Ceruloplasmin, a reliable marker of fibrosis in chronic hepatitis B virus patients with normal or minimally raised alanine aminotransferase

AIM To develop a non-invasive model to evaluate significant fibrosis and cirrhosis by investigating the association between serum ceruloplasmin(CP) levels and liver fibrosis in chronic hepatitis B(CHB) patients with normal or minimally raised alanine aminotransferase(ALT).METHODS Serum samples and liver biopsy were obtained from 193 CHB patients with minimally raised or normal ALT who were randomly divided into a training group(n = 97) and a validation group(n = 96). Liver histology was evaluated by the METAVIR scoring system. Receiver operator characteristic curves were applied to the diagnostic value of CP for measuring liver fibrosis in CHB patients. Spearman rank correlation analyzed the relationship between CP and liver fibrosis. A noninvasive model was set up through multivariate logistic regression analysis.RESULTS Serum CP levels individualized various fibrosis stages via area under the curve(AUC) values. Multivariate analysis revealed that CP levels were significantlyrelated to liver cirrhosis. Combining CP with serum GGT levels, a CG model was set up to predict significant fibrosis and liver cirrhosis in CHB patients with normal or minimally raised ALT. The AUC, sensitivity, specificity, positive predictive value, and negative predictive value were 0.84, 83.1%, 78.6%, 39.6%, and 96.5% to predict liver cirrhosis, and 0.789, 80.26%, 68.38%, 62.25%, and 84.21% to predict significant fibrosis. This model expressed a higher AUC than FIB-4(age, ALT, aspartate aminotransferase, platelets) and GP(globulin, platelets) models to predict significant fibrosis(P = 0.019 and 0.022 respectively) and revealed a dramatically greater AUC than FIB-4(P = 0.033) to predict liver cirrhosis.CONCLUSION The present study showed that CP was independently and negatively associated with liver fibrosis. Furthermore, we developed a novel promising model(CG), based on routine serum markers, for predicting liver fibrosis in CHB patients with normal or minimally raised ALT.

Ceruloplasmin-ferroportin system of iron traffic in vertebrates

Safe trafficking of iron across the cell membrane is a delicate process that requires specific protein carriers. While many proteins involved in iron uptake by cells are known, only one cellular iron export protein has been identified in mammals: ferroportin(SLC40A1). Ceruloplasmin is a multicopper enzyme endowed with ferroxidase activity that is found as a soluble isoform in plasma or as a membrane-associated isoform in specific cell types. According to the currently accepted view, ferrous iron transported out of the cell by ferroportin would be safely oxidized by ceruloplasmin to facilitate loading on transferrin. Therefore, the ceruloplasminferroportin system represents the main pathway for cellular iron egress and it is responsible for physiological regulation of cellular iron levels. The most recent findings regarding the structural and functional features of ceruloplasmin and ferroportin and their relationship will be described in this review.

An inhibition of ceruloplasmin expression induced by cerebral ischemia in the cortex and hippocampus of rats

Objective To explore effects of cerebral ischemia on the ceruloplasmin （Cp） expression in the cortex and hippoc-ampus of rats. Methods Male Wistar rats were randomly divided into cerebral ischemia group and control group. Cerebral ischemia was induced by ligating bilateral common carotid arteries and the ischemic rats were further subgrouped according to ischemia time. The control rats received a sham operation. The expression of Cp mRNA in the cortex and hippocampus was measured by reverse transcription polymerase chain reaction （RT-PCR）. The Cp expression was shown by immunohistochemistrical （streptavidin peroxidase, SP） method. Results In ischemia group, the expression of Cp mRNA in the cortex and hippocampus decreased compared with that in control group （P 〈 0.01）; and the longer rats experienced cerebral ischemia, the lower Cp mRNA expressed. By immunohistochemistry, Cp was shown expressed in the neural cells including epithelial cells of choroid plexus, ependymal cells, astrocytes of cortex and hippocampus, and vascular endothelial cells, but not in pyramidal cells and granulosa cells of cortex and hippocampus. Cp levels in the cortex and hippocampus decreased in rats suffering from cerebral ischemia for 3 d, 7 d and 28 d but not in rats exposed to ischemia for 1 d compared with that in control group （P 〈 0.05）. Iron concentration correlated negatively with Cp expression in the cortex and hippocampus of rats exposure to ischemia （the cortex, r=-0.831, P〈0.01; the hippocampus, r=-0.809, P〈0.01）. Conclusion Cerebral ischemia inhibited Cp expression in the cortex and hippocampus of rats. The decrease of Cp might be involved in iron deposition in neurons.

Serum ceruloplasmin can predict liver fibrosis in hepatitis B virusinfected patients

BACKGROUND The presence of significant liver fibrosis in hepatitis B virus(HBV)-infected individuals with persistently normal serum alanine aminotransferase(PNALT)levels is a strong indicator for initiating antiviral therapy.Serum ceruloplasmin(CP)is negatively correlated with liver fibrosis in HBV-infected individuals.AIM To examine the potential value of serum CP and develop a noninvasive index including CP to assess significant fibrosis among HBV-infected individuals with PNALT.METHODS Two hundred and seventy-five HBV-infected individuals with PNALT were retrospectively evaluated.The association between CP and fibrotic stages was statistically analyzed.A predictive index including CP[Ceruloplasmin hepatitis B virus(CPHBV)]was constructed to predict significant fibrosis and compared to previously reported models.RESULTS Serum CP had an inverse correlation with liver fibrosis(r=-0.600).Using CP,the areas under the curves(AUCs)to predict significant fibrosis,advanced fibrosis,and cirrhosis were 0.774,0.812,and 0.853,respectively.The CPHBV model was developed using CP,platelets(PLT),and HBsAg levels to predict significant fibrosis.The AUCs of this model to predict significant fibrosis,advanced fibrosis,and cirrhosis were 0.842,0.920,and 0.904,respectively.CPHBV was superior to previous models like the aspartate aminotransferase(AST)-to-PLT ratio index,Fibrosis-4 score,gamma-glutamyl transpeptidase-to-PLT ratio,Forn’s score,and S-index in predicting significant fibrosis in HBV-infected individuals with PNALT.CONCLUSION CPHBV could accurately predict liver fibrosis in HBV-infected individuals with PNALT.Therefore,CPHBV can be a valuable tool for antiviral treatment decisions.

Evaluation of Glutathione-S-transferase and ceruloplasmin levels in gingival crevicular fluid and gingival tissue as diagnostic markers for chronic periodontitis

Periodontitis, is an infectious ailment of multifactorial origin, that brings about destruction of bone and surrounding tissues. There are various oral pathogens that may be responsible for the destruction. The host encounters these microbial invasions and their products by the production and release of inflammatory mediators from the cells within the body. Glutathione-S-transferase (GST) are a group of enzymes that utilize glutathione in conditions resulting in oxidative stress. These enzymes play a key role in the detoxifycation of such substance. It aids in preventing damage to important cellular components caused by release of free reactive oxygen species. Ceruloplasmin is a ferroxidase enzyme. It plays a role as an anti-inflammatory agent, by its ability to scavenge free radicals within the body. The present study was targeted at evaluating the levels of Glutathione-S-Transferase (GST) and Ceruloplasmin as diagnostic markers for patients with chronic periodontitis in gingival crevicular fluid (GCF) and the gingival tissues. Thirty patients were divided into two groups. Experimental group comprising of 15 subjects with chronic perio- dontitis and the control group was composed of 15 healthy individuals. Highly significant changes in GST between the diseased and normal patients (P = 0.001) were detected. There was a decrease in GST level in both gingival tissue & GCF in diseased patients when compared to the control patients. The ceruloplasmin levels in GCF and gingival tissues showed no difference between the control and diseased group. Hence,these results indicate a relationship suggesting that GST produced during chronic inflammation could be used as biomarker that indicate periodontal disease .

Ceruloplasmin or Fibronectin Synergism with Quartz Dust on Stimulating Collagen Gene Transcription in Human 2BS Fibroblast

Human α1(Ⅰ), α2(Ⅰ) and α1(Ⅲ) cDNA probes and RNA dot hybridization were employed to quantitate collagen mRNA changes after adding silica dust into the media of human 2BS fibroblasts. At all dosages used (100, 200, 500 and 1000μg), the α1(Ⅰ), α2(Ⅰ)and α1(Ⅲ) mRNA levels increased one day after dusting. At the same dosage of silica (100μg), α1(Ⅲ) mRNA increased earlier than type Ⅰ collagen mRNA did. The type Ⅰ and type Ⅲ collagen mRNA contents in the experimental groups were higher than those in control on days 3, 5, 7 and 9. The effect of ceruloplasmin (Cp) and fibronectin (Fn) on collagen mRNA synthesis was also studied, after adding silica dust, Cp or Fn into the media of human 2BS fibroblast. The results showed that Cp and Fn have stimulating effect on collagen mRNA production. When both Cp and silica dust were added into cell culture media, the collagen mRNA level was increased more than those of adding either Cp or silica dust alone. Similar situations were found for Fn. Cp (or Fn) synergism with silica dust on stimulating transcription of human collagen gene was suggested

INTRACELLULAR CERULOPLASMIN (CP) IN NORMAL AND LEUKEMIC BLOOD LEUCOCYTES

Ceruloplasmin (CP) in peripheral leucocytes was determined by radioimmunoassay.It was observed that leucocytes of normal persons and leukemic patients contained CP. TheCP contents of polymorphonuclear cells (PMN) and blast cells of acute leukemia not in re-mission were both significantly higher than that of normal (P【0.05) and than that of acuteleukemia complete remission (P【0.05).

STUDY ON SERUM CERULOPLASMIN LEVELS IN VARIOUS CONDITIONS AND TYPES OF LEUKEMIA

Serum ceruloplasmin (CP) was determined by electroimmunodiffusion method in 89 normal persons and 92 leukemic patients. It was found that the serum CP of acute and chronic leukemia was very significantly higher than normal (P【0.01). There were no signifcant difference in elevation of serum CP between various types of leukemia. During remission oJ acute or chronic leukemia, the serum CP decreased significantly (P【0.05), but still higher than normal (P【0.01). In the case of long-term remission, serum CP decreased to normal level. During relapse of acute leukemia or acute blast crisis of chronic leukemia, serum CP raised again significantly (P【0.05). Infection enabled the leukemic patient to further increase serum CP (P【0.01). In acute leukemia, serum CP level correlated positively with the percentage of blast cells in bone marrow (P【0.05).

Ceruloplasmin levels in human sera from various diseases and their correlation with patient’s age and gender

Ceruloplasmin (Cp), a copper metalloprotein in human serum has been a valuable diagnostic marker in Wilson’s disease where Cp levels tend to be low while high levels in serum were asso-ciated with myocardial infarction, neoplastic and inflammatory conditions. There is no stan-dardized reference method for Cp and current immunologic and bichromatic assays have a number of drawbacks. The method described here uses immunoaffinity chromatography to remove six of the most abundant proteins from a serum sample and high-pressure liquid chro- matography (HPLC) with a size-exclusion col-umn to separate Cp from other serum proteins and any free Cu prior to analysis of 63Cu and 65Cu by inductively-coupled plasma mass spec-trometry (ICPMS). Identification of Cp is based on retention time match of the unknown protein in the serum sample with the Cp external stan-dard and the presence of 63Cu and 65Cu at a ratio of 2.2 ± 0.1. The method accuracy, as estab-lished independently by two of the authors with a reference serum certified for Cp, is 98 to 101% and the coefficient of variation is 6.4% and 5.4%, respectively. The assay was used to analyze a total of 167 human sera for Cp from patients with myocardial infarction (MI), pulmonary em-bolism (PE), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), other forms of ar-thritis, and a set of healthy patients as normal controls (NC). Our data show that Cp concen-trations tend to be higher in MI, RA, and SLE patients, higher in female as compared to male patients, and we did not observe a correlation between Cp concentration and patient’s age for the set of 70 patients for which we had gender and age information.

Correlation of Ceruloplasmin with Biomarkers of Cardiac Remodelling and Myofibrosis in Patients with Acute Decompensated Heart Failure Referred to a Tertiary Nurse Lead Heart Failure Clinic

Background: Ceruloplasmin is an acute phase protein with plasma copper binding properties, and is a potent extracellular antioxidative enzyme. Inflammation and oxidative stress might explain the role of ceruloplasmin in the pathophysiology of heart failure. Study objective: The objective is to assess the correlation of ceruloplasmin levels with biomarkers of cardiac remodelling and myofibrosis in patients with acute decompensated heart failure. Patients and methods: Blood samples were taken and serum levels of soluble ST2, galectin-3, NT-proBNP and ceruloplasmin were analysed in 31 consecutive patients with systolic HF referred to tertiary care nurse lead heart failure clinic with acute decompensated CHF requiring i.v. diuretics. The mean patients’ age was 68 years, mean left ventricular ejection fraction (LV EF) was 29%, 66% patients had ischemic aetilogy of CHF and 33% had atrial fibrillation. Results: The mean ceruloplasmin level was 0.243 g/l, mean galectin-3 level was 1.26 ng/ml, mean sST2 level was 38.15 ng/ml, and mean NT-proBNP was 1927 pg/ml. The ceruloplasmin level correlated with NT-proBNP (r = 0.58, p < 0.05) and with sST2 (r = 0.77, p < 0.001), sST2 levels correlated significantly with NT-proBNP (r = 0.66, p < 0.01). The ceruloplasmin level did not correlate with galectin-3 concentration. Conclusion: The ceruloplasmin level correlates with the biomarkers of cardiac remodelling (NT-proBNP, sST2), but not with the biomarker of myofibrosis (galectin-3). This finding supports the hypothesis of inflammatory response in acute decompensated heart failure.

The Role of Serum Ceruloplasmin and Oxidative Stress Markers in Primary Open Angle Glaucoma

Purpose: The study aimed at evaluation of the role of ceruloplasmin (A protein involved in iron homeostasis and can inactivate free radicals) and other oxidative stress markers as superoxide dismutase (SOD), malondialdehyde (MDA) and catalase activity (CAT) in primary open angle glaucoma (POAG). Methods: This observational case control study included 90 persons divided into 3 equal groups: group A of 30 normal persons as a control group, group B of 30 patients of untreated (POAG) (firstly diagnosed) by the clinical characters including measuring intraocular pressure (IOP), optic disc cupping and visual field changes and group C of 30 patients of POAG under medical treatment by topical anti-glaucomatous drugs. Serum ceruloplasmin, superoxide dismutase, malondialdehyde and catalase activity were measured in all groups, statistical analysis of the data was performed. Results: In a comparison to group A of control, serum ceruloplasmin decreased significantly in group B of untreated POAG (20.95 ± 6.01) mg-dl and in group C of POAG under treatment (22.15 ± 6.14) mg-dl (P 0.05). Also, serum superoxide dismutase increased significantly in group B (2.23 ± 0.4) and in group C (2.19 ± 0.38) U-ml (P 0.05). Serum malondialdehyde increased significantly in group B (3.82 ± 0.74) nmol-ml and in group C (3.55 ± 0.73) nmol-ml (P 0.05). Serum catalase decreased significantly in group B (17.97 ± 2.75) U-ml and in group C (18.75 ± 2.33) U-ml in a comparison to the control group A (22.67 ± 3.05) U-ml (P 0.05). Conclusions: Serum ceruloplasmin level and the antioxidant (CAT) activity significantly decreased, while serum levels of SOD, MDA significantly increased in cases of POAG. This may indicate the need for addition of anti-oxidative stress therapy in combination with the anti-glaucomatous drugs. Monitoring these markers can be considered good indicators for determination of the oxidative stress condition in such cases.

基于CER论证模型的“特异性免疫”教学探究

文章以“特异性免疫”(第一课时)教学为例,阐述如何将CER论证模型融入高中生物学教学,引导学生基于事实和证据进行推理,最终形成主张。在运用CER论证模型的过程中,教师应注重将学生的思维过程外显化,培养他们“以证据说话”的意识,从而帮助他们达成对知识的深度理解,促进他们生物学学科核心素养的形成及发展。

孕早期妇女血清C18∶1-Cer和LPC18∶0水平检测对妊娠期糖尿病的预测价值研究

目的探究孕妇孕期血清样本中血清十八碳一不饱和脂肪酸硬脂酰鞘氨醇(serum stearoyl sphingosine,C18∶1-Cer)和1-硬脂酰基-sn-甘油-3-磷酸胆碱(lysophosphatidyl choline,LPC18∶0)水平在预测孕妇患妊娠期糖尿病(gestational diabetes mellitus,GDM)方面的价值。方法回顾性分析126例孕妇的临床资料和实验室指标,根据GDM诊断结果,将研究对象分为GDM组(n=66)和对照组(n=60)。采用质谱法检测研究对象孕早期和孕中期血清C18∶1-Cer和LPC18∶0水平,通过Logistic回归分析筛选出GDM的危险因素,采用受试者工作特征(receiver operating characteristic,ROC)曲线评估C18∶1-Cer,LPC188∶0和两者联合对GDM的预测价值。结果与对照组相比,GDM组血清C18∶1-Cer和LPC18∶0水平在孕早期(18.92±2.77ng/ml vs 23.47±4.18ng/ml,41.32±17.55ng/ml vs 88.08±16.02ng/ml)和孕中期(23.14±4.10ng/ml vs 18.76±4.05ng/ml,84.60±14.53ng/ml vs 40.50±17.79ng/ml)均显著升高,差异具有统计学意义(t=7.127,15.637;-5.984,2.174,均P<0.05)。C18∶1-Cer与空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting plasma insulin,FPI)、胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、糖化血红蛋白(glycated hemoglobin,HbA1c)和三酰甘油(triglyceride,TG)呈正相关(r=0.458,0.209,0.317,0.223,0.219,均P<0.05)。LPC18∶0与FPG,FPI,HOMA-IR,HbA1c,总胆固醇(total cholesterol,TC)和TG呈正相关(r=0.715,0.426,0.580,0.465,0.232,0.372,均P<0.05)。Logistic回归分析结果显示,C18∶1-Cer[OR(95%CI):1.522(1.136~.039),P<0.05]和LPC18∶0[OR(95%CI):1.198(1.102~1.302),P<0.001]是GDM的独立危险因素。ROC曲线分析结果显示,血清C18∶1-Cer,LPC18∶0和两指标联合的曲线下面积(area under the curve,AUC)分别为0.819,0.971和0.986,两者联合检测的预测效能优于单独检测。结论妊娠早期血清中的C18∶1-Cer和LPC18∶0与GDM的发生密切相关,C18∶1-Cer联合LPC18∶0对GDM早期诊断有一定的预测价值。

Association of bilirubin and protein thiols in relation to copper and ceruloplasmin in hyperbilirubinemic patients

Objective:Bilirubin is a double edged sword in biological system,acting as a toxic molecule and cytoprotectant.Unconjugated bilirubin is proved to show antioxidant activity in vitro and in vivo.In the current work we tried to know the relationship between both conjugated and unconjugated bilirubin with copper and protein thiols in patients with hyperbilirubinemia.Methods:Study was conducted on 56 hyperbilirubinemic cases and 56 healthy controls.Serum copper,ceruloplasmin,protein thiols,total bilirubin,conjugated and unconjugated bilirubin,unconjugated bilirubin/albumin ratio,total protein,albumin,AST,ALT and ALP were estimated.Results:There was significant increase in serum copper,total bilirubin,conjugated and unconjugated bilirubin,unconjugated bilirubin/albumin ratio,AST,ALT,and ALP,and decrease in serum ceruloplasmin,protein thiols,total protein,and albumin in hyperbilirubinemic cases when compared to healthy controls.Conjugated bilirubin correlated positively with liver enzymes AST and ALP,and negatively with protein thiols,total protein and albumin.Unconjugated bilirubin correlated positively with ALT.Protein thiols correlated negatively with copper and positively with ceruloplasmin,and also correlated negatively with liver enzymes like AST,ALT and ALP,and positively with total protein and albumin.Conclusion:Combination of elevated levels of trace elements like copper and availability of reducing agent like bilirubin may prove deleterious by generating free radicals.

Hsp90α、CER及AFP预测原发性肝癌患者TACE疗效的价值

目的 分析血清热休克蛋白90(Hsp90α)、铜蓝蛋白(CER)及甲胎蛋白(AFP)预测原发性肝癌患者肝动脉化疗栓塞术(TACE)疗效的价值。方法 选取2020年1月至2023年1月临泉县人民医院收治的70例行TACE治疗的原发性肝癌患者作为研究对象,于术后2个月采用mRECIST标准评价术后疗效,根据疗效差异将其分为良好组和不良组。比较两组的基线资料、血清Hsp90α、CER及AFP水平差异,绘制ROC曲线分析TACE治疗前上述血清指标对TACE后疗效的预测价值。结果 入组对象经TACE治疗有效率为72.86%。良好组和不良组临床分期、肿瘤边界比较,差异均有统计学意义(t/χ^(2)=5.440、10.928,P<0.05)。TACE治疗前不良组血清Hsp90α、CER及AFP水平均高于良好组,差异有统计学意义(t=2.501、2.082、2.964,P<0.05),TACE治疗结束后不良组血清Hsp90α、CER及AFP水平均高于良好组,差异有统计学意义(t=7.196、6.866、8.687,P<0.05)。TACE治疗前,随着临床分期增加,血清Hsp90α、CER、AFP值均不断升高(F=4.966、4.817、7.878,P<0.05);肿瘤边界不规则血清Hsp90α、CER及AFP水平高于肿瘤边界规则的患者,差异有统计学意义(t=8.169、3.434、10.276,P<0.05)。ROC曲线分析显示,TACE治疗前,血清Hsp90α、CER及AFP水平联合预测TACE后疗效的AUC最大(P<0.05)。结论 血清Hsp90α、CER及AFP水平检测可以较好预测TACE后临床疗效,上述指标可以为临床干预提供一定依据。

血清CERP、SF、α-Klotho、FGF-23水平在2型糖尿病患者白蛋白尿进展中的预测价值

目的分析血清铜蓝蛋白(ceruloplasmin,CERP)、血清铁蛋白(serum ferritin,SF)、α-Klotho、成纤维细胞生长因子-23(fibroblast growth factor,FGF-23)在2型糖尿病患者白蛋白尿进展中的预测价值。方法选择2020年6月至2022年5月沭阳医院内分泌科因控制血糖重复收住院的120例2型糖尿病患者进行回顾性队列研究,将首次住院和第二次住院的资料分别作为基线资料和随访资料。根据基线中患者白蛋白尿情况将其分为3组:无白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组,比较3组患者中CERP、SF、α-Klotho、FGF-23水平的差异;根据随访资料评价白蛋白尿进展的情况,比较白蛋白尿进展的患者与未进展的患者的基线临床资料及其CERP、SF、α-Klotho、FGF-23水平的差异,采用logistic回归分析白蛋白尿进展的影响因素,采用ROC曲线分析白蛋白尿进展的预测指标。结果随着2型糖尿病患者尿白蛋白水平升高,血清CERP、SF、FGF-23水平升高,而α-Klotho水平降低(P<0.05);白蛋白尿进展的2型糖尿病患者的糖尿病病程长于未进展的2型糖尿病患者,其二甲双胍及SGLT2抑制剂(SGLT2i)使用比例、α-Klotho水平均低于未进展的2型糖尿病患者,其高血压比例、FBG、UA、CERP、SF、FGF-23水平均高于未进展的2型糖尿病患者,差异有统计学意义(P<0.05);logistic回归分析显示CERP、SF、FGF-23水平升高是白蛋白尿进展的危险因素,而使用二甲双胍及SGLT2i以及α-Klotho水平的升高均是白蛋白尿进展的保护因素;ROC曲线分析显示首次住院时血清CERP、SF、α-Klotho、FGF-23的水平对白蛋白尿进展具有预测价值,logistic回归方程的联合指标预测尿白蛋白的灵敏度和特异性均优于单一指标。结论血清CERP、SF、FGF-23水平的升高及α-Klotho水平的降低与2型糖尿病患者中白蛋白尿进展有关,检测4项血清指标对白蛋白尿进展具有预测价值。

基于CER理论促进科学论证思维的初中化学复习课教学策略

《普通高中化学课程标准(2017年版2020年修订)》中强调科学探究的重要性,也明确提出核心素养的重要地位,尤其强调提升学生的科学思维品质。论证是科学探究中的重要环节,能有效提高学生的证据意识和推理能力,进而促进学生科学思维品质的提升。本文基于CER理论,以中学化学试题为例,剖析如何在初中化学复习课教学中,引导学生提出合理的主张,列出多方的证据,链接知识进行推理,提高学生的审题能力、论证能力以及科学解释能力,进而发展科学思维。

CCER现行体系及未来发展趋势

我国是世界上碳排放量最大的国家,党中央已于2020年提出碳达峰碳中和重大战略决策,中国碳减排任务非常严峻。国家核证自愿减排量(CCER),是指企业自愿开展并经中国政府认证的可再生能源发电、垃圾发电项目以及林业项目等活动,是控排企业未来实现碳减排的有效手段。通过研究CCER的发展历程,收集和整理CCER项目现状,并预测CCER市场未来的发展趋势。

基于CER理论提高学科解释能力的教学实践——以“废水中氨氮的去除”为例

借助CER理论模型,以废水中氨氮去除为真实情境,通过创设“情境问题”搭建脚手架,指导学生能够获取和处理信息以及分析推理获得与论断匹配的证据,形成“证据—推理—论断”的化学学科解释表达范式,提高学生的学科解释能力。

肝脏硬度值及血清CER、AST水平在ALT轻度升高乙肝患者肝纤维化中的评估价值

【目的】探讨肝脏硬度值(LSM)及血清铜蓝蛋白(CER)、谷草转氨酶(AST)在丙氨酸转氨酶(ALT)轻度升高乙肝患者肝纤维化中的评估价值。【方法】选取2020年6月至2022年6月本院收治的100例ATL轻度升高的乙肝患者,根据肝纤维化分期情况将其分为无纤维化组(n=10)和纤维化组(n=90)。根据肝纤维化严重程度情况将患者分为重度纤维化组(n=42)、中度纤维化组(n=36)、轻度纤维化组(n=12)。比较不同组别患者ALT、白蛋白(ALB)、AST及CER、LSM,绘制受试者工作特征(ROC)曲线分析CER、AST、LSM对ALT轻度升高乙肝患者肝纤维化的评估价值。【结果】两组患者ALT、ALB比较,差异无统计学意义(P>0.05);纤维化组AST、LSM均高于无纤维化组,CER低于无纤维化组,差异有统计学意义(P<0.05)。ROC曲线分析显示,AST、CER、LSM评估ATL轻度升高乙肝患者肝纤维化的曲线下面积分别为0.914、0.616、0.946(P<0.05)。重度纤维化组、中度纤维化组、轻度纤维化组CER逐渐升高,差异有统计学意义(P<0.05);重度纤维化组、中度纤维化组、轻度纤维化组AST、LSM逐渐降低,差异有统计学意义(P<0.05)。【结论】不同纤维化程度的ATL轻度升高乙肝患者AST、CER、LSM存在差异,其中AST、CER、LSM对于肝纤维化有一定评估价值,可用于临床对此类患者肝纤维化的早期诊断或评估。