ObjectiveTo investigate the association between neutrophil-to-lymphocyte and platelet ratio （NLPR） and recompensation in patients with hepatitis B cirrhotic ascites， and to establish an individualized risk prediction model. MethodsThe patients with hepatitis B cirrhotic ascites who were hospitalized in Department of Gastroenterology， The General Hospital of Western Theater Command of Chinese PLA， from January 2015 to December 2022 were enrolled. General information and laboratory markers were collected， and NLPR was calculated. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the chi-square test with correction was used for comparison of categorical data between two groups. The subjects were randomly divided into a training set and a validation set at a ratio of 7∶3. In the training set， univariate and multivariate binary Logistic regression analyses were used to investigate the independent influencing factors for recompensation in patients with hepatitis B cirrhotic ascites， and a nomogram was established； the receiver operating characteristic （ROC） curve was used to assess the value of the new model in predicting recompensation in patients with hepatitis B cirrhotic ascites， and the Delong test was used for comparison of the area under the ROC curve （AUC）. The calibration curve and the decision curve were plotted for the model， and the model was assessed in terms of degree of fitting and predictive benefits. ResultsA total of 360 patients were enrolled， among whom134 achieved recompensation. There were 252 patients in the training set and 108 patients in the validation set， and there were no significant differences in baseline characteristics between the two groups （all P>0.05）. The Logistic regression analysis showed that the onset of hepatic encephalopathy （odds ratio ［OR］=0.066， 95% confidence interval ［CI］： 0.008 — 0.545， P=0.012）， NLPR （OR=0.950， 95%CI： 0.912 — 0.989， P=0.012）， alpha-fetoprotein （OR=1.012， 95%CI： 1.005 — 1.020， P<0.001）， and albumin （OR=1.096， 95%CI： 1.031 — 1.166， P=0.003） were independent influencing factors for recompensation in patients with hepatitis B cirrhotic ascites. The above four factors were included in a nomogram predictive model， which had an AUC of 0.776， a sensitivity of 66.5%， and a specificity of 76.3% in the training set and an AUC of 0.746， a sensitivity of 63.4%， and a specificity of 75.7% in the validation set， while Model for End-Stage Liver Disease score， Child-Pugh score， and albumin-bilirubin score had an AUC of 0.574， 0.628， and 0.621， respectively. The nomogram model had a better performance than the other three scores in predicting recompensation in patients with hepatitis B cirrhotic ascites （Z=4.191， 3.369， and 3.527， P<0.001， P=0.001， and P<0.001）. The calibration curve and the decision curve showed that the model had a good degree of fitting， and the decision made using this model could bring net benefits. ConclusionNLPR has a good value in predicting recompensation in patients with hepatitis B cirrhotic ascites， and the nomogram model established can help to predict recompensation in such patients in clinical practice.

Purpose To investigate the expression of SMOC2 in papillary thyroid carcinomas(PTC)and its efficacy in joint diagnosis with CK19,Galectin-3,MC and BRAF V600E.Methods Bioinformatics was uesd to analyze the mR-NA expression differences of SMOC2 in PTC and benign thyroid tissues in the Gene Expression Omnibus database and The Canc-er Genome Atlas database.Detection of SMOC2 protein expres-sion in paraffin tissue of 75 cases of PTC and 45 cases of papilla-ry thyroid hyperplasia(PTH)was used by using EnVision meth-od,combined with CK19,Galectin-3,and MC and BRAF V600E for sensitivity and specificity analysis.Results The bioinformatics analysis results showed that the mRNA expression level of SMOC2 in PTC tissue was significantly lower than that in benign thyroid tissue(P<0.05),and the area under the curve(AUC)predicted by SMOC2 for PTC diagnosis was 0.910(P<0.001).The immunohistochemical results showed that the ex-pression of SMOC2 in PTC was significantly lower than that in PTH tissue(P<0.001),and the AUC of SMOC2 for PTC diag-nosis was 0.898(P<0.001).The AUC of SMOC2 combined with CK19,Galectin-3,MC and BRAF V600E in the diagnosis of PTC was 1.000(P<0.001),and the AUC values of the combination of other markers were lower than 1.000.Conclu-sion The expression of SMOC2 in PTC is significantly de-creased,which can be used as an important marker for the diag-nosis and differential diagnosis of PTC.Combined with CK19,Galectin-3,MC and BRAF V600E,the sensitivity and specifici-ty of PTC can be improved to a certain extent.

ObjectiveTo analyze the quality of life and related factors in patients with depression， and to provide evidence for formulating the corresponding measures to improve the patients' quality of life. MethodsA total of 117 inpatients who met the International Classification of Diseases， tenth edition（ICD-10） for depression were selected in Central People's Hospital of Zhanjiang， Affiliated Hospital of Guangdong Medical University and Guangdong 999 Brain Hospital from November 19， 2018 to September 7， 2019. The values of patients' clinical objective indicators consisted of routine blood test， routine urine examination， blood biochemical tests and blood gas analysis were collected by reviewing their medical records， and all subjects were assessed using Quality of Life Instruments for Chronic Diseases-Depression V2.0 ［QLICD-DE（V2.0）］. Simple correlation analysis was used to explore the correlation between the QLICD-DE （V2.0） scores and various clinical objective indicators， and multiple linear regression was adopted to further screen factors affecting quality of life of patients with depression. ResultsSimple correlation analysis suggested that QLICD-DE （V2.0） total score was positively correlated with total protein and platelet distribution width in patients with depression （r=0.198， 0.281， P<0.05 or 0.01）， and negatively correlated with hematocrit （r=-0.300， P<0.01）. Multiple linear regression analysis showed that albumin-to-globulin ratio and treatment compliance （B=-19.836， -3.711， P<0.05 or 0.01） were influential factors for physical function. Platelet distribution width （B=2.706， P<0.01） was an influential factor for psychological function. Bilirubin （B=-6.375， P<0.05） was an influential factor for social function. Platelet distribution width （B=2.101， P<0.05） was an influencing factor for specific module. The albumin-to-globulin ratio and platelet distribution width （B=-10.653， 2.114， P<0.05 or 0.01） were influencing factors for total score of QLICD-DE （V2.0）. ConclusionTreatment compliance and clinical objective indicators platelet distribution width， bilirubin and albumin-to-globulin ratio may be the influencing factors of quality of life in patients with depression.

Objective To investigate the clinical features and prognosis of central nervous system(CNS)in-volvement in Epstein-Barr virus(EBV)associated hemophagocytic lymphohistiocytosis(HLH).Methods A total of 89 patients with EBV-HLH diagnosed in Children's Hospital of Chongqing Medical University from June 2006 to Octo-ber 2015 were divided into involved CNS group and non-involved group according to whether there was CNS involve-ment. The clinical manifestations,laboratory examinations and outcomes of these two groups were analyzed. Results Among these 89 patients with EBV-HLH,39 patients developed CNS disease,19 cases of them had neuro-logical symptoms or signs,including convulsions,unconsciousness,facial palsy,dysarthria,dysphagia,irritability,neck stiffness,Babinski sign positive,opisthotonus;9 cases of them had abnormal cerebrospinal fluid(CSF),with elevated white blood cell count and protein level;26 patients had abnormal brain images,including deepen or widening cortical sulci,atrophy,hemorrhage,high T2 signal in magnetic resonance imaging(MRI).The 3-year survival rate in involved CNS group was lower than those of non-involved group(66.7% vs.86.0%),and there was statistical significance (χ2=4.267,P=0.039).The involved CNS group had higher ferritin(χ2=5.092,3.921;P=0.024,0.048)and lower platelets(Z= -2.643,P=0.008)than those of non-involved group,and there were statistical significances.COX mul-tivariate analysis showed that neurological symptom and abnormal CSF were independent prognostic factors(RR=3.134, 3.339,all P<0.05).Conclusion CNS involvement is frequent in EBV-HLH.The prognosis of children with involved CNS group is worse than those of non-involved group.Neurological symptoms and abnormal CSF are related to poor prognosis.

Objective: To investigate the characteristics and prognostic factor of central nervous system (CNS) involvement in patients with hemophagocytic lymphohistiocytosis (HLH) . Methods: From January 2006 to October 2015, 152 patients with HLH, 88 patients had CNS involvement, their clinical data were collected, and survival was analyzed using the Kaplan-Meier life table method, univariate and multivariate Cox regression model analyses were applied to identify the risk factors of prognosis. Results: ①57.9% patients complicated with neurological symptoms, cerebrospinal fluid abnormalities were observed in 37.0% patients, 57.5% patients had abnormal neuroradiology. ②36 patients survived well, 3 patients lost to follow-up, 49 dead, 1 survival patient had epilepsy. ③The 3-year overall survival rate of 88 patients was 44%. ④abnormal CSF and unreceived IT bore a significant, independent adverse prognostic value (P<0.05) . Conclusion CNS involvement in HLH has a high frequency and poor prognosis, few patients remained neurologic sequelae; abnormal CSF related to poor prognosis, positive intrathecal injections could improve the prognosis.