清c5ar1、ALP、25(OH)D3水平进行测定,采用Pearson相关性分析c5ar1、ALP、25(OH)D3的相关性.采用受试者工作(Receiver operating characteristic,ROC)曲线分析血清c5ar1、ALP及25(OH)D3对股骨颈骨折术后骨折的愈合情况的预测价值.结果:骨折愈合组术后血清c5ar1、ALP及25(OH)D3的表达水平均高于术前(P<0.05),未愈合组术后血清c5ar1、ALP及25(OH)D3的表达水平均低于术前(P<0.05);Pearson相关性分析结果显示,c5ar1与25(OH)D3呈正相关关系(P<0.05);c5ar1、ALP、25(OH)D3诊断股骨颈骨折术后骨折愈合情况的敏感度分别为92.20%、62.30%、76.60%,特异度分别为90.50%、47.60%、52.40%,ROC曲线分析显示,c5ar1、ALP、25(OH)D3诊断股骨颈骨折术后骨折愈合情况的曲线下面积(area under curve,AUC)分别为0.953、0.515、0.765.结论:血清c5ar1、ALP及25(OH)D3的表达水平升高可促进股骨颈骨折术后骨折愈合,c5ar1与25(OH)D3呈正相关关系,c5ar1、25(OH)D3诊断股骨颈骨折术后骨折愈合情况具有较高的准确性,而ALP预测股骨颈骨折术后骨折愈合情况的准确性较低.

Diagnostic Value of the Padua Score Combined with Thrombotic Biomarker Tissue Plasminogen Activator Inhibitor-1 (tPAI-1) Detection for the Risk of Deep Vein Thrombosis in Patients with Pulmonary Heart Disease

This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with pulmonary heart disease.These patients often exhibit symptoms similar to venous thrombosis,such as dyspnea and bilateral lower limb swelling,complicating differential diagnosis.The Padua Prediction Score assesses the risk of venous thromboembolism(VTE)in hospitalized patients,while tPAI-1,a key fibrinolytic system inhibitor,indicates a hypercoagulable state.Clinical data from hospitalized patients with cor pulmonale were retrospectively analyzed.ROC curves compared the diagnostic value of the Padua score,tPAI-1 levels,and their combined model for predicting DVT risk.Results showed that tPAI-1 levels were significantly higher in DVT patients compared to non-DVT patients.The Padua score demonstrated a sensitivity of 82.61%and a specificity of 55.26%at a cutoff value of 3.The combined model had a significantly higher AUC than the Padua score alone,indicating better discriminatory ability in diagnosing DVT risk.The combination of the Padua score and tPAI-1 detection significantly improves the accuracy of diagnosing DVT risk in patients with pulmonary heart disease,reducing missed and incorrect diagnoses.This study provides a comprehensive assessment tool for clinicians,enhancing the diagnosis and treatment of patients with cor pulmonale complicated by DVT.Future research should validate these findings in larger samples and explore additional thrombotic biomarkers to optimize the predictive model.

Bayesian system identification and chaotic prediction from data for stochastic Mathieu-van der Pol-Duffing energy harvester

In this paper,the approximate Bayesian computation combines the particle swarm optimization and se-quential Monte Carlo methods,which identify the parameters of the Mathieu-van der Pol-Duffing chaotic energy harvester system.Then the proposed method is applied to estimate the coefficients of the chaotic model and the response output paths of the identified coefficients compared with the observed,which verifies the effectiveness of the proposed method.Finally,a partial response sample of the regular and chaotic responses,determined by the maximum Lyapunov exponent,is applied to detect whether chaotic motion occurs in them by a 0-1 test.This paper can provide a reference for data-based parameter iden-tification and chaotic prediction of chaotic vibration energy harvester systems.

Serum inter-cellular adhesion molecule 1 is an early marker of diagnosis and prediction of severe acute pancreatitis

AIM:To determine if serum inter-cellular adhesion molecule 1(ICAM-1)is an early marker of the diagnosis and prediction of severe acute pancreatitis(SAP) within 24 h of onset of pain,and to compare the sensitivity,specificity and prognostic value of this test with those of acute physiology and chronic health evaluation(APACHE)Ⅱscore and interleukin-6(IL-6). METHODS:Patients with acute pancreatitis(AP)were divided into two groups according to the Ranson's criteria:mild acute pancreatitis(MAP)group and SAP group.Serum ICAM-1,APACHEⅡand IL-6 levels were detected in all the patients.The sensitivity,specificity and prognostic value of the ICAM-1,APACHEⅡscore and IL-6 were evaluated. RESULTS:The ICAM-1 level in 36 patients with SAP within 24 h of onset of pain was increased and was significantly higher than that in the 50 patients with MAP and the 15 healthy volunteers(P<0.01).The ICAM-1 level(25 ng/mL)was chosen as the optimum cutoff to distinguish SAP from MAP,and the sensitivity,specificity,positive predictive value,negative predictive value(NPV),positive likelihood ratio and negative likelihood ratio were 61.11%,71.42%,0.6111,0.7142, 2.1382 and 0.5445,respectively.The area under the curve demonstrated that the prognostic accuracy of ICAM-1(0.712)was similar to the APACHE-Ⅱscoring system(0.770)and superior to IL-6(0.508)in distinguishing SAP from MAP. CONCLUSION:ICAM-1 test is a simple,rapid and reliable method in clinical practice.It is an early marker of diagnosis and prediction of SAP within the first 24 h after onset of pain or on admission.As it has a relatively low NPV and does not allow it to be a stand-alone test for the diagnosis of AP,other conventional diagnostic tests are required.

Combined SAI-SHAO prediction of Earth Orientation Parameters since 2012 till 2017

As the participants of Earth Orientation Parameters Combination of Prediction Pilot Project(EOPC PPP),Sternberg Astronomical Institute of Moscow State University(SAI) and Shanghai Astronomical Observatory(SHAO) have accumulated ～1800 days of Earth Orientation Parameters(EOP) predictions since2012 till 2017, which were up to 90 days into the future, and made by four techniques: auto-regression(AR), least squares collocation(LSC), and neural network(NNET) forecasts from SAI, and least-squares plus auto-regression(LS+AR) forecast from SHAO. The predictions were finally combined into SAISHAO COMB EOP prediction. In this work we present five-year real-time statistics of the combined prediction and compare it with the uncertainties of IERS bulletin A predictions made by USNO.

Study on the Prediction of Rice Blast Based on the Unbiased GM (1,1) Model

To create a new prediction model, the unbiased GM （1,1） model is optimized by the five-point slide method in this paper. Then, based on the occurrence areas of dce blast in Enshi District during 1995 -2004, the new model and unbiased GM （1, 1 ） model are applied to predict the occurrence areas of rice blast during 2005 -2010. Predicting outcomes show that the prediction accuracy of five-point unbiased sliding optimized GM （1, 1 ） model is higher than the unbiased GM （1,1） model. Finally, combined with the prediction results, the author provides some suggestion for Enshi District in the prevention and control of rice blast in 2010.

Prediction of Climate Change in Yangtze-Huaihe Region under the Background of Global Warming

Based on the prediction results of over twenty new climate models provided by Intergovernmental Panel on Climate Change(IPCC) ,the climate change trends in Yangtze-Huaihe region during 2011-2100 were analyzed under the SRES A1B scenario. The results showed that annual mean temperature in Yangtze-Huaihe region would go up gradually under the background of global warming,and temperature increase rose from southeast to northwest,while annual average temperature would increase by 3.3 ℃ in the late 20th century. Meanwhile,annual average precipitation would rise persistently,and precipitation increase would go up with the increase of latitude and the lapse of time,being obviously strengthened after 2041.

重度创伤性颅脑损伤后凝血功能障碍患者血浆α2-抗纤溶酶、vWF及ET-1水平及其影响因素分析

目的探讨重度创伤性颅脑损伤(TBI)后凝血功能障碍患者血浆α2-抗纤溶酶(α2-AP)、血管性血友病因子(vWF)及内皮素-1(ET-1)水平变化及影响因素。方法回顾性分析2021年1月—2022年12月南阳市第一人民医院神经外科和新乡市中心医院神经外科收治的106例重度TBI患者。其中男性58例,女性48岁;年龄32~60岁,平均43.7岁。根据TBI后24 h内是否发生凝血功能障碍分为凝血正常组(74例)和凝血障碍组(32例)。比较两组重度TBI患者临床资料和入院次日清晨的凝血功能指标及血浆α2-AP、vWF、ET-1水平;Pearson相关性分析重度TBI后凝血功能障碍患者血浆α2-AP、vWF、ET-1水平与凝血功能指标的关系;Logistic回归性分析影响重度TBI患者发生凝血功能障碍的危险因素;受试者工作特征(ROC)曲线分析血浆α2-AP、vWF、ET-1水平对重度TBI患者发生凝血功能障碍的预测价值。结果两组患者年龄、入院GCS、入院头部最高AIS和入院时平均MAP比较,差异有统计学意义[(45.4±5.7)岁vs.(42.8±4.2)岁、(6.7±1.1)分vs.(7.2±0.9)分、(4.6±0.8)分vs.(3.7±0.6)分、(84.1±11.2)mmHg vs.(91.0±9.7)mmHg],P<0.05。凝血障碍组TBI患者PT、APTT和INR等凝血功能指标水平和血浆α2-AP、vWF、ET-1水平高于凝血正常组,纤维蛋白原(FIB)水平低于凝血正常组[(27.9±3.4)s vs.(12.0±1.9)s、(66.4±5.8)s vs.(36.2±2.3)s、1.6±0.2 vs.1.0±0.1、(67.8±8.2)mg/L vs.(19.3±2.4)mg/L、(162.5±24.6)%vs.(94.8±10.4)%、(65.1±5.2)mg/L vs.(41.6±3.9)mg/L、(2.6±0.3)g/L vs.(3.9±0.5)g/L,差异有统计学意义(P<0.05)。Pearson相关性分析,重度TBI后凝血功能障碍患者血浆α2-AP、vWF、ET-1与PT呈强正相关(r=0.723、0.528、0.586,P<0.05),与APTT呈强正相关(r=0.646、0.572、0.585,P<0.05),与INR呈强正相关(r=0.592、0.507、0.548,P<0.05),与FIB呈强负相关(r=-0.653、-0.672、-0.526,P<0.05);Logistic回归分析显示,入院时GCS降低(OR=2.593,95%CI:1.018~6.606,P<0.05)、α2-AP水平升高(OR=3.019,95%CI:1.107~8.236,P<0.05)和vWF水平升高(OR=2.729,95%CI:1.028~7.243,P<0.05)为重度TBI患者发生凝血功能障碍的相关危险因素;ROC曲线显示,α2-AP、vWF、ET-1预测重度TBI患者发生凝血功能障碍的AUC分别为0.887(95%CI:0.805~0.969,P<0.05)、0.828(95%CI:0.734~0.922,P<0.05)和0.807(95%CI:0.695~0.918,P<0.05),联合检测的AUC为0.912(95%CI:0.854~0.970,P<0.05),灵敏度为91.67%,特异度为87.14%。结论重度TBI后凝血功能障碍患者血浆α2-AP、vWF和ET-1水平均显著升高,其中血浆α2-AP、vWF水平升高为重度TBI患者发生凝血功能障碍的相关危险因素。

血清细胞因子表达水平与非小细胞肺癌PD-1抑制剂疗效研究进展

程序性死亡受体-1(PD-1)/程序性死亡分子配体-1信号通路抑制剂激活机体免系统后产生的细胞因子在抗肿瘤细胞过程中发挥关键作用。本文回顾近年来接受PD-1抑制剂治疗的非小细胞肺癌患者血清细胞因子表达水平与临床获益的相关性研究,揭示非小细胞肺癌患者PD-1治疗前后白介素-6、白介素-8、肿瘤坏死因子、干扰素、白介素-17A等细胞因子水平变化,为寻找经济、便捷的PD-1抑制剂疗效生物标志物提供思路和线索。

血清肿瘤坏死因子受体相关因子3和卵泡抑素样蛋白1检测对系统性红斑狼疮患者吗替麦考酚酯治疗无效的预测价值

目的:分析血清肿瘤坏死因子受体相关因子3(TRAF3)和卵泡抑素样蛋白1(FSTL1)水平检测对系统性红斑狼疮患者吗替麦考酚酯治疗无效的预测价值。方法:选择系统性红斑狼疮患者58例为研究对象,采用吗替麦考酚酯治疗,根据治疗效果分为有效组(45例)和无效组(13例)。检测血清TRAF3、FSTL1水平,分析TRAF3、FSTL1与系统性红斑狼疮患者吗替麦考酚酯治疗效果的关系,以及血清TRAF3、FSTL1对系统性红斑狼疮患者吗替麦考酚酯治疗无效的预测价值。结果:系统性红斑狼疮患者经吗替麦考酚酯治疗后,血清TRAF3、FSTL1水平降低(均P<0.05)。与无效组比较,有效组血清TRAF3、FSTL1水平降低(均P<0.05)。Logistic回归分析结果显示,TRAF3、FSTL1是系统性红斑狼疮患者吗替麦考酚酯治疗效果的影响因素(均P<0.05)。ROC曲线分析显示,血清TRAF3、FSTL1对系统性红斑狼疮患者吗替麦考酚酯治疗无效具有一定的预测价值,且联合检测预测价值更高(均P<0.05)。结论:血清TRAF3、FSTL1高表达与系统性红斑狼疮患者吗替麦考酚酯治疗无效相关,两者联合检测能提升系统性红斑狼疮患者治疗无效风险的预测价值。

血清sFlt-1、VASP水平对重症急性胰腺炎并发急性肾损伤的预测价值

目的 研究血清可溶性血管内皮生长因子受体1(sFlt-1)、血管扩张刺激磷蛋白(VASP)对重症急性胰腺炎(SAP)患者并发急性肾损伤(AKI)的预测价值。方法 选取2015年2月至2021年2月该院诊治的198例SAP患者作为SAP组。根据SAP患者是否发生AKI分为AKI组(42例)和非AKI组(156例),根据AKI的严重程度将AKI组分为Ⅰ~Ⅲ期。另选取同期于该院体检中心体检的100例健康人作为对照组。采用酶联免疫吸附试验检测血清sFlt-1、VASP水平。采用多因素Logistic回归分析SAP并发AKI的影响因素。采用受试者工作特征曲线评估血清sFlt-1、VASP对SAP并发AKI的预测价值。结果 SAP组血清sFlt-1、VASP水平均高于对照组,差异均有统计学意义(P<0.05)。不同AKI分期患者血清sFlt-1、VASP水平均为Ⅲ期>Ⅱ期>Ⅰ期,且不同分期间两两比较差异均有统计学意义(P<0.05)。AKI组血淀粉酶、血清sFlt-1、VASP水平均明显高于非AKI组,血尿素氮/血肌酐比值低于非AKI组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,血淀粉酶升高、血清sFlt-1升高、VASP升高是SAP并发AKI的独立危险因素(P<0.05),血尿素氮/肌酐比值升高是SAP并发AKI的保护因素(P<0.05)。血清sFlt-1、VASP联合预测SAP并发AKI的曲线下面积(AUC)为0.868,大于血清sFlt-1、VASP单独检测的0.812、0.784,差异均有统计学意义(Z=3.348、3.847,P<0.05)。血清sFlt-1、VASP联合检测预测SAP并发AKI的灵敏度为0.826,特异度为0.755。结论 SAP并发AKI患者血清sFlt-1、VASP水平升高是SAP并发AKI的独立危险因素,2项指标联合检测对SAP并发AKI具有较高的预测价值。

脂联素、瘦素、Pref-1与胰岛素抵抗关系及联合检测预测糖尿病前期病情进展风险的效能

目的探讨脂联素、瘦素、前脂肪细胞因子-1(Pref-1)与胰岛素抵抗的关系及联合检测预测糖尿病前期病情进展风险的效能。方法选取2019年1月至2023年1月郑州大学第一附属医院收治的304例糖尿病前期患者进行前瞻性队列研究。根据1年内是否进展为糖尿病分为糖尿病组(62例)、糖尿病前期组(242例),另选同期正常糖耐量人群60例作为对照组。比较三组受检者的基线资料及血清脂联素、瘦素、Pref-1表达水平,采用Pearson法分析血清脂联素、瘦素、Pref-1水平与胰岛素抵抗(IR)的相关性,采用Logistic回归分析血清脂联素、瘦素、Pref-1水平对糖尿病前期病情进展的影响,采用受试者工作特征曲线(ROC)分析血清脂联素、瘦素、Pref-1单独及联合检测对糖尿病前期病情进展风险的预测效能。结果三组受检者的年龄、体质量指数(BMI)、甘油三酯、空腹血糖、胰岛素抵抗指数(HOMA-IR)比较,糖尿病组高于糖尿病前期组,且糖尿病前期组高于对照组,差异均有统计学意义(P<0.05);糖尿病组患者的脂联素、Pref-1分别为(2.82±0.93)mg/L、(0.30±0.10)μg/L,明显低于糖尿病前期组的(6.76±2.17)mg/L、(0.51±0.16)μg/L,且糖尿病前期组患者的脂联素、Pref-1明显低于对照组的(8.45±2.80)mg/L、(0.84±0.27)μg/L,而糖尿病组患者的瘦素为(12.00±2.98)μg/L,明显高于糖尿病前期组的(8.79±2.87)μg/L,且糖尿病前期组患者的瘦素明显高于对照组的(3.56±1.09)μg/L,差异均有统计学意义(P<0.05);脂联素(r=-0.694)、Pref-1(r=-0.853)与HOMA-IR呈负相关(P<0.05),瘦素(r=0.660)与HOMA-IR呈正相关(P<0.05);Logistic回归分析结果显示,年龄、BMI、甘油三酯、空腹血糖、脂联素、瘦素、Pref-1是糖尿病前期患者病情进展的独立影响因素,将年龄、BMI、甘油三酯、空腹血糖进行校正,以脂联素、瘦素、Pref-1作为自变量,脂联素、瘦素、Pref-1仍是糖尿病前期患者病情进展的独立影响因素(P<0.05);ROC曲线分析结果显示,脂联素预测糖尿病前期病情进展风险的曲线下面积(AUC)为0.730,截断值≤3.51 mg/L,敏感度为79.03%,特异度为59.09%,瘦素预测的AUC为0.760,截断值>10.78μg/L,敏感度为67.74%,特异度为73.55%,Pref-1预测的AUC为0.795,截断值≤0.37μg/L,敏感度为80.65%,特异度为65.70%,且联合检测预测糖尿病前期病情进展的AUC为0.904,敏感度为87.10%,特异度为82.23%(P<0.05)。结论血清脂肪因子脂联素、Pref-1与不同糖耐量受损人群IR呈负相关,瘦素与之呈正相关,且联合检测对糖尿病前期病情进展风险具有一定预测价值,可作为临床早期预测病情进展风险的辅助指标。

脓毒症患者血清HMGB1、sTLT-1、NLR变化及其对并发急性肺损伤的预测价值

目的探讨脓毒症患者血清高迁移率族蛋白B1(HMGB1)、可溶性髓样细胞触发受体样转录因子-1(sTLT-1)、中性粒细胞/淋巴细胞比值(NLR)变化及其对并发急性肺损伤(ALI)的预测价值。方法回顾性分析2022年1月至2023年12月新乡医学院第一附属医院收治的120例脓毒症患者的临床资料,根据住院期间是否发生ALI分为ALI组35例、非ALI组85例。比较ALI组与非ALI组、ALI组不同病情程度患者血清HMGB1、sTLT-1、NLR水平,并采用受试者工作(ROC)曲线分析血清HMGB1、sTLT-1、NLR对脓毒症并发ALI的预测价值。结果ALI组患者的血清HMGB1、sTLT-1、NLR水平分别为(74.21±11.70)pg/mL、(593.06±82.45)pg/mL、5.13±1.16,明显高于非ALI组的(60.15±7.95)pg/mL、(525.73±54.84)pg/mL、4.08±0.64,差异均有统计学意义(P<0.05);ALI组中,高危组患者的血清HMGB1、sTLT-1、NLR水平分别为(86.43±5.90)pg/mL、(686.31±23.91)pg/mL、(6.49±1.11),明显高于中危组的(76.64±11.44)pg/mL、(599.28±88.40)pg/mL、5.27±1.00及低危组的(64.48±5.06)pg/mL、(539.93±35.90)pg/mL、4.27±0.71,且中危组患者均高于低危组,差异均有统计学意义(P<0.05);血清HMGB1、sTLT-1、NLR联合预测脓毒症并发ALI的曲线下面积(AUC)、敏感度、特异度分别为0.890、90.60%、92.10%,HMGB1单独检测分别为0.848、84.70%、77.10%,sTLT-1单独检测分别为0.732、71.40%、68.20%,NLR单独检测分别为0.785、62.90%、84.20%,联合检测高于各指标单独检测(P<0.05)。结论脓毒症并发ALI患者血清HMGB1、sTLT-1、NLR明显升高,且三者联合检测对并发ALI有较高的预测价值。

血清sTREM-1联合降钙素原对老年胆道结石术后继发急性胆管炎的预测价值

目的 探讨联合检测血清可溶性髓系细胞触发受体-1(sTREM-1)和降钙素原(PCT)对老年胆道结石术后继发急性胆管炎(AC)的预测价值。方法 以2019年1月至2022年9月收治的145例行胆道结石术的老年病人作为研究对象,按术后是否继发AC将病人分为对照组(未继发AC,n=56)和观察组(继发AC,n=89),再根据AC病情程度将观察组病人分为轻度(n=37)、中度(n=29)和重度(n=23)3个亚组。检测各组病人血清WBC、CRP、PCT和sTREM-1水平并进行比较。采用Logistic回归分析继发AC以及AC严重程度的影响因素;绘制ROC曲线分析PCT和sTREM-1水平对老年胆道结石术后继发AC的预测效能。结果 与对照组比较,观察组血清WBC、CRP、PCT和sTREM-1水平显著升高(P<0.01)。与轻度组比较,中度组和重度组病人血清CRP、PCT和sTREM-1水平均显著升高;与中度组比较,重度组病人血清WBC和PCT水平显著升高(均P<0.05)。Logistic回归分析结果显示,血清CRP、PCT和sTREM-1水平升高是老年胆道结石术后继发AC和AC重症的独立危险因素(均P<0.05)。ROC曲线评估结果显示,血清PCT和sTREM-1联合检测对术后继发AC以及AC严重程度的预测效能均显著高于单一指标(均P<0.05)。结论 胆道结石术后继发AC的老年病人血清PCT和sTREM-1水平明显升高,二者联合检测对胆道结石术后继发AC具有预测价值。

MRI检查指标、血清骨钙素、MMP-1及IL-1对膝骨关节炎合并软骨损伤的预测价值

目的探讨磁共振成像(MRI)及血清骨钙素、基质金属蛋白酶(MMP-1)及白细胞介素-1(IL-1)对膝骨关节炎合并软骨损伤的预测价值。方法回顾性分析2021年8月至2023年5月广西贵港市人民医院收治的84例膝骨关节炎患者的临床资料。入院后均行关节镜检查,依据检查结果是否合并软骨损伤分组,分为合并组(n=40)与未合并组(n=44)。比较两组资料[性别、年龄、体重指数、合并疾病(高血压、高脂血症、糖尿病)、病变部位(左膝、右膝)、饮酒史、吸烟史]、MRI不同区域软骨T_(2)值[股骨外侧(LF)、股骨内侧(MF)、胫骨外侧(LT)、胫骨内侧(MT)、髌骨区(P)]以及血清骨钙素、MMP-1、IL-1水平。通过多因素采取非条件Logistic逐步回归分析明确膝骨关节炎合并软骨损伤的危险因素。通过受试者操作特征(ROC)曲线分析MRI不同区域软骨T_(2)值、血清骨钙素、MMP-1、IL-1预测膝骨关节炎合并软骨损伤的价值。结果两组性别构成比、年龄、体重指数、病变部位、合并高血压、高脂血症、糖尿病、饮酒史、吸烟史比较,差异均无统计学意义(P>0.05);合并组MRI不同区域软骨T_(2)值以及血清骨钙素、MMP-1、IL-1水平均显著高于未合并组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,MRI不同区域软骨T_(2)值、骨钙素、MMP-1、IL-1是膝骨关节炎患者合并软骨损伤的危险因素(P<0.05)。经ROC分析证实,LF软骨T_(2)值、MF软骨T_(2)值、LT软骨T_(2)值、MT软骨T_(2)值、P软骨T_(2)值、骨钙素、MMP-1、IL-1最佳截断值分别为39.705 ms、44.250 ms、36.855 ms、35.715 ms、38.005 ms、6.655μg/L、7.335μg/L、389.340 pg/mL,曲线下面积分别为0.796、0.840、0.859、0.882、0.728、0.705、0.763、0.721,均有较高预测价值(P<0.05)。结论MRI不同区域软骨T_(2)值、血清骨钙素、MMP-1、IL-1是膝骨关节炎合并软骨损伤的危险因素;同时LF软骨T_(2)值≥39.705 ms、MF软骨T_(2)值≥44.250 ms、LT软骨T_(2)值≥36.855 ms、MT软骨T_(2)值≥35.715 ms、P软骨T_(2)值≥38.005 ms、骨钙素≥6.655μg/L、MMP-1≥7.335μg/L、IL-1≥389.340 pg/mL可用于预测此类患者合并风险。