OBJECTIVE: To evaluate the value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for assessing disease activity in patients with rheumatoid arthritis (RA) treated with tofacitinib. METHODS: This retrospective study was conducted among 98 RA patients in active stage treated with tofacitinib in Third Xiangya Hospital and 100 healthy control subjects from the Health Management Center of the hospital from 2019 to 2021. We collected blood samples from all the participants for measurement of erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and other blood parameters 1 month before and 6 months after tofacitinib treatment. We further evaluated PLR and NLR before and after tofacitinib treatment in the RA patients, and analyzed their correlations with RA disease activity. RESULTS: PLR and NLR increased significantly in RA patients as compared with the healthy controls. In the RA patients, PLR and NLR were positively correlated with the levels of hs- CRP, ESR, IL- 6, Disease Activity Score of 28 joints-ESR (DAS28-ESR), anti-cyclic citrullinated peptide (CCP), and rheumatoid factor (RF) before and after tofacitinib treatment. Tofacitinib treatment for 6 months significantly decreased hs-CRP, ESR, IL-6, CCP, RF and DAS28-ESR levels in the RA patients. CONCLUSION NLR and PLR can be useful biomarkers for assessing disease activity in RA patients treated with tofacitinib.
Humans ; Neutrophils ; Retrospective Studies ; C-Reactive Protein/analysis* ; Interleukin-6/metabolism* ; Arthritis, Rheumatoid ; Lymphocytes

Objective:To synthesize non-contrast-enhanced CT images from enhanced CT images using deep learning method based on convolutional neural network, and to evaluate the similarity between synthesized non-contrast-enhanced CT images by deep learning(DL-SNCT) and plain CT images considered as gold standard subjectively and objectively, as well as to explore their potential clinical value.Methods:Thirty-four patients who underwent conventional plain scan and enhanced CT scan at the same time were enrolled. Using deep learning model, DL-SNCT images were generated from the enhanced CT images for each patient. With plain CT images as gold standard, the image quality of DL-SNCT images was evaluated subjectively. The evaluation indices included anatomical structure clarity, artifacts, noise level, image structure integrity and image deformation using a 4-point system). Paired t-test was used to compare the difference in CT values of different anatomical parts with different hemodynamics (aorta, kidney, liver parenchyma, gluteus maximus) and different liver diseases with distinct enhancement patterns (liver cancer, liver hemangioma, liver metastasis and liver cyst) between DL-SNCT images and plain CT images. Results:In subjective evaluation, the average scores of DL-SNCT images in artifact, noise, image structure integrity and image distortion were all 4 points, which were consistent with those of plain CT images ( P>0.05). However, the average score of anatomical clarity was slightly lower than that of plain CT images (3.59±0.70 vs. 4) with significant difference ( Z = -2.89, P<0.05). For different anatomical parts, the CT values of aorta and kidney in DL-SNCT images were significantly higher than those in plain CT images ( t=-12.89, -9.58, P<0.05). There was no statistical difference in the CT values of liver parenchyma and gluteus maximus between DL-SNCT images and plain CT images ( P>0.05). For liver lesions with different enhancement patterns, the CT values of liver cancer, liver hemangioma and liver metastasis in DL-SNCT images were significantly higher than those in plain CT images( t=-10.84, -3.42, -3.98, P<0.05). There was no statistical difference in the CT values of liver cysts between DL-SNCT iamges and plain CT images ( P>0.05). Conclusions:The DL-SNCT image quality as well as the CT values of some anatomical structures with simple enhancement patterns is comparable to those of plain CT images considered as gold-standard. For those anatomical structures with variable enhancement and those liver lesions with complex enhancement patterns, there is still vast space for DL-SNCT images to be improved before it can be readily used in clinical practice.

【Objective】 To investigate the effect of multiple apheresis platelet donation on platelet indexes and aggregation function in platelet donors, and to analyze the relationship between platelet indexes and their relationship with platelet aggregation rate. 【Methods】 A total of 83 platelet donors were randomly selected from Foshan Central Blood Station from September 2021 to October 2022, and were divided into control group (n= 9, first-time platelet donors or donors with the time interval from the last platelet donation >1 year) and study group (n= 74, repeat platelet donors or donors with the time interval from the last platelet donation ≤ 1 year) according to the times of blood donation. The study group was divided into 4 subgroups: 2-5 times group, 6-10 times group, 11-15 times group and 16 times group. The platelet count(Plt), platelet distribution width (PDW), mean platelet volume (MPV), large platelet ratio (P-LCR), and maximum platelet aggregation rate (MAR) before donation in each group were detected and analyzed. 【Results】 There were no significant differences in Plt, MPV, PDW, P-LCR and MAR between the subgroups and the control group (P>0.05), and there were no significant differences in Plt, MPV, PDW, P-LCR and MAR between each subgroup (P>0.05) .There was a positive correlation between Plt and MAR in blood donors (P<0.05), and the correlation coefficient was 0.445. MPV, PDW and P-LCR were negatively correlated with MAR (P<0.05), and the correlation coefficients were -0.282, -0.233 and -0.217, respectively. Plt was negatively correlated with MPV, PDW and P-LCR (P < 0. 05), and the correlation coefficients were -0.399, -0.307 and -0.339, respectively. MPV, PDW and P-LCR are positively correlated with each other. The correlation coefficient between MPV and PDW was 0.792, that between MPV and P-LCR was 0.863, and tthat between PDW and P-LCR was 0.817. 【Conclusion】 There was no significant effect of multiple platelet donations on Plt, PDW, MPV, P-LCR and MAR in blood donors. Plt has the most significant impact on MAR among platelet indexes of platelet donors.

Objective:To investigate the clinical value of magnetic resonance imaging (MRI) plain scan and diffusion weighted imaging (DWI) in the diagnosis of brain metastases.Methods:The MRI plain imaging findings of 105 cases with brain metastases and 103 cases without brain metastases confirmed by enhanced MRI examination and clinical diagnosis were retrospectively analyzed. The comparisons of plain MRI findings including T1 weighted image (T1WI), T2WI, T2/fluid attenuated inversion recovery (T2/FLAIR), DWI and apparent diffusion coefficient (ADC) values were made between brain metastases and non-brain metastases.Results:The numbers of hypo-intensity, iso-intensity, hyper-intensity and heterogeneous signal intensity of T1WI in the brain metastatic group were 54, 23, 9 and 19, respectively, while the numbers of hypo-intensity and iso-intensity in the non-brain metastatic group were 52 and 51, respectively, with statistically significant difference ( P<0.001). The numbers of hypo-intensity, iso-intensity, hyper-intensity and heterogeneous signal intensity of T2WI in the brain metastatic group were 1, 9, 72 and 23, respectively, while the numbers of iso-intensity and hyper-intensity in the non-brain metastatic group were 11 and 92, respectively, with statistically significant difference ( P<0.001). The numbers of hypo-intensity, hyper-intensity and heterogeneous signal intensity of DWI in the brain metastatic group were 4, 31 and 65, respectively, while the number of hyper-intensity in the non-brain metastatic group was 4 and others were iso-intensity, respectively, with statistically significant difference ( P<0.001). The numbers of hypo-intensity, iso-intensity, hyper-intensity and heterogeneous signal intensity of T2WI/FLAIR in the brain metastatic group were 4, 5, 60 and 36, respectively, while all cases in the non-brain metastatic group were hyper-intensity, with statistically significant difference ( P<0.001). The number of lesion accompanied with peripheral edema in the brain metastatic group were 69 cases, significantly higher than 0 cases in the non-brain metastatic group ( P<0.001). The mean ADC value in the brain metastatic group were (0.919±0.019)×10 -3 mm 2/s, significantly lower than (1.098±0.012)×10 -3 mm 2/s of non-brain metastatic group ( P<0.05). Conclusions:For patients with a history of primary malignancy, the MRI plain scan signals of T1WI, T2WI, T2WI/FLAIR and DWI are significantly different between brain metastatic tumor and non-metastatic tumor. The mixed signal, peripheral edema and the restriction of DWI diffusion indicate brain metastases. The combined application of the above parameters can improve the diagnostic efficacy of predicting brain metastases, and contrast enhancement MRI examination should be performed for the confirmation of diagnosis.

Objective:To investigate the clinical value of magnetic resonance imaging (MRI) plain scan and diffusion weighted imaging (DWI) in the diagnosis of brain metastases.Methods:The MRI plain imaging findings of 105 cases with brain metastases and 103 cases without brain metastases confirmed by enhanced MRI examination and clinical diagnosis were retrospectively analyzed. The comparisons of plain MRI findings including T1 weighted image (T1WI), T2WI, T2/fluid attenuated inversion recovery (T2/FLAIR), DWI and apparent diffusion coefficient (ADC) values were made between brain metastases and non-brain metastases.Results:The numbers of hypo-intensity, iso-intensity, hyper-intensity and heterogeneous signal intensity of T1WI in the brain metastatic group were 54, 23, 9 and 19, respectively, while the numbers of hypo-intensity and iso-intensity in the non-brain metastatic group were 52 and 51, respectively, with statistically significant difference ( P<0.001). The numbers of hypo-intensity, iso-intensity, hyper-intensity and heterogeneous signal intensity of T2WI in the brain metastatic group were 1, 9, 72 and 23, respectively, while the numbers of iso-intensity and hyper-intensity in the non-brain metastatic group were 11 and 92, respectively, with statistically significant difference ( P<0.001). The numbers of hypo-intensity, hyper-intensity and heterogeneous signal intensity of DWI in the brain metastatic group were 4, 31 and 65, respectively, while the number of hyper-intensity in the non-brain metastatic group was 4 and others were iso-intensity, respectively, with statistically significant difference ( P<0.001). The numbers of hypo-intensity, iso-intensity, hyper-intensity and heterogeneous signal intensity of T2WI/FLAIR in the brain metastatic group were 4, 5, 60 and 36, respectively, while all cases in the non-brain metastatic group were hyper-intensity, with statistically significant difference ( P<0.001). The number of lesion accompanied with peripheral edema in the brain metastatic group were 69 cases, significantly higher than 0 cases in the non-brain metastatic group ( P<0.001). The mean ADC value in the brain metastatic group were (0.919±0.019)×10 -3 mm 2/s, significantly lower than (1.098±0.012)×10 -3 mm 2/s of non-brain metastatic group ( P<0.05). Conclusions:For patients with a history of primary malignancy, the MRI plain scan signals of T1WI, T2WI, T2WI/FLAIR and DWI are significantly different between brain metastatic tumor and non-metastatic tumor. The mixed signal, peripheral edema and the restriction of DWI diffusion indicate brain metastases. The combined application of the above parameters can improve the diagnostic efficacy of predicting brain metastases, and contrast enhancement MRI examination should be performed for the confirmation of diagnosis.

Objective To explore the risk factors of hepatic failure after major hepatectomy. Methods Clinical data of 293 patients receiving major hepatectomy in Sun Yat-sen Memorial Hospital of Sun Yat-sen University between January 2008 and February 2017 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. According to whether there was postoperative hepatic failure, the patients were divided into the hepatic failure group and non-hepatic failure group. There were 23 cases in the hepatic failure group, including 22 males and 1 female with the mean age of (53±12) years. There were 270 cases in non-hepatic failure group, including 224 males and 46 females with the age of (49±12) years. Single factor analysis and Logistic regression analysis were used to analyze the risk factors of postoperative hepatic failure. Results The incidence of hepatic failure after major hepatectomy was 7.8% (23/293). Multi-factor Logistic regression analysis showed that preoperative Plt, Child-Pugh classification of liver function, tumor diameter and vascular tumor thrombus were the independent influence factors of postoperative hepatic failure (OR=0.983, 0.020, 0.726, 0.225;P<0.05). Conclusion Preoperative Plt, Child-Pugh classification of liver function, tumor diameter and vascular tumor thrombus are the independent influence factors of hepatic failure after major hepatectomy.

Objective To analyze the related factors of donor′s donation reaction in first time apheresis platelets to provide a basis for formulating the preventive measures of donation reactions in apheresis platelets.Methods The donation data in 743 cases of first time apheresis platelet in this blood station were retrospectively analyzed,and the factors possible influencing the donation reaction occurrence in donors of the first time apheresis platelet were performed the univariate Logistic regression analysis,then observation indicators with statistical significance were performed the multivariate Logistic regression analysis.Results The univariate Logistic regression analysis showed that gender,age,body mass,whole blood donation history were the influencing factors of donors′ donation reaction in the first time apheresis platelets.In multivariate Logistic regression analysis,the main factors were age (OR=0.301,P<0.05),body mass (OR=0.411,P<0.05)and whole blood donation history(OR=0.441,P<0.05).Conclusion Age,body mass and whole blood donation history are the main influencing factors of donors′ donation reactions in the first time apheresis platelets.

Objective To analyze the genetic characteristics of echovirus type 25( Echo25) strains isolated from patients with viral encephalitis in Longyan city. Methods Cerebrospinal fluid(CSF) specimens were collected from hospitalized patients with viral encephalitis or central nervous system infection in Longyan,2012. Enteroviruses(EV)were isolated from the specimens and then identified. Four strains of Echo25 were screened out by using serum neutralization test. Coding sequence of the VP1 region of the 4 Echo25 strains were amplified by RT-PCR and then sequenced. A phylogenetic tree was constructed to ana-lyze the nucleotide sequence homology between those sequences and the sequences of reference Echo25 strains available in the GenBank database. Results The VP1 nucleotide sequences of Echo25 strains isola-ted in Longyan were 498 bp in length,encoding 166 amino acid residues. The homology analysis showed that the VP1 nucleotide sequences of 3 strains were identical,sharing 97% homology in nucleotide with the rest strain. The Echo25 strains isolated in Longyan were highly similar to KJ957190( Beijing,2010)and HM031189(Henan,2008)strains. Phylogenetic analysis revealed that the Echo25 strains isolated in Longyan belonged to genotype B1. Conclusion Echo25 was one of the pathogens causing viral encephalitis in Longyan in 2012 and different transmission chains of Echo25 had emerged. This study indicates that it is necessary to strengthen the surveillance for EV and understand the genetic variation of the Echo25 for provi-ding better supportive evidences for the prevention and control of related diseases.

Objective To synthesize Wye-125132,an inhibitor of mTOR,and to establish a synthetic route for industrial production.Methods Barbituric acid was used as the raw material to synthesize the intermediate 2, 4, 6-trichrolo-pyrimidine-5-carbaldehyde 2 via Vilsmeier-Haack and chlorination reaction, while intermediate 5 was prepared via 3-step reaction from 1,4-dioxaspiro-[4,5]decan-8-one.The condensation of 2 and 5 was followed by substitution reaction to obtain the key intermediate 7.The side chain 9 was prepared by 3-step reaction from bromine aniline.Then the title product 1 was obtained with the reaction of Suzuki cross-coupling of 7 and 9.The structures of intermediate and target compounds were confirmed by MS and 1 H-NMR.Results and Conclusion Compared with the method reported in the literature,this new synthesis method possesses some advantages, such as ready availablity of raw materials, simple operation, mild reaction conditions and easy disposal of products.The total yield is 13.2%,and the purity of the target compound is 99.77%.

Objective To study the brain functional activation under speech stimulation in presbycusis pa‐tients using blood oxygenation level dependent functional magnetic resonance imaging (BOLD - fMRI) .Methods Eighteen normal hearing young volunteers ,10 normal hearing elderly people and 10 presbycusis patients received fM ‐RI under auditory task .Experimental tasks included monosyllabic verbal stimulating at tone of 1 kHz and sound in‐tensity to 90 dB ± 3 dB(after ambient noise detector Smart Sensor AR844 measurement and calibration) randomly transmitted to left and right ear .Following block design ,each stimulus was repeated twice .The lateralization of brain activation analysis observed changes in hemispheric dominance cases (or ear advantage change) .We observed brain activation analysis and changes of hemispheric lateralization advantage (or ear advantages) .SPM5 software was used to deal with the original pictures in the off - line work station to get fictional maps ,volume and intensity of the acti‐vated brain regions of interest ,and calculate the laterality index (LI) .Results To young people ,regardless of left or right ear stimulation ,the contralateral (region of intrest ,ROI) activation volume and intensity significantly increased compared to ipsilateral ,appearing contralateral hemispheric dominance ,and laterality index were - 0 .58 (left ear stimulation) and 0 .37 (right ear stimulation) .Compared to young people ,elderly people with normal hearing and presbycusis contralateral hemisphere conduction advantage was significantly reduced under monaural stimulation ,and the laterality indexes were - 0 .24 ,0 .28 (the aged group) ,- 0 .18 ,0 .25 (presbycusis group) .Young people received the left and the right ear auditory task respectively ,and the ratio of the total volume of bilateral ROI activation was 1 :2 .06 ,appearing to the right ear advantage (left brain dominance) .While the aged and presbycusis group manifes‐ted as right ear advantage decreased (left ear advantage enhanced) ,whose the total volume ratio was 1 :1 .51 for the old normal subjects and 1 :1 .61 for the hearing impaired seniors .Conclusion Auditory verbal tasks activated brain regions in the superior temporal gyrus and middle temporal gyrus were most obvious .Aging may cause these brain regions to be activated weaker ,appearing to the trend of contralateral hemisphere .The aging and deafness lead to the cortical reorganization .This may be one of the reasons for the declined speech recognition .