0.05).In terms of toxicity,Aleucocytosis,phlebitis and constipation were more common in NP group while thrombocytopenia and skin rash were more common in GP group(P

Objective To investigate the clinical value of von Willebrand factor antigen-to-albumin ratio (VAR) score and glycocalicin index (GCI) score in predicting the development and classification of esophageal varices in comparison with von Willebrand factor antigen-to-platelet ratio (VITRO) score. Methods A retrospective analysis was performed for 146 patients with hepatitis B cirrhosis who were hospitalized from April 2020 to December 2021, and esophageal varices (EV) was diagnosed and graded with the results of gastroscopy as the standard. VITRO, VAR, and GCI were calculated, and their association with EV was analyzed. The t -test was used for comparison of normally distributed continuous data between two groups, and a one-way analysis of variance was used for comparison between multiple groups; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. The chi-square test was used for comparison of categorical data between groups. A logistic regression model analysis was used to identify the predictive factors for EV, and the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of each index. Results Gastroscopy showed 54 patients without EV, 30 with mild EV, 33 with moderate EV, and 29 with severe EV. The patients with EV had significantly higher VAR and GCI scores than those without EV ( t =-5.819 and -3.449, both P < 0.001). The linear regression analysis showed that VAR and GCI increased with the increase in EV grade ( P =0.002 and 0.005). The multivariate logistic regression analysis showed that VAR (odds ratio [ OR ]=1.46, 95% confidence interval [ CI ]: 1.21-1.75, P < 0.001) and GCI ( OR =1.84, 95% CI : 1.22-2.77, P =0.003) were independently associated with EV. VITRO score had an area under the ROC curve (AUC) of 0.718 in diagnosing EV and 0.863 in diagnosing severe EV, with the optimal cut-off values of 2.77 and 5.37, respectively. VAR and GCI had an AUC of 0.745 and 0.710, respectively, in diagnosing EV, with the optimal cut-off values of 8.88 and 1.70, respectively; VAR and GCI had an AUC of 0.755 and 0.787, respectively, in diagnosing severe EV, with the optimal cut-off values of 9.81 and 2.00, respectively. VAR combined with GCI had significantly better efficacy than VITRO in diagnosing EV ( P =0.009), with an AUC of 0.808, a sensitivity of 55.43%, and a specificity of 94.44%; VAR combined with GCI had an AUC of 0.869 in diagnosing severe EV, which was similar to VITRO ( P =0.421). Conclusion VAR and GCI scores are potential noninvasive markers for the prediction and risk stratification of EV in patients with hepatitis B cirrhosis.

ObjectiveTo investigate the value of intestinal fatty acid binding protein （I-FABP） in predicting the development and progression of acute-on-chronic liver failure （ACLF）. MethodsA retrospective analysis was performed for the clinical data of 168 patients with decompensated liver cirrhosis who were admitted to The Affiliated Hospital of Yanbian University from September 2020 to March 2023. The conditions of the patients with ACLF on admission were observed， and the patients were followed up for 6 months to identify new-onset ACLF cases. ELISA was used to measure the serum level of I-FABP on admission. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Kruskal-Wallis H rank sum test was used for comparison between multiple groups； the chi-square test was used for comparison of categorical data between groups； the Jonckheere-Terpstra test was used for trend analysis. The Spearman correlation analysis was used to investigate the correlation between two variables， and the multivariate Cox regression analysis was used to investigate the influencing factors for new-onset ACLF during follow-up. The Kaplan-Meier curve was used to analyze the onset of ACLF in different groups， and the log-rank test was used for the analysis of such differences. The receiver operating characteristic （ROC） curve and the area under the ROC curve （AUC） were used to investigate the performance of I-FABP in predicting the development and progression of ACLF. ResultsAmong the 168 patients enrolled in this study， there were 43 patients with ACLF and 125 patients without ACLF， among whom 19 developed ACLF during follow-up. The patients with ACLF on admission had a significantly higher level of I-FABP than those without ACLF （Z=4.359， P<0.001）. The patients with new-onset ACLF had a significantly higher level of I-FABP than those without new-onset ACLF （Z=3.414， P<0.001）. The level of I-FABP increased with the increase in ACLF severity grade （H=17.385， P<0.001，P_trend<0.001）. The multivariate Cox regression analysis showed that I-FABP was independently associated with new-onset ACLF during follow-up （hazard ratio=2.138， 95% confidence interval ［CI］： 1.297 — 3.525， P=0.003）， and the tertile of I-FABP showed a good discriminatory ability （χ²=12.16， P<0.001）. The ROC curve showed that I-FABP had a good performance in predicting the development and progression of ACLF， with an area under the ROC curve of 0.854 （95%CI： 0.791 — 0.903） and 0.747 （95%CI： 0.661 — 0.820）， respectively， and an optimal cut-off value of 2.07 μg/L and 1.86 μg/L， respectively. ConclusionI-FABP can be used as a biomarker to predict the development and progression of ACLF， and it may help to identify high-risk patients and improve clinical management.