Prognostic utility of gamma-glutamyl transpeptidase to platelet ratio in patients with solitary hepatitis B virus-related hepatocellular carcinoma after hepatectomy

BACKGROUND The prognostic impact of preoperative gamma-glutamyl transpeptidase to platelet ratio(GPR)levels in patients with solitary hepatitis B virus(HBV)-related hepatocellular carcinoma(HCC)following radical resection has not been established.AIM To examine the clinical utility of GPR for prognosis prediction in solitary HBVrelated HCC patients.METHODS A total of 1167 solitary HBV-related HCC patients were retrospectively analyzed.GPR levels were compared with 908 non-HCC individuals.Overall survival(OS)and recurrence-free survival(RFS)were evaluated,and cox proportional hazard model analyses were performed to identify independent risk factors.Differences in characteristics were adjusted by propensity score matching(PSM).Subgroup and stratified survival analyses for HCC risks were performed,and a linear trend of the hazard ratio(HR)according to GPR levels was constructed.RESULTS GPR levels of patients with solitary HBV-related HCC were higher than those with hepatic hemangiomas,chronic hepatitis B and healthy control(adjusted P<0.05).Variable bias was diminished after the PSM balance test.The low GPR group had improved OS(P<0.001)and RFS(P<0.001)in the PSM analysis and when combined with other variables.Multivariate cox analyses suggested that low GPR levels were associated with a better OS(HR=0.5,95%CI:0.36-0.7,P<0.001)and RFS(HR=0.57,95%CI:0.44-0.73,P<0.001).This same trend was confirmed in subgroup analyses.Prognostic nomograms were constructed and the calibration curves showed that GPR had good survival prediction.Moreover,stratified survival analyses found that GPR>0.6 was associated with a worse OS and higher recurrence rate(P for trend<0.001).CONCLUSION Preoperative GPR can serve as a noninvasive indicator to predict the prognosis of patients with solitary HBVrelated HCC.

基于B-W矩阵的老龄虚拟助手情感化设计研究

目的为探究老龄虚拟助手情感化设计,采用B-W矩阵对老龄虚拟助手开展设计研究,以提升老年人居家养老情感陪伴的幸福感。方法首先,通过对相关老龄人群进行访谈以得到31项设计要素,经偏态分析、T检验、同质性检验等方法对得到的设计要素进行验证。通过因子分析得到5类主因子,分别为外观、交互、情感、声音、场景因子。其次,通过B-W矩阵构建以进行设计要素归类,利用TOPSIS进行进一步的权重修正,按照Kano属性的剔除规则,得到29项针对老年人群的虚拟助手设计要素及其权重排序,推理得到老龄虚拟助手的设计策略。最后,根据设计策略对虚拟助手陪伴APP开展案例实践和评估,验证了老龄虚拟助手设计策略的可行性。结论研究结果为我国老龄虚拟助手设计提供了相关建议,可为相关虚拟助手设计领域提供参考。

热处理对铸态Fe-Cr-W-B合金微观结构与力学性能的影响

Fe-W-B系合金具有优异的核辐射屏蔽效果,在添加一定量的Cr元素后,原本粗大的脆性硼化物组织得到了一定的细化,但其塑韧性等力学性能依然较差。为进一步改善Fe-Cr-W-B合金的微观结构和力学性能,本文引入1200℃保温1 h的热处理工艺,研究其对铸造Fe-Cr-W-B合金微观结构和力学性能的影响。结果表明,铸态Fe-Cr-W-B合金以α-(Fe,Cr,W)为基体,以M_(3)B_(2)(M=W,Cr,Fe)为硼化物析出相,硼化物在晶界处呈连续网状分布,因而合金在变形过程中易形成应力集中而产生微小裂纹以致断裂,使得Fe-Cr-W-B合金塑韧性极差。经过1200℃保温1 h的热处理后,Fe-Cr-W-B合金基体中的过饱和W原子扩散进入硼化物,基体的固溶强化效应减弱,硬度降低,合金强度略有下降;但硼化物体积收缩,晶界处的连续网状结构断开,硼化物弥散分布,Fe-Cr-W-B合金的塑韧性得到较大改善。

激光熔覆工艺参数对Fe-W-B熔覆层质量的影响

采用激光熔覆技术在65Mn钢表面熔覆Fe-W-B三元硼化物熔覆层。通过单道熔覆与单层多道熔覆实验,探究激光功率、扫描速度、送粉速率、搭接率对熔覆层质量的影响,获得优化激光工艺参数组合。并通过光学显微镜、X射线衍射仪和维氏硬度计对熔覆层进行分析。结果表明:工艺参数对熔池高度与熔池宽度的影响程度由小到大排列为:送粉速率、扫描速度、激光功率,对维氏硬度的影响程度由小到大排列为:扫描速度、送粉速率、激光功率。获得的最优工艺参数组合为:激光功率800 W,扫描速度3 mm/s,送粉速率4 g/min,搭接率50%。此时熔覆层的维氏硬度均值为757.9 HV,是基材的3.5倍。熔覆层与基材冶金结合良好,其微观组织由枝状晶、胞状晶和柱状晶组成。

Lymphocyte-to-white blood cell ratio is associated with outcome in patients with hepatitis B virus-related acute-on-chronic liver failure

BACKGROUND The lymphocyte-to-white blood cell ratio(LWR)is a blood marker of the systemic inflammatory response.The prognostic value of LWR in patients with hepatitis B virus-associated acute-on-chronic liver failure(HBV-ACLF)remains unclear.AIM To explore whether LWR could stratify the risk of poor outcomes in HBV-ACLF patients.METHODS This study was conducted by recruiting 330 patients with HBV-ACLF at the Department of Gastroenterology in a large tertiary hospital.Patients were divided into survivor and non-survivor groups according to their 28-d prognosis.The independent risk factors for 28-d mortality were calculated by univariate and multivariate Cox regression analyses.Patients were divided into low-and high-LWR groups according to the cutoff values.Kaplan-Meier analysis was performed according to the level of LWR.RESULTS During the 28-d follow-up time,135 patients died,and the mortality rate was 40.90%.The LWR level in non-surviving patients was significantly decreased compared to that in surviving patients.A lower LWR level was an independent risk factor for poor 28-d outcomes(hazard ratio=0.052,95%confidence interval:0.005-0.535).The LWR level was significantly negatively correlated with the Child-Turcotte-Pugh,model for end-stage liver disease,and Chinese Group on the Study of Severe Hepatitis B-ACLF II scores.In addition,the 28-d mortality was higher for patients with LWR<0.11 than for those with LWR≥0.11.CONCLUSION LWR may serve as a simple and useful tool for stratifying the risk of poor 28-d outcomes in HBVACLF patients.

超过饱和固溶W-B合金力学性质的第一性原理研究

针对小原子元素在金属合金中可同时提高硬度和韧性的现象,本文采用基于第一性原理方法,研究了W-B合金的超过饱和固溶结构和力学性能.计算结果表明:无论是几何结构的晶格畸变,还是热力学上的结合能,B原子以置换形式固溶于W晶体中均优于其他固溶形式,这主要是由于置换B原子与周围W原子形成以共价型为主兼有离子型的键合作用.在合金中添加B元素虽然降低了合金材料的弹性模量,杨氏模量由414.34 GPa降低至338.36 GPa,但却显著增加了材料的韧性,B/G值由1.97提高到2.30(纯W晶体相较于B含量6.25 at.%时).并且合金的各向异性显著地减弱.另外,合金中B元素的添加,还使得材料理想剪切强度和最大应变值也得到了增加,分别由原来的19.981 GPa和0.187增加至21.814 GPa和0.209.这说明B元素在W合金中的超过饱和固溶不仅增加了合金的强度,还提高了合金的韧性.

急性B淋巴细胞白血病儿童乳酸脱氢酶、前白蛋白及二者比值与化疗早期疗效的相关性

目的:探讨急性B淋巴细胞白血病(B-ALL)患儿乳酸脱氢酶(LDH)、前白蛋白(PA)及二者比值(LPR)与化疗早期疗效的相关性。方法:选取2020年5月至2022年5月我院收治的B-ALL患儿126例,观察患儿初诊时(化疗前,T0)、化疗第3 d(T1)、化疗第33 d(T2)的LDH、PA水平及LPR值。按照化疗第33 d微小残留病比例,将患儿分为疗效良好组(n=94)和疗效不良组(n=32),采用logistic回归分析化疗早期疗效的影响因素。结果:T1时患儿LDH及LPR低于T0,且T2低于T1(P<0.05);T2时PA高于T1(P<0.05)。临床危险度为高危、T0-WBC≥100×10~9/L、T0及T2时的LPR较高是患儿化疗早期疗效不良的危险因素(P<0.05)。结论:化疗后,B-ALL患儿LDH及LPR呈逐渐下降趋势,PA呈逐渐上升趋势,LPR与患儿化疗早期疗效具有相关性。

Value of gamma-glutamyltranspeptidase-to-platelet ratio in diagnosis of hepatic fibrosis in patients with chronic hepatitis B

AIM To investigate the value of the gamma-glutamyltraspeptidase(GGT)-to-platelet(PLT) ratio(GPR) in the diagnosis of hepatic fibrosis in patients with chronic hepatitis B(CHB). METHODS We included 390 untreated CHB patients in this study. The GPR, aspartate aminotransferase(AST)-to-PLT ratio index(APRI), and fibrosis-4(FIB-4) of all patients were analysed to determine if these parameter were correlated with age, gender, medical history, liver function [total bilirubin(TBil), alanine aminotransferase(ALT), and AST], GGT, PLT count, or hepatic fibrosis stage. The GPR, APRI, and FIB-4, as well as the combination of the GPR and APRI or the GPR and FIB-4 were assessed in different cirrhosis stages using receiver operating characteristic(ROC) curve analysis to evaluate their value in diagnosing hepatic fibrosis in CHB patients. RESULTS The GPR, APRI, and FIB-4 were not correlated withCHB patients' age, gender, or disease duration(P > 0.05), but all of these parameters were positively correlated with serum ALT, AST, GGT, and PLT count(P < 0.01). Additionally, the GPR, APRI, and FIB-4 were positively correlated with hepatic fibrosis(P < 0.01); the areas under the ROC curve for the GPR in F1, F2, F3, and F4 stages were 0.723, 0.741, 0.826, and 0.833, respectively, which were significantly higher than the respective values for the FIB-4 and APRI(F1: 0.581, 0.612; F2: 0.706, 0.711; F3: 0.73, 0.751; and F4: 0.799, 0.778). The respective diagnostic cut-off points for each stage were 0.402, 0.448, 0.548, and 0.833, respectively. The diagnostic sensitivity and specificity were, respectively, 88.8% and 87.5% in F1, 72.7% and 89.7% in F2, 81.3% and 98.6% in F3, and 80% and 97.4% in F4 when the GPR and APRI were connected in parallel; 86.6% and 90.2%, 78.4% and 96%, 78.6% and 97.4%, and 73.2% and 97.9%, respectively, when the GPR and APRI were connected in series; 80.2% and 89%, 65% and 89%, 70.3% and 98.5%, and 78.8% and 96.8%, respectively, when the GPR and FIB-4 were connected in parallel; and 83.6% and 87.9%, 76.8% and 96.6%, 72.7% and 98%, and 74.4% and 97.7%, respectively, when the GPR and FIB-4 were connected in series.CONCLUSION The GPR, as a serum diagnostic index of liver fibrosis, is more accurate, sensitive, and easy to use than the FIB-4 and APRI, and the GPR can significantly improve the sensitivity and specificity of hepatic fibrosis diagnosis in CHB when combined with the FIB-4 or APRI.

Is the neutrophil to lymphocyte ratio associated with liver fibrosis in patients with chronic hepatitis B?

AIM: To determine the association between the neutrophil to lymphocyte(N/L) ratio and the degree of liver fibrosis in patients with chronic hepatitis B(CHB) infection. METHODS: Between December 2011 and February 2013, 129 consecutive CHB patients who were admitted to the study hospitals for histological evaluation of chronic hepatitis B-related liver fibrosis were included in this retrospective study. The patients were divided into two groups based on the fibrosis score: individuals with a fibrosis score of F0 or F1 were included in the "no/minimal liver fibrosis" group, whereas patients with a fibrosis score of F2, F3, or F4 were included in the "advanced liver fibrosis" group. The Statistical Package for Social Sciences 18.0 for Windows was used to analyze the data. A P value of < 0.05 was accepted as statistically significant.RESULTS: Three experienced and blinded pathologists evaluated the fibrotic status and inflammatory activity of 129 liver biopsy samples from the CHB patients. Following histopathological examination, the "no/minimal fibrosis" group included 79 individuals, while the "advanced fibrosis" group included 50 individuals. Mean(N/L) ratio levels were notably lower in patients with advanced fibrosis when compared with patients with no/minimal fibrosis. The mean value of the aspartate aminotransferase-platelet ratio index was markedly higher in cases with advanced fibrosis compared to those with no/minimal fibrosis.CONCLUSION: Reduced levels of the peripheral blood N/L ratio were found to give high sensitivity, specificity and predictive values in CHB patients with significant fibrosis. The prominent finding of our research suggests that the N/L ratio can be used as a novel noninvasive marker of fibrosis in patients with CHB.

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.

Combined Hangzhou criteria with neutrophillymphocyte ratio is superior to other criteria in selecting liver transplantation candidates with HBV-related hepatocellular carcinoma

BACKGROUND： The elevation of neutrophil-lymphocyte ratio （NLR） has adverse effects on the prognosis of patients with hepatocellular carcinoma （HCC） who have received liver transplantation （LT）. The Hangzhou criteria are set for selecting HCC patients for LT. The present study aimed to establish a set of new criteria combining the NLR and Hangzhou crite- ria for selecting HCC patients for LT.

多组元Fe-W-B合金本构方程及热加工图的研究

为解决铸造高硼合金难热加工以及硼化物呈网状分布的问题,本文以多组元Fe-W-B合金为例,采用Gleeble-3500热模拟实验机研究了其在变形温度800℃~1150℃、应变速率0.01s-1~10s-1条件下的高温流变行为。结果表明,多组元Fe-W-B合金的高温流变应力状态主要受温度和应变速率影响,具体表现为流变应力随着应变速率降低和变形温度升高而减小,真应力一应变曲线表现出动态回复型和动态再结晶型特征。本文还构建了Arrhenius型热变形本构方程并对其准确性进行了验证;根据热加工图确定了多组元Fe-W-B合金最佳热加工窗口并进行锻造验证。锻后,多组元Fe-W-B合金中的网状硼化物被有效破碎并且力学性能大幅提升。

Effect of Hydration Aging and Water Binder Ratio on Microstructure and Mechanical Properties of Sprayed Concrete

In order to study the durability of sprayed concrete （shotcrete）, effects of different hydration aging and water-binder ratio （w/b） on the microstructure of cement paste and basic mechanical properties of test specimens were investigated. The phase composition, mass percentage of ettringite and portland in hydration production and microstructure were characterized by X-ray diffraction （XRD）, thermo gravimetry-differential scanning calorimetry （TG-DSC） and scanning electron microscopy （SEM）, respectively. The experimental results showed that changes in phase composition was more significant than those of water-binder ratio. With hydration aging and water-binder ratio increased, the mass percentage of ettringite and portland was decreased from 4.42%, 1.49% to 3.31%, 1.35%, respectively and the microstructure of paste was significantly compacted. Likewise, the mechanical properties including cubic compressive strength and splitting tensile strength were rised obviously.

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.

The Hydration of Blended Cement at Low W/B Ratio

The hydration process,hydration product and hydration heat of blended cement paste mixed with mineral admixture and expansive agent at low W/B ratio are studied by XRD,thermo analysis,and calorimetry instrument,and they were compared with those of pure cement paste.The results show that pure cement and blended cement at low W/B ratio have the same types of hydration products,but their respective amounts of hydration products of various blended cements at same ages and the variation law of the amount of same hydration products with ages are different;The joint effect of tumefaction of gel-ettringite due to water absorption and the expansive pressure on the pore and rift caused by the crystalloid ettringite is the impetus of the volume expansion of cement paste,and the former effect is much greater than the latter one.

T-SPOT联合颗粒酶B阳性Ts淋巴细胞对成人结核病诊断的价值

目的探讨结核感染T细胞斑点试验(T-SPOT.TB)联合颗粒酶B(GrB)+CD8^(+)T淋巴细胞在诊断结核病中的价值。方法选取南昌大学第一附属医院2021年2月至2022年3月疑似结核病患者212例,所有患者均保留T-SPOT结果,流式细胞仪检测外周血中T淋巴细胞亚群及其穿孔素和GrB的表达,根据出院最终诊断分为结核病组和非结核病组,比较两组间T-SPOT斑点数和淋巴细胞亚群及其穿孔素和GrB表达差异,ROC曲线分析ESAT-6斑点数,CFP-10斑点数,结核特异性抗原(TBAg)与植物血凝素(PHA)斑点数的比值(TBAg/PHA)(ESAT-6/PHA和CFP-10/PHA中较大的一个),GrB^(+)Ts(CD8^(+)T)及“结核比值”[TBAg/(PHA*GrB^(+)Ts)]的诊断效能。结果GrB^(+)Ts细胞百分比在结核组中显著高于非结核组(44.95±2.98 vs 33.49±1.87,P<0.05),而总T细胞、穿孔素+T细胞,GrB^(+)T细胞,Ts细胞和穿孔素+Ts细胞百分比差异无统计学意义(P>0.05);非结核组T-SPOT.TB阳性率为51.85%,明显低于结核组的92%,且结核组的A抗原斑点数及B抗原斑点数显著大于非结核组(P<0.05),ROC曲线显示A抗原诊断结核病的灵敏度和特异性分别为80.0%和56.8%,曲线下面积(AUC)为0.748,约登指数为0.368;B抗原的灵敏度和特异性为分别62.0%和77.8%,AUC为0.758,约登指数为0.398;A抗原+B抗原灵敏度和特异性为72.0%和74.1%,AUC为0.796,约登指数为0.461;结核组的TBAg/PHA比率要显著高于非结核组(1.21±0.17 vs 0.26±0.02,P<0.001)以0.59为cut-off值时,诊断结核病的灵敏度和特异性分别为66%和91.4%,AUC高达0.852,约登指数为0.574;结核组的“结核比值”要显著高于非结核组(4.58±0.87 vs 1.71±0.24,P<0.01),以1.24为cut-off值时,诊断结核病的灵敏度和特异性分别为82.0%和72.2%,AUC为0.794,约登指数为0.542。结论应用TBAg/PHA比率和TBAg/(PHA*GrB^(+)Ts)比值诊断结核病的效能要优于常规的T-SPOT检测,两者结合使用对结核病诊断可能具有重要价值。

Change of the mode of failure by interface friction and width-to-height ratio of coal specimens

Bumps in coal mines have been recognized as a major hazard for many years. These sudden and violent failures around mine openings have compromised safety, ventilation and access to mine workings.Previous studies showed that the violence of coal specimen failure depends on both the interface friction and width-to-height（W/H） ratio of coal specimen. The mode of failure for a uniaxially loaded coal specimen or a coal pillar is a combination of both shear failure along the interface and compressive failure in the coal. The shear failure along the interface triggered the compressive failure in coal. The compressive failure of a coal specimen or a coal pillar can be controlled by changing its W/H ratio. As the W/H ratio increases, the ultimate strength increases. Hence, with a proper combination of interface friction and the W/H ratio of pillar or coal specimen, the mode of failure will change from sudden violent failure which is brittle failure to non-violent failure which is ductile failure. The main objective of this paper is to determine at what W/H ratio and interface friction the mode of failure changes from violent to non-violent. In this research, coal specimens of W/H ratio ranging from 1 to 10 were uniaxially tested under two interface frictions of 0.1 and 0.25, and the results are presented and discussed.

HBC患者RDW、PA、WPR的水平变化和临床意义

目的探讨乙肝肝硬化(HBC)患者红细胞分布宽度(RDW)、前白蛋白(PA)、白细胞(WBC)、血小板(PLT)、白细胞比血小板(WPR)的水平变化,分析其临床意义。方法遴选2020年1月到2022年10月就诊于安徽理工大学第一附属医院的HBC患者120例作为研究组,根据Child-pugh分级将研究组分为3组:A组50例、B组44例、C组26例。将同时段120名健康检查者作为对照组。检测并分析患者RDW、PLT、PA、WBC、WPR水平变化,运用受试者工作特征曲线(ROC)评估其诊断价值。结果RDW、PA、PLT、PA、WBC、WPR在对照组和研究组之间存在明显差异(P<0.01)。RDW、PA在Child-pugh分级分组方面差异显著(P<0.01)。RDW与Child-pugh分级显著正相关(P<0.01),WBC与Child-pugh分级正相关(P<0.05),PA与Child-pugh分级显著负相关(P<0.01)。ROC曲线分析结果显示RDW、WPR对乙肝肝硬化的诊断均具有统计学意义(P<0.01),二者联合检测的特异性和敏感性分别为84.2%和98.3%,AUC值为0.961,高于单个指标检测(P<0.01)。结论RDW、WBC、PA与Child-pugh分级具有相关性,可以作为HBC患者病情轻重程度的参考指标。RDW、WPR可以作为诊断HBC的临床指标。

Total cholesterol to high-density lipoprotein ratio and nonalcoholic fatty liver disease in a population with chronic hepatitis B

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is characterized by hypertriglyceridemia,increased low-density lipoprotein cholesterol levels,and reduced highdensity lipoprotein cholesterol(HDL-C)particles.Previous studies have shown that the total cholesterol to high-density lipoprotein cholesterol ratio(TC/HDL-C)was superior to other lipid metabolism biomarkers for predicting NAFLD risk and could be a new indicator of NAFLD.However,the association between TC/HDL-C and NAFLD in patients with hepatitis B virus(HBV)has not yet been determined.AIM To investigate the association between TC/HDL-C and NAFLD in a population with chronic hepatitis B(CHB).METHODS In this study,183 HBV-infected patients were enrolled.All participants underwent blood chemistry examinations and abdominal ultrasound.Univariate and multivariate logistic regression models,curve fitting analysis,and threshold calculation were used to assess the relationship between TC/HDL-C and NAFLD.RESULTS The overall prevalence of NAFLD was 17.49%(n=32)in the 183 CHB participants.The TC/HDL-C of non-NAFLD and NAFLD patients were 3.83±0.75 and 4.44±0.77,respectively(P<0.01).Logistic regression analysis showed that TC/HDL-C was not associated with NAFLD after adjusting for other pertinent clinical variables.However,at an optimal cutoff point of 4.9,a non-linear correlation between TC/HDL-C and NAFLD was detected.The effect size of the left and right sides of the inflection point were 5.4(95%confidence interval:2.3-12.6,P<0.01)and 0.5(95%confidence interval:0.1-2.2,P=0.39),respectively.On the left side of the inflection point,TC/HDL-C was positively associated with NAFLD.However,no significant association was observed on the right side of the inflection point.CONCLUSION This study demonstrated a non-linear correlation between TC/HDL-C and NAFLD in a population with CHB.TC/HDL-C was positively associated with NAFLD when TC/HDL-C was less than 4.9 but not when TC/HDL-C was more than 4.9.

外周血血小板与淋巴细胞的比值及淋巴细胞与单核细胞的比值与老年眼眶弥漫性大B细胞淋巴瘤的相关性

目的探讨外周血常规检测各项指标及比值与眼眶弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)的相关性。方法本研究为病例对照研究,收集2015年1月-2022年12月于复旦大学附属肿瘤医院确诊为眼眶DLBCL老年患者作为疾病组(眼眶DLBCL组),原发性中枢神经系统DLBCL患者作为疾病对照组(PCNSL-DLBCL组),以及健康人群作为健康对照组。使用方差分析比较3组间血常规检测的各项参数的差异。Lasso回归筛选出眼眶DLBCL的关键因素,并通过Logistic回归确认。绘制ROC曲线,计算线下面积。结果3组之间年龄与性别相匹配(P>0.05)。相较于健康对照组,眼眶DLBCL组的单核细胞计数(M)、血小板与淋巴细胞的比值(PLR)、中性粒细胞与淋巴细胞的比值(NLR)、系统性免疫炎症指数(SII)、红细胞分布宽度(RDW)、乳酸脱氢酶(LDH)显著升高,而淋巴细胞计数(L)、淋巴细胞与单核细胞比值(LMR)显著降低,差异均具有统计学意义(P<0.05)。Lasso回归分析显示,PLR和LMR是眼眶DLBCL病变的重要影响因素。进一步Logistic回归分析发现,L降低(OR,11.1868;95%CI,4.222229.6401;P<0.0001)、M升高(OR,1.8990;95%CI,1.488929.6401;P<0.0001)、PLR升高(OR,1.0609;95%CI,1.02251.1009;P=0.0017)和NLR升高(OR,4.5157;95%CI,2.71277.5170;P<0.0001)是眼眶DLBCL的独立危险因素,而LMR升高是DLBCL的保护因素(OR,0.3923;95%CI,0.22970.6698;P=0.006)。ROC曲线分析发现,PLR与LMR联合运用对眼眶DLBCL具有一定的诊断价值(AUC=0.877)。结论外周血PLR和LMR与眼眶DLBCL相关。PLR升高和LMR减低可能是眼眶DLBCL病变的危险因素,为疾病探索新的生物标志物提供初步临床检验学证据。