血清PLT、ALC与弥漫大B细胞淋巴瘤预后的关系研究

目的分析血小板计数(platelet,PLT)、淋巴细胞绝对值(absolute lymphocyte count,ALC)与弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)预后的关系。方法选取本院2020年3月-2023年2月收治的DLBCL患者85例为研究对象(DLBCL组),另选取同期我院健康体检人群70例作为对照组。比较DLBCL组和对照组血清PLT、ALC水平;根据1年随访结果将85例DLBCL患者分为预后良好组和预后不良组,并比较两组临床特征和血清PLT、ALC水平;采用多因素Logistic回归分析影响DLBCL预后的相关因素。结果DLBCL组PLT、ALC水平均低于对照组,差异有统计学意义(P<0.05);85例DLBCL患者1年预后中,预后良好者62例、预后不良者23例,不同预后者性别、年龄比较无明显差异(P>0.05);预后不良组患者临床Ⅲ/Ⅳ期者占比、IPI评分≥2分者占比、PLT水平均高于预后良好组,预后不良组患者ALC水平均低于预后良好组,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,临床Ⅲ/Ⅳ期、IPI评分≥2分、PLT水平上升、ALC水平下降均是影响DLBCL预后的危险因素(P<0.05)。结论血清PLT、ALC水平变化与DLBCL患者预后密切,通过检测PLT、ALC水平,能为临床评估DLBCL预后不良提供可靠信息。

FDP、D-D联合PLT预测创伤性凝血病患者生存预后的效能分析

目的分析纤维蛋白原降解产物(FDP)、D-二聚体(D-D)联合血小板(PLT)预测创伤性凝血病(TIC)患者生存预后的效能。方法回顾性收集2020年2月至2023年2月昆明市第一人民医院收治的182例创伤患者的临床资料,根据TIC发生情况将其分为TIC组(85例)和非TIC组(97例)。比较两组临床资料,采用多因素logistic回归分析探讨TIC患者入院时FDP、D-D、PLT水平对入院后30 d内死亡发生的影响,并采用受试者工作特征(ROC)曲线分析探讨上述指标的预测效能。结果TIC组创伤严重程度评分(ISS)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶原时间比值(PTR)、国际标准化比值(INR)水平以及死亡发生率高于非TIC组,纤维蛋白原(Fib)、PLT、血红蛋白(Hb)水平低于非TIC组,差异有统计学意义(P<0.05)。TIC患者入院后30 d内存活59例,死亡26例。存活组FDP、D-D水平显著低于死亡组(P<0.05),PLT水平显著高于死亡组(P<0.05),两组Fib水平比较差异无统计学意义(P>0.05)。经调整年龄、性别、住院时间、ISS因素后,多因素logistic回归分析结果显示,FDP[OR(95%CI)=1.021(1.007~1.036)]、D-D[OR(95%CI)=1.087(1.027~1.250)]水平升高是促进TIC患者发生死亡的危险因素(P<0.05),PLT[OR(95%CI)=0.990(0.983~0.997)]水平升高是抑制TIC患者发生死亡的保护因素(P<0.05)。ROC曲线分析结果显示,FDP、D-D、PLT可有效预测TIC患者入院30 d内死亡(P<0.05),且三项指标联合的预测效能更高[AUC(95%CI)=0.823(0.720~0.925),P<0.001]。结论入院时检测FDP、D-D、PLT指标有助于评估TIC患者的生存预后情况,值得临床医师关注。

急性脑梗死患者PLT、CRP、UA水平与颈动脉粥样硬化斑块稳定性的相关性研究

目的:探讨急性脑梗死患者血小板计数(PLT)、血清C反应蛋白(CRP)和尿酸(UA)水平与颈动脉粥样硬化斑块(CAS)稳定性的相关性。方法:选取某院收治的107例急性脑梗死患者为研究对象,根据入院时颈动脉超声检查结果分为不稳定斑块组(44例)和稳定斑块组(63例)。比较2组临床资料,采用相关分析法分析入院时PLT、CRP、UA与总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、斑块稳定性的相关性,采用Logistic回归方程分析斑块稳定性的影响因素,采用ROC分析PLT、CRP、UA水平联合检测对不稳定斑块的诊断价值。结果:单因素分析结果显示,不稳定斑块组入院时TC、TG、LDL-C、PLT、CRP、UA水平高于稳定斑块组,HDL-C水平低于稳定斑块组;Logistic回归分析显示,入院时TC(>5.98 mmol/L)、TG(>1.21 mmol/L)、LDL-C(>3.40 mmol/L)、PLT(≥218.61×109/L)、CRP(>10 mg/L)、UA(>323.46μmol/L)是不稳定斑块形成的危险因素,入院时HDL-C(≥0.90 mmol/L)是不稳定斑块的形成保护因素;相关性分析显示,入院时PLT、CRP、UA水平与TC、TG、LDL-C呈正相关,与斑块稳定性、HDL-C水平呈负相关(P<0.05);ROC分析显示,入院时PLT、CRP、UA联合诊断不稳定斑块的AUC为0.808,敏感度、特异度分别为93.18%、68.25%(P<0.001)。结论:PLT、CRP、UA水平是不稳定斑块形成的影响因素,且在诊断CAS稳定性方面具有较高价值。

花生PLT基因家族全基因组鉴定与表达分析

PLT家族是植物特有的一类转录因子,在植物胚胎、干细胞、分生组织及器官生长发育等过程都起着重要作用。本研究利用生物信息学技术在栽培种花生基因组中鉴定到12个PLT家族基因,分布在11条染色体上;AhPLT蛋白大多含有2个保守的AP2结构域,编码439~713个氨基酸,预测定位在细胞核或叶绿体中;AhPLT基因结构复杂,具有多样的短外显子结构,外显子数在5~8个之间,不同家族成员中分布不同的保守基序;AhPLT家族成员启动子区存在生长素、赤霉素和茉莉酸等激素相关的顺式作用元件。qRT-PCR结果显示,AhPLT1-B和AhPLT5-B分别在根中和种子中的表达量最高;两基因对激素IAA、6-BA和GA_(3)有不同的响应,其中AhPLT1-B受6-BA调控上调表达最显著,AhPLT5-B受6-BA、IAA和GA_(3)调控呈先升高后降低的表达模式。本研究为花生PLT基因的生物学功能研究提供了参考。

AMI患者PLT、PDW、PLR水平及其与疾病严重程度的相关性研究

目的探讨急性心肌梗死(AMI)患者血小板计数(PLT)、血小板分布宽度(PDW)、血小板/淋巴细胞比值(PLR)水平及其与疾病严重程度的相关性。方法选取2017年1月至2020年12月苏州市相城区中医医院收治的200例AMI患者作为观察组,另选取同期150例常规体检健康者作为对照组。根据AMI患者随访结果又分为预后不良组和预后良好组。比较观察组和对照组,以及预后良好组和预后不良组PLT、PDW、PLR水平。采用多因素Logistic回归分析AMI患者预后的危险因素。采用Spearman相关分析Killip心功能分级与PLT、PDW、PLR水平的相关性;采用Pearson相关分析PLT、PDW、PLR水平的相关性。结果观察组PLT[(166.32±28.44)×10^(9)/L]高于对照组[(158.77±30.52)×10^(9)/L],PDW[(16.59±4.95)%]高于对照组[(15.54±3.01)%],PLR(162.40±78.85)高于对照组(114.74±12.34),差异均有统计学意义(P<0.05)。预后不良组和预后良好组性别、年龄、体质量指数、吸烟史、糖尿病、高血压、高血脂比较,差异均无统计学意义(P>0.05);预后不良组和预后良好组Killip心功能分级,PLT、PDW、PLR水平比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,PLT、PDW、PLR水平升高是AMI患者预后不良的独立危险因素(P<0.05)。Spearman相关分析结果显示,Killip心功能分级与PLT、PDW、PLR水平均呈正相关(r=0.702、0.664、0.302,P<0.05);Pearson相关分析结果显示,PLT水平与PDW、PLR水平均呈正相关(r=0.361、0.507,P<0.05),PDW水平与PLR水平呈正相关(r=0.596,P<0.05)。结论AMI患者PLT、PDW、PLR水平均升高,并且与AMI患者的Killip心功能分级均呈正相关,PLT、PDW、PLR可作为预测AMI患者预后的良好指标,对预防和治疗AMI有重要临床意义。

利伐沙班所致PLT计数和功能变化研究进展

血栓性疾病严重威胁着人类的生命健康。目前,临床治疗血栓性疾病以抑制凝血机制启动、阻断凝血酶活化为主要策略。利伐沙班作为一种新型口服抗凝药物,可以高效、准确地阻断血栓瀑布形成,具有靶向、低副作用、低出血风险的优势。随着利伐沙班的临床广泛使用,其对血小板(PLT)数量和功能的影响开始显现。文章就利伐沙班临床应用中引起的PLT计数和功能变化及其机制的相关研究进行综述,以期对用药期间患者凝血功能的合理评价提供参考。

Chemokine platelet factor 4 accelerates peripheral nerve regeneration by regulating Schwann cell activation and axon elongation

Schwann cells in peripheral nerves react to traumatic nerve injury by attempting to grow and regenerate.Howeve r,it is unclear what factors play a role in this process.In this study,we searched a GEO database and found that expression of platelet factor 4 was markedly up-regulated after sciatic nerve injury.Platelet factor is an important molecule in cell apoptosis,diffe rentiation,survival,and proliferation.Further,polymerase chain reaction and immunohistochemical staining confirmed the change in platelet factor 4 in the sciatic nerve at different time points after injury.Enzyme-linked immunosorbent assay confirmed that platelet factor 4 was secreted by Schwann cells.We also found that silencing platelet factor 4 decreased the proliferation and migration of primary cultured Schwann cells,while exogenously applied platelet factor 4 stimulated Schwann cell prolife ration and migration and neuronal axon growth.Furthermore,knocking out platelet factor 4 inhibited the prolife ration of Schwann cells in injured rat sciatic nerve.These findings suggest that Schwann cell-secreted platelet factor 4 may facilitate peripheral nerve repair and regeneration by regulating Schwann cell activation and axon growth.Thus,platelet factor 4 may be a potential therapeutic target for traumatic peripheral nerve injury.

Clinical significance of platelet mononuclear cell aggregates in patients with sepsis and acute respiratory distress syndrome

BACKGROUND The diagnosis of sepsis combined with acute respiratory distress syndrome(ARDS)has increased owing to the enhanced awareness among medical profes-sionals and the continuous development of modern medical technologies,while early diagnosis of ARDS still lacks specific biomarkers.One of the main patho-genic mechanisms of sepsis-associated ARDS involves the actions of various pathological injuries and inflammatory factors,such as platelet and white blood cells activation,leading to an increase of surface adhesion molecules.These adhesion molecules further form platelet-white blood cell aggregates,including platelet-mononuclear cell aggregates(PMAs).PMAs has been identified as one of the markers of platelet activation,here we hypothesize that PMAs might play a potential biomarker for the early diagnosis of this complication.METHODS We selected 72 hospitalized patients diagnosed with sepsis as the study population between March 2019 and March 2022.Among them,30 patients with sepsis and ARDS formed the study group,while 42 sepsis patients without ARDS comprised the control group.After diagnosis,venous blood samples were imme-diately collected from all patients.Flow cytometry was employed to analyze the expression of PMAs,platelet neutrophil aggregates(PNAs),and platelet aggregates(PLyAs)in the serum.Additionally,the Acute Physiology and Chronic Health Evaluation(APACHE)II score was calculated for each patient,and receiver operating characteristic curves were generated to assess diagnostic value.RESULTS The study found that the levels of PNAs and PLyAs in the serum of the study group were higher than those in the control group,but the difference was not statistically significant(P>0.05).However,the expression of PMAs in the serum of the study group was significantly upregulated(P<0.05)and positively correlated with the APACHE II score(r=0.671,P<0.05).When using PMAs as a diagnostic indicator,the area under the curve value was 0.957,indicating a high diagnostic value(P<0.05).Furthermore,the optimal cutoff value was 8.418%,with a diagnostic sensitivity of 0.819 and specificity of 0.947.CONCLUSION In summary,the serum levels of PMAs significantly increase in patients with sepsis and ARDS.Therefore,serum PMAs have the potential to become a new biomarker for clinically diagnosing sepsis complicated by ARDS.

Case of Refractory Thrombocytopenia in Pregnancy Associated with May-Heglin Anomaly after Repeated Platelet Transfusions

May-Heglin Anomaly is an autosomal dominant disorder characterized by macrothrombocytopenia with a platelet function that is usually preserved. Platelets play an essential role in hemostasis. During pregnancy, a woman is susceptible to complications, including postpartum hemorrhage. Monitoring patients’ hemostatic functions and observing the patient’s clinical picture to maintain patient safety is paramount, while avoiding unnecessary therapeutic measures. This case report presents a rare instance of May-Heglin Anomaly (MHA) in a 35-year-old pregnant patient, with refractory thrombocytopenia despite receiving multiple platelet transfusions. Initially referred to as gravida 5 para 4 with severe thrombocytopenia at 28 weeks gestation, throughout her pregnancy, she was closely monitored and received over 40 units of platelets, which failed to increase her platelet count significantly. She delivered a healthy baby via vaginal delivery at 38 weeks, with her platelet count still critically low. This report highlights the challenges of managing MHA in pregnancy, the inefficacy of standard thrombocytopenia treatments such as platelet transfusion in MHA patients, and the importance of tailored management strategies to ensure maternal and fetal safety.

Kelp Fucoidans Facilitate Vascular Recanalization via Inhibiting Excessive Activation of Platelet in Deep Venous Thrombosis Model of Mouse

This study was carried out explore the mechanism underlying the inhibition of platelet activation by kelp fucoidans in deep venous thrombosis(DVT)mouse.In the control and sham mice,the walls of deep vein were regular and smooth with intact intima,myometrium and adventitia.The blood vessel was wrapped with the tissue and there was no thrombosis in the lumen.In the DVT model,the wall was uneven with thicken intima,myometrium and adventitia.After treated with fucoidans LF1 and LF2,the thrombus was dissolved and the blood vessel was recanalized.Compared with the control group,the ROS content,ET-1 and VWF content and the expression of PKC-βand NF-κB in the model were significantly higher(P<0.05);these levels were significantly reduced following treatments with LF2 and LF1.Compared with H_(2)O_(2)treated-HUVECs,combined LF1 and LF2 treatment resulted in significant decrease in the expression of PKC-β,NF-κB,VWF and TM protein(P<0.05).It is clear that LF1 and LF2 reduces DVT-induced ET-1,VWF and TM expressions and production of ROS,thus inhibiting the activation of PKC-β/NF-κB signal pathway and the activation of coagulation system and ultimately reducing the formation of venous thrombus.

Aspirin suppresses hepatocellular carcinoma progression by inhibiting platelet activity

BACKGROUND Hepatocellular carcinoma(HCC)is the most common malignant liver disease in the world.Platelets(PLTs)are known to play a key role in the maintenance of liver homeostasis and the pathophysiological processes of a variety of liver diseases.Aspirin is the most classic antiplatelet agent.However,the molecular mechanism of platelet action and whether aspirin can affect HCC progression by inhibiting platelet activity need further study.AIM To explore the impact of the antiplatelet effect of aspirin on the development of HCC.METHODS Platelet-rich plasma,platelet plasma,pure platelet,and platelet lysate were prepared,and a coculture model of PLTs and HCC cells was established.CCK-8 analysis,apoptosis analysis,Transwell analysis,and real-time polymerase chain reaction(RT-PCR)were used to analyze the effects of PLTs on the growth,metastasis,and inflammatory microenvironment of HCC.RT-PCR and Western blot were used to detect the effects of platelet activation on tumor-related signaling pathways.Aspirin was used to block the activation and aggregation of PLTs both in vitro and in vivo,and the effect of PLTs on the progression of HCC RESULTS PLTs significantly promoted the growth,invasion,epithelial-mesenchymal transition,and formation of an inflammatory microenvironment in HCC cells.Activated PLTs promoted HCC progression by activating the mitogenactivated protein kinase/protein kinase B/signal transducer and activator of transcription three(MAPK/AKT/STAT3)signaling axis.Additionally,aspirin inhibited HCC progression in vitro and in vivo by inhibiting platelet activation.CONCLUSION PLTs play an important role in the pathogenesis of HCC,and aspirin can affect HCC progression by inhibiting platelet activity.These results suggest that antiplatelet therapy has promising application prospects in the treatment and combined treatment of HCC.

子痫前期患者ACR、PLT、D-D水平变化及其在预测不良妊娠结局中的价值

目的探讨子痫前期(PE)患者尿蛋白/肌酐比值(ACR)、血小板计数(PLT)、D-二聚体(D-D)水平变化及其在预测不良妊娠结局中的价值。方法回顾性选取2019年10月至2022年10月在本院就诊的103例PE患者为PE组,另取同期40例正常妊娠产妇为对照组。测定两组受试者ACR、PLT、D-D水平,根据病情严重程度,将PE患者分为重度组和轻度组,比较不同病情严重程度患者ACR、PLT、D-D水平,根据妊娠结局,将PE患者分为妊娠结局良好组和妊娠结局不良组,比较不同妊娠结局患者ACR、PLT、D-D水平,并分析ACR、PLT、D-D评估不良妊娠结局的价值。结果PE组ACR和D-D水平高于对照组,PLT水平低于对照组(P<0.05);重度组ACR和D-D水平高于轻度组,PLT水平低于轻度组(P<0.05);妊娠结局不良组ACR和D-D水平高于妊娠结局良好组,PLT水平低于妊娠结局良好组(P<0.05);ROC曲线结果显示,ACR评估患者不良妊娠结局的AUC和截点值分别为0.799、89.61mg/mmol,PLT评估患者不良妊娠结局的AUC和截点值分别为0.860、52.05×10^(9)/L,D-D评估患者不良妊娠结局的AUC和截点值分别为0.762、1.52μg/mL,联合评估患者不良妊娠结局的AUC为0.930,高于单项评估(P<0.05)。结论PE患者中ACR和D-D水平上升,PLT水平下降,这3个指标均与患者病情严重程度有关,且联合评估不良妊娠结局价值较高。

Inverse relationship between platelet Akt activity and hippocampal atrophy:A pilot case-control study in patients with diabetes mellitus

BACKGROUND Akt plays diverse roles in humans.It is involved in the pathogenesis of type 2 diabetes mellitus(T2DM),which is caused by insulin resistance.Akt also plays a vital role in human platelet activation.Furthermore,the hippocampus is closely associated with memory and learning,and a decrease in hippocampal volume is reportedly associated with an insulin-resistant phenotype in T2DM patients without dementia.AIM To investigate the relationship between Akt phosphorylation in unstimulated platelets and the hippocampal volume in T2DM patients.METHODS Platelet-rich plasma(PRP)was prepared from the venous blood of patients with T2DM or age-matched controls.The pellet lysate of the centrifuged PRP was subjected to western blotting to analyse the phosphorylation of Akt,p38 mitogen-activated protein(MAP)kinase and glyceraldehyde 3-phosphate dehydrogenase(GAPDH).Phosphorylation levels were quantified by densitometric analysis.Hippocampal volume was analysed using a voxel-based specific regional analysis system for Alzheimer’s disease on magnetic resonance imaging,which proposes the Z-score as a parameter that reflects hippocampal volume.RESULTS The levels of phosphorylated Akt corrected with phosphorylated p38 MAP kinase were inversely correlated with the Z-scores in the T2DM subjects,whereas the levels of phosphorylated Akt corrected with GAPDH were not.However,this relationship was not observed in the control patients.CONCLUSION These results suggest that an inverse relationship may exist between platelet Akt activation and hippocampal atrophy in T2DM patients.Our findings provide insight into the molecular mechanisms underlying T2DM hippocampal atrophy.

Platelet indices as predictors of poor glucoregulation in type 2 diabetes mellitus adults at Bishoftu General Hospital,Ethiopia

BACKGROUND Diabetes is a chronic metabolic syndrome that has become a global public health problem with significant morbidity and mortality.It is a pro-inflammatory and pro-thrombotic condition characterized by increased platelet activation and alterations in platelet indices.However,the use of platelet indices as predictors of poor glucoregulation has not been fully evaluated in this context,and evidence for their role as predictors of poor glycemic status in diabetic patients is limited.AIM To evaluate platelet indices and determine their prognostic significance in relation to inadequate glucoregulation among individuals diagnosed with type 2 diabetes at Bishoftu General Hospital in Ethiopia,from June 15 to August 12,2022.METHODS A comparative cross-sectional study was conducted in 261 participants including 174 individuals with type 2 diabetes mellitus(T2DM)and 87 non-diabetic controls.The systematic random sampling technique was used to select participants.Data were collected using structured questionnaires,physical measurements,checklists,and laboratory tests.Platelet parameters and fasting blood glucose levels were determined from blood samples using Sysmex-XN550 and CobasC311 analyzers,respectively.The hematology analyzer output was checked and participants were also screened for malaria parasites using a prepared blood smear.Collected data were entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis.Theχ2 test,Mann-Whitney U test,Kruskal-Wallis test,post hoc test,Spearman correlation,and receiver operating characteristic curve were used for analysis.A P value<0.05 was considered statistically significant.RESULTS The results of our study indicate that diabetic patients have significantly higher levels of platelet distribution width(PDW),mean platelet volume(MPV),platelet large cell ratio(PLCR),and plateletcrit(PCT)compared to healthy individuals(P<0.001).Furthermore,these indices were found to be significantly elevated in individuals with poor glycemic control in T2DM compared to those with good glycemic control and healthy controls.We also observed significant correlations between these indices and various anthropometric and clinical variables.Our findings suggest that PDW,with a cut-off value of 15.75 fL and an area under the curve(AUC)of 0.803,MPV,with a cut-off value of 12.25 fL and an AUC of 0.774,PLCR,with a cut-off value of 36.3%and an AUC of 0.775,and PCT,with a cut-off value of 0.24%and an AUC of 0.761,can serve as predictors of poor glycemic control in patients with diabetes mellitus.CONCLUSION The observed correlation between diabetic patients and a significant increase in platelet indices has highlighted their potential as predictors of poor glycemic control in diabetes.Therefore,regular screening and profiling of platelet indices is recommended as part of the follow-up process for individuals with diabetes mellitus.

PCT、IL-6联合PLT检测在烧伤脓毒症患者早期诊断中的应用

目的:探索降钙素原(PCT)、白介素-6(IL-6)联合血小板(PLT)检测在大面积烧伤合并脓毒症患者早期诊断中的应用价值。方法:回顾性分析医院收治的101例大面积烧伤患者的临床资料,依据是否合并脓毒症分为脓毒症组和对照组。比较两组患者烧伤后第3天PLT水平和第7天血清PCT及IL-6水平,绘制受试者工作特征(ROC)曲线分析血清PCT、IL-6、PLT联合检测在大面积烧伤患者早期脓毒症诊断中的应用价值。结果:脓毒症组患者血清PCT、IL-6水平均高于对照组,PLT水平低于对照组,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,PCT、IL-6、PLT单项检测及联合检测的AUC分别为0.935、0.794、0.904.0.961。结论:PCTIL-6、PLT在大面积烧伤患者早期诊断脓毒症中均具有较高的诊断价值,且联合检测的效率最佳,对临床早期诊断大面积烧伤患者合并脓毒症具有一定的价值。

Intra-articular interventions in osteoarthritis:Navigating the landscape of hyaluronic acid,mesenchymal stem cells,and plateletrich plasma

Osteoarthritis(OA)poses a substantial burden on patients,leading to pain,functional decline,and reduced quality of life.While conventional treatments focus on symptom management,disease-modifying interventions are yet to be established.This review explores the efficacy of intra-articular interventions,particularly hyaluronic acid(HA),mesenchymal stem cells(MSCs),and platelet-rich plasma(PRP),in the context of OA management.HA injections,with diverse formulations like Hylan G-F20,sodium hyaluronate,and hyaluronan,present varying outcomes,necessitating a nuanced understanding of their effectiveness and timing.MSC therapy,derived from adipose tissue,umbilical cord,or bone marrow,shows promising results in clinical improvement,with adipose-derived MSCs demonstrating efficacy in maintaining benefits over 6 mo.Conversely,bone-marrow-derived MSCs show limited effectiveness,highlighting the need for sourcespecific considerations.PRP has emerged as a superior option for long-term pain reduction and quality of life improvement,with leukocyte-poor formulations and a critical platelet count of 10 billion demonstrating optimal results.This comprehensive analysis underscores the potential of intra-articular interventions in OA management,emphasizing the need for personalized and evidence-based approaches to enhance treatment efficacy and patient outcomes.

Platelet counts to spleen diameter ratio:A promising noninvasive tool for predicting esophageal varices in cirrhosis patients

BACKGROUND Liver cirrhosis is the end stage of progressive liver fibrosis as a consequence of chronic liver inflammation,wherein the standard hepatic architecture is replaced by regenerative hepatic nodules,which eventually lead to liver failure.Cirrhosis without any symptoms is referred to as compensated cirrhosis.Complications such as ascites,variceal bleeding,and hepatic encephalopathy indicate the onset of decompensated cirrhosis.Gastroesophageal varices are the hallmark of clini-cally significant portal hypertension.AIM To determine the accuracy of the platelet count-to-spleen diameter(PC/SD)ratio to evaluate esophageal varices(EV)in patients with cirrhosis.METHODS This retrospective observational study was conducted at Tikur Anbessa Specia-lized Hospital and Adera Medical Center from January 1,2019,to December 30,2023.Data were collected via chart review and direct patient interviews using structured questionnaires.The data were exported to the SPSS software version 26 for analysis and clearance.A receiver operating characteristic curve was plotted for splenic diameter,platelet count,and PC/SD ratio to obtain sensitivity,speci-ficity,positive predictive value,negative predictive value,positive likelihood ratio,and negative likelihood ratio.RESULTS Of the 140 participants,67%were men.Hepatitis B(38%)was the most common cause of cirrhosis,followed by cryptogenic cirrhosis(28%)and hepatitis C(16%).Approximately 83.6%of the participants had endoscopic evidence of EV,whereas 51.1%had gastric varices.Decompensated cirrhosis and PC were associated with the presence of EV with adjusted odds ratios of 12.63(95%CI:3.16-67.58,P=0.001)and 0.14(95%CI:0.037-0.52,P=0.004),respectively.A PC/SD ratio<1119 had a sensitivity of 86.32%and specificity of 70%with area under the curve of 0.835(95%CI:0.736-0.934,P<0.001).CONCLUSION A PC/SD ratio<1119 predicts EV in patients with cirrhosis.It is a valuable,noninvasive tool for EV risk assess-ment in resource-limited settings.

肝硬化并SBP患者外周血SAA、WBC/PLT、CD64及腹水CD64联合检测的意义

目的 分析肝硬化并自发性细菌性腹膜炎(SBP)外周血淀粉样蛋白A(SAA)、白细胞计数(WBC)/血小板(PLT)、白细胞分化抗原64(CD64)及腹水CD64联合检测的意义。方法 2021年1月至2022年12月成都中医药大学附属医院收治的106例肝硬化并腹水患者,根据是否发生SBP分为SBP组49例和非SBP组57例,选取同期50名健康人为对照组。免疫透射比浊法测定外周血SAA,全自动血液分析仪测定WBC、PLT,流式细胞仪测定外周血及腹水CD64。比较3组外周血SAA、WBC/PLT、CD64及腹水CD64,并通过绘制受试者工作特征曲线(ROC)评价外周血SAA、WBC/PLT、CD64及腹水CD64对肝硬化并SBP的诊断效能。结果 SBP组外周血SAA、WBC/PLT、CD64及腹水CD64分别为(82.3±17.2)mg/mL、(0.4±0.2)、(13 126.3±90.1)mol/cell、(14 912.8±101.7)mol/cell,高于非SBP组的(11.2±3.4)mg/mL、(0.1±0.1)、(1083.9±61.4)mol/cell、(936.2±51.1)mol/cell,(P<0.05);SBP组外周血SAA、WBC/PLT、CD64显著高于对照组的(10.6±2.8)mg/mL、(0.1±0.1)、(1063.7±57.5)mol/cell,(P<0.05)。非SBP组与对照组外周血SAA、WBC/PLT、CD64比较差异无统计学意义(P>0.05)。SBP组治疗后外周血SAA、WBC/PLT、CD64及腹水CD64分别为(35.6±6.9)mg/mL、(0.3±0.1)、(3302.4±70.5)mol/cell、(4758.4±78.6)mol/cell,显著低于SBP组治疗前(P<0.05)。ROC曲线分析显示,外周血SAA、WBC/PLT、CD64及腹水CD64联合诊断肝硬化并SBP的敏感度为96.00%,AUC为0.930,均高于单独检测(P<0.05)。结论 肝硬化并SBP患者外周血SAA、WBC/PLT、CD64及腹水CD64异常增高,且联合检测对肝硬化并SBP的早期诊断价值高。

PLT和HCT对腹腔镜胆囊切除术患者术后并肺部感染的预测价值

目的分析血小板计数(PLT)及红细胞比容(HCT)在预测腹腔镜胆囊切除术(LC)患者术后并肺部感染中的临床应用价值。方法收集2022年1月~2023年1月医院收治的182例行LC患者,根据术后是否发生肺部感染分为无肺部感染组及合并感染组。检测两组患者PLT、HCT水平。收集患者相关临床资料,并利用Logistic回归因素分析LC患者术后肺部感染的相关因素,并应用受试者工作特征曲线(ROC)分析PLT、HCT对于LC患者术后肺部感染的预测价值。结果182例患者中共发生肺部感染患者38例。合并肺部感染组患者HCT水平明显高于无肺部感染组(P<0.05),PLT水平明显低于无肺部感染组(P<0.05)。合并肺部感染组患者年龄、既往肺部疾病病史、手术时间、术中出血量、WBC、Neu、CRP水平均高于无肺部感染组(P<0.05)。Logistic多因素回归分析显示,年龄、PLT、HCT均为影响LC患者术后肺部感染的相关因素(P<0.05)。ROC曲线分析显示,PLT联合HCT预测LC患者术后并发肺部感染的灵敏度、准确度及AUC分别为87.67%、82.89%、0.817,均高于血清PLT、HC单独预测,而特异度为62.08%低于PLT、HCT单独预测。结论PLT在LC术后合并肺部感染患者体内呈现低表达,HCT高表达,且是影响LC患者术后肺部感染的危险因素,可用于临床中预测LC患者术后肺部感染.

Red cell distribution width/platelet ratio estimates the 3-year risk of decompensation in Metabolic Dysfunction-Associated Steatotic Liver Disease-induced cirrhosis

BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.