Objective To investigate the correlations of serum eukaryotic translation promoter 2α(eIF2α)and activated transcription factor 4(ATF4)levels with the degree of renal tissue injury and renal function in patients with diabetic nephropathy(DN).Methods A total of 102 patients with DN(DN group)and 102 patients with simple diabetes(control group)were selected.According to the severe degree of renal tissue damage,the patients with DN were divided into microalbuminuria group(MG group,35 cases)and dominant albuminuria group(PG group,41 cases)and renal dysfunction group(RIG group,26 cases).Serum levels of eIF2α,ATF4,urea nitrogen(BUN),creatinine(Scr),cystatin C(CysC)and estimated glomerular filtration rate(eGFR)were measured.Pearson correlation analysis was used to explore the correlations of eIF2α and ATF4 with BUN,Scr,CysC and eGFR;multivariate Logistic regression analysis was used to explore the risk factors of DN;receiver op-erating characteristic(ROC)curve was used to analyze the value of eIF2α and ATF4 in diagnostic of DN.Results Serum levels of eIF2α,ATF4,BUN,Scr and CysC in the DN group were higher than those in control group,eGFR was lower than that in control group(P＜0.05).Serum eIF2α and ATF4levels in the RIG group were higher than those in PG and MG groups(P＜0.05).Serum eIF2α and ATF4 levels in DN patients were positively correlated with BUN,Scr and CysC,and neg-atively correlated with eGFR(P＜0.05).Long duration of diabetes,higher body mass index,high level of eIF2α and high level of ATF4 were risk factors for DN(P＜0.05).The area under the curve of eIF2α and ATF4 in diagnosis DN was 0.770 and 0.799,respectively,and the area under the curve of their combined diagnosis was 0.879,which was higher than that of single diagnosis(P＜0.05).Conclusion Serum levels of eIF2α and ATF4 are increased in patients with DN,which is related to the severity of renal injury and renal dysfunction in DN.The combination of eIF2α and ATF4 is of high value in the diagnosis of DN.

Objective To investigate the correlations of serum eukaryotic translation promoter 2α(eIF2α)and activated transcription factor 4(ATF4)levels with the degree of renal tissue injury and renal function in patients with diabetic nephropathy(DN).Methods A total of 102 patients with DN(DN group)and 102 patients with simple diabetes(control group)were selected.According to the severe degree of renal tissue damage,the patients with DN were divided into microalbuminuria group(MG group,35 cases)and dominant albuminuria group(PG group,41 cases)and renal dysfunction group(RIG group,26 cases).Serum levels of eIF2α,ATF4,urea nitrogen(BUN),creatinine(Scr),cystatin C(CysC)and estimated glomerular filtration rate(eGFR)were measured.Pearson correlation analysis was used to explore the correlations of eIF2α and ATF4 with BUN,Scr,CysC and eGFR;multivariate Logistic regression analysis was used to explore the risk factors of DN;receiver op-erating characteristic(ROC)curve was used to analyze the value of eIF2α and ATF4 in diagnostic of DN.Results Serum levels of eIF2α,ATF4,BUN,Scr and CysC in the DN group were higher than those in control group,eGFR was lower than that in control group(P＜0.05).Serum eIF2α and ATF4levels in the RIG group were higher than those in PG and MG groups(P＜0.05).Serum eIF2α and ATF4 levels in DN patients were positively correlated with BUN,Scr and CysC,and neg-atively correlated with eGFR(P＜0.05).Long duration of diabetes,higher body mass index,high level of eIF2α and high level of ATF4 were risk factors for DN(P＜0.05).The area under the curve of eIF2α and ATF4 in diagnosis DN was 0.770 and 0.799,respectively,and the area under the curve of their combined diagnosis was 0.879,which was higher than that of single diagnosis(P＜0.05).Conclusion Serum levels of eIF2α and ATF4 are increased in patients with DN,which is related to the severity of renal injury and renal dysfunction in DN.The combination of eIF2α and ATF4 is of high value in the diagnosis of DN.

Objective:To explore the predictive value of the prognostic nutritional index (PNI) in concurrently infected patients with acute-on-chronic liver failure (ACLF).Methods:220 cases with ACLF diagnosed and treated at the First Affiliated Hospital of Xi'an Jiaotong University from January 2011 to December 2016 were selected. Patients were divided into an infection and non-infection group according to whether they had co-infections during the course of the disease. Clinical data differences were compared between the two groups of patients. Binary logistic regression analysis was used to screen out influencing factors related to co-infection. The receiver operating characteristic curve was used to evaluate the predictive value of PNI for ACLF co-infection. The measurement data between groups were compared using the independent sample t-test and the Mann-Whitney U rank sum test. The enumeration data were analyzed using the Fisher exact probability test or the Pearson χ2 test. The Pearson method was performed for correlation analysis. The independent risk factors for liver failure associated with co-infection were analyzed by multivariate logistic analysis. Results:There were statistically significant differences in ascites, hepatorenal syndrome, PNI score, and albumin between the infection and the non-infection group ( P ?

ObjectiveTo investigate the influencing factors for the prognosis of patients with acute－on－chronic liver failure （ACLF）， and to establish a short－term prognostic model. MethodsA retrospective analysis was performed for the baseline clinical data of 247 patients with ACLF who were hospitalized in Department of Infectious Diseases， The First Affiliated Hospital of Xi’an Jiaotong University， from January 2011 to December 2016， and the patients were divided into survival group and death group. The two groups were compared to identify the influencing factors for prognosis； a prognostic model was established， and the receiver operating characteristic （ROC） curve was used to assess its predictive efficacy and determine the optimal cut－off value. The independent－samples t test was used for comparison of normally distributed continuous data between groups， and the Mann－Whitney U rank sum test was used for comparison of non－normally distributed continuous data between groups； the Fisher’s exact test or the Pearson’s chi－square test was used for comparison of categorical data between groups. The univariate and multivariate logistic regression analyses were used to investigate the independent risk factors for 28－ and 90－day prognosis， and the Kaplan－Meier method was used to plot the 28－day survival curves. ResultsA total of 220 patients with ACLF were included based on the inclusion and exclusion criteria； there were 148 patients in the 28－day survival group and 72 patients in the 28－day death group， with a 28－day transplantation－free survival rate of 67.27%； there were 115 patients in the 90－day survival group and 105 patients in the 90－day death group， with a 90－day transplantation－free survival rate of 52.27%. The logistic regression analysis showed that female sex （odds ratio ［OR］=2.149， P=0.030）， high Model for End－Stage Liver Disease （MELD） score （OR=1.120， P<0.001）， and low lymphocyte count （OR=0.411， P=0.002） were independent risk factors for 28－day prognosis， and an LS－MELD model for 28－day prognosis was established as Logit （28－day prognosis）=－3.432+0.765×sex－0.890×lymphocyte count×10^－9+0.113×MELD（1 for male sex and 2 for female sex）. The ROC curve analysis showed that this model had an optimal cut－off value of 0.35， and then the patients were divided into low LS－MELD group （≤0.35） and high LS－MELD group （>0.35）； the low LS－MELD group had a significantly higher 28－day survival rate than the high LS－MELD group （P<0.001）. ConclusionPeripheral blood lymphocyte count combined with sex and MELD score has a certain value in predicting the short－term prognosis of ALCF patients.