C-reactive protein to albumin ratio predict responses to programmed cell death-1 inhibitors in hepatocellular carcinoma patients

BACKGROUND Over the years,programmed cell death-1(PD-1)inhibitors have been routinely used for hepatocellular carcinoma(HCC)treatment and yielded improved survival outcomes.Nonetheless,significant heterogeneity surrounds the outcomes of most studies.Therefore,it is critical to search for biomarkers that predict the efficacy of PD-1 inhibitors in patients with HCC.AIM To investigate the role of the C-reactive protein to albumin ratio(CAR)in evaluating the efficacy of PD-1 inhibitors for HCC.METHODS The clinical data of 160 patients with HCC treated with PD-1 inhibitors from January 2018 to November 2022 at the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed.RESULTS The optimal cut-off value for CAR based on progression-free survival(PFS)was determined to be 1.20 using x-tile software.Cox proportional risk model was used to determine the factors affecting prognosis.Eastern Cooperative Oncology Group performance status[hazard ratio(HR)=1.754,95%confidence interval(95%CI)=1.045-2.944,P=0.033],CAR(HR=2.118,95%CI=1.057-4.243,P=0.034)and tumor number(HR=2.932,95%CI=1.246-6.897,P=0.014)were independent prognostic factors for overall survival.CAR(HR=2.730,95%CI=1.502-4.961,P=0.001),tumor number(HR=1.584,95%CI=1.003-2.500,P=0.048)and neutrophil to lymphocyte ratio(HR=1.120,95%CI=1.022-1.228,P=0.015)were independent prognostic factors for PFS.Two nomograms were constructed based on independent prognostic factors.The C-index index and calibration plots confirmed that the nomogram is a reliable risk prediction tool.The ROC curve and decision curve analysis confirmed that the nomogram has a good predictive effect as well as a net clinical benefit.CONCLUSION Overall,we reveal that the CAR is a potential predictor of short-and long-term prognosis in patients with HCC treated with PD-1 inhibitors.If further verified,CAR-based nomogram may increase the number of markers that predict individualized prognosis.

C-reactive Protein/Albumin Ratio as a Prognostic Indicator in Posttraumatic Shock and Outcome of Multiple Trauma Patients

Objective C-reactive protein(CRP)/albumin ratio(CAR)is a new inflammation-based index for predicting the prognosis of various diseases.The CAR determined on admission may help to predict the prognostic value of multiple trauma patients.Methods A total of 264 adult patients with severe multiple trauma were included for the present retrospective study,together with the collection of relevant clinical and laboratory data.CAR,CRP,albumin,shock index and ISS were incorporated into the prognostic model,and the receiver operating characteristic(ROC)curve was drawn.Then,the shock index for patients with different levels of CAR was analyzed.Finally,univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for the 28-day mortality of multiple trauma patients.Results A total of 36 patients had poor survival outcomes,and the mortality rate reached 13.6%.Furthermore,after analyzing the shock index for patients with different levels of CAR,it was revealed that the shock index was significantly higher when CAR was≥4,when compared to CAR<2 and 2≤CAR<4,in multiple trauma patients.The multivariate logistic analysis helped to identify the independent association between the variables CAR(P=0.029)and shock index(P=0.019),and the 28-day mortality of multiple trauma patients.Conclusion CAR is higher in patients with severe multiple trauma.Furthermore,CAR serves as a risk factor for independently predicting the 28-day mortality of multiple trauma patients.The shock index was significantly higher when CAR was≥4 in multiple trauma patients.

Effects of Na^+/K^+ Ratio of Groundwaters on the Gill Ion-Transport Enzyme Activity,Plasma Osmolality and Growth of Cynoglossus semilaevis Juveniles

The effects of environmental Na+/K+ ratio on the gill ion-transport enzyme activity,plasma osmolality and growth of Cynoglossus semilaevis juveniles were investigated. The results showed that,plasma osmolality was similar among flounder adapted to different Na+/K+ ratios of saline groundwaters (P>0.05),while the growth,gill Na+,K+-ATPase and HCO3--ATPase activities were affected by Na+/K+ ratio significantly (P<0.05). The gill Na+,K+-ATPase activity reached its maximum on day 3,then decreased gradually from day 3 to day 9 and remained constant from day 9 to day 15. The peak values of gill Na+,K+-ATPase activity were detected on day 3 for all Na+/K+ ratios of saline groundwaters,then the enzyme activities descended,and on day 9 the enzyme activi-ties achieved steady state,and the gill HCO3--ATPase activity increased rapidly and achieved steady state after one day. During steady state,the gill Na+,K+-ATPase and HCO3--ATPase activity of Na+/K+ ratios 20 and 40 treatments were significantly higher than those in the control group (Na+/K+ ratio 27.5),while there were no significant differences between the Na+/K+ ratio 30 treatment and the control group; the gill Na+,K+-ATPase activity of Na+/K+ ratio 20 and 40 treatments were significantly higher than that for ratio 30 treatment,but there were no significant differences of gill HCO3--ATPase activity among these treatments. At the end of the 15-day experiment,the weight gain (%) and specific growth rate (SGR) of flounders maintained in seawater were significantly higher than those in groundwaters; significant differences also occurred among the treatments; Na+/K+ ratio 30 treatment had the highest values (33.7% and 1.94 respectively),which were significantly higher than those under Na+/K+ ratios 20 and 40 treatments. There-fore,for the saline groundwater used in this experiment,it is suggested that the Na+/K+ ratio be adjusted to approximately 30,i.e.,as close to that of natural seawater as possible in the culture of flounder.

Effects of Different Protein Energy Ratios on Fattening Performance,Slaughter Performance and Meat Quality of Pigs

[Objectives]Protein energy ratio refers to the proportional relationship between protein and energy levels in animal diets,i.e.,the grams of crude protein corresponding to every megacalorie of energy,which is generally expressed as CP:ME or CP:DE.This study was conducted to investigate the effects of different diets on fattening and slaughter performance and meat quality traits for"L(Large Yorkshire)×L(Landrace)"crossbred pigs.[Methods]Eighteen piglets of L×L crossbred with similar body weights about 51 kg were selected.The piglets were divided into 3 groups randomly and each group was assigned to 3 replicates with 2 piglets in a replicate.Group A was fed diet Ⅰ (control diet),group B was fed the same diet of group A in the first month of the trial but fed diet Ⅱ in second month,and group C consumed diet Ⅲ.All the pigs were fed in the same feeding condition for two months except the different diets during the trial.One pig in similar body weight from each replicate was slaughtered for the determination of slaughter performance and meat quality traits in the end of the trial.[Results]The average daily feed intake(ADFI)of pigs from group B was only(2.32±0.52)kg and significantly lower than those from group A and group C(P<0.05),but no difference was found in average daily gain(ADG) and feed/gain(P>0.05).Also,no differences occurred in the carcass length,back fat thickness,longissimus muscle (LM) area and dressing percentage(P>0.05).In addition,no differences were found in the meat quality traits of shear force,meat color,pH_(45 min),pH_(24 h) and cooking loss(P>0.05).However,the water-holding capacity of meat from group C was(2.58±0.02)ms and significantly lower than that of(2.80±0.20)ms from group A(P<0.05).Although the contents of glutamic acid and cystine in LM from group B was significantly lower than those from group A and group C(P<0.05),no differences occurred in the contents of other amino acids,the total amino acid and total flavor amino acid among the three groups(P>0.05).However,the inosine monophosphate content of LM from group C was only(331.80±11.53)mg/100 g and significantly lower than those of(361.00±6.36)and(366.37±4.80)mg/100 g from group A and B(P<0.05).Even though no differences were found in the contents of DM and CP in LM among the three groups of pigs,the content of intramuscular fat(IMF)in LM from group B and group C was increased by 45.6%and 46.58%respectively from that of group A(P<0.05),but no difference occurred between group B and C(P>0.05).[Conclusions]DietsⅡ and Ⅲ in this study caused no differences in fattening and slaughter performance of L×L crossbred pigs,but the effects on some meat traits were still significant,especially on the improvement of intramuscular fat in experimental pigs.Therefore,they could improve the meat quality of crossbred pigs to a certain extent.

Activated Protein C Resistance in Patients with Pre-Eclampsia in Lagos, Nigeria

Background: Preeclampsia is reported to complicate 2% - 8% of pregnancies globally and is an important cause of maternal and perinatal morbidity and mortality. The aetiology and pathogenesis are still poorly understood and substantial improvement has not been made in the prediction, prevention and treatment of the disease. Objective: To compare the frequency of activated protein C resistance (APC-R) in patients with pre-eclampsia to that of normotensive pregnant women and to determine the correlation between activated protein ratio (APC-ratio) and the severity of pre-eclampsia. Methodology: A cross-sectional study was carried out in 100 pre-eclamptic patients and 100 normotensive pregnant controls. The APC-ratio was determined using the modified activated partial thromboplastin time. Study participants with APC-ratio of less than 2.0 were defined as having APC-R. Data was analyzed using SPSS version 22.0. Results: Mean APC-ratio was significantly lower in pre-eclamptics (2.89 ± 1.70) compared to normotensive pregnant women (3.57 ± 1.06) (p = 0.0008) and the levels were also higher in mild (2.95 ± 1.15) compared to severe pre-eclamptics (2.62 ± 1.14). The frequency of APC-R was 26% among women with pre-eclampsia compared to 4% among normotensive controls (p = 0.000). Among 100 pre-eclamptic women 7 (21.2%) out of 33 with mild pre–eclampsia had APC-R, while 19 (28.4%) out of 67 with severe pre-eclampsia had APC-R. APC-ratio had a significant negative correlation with mean arterial blood pressure (r = −0.324;p = 0.000) and proteinuria (r = −0.379;p = 0.000) among study participants. Conclusion: The frequency of activated protein c resistance is significantly higher in pre-eclamptics compared to normotensive pregnant women and this is more pronounced in those with severe pre-eclampsia compared with those with mild disease. APC-R may therefore be used as a marker of severity in the disease.

Effects of salinity fluctuation and dietary protein/ carbohydrate ratio on the survival and growth of Juvenile Litopenaeus vannamei

A factorial study was conducted to determine the effects of salinity （constant （SO） and fluctuating （S10）） and isoenergetic diet of different protein/carbohydrate ratios （P/C： 4.1, 1.9, 1.0 and 0.6） on the survival and growth of juvenile Litopenaeus vannamei. The experiment lasted for 35 days. The results showed that I） At S0 and S10, specific growth rate and apparent digestibility coefficient exhibited decreasing trend, while food conversion ratio exhibited increasing trend, with decreasing P/C ratio. At SO, food consumption and specific growth rate of the shrimp fed 4.1 P/C were significantly higher than those fed 1.0 and 0.6 P/C, whereas at S10, no significant differences were detected among different treatments; II） At 4.1 and 1.9 P/C, food consumption and specific growth rate were higher in the shrimp maintained at SO as compared with those at S10, while at 1.0 and 0.6 P/C, an inverse trend was observed. Among four P/C ratios, food conversion ratio of the shrimp at SO was the lowest.

In situ Detection of Amide A Bands of Proteins in Water by Raman Ratio Spectrum

The amide A band of protein is sensitive to the hydrogen bands of amide groups of proteins. However, it is hard to distinguish the amide A band of aqueous protein in situ directly, since it overlaps with O-H stretching vibration of water. In this work, we presented a new analytical method of Raman ratio spectrum, which can extract the amide A band of proteins in water. To obtain the Raman ratio spectrum, the Raman spectrum of aqueous protein was divided by that of pure water. A mathematical simulation was employed to examine whether Raman ratio spectrum is effective. Two kinds of protein, lysozyme and （^-chymotrypsin were employed. The amide A bands of them in water were extracted from Raman ratio spectra. Additionally, the process of thermal denaturation of lysozyme was detected from Raman ratio spectrum. These results demonstrated the Raman ratio spectra could be employed to study the amide A modes of proteins in water.

Effects of dietary protein/energy ratio on growth performance,carcass trait,meat quality,and plasma metabolites in pigs of different genotypes

Background： The protein/energy ratio is important for the production performance and utilization of available feed resources by animals. Increased protein consumption by mammals leads to elevated feed costs and increased nitrogen release into the environment. This study aimed to evaluate the effects of dietary protein/energy ratio on the growth performance, carcass traits, meat quality, and plasma metabolites of pigs of different genotypes. Methods： Bama mini-pigs and Landrace pigs were randomly assigned to two dietary treatment groups （Chinese conventional diet with low protein/energy ratio or National Research Council diet with high protein/energy ratio; n = 24 per treatment） in a 2 x 2 factorial arrangement. Blood and muscle samples were collected at the end of the nursery, growing, and finishing phases. Results： We observed significant interactions （P 〈 0.05） between breed and diet for total fat percentage, intramuscular fat （IMF） content, protein content in biceps femoris （BF） muscle, and plasma urea nitrogen （UN） concentration in the nursery phase; for average daily gain （ADG）, average daily feed intake （ADFI）, dry matter, IMF content in psoas major （PM） muscle, and plasma total protein and albumin concentrations in the growing phase; and for drip loss and plasma UN concentration in the finishing phase. Breed influenced （P 〈 0.05） growth performance, carcass traits, and meat quality, but not plasma metabolites. Throughout the trial, Landrace pigs showed significantly higher （P 〈 0.0_5） ADG, ADFI, dressing percentage, lean mass rate, and loin-eye area than did Bama mini-pigs, but significantly lower （P 〈 0.0.5） feed/gain ratio, fat percentage, backfat thickness, and IMF content. Dietary protein/energy ratio influenced the pH value, chemical composition of BF and PM muscles, and plasma activities of glutamic-pyruvic transaminase and gamma-glutamyl transpeptidase, and plasma concentration of UN. Conclusions： Compared with Landrace pigs, Bama mini-pigs showed slower growth and lower carcass performance, but had better meat quality. Moreover, unlike Landrace pigs, the dietary protein/energy ratio did not affect the growth performance of Bama mini-pigs. These results suggest that, in swine production, low dietary protein/energy ratio may be useful for reducing feed costs and minimizing the adverse effects of ammonia release into the environment.

C-reactive Protein Level,Apolipoprotein B-to-apolipoprotein A-1 Ratio,and Risks of Ischemic Stroke and Coronary Heart Disease among Inner Mongolians in China

Objective We aimed to investigate the cumulative effect of high CRP level and apolipoprotein B-to-apolipoprotein A-1（ApoB/ApoA-1） ratio on the incidence of ischemic stroke（IS） or coronary heart disease（CHD） in a Mongolian population in China.Methods From June 2003 to July 2012,2589 Mongolian participants were followed up for IS and CHD events based on baseline investigation.All the participants were divided into four subgroups according to C-reactive protein（CRP） level and ApoB/ApoA-1 ratio.Cox proportional hazard models were used to estimate the hazard ratios（HRs） and 95% confidence intervals（CIs） for the IS and CHD events in all the subgroups.Results The HRs（95% CI） for IS and CHD were 1.33（0.84-2.12）,1.14（0.69-1.88）,and 1.91（1.17-3.11） in the ‘low CRP level with high ApoB/ApoA-1＇,‘high CRP level with low ApoB/ApoA-1＇,and ‘high CRP level with high ApoB/ApoA-1＇ subgroups,respectively,in comparison with the ‘low CRP level with low ApoB/ApoA-1＇ subgroup.The risks of IS and CHD events was highest in the ‘high CRP level with high ApoB/ApoA-1＇ subgroup,with statistical significance.Conclusion High CRP level with high ApoB/ApoA-1 ratio was associated with the highest risks of IS and CHD in the Mongolian population.This study suggests that the combination of high CRP and ApoB/ApoA-1 ratio may improve the assessment of future risk of developing IS and CHD in the general population.

Relationship Between Leaf C/N Ratio and Insecticidal Protein Expression in Bt Cotton as Affected by High Temperature and N Rate

Expression of insecticidal protein for transgenic Bacillus thuringiensis （Bt） cotton is unstable and related to nitrogen metabolism. The objective of this study was to investigate the relationship between leaf carbon nitrogen ratio （C/N） and insecticidal efficacy of two Bt cotton cultivars. C/N ratio and Bt protein content were both measured at peak square period and peak boll period respectively under 5-7 d high temperature and different nitrogen fertilizer rates on the Yangzhou University Farm and the Ludong Cotton Farm, China. All plants were grown in field. The results showed that the C/N ratio enhanced slightly and the Bt protein content remained stable at peak square period, but significant increases for the C/N ratio and decreases markedly for the leaf Bt protein concentration were detected at the peak boll period. The similar patterns at the two growth periods were found for the leaf C/N ratio and Bt protein content by different N fertilizer treatments. When nitrogen rate was from 0 to 600 kg ha-l, the C/N ratio was reduced by 0.017 and 0.006 for Sikang 1 and Sikang 3 at peak square period, compared to the 1.350 to 1.143 reduction for Sikang 1 and Sikang 3 at peak boll period, respectively. Correspondingly, the leaf Bt protein contents were bolstered by 2.6-11.8 and 26.9-36.9% at the two different growth periods, respectively. The results suggested that enhanced C/N ratio by high temperature and nitrogen application may result in the reduction of inseetiocidal efficacy in Bt cotton, especially in peak boll period.

Preoperative lymphocyte to C-reactive protein ratio as a new prognostic indicator in patients with resectable gallbladder cancer

Background:Inflammation is often related to cancer,and several inflammatory scores have been established to predict the prognosis of various types of cancer.Our study aimed to determine the prognostic value of the preoperative lymphocyte to C-reactive protein ratio(LCR)for predicting postoperative outcomes in patients with resectable gallbladder cancer(GBC).Methods:A retrospective analysis of 104 GBC patients who received curative surgery at Xinhua Hospital,Affiliated to Shanghai Jiao Tong University School of Medicine from January 2000 to December 2016 was performed.A time-dependent receiver operating characteristic curve was constructed to evaluate the accuracy of different markers.Univariate and multivariate Cox proportional hazard models were used to define factors associated with overall survival.Results:Among the assessed variables,the preoperative LCR showed the highest accuracy in predicting the overall survival of GBC patients(AUC:0.736).Decreased preoperative LCR was significantly associated with advanced tumor stage,including tumor invasion(P=0.018),lymph node metastasis(P=0.011)and TNM stage(P=0.022).A low preoperative LCR(cutoff threshold=145.5)was an independent risk factor for overall survival in patients with resectable GBC(P<0.001).Conclusions:The preoperative LCR is a novel and valuable prognostic indicator of postoperative survival in patients with resectable GBC.

Diagnostic and prognostic significance of the lymphocyte/C-reactive protein ratio,neutrophil/lymphocyte ratio,and D-dimer values in patients with COVID-19

In this study,our aim was to examine the diagnostic and prognostic significance of lymphocyte/C-reactiveprotein ratio(LCR),neutrophil/lymphocyte ratio(NLR)and D-dimer parameters in COVID-19 infection.The LCR,NLR,neutrophil count,mean platelet volume(MPV),C-reactive protein(CRP),and D-dimer parameters wereevaluated retrospectively.This was a retrospective cohort study with 1000 COVID-19 positive and 1000 healthycontrol groups,all over the age of 18 years.Odds ratio(OR)and 95%confidence interval(CI)values were calculatedfor each parameter found to be statistically significant in the univariate and multivariate logistic regression models.Herein,127(12.7%)of the COVID-19^(+)patients,whose data was included in this study,died.The neutrophil,MPV,CRP,D-dimer,and NLR values were higher in the COVID-19^(+)/deceased group than in the COVID-19^(+)/alive andcontrol groups(p<0.001,p<0.001,p<0.001,p<0.001,p<0.001).The lymphocyte and LCR values were lower inthe COVID-19^(+)/deceased group than in the COVID-19^(+)/alive and control groups(p<0.001,p<0.001).Variableswith statistically significance in predicting COVID-19 infection were lymphocyte,LCR,D-dimer,NLR,CRP,MPV,PLT,and neutrophil values.Statistically significant variables in predicting mortality due to COVID-19 were LCR,CRP,NLR,lymphocyte,D-dimer,neutrophil,and MPV values.A low LCR and high NLR are associated with thepresence,prognosis,and mortality due to COVID-19.LCR and NLR parameters can thus be used in clinicalmonitoring to reduce morbidity and mortality rates.

The prognostic potential of pretreatment C-reactive protein to albumin ratio in stage IE/IIE extranodal natural killer/T-cell lymphoma

Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Methods One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC). Results The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/ Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores. Conclusion CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.

A study on liver mitochondria respiration and protein synthesis in cold adapted rats

Mitochondria were isolated from normal and cold adapted rat livers.The respiratory func-tion of mitochondria in rat livers,including ADP:O ratio(P/O)and the respiratory control ratio(RCR),was determined by oxygen electrode method,The protein synthesis in mitochondria wasstudied by observing the incorporation of[~3H]-Leucine into mitochondria.Polyacrylamide gelelectrophoresis was carried out to detect the changes of the inner membrane proteins.It was shownthat the P/O and RCR decreased in cold adapted rats in the 2nd and 4th weeks and returned tothe control level in the 6th week,the protein synthesis of mitochondria decreased significantly incold adapted rats in 1,2 and 4 weeks;the electrophoretic pattern of the inner membrane proteinsin mitochondria from cold adapted rat livers revealed some new bands.

Increased Spot Urinary Protein-to-Creatinine Ratio Can Be a Useful Predictor of Preeclampsia

Objectives: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Early diagnosis of preeclampsia is important to help patients with preeclampsia. However, 24-hour urine collection is the gold standard diagnostic method at present. Recently, the spot urinary protein-to-creatinine ratio (P/C ratio) has been used to detect suspected preeclampsia, because it can be used to estimate the amount of 24-hour urinary protein. The aim of this study is to investigate whether an increase in P/C ratio precedes emergence of hypertension among inpatients with preeclampsia. Method: The P/C ratio in normotensive (systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg) pregnant women was measured during regular prenatal checkups and in inpatients with preeclampsia between April 1, 2013 and March 31, 2014. Results: We included in this study 4074 normotensive pregnant women. The 95th percentile values for the trimester of pregnancy were 0.100, 0.157, and 0.195, respectively. The 95th percentile value for each trimester of pregnancy and gestational age were determined as criterion (Y) and predictive variables (X), respectively. In a simple regression analysis, the regression line was calculated as Y = 0.0035X + 0.0849 (R2 = 0.9913). Twenty-one women were diagnosed with preeclampsia. In 14 patients with preeclampsia, the timing of the increase in P/C ratio to higher than the regression line preceded the emergence of hypertension. Six patients had no data on P/C ratio, and 1 patient had hypertension before the increase in P/C ratio. Conclusions: An increase in P/C ratio to higher than the 95th percentile value can be a useful predictor of preeclampsia.

Clinical application of neutrophil/lymphocyte ratio combined with high sensitive C reactive protein in evaluation of community acquired pneumonia

Objective:To explore the application value of neutrophil/lymphocyte ratio (NLR) combined with high sensitive C reactive protein (hs-CRP) in the evaluation of community acquired pneumonia (CAP). Methods:From November 2015 to October 2016, 58 cases of CAP patients admitted in our department were selected as research objects and were divided into low risk group and high risk group according to the PSI score and CURB-65 standard for evaluation. They were divided into improved group (48 cases) and death group (10 cases) according to prognosis. Hs-CRP was determined by immunoturbidimetric assay, procalcitonin (PCT) by immunofluorescence, NLR by count method of laser scattering, and white blood (WBC) was counted. The differences in WBC, PCT, NLR and hs-CRP between different risk groups were compared, and the correlation was evaluated using Spearman's rank correlation analysis method. The changes in indexes were observed in the improved and death cases. Results:The high risk group had higher NLR, PCT and hs-CRP than low risk group (P<0.05), while no significant difference was found in WBC (P>0.05). No correlation was found between NLR and WBC, while a strong correlation was found between hs-CRP and PCT. The WBC, PCT, NLR and hs-CRP levels were significantly lower in the improved group than the death group (P<0.05). Conclusions:NLR combined with hs-CRP, WBC, and PCT has a good assessment of the severity of CAR, and high levels of NLR, hs-CRP, WBC, and PCT predict the severity of the disease and poor prognosis.

Spot urine protein/creatinine ratio—A quick and accurate method for diagnosis of pre-eclampsia

Objective(s):To assess the diagnostic accuracy of spot urine protein-creatinine (P/C) ratio and its compareson with 24-hour urine proteinuria for predicting eclampsia. Method(s): Spot urine P/C ratio was determined in a mid-stream urine sample, and the 24-hour urine protein was measured. The correlation between the spot P/C ratio and 24-hour urine protein amount was done. Logistic regression analysis and ROC curve analysis have been used to analyse data. Result(s): There was a strong correlation between the spot P/C ratio and 24-hour urine protein excretion (pearson’s correlation coefficient r = 0.71;P < 0.0001). The optimal spot P/C ratio cutoff point was 0.25, for 300 mg/24 h of protein excretion, with sensitivity and specificity of 69% and 75% respectively. Conclusion(s): Spot urine P/C ratio is a quick and reliable tool which can be used as an alternative method for evaluation of proteinuria for diagnosis of pre-eclampsia.

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。

淋巴细胞与单核细胞比值、C反应蛋白与前白蛋白比值检测对甲型流感病毒重症感染婴幼儿的临床价值

目的 探讨淋巴细胞与单核细胞比值(LMR)、C反应蛋白与前白蛋白比值(CRP/PA)预测甲型流感病毒重症感染婴幼儿的临床价值。方法 选取2019年1月至2022年12月泰安市妇幼保健院儿内科住院的婴幼儿甲型流感病毒感染重症组(192例)、轻症组(187例)及健康对照者(393例),检测其血常规、CRP及PA水平,计算中性粒细胞/淋巴细胞比值(NLR)、LMR、血小板/淋巴细胞比值(PLR)、系统免疫炎症指数(SII)、CRP/PA。采用受试者工作特征(ROC)曲线和Logistic回归分析LMR、CRP/PA对甲型流感病毒重症感染的诊断及预测价值。结果 与对照组和轻症组比较,重症组NLM、PLR、SII、CRP/PA均显著升高,LMR显著降低(分别为1.09、88.07、310.75、0.05和3.90,P<0.05)。与对照组相比,轻症组CRP/PA显著升高,LMR显著降低(分别为0.04和6.31,P<0.05)。ROC曲线显示,诊断重症感染时,CRP/PA的特异度最高,为96.1%,LMR、CRP/PA联合检测的灵敏度、ROC曲线下面积(AUC)均优于单项检测(分别为88.5%、0.941)。LMR、CRP/PA联合检测对轻症与重症感染鉴别诊断的灵敏度、特异度和AUC均优于单项检测(分别为76.4%、60.2%、0.707)。校正年龄、性别及NLM、PLR、SII后,CRP/PA的升高与LMR的降低与甲型流感病毒感染独立相关,并区分轻症和重症。结论 甲型流感病毒感染患儿CRP/PA升高与LMR降低,还有助于区分轻症和重症,可为预测感染严重程度的指标,LMR、CRP/PA联合分析对轻重症感染的鉴别诊断具有重要价值。

C反应蛋白与白蛋白比值联合握力和血清前白蛋白在食管癌患者中的应用价值

目的 探讨C反应蛋白与白蛋白比值(CAR)联合握力和血清前白蛋白对食管癌患者生存期及营养不良的预测价值。方法 回顾性选取212例食管癌患者作为研究对象,收集患者的基本资料和治疗前CAR、握力、血清前白蛋白检测结果,评估患者营养不良情况并随访总生存期。采用受试者工作特征(ROC)曲线评估治疗前CAR、握力和血清前白蛋白水平对患者营养不良的预测价值,采用Kaplan-Meier生存曲线及Cox回归模型分析治疗前CAR、握力和血清前白蛋白水平对患者生存预后的预测价值。结果 ROC曲线分析结果显示,握力预测食管癌患者营养不良的曲线下面积(0.625)最大,其后依次为血清前白蛋白、CAR(分别为0.604、0.594);根据约登指数确定CAR、握力、血清前白蛋白的最佳截断值分别为0.732、23.1 kg、0.190 g/L,三者联合预测营养不良的灵敏度高达80.7%。Kaplan-Meier生存曲线分析结果显示,CAR增高(≥0.732)、握力降低(<23.1 kg)、血清前白蛋白水平降低(<0.190 g/L)患者的总生存期分别短于CAR<0.732、握力≥23.1 kg、血清前白蛋白水平≥0.190 g/L的患者,差异有统计学意义(P<0.01);多因素Cox回归分析结果显示,治疗前CAR增高(≥0.732)、握力降低(<23.1 kg)、血清前白蛋白水平降低(<0.190 g/L)是食管癌患者生存预后不良的独立危险因素(P<0.05)。结论 治疗前CAR、握力和血清前白蛋白是评估食管癌患者营养状态和生存预后的重要指标,三者联合检测有助于营养不良的早期诊断与及时干预,或可改善食管癌患者的生存预后。