Systemic Inflammation Response Index and weight loss as prognostic factors in metastatic pancreatic cancer: A concept study from the PANTHEIA-SEOM trial

BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AIM To study the prognostic significance of SIRI and weight loss in metastatic pancreatic cancer.METHODS The PANTHEIA-Spanish Society of Medical Oncology(SEOM)study is a multicentric(16 Spanish hospitals),observational,longitudinal,non-interventional initiative,promoted by the SEOM Real World-Evidence work group.This pilot study sought to analyze the association between weight loss and inflammatory status as defined by SIRI.The cohort stems from a proof-of-concept pilot study conducted at one of the coordinating centers.Patients with pathologically confirmed metastatic pancreatic adenocarcinoma,treated from January 2020 to January 2023,were included.The index was calculated using the product of neutrophil and monocyte counts,divided by lymphocyte counts,obtained within 15 days before initiation chemotherapy.This study evaluated associations between overall survival(OS),SIRI and weight loss.RESULTS A total of 50 patients were included.66%of these patients were male and the median age was 66 years.Metastasis sites:36%liver,12%peritoneal carcinomatosis,10%lung,and 42%multiple locations.Regarding the first line palliative chemotherapy treatments:50%received gemcitabine plus nab-paclitaxel;28%,modified fluorouracil,leucovorin,irinotecan and oxaliplatin,and 16%were administered gemcitabine.42%had a weight loss>5%in the three months(mo)preceding diagnosis.21 patients with a SIRI≥2.3×10^(3)/L exhibited a trend towards a lower median OS compared to those with a SIRI<2.3×10^(3)/L(4 vs 18 mo;P<0.000).Among 21 patients with>5%weight loss before diagnosis,the median OS was 6 mo,in contrast to 19 mo for those who did not experience such weight loss(P=0.003).Patients with a weight loss>5%showed higher SIRI levels.This difference was statistically significant(P<0.000).For patients with a SIRI<2.3×10^(3)/L,those who did not lose>5%of their weight had an OS of 20 mo,compared to 11 mo for those who did(P<0.001).No association was found between carbohydrate antigen 19-9 levels≥1000 U/mL and weight loss.CONCLUSION A higher SIRI was correlated with decreased survival rates in patients with metastatic pancreatic cancer and associated with weight loss.An elevated SIRI is suggested as a predictor of survival,emphasizing the need for prospective validation in the upcoming PANTHEIA-SEOM study.

Effects of serum inflammatory factors,health index and disease activity scores on ankylosing spondylitis patients with sleep disorder

BACKGROUND Patients with ankylosing spondylitis(AS)frequently suffer from comorbid sleep disorders,exacerbating the burden of the disease and affecting their quality of life.AIM To investigate the clinical significance of serum inflammatory factors,health index and disease activity scores in patients with AS complicated by sleep disorders.METHODS A total of 106 AS patients with comorbid sleep disorders were included in the study.The patients were grouped into the desirable and undesirable prognosis groups in accordance with their clinical outcomes.The serum levels of inflammatory factors,including C-reactive protein,erythrocyte sedimentation rate,interleukin(IL)-6,tumour necrosis factor-αand IL-1β,were measured.Disease activity scores,such as the Bath AS functional index,Bath AS disease activity index,Bath AS metrology index and AS disease activity score,were assessed.The health index was obtained through the Short Form-36 questionnaire.RESULTS The study found significant associations amongst serum inflammatory factors,health index and disease activity scores in AS patients with comorbid sleep disorders.Positive correlations were found between serum inflammatory factors and disease activity scores,indicating the influence of heightened systemic inflammation on disease severity and functional impairment.Conversely,negative correlations were found between disease activity scores and health index parameters,highlighting the effect of disease activity on various aspects of healthrelated quality of life.Logistic regression analysis further confirmed the predictive value of these factors on patient outcomes,underscoring their potential utility in risk assessment and prognostication.CONCLUSION The findings demonstrate the intricate interplay amongst disease activity,systemic inflammation and patientreported health outcomes in AS patients complicated by sleep disorders.The results emphasise the need for comprehensive care strategies that address the diverse needs and challenges faced by these patients and underscore the potential relevance of serum inflammatory factors,health index and disease activity scores as prognostic markers in this patient population.

Novel prognostic factors after radical resection of hepatocellular carcinoma: Updating an old issue

In this editorial,I comment on the article by Li et al published in the recent issue of the World Journal of Gastrointestinal Surgery in 2023,investigating the role of some novel prognostic factors for early survival after radical resection of liver cancer.Liver cancer is an important burden among Asian and Western popu-lations,despite recent advances in both medicine(from virus eradication to systemic target therapies)and surgery.However,survival after proven radical surgery remains poor,with recurrences being the rule.Many prognostic scores have been developed and validated to select those patients who will best benefit from radical liver surgery,although the final general and oncological outcomes continue to be highly jeopardized.Unfortunately,no single biomarker can resolve all these issues for hepatocellular carcinoma,and it remains to be proven whether some of them main-tain predictive power in the long-term follow-up.In the ongoing era of“preci-sion”medicine,the novel prognostic markers,including immune inflammatory and nutritional indexes could be of great help in better stratify surgical candi-dates.

Joint Detection of Serum Vitamin D,Body Mass Index,and Tumor Necrosis Factor Alpha for the Diagnosis of Crohn’s Disease

Objective Vitamin D(VD)deficiency was reported to contribute to the progression of Crohn’s disease(CD)and affect the prognosis of CD patients.This study investigated the role of serum VD,body mass index(BMI),and tumor necrosis factor alpha(TNF-α)in the diagnosis of Crohn’s disease.Methods CD patients(n=76)and healthy subjects(n=76)were enrolled between May 2019 and December 2020.The serum 25-hydroxyvitamin D[25(OH)D]levels,BMI,and TNF-αlevels,together with other biochemical parameters,were assessed before treatment.The diagnostic efficacy of the single and joint detection of serum 25(OH)D,BMI,and TNF-αwas determined using receiver operating characteristic(ROC)curves.Results The levels of 25(OH)D,BMI,and nutritional indicators,including hemoglobin,total protein,albumin,and high-density lipoprotein cholesterol,were much lower,and the TNF-αlevels were much higher in the CD patients than in the healthy subjects(P<0.05 for all).The areas under the ROC curve for the single detection of 25(OH)D,BMI,and TNF-αwere 0.887,0.896,and 0.838,respectively,with the optimal cutoff values being 20.64 ng/mL,19.77 kg/m^(2),and 6.85 fmol/mL,respectively.The diagnostic efficacy of the joint detection of 25(OH)D,BMI,and TNF-αwas the highest,with an area under the ROC curve of 0.988(95%CI:0.968–1.000).Conclusion The joint detection of 25(OH)D,TNF-α,and BMI showed high sensitivity,specificity,and accuracy in CD diagnosis;thus,it would be effective for the diagnosis of CD in clinical practice.

Real-time Three-dimensional Echocardiographic Assessment of Left Ventricular Remodeling Index in Patients with Hypertensive Heart Disease and Coronary Artery Disease

Left ventricular remodeling index （LVRI） was assessed in patients with hypertensive heart disease （HHD） and coronary artery disease （CAD） by real-time three-dimensional echocardiography （RT3DE）. RT3DE data of 18 patients with HHD, 20 patients with CAD and 22 normal controis （NC） were acquired. Left ventricular end-diastolic volume （EDV） and left ventricular end-diastolic epicardial volume （EDVepi） were detected by RT3DE and two-dimensional echocardiography Simpson biplane method （2DE）. LVRI （left ventricular mass/EDV） was calculated and compared. The results showed that LVRI measurements detected by RT3DE and 2DE showed significant differences inter-groups （P〈0.01）. There was no significant difference in NC group （P〉0.05）, but significant difference in HHD and CAD intra-group （P〈0.05）. There was good positive correlations between LVRI detected by RT3DE and 2DE in NC and HHD groups （t=0.69, P〈0.01; r=0.68, P〈0.01）, but no significant correlation in CAD group （r=0.30, P〉0.05）. It was concluded that LVRI derived from RT3DE as a new index for evaluating left ventricular remodeling can provide more superiority to LVRI derived from 2DE.

An Assessment of Heavy-Metal Contamination in Soils within Auto-Mechanic Workshops Using Enrichment and Contamination Factors with Geoaccumulation Indexes

Soil characterization and heavy metals in different layers (0 - 15 cm;15 - 30 cm and 30 - 45 cm depth) of automobile mechanic waste dumps were studied. The soils showed remarkably high levels of all the metals above background concentrations with most (Ni, Cu, Fe, Cr and Cd) decreasing with soil depth. The distribution pattern were in the following order Fe > Cu > Zn > Pb > Cr > Ni > Cd. Across all the sampling locations and profiles, Fe and Cd showed the highest (476.4 μg·g-1) and least (37.5 μg·g-1) mean concentrations respectively. Pollution load index (PLI) and index of geoaccumulation (Igeo) revealed overall high and moderate contamination respectively but the enrichment factors (EFs) for Pb Ni and Cd are severe. The inter-element relationship revealed the identical source of elements in the soils of the studied area. The accuracy of the results has been cheeked using the standard reference material;SRM (PACS-2). The mechanic waste dumps represent potential sources of heavy metal pollution to environment. The elevated levels of heavy metals in these soil profiles constitute a serious threat to both surface and groundwater.

Three-dimensional-arterial spin labeling perfusion correlation with diabetes-associated cognitive dysfunction and vascular endothelial growth factor in type 2 diabetes mellitus rat

BACKGROUND Type 2 diabetes mellitus(T2DM) has been strongly associated with an increased risk of developing cognitive dysfunction and dementia.The mechanisms of diabetes-associated cognitive dysfunction(DACD) have not been fully elucidated to date.Some studies proved lower cerebral blood flow(CBF) in the hippocampus was associated with poor executive function and memory in T2DM.Increasing evidence showed that diabetes leads to abnormal vascular endothelial growth factor(VEGF) expression and CBF changes in humans and animal models.In this study,we hypothesized that DACD was correlated with CBF alteration as measured by three-dimensional(3D) arterial spin labeling(3D-ASL) and VEGF expression in the hippocampus.AIM To assess the correlation between CBF(measured by 3D-ASL and VEGF expression) and DACD in a rat model of T2DM.METHODS Forty Sprague-Dawley male rats were divided into control and T2DM groups.The T2DM group was established by feeding rats a high-fat diet and glucose to induce impaired glucose tolerance and then injecting them with streptozotocin to induce T2DM.Cognitive function was assessed using the Morris water maze experiment.The CBF changes were measured by 3D-ASL magnetic resonance imaging.VEGF expression was determined using immunofluorescence.RESULTS The escape latency time significantly reduced 15 wk after streptozotocin injection in the T2DM group.The total distance traveled was longer in the T2DM group;also,the platform was crossed fewer times.The percentage of distance in the target zone significantly decreased.CBF decreased in the bilateral hippocampus in the T2DM group.No difference was found between the right CBF value and the left CBF value in the T2DM group.The VEGF expression level in the hippocampus was lower in the T2DM group and correlated with the CBF value.The escape latency negatively correlated with the CBF value.The number of rats crossing the platform positively correlated with the CBF value.CONCLUSION Low CBF in the hippocampus and decreased VEGF expression might be crucial in DACD.CBF measured by 3D-ASL might serve as a noninvasive imaging biomarker for cognitive impairment associated with T2DM.

Effects of Yinzhihuang oral liquid and albumin on bilirubin, inflammatory factors, immune indexes and related factors in neonatal pathologic jaundice

Objective: To explore the effects of Yinzhihuang oral liquid and albumin on bilirubin, inflammatory factors, immune indexes and related factors in neonatal pathologic jaundice. Methods: A total of 134 neonates with pathologic jaundice admitted to our hospital from May 2017 to April 2018 were randomly selected as the control group (n=67) and the observation group (n=67), the control group was treated with albumin, the observation group was treated with Yinzhihuang Oral Liquid on the basis of the control group. The bilirubin, inflammatory factors, immune indicators, alpha-fetoprotein (AFP) and transferrin (TRF) were compared and analyzed before and after treatment. Results: After treatment, the levels of TBIL, DBIL and IBIL in both groups were significantly lower than those before treatment (P<0.05), and the levels of TBIL, DBIL and IBIL [(118.60±10.85) μmol/L, (6.95±1.52) μmol/L, (115.30±14.20)μmol/L] in observation group were significantly lower than those in control group;the levels of CRP and IL-6 in both groups were significantly lower than those before treatment (P<0.05), and the levels of CRP and IL-6 [(8.26±2.07) mg/L, (12.69±2.15) pg/mL] in observation group were significantly lower than those in control group (P<0.05);the levels of CD4+, CD4+/CD8+ in both groups were significantly higher than those before treatment (P<0.05), while the levels of CD8+ was significantly lower than that before treatment, the levels of CD4+, CD4+/CD8+ [(47.08±5.70)%, (2.08±0.41)] in observation group were significantly higher than those in control group (P<0.05), and the level of CD8+ [(22.90±2.05)%] was significantly lower than that in control group (P<0.05);the levels of AFP in significantly higher than before treatment (P<0.05), and the levels of AFP [(12.69±3.04)mg/L] in observation group were significantly lower than those in control group (P<0.05), the levels of TRF [(2.02±0.35) g/L] were significantly higher than those in control group (P<0.05). Conclusions: The combination of Yinzhihuang oral liquid and albumin can effectively reduce the bilirubin level in neonatal jaundice, inhibit its inflammatory reaction, enhance the cellular immune function and improve the expression of AFP and TRF, which is of clinical significance.

Correlation of coronary CTA calcification score with serum inflammatory factors and plaque stability-related indexes in patients with coronary heart disease

Objective: To investigate the correlation of coronary CTA calcification score (CACS) with serum inflammatory factors and plaque stability-related indexes in patients with coronary heart disease. Methods: A total of 228 patients with possible coronary heart disease who were examined in this hospital between November 2014 and March 2017 were selected, and the CACS levels as well as the serum contents of inflammatory factors and plaque stability indexes in patients with different lesions were determined. Pearson test was used to assess the correlation between CACS level and disease severity in patients with coronary heart disease. Results: The CACS level of triple vessel disease group was higher than that of double vessel disease group and single vessel disease group, and the CACS level of double vessel disease group was higher than that of single vessel disease group;serum sICAM-1, IL-6, IL-18, CRP, PTX3, Lp-PLA2 and Cat K contents were higher than those of double vessel disease group and single vessel disease group;serum sICAM-1, IL-6, IL-18, CRP, PTX3, Lp-PLA2 and Cat K contents of double vessel disease group were higher than those of single vessel disease group;serum Cys C content of triple vessel disease group was lower than that of double vessel disease group and single vessel disease group, and serum Cys C content of double vessel disease group was lower than that of single vessel disease group. Pearson test showed that the CACS level in patients with coronary heart disease was directly correlated with serum contents of inflammatory factors and plaque stability indexes. Conclusion: The CACS levels in patients with coronary heart disease increase with the aggravation of disease, and the specific CACS level is directly correlated with the degree of inflammatory response and the stability of the plaques.

CONVOLUTION OF THE IMPACT THREE-DIMENSIONAL ELASTO-DYNAMICS AND DYNAMIC STRESS INTENSITY FACTOR FOR AN ELLIPTIC CRACK

This paper presents a formulation for three-dimensional elasto-dynamics with an elliptic crack based on the Laplace and Fourier transforms and the convolution theorem. The dynamic stress intensity factor for the crack is determined by solving a Fredholm integral equation of the first kind. The results of this paper are very close to those given by the two-dimensional dual integral equation method.

Risk factors and ankle brachial indexes in cerebral infarction combined with peripheral arterial disease

BACKGROUND: Ankle brachial index (ABI) is widely involved in researches and clinical application of peripheral vascular injury of patients with diabetes mellitus (DM); however, the application in cerebral infarction (CI) is rare. OBJECTIVE: To investigate the possible risk factor of cerebral infarction plus peripheral arterial disease (PAD), compare metabolic characteristics of patients who having CI plus PAD or only having CI, and understand the significance of ABI on screening and diagnosing CI plus PAD of lower limb. DESIGN: Contrast observation based on CI patients. SETTING: Department of Neurology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region. PARTICIPANTS: A total of 124 CI patients were selected from Department of Neurology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2005 to April 2006, including 72 males and 52 females aged from 45 to 88 years. All patients met the diagnostic criteria of cerebrovascular disease established by National Academic Conference of Cerebrovascular Diseases in 1995 and determined as cerebral infarction with MRI or CT examination. All patients provided informed consent. There were 46 cases (37.2%) with CI plus PAD and 78 cases (62.8%) only with CI. METHODS: Blood pressure of bilateral ankles and upper extremities was measured at plain clinostatism with DINAMAP blood pressure monitor (GE Company). The ratio between average systolic pressure of lateral ankle and average systolic pressure of both upper extremities was regarded as ABI. The normal ABI was equal to or more than 0.9. If ABI < 0.9 occurred at one side, patients were diagnosed as PAD. On the second morning after hospitalization, blood was collected to measure fasting blood glucose (FBG), 2-hour postprandial blood glucose (PBG2h), glycosylated hemoglobin (HbA1c), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Among them, blood glucose, lipid and other biochemical markers were measured with enzyme chemistry assay and HbA1c was measured with HbA1c meter based on high liquid phase. Measurement data and enumeration data were compared with t test and Chi-square test, and multiple factors were dealt with Logistic regression analysis and multivariate linear regression analysis. MAIN OUTCOME MEASURES: Results of correlation between ABI and metabolic markers with multivariate linear regression analysis; risk factors of CI plus PAD with Logistic regression analysis; comparisons of metabolic markers between PAD and non-PAD patients. RESULTS: All 124 patients with acute CI were involved in the final analysis. ① Comparisons of metabolic markers: Levels of serum LDL-C and uric acid (UA) were higher of PAD patients than those of non-PAD patients (t =2.051 9, 3.339 1, P < 0.05); however, there were no significant differences among other metabolic markers (P > 0.05). ② Results of multivariate linear regression analysis: PBG2h, LDL-C and UA were obvious correlation with ABI of posterior tibial artery of lower limb and dorsal pedis artery (partial regression coefficient = -0.231 to -1.010, P < 0.05). ③ Risk factors of CI plus PAD with Logistic regression analysis: Age, smoking history, sum of CI focus (≥3) and LDL-C were independent risk factor of CI plus PAD (OR =1.524-5.422, P < 0.05-0.01). CONCLUSION: ① Levels of serum LDL-C and UA of patients with CI plus PAD are high. ② ABI of lower limbs is correlation with PBG2h, LDL-C and UA. In addition, measuring ABI is beneficial for early diagnosing PAD of lower limbs of patients who have poorly controlled blood glucose, abnormal lipid and poor renal function. ③ Age, LDL-C and sum of CI focus (≥3) are independent risk factors of CI plus PAD. It is of significance for screening non-PAD patients to evaluate risk degrees and prognosis and select therapeutic methods based on ABI measurement.

Effect of Kangfuxin solution on inflammatory, immune, oxidative indexes and vascular factors in patients with ulcerative colitis

Objective:To explore the effect of Kangfuxin solution on inflammatory, immune, oxidative indexes and vascular factorsin patients with ulcerative colitis.Methods: 172 cases of ulcerative colitis from August 2015 to February 2017 were selected and divided into control group (n=86) and observation group (n=86) according to random principle, the control group was treated with Mesalazin Enteric-coated Tablets, and the observation group was treated with enema by infusion of rectal drip on the basis of the control group, and the levels of the two groups of inflammatory factors, immune indexes, oxidation indexes and vascular factors were compared.Results: After treatment, the total effective rate of the observation group (88.37%) was significantly higher than that of the control group (73.26%) (P<0.05);the two groups of CRP and TNF-α were significantly lower than those before treatment (P<0.05), and the observation group was significantly lower than that of the control group (P<0.05);the two groups of CD4+, CD4+/CD8+ and SOD increased significantly compared with those before treatment (P<0.05), while CD8+, MDA and LOP were significantly lower than those before treatment (P<0.05), and the CD4+, CD4+/CD8+ and SOD in the observation group were significantly higher than those in the control group (P<0.05), while CD8+, MDA and LOP were significantly lower than those in the control group (P<0.05);The levels of VEGF and PDGF in both groups were significantly higher than those before treatment (P<0.05), and the levels of VEGF and PDG in observation group were significantly higher than those in control group (P<0.05).Conclusions:The combined treatment of Kangfuxin Liquid and mesalazine can significantly improve the clinical efficacy of the patients. The mechanism of its action is related to reducing the inflammatory response and enhancing the immune, antioxidant functionsand vascular factors. It is worthy of further study in clinical.

Effect of peritoneal dialysis on inflammatory factors, nutritional index and renal function in patients with chronic renal failure

Objective:To explore the effect of peritoneal dialysis on inflammatory factors, nutritional index and renal function indexes in patients with chronic renal failure, and to provide help for clinical treatment of patients with chronic renal failure. Methods:80 cases of chronic renal failure patients in our hospital were selected as the study group, given peritoneal dialysis treatment;80 healthy people during the same period in our hospital selected as the normal group. The inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and IL-8], renal function indices [BUN (Urea nitrogen) and SCR (serum creatinine)] and nutritional index [PA (prealbumin), Hb (hemoglobin), ALB (albumin) and TF (Transferrin)] levels were detected in healthy population and patients with chronic renal failure patients before and after treatment of 1 and 30 d, and the relative significance was analyzed. Results:Compared with the normal group, the inflammatory factors (CRP, IL-6, TNF-αand IL-8) and renal function indices (BUN and SCR) of patients with chronic renal failure in study group increased significantly and nutritional indexes (TF, PA and ALB) decreased significantly (P<0.05). The inflammatory factors (CRP, IL-6, TNF-αand IL-8), nutritional index (TF, PA and ALB) and renal function indices (BUN and SCR) of patients with chronic renal failure by peritoneal dialysis in the treatment of 1 d in research group were significantly lower than the level before treatment, and Hb was significantly higher than that before treatment (P<0.05). After 30 d of dialysis, inflammatory factors (CRP, IL-6, TNF-αand IL-8), nutritional index (TF, PA and ALB) and renal function indices (BUN and SCR) decreased further and Hb increased further (P<0.05). Conclusions:Peritoneal dialysis can improve the inflammatory factors levels of patients with chronic renal failure, reduce the renal function index, and can affect the nutritional index of patients, and has important significance in clinical treatment of patients with chronic renal failure.

Study on Characteristics and Influencing Factors of Coagulation Indexes in Pulmonary Infection Sepsis

Objective:To explore the characteristics and influencing factors of coagulation indexes in patients with pulmonary infection sepsis.Methods:104 patients in Shaanxi Provincial Hospital of Chinese Medicine from January 2015 to April 2021 were collected and divided into case group(52 cases)and control group(52 cases).The general data and coagulation indexes of the two groups were statistically analyzed.The difference was statistically significant(P<0.05).Binary logistic regression analysis was used.Results:The indexes of age PT,APTT,TT,FDP,D-Dimer,INR and PLT in the control group were significantly higher than those in the control group(P<0.05);There was no significant difference in FIB-C(P>0.05);Binary logistic regression analysis showed that D-Dimer and PLT were the risk factors of pulmonary infection sepsis(OR>1,P<0.05).Conclusion:FDP and D-Dimer are risk factors for the development of pneumonia into sepsis.

Effects of adjuvant therapy with anluohuaxian capsule on serum inflammatory factors, hepatic fibrosis indexes and immune function in patients with hepatitis B cirrhosis

Objective: To investigate the effect of adjuvant therapy with anluohuaxian capsule on the treatment of hepatitis B cirrhosis, and its influence on serum inflammatory factors, liver fibrosis indexes and immune function. Methods: A total of 112 cases of hepatitis B cirrhosis patients were divided into the control group (n=55) and observation group (n=57) according to the random data table, patients in the two groups were given routine treatment, on this basis, the control group received the treatment of Adefovir Dipivoxil Tablets, and the observation group was treated with Adefovir Dipivoxil Tablets combined with Anluo Huaxian pill treatment, two groups were treated for 48 weeks. The levels of serum inflammatory factors, liver fibrosis indexes and immune function indexes of the two groups were compared before and after treatment. Results: Before treatment, There was no significant difference between the two groups of TNF-α, IL-6, hs-CRP, IVC, HA, PIIIP, LN, CD3+, CD4+, CD8+and CD4+/CD8+ levels. After treatment, TNF-α, IL-6, hs-CRP, IVC, HA, PIIIP, LN, CD3+, CD4+, CD8+and CD4+/CD8+ levels in the observation group and control group were significantly lower than those before treatment in the same group, and levels in the observation group after treatment were significantly lower than the control group;Compared with the group before treatment, the levels of CD3+, CD4+ and CD4+/CD8+ of two groups after treatment were significantly increased, and the observation group was significantly higher than the control group. Conclusion: Adjuvant therapy with anluohuaxian capsule on the treatment of hepatitis B cirrhosis, can effectively reduce the inflammatory stress reaction, reduce the level of serum liver fibrosis index and improve the immune function, and has important clinical value.

Influence of compound glycyrrhizin on liver functions, liver fibrosis indexes and inflammatory factors of patients with chronic hepatitis B

Objective:To investigate influence of Compound Glycyrrhizin on liver functions, liver fibrosis indexes and inflammatory factors of patients with chronic hepatitis B.Methods:A total of 96 cases of patients with chronic hepatitis B treated in our hospital from Jan2015 to Jun2016 were selected as subjects, and randomly divided to be 48 cases of observation group and 48 cases of control group. Patients in both of the two groups were received routine liver protecting drug treatment. For observation group, Compound Glycyrrhizin injection was given on the basis of routine treatment. Variations of liver function indexes, liver fibrosis indexes and inflammatory factors between the two groups before and after treatment were compared and observed.Results:No obvious difference showed on AST, ALT, ALB TBIL levels between two groups of patients before treatment;After treatment, AST, ALT, TBIL in two groups of patients were significantly decreased, ALB were significantly increased. Significant difference showed comparing with prior treatment;After treatment, AST, ALT and TBIL levels in observation group were (29.53±9.44) U/L, (32.36±10.93) U/L and (10.12±3.22) μmol/L, which were significantly lower than in control group. ALB levels in observation group were (43.57±12.42) g/L, which were significantly higher than ALB levels in control group. Before treatment, no statistical difference showed on HA, LN, IV-C and PCIII levels between two groups of patients. After treatment, HA, LN, IV-C and PCIII in two groups of patients were significantly decreased, which showed significant difference comparing with prior treatment;After treatment, HA, LN, IV-C and PCIII levels in observation group were (97.33±31.75) μg/L, (77.52±23.72) μg/L, (82.92±24.55) μg/L, (15.33±5.11) μg/L, which were significantly lower than in control group. Before treatment, no significant difference showed on IL-2, IL-6 and TNF- levels between two groups of patients;After treatment, IL-2 levels in two groups of patients were significantly increased, IL-6 and TNF-α were significantly decreased, the differences showed significance;After treatment, IL-2 levels in observation group were (131.48±30.63) U/mL, which were higher than IL-2 levels in control group. IL-6 and TNF-αlevels in observation group were (45.23±16.45) μg/L, (41.75±17.53) ng/L, which were lower than IL-6 and TNF-α levels in control group, differences showed significance.Conclusion:Compound Glycyrrhizin could effectively release liver fibrosis and inflammatory reactions for patients with chronic hepatitis B, and could further improve liver functions.

Analysis on Factors Causing Project Delays in Road and Highways Sector in India Using Relative Ranking Index Technique

On-time completion of road infrastructure projects is a critical goal.When projects were not completed on schedule and real construction progress is slower than expected,the inconvenience and disruption to business access increases.On time completion is linked to economic and social welfare,as well as safety.Construction delays continue to be a typical occurrence,despite the need of prompt completion.A literature study is conducted in this context in order to learn more about the causes and factors that contribute to delays.Following a thorough review of the literature,it was determined that a questionnaire survey is the most effective and trustworthy way for gathering information about the causes and quantifying delays caused by emergent factors.The Relative Importance Index(RII)method was used to analyze the data,and the reasons for the delay were prioritized according to their importance.This study focuses on the emergent concerns/causes and reasons of concern in road infrastructure projects,as well as how to priorities these issues sequentially during the planning stage.This study survey can assist construction companies doing business in India in understanding the essential or sensitive issues that require special attention in order to conduct their businesses smoothly in this country while employing appropriate project management practices.

The Impacts of Mosquito Density and Meteorological Factors on Dengue Fever Epidemics in Guangzhou, China, 2006-2014: a Time-series Analysis

Objective To explore the associations between the monthly number of dengue fever（DF） cases and possible risk factors in Guangzhou, a subtropical city of China. Methods The monthly number of DF cases, Breteau Index （BI）, and meteorological measures during 2006-2014 recorded in Guangzhou, China, were assessed. A negative binomial regression model was used to evaluate the relationships between BI, meteorological factors, and the monthly number of DF cases. Results A total of 39,697 DF cases were detected in Guangzhou during the study period. DF incidence presented an obvious seasonal pattern, with most cases occurring from June to November. The current month＇s BI, average temperature （Tare）, previous month＇s minimum temperature （Train）, and Tare were positively associated with DF incidence. A threshold of 18.25℃ was found in the relationship between the current month＇s Tmin and DF incidence. Conclusion Mosquito density, Tove, and Tmin play a critical role in DF transmission in Guangzhou. These findings could be useful in the development of a DF early warning system and assist in effective control and prevention strategies in the DF epidemic.

Estimation and Prediction of Bioconcentration Factors of Nonionic Organic Chemicals in Fish by Electrotopological State Indices and Structural Parameter

Based on the characteristics of atom types, Hall＇s electrotopological state indices （En） are calculated for 165 nonionic organic compounds. On the basis of the characteristics of substituent and conjugated matrix, a novel molecular structure parameter （G） is defined and calculated for 165 molecules in this paper. En and G show good structural selectivity for organic molecules. G, a satisfactory relationship between bioconcentration factor （BCF） and En, is expressed as： 1gBCF = -0.283 ＋ 1.246G ＋ 0.079E42 ＋ 0.351E9- 0.063E17 （n＇ = 122, R = 0.967, F = 425.636, s = 0.394）, which could provide estimation and prediction for the lgBCF of nonionic organic chemicals. Furthermore, the model is examined to validate overall robustness with Jackknife tests, and the independent variables in model do not exist cross correlation with VIF. All these regression results show that the new parameter G and electrotopological state index have good rationality and efficiency. It is concluded that the En and G will be used widely in quantitative structure-property/activity relationship （QSPR/QSAR） research.

Regional ecological security anddiagnosisof obstaclefactors in underdevelopedregions：acasestudy in Yunnan Province,China

In order toclarify regional ecological security status and formation mechanism of regional ecological security barriers in underdeveloped regions of China,we took Yunnan province as a case to evaluate its regional ecological security by using entropy matter-element model,comprehensive index and GIS spatial method,and we diagnosed itsobstacle factors through obstacle degree model. We found a low overall level of regional ecological security in Yunnan. Only Kunmingfell into the good level, 68% of the regions were below the critical safe level. For the vast majority of regions in Yunnan, their regional ecological security was unstable. The indexes related to per capita resources, geological and topographyenvironment, economic, and technologywere at the unsafe or dangerous level.The indexes related to urban expansion, level of income, cultivated land quality were at the level of critical safety. The indexes concerning urban management capacity, airqualityand waterenvironment were at the good or ideallevel. Yunnan's regional ecological security was not good due to natural obstructive environment itself, simultaneously lower backward economic and social level restricted the ability of ecological security response to manage ragile ecological environment. The results of the composite index wereroughly consistent with those of the entropy weight matterelement model. The mean values of the classification index,from high to low, were: the state index>the response index>the pressure index. The state index and the response index had a significant mutual promotion to each other.The regions with good composite index, state index and response index mainly distributed in the central regions of Yunnan Province. Spatial autocorrelation of regional ecological security level in Yunnan was not obvious. Water resources, economic and social development were main obstacle factors of the regional ecological security.When distinguishing with obstacle type, Kunming belonged to natural ecological environment barrier type, while other regions belonged to economic and social barrier type.