心房迷宫式射频消融治疗心房颤动

目的：探讨经心外膜迷宫式射频消融心房治疗心房颤动（房颤）的可行性。方法：对６例风湿性心脏病合并房颤患者〔持续性房颤史３．３±２．７年，左心房直径３４．７±５．３ｍｍ，心功能（ＮＹＨＡ分级）Ⅱ～Ⅳ级〕，在瓣膜置换或分离术后继续在开胸状态下分别环形消融左右心耳根部及其间横窦、上下腔静脉之间及右房前壁和冠状窦。结果：６例患者术后均恢复窦性心律。平均射频消融加瓣膜手术时间为３．０±０．７小时。无一例术中及术后发生心房穿孔或Ⅲ度房室传导阻滞。心功能较术前显著改善（Ｐ＜０．０５）。术后随访１２～２０个月，除１例患者于第８个月恢复房颤外，余均维持窦性心律。结论：本方法可以达到治疗房颤的目的。     

Neutrophil percentage‐to‐albumin ratio and monocyte‐to‐lymphocyte ratio as predictors of free‐wall rupture in patients with acute myocardial infarction

BackgroundsFree‐wall rupture (FWR) has a high mortality rate. We aimed to find sensitive predictive indicators to identify high‐risk FWR patients by exploring the predictive values of neutrophil percentage‐to‐albumin ratio (NPAR) and monocyte‐to‐lymphocyte ratio (MLR) on patients with acute myocardial infarction (AMI).Methods76 FWR patients with AMI were collected, and then 228 non‐CR patients with AMI were randomly selected (1:3 ratio) in this retrospective study. The independent influencing factors of FWR were evaluated by univariate and multivariate logistic regression analysis. The receiver‐operating characteristic (ROC) curve analysis was applied to evaluate the predictive value of NPAR and MLR for FWR.ResultsAccording to the results of multivariate logistic regression analysis, emergency percutaneous coronary intervention (PCI) (OR = 0.27, 95% CI: 0.094–0.751, p = 0.012), angiotensin‐converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) treatment (OR = 0.17, 95% CI: 0.044–0.659, p = 0.010), NPAR (OR = 2.69, 95% CI: 1.031–7.044, p = 0.043), and MLR (OR = 5.99, 95% CI: 2.09–17.168, p = 0.001) were the influencing factors of the FWR patients with AMI, independently. Additionally, the NPAR and MLR were the predictors of FWR patients, with AUC of 0.811 and 0.778, respectively (both p < 0.001).ConclusionsIn summary, the emergency PCI and ACEI/ARB treatment were independent protective factors for FWR patients with AMI, while the increase of MLR and NPAR were independent risk factors. What''s more, NPAR and MLR are good indicators for predicting FWR.     

Predictive value of lymphocyte‐to‐monocyte ratio in critically Ill patients with atrial fibrillation: A propensity score matching analysis

BackgroundInflammation plays a key role in the initiation and progression of atrial fibrillation (AF). Lymphocyte‐to‐monocyte ratio (LMR) has been proved to be a reliable predictor of many inflammation‐associated diseases, but little data are available on the relationship between LMR and AF. We aimed to evaluate the predictive value of LMR in predicting all‐cause mortality among AF patients.MethodsData of patients diagnosed with AF were retrieved from the Medical Information Mart for Intensive Care‐III (MIMIC‐III) database. X‐tile analysis was used to calculate the optimal cutoff value for LMR. The Cox regression model was used to assess the association of LMR and 28‐day, 90‐day, and 1‐year mortality. Additionally, a propensity score matching (PSM) method was performed to minimize the impact of potential confounders.ResultsA total of 3567 patients hospitalized with AF were enrolled in this study. The X‐tile software indicated that the optimal cutoff value of LMR was 2.67. A total of 1127 pairs were generated, and all the covariates were well balanced after PSM. The Cox proportional‐hazards model showed that patients with the low LMR (≤2.67) had a higher 1‐year all‐cause mortality than those with the high LMR (>2.67) in the study cohort before PSM (HR = 1.640, 95% CI: 1.437–1.872, p < 0.001) and after PSM (HR = 1.279, 95% CI: 1.094–1.495, p = 0.002). The multivariable Cox regression analysis for 28‐day and 90‐day mortality yielded similar results.ConclusionsThe lower LMR (≤2.67) was associated with a higher risk of 28‐day, 90‐day, and 1‐year all‐cause mortality, which might serve as an independent predictor in AF patients.     

Distribution and reference interval establishment of neutral‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), and platelet‐to‐lymphocyte ratio (PLR) in Chinese healthy adults

BackgroundNeutral‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), and platelet‐to‐lymphocyte ratio (PLR) are associated with coronavirus disease 2019 (COVID‐19) and many diseases, but there are few data about the reference interval (RI) of NLR, LMR, and PLR.MethodsThe neutrophil count, lymphocyte count, monocyte count, and platelet count of 404,272 Chinese healthy adults (>18 years old) were measured by Sysmex XE‐2100 automatic hematology analyzer, and NLR, LMR, and PLR were calculated. According to CLSI C28‐A3, the nonparametric 95% percentile interval is defined as the reference interval.ResultsThe results of Mann‐Whitney U test showed that NLR (p < .001) in male was significantly higher than that in female; LMR (p < .001) and PLR (p < .001) in male were significantly lower than that in female. Kruskal‐Wallis H test showed that there were significant differences in NLR, LMR, and PLR among different genders and age groups (p < .001). The linear graph showed that the reference upper limit of NLR and PLR increased with age and the reference upper limit of LMR decreases with age in male population. In female population, the reference upper limit of NLR in 50–59 group, LMR in >80 group, and PLR in 70–79 group appeared a trough; the reference upper limit of NLR in >80 group, LMR in 50–59 group, and PLR in 40–49 group appeared peak.ConclusionThe establishment of RI for NLR, LMR, and PLR in Chinese healthy adults according to gender and age will promote the standardization of clinical application.     

左房容积指数用于预测心房颤动患者射频消融后复发的meta分析

目的 评价左房容积指数(left atrial volume index,LAVI)用于预测心房颤动(atrial fibrillation,AF)患者射频消融术后复发的临床价值。方法 计算机检索PubMed、the Cochrane Library、Web of Science、中国知网、中国生物医学文献数据库、维普数据库等,查找LAVI用于预测AF患者射频消融后复发的相关文献。采用STATA 12.0进行meta分析。结果 共纳入13项研究1 519例AF患者。Meta分析结果显示与AF射频消融后未复发患者相比,复发患者平均LAVI更高(SMD=2.51, 95%CI:1.61～3.41,P=0.001),同时AF射频消融后未复发患者与复发患者LAV/LAVI两组间差异有统计学意义(OR=2.88,95%CI:2.68～3.10,P=0.001),提示AF患者接受射频消融术后密切监测LAVI变化可有效评估其术后复发的可能性。结论 与AF射频消融术后未复发的患者相比,复发的患者平均LAVI更高,其可作为评估AF患者接受射频消融术后复发的有效指标。结论仍需更多多中心、大样本的随机对照试...     

New prognostic factor for hepatitis B virus‐related decompensated cirrhosis: Ratio of monocytes to HDL‐cholesterol

AimHepatitis B virus‐related decompensated cirrhosis (HBV‐DeCi) has a high mortality rate, and it remains a challenge to predict its outcomes in clinical practice. We aimed to determine the association between monocyte‐to‐HDL‐cholesterol ratio (MHR) and short‐term prognosis in HBV‐DeCi patients.MethodsA total of 145 HBV‐DeCi patients were enrolled. A multivariate analysis was performed to identify predictors of mortality. The findings were validated by a receiver operating characteristic analysis using the area under the curve (AUC).ResultsA total of 20 (13.8%) patients had died 30 days after admission. MHR was markedly increased in the non‐survivors compared with the survivors. In the multivariate analysis, MHR was identified as an independent risk factor for mortality, with a significant predictive value (AUC = 0.825; sensitivity, 90.0%; specificity, 62.4%).ConclusionsElevated MHR is associated with increased mortality rate in HBV‐DeCi patients.     

Monocyte to high‐density lipoprotein cholesterol ratio as an independent risk factor for papillary thyroid carcinoma

BackgroundPapillary thyroid carcinoma (PTC) is considered to be an inflammatory disease. This study aimed to investigate the association of monocyte to high‐density lipoprotein cholesterol ratio (MHR) with PTC.MethodsClinical parameters from 300 patients with PTC and 552 patients with benign thyroid nodule were compared. Serum renal function and liver enzymes, fasting plasma glucose, lipid profile, and blood cell count were measured.ResultsPatients with PTC had a higher MONO (p < 0.001) and MHR (p < 0.001). There was a step‐wise increase in the prevalence of PTC (p = 0.003) with the tertile of MHR. Logistic regression analysis revealed that MHR could be considered an independent risk factor (p < 0.001) in the case‐control study and the cohort study. Pearson correlation analysis and simple linear regression analysis indicated that MHR was positively associated with neutrophil (NEU) and lymphocyte (LYM) count as well as neutrophil‐to‐lymphocyte ratio (NLR). Area under the curve (AUC) was 0.711. The optimal cutoff of MHR was 0.33 × 10⁹/mmol.ConclusionThis study identifies novel evidence that patients with PTC have a higher MHR. MHR is an independent risk factor for PTC. These findings support the application of MHR to predict, diagnose, and evaluate the occurrence of PTC.     

The association between Monocyte‐to‐Lymphocyte ratio and postoperative delirium in ICU patients in cardiac surgery

ObjectiveTo analyze the relationship between monocyte‐to‐lymphocyte ratio (MLR) and postoperative delirium (POD).MethodsThis cohort study was conducted in the Medical Information Mart for Intensive Care‐III (MIMIC‐III) version 1.4 database. MLR was measured according to the complete blood count. ICD‐9 was used to measure postoperative delirium. Multivariable logistic regression was utilized to examine the relationship between MLR and POD.ResultsThree thousand eight hundred sixty‐eight patients who had received cardiac surgery were retrospectively enrolled, including 2171 males and 1697 females, with a mean age of 63.9 ± 16.2 years. The univariate analysis suggested that high MLR (as a continuous variable) as associated with a 21% higher risk of POD (O R: 1.12, 95% CI, 1.02, 1.43, p = 0.0259), After adjustments for other confounding factors, gender, age, race, temperature, SBP, DBP, MAP, respiratory rate, SOFA, peripheral vascular disease, AG, psychoses, drug, and alcohol addiction, the results showed that high MLR (as a continuous variable) independently served as a risk factor for POD (OR: 1.21; 95% CI: 1.01–1.44; p = 0.0378). MLR was assessed as quintile and tertiles, high MLR was an independent risk factor for POD. In the subgroup analysis, there were no differences in MLR for patients with POD in pre‐specified subgroups.ConclusionsMonocyte‐to‐lymphocyte ratio was a risk factor for POD. More research is necessary to thoroughly examine the function of MLR in POD.     

Lymphocyte‐to‐monocyte ratio combined with CA19‐9 for predicting postoperative recurrence of colorectal cancer in patients with diabetes

ObjectiveTo investigate the significance of lymphocyte‐to‐monocyte ratio (LMR) combined with carbohydrate antigen (CA) 19‐9 for predicting postoperative recurrence of colorectal cancer (CRC) in patients with type II diabetes.MethodsWe conducted a retrospective analysis of 106 postoperative patients with stage II–III CRC and with type II diabetes. Their clinical indexes such as LMR and CA19‐9 were collected, and the patients were followed up for 5 years.ResultsThe CA19‐9 level was 119.7 U/ml at baseline in the relapsed group, while this was 24.81 U/ml in non‐relapsed group (p = 0.001). On the contrary, the LMR level was 5.10 and 2.57 for non‐relapsed and relapsed group (p < 0.001), respectively. Kaplan‐Meier survival curves stratified by CA19‐9 and LMR suggested that patients with lower CA19‐9 had higher survival probability (p < 0.001), while patients with high LMR level had higher survival probability (p < 0.001). The multivariable Cox proportional hazard regression analysis with CA19‐9 and LMR indicated that although the baseline CA19‐9 is significantly associated with increasing risk of disease recurrence, the HR (HR = 1.0, 95% CI 1.00–1.01) was small and close to 1, whereas the high baseline LMR (HR = 0.44, 95% CI 0.32–0.61) was associated with decrease in disease recurrence. Model with continuous CA19‐9 and LMR was able to better predict (AUC 73.17%) the disease recurrence.ConclusionLMR combined with CA19‐9 may become a new index for predicting postoperative recurrence of CRC in patients with diabetes.     

心房颤动射频消融术后复发影响因素的荟萃分析

目的探讨心房颤动（房颤）患者病程,患有冠心病、糖尿病、高血压,左心房前后径（left atrial dimension, LAD）,左心室射血分数（left ventricular ejection fraction, LVEF）,身体质量指数(body mass index,BMI)对持续性房颤射频消融术后复发的预测价值。方法 计算机检索PubMed(1995-2018)、CBM(1995-2018)、中国知网(1958-2018)、万方数据库(1995-2018)、VIP(1989-2018)等数据库,对房颤患者射频消融术后,影响术后复发的危险因素的队列研究进行检索,并按照纳入与排除标准筛选文献、评价质量并提取资料后,采用RevMan5.3软件进行mta分析。结果 共纳入17个RCT,2827例患者。Meta分析结果显示：复发组房颤病程［MD=2.83,95％CI(2.48,3.19),P<0.05］、BMI［MD=0.84,95％CI(0.49,1.18),P<0.05］、左心房前后径［MD=2.63,95％CI(2.14,3.12),P<0.05］均大于未复发组;复发组LVEF低于未复发组［MD=-2.14,95％CI(-3.04,-1.25),P<0.05］;患者术前是否患有冠心病［OR=0.75,95％CI(0.55,1.03),P＞0.05］、糖尿病［OR=1.15,95％CI(0.86,1.53),P＞0.05］、高血压病［OR=1.07,95％CI(0.75,1.54),P＞0.05］与房颤射频消融术后复发无关系。结论 现有证据显示,房颤病程长、BMI数值大、左心房前后径长和LVEF低是房颤射频消融术后复发的危险因素,而患者术前是否患有冠心病、糖尿病、高血压病与房颤射频消融术后复发无关系。     

Gamma‐Glutamyl Transpeptidase‐to‐Platelet ratio predicts liver fibrosis in patients with concomitant chronic hepatitis B and nonalcoholic fatty liver disease

ObjectivesThe aim of this study was to compare the correlation of gamma‐glutamyl transpeptidase‐to‐platelet ratio (GPR), aspartate aminotransferase‐to‐platelet ratio index (APRI), fibrosis index‐4 (FIB‐4), and liver stiffness measurement (LSM) in the diagnosis of liver fibrosis, and perform a diagnostic value of GPR for predicting fibrosis in CHB patients with NAFLD.MethodsA retrospective study was conducted on CHB patients concurrent with NAFLD between September 2019 and December 2020. They were divided into control group (LSM ≤ 9.7 kpa) and fibrosis group (LSM ≥ 9.8 kpa). Demographic data were collected; ALT, AST, and PLT were also detected. LSM was measured by transient elastography (TE). The GPR, APRI, and FIB‐4 were calculated. The correlation between GPR, APRI, FIB‐4, and LSM was compared. The accuracy of predicting liver fibrosis using GPR, APRI, and FIB‐4 was assessed.ResultsEighty‐five CHB patients with NAFLD were enrolled. Multivariate analysis showed that age (p = 0.005), GGT (p = 0.001), and PLT (p = 0.013) were the independent risk factors for LSM. The GPR (p = 0.008), APRI (p = 0.001), and FIB‐4 (p = 0.001) values in fibrosis group were higher than control group. Pearson linear correlation was used to analyze the correlations between LSM and GPR, APRI, and FIB‐4. LSM was correlated with GPR, APRI, and FIB‐4. The AUCs of GPR, APRI, and FIB4 were 0.805, 0.766, and 0.826 in assessing liver fibrosis, respectively. No significant differences in the areas of GPR were comparable to that of APRI and FIB‐4.ConclusionGPR has a good correlation with LSM in assessing liver fibrosis and can be used as a noninvasive index for the assessment of liver fibrosis in patients with concomitant CHB and NAFLD.     

The neutrophil percentage‐to‐albumin ratio is related to the occurrence of diabetic retinopathy

BackgroundAmong patients with diabetic retinopathy (DR), no proof was available to confirm the prognostic significance of the neutrophil percentage‐to‐albumin ratio (NPAR). We hypothesized that NPAR plays a role in the incidence of DR in diabetic patients.MethodsWe extracted all diabetes mellitus (DM) data from the National Health and Nutrition Examination Survey (NHANES) database between 1999 and 2018, NPAR was expressed as neutrophil percentage/albumin. Multivariable logistic regression and generalized additive model were utilized for the purpose of examining the correction between NPAR levels and DR. Subgroup analysis of the associations between NPAR and DR was carried out to investigate if the impact of the NPAR varied among different subgroups.ResultsAn aggregate of 5850 eligible participants were included in the present research. The relationship between NPAR levels and DR was positive linear. In the multivariate analysis, following the adjustment for confounders (gender, white blood cell, age, monocyte percent, red cell distribution width, eosinophils percent, bicarbonate, body mass index, iron, glucose, basophils percent, total bilirubin, creatinine, and chloride), higher NPAR was an independent risk factor for DR compared to lower NPAR (OR, 95% CI: 1.18, 1.00–1.39; 1.24, 1.04–1.48). For the purpose of sensitivity analysis, we found a trend of consistency (p for trend: 0.0190). The results of the subgroup analysis revealed that NPAR did not exert any statistically significant interactions with any of the other DR risk variables.ConclusionsElevated NPAR is associated with an elevated risk of occurrence of DR in diabetic patients.     

Combined fibrinogen‐to‐pre‐albumin ratio and carbohydrate antigen 19–9 score is a promising metric to predict progression of metastatic colorectal mucinous adenocarcinoma

BackgroundChronic inflammation is a hallmark of colorectal mucinous adenocarcinoma (CMA). Albumin‐to‐fibrinogen ratio (AFR) and fibrinogen‐to‐pre‐albumin ratio (FPR) were independent prognostic factors for many kinds of solid malignancies. However, the association between the inflammatory scores and progression of metastatic CMA remains unknown.MethodsPeripheral blood neutrophil count and circulating fibrinogen, albumin, and pre‐albumin levels were detected, and neutrophil‐to‐albumin ratio (NAR), neutrophil‐to‐pre‐albumin ratio(NPAR), AFR, and FPR were calculated in 42 metastatic MCA patients. Kaplan‐Meier curve, Cox regression, time‐dependent receiver operating characteristic curve (tdROC) were selected to investigate the prognostic utility of them in the patients.ResultsMetastatic CMA patients commonly occurred in middle‐younger patients (80.95%). NPAR (adjusted hazard ratio (HR)=2.405, 95% confidence interval (CI)=1.195–4.842) and FPR (p _log‐rank=0.007, adjusted HR=2.364, 95% CI=1.203–4.645) were significantly associated with poor progression‐free survival in these patients. The prognostic prediction area under tdROC (AUROC) of FPR was significantly higher than that of NPAR(0.703 versus 0.537). Moreover, the patients with a high CA19‐9‐FPR score showed worse outcomes than those with the low score (p _log‐rank<0.001, adjusted HR=7.273, 95% CI=2.721–19.435 for the score 1 versus 0). The prediction AUROC, sensitivity, and specificity of the score were 0.892 (0.788–0.996), 76.32%, and 100.00%, respectively, and its predicted efficacy was better than that of the single biomarkers.ConclusionThe combined CA19‐9‐FPR score is an economical, simple, effective, and independent prognostic factor for metastatic MCA.     

Post‐COVID‐19 splenic infarction in a patient with chronic atrial fibrillation: A case report

We describe splenic infarction (SI), an infrequent condition, in an 82‐year‐old COVID‐19 patient with chronic atrial fibrillation (AF). COVID‐19 may cause thrombosis, and AF is a predisposing factor for splenic infarction. Suspicion of SI may be warranted in COVID‐19 patients with abdominal pain, especially if a predisposing factor exists.     

Prognostic value of glucose‐to‐lymphocyte ratio in critically ill patients with acute respiratory distress syndrome: A retrospective cohort study

BackgroundThere is need to identify biomarkers for prognosis of acute respiratory distress syndrome (ADRS). This may allow early and accurate identification of patients with high‐risk ARDS to guide adjustment of clinical treatment and nursing intervention, which would ultimately improve prognosis of patients with ARDS. Biomarkers based on a combination of fasting glucose and lymphocyte counts to predict prognosis in critically ill patients with ARDS remain undefined. In this study, we investigated the association between glucose‐to‐lymphocyte ratio (GLR) and in‐hospital mortality.MethodsThe study obtained data from Medical Information Mart for Intensive Care‐IV (MIMIC‐IV Version 1.0) database. We defined the GLR as fasting glucose/lymphocyte count and the patient in‐hospital mortality was considered as the outcome. In addition, we employed linear and logistic regression models for analysis.ResultsIn total, 1,085 patients with ARDS were included in this study. The eligible participants included 498 female and 587 males, with a mean age of 64.2 ± 17.5 years. Logistic regression analysis demonstrated that higher GLR was an independent risk factor for all‐cause mortality (OR =1.67, 95% CI: 1.26–2.22) after adjusting for age, sex, anion gap, white blood cell count, congestive heart failure, sequential organ failure assessment (SOFA), SBP, DBP, and respiratory rate in both the dichotomized group and subgroups. We also analyzed the in‐hospital mortality to ROC curves by comparing the value between SOFA + GLR and SOFA. The area under the curve (AUC) was 0.6991 for the SOFA + GLR (95% CI: 0.6634–0.7348), and 0.6613 for the SOFA (95% CI: 0.6238–0.6988).ConclusionOur data showed that the GLR was an independent predictor of in‐hospital mortality for patients with ARDS. The GLR is an integrated, readily available clinical biomarker for mortality in patients with ARDS.     

The predictive value of fibrinogen‐to‐albumin ratio in the active,severe active,and poor prognosis of systemic lupus erythematosus: A single‐center retrospective study

ObjectiveTo evaluate the prediction and effect of fibrinogen‐to‐albumin ratio (FAR) on active, severe active, and poor prognosis of systemic lupus erythematosus (SLE).MethodsOne hundred and sixty‐eight patients with SLE who were treated in our hospital were enrolled, the clinical data, laboratory indexes, and disease prognosis of all patients were collected and analyzed.ResultsTriglyceride (TG), FAR, ESR, and anti‐dsDNA (+) were the influencing factors, while complement 3 (C3) was the protective factor of active SLE, the odds ratio (OR) values were 2.968, 3.698, 2.114, 2.727, and 0.652, respectively (p < 0.05). FAR, ESR, and anti‐dsDNA (+) were the influencing factors, while C3 was the protective factor of severe active SLE, the OR values were 3.791, 1.953, 2.187, and 0.742, respectively (p < 0.05). SLE disease activity index (SLEDAI), TG, FAR, and anti‐dsDNA (+) were the influencing factors, while C3 was the protective factor of poor prognosis SLE, the OR values were 3.024, 2.293, 3.012, 2.323, and 0.801, respectively (p < 0.05). FAR and FIB were positively correlated with SLEDAI, while ALB was negatively correlated with SLEDAI, the related coefficient (r) were 0.398, 0.267, −0.270, respectively. The receiver operating curve (ROC) analysis showed that the predictive values of FAR for active, severe active and poor prognosis SLE were 0.769, 0.769, and 0.734, respectively, were significant higher than FIB and ALB (p < 0.05).ConclusionFibrinogen‐to‐albumin ratio was an influencing factor of active, severe active, and poor prognosis SLE had higher predictive value than FIB and ALB for the activity and prognosis of SLE.     

The predictive value of the ratio of the product of neutrophils and hemoglobin to lymphocytes in non‐muscular invasive bladder cancer patients with postoperative recurrence

PurposeThe purpose of this study was to explore the predictive value of the ratio of the product of neutrophils and hemoglobin to lymphocytes (NHL) in patients with non‐muscular invasive bladder cancer (NMIBC).Materials and MethodsWe retrospectively collected clinical and pathological data of patients with NMIBC who underwent transurethral resection of bladder tumor (TURBT) at our hospital between 2013 and 2018. The ratio of neutrophils to lymphocytes (NLR), the Systemic Immune Inflammation Index (SII), and NHL were obtained based on routine blood settlement within a week before surgery. The receiver operating characteristic curve was used to determine the optimal cutoff value of each index, and different groups were grouped accordingly. Kaplan‐Meier survival curve and Cox regression model were used to study the factors affecting the prognosis of NMIBC patients.ResultsThere was significant difference in recurrence‐free survival (RFS) rate between the high NLR group and the low NLR group, the high SII group and the low SII group, and the high NHL group and the low NHL group. Cox univariate regression analysis showed that tumor number, tumor size, tumor pathological grade, tumor pathological stage, NLR, SII, and NHL were related to postoperative RFS in patients with NMIBC. The tumor number, tumor pathological grade, SII, and NHL were independent predictors of RFS in multivariate analysis.ConclusionsThe preoperative clinical inflammatory indexes NLR, SII, and NHL have certain predictive value for postoperative RFS in NMIBC patients.     

The effect of granulocyte colony‐stimulating factor dose and administration interval after allogeneic hematopoietic cell transplantation on early engraftment of neutrophil and platelet

BackgroundHematopoietic stem cell transplantation (HSCT) is one of the treatments for hematologic malignancies. Numerous factors affect the HSCT outcome. The purpose of this study was to investigate the effect of post‐HSCT administration of granulocyte colony‐stimulating factor (post‐G‐CSF) on early neutrophil and platelet engraftment in allogeneic HSCT (allo‐HSCT).Material & methodsThe study was performed on 76 patients diagnosed with AML and ALL. All patients underwent allo‐HSCT at Taleghani stem cell transplantation center, Tehran, Iran, from February 2016 to December 2018. Chemotherapy regimens based on patients'' conditions were selected between myeloablative and reduced‐intensity regimens.ResultsStatistical analysis revealed that the number of administered G‐CSF units after HSCT was a time‐dependent variable. Statistical analysis before day +11 reported that patients who received G‐CSF <14 units had three times better early neutrophil engraftment than those with G‐CSF ≥14 (CI 95%, AHR = 3.03, p:0.002). CD3+ cells count <318.5 × 10⁶/kg was associated with fast platelet engraftment (CI 95%, AHR 2.28, p:0.01).ConclusionIn this study, post‐G‐CSF stimulation was associated with early engraftment in a time‐ and dose‐dependent manner. Administration of G‐CSF beyond 14 units resulted in adverse effects on neutrophil early engraftment. It also appeared that with a reduction in CD3+ cell counts, the likelihood of GVHD decreases, and platelet engraftment occurs earlier. Further investigations in the future are required to determine the factors affecting the process of early engraftment.     

Serum concentrations of small dense low‐density lipoprotein cholesterol and lipoprotein(a) are related to coronary arteriostenosis in Takayasu arteritis

BackgroundSerum small dense low‐density lipoprotein cholesterol (sdLDL‐C) and lipoprotein(a) [Lp(a)] levels are related to coronary disease, but their specific associations with coronary arteriostenosis in Takayasu arteritis (TA) have not been ascertained. This study explored the correlations between serum sdLDL‐C and Lp(a) levels and coronary arteriostenosis in TA patients as well as the degree of artery stenosis.MethodsThis retrospective study included 190 TA patients and 154 healthy subjects. TA patients were divided into three categories based on the degree of coronary stenosis: Group I, stenosis >50%; Group II, stenosis 1%–50%; and Group III, stenosis 0%. Independent risk factors for coronary arteriostenosis in TA were identified by logistic regression, followed by receiver operating characteristic curve analysis to determine the specificity and sensitivity of risk factors and Youden''s Index score calculation to determine the cutoff points.ResultsTakayasu arteritis patients had significantly higher serum levels of sdLDL‐C and Lp(a) than healthy controls (p < 0.0001). The total cholesterol, triglyceride, LDL‐C, sdLDL‐C, and Lp(a) levels and the sdLDL‐C/LDL‐C ratio in Group I were significantly higher than those in Groups II and III (p < 0.05). An elevated serum sdLDL‐C level elevated the risk of coronary arteriostenosis by 5‐fold (cutoff value, 0.605 mmol/l). An increased serum Lp(a) level increased the risk of coronary arteriostenosis by 3.9‐fold (cutoff value, 0.045 g/l). An elevated sdLDL‐C/LDL‐C ratio increased the risk of coronary arteriostenosis by 2.1‐fold (cutoff value, 0.258).ConclusionsSerum sdLDL‐C and Lp(a) levels and sdLDL‐C/LDL‐C ratio may be used as diagnostic factors for coronary arteriostenosis in TA patients.