目的 探讨血清乳酸脱氢酶（LDH）在中晚期肝癌患者接受靶向联合免疫治疗后的预后预测价值。方法 选取2022年1月—2024年8月在莆田学院附属医院肿瘤内科经病理和影像学检查确诊的中晚期肝癌患者作为研究对象。从医院的电子病历系统中收集患者的基线资料，随访截止2025年8月，并记录随访结果，包括患者的疾病缓解情况和死亡情况，以及无疾病进展生存期（PFS）、总生存期（OS）。采用Kaplan-Meier方法绘制不同基线LDH水平患者的OS生存曲线，并通过Log-rank检验比较生存曲线。同时，运用多因素Cox比例风险回归分析探讨影响中晚期肝癌患者在接受靶向联合免疫治疗后OS的相关因素。结果 结果显示，在50例肝癌患者中，基线LDH低于200 U/L的有15例，而高于200 U/L的有35例。与基线LDH＜200 U/L组相比，基线 LDH≥200 U/L患者PFS、OS更短，差异均有统计学意义（χ²分别为5.51、15.6，P值分别为0.019、0.017）。治疗8周后，与LDH降低患者相比，LDH升高患者OS更短，差异有统计学意义（χ²=13.2，P=0.04）。多因素Cox比例风险回归分析结果表明，基线LDH水平超过200 U/L是中晚期肝癌患者接受靶向联合免疫治疗后OS的影响因素［P=0.035，HR（95%CI）=5.03（1.12，22.54）］。结论 基线LDH水平较低的患者表现出更好的OS。基线LDH水平可以作为预测中晚期肝癌患者在接受靶向联合免疫治疗时预后的指标。 

   Objective To evaluate the prognostic significance of serum lactate dehydrogenase（LDH）levels in patients with advanced hepatocellular carcinoma（HCC）undergoing targeted therapy combined immunotherapy．Methods Patients diagnosed with advanced HCC were selected in Putian College Affiliated Hospital from January 2022 to August 2024，diagnosed with pathological and imaging examinations results．Patient baseline data were collected from the hospital’s electronic medical records，with follow-up extending until August 2025．We documented outcomes such as disease response and mortality，along with progression-free survival（PFS）and overall survival（OS）．Kaplan-Meier survival curves were constructed based on baseline LDH levels，and the Log-rank test was employed for comparison．Additionally，multivariate Cox proportional hazards regression analysis was conducted to identify factors influencing OS in patients receiving targeted therapy combined immunotherapy．Results Among the 50 patients，15 had baseline LDH levels below 200 U/L，while 35 had levels above．Patients with baseline LDH≥200 U/L had significantly shorter PFS and OS than those with baseline LDH ＜200 U/L（χ²=5.51 and 15.6 for PFS and OS，respectively；P=0.019 and 0.017，respectively）．After 8 weeks of treatment，patients with increased LDH had significantly shorter OS compared with patients with decreased LDH（χ²=13.2，P=0.04）．Multivariate Cox proportional hazards regression analysis indicated that a baseline LDH level exceeding 200 U/L is an independent prognostic factor for OS in patients with intermediate to advanced HCC receiving targeted therapy combined with immunotherapy（P=0.035，HR 5.03［1.12，22.54］）．Conclusions Patients with lower baseline LDH levels demonstrated better OS，suggesting that baseline LDH can serve as an important prognostic indicator for advanced HCC patients undergoing targeted combined immunotherapy．

目的 探讨血清白蛋白（ALB）、纤维蛋白原（FIB）、乳酸脱氢酶（LDH）水平联合检测对急性心肌梗死患者短期预后的预测价值，以期为临床早期制定相应干预方案、改善患者预后提供参考。 方法 回顾性选取我院2023年1月~2025年1月收治的132例急性心肌梗死患者，入院后均接受经皮冠脉介入术（PCI）术治疗，根据术后6个月是否发生心血管主要不良事件（MACE）分为预后不良组（n=34）、预后良好组（n=98），比较两组临床资料及入院时血清ALB、FIB、LDH水平，Logistic回归方程分析血清ALB、FIB、LDH水平与急性心肌梗死患者PCI术后预后的关系，受试者工作特征（ROC）曲线分析其预测价值。 结果 两组病变血管支数、Killip分级及入院时血清ALB、FIB、LDH水平比较，差异具有统计学意义（P＜0.05）；入院时血清ALB、FIB、LDH水平与PCI术后预后显著相关，均为其独立影响因素（P＜0.05）；绘制ROC曲线结果显示，入院时血清ALB、FIB、LDH对于PCI术后预后不良的预测AUC分别为0.795、0.856、0.832，联合预测预后不良的AUC为0.927（95%CI：0.892~0.963），大于各方案单独预测，敏感度为91.18%，特异度为89.80%；危险度分析显示，血清ALB低水平患者预后不良风险是高水平患者的6.127倍，血清FIB、LDH高水平患者预后不良风险是低水平患者的10.493、8.170倍（P＜0.05）。 结论 血清ALB、FIB、LDH水平联合检测对急性心肌梗死患者PCI术后预后具有较高预测价值，临床可根据其早期评估患者预后不良风险，以制定个体化干预方案，改善患者预后。

      目的   残余胆固醇（RC）是反映动脉粥样硬化性血脂异常的重要指标，其在糖尿病合并冠心病患者中的临床意义尚不明确。本研究旨在探讨RC水平对糖尿病合并冠心病患者心力衰竭风险的预测价值，并分析其相关性。方法   本研究为回顾性横断面研究，纳入2021年1月—2024年1月期间在鹤壁市人民医院接受诊治的292例糖尿病合并冠心病患者。根据是否存在心力衰竭分为心力衰竭组（128例）和无心力衰竭组（164例）。对基线特征进行比较，采用单因素和多因素Logistic回归分析RC与心力衰竭的相关性。同时，通过限制性立方样条（RCS）分析探讨RC与心力衰竭风险的线性关系，并通过受试者操作特征（ROC）曲线和曲线下面积（AUC）评估RC的预测价值。结果   心力衰竭组患者的男性比例、高血压患病率、RC水平等高于无心力衰竭组，而估算肾小球滤过率水平显著降低（P＜0.05）。单因素分析显示，RC＞0.7 mmol/L显著增加心力衰竭风险（OR=1.854，95%CI：1.161~2.960，P=0.010）。多因素Logistic回归分析中，全调整模型结果显示，RC作为分类变量时，RC＞0.7 mmol/L的患者心力衰竭风险显著增加1.891倍（OR=1.891，95%CI：1.047~3.415，P=0.035）；作为连续变量时，RC每增加1单位，心力衰竭风险增加2.464倍（OR=2.464，95%CI：1.495~4.064，P＜0.001）；Log₁₀RC的风险比为6.411（95%CI：2.246~18.302，P=0.001）；标化RC的风险比为1.687（95%CI：1.262~2.255，P＜0.001）。限制性立方样条分析表明RC与心力衰竭风险呈线性正相关，ROC分析显示RC预测心力衰竭的AUC为0.621（95%CI：0.555~0.687，P＜0.001）。结论  RC水平与糖尿病合并冠心病患者心力衰竭风险显著相关，且呈线性正相关。RC具有一定的预测价值，可作为该人群心力衰竭风险评估的潜在指标。

       Objective  Residual cholesterol（RC）is  an important marker  reflecting  dyslipidemia  associated with atherosclerosis．Its clinical significance in patients with diabetes and coronary heart disease（CHD）remains unclear．To explore the predictive value of RC level for the risk of heart failure（HF）in patients with diabetes and CHD and analyze their association．Methods  This retrospective cross-sectional study included 292 patients with diabetes and CHD who were treated at Hebi People’s Hospital between January 2021 and January 2024．Patients were divided into the HF group（128 cases）and the non-HF group（164 cases）based on the presence of HF．Baseline characteristics were compared，and univariate and multivariate Logistic  regression analyses were performed to assess the association between RC and HF．Additionally，restricted cubic spline（RCS）analysis was used to explore the linear relationship between RC and HF risk，and the predictive value of RC was evaluated using receiveroperating characteristic（ROC）curves and the area under the curve（AUC）．Results  The HF group had significantly higher proportions of males，hypertension prevalence and RC levels，while estimated glomerular filtration rate were significantly lower compared to the non-HF group（P＜0.05）．Univariate analysis showed that RC＞0.7 mmol/L significantly increased the risk of HF（OR=1.854，95%CI：1.161–2.960，P=0.010）．In the fully adjusted multivariate Logistic regression model，RC（RC＞0.7 mmol/L）was associated with a 1.891-fold increased risk of HF as a categorical variable（OR=1.891，95%CI：1.047–3.415，P=0.035）．As a continuous variable，each increased unit in RC was associated with a 2.464-fold increased risk of HF（OR=2.464，95%CI：1.495–4.064，P＜0.001）．The odds ratios for Log₁₀RC and standardized RC were 6.411（95%CI：2.246–18.302，P=0.001）and 1.687（95%CI：1.262–2.255，P＜0.001），respectively．ROC analysis indicated a linear positive association between RC and HF risk（P=0.002）．ROC analysis showed that RC had predictive value for HF，with an AUC of 0.621（95%CI：0.555–0.687，P＜0.001）．Conclusions  RC levels are significantly associated with the risk of HF in patients with diabetes and CHD，demonstrating a linear positive correlation．RC has potential predictive value and may serve as a useful indicator for assessing HFrisk in this population．

      目的   探讨妊娠期糖尿病（GDM）患者载脂蛋白B（Apo-B）、载脂蛋白A1（Apo-A1）水平在分娩巨大儿中的预测价值。方法   选取2023年1月—2024年1月在珠海市第五人民医院建档并进行孕检、分娩的85例GDM患者，按照分娩的新生儿体质量情况分为分娩正常组55例（新生儿体质量＜4 000 g）和分娩异常组30例（新生儿体质量≥4 000 g）。比较两组孕妇一般资料及孕早期的Apo-B、Apo-A1、Apo-B/Apo-A1比值，采用受试者操作特征（ROC）曲线分析Apo-B、Apo-A1、Apo-B/Apo-A1对GDM患者分娩巨大儿的预测价值。结果   分娩异常组Apo-B水平、Apo_B/Apo_A1比值（1.05±0.15）g/L、（0.81±0.23）］高于分娩正常组（0.95±0.12）g/L、（0.65±0.18）］（t分别为3.357、3.544，P＜0.05）；Apo-A1水平［（1.29±0.26）g/L］低于分娩正常组［（1.47±0.23）g/L］（t=3.292，P＜0.05）；ROC曲线显示，Apo-B、Apo-A1水平及Apo-B/Apo-A1比值预测GDM患者分娩巨大儿的曲线下面积（AUC）分别为0.705、0.660、0.709，灵敏度分别为63.33%、63.33%、66.67%，特异度分别为72.73%、74.55%、76.36%，其中Apo-B/Apo-A1比值预测效能最高（P＜0.05）。结论  GDM患者分娩巨大儿与孕早期Apo-B升高、Apo-A1水平降低密切相关，监测患者孕早期的Apo-B、Apo-A1水平及Apo-B/Apo-A1比值有助于临床对分娩巨大儿进行预测。

      Objective  To explore the predictive value of apolipoprotein B（Apo-B）and apolipoprotein A1（Apo-A1）levels on delivery of macrosomia in patients with gestational diabetes mellitus（GDM）．Methods  From January 2023 to January 2024，85 patients with GDM who were filed in the hospital and received pregnancy examination and delivery were selected．According to the neonatal body mass，the patients were divided into 55 cases in normal delivery group（newborn birth weight ＜4 000 g）and 30 cases in abnormal delivery group（ newborn birth weight ≥4 000 g）．The general data and levels of Apo-B，Apo-A1 and Apo-B/Apo-A1 in early pregnancy were compared between the two groups．Receiver operating characteristic（ROC）curve was used to analyze the predictive value of Apo-B，Apo-A1 and Apo-B/Apo-A1 on delivery of macrosomia in GDM patients．Results  The Apo-B and Apo-B/Apo-A1 in abnormal delivery group were（1.05±0.15）g/L and（0.81±0.23），which were higher than（0.95±0.12）g/L and（0.65±0.18）in normal delivery group（t=3.357，3.544，P＜0.05）．While the level of Apo-A1 in abnormal delivery group，（1.29±0.26）g/L，was lower than（1.47±0.23）g/L in normal delivery group（t=3.292，P＜0.05）．ROC curve showed that the areas under the curve（AUC）of Apo-B，Apo-A1 and Apo-B/Apo-A1 in  predicting macrosomia in GDM patients were 0.705，0.660 and 0.709，and the sensitivities were 63.33%，63.33% and 66.67%，and the specificities were 72.73%，74.55% and 76.36%，respectively．Apo-B/Apo-A1 had the highest predictive efficiency（P＜0.05）．Conclusions  The delivery of macrosomia in GDM patients is closely related to the increase of Apo-B and the decrease of Apo-A1 in early pregnancy．Monitoring Apo-B，Apo-A1 and Apo-B/Apo-A1 in early pregnancy is helpful to predict the delivery of macrosomia．

       目的   探讨脓毒性休克患者肿瘤坏死因子相关受体6 （TRAF6）、胆碱酯酶（ChE）及急性生理学和慢性健康状况评价Ⅱ（APACHE Ⅱ）对预后不良的预测价值。方法   回顾分析2023年2月—2024年3月于某院ICU病区收治的226例脓毒性休克患者的临床资料，基于患者预后情况分为预后良好组（n=151）以及预后不良组（n=75）。回顾226例脓毒性休克患者入院时及治疗后的TRAF6、ChE表达变化，并记录患者APACHEⅡ评分和序贯器官功能衰竭评估（SOFA）评分动态变化；比较并分析两组患者详尽的临床资料，探讨TRAF6、ChE联合APACHE Ⅱ评分之间的关联性以及上述指标对脓毒性休克患者预后情况的临床评估价值。采用Logistic回归来分析对脓毒性休克患者生存状况产生影响的潜在因素。结果   多因素Logistic回归分析，年龄、APACHE Ⅱ评分、SOFA评分、机械通气时间、TRAF6与ChE表达水平均是影响患者预后的独立危险因素（P＜0.05）；受试者操作特征曲线分析显示，年龄、APACHE Ⅱ评分、机械通气时间、SOFA评分、TRAF6、ChE表达水平联合预测脓毒性休克患者预后不良的曲线下面积为0.925，高于单独检测的0.689、0.783、0.794、0.781、0.708、0.827。结论   临床需要及时识别高龄、长时间机械通气时间、高APACHE Ⅱ与SOFA评分、高TRAF6和ChE表达水平的高风险患者，TRAF6、ChE表达水平、SOFA评分、APACHE Ⅱ评分可作为评估脓毒性休克患者预后情况的临床指标，联合应用能进一步提升临床价值。

      Objective  To explore the predictive value of tumor necrosis factor receptor associated factor 6（TRAF6），cholinesterase（ChE）and Acute Physiology and Chronic Health Evaluation II scove（APACHE II）for adverse prognosis in patients with septic shock．Methods  The clinical data of 226 patients with septic shock admitted to the Intensive Care Unit（ICU） of a hospital from February 2023 to March 2024 were retrospectively analyzed，and the patients were divided into a good prognosis group（n=151）and an adverse prognosis group（n=75）based on their prognosis．The expression of TRAF6 and ChE in 226 patients with septic shock was reviewed at admission and after treatment，while the dynamic changes of APACHE  II score and Sequential Organ Failure Assessment（SOFA）score were recorded．Detailed clinical data of the two groups were compared and analyzed to explore the correlation between TRAF6，ChE，APACHE II scores and the clinical evaluation value of the above indexes in the prognosis of patients with septic shock．Logistic regression was used to analyze the potential factors affecting the survival of septic shock patients．Results  Multiple Logistic regression analysis revealed that age，APACHE II score，SOFA score，mechanical ventilation time，TRAF6 and ChE expression levels were independent risk factors for prognosis（P＜0.05）．Receiver Operating Characteristic（ROC）curve analysis showed that the area under curve（AUC）was 0.925，which was higher than single index prediction（0.689，0.783，0.794，0.781，0.708 and 0.827）．Conclusions  High-risk patients with advanced age，prolonged mechanical ventilation，high APACHE II and SOFA scores，and high TRAF6 and ChE expression levels need to be identified in time．TRAF6，ChE expression levels，SOFA scores，and APACHE  II scores can be used as clinical indicators to evaluate the prognosis of septic shock patients．The combined application of those four indicators can further improve the clinical value．

目的 探讨转录因子E盒结合锌指蛋白1（ZEB1）、溶酶体相关膜蛋白5（LAMP5）在结直肠癌组织中的表达水平分析及预后预测价值。方法 选取驻马店市中心医院2018年1月—2020年1月收治的120例结直肠癌患者,分别采取所有患者的结直肠癌组织及癌旁组织进行免疫组化染色,对比ZEB1、LAMP5阳性率。对比不同病理特征结直肠癌患者ZEB1、LAMP5表达水平差异。对所有患者进行4年随访,依照随访结果将患者分为2个亚组,即预后不良组（n=35）和预后良好组（n=85）,对比两组患者一般临床特征及ZEB1、LAMP5表达水平,应用Logistic回归分析ZEB1、LAMP5对结直肠癌预后的预测价值。结果 结直肠癌组织ZEB1、LAMP5相对表达量（38.26±5.49、26.77±3.85）与ZEB1、LAMP5阳性率（86.67%、72.22%）高于癌旁组织（15.46±2.54、8.04±1.59、23.33%、15.56%],对比差异有统计学意义（t=41.280,χ²=25.437;t=49.255,χ²=16.071;P<0.05）。不同TNM分期[Ⅰ~Ⅱ期（35.55±4.13）、Ⅲ~Ⅳ期（42.32±4.75）]、淋巴结转移患者[是（44.37±4.28）、否（35.84±3.77）]、肿瘤分化程度[低分化（35.27±4.57）、中高分化（41.34±4.60）]ZEB1相对表达量对比差异有统计学意义（t=-8.281,P<0.001;t=10.746,P<0.001;t=-7.253,P<0.001）;不同TNM分期[Ⅱ期（24.88±3.37）、Ⅲ~Ⅳ期（29.61±2.57）]、淋巴结转移[是（30.72±2.19）、否（25.21±3.19）]、肿瘤分化程度[低分化（24.57±3.62）、中高分化（29.04±2.55）]患者LAMP5相对表达量对比差异有统计学意义（t=-8.254,P<0.001;t=9.227,P<0.001;t=-7.797,<0.001）;预后良好组与预后不良组患者性别、年龄、大体类型、肿瘤大小对比差异无统计学意义（P>0.05）,预后良好组与预后不良组患者TNM分期、淋巴结转移、肿瘤分化程度、ZEB1、LAMP5阳性比例对比差异有统计学意义（P<0.05）;Logistic回归分析显示：淋巴结转移、ZEB1阳性、LAMP5阳性为结直肠癌预后不良独立预测因素（P<0.05）。结论 ZEB1、LAMP5在结直肠癌组织中呈现高表达状态,且与结直肠癌的发生有关,同时ZEB1、LAMP5是结直肠癌预后的独立预测因素,两者有希望成为结直肠癌的治疗靶点。

Objective To investigate the expression levels and prognostic value of transcription factor E-box binding to zinc finger protein 1（ZEB1）and lysosomal associated membrane protein 5（LAMP5）in colorectal cancer tissues. Methods A total of 120 colorectal cancer patients admitted to a hospital from January 2018 to January 2020 were selected．Immunohistochemical staining was performed on the colorectal cancer tissues and adjacent tissues of all patients,and the positivity rates of ZEB1 and LAMP5 were compared．The expression levels of ZEB1 and LAMP5 in colorectal cancer patients with different pathological characteristics were compared．All patients were followed up for 4 years and divided into two subgroups based on the follow-up results,namely the poor prognosis group（n=35）and the good prognosis group（n=85）．The general clinical characteristics and expression levels of ZEB1 and LAMP5 were compared between the two groups．Logistic regression analysis was used to evaluate the predictive value of ZEB1 and LAMP5 for the prognosis of colorectal cancer. Results The relative expression level of ZEB 1 and LAMP 5 in colorectal cancer tissues [（38.26±5.49）,（26.77±3.85）] and the positive rate of ZEB 1 and LAMP 5（86.67%,72.22%）were significantly higher than that of adjacent tissues [（15.46±2.54）,（8.04±1.59）,23.33%,15.56%],the contrast difference was statistically significant（t=41.280,χ²=25.437;t=49.255,χ²=16.071;P<0.05）．Relative ZEBI expression levels in different TNM stages [I-Ⅱstage（35.55±4.13）,Ⅲ-Ⅳstage（42.32±4.75）],lymph node metastasis[Yes（44.37±4.28）,No（35.84±3.77）],degree of tumor differentiation [hypodifferentiated（35.27±4.57）,and middle or high differentiated（29.04±2.55）],those differences were statistically significant（t=-8.254,P<0.001;t=9.227,P<0.001;t=-7.797,P<0.001）．The relative expression of LAMP 5 between different TNM stages [I-Ⅱstage（24.88±3.37）,Ⅲ-Ⅳstage（29.61±2.57）],lymph node metastasis [yes（30.72±2.19）,no（25.21±3.19）],degree of tumor differentiation [hypodifferentiated（24.57±3.62）,and middle or high differentiated（29.04±2.55）],the contrast was statistically significant（t=-8.254,P<0.001;t=9.227,P<0.001;t=-7.797,P<0.001）．There were no differences in gender,age,gross type,and tumor size between the good prognosis group and the poor prognosis group（P>0.05）,while there were differences in TNM stages,lymph node metastasis,tumor differentiation degrees,ratio of ZEB 1 and LAMP 5（P<0.05）．Logistic regression analysis showed that TNM stage,lymph node metastasis,ZEB 1 positive,and LAMP 5 positive were independent predictive factors of poor prognosis in colorectal cancer（P<0.05）. Conclusions ZEB1 and LAMP5 are highly expressed in colorectal cancer tissues and closely related to the occurrence and development of colorectal cancer．ZEB1 and LAMP5 are independent prognostic factors for colorectal cancer,and they have the potential to become therapeutic targets for colorectal cancer．

目的 探讨肝脏衰弱程度联合肝功能分级预测肝硬化患者肝病复合不良事件的价值,作为识别和干预不良结局的依据。方法 选择2022年12月—2023年12月医院接收的肝硬化患者80例进行研究,随访6个月观察患者不良事件发生情况,将出现2个及以上肝病并发症的肝病复合不良事件患者25例作为观察组,将出现1个肝病并发症或未出现并发症的患者55例作为对照组,比较两组患者的基本资料、实验室指标、营养指标、体力活动水平、肝脏衰弱指数（LFI）、肝功能Child-Turcotte-Pugh（CTP）评分,采用单因素和多因素Cox回归分析评估肝硬化患者肝病复合不良事件的危险因素,使用受试者工作特征（ROC）曲线下面积评估LFI联合CTP评分预测肝硬化患者肝病复合不良事件的价值。结果 观察组年龄、丙氨酸氨基转移酶（ALT）高于对照组,红细胞计数（RBC）、血红蛋白（Hb）、血肌酐（Scr）、总胆红素（TBIL）、步速、小腿围低于对照组（t分别为4.235、6.500、3.826、3.989、4.289、8.878、2.474,均P<0.05）。观察组营养风险48.00%、LFI≥4.5分52.00%、CTP分级B/C级76.00%高于对照组18.18%、14.55%、27.27%（χ²分别为7.664、12.454、16.699,均P<0.05）。单因素Cox回归分析显示年龄、ALT、营养风险、LFI≥4.5分、CTP分级B/C级、RBC、Scr、TBIL、Hb、步速、小腿围为肝硬化患者发生肝病复合不良事件的危险因素（HR分别为2.251、1.578、1.626、1.981、1.715、1.428、1.443、1.419、1.336、1.332、1.254,均P<0.05）。多因素Cox回归分析显示年龄、营养风险、LFI≥4.5分、CTP分级B/C级为肝硬化患者发生肝病复合不良事件的独立危险因素（HR分别为2.275、1.746、2.025、1.895,P均<0.05）。ROC曲线结果显示LFI、CTP、LFI联合CTP预测肝硬化患者肝病复合不良事件的AUC分别为0.82、0.79、0.88（P<0.05）。结论 年龄、肝脏衰弱、CTP分级B/C级、营养风险为肝硬化患者肝病复合不良事件的危险因素,肝脏衰弱程度联合肝功能分级预测肝硬化患者肝病复合不良事件具有更高的效能。

Objective To explore the value of predicting liver disease complex adverse events in patients with liver cirrhosis by combining the degree of liver frailty with liver function grading,as a basis for identifying and intervening in adverse outcomes．Methods A study was conducted on 80 patients with liver cirrhosis admitted to the hospital from December 2022 to December 2023． Patients were followed up for six months to observe the occurrence of adverse events．Twenty-five patients with liver disease complex adverse events with two or more liver disease complications were selected as the observation group,and 55 patients with one or no liver disease complication were selected as the control group．The basic information,laboratory indicators,nutritional indicators,physical activity levels,liver frailty index（LFI）,Child Turcotte Pugh（CTP）scores,univariate and multivariate Cox regression analysis were used to evaluate the risk factors for liver disease complex adverse events in liver cirrhosis patients．The value of combining LFI and CTP score in predicting liver disease complex adverse events in patients with liver cirrhosis was assessed by Receiver Operating Characteristic（ROC）curve area．Results The age,alanine aminotransferase（ALT）,red blood cell count（RBC）,hemoglobin（Hb）,serum creatinine（Scr）,total bilirubin（TBIL）,walking speed,and calf circumference of the observation group were higher than those of the control group（t=4.235,6.500,3.826,3.989,4.289,8.878,2.474,all P<0.05）．The nutritional risk of the observation group was 48.00%,LFI score≥4.5 was 52.00%,CTP grade B/C was 76.00%,which was higher than that of the control group at 18.18%,14.55%,and 27.27%（χ²=7.664,12.454,16.699,all P<0.05）．Univariate Cox regression analysis showed age,ALT,nutritional risk,LFI ≥ 4.5,CTP grade B/C,RBC,Scr,TBIL,Hb,step speed and calf circumference were risk factors for the occurrence of liver disease complex adverse events in patients with liver cirrhosis（HR values=2.251,1.578,1.626,1.981,1.715,1.428,1.443,1.419,1.336,1.332,1.254,all P<0.05）．Multivariate Cox regression analysis showed that age,nutritional risk,LFI ≥ 4.5,and CTP grade B/C were independent risk factors for liver disease complex adverse events in patients with liver cirrhosis（HR values=2.275,1.746,2.025,1.895,all P<0.05）．The ROC curve results showed that the AUC of LFI,CTP,and LFI combined with CTP in predicting liver disease composite adverse events in patients with liver cirrhosis were 0.82,0.79,and 0.88,respectively（P<0.05）．Conclusions Age,liver frailty,CTP grade B/C,and nutritional risk are risk factors for liver disease complex adverse events in patients with liver cirrhosis．The combination of LFI and liver function grade has higher efficacy in predicting liver disease complex adverse events in patients with liver cirrhosis．

目的 研究单核细胞/高密度脂蛋白比值（MHR）对免疫球蛋白A肾病（IgAN）患者肾小球硬化严重程度的预测价值。方法 回顾性分析2016年1月—2022年6月龙岩人民医院收治的296例IgAN患者的临床和肾脏病理资料,参照牛津分型将患者分为无肾小球节段性硬化组（S0组）、有肾小球节段性硬化组（S1组）及球性硬化组;根据Katafuchi肾小球积分将患者分为低三分位组、中三分位组及高三分位组。比较不同肾小球硬化程度和不同Katafuchi肾小球积分患者的MHR水平,对MHR与Katafuchi肾小球积分的关系进行相关性分析,绘制受试者操作特征（ROC）曲线分析MHR对肾小球硬化程度的预测效能。结果 S1组和球性硬化组的单核细胞计数分别为（0.41±0.11）×10⁹ /L、（0.45±0.10）×10⁹ /L,均高于S0组的（0.30±0.06）×10⁹ /L,对比差异有统计学意义（t₁=10.381,P₁<0.001;t₂=12.169,P₂<0.001）,球性硬化组的HDL水平为（1.14±0.16）mmoL/L,低于S0组（1.26±0.24）mmoL/L（t₂=2.992,P₂=0.003）。S1组和球性硬化组的MHR为（0.36±0.04）、（0.44±0.05）,大于S0组的（0.24±0.02）,对比差异有统计学意义（t₁=37.852,P₁<0.001;t₂=42.037,P₂<0.001）,球性硬化组的MHR大于S1组（t₃=9.673,P₃<0.001）。中三分位组和高三分位组的单核细胞计数为（0.34±0.06）×10⁹ /L、（0.48±0.10）×10⁹ /L,高于低三分位组的（0.27±0.05）×10⁹ /L,对比差异有统计学意义（t₁=9.017,P₁<0.001;t₂=20.080,P₂<0.001）,高三分位组的单核细胞计数高于中三分位组（t₃=8.855,P₃<0.001）。高三分位组的HDL水平为（0.96±0.12）mmoL/L,低于低三分位组的（1.23±0.21）mmoL/L和中三分位组的（1.19±0.16）mmoL/L,对比差异有统计学意义（t₂=8.132,P₂<0.001;t₃=7.954,P₃<0.001）。高三分位组的MHR为（0.49±0.07）,大于低三分位组的（0.25±0.03）和中三分位组（0.26±0.08）,对比差异有统计学意义（t₂=35.382,P₂<0.001;t₃=15.146,P₃<0.001）。相关性分析显示,单核细胞与Katafuchi肾小球积分呈正相关（r=0.58,P<0.05）,HDL与Katafuchi肾小球积分呈负相关（r=-0.52,P<0.05）,MHR与Katafuchi肾小球积分呈正相关（r=0.66,P<0.05）。MHR预测肾小球节段性硬化的曲线下面积（AUC）为0.609（95%CI：0.325~0.917）,此时截断值为0.29,灵敏度为68.42%,特异度为65.45%。MHR预测球性硬化的AUC为0.735（95%CI：0.527~1.001）,此时截断值为0.40,灵敏度为73.08%,特异度为66.14%。结论 MHR在预测IgAN患者肾小球硬化程度方面具有潜能。

Objective To explore predictive value of the monocyte / high-density lipoprotein ratio（MHR）on the severity of glomerulosclerosis in patients with immunoglobulin A nephropathy（IgAN）．Methods The clinical and renal pathological data of 296 IgAN patients admitted to Longyan People's Hospital from January 2016 to June 2022 were analyzed retrospectively,and the patients were divided into no segmental sclerosis group（S0）,segment sclerosis group（S1）and glomerular sclerosis group according to Oxford classification;the patients were divided into low group,middle group and high group according to Katafuchi score．MHR levels in patients with different degrees of glomerular sclerosis and different Katafuchi score were compared,the relationship between MHR and Katafuchi glomerular integration was analyzed,and ROC curves were drawn to analyze the predictive efficacy of MHR on the degree of glomerular sclerosis．Results Monocyte counts in the S1 and glomerular sclerosis groups [（0.41±0.11）10⁹ /L,（0.45±0.10）10⁹ /L] were all significantly higher than the S0 group（0.30±0.06）10⁹ /L,with statistically significant difference（t₁=10.381,P₁<0.001,t₂=12.169,P₂<0.001）．The HDL level（1.14±0.16）mmoL / L was significantly lower than that in the S0 group（1.26±0.24）mmoL / L（t₂=2.992,P₂=0.003）．The MHR in S1 and glomerular sclerosis group[（0.36±0.04）,（0.44±0.05）] were significantly greater than S0（0.24±0.02）（t₁=37.852,P₁<0.001,t₂=42.037,P₂<0.001）,and the MHR in glomerular sclerosis group was significantly greater than that of S1（t₃=9.673,P₃<0.001）．The monocyte counts of middle and high group[（0.34±0.06）10⁹ /L,（0.48±0.10）10⁹ /L] were significantly higher than the low group（0.27±0.05）10⁹ /L（t₁=9.017,P₁<0.001;t₂=20.080,P₂<0.001）and high group was significantly higher than middle group（t₃=8.855,P₃<0.001）．The HDL level of high group（0.96±0.12）mmoL/L was significantly lower than the low group（1.23±0.21）mmoL/L and middle group（1.19±0.16）mmoL/L,with statistically significance（t₂=8.132,P₂<0.001,t₃=7.954,P₃<0.001）．The MHR（0.49±0.07）in the high group was significantly greater than the low group（0.25±0.03）and middle group（0.26±0.08）,with statistically significance（t₂=35.382,P₂<0.001,t₃=15.146,P₃<0.001）．Correlation analysis showed that monocytes were positively correlated with Katafuchi score（r=0.58,P<0.05）,HDL negatively with Katafuchi score（r=-0.52,P<0.05）,and MHR positively with Katafuchi score（r=0.66,P<0.05）．The AUC of MHR predicting segmental sclerosis was 0.609（95%CI：0.325~0.917）,when the cut-off was 0.29,sensitivity was 68.42% and specificity of 65.45%．The AUC of MHR predicting glomerulosclerosis was 0.735（95%CI：0.527~1.001）,when the cut-off was 0.40,sensitivity was 73.08% and specificity was 66.14%．Conclusions MHR has the potential in predicting the degree of glomerulosclerosis in IgAN patients．

目的 探讨血沉(ESR)对川崎病(KD)冠状动脉病变(CAL)的预测价值。方法 收集 2017 年 5 月— 2021 年 6 月收治入院的KD患儿的临床资料,分析ESR对KD患儿CAL发生的预测作用。结果 纳入272例KD患儿,70例KD患儿合并CAL,202例KD患儿无CAL。KD患儿的ESR升高。单因素分析提示CAL组的ESR低于非CAL组,差异有统计学意义(P＜0.05)。ROC曲线下的面积为0.586,提示ESR可作为CAL的预测因子(P＜0.05)。ESR预测川崎病冠脉病变发生的临界值为76.5 mm/h。二分类Logistic回归分析显示,ESR是KD患儿发生CAL的独立危险因素(P＜0.05),当ESR＜76.5 mm·h^-1时,KD患儿CAL发生风险增加 (OR=2.38,95% CI: 1.25~4.53)。结论 KD急性期的ESR水平可用于预测KD患儿CAL的发生,ESR＜76.5 mm·h^-1时,提示KD患儿可能会出现CAL。

Objective To investigate the predictive value of erythrocyte sedimentation rate (ESR) on coronary artery lesions (CAL) in Kawasaki disease (KD). Methods Clinical data of children with KD admitted to the hospital from May 2017 to June 2021 were collected to analyze the predictive value of ESR on the occurrence of CAL in children with KD. Results Of the 272 enrolled children with KD, 70 children with CAL and 202 children without CAL. ESR was significantly higher in children with KD. Univariate analysis suggested that ESR was lower in the CAL group than in the non-CAL group, and the difference was statistically significant (P<0.05). The area under the ROC curve was 0.586, suggesting that ESR could be a predictor of CAL (P<0.05). The critical value of ESR for predicting the occurrence of CAL in KD was 76.5 mm/h. Dichotomous Logistic regression analysis showed that ESR was an independent risk factor for the development of CAL in children with KD (P<0.05), and the risk of CAL in children with KD was significantly increased when ESR was<76.5 mm/h. (OR = 2.38, 95% CI: 1.25-4.53). Conclusions ESR levels in the acute phase of KD can be used to predict the development of CAL in children with KD, and ESR <76.5 mm/h suggests that children with KD may develop CAL.

目的 研究CXC趋化因子配体4（CXCL4）、基质金属蛋白酶-9（MMP-9）、微小RNA-24（miR-24）对急性脑梗死（ACI）早期神经功能恶化（END）的预测价值。方法 分别选择2020年1月—2021年6月我院收治的30例ACI早期END患者（ACI+END组）,30例单纯ACI患者（ACI组）,同时期30例健康人群作为对照组,检测受试者CXCL4、MMP-9、miR-24表达情况及存在的相关性,分析血清CXCL4、MMP-9、miR-24表达情况与ACI早期发生END的关系。结果 CXCL4、MMP-9水平在对照组、ACI组、ACI+END组中依次升高,miR-24相对表达量依次降低（P<0.05）。血清CXCL4、MMP-9、miR-24水平在轻度、重度患者中呈升高趋势,miR-24相对表达呈降低趋势（P<0.05）。Logistic回归分析血清CXCL4、MMP-9、miR-24表达异常与ACI早期发生END独立相关（P<0.05）。经Pearson相关性分析发现,CXCL4与MMP-9之间呈正相关（r=0.584,P=0.001）;CXCL4、miR-24之间呈负相关（r=-0.569,P=0.001）,MMP-9、miR-24之间呈负相关（r=-0.567,P=0.001）。ROC曲线显示,与CXCL4、MMP-9、miR-24单项预测相比,三项联合对ACI的关系及对早期END的预测价值较高（P<0.05）。结论 CXCL4、MMP-9、miR-24在ACI发生END时出现异常表达,检测CXCL4、MMP-9、miR-24水平对ACI早期END具有一定预测价值,可尽早制定相关措施干预,提高治疗效率。

Objective To study the predictive value of CXC chemokine ligand 4（CXCL4）,matrix metalloproteinase-9（MMP-9）,microRNA-24（miR-24）in early neurological deterioration（END）of acute cerebral infarction（ACI）．Methods A total of 30 patients with ACI early END（ACI+END group）and 30 patients with ACI only（ACI group）who were admitted to our hospital from January 2020 to June 2021 were selected,and 30 healthy people（control group）who underwent physical examination in our hospital during the same period were selected．Expressions of CXCL4,MMP-9,and miR-24 were detected and their correlations were analyzed,and the relationship between the expressions of serum CXCL4,MMP-9,miR-24 and the early occurrence of END in ACI were analyzed．Results The levels of CXCL4 and MMP-9 were increased in the control group,ACI group and ACI+END group in turn,and the relative expression of miR-24 was decreased in turn,and the differences among the groups were statistically significant（P<0.05）．The levels of serum CXCL4,MMP-9,and miR-24 increased in mild and severe patients,while the relative expression of miR-24 decreased,and the differences between groups were statistically significant（P<0.05）．Logistic regression analysis showed that abnormal expressions of serum CXCL4,MMP-9 and miR-24 were independently correlated with the early occurrence of END in ACI（P<0.05）．After Pearson correlation analysis,it was found that there was a positive correlation between CXCL4 and MMP-9（r=0.584,P=0.001）,a negative correlation between CXCL4 and miR-24（r=-0.569,P=0.001）;a negative correlation between MMP-9 and miR-24（r=-0.567,P=0.001）．The ROC curve showed that compared with the single prediction of CXCL4,MMP-9 and miR-24,the predictive value of the combined prediction on ACI and early END were higher（P<0.05）．Conclusions CXCL4,MMP-9,and miR-24 are abnormally expressed in ACI when END occurs．Detection of CXCL4,MMP-9,and miR-24 levels has certain predictive value for early END of ACI,and relevant measures can be formulated as soon as possible to improve treatment efficiency．