Objective To investigate the value of preoperative neutrophil?to?lymphocyte ratio(NLR) as a prognostic predictor after radical resection of bladder cancer for muscle?bladder cancer. Methods Two hundred and fifty?two cases consecutive muscle?invasive bladder cancer patients treated with total excision radi?cal bladder at the Rology Surgery Department of Affiliated Hospital of Weifang Medical College from January 2006 to March 2010 were retrospectively analyzed,and all patients were diagnosed bladder cancer by pathological examination. Based on the cut?off value of 2. 7,all the patients were divided into two groups:a low NLR(<2. 7,n=142) group and a high NLR(≥2. 7,n=110) group. None accepted neoadjuvant therapy. Results The 5?year overall survival rate was 75. 2% in patients of the low NLR group and 53% in the high NLR group,the difference was significant(P=0. 005). Univariate analysis showed that NLR(P=0. 002),tumor size(P=0. 035),T stage (P=0. 0022),tumor grade(P=0. 04),hydronep?hrosis or no(P=0. 031),Lymph node metastasis or no(P=0. 003) were associated with survival. Cox multivariate analysis revealed that NLR was independent risk factors of prognosis(HR:2. 586;95%CI:1. 256-2. 851;P=0. 039). Conclusion Preoperative NLR≥2. 7 may be a convenient biomarker to predict patients with a poor prognosis after radical cystectomy for muscle?invasive blad?der cancer.

Objective:To explore the predictive value of lipoproteins on the progression of critically ill patients to chronic critical illness (CCI).Methods:A retrospective cohort study was conducted to analyze clinical data of patients admitted to the intensive care unit (ICU) of Nanjing Drum Tower Hospital from January 1, 2020, to December 31, 2022. The levels of high-density lipoprotein (HDL), low-density lipoprotein (LDL) and apolipoproteins (ApoA-Ⅰ, ApoB) at 1, 3, 7, 14 and 21 days after admission to ICU were collected. The progression to CCI was recorded. CCI was defined as the length of ICU stay ≥14 days with sustained organ dysfunction [sequential organ failure assessment (SOFA) score ≥2]. Differences in lipoprotein levels between the patients with and without CCI were compared. Multivariate Logistic regression was used to analyze risk factors for critically ill patients progressing to CCI. Receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of lipoproteins on critically ill patients progressing to CCI.Results:A total of 200 patients were enrolled in the final analysis. 137 patients (68.5%) progressed to CCI, and 63 patients (31.5%) did not. The lipoprotein indicators in the CCI group showed a decrease after the acute phase, while the lipoprotein indicators in the non-CCI group showed an increase. The levels of HDL, LDL, ApoA-Ⅰ, and ApoB at various time points in the CCI group were significantly lower than those in the non-CCI group. HDL at 7 days in the CCI group was significantly lower than that in the non-CCI group [mmol/L: 0.44 (0.31, 0.61) vs. 0.67 (0.49, 0.75), P < 0.01]. Multivariate Logistic regression analysis showed that 7-day HDL was an independent risk factor for critically ill patients progressing to CCI [odds ratio ( OR) = 0.033, 95% confidence interval (95% CI) was 0.004-0.282, P = 0.002]. ROC curve analysis showed that the area under the ROC curve (AUC) of 7-day HDL for predicting critically ill patients progressing to CCI was 0.702, with a 95% CI of 0.625-0.779, P < 0.001. When the optimal cut-off value was 0.59 mmol/L, the sensitivity was 69.8%, and the specificity was 72.4%. Conclusions:The low level of lipoproteins is closely related to the progression of critically ill patients, and 7-day HDL has a certain predictive value for critically ill patients progressing to CCI. Continuously observation of the change trend of lipoprotein level is helpful to judge the progression of CCI in critically ill patients.