Systemic immune-inflammation index,neutrophilto-lymphocyte ratio,and platelet-to-lymphocyte ratio in patients with type 2 diabetes at different stages of diabetic retinopathy

AIM:To investigate systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),and plateletto-lymphocyte ratio(PLR)levels in patients with type 2 diabetes at different stages of diabetic retinopathy(DR).METHODS:This retrospective study included 141 patients with type 2 diabetes mellitus(DM):45 without diabetic retinopathy(NDR),47 with non-proliferative diabetic retinopathy(NPDR),and 49 with proliferative diabetic retinopathy(PDR).Complete blood counts were obtained,and NLR,PLR,and SII were calculated.The study analysed the ability of inflammatory markers to predict DR using receiver operating characteristic(ROC)curves.The relationships between DR stages and SII,PLR,and NLP were assessed using multivariate logistic regression.RESULTS:The average NLR,PLR,and SII were higher in the PDR group than in the NPDR group(P=0.011,0.043,0.009,respectively);higher in the NPDR group than in the NDR group(P<0.001 for all);and higher in the PDR group than in the NDR group(P<0.001 for all).In the ROC curve analysis,the NLR,PLR,and SII were significant predictors of DR(P<0.001 for all).The highest area under the curve(AUC)was for the PLR(0.929 for PLR,0.925 for SII,and 0.821 for NLR).Multivariate regression analysis indicated that NLR,PLR,and SII were statistically significantly positive and independent predictors for the DR stages in patients with DM[odds ratio(OR)=1.122,95%confidence interval(CI):0.200–2.043,P<0.05;OR=0.038,95%CI:0.018–0.058,P<0.05;OR=0.007,95%CI:0.001–0.01,P<0.05,respectively).CONCLUSION:The NLR,PLR,and SII may be used as predictors of DR.

An evaluation of ureteral diameter ratio and vesicoureteral reflux index in the treatment of primary vesicoureteral reflux

Objective:Vesicoureteral reflux(VUR)index is a simple,validated tool that reliably predicts significant improvement and spontaneous resolution of primary reflux in children.The aim of this study was to evaluate and compare the ureter diameter ratio(UDR)and VUR index(VURx)of patients treated with endoscopic injection(EI)and ureteroneocystostomy(UNC)methods in the pediatric age group due to primary VUR.Methods:Patients under the age of 18 years old who underwent EI and UNC with the diagnosis of primary VUR between January 2011 and September 2021 were determined as the participants.The UDR was assessed using voiding cystourethrography,and the VURx score was determined prior to treatment based on hospital records included in the study.Results:A total of 255 patients,60(23.5%)boys and 195(76.5%)girls,with a mean age of 76.5(range 13.0e204.0)months,were included in the study.EI was applied to 130(51.0%)patients and UNC was applied to 125(49.0%)patients due to primary VUR.The optimum cut-off for the distal UDR was obtained as 0.17 with sensitivity and specificity of 73.0%and 63.0%,respectively.The positive and negative predictive values were 66.0%and 70.0%,respectively.Conclusion:When the UDR and VURx score are evaluated together for the surgical treatment of primary VUR in the pediatric age group,it is thought that it may be useful in predicting the clinical course of the disease and evaluating surgical treatment options.

Ca^(2+)/cAMP ratio:An inflammatory index for diabetes,hypertension,and COVID-19

Ca^(2+)/cAMP ratio could serve as an inflammatory index for diseases like hypertension,diabetes,and coronavirus disease 2019.

Diagnostic value of FIB-4, aspartate aminotransferaseto-platelet ratio index and liver stiffness measurement in hepatitis B virus-infected patients with persistently normal alanine aminotransferase

AIM To assess the diagnostic value of FIB-4, aspartate aminotransferase-to-platelet ratio index(APRI), and liver stiffness measurement(LSM) in patients with hepatitis B virus infection who have persistently normal alanine transaminase(PNALT).METHODS We enrolled 245 patients with chronic hepatitis B: 95 in PNALT group, 86 in intermittently elevated alanine transaminase(PIALT1) group [alanine transaminase(ALT) within 1-2 × upper limit of normal value(ULN)], and 64 in PIALT2 group(ALT > 2 × ULN). All the patients received a percutaneous liver biopsy guided by ultrasonography. LSM, biochemical tests, and complete blood cell counts were performed.RESULTS The pathological examination revealed moderate inflammatory necrosis ratios of 16.81%(16/95), 32.56%(28/86), and 45.31%(28/64), and moderate liverfibrosis of 24.2%(23/95), 33.72%(29/86), and 43.75%(28/64) in the PNALT, PIALT1, and PIALT2 groups, respectively. The degrees of inflammation and liver fibrosis were significantly higher in the PIALT groups than in the PNALT group(P < 0.05). No significant difference was found in the areas under the curve(AUCs) between APRI and FIB-4 in the PNALT group; however, significant differences were found between APRI and LSM, and between FIB-4 and LSM in the PNALT group(P < 0.05 for both). In the PIALT1 and PIALT2 groups, no significant difference(P > 0.05) was found in AUCs for all comparisons(P > 0.05 for all). In the overall patients, a significant difference in the AUCs was found only between LSM and APRI(P < 0.05).CONCLUSION APRI and FIB-4 are not the ideal noninvasive hepatic fibrosis markers for PNALT patients. LSM is superior to APRI and FIB-4 in PNALT patients because of the influence of liver inflammation and necrosis.

Detection of Internal Leaf Structure Deterioration Using a New Spectral Ratio Index in the Near-Infrared Shoulder Region

Spectral reflectance in the near-infrared （NIR） shoulder （750-900 nm） region is affected by internal leaf structure, but it has rarely been investigated. In this study, a dehydration treatment and three paraquat herbicide applications were conducted to explore how spectral reflectance and shape in the NIR shoulder region responded to various stresses. A new spectral ratio index in the NIR shoulder region （NSRI）, defined by a simple ratio of reflectance at 890 nm to reflectance at 780 nm, was proposed for assessing leaf structure deterioration. Firstly, a wavelength-independent increase in spectral reflectance in the NIR shoulder region was observed from the mature leaves with slight dehydration. An increase in spectral slope in the NIR shoulder would be expected only when water stress developed sufficiently to cause severe leaf dehydration resulting in an alteration in cell structure. Secondly, the alteration of leaf cell structure caused by Paraquat herbicide applications resulted in a wavelength-dependent variation of spectral reflectance in the NIR shoulder region. The NSRI in the NIR shoulder region increased significantly under an herbicide application. Although the dehydration process also occurred with the herbicide injury, NSRI is more sensitive to herbicide injury than the water-related indices （water index and normalized difference water index） and normalized difference vegetation index. Finally, the sensitivity of NSRI to stripe rust in winter wheat was examined, yielding a determination coefficient of 0.61, which is more significant than normalized difference vegetation index （NDVI）, water index （WI） and normalized difference water index （NDWI）, with a determination coefficient of 0.45, 0.36 and 0.13, respectively. In this study, all experimental results demonstrated that NSRI will increase with internal leaf structure deterioration, and it is also a sensitive spectral index for herbicide injury or stripe rust in winter wheat.

Human development index is associated with mortality-to-incidence ratios of gastrointestinal cancers

AIM:To identify the role of human development in the incidence and mortality rates of gastrointestinal cancers worldwide.METHODS:The age-standardized incidence and mortality rates for gastrointestinal cancers,including cancers of the esophagus,stomach,pancreas,liver,gallbladder,and colorectum,were obtained from the GLOBOCAN 2008 database and United States Cancer Statistics(USCS)report.The human development index(HDI)data were calculated according to the 2011 Human Development Report.We estimated the mortality-toincidence ratios(MIRs)at the regional and national levels,and explored the association of the MIR with development levels as measured by the HDI using a modified"drug dose to inhibition response"model.Furthermore,countries were divided into four groups according to the HDI distribution,and the MIRs of the four HDI groups were compared by one-way ANOVA followed by the Tukey-Kramer post-hoc test.Statespecific MIRs in the United States were predicted from the estimated HDI using the fitted non-linear model,and were compared with the actual MIRs calculated from data in the USCS report.RESULTS:The worldwide incidence and mortality rates of gastrointestinal cancers were as high as 39.4and 54.9 cases per 100000 individuals,respectively.Linear and non-linear regression analyses revealed an inverse correlation between the MIR of gastrointestinal cancers and the HDI at the regional and national levels(<0;P=0.0028 for regional level and<0.0001 for national level,ANOVA).The MIR differed significantly among the four HDI areas(very high HDI,0.620±0.033;high HDI,0.807±0.018;medium HDI,0.857±0.021;low HDI,0.953±0.011;P<0.001,oneway ANOVA).Prediction of the MIRs for individual United States states using best-fitted non-linear models showed little deviation from the actual MIRs in the United States.Except for 28 data points(9.93%of282),the actual MIRs of all gastrointestinal cancers were mostly located in the prediction intervals via the best-fit non-linear regression models.CONCLUSION:The inverse correlation between HDI and MIR demonstrates that more developed areas have a relatively efficacious healthcare system,resulting in low MIRs,and HDI can be used to estimate the MIR.

Combined acoustic radiation force impulse, aminotransferase to platelet ratio index and Forns index assessment for hepatic fibrosis grading in hepatitis B

AIM: To investigate the combined diagnostic accuracy of acoustic radiation force impulse(ARFI), aspartate aminotransferase to platelet ratio index(APRI) and Forns index for a non-invasive assessment of liver fibrosis in patients with chronic hepatitis B(CHB). METHODS: In this prospective study, 206 patients had CHB with liver fibrosis stages F0-F4 classified by METAVIR and 40 were healthy volunteers were measured by ARFI, APRI and Forns index separately or combined as indicated. RESULTS: ARFI, APRI or Forns index demonstrated a significant correlation with the histological stage(all P < 0.001). According to the AUROC of ARFI and APRI for evaluating fibrotic stages more than F2, ARFI showed an enhanced diagnostic accuracy than APRI(P < 0.05). The combined measurement of ARFI and APRI exhibited better accuracy than ARFI alone when evaluating ≥ F2 fibrotic stage(Z = 2.77, P = 0.006). Combination of ARFI, APRI and Forns index did not obviously improve the diagnostic accuracy compared to the combination of ARFI and APRI(Z = 0.958, P = 0.338). CONCLUSION: ARFI + APRI showed enhanced diagnostic accuracy than ARFI or APRI alone for significant liver fibrosis and ARFI + APRI + Forns index shows the same effect with ARFI + APRI.

Noninvasive assessment of liver fibrosis with combined serum aminotransferase/platelet ratio index and hyaluronic acid in patients with chronic hepatitis B

AIM： To construct a noninvasive assessment model consisting of routine laboratory data to predict significant fibrosis and cirrhosis in patients with chronic hepatitis B （CHB）. METHODS： A total of 137 consecutive patients with CriB who underwent percutaneous liver biopsy were retrospectively analyzed. These patients were divided into two groups according to their aminotransferase （ALT） level. The sensitivity, specificity, positive predictive value （PPV）, negative predictive value （NPV）, the likelihood ratio （LR） of aminotransferase/platelet ratio index （APRI） ≥ 1.5 or 〈 1.5 in combination with different hyaluronic acid （HA） cut-off points were calculated for the presence of moderate to severe fibrosis/cirrhosis （fibrosis stages 2 and 4） and no to mild fibrosis/cirrhosis （fibrosis stages 0 and 1）. RESULTS： The APRI correlated with fibrosis stage in CriB patients. The APRI ≥1.5 in combination with a cut-off HA cut-off point 〉 300 ng/mL could detect moderate to severe fibrosis （stages 2-4） in Crib patients. The PPV was 93.7%, the specificity was 98.9%. The APRI 〈 1.5 in combination with different HA cut-off points could not detect no to mild fibrosis in CHB patients. CONCLUSION： The APRI ≥ 1.5 in combination with a HA cut-off point 〉 300 ng/mL can detect moderate to severe fibrosis （stages 2-4） in Crib patients.

Prediction of hepatocellular carcinoma development by aminotransferase to platelet ratio index in primary biliary cholangitis

AIM To investigate the usefulness of aspartate aminotransferase to platelet ratio index(APRI) in predicting hepatocellular carcinoma(HCC) risk in primary biliary cholangitis(PBC).METHODS We identified PBC patients between 2000 and 2015 by searching the electronic medical database of a tertiary center. The hazard ratio(HR) of HCC with different risk factors was determined by Cox proportional hazards model. RESULTS One hundred and forty-four PBC patients were recru-ited. Patients were diagnosed at a median age of 57.8 years [interquartile range(IQR): 48.7-71.5 years), and 41(28.5%) patients had cirrhosis at baseline. The median follow-up duration was 6.9 years(range: 1.0-26.3 years). Twelve patients developed HCC, with an incidence rate of 10.6 cases per 1000 patient-years. The overall 5-, 10-and 15-year cumulative incidences of HCC were 2.3% 95%CI: 0%-4.8%), 8.4%(95%CI: 1.8%-14.5%) and 21.6%(6.8%-34.1%), respectively. Older age(HR = 1.07), cirrhosis(HR = 4.38) and APRI at 1 year after treatment(APRI-r1) > 0.54(HR = 3.94) were independent factors for HCC development. APRI-r1, when combined with treatment response, further stratified HCC risk(log rank P < 0.05). The area under receiver operating curve of APRI-r1 in predicting HCC was 0.77(95%CI: 0.64-0.88).CONCLUSION APRI-r1 can be used to predict the development of HCC in PBC patients. Combination of APRI-r1 with treatment response can further stratify the HCC risk.

Systemic immune inflammation index, ratio of lymphocytes to monocytes, lactate dehydrogenase and prognosis of diffuse large Bcell lymphoma patients

BACKGROUND In malignant tumors,inflammation plays a vital role in the development,invasion,and metastasis of cancer cells.Diffuse large B-cell lymphoma(DLBCL),the most common malignant proliferative disease of the lymphatic system,is commonly associated with inflammation.The international prognostic index(IPI),which includes age,lactate dehydrogenase(LDH),number of extranodal lesions,Ann Arbor score,and Eastern Cooperative Oncology Group(ECOG)score,can evaluate the prognosis of DLBCL.However,its use in accurately identifying highrisk patients and guiding treatment is poor.Therefore,it is important to find novel immune markers in predicting the prognosis of DLBCL patients.AIM To determine the association between the systemic immune inflammation index(SII),ratio of lymphocytes to monocytes(LMR),ratio of LMR to LDH(LMR/LDH),and prognosis of patients with DLBCL.METHODS A total of 68 patients diagnosed with DLBCL,treated in our hospital between January 2016 and January 2020,were included.χ2 test,Pearson’s R correlation,Kaplan Meier curves,and Cox proportional risk regression analysis were used.The differences in the SII,LMR,and LMR/LDH among patients with different clinicopathological features were analyzed.The differences in progression-free survival time among patients with different SII,LMR,and LMR/LDH expressions and influencing factors affecting the prognosis of DLBCL patients,were also analyzed.RESULTS The LMR and LMR/LDH in patients with Ann Arbor stage III–IV,ECOG score≥2,and SII,IPI score 2–5 were significantly higher than those of patients with Ann Arbor stage I-II and ECOG score<2(P<0.05).Patients with high SII,LMR,and LMR/LDH had progression-free survival times of 34 mo(95%CI:32.52–38.50),35 mo(95%CI:33.42–36.58)and 35 mo(95%CI:33.49–36.51),respectively,which were significantly lower than those with low SII,LMR,and LMR/LDH(P<0.05);the SII,LMR,and LMR/LDH were positively correlated(P<0.05).Cox proportional risk regression analysis showed that the SII,LMR,and LMR/LDH were influencing factors for the prognosis of DLBCL patients(hazard ratio=1.143,1.665,and 1.704,respectively;P<0.05).CONCLUSION The SII,LMR,and LMR/LDH are related to the clinicopathological features of DLCBL,and they also influence the prognosis of patients with the disease.

Fall cone tests considering water content, cone penetration index, and plasticity angle of fine-grained soils

This paper analyzed the consistency of some parameters of soils in the literature and experimental results from fall cone test and its application to soil plasticity classification.Over 500 data from both literatures and experiments using fall cone and Casagrande methods were compiled to assess the relationships among specified water content,cone penetration index ebT,and plasticity angle eaT of finegrained soils.The results indicate that no unique correlation exists among b,liquid limit of the fall cone test(LLc)and a.The water content at 1 mm cone penetration eC0T correlates well with b,plasticity ratio eRpT(i.e.the ratio of plastic limit to liquid limit),and a.Finally,the potential of using the btan a diagram to classify soil plasticity was also discussed.

Female waist-to-hip ratio,body mass index and sexual attractiveness in China

Men and women at Northwest University （n=751）, Xi＇an, China were asked to judge the attractiveness of photographs of female patients who had undergone micrograft surgery to reduce their waist-to-hip ratios （WHR）. Micrograft surgery involves harvesting adipose tissue from the waist and reshaping the buttocks to produce a low WHR and an ‘hourglass＇ female figure. This gynoid distribution of female body fat has been shown to correlate with measures of fertility and health. Significantly larger numbers of subjects, of both sexes, chose post-operative photographs, with lower WHRs, as more attractive than pre-operative photographs of the same women. Some patients had gained, and some had lost weight, post-operatively, with resultant changes in body mass index （BMI）. However, these changes in BMI were not related to judgments of attractiveness. These results show that the hourglass female figure is rated as attractive in China, and that WHR, rather than BMI, plays a crucial role in such attractiveness judgments.

Aspartate transferase-to-platelet ratio index-plus: A new simplified model for predicting the risk of mortality among patients with COVID-19

BACKGROUND Coronavirus disease 2019(COVID-19)has a spectrum of clinical syndromes with serious involvement of the lung and frequent effection of the liver and hemostatic system.Blood biomarkers are affordable,rapid,objective,and useful in the evaluation and prognostication of COVID-19 patients.AIM To investigate the association between aspartate transferase-to-platelet ratio index(APRI)and in-hospital mortality to develop a COVID-19 mortality prediction model.METHODS A multicenter cohort study with a retrospective design was conducted.Medical records of all consecutive adult patients admitted to Al-Azhar University Hospital(Assiut,Egypt)and Chest Hospital(Assiut,Egypt)with confirmed COVID-19 from July 1,2020 to October 1,2020,were retrieved and analyzed.The patient cohort was classified into the following two categories based on the APRI:(1)COVID-19 presenting with APRI≤0.5;and(2)COVID-19 presenting with APRI(>0.5 and≤1.5).The association between APRI and all-cause in-hospital mortality was analyzed,and the new model was developed through logistic regression analyses.RESULTS Of the 353 patients who satisfied the inclusion criteria,10%were admitted to the intensive care unit(n=36)and 7%died during the hospital stay(n=25).The median age was 40 years and 50.7%were male.On admission,49%had aspartate transferase-dominant liver injury.On admission,APRI(>0.5 and≤1.5)was independently associated with all-cause in-hospital mortality in unadjusted regression analysis and after adjustment for age and sex;after stepwise adjustment for several clinically relevant confounders,APRI was still significantly associated with all-cause inhospital mortality.On admission,APRI(>0.5 and≤1.5)increased the odds of mortality by fivetimes(P<0.006).From these results,we developed a new predictive model,the APRI-plus,which includes the four predictors of age,aspartate transferase,platelets,and serum ferritin.Performance for mortality was very good,with an area under the receiver operating curve of 0.90.CONCLUSION APRI-plus is an accurate and simplified prediction model for mortality among patients with COVID-19 and is associated with in-hospital mortality,independent of other relevant predictors.

Effects of Use and Re-Use of Selected Vegetable Oils on the Proximate, Minerals, Mineral Ratios and Mineral Safety Index of Raw and Fried Plantain Chips: Note I

Raw and fried plantain chips obtained from the use and re-use of olive, refined palm olein and coconut oils were investigated for the proximate, mineral compositions, computed mineral ratios and the mineral safety index using standard analytical methods. For the selected oils (both use and re-use): first and second re-use and the fresh plantain chips (unprocessed plantain chips;UPC) had the following range results: proximate composition (%) (moisture: 8.20 - 12.3, crude protein: 9.70 - 8.60, fat: 7.40 - 12.9, fibre: 3.50 - 4.90, ash: 2.80 - 3.80 and carbohydrates: 63.5 - 64.8), % energy contributions (PEC: 63.4 - 70.8, PEF: 20.2 - 28.6, PEP: 8.03 - 9.66, UEDP: 4.49 - 5.08). The mineral composition (mg/100g) of the samples had the following greater than 80.0: Ca, Mg, K and P;Fe, Cu, Mn and Zn recorded values ranging between 1.00 and 4.00;Co, Se and Ni had their concentrations between 0.00 and 0.0363 whereas Pb and Cd recorded levels lower than 0.0006. In the mineral ratios, only K/(Ca + Mg) values fell within the acceptable ideal range. No MSI aberration was observed for the minerals from all the samples obtained from the various oils. The chi-square analysis showed that on parameter wise comparisons, there were no significant differences among the levels as treated based on the various oils except gross energy, Mg, K, P, Ca/P, Fe/Pb and K/Co. Also on pairwise comparison from linear correlation and regression, all these parameters were significantly different at r = 0.01 between the unprocessed and fried plantain samples: proximate, percentage energy distribution, mineral and mineral ratios. Generally, the first (day) frying showed fairly high nutrient concentration than the first and second re-use oils products. Therefore, for optimum nutrient preservation from fried plantain chips re-use of oil for frying should be sparingly allowed. However, olive showed highest level of nutrients in terms of proximate and mineral compositions.

Analysis of Ankle-Brachial Index, Waist-Hip Ratio, Ejection-Fraction, Obesity, Smoking, Alcohol Habits, Diabetes and Hypertension as Independent Predictors of Complexity and Severity of Coronary Artery Disease

Background: The present study was conducted to examine the association between various coronary risk factors and clinical parameters, with special emphasis on ankle-brachial index, in predicting the severity and complexity of coronary artery disease. Methods: Patients diagnosed with coronary artery disease at our hospital between September-2012 and December-2014 were examined in this study. Selected patients were screened for cardiovascular risk factors including diabetes, hypertension, smoking, and alcohol habits as well as for clinical parameters including body-mass index, waist-hip ratio, ankle-brachial index, and ejection fraction. All patients underwent coronary angiography and were evaluated for severity of coronary artery disease (based on number of vessels involved) and complexity of coronary angiographic lesions (measured by computer-assisted Syntax score calculator). The collected data were analyzed to determine the role of cardiovascular risk factors and clinical parameters as predictors of complexity and severity of coronary artery disease. Results: A total of 211 patients (mean age: 54.64 ± 9.9 years;81% males) with coronary artery disease were analyzed. Findings revealed that diabetes mellitus (p < 0.001), hypertension (p < 0.001), smoking habits (p = 0.036), and low ankle-brachial index (p < 0.001) were independent predictors of complex coronary artery disease as measured by Syntax score. Significant associations were also evident between severity of coronary artery disease and diabetes mellitus (p < 0.001), hypertension (p < 0.001), and ankle-brachial index (p < 0.001). Conversely, other cardiovascular risk factors including body-mass index, alcohol habits, wait-hip ratio, and ejection fraction did not exhibit significant associations with severity and complexity of coronary artery. Conclusions: The early diagnosis of coronary artery can be predicated by evaluating diabetes, hypertension, and smoking habits in patients presenting with acute coronary syndrome. In addition, ankle-brachial index can be used as an effective non-invasive bed-side tool, as an alternative to Syntax score, in predicting the severity and complexity of coronary artery disease.

Effects of Fuzheng Huayu Capsules combined with nucleoside antiviral drugs on liver and kidney function, serum inflammatory factors, TLR-4, TGF-β1 and aspartate aminotransferase-platelet ratio index in patients with HBV infection and decompensated liver

Objective:To investigate the effect of Fuzheng Huayu Capsule combined with nucleoside antiviral drugs on liver and kidney function,serum inflammatory factors,Toll-like receptor 4(TLR-4),transforming growth factorβ1(TGF-β1)And aspartate aminotransferase-platelet ratio index(APRI).Methods:A total of 144 patients with HBV infection and decompensated cirrhosis were selected.All patients were divided into control group and case group by random number table method,with 72 cases in each group.The control group was given conventional liver protection and antiviral therapy;the case group was supplemented with Fuzheng Huayu Capsule on the basis of treatment in the control group.The changes of liver and kidney function,serum inflammatory factors,TLR-4,TGF-β1 and APRI in the two groups were observed.Results:The total effective rate of the case group was 93.06%,higher than 76.32%of the control group(P<0.05).Case group HBV DNA negative rate,negative rate of hepatitis B virus surface antigen(HBsAg),negative rate of hepatitis B virus e antigen(HBeAg)were significantly higher than the control group(76.39%vs 59.72%,55.56%vs 31.94%,51.39%vs 29.17%),the difference was statistically significant(P<0.05).Alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),hyaluronic acid(HA),laminin(LN),typeⅢprocollagen after treatment(PCⅢ),typeⅣcollagen(CⅣ),inner diameter of portal vein,inner diameter of splenic vein,spleen thickness,resistance index,urea nitrogen(BUN),creatinine(Cr),interleukin-6(IL-6),interleukin-8(IL-8),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),TLR-4,TGF-β1,APRI are lower than before treatment,albumin(ALB)and renal blood The flow rate was higher than before treatment;liver function indicators,liver fibrosis indicators,liver and spleen imaging indicators,renal hemodynamic indicators,serum inflammatory factors,TLR-4 in the case group The improvement of TGF-β1 and APRI.Conclusion:Fuzheng Huayu Capsules combined with nucleoside antiviral drugs have a clear clinical effect on patients with HBV infection and decompensated liver cirrhosis,significantly improve the clinical symptoms of patients,improve liver and kidney function,reduce inflammatory factor production,and can effectively inhibit HBV replication.Certain promotion value is worthy of further clinical research.

An Algorithm to Reduce Compression Ratio in Multimedia Applications

In recent years,it has been evident that internet is the most effective means of transmitting information in the form of documents,photographs,or videos around the world.The purpose of an image compression method is to encode a picture with fewer bits while retaining the decompressed image’s visual quality.During transmission,this massive data necessitates a lot of channel space.In order to overcome this problem,an effective visual compression approach is required to resize this large amount of data.This work is based on lossy image compression and is offered for static color images.The quantization procedure determines the compressed data quality characteristics.The images are converted from RGB to International Commission on Illumination CIE La^(∗)b^(∗);and YCbCr color spaces before being used.In the transform domain,the color planes are encoded using the proposed quantization matrix.To improve the efficiency and quality of the compressed image,the standard quantization matrix is updated with the respective image block.We used seven discrete orthogonal transforms,including five variations of the Complex Hadamard Transform,Discrete Fourier Transform and Discrete Cosine Transform,as well as thresholding,quantization,de-quantization and inverse discrete orthogonal transforms with CIE La^(∗)b^(∗);and YCbCr to RGB conversion.Peak to signal noise ratio,signal to noise ratio,picture similarity index and compression ratio are all used to assess the quality of compressed images.With the relevant transforms,the image size and bits per pixel are also explored.Using the(n,n)block of transform,adaptive scanning is used to acquire the best feasible compression ratio.Because of these characteristics,multimedia systems and services have a wide range of possible applications.

Stability evaluation method of large cross-section tunnel considering modification of thickness-span ratio in mechanized operation

Purpose-This study aims to research the large cross-section tunnel stability evaluation method corrected after considering the thickness-span ratio.Design/methodology/approach-First,taking the Liuyuan Tunnel of Huanggang-Huangmei High-Speed Railway as an example and taking deflection of the third principal stress of the surrounding rock at a vault after tunnel excavation as the criterion,the critical buried depth of the large section tunnel was determined.Then,the strength reduction method was employed to calculate the tunnel safety factor under different rock classes and thickness-span ratios,and mathematical statistics was conducted to identify the relationships of the tunnel safety factor with the thickness-span ratio and the basic quality(BQ)index of the rock for different rock classes.Finally,the influences of thickness-span ratio,groundwater,initial stress of rock and structural attitude factors were considered to obtain the corrected BQ,based on which the stability of a large cross-section tunnel with a depth of more than 100 m during mechanized operation was analyzed.This evaluation method was then applied to Liuyuan Tunnel and Cimushan No.2 Tunnel of Chongqing Urban Expressway for verification.Findings-This study shows that under different rock classes,the tunnel safety factor is a strict power function of the thickness-span ratio,while a linear function of the BQ to some extent.It is more suitable to use the corrected BQ as a quantitative index to evaluate tunnel stability according to the actual conditions of the site.Originality/value-The existing industry standards do not consider the influence of buried depth and span in the evaluation of tunnel stability.The stability evaluation method of large section tunnel considering the correction of overburden span ratio proposed in this paper achieves higher accuracy for the stability evaluation of surrounding rock in a full or large-section mechanized excavation of double line high-speed railway tunnels.

California Bearing Ratio for Cohesive Soils from Quasi Static Cone Tests

The California bearing ratio (CBR) test is the most widely spread method of determining the bearing strength of the pavement material and is fundamental to pavement design practice in most countries. This test is expensive, laborious and time consuming, and to overcome this, Quasi static cone penetrometer machine was fabricated and used to measure the consistency limits (liquid limit-LL, Plastic limit-PL and Plasticity index-PI), which were used to develop an empirical equation to determine CBR. Soil samples were collected and unsoaked CBR, PL, LL and PI were determined according to BS 1377 part 9 and BS 1377-2;1990. Quasi static penetration forces at 20 mm depth of penetration were also determined at consistency limits. It was found that the force of 1020 gf and 60 gf was achieved at a depth of 20 mm at PI and LL respectively. The correlation and regression analysis between consistency limits, and the experimental CBR obtained showed coefficient of determination, R2 = 0.907 between CBR and all the parameters using multiple linear regression analysis (MLRA). The regression equation developed was used together with the relationship developed between the Quasi static Penetration force at consistency limits and the tested consistency limits to come up with the General Empirical Equation. Verification of the formula showed that the correlation can be used accurately to determine the un soaked CBR.

脑卒中静脉溶栓后早期神经功能恶化诺莫图预测模型的建立与验证

目的探究脑卒中静脉溶栓(IVT)后早期神经功能恶化(END)的危险因素,并构建诺莫图预测模型进行验证。方法回顾性分析2020年5月至2023年5月期间在大连市中心医院就诊的182例脑卒中患者的临床资料,所有患者均接受重组组织型纤溶酶原激活剂(rt-PA)溶栓治疗,根据溶栓后患者发生END的情况分为END组(n=52)和非END组(n=130)。比较两组临床资料,采用二元Logistic回归分析法明确发生END的危险因素,将独立危险因素引入R软件构建风险列线图,采用Bootstrap法验证模型区分度,绘制Calibration曲线和受试者工作特征(ROC)曲线进行拟合度及预测效能评估。结果END组患者既往脑梗死占比、入院时美国国立卫生研究院卒中量表(NIHSS)评分、发病至溶栓时间、溶栓时间、责任血管重度狭窄占比及糖化血红蛋白(HbA1c)、白细胞计数(WBC)、中性粒细胞/淋巴细胞比值(NLR)水平高于非END组,血红蛋白(Hb)、预后营养指数(PNI)水平则低于非END组(P<0.05)。二元Logistic回归模型显示,入院时高NIHSS评分、高HbA1c、责任血管重度狭窄及高NLR和低PNI是脑卒中IVT后发生END的独立危险因素(P<0.05)。根据独立危险因素建立脑卒中IVT后发生END的预测模型方程,采用Bootstrap法对预测模型进行内部验证,结果显示模型区分度良好,Calibration curve显示模型拟合度好,引入独立危险因素构建的诺莫图预测模型的AUC为0.928(95%CI:0.880~0.961,P<0.05),预测效能优于PNI、NLR单独预测(P<0.05)。结论入院NIHSS评分、HbA1c、责任血管狭窄程度及NLR和PNI是患者脑卒中IVT后发生END的影响因素,以此构建诺莫图预测模型区分度、拟合度良好,对发生END具有较高的预测价值。