BACKGROUND The hemoglobin-to-red cell distribution width ratio(HRR)is a recently intro-duced,easily accessible marker that provides insights into inflammation and the tumor vascular microenvironment.It has been sugges...BACKGROUND The hemoglobin-to-red cell distribution width ratio(HRR)is a recently intro-duced,easily accessible marker that provides insights into inflammation and the tumor vascular microenvironment.It has been suggested to have prognostic value for overall survival in various types of cancer,including urothelial carcinoma,lung cancer,and hepatocellular carcinoma.It has not yet been sufficiently invest-igated in colorectal cancers(CRC).AIM To investigate the prognostic significance of the HRR and other inflammation-based hematological markers in patients with metastatic CRC.Additionally,the study evaluated the impact of surgical interventions,particularly metastasectomy,and multiple clinical and laboratory parameters on overall survival.By iden-tifying low-cost,accessible prognostic indicators,this research seeks to support clinicians in optimizing treatment strategies and risk stratification for patients with CRC.METHODS In this retrospective study,patients diagnosed with CRC between January 2020 and December 2024 were analyzed.The impact of HRR in conjunction with inflammatory markers and a total of 22 different clinical and laboratory para-meters on overall survival were evaluated using univariate Cox regression and a multivariate model.Survival curves were visualized using Kaplan-Meier analysis.RESULTS A total of 155 patients with CRC were included in the study.The median age was 60 years,and 61.9%presented with de novo metastasis.In the receiver operating characteristic curve and area under the curve analysis performed to determine the optimal cutoff,the values were found to be 6.10 for carcinoembryonic antigen(CEA)(P=0.036),18.85 for platelet-to-red cell distribution width ratio(P=0.028),and 10.87 for platelet distribution width-to-lymphocyte ratio(P=0.028).For neutrophil-to-lymphocyte ratio,systemic immune-inflammation index(SII),platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio,HRR,and carbohydrate antigen 19-9,an optimal cutoff could not be determined using the receiver operating characteristic-area under the curve analysis.Therefore,the median values were adopted as the cutoffs(3.09,835.96,177.50,0.380,0.824,and 21.6,respectively).Univariate analysis identified male gender(P=0.045),being under 65 years of age(P=0.001),history of metastas-ectomy(P=0.001),low serum CEA level(P=0.010),low PLR(P=0.024),low SII(P=0.010),and high HRR(P=0.025)as favorable prognostic factors for overall survival.In the multivariate model,being under 65 years of age[hazard ratio(HR)=1.59,95%confidence interval(CI):1.06-2.39,P=0.025],metastasectomy(HR=0.49,95%CI:0.29-0.85,P=0.011),CEA(HR=1.51,95%CI:1.0-2.28,P=0.048),and PLR(HR=1.63,95%CI:1.09-2.44,P=0.018)emerged as independent prognostic factors for overall survival,whereas gender,SII,and HRR did not retain statistical significance.CONCLUSION In conclusion,low HRR alone was a prognostic indicator.However,when modelled with other inflammatory and clinical parameters,it did not provide a sufficiently strong marker feature.展开更多
AIM:To assess and compare the utility of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic inflammation index(SII),and red blood cell distribution width(RDW)as potential biomarkers to pred...AIM:To assess and compare the utility of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic inflammation index(SII),and red blood cell distribution width(RDW)as potential biomarkers to predict the severity of diabetic retinopathy(DR)in the United States population.METHODS:The observational study enlisted patients diagnosed with DR from the National Health and Nutrition Examination Survey(NHANES)database,spanning the period from 2005 to 2008.The severity of DR was defined according to Early Treatment for Diabetic Retinopathy Study(ETDRs).The effect of NLR,PLR,SII,and RDW on proliferative diabetic retinopathy(PDR)were explored using multivariable logistic regression analysis model.Subgroup analysis and restricted cubic splines(RCS)were conducted to assess the robustness of the correlations across subgroups and to explore nonlinear relationships between four indices and PDR.The receiver operating characteristic(ROC)analysis was employed for the purpose of assessing and evaluating the predictive efficacy of NLR,PLR,SII,and RDW in determining the severity of DR.RESULTS:After adjusting for other confounders(age,gender,race,body mass index,diabetes duration,and HbA1c)in multivariable analysis,a unit increase of PLR×0.1,SII×0.01,and RDW would raise the risk for PDR by 15.6%,22.2%,and 33%,respectively.Particularly,there was a 2.208-fold greater risk of PDR in individuals with an elevated NLR(OR=2.208,95%CI,1.348-3.617,P<0.001).RCS analyses showed positive relationships of four indices and PDR after segmented regression based on their own turning points.The results of ROC analysis revealed that PLR+RDW[area under the curve(AUC)=0.772,95%CI:0.669-0.874]had the best predictive value for PDR,compared with NLR+PLR+SII(AUC=0.697,95%CI:0.570-0.825)or RDW alone(AUC=0.736,95%CI:0.646-0.826).CONCLUSION:The combination of RDW and NLR demonstrates a promising ability to predict the severity of DR across the United States population,and it could be promisingly used in clinics for monitoring the progress of DR.展开更多
AIM: To evaluate the accuracy of red cell distribution width (RDW) to platelet ratio (RPR) to predict in-hospital mortality in acute pancreatitis (AP).
BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to deco...BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.展开更多
BACKGROUND In spite of developing medical technologies to discover the etiopathogenesis of diseases and developments in the treatment of coronary artery disease, acute coronary syndromes(ACS) continue to be the main c...BACKGROUND In spite of developing medical technologies to discover the etiopathogenesis of diseases and developments in the treatment of coronary artery disease, acute coronary syndromes(ACS) continue to be the main cause of mortality and morbidity worldwide. New cardiac biomarkers and techniques are needed to help provide rapid diagnosis in order to evaluate risk in coronary artery patients.AIM To evaluate the effects of R to S ratio(RSR) in the electrocardiograph of patients with ACS, from the point of the arising complication after myocardial infarction(MI), to three-vessel disease(TVD) and mortality.METHODS The data of 1,296 patients with ACS, who presented to the emergency department of our hospital with chest pain between January 2014 and December2018 and were admitted to the cardiology clinic, were retrospectively included in this cross-sectional cohort study. Patients with an RSR value less than I were assigned to group Ⅰ, while those with an RSR value greater than Ⅰ were assigned to group Ⅱ.RESULTS In our study, 466(35.9%) of the 1,296 patients, 357(38.3%) in group 1 and 109(29.9%) in group 2, were female, with a mean age of 61.56 ± 9.42. ST-elevation MI 573(44.2%), unstable angina(UA) 502(38.7%) and non ST-elevation MI 220(17%)were more prevalent in group Ⅰ. Acute anterior MI 263(20.3) in group Ⅰ, and acute inferior MI 184(14.2) in group Ⅱ was higher. Ischemic heart failure was the most common complication. In group Ⅱ, the red cell distribution width(RDW) was 15.42 ± 1.82, the gensini score was 48.39 ± 36.44, the left ventricular ejection fraction was 41.17 ± 10.41, the TVD was 111(8.5), and the mortality rate was 72(5.6), which was significantly higher than group Ⅰ RDW; in MI with ST and nonST-elevation, in TVD, mortality and complications were high and low in UA. In single and multivariate regression analyses, the variables were associated with ACS risk.CONCLUSION RSR levels may be an auxiliary predictive value in ACS in terms of complications developing after MI, TVD, and mortality.展开更多
The effects of process parameters on the depth-to-width ratio （D/W） of flux-cored wire underwater wet welding with a certain type of homemade .flux-cored wire are studied. It is found that the welding .speed, wire f...The effects of process parameters on the depth-to-width ratio （D/W） of flux-cored wire underwater wet welding with a certain type of homemade .flux-cored wire are studied. It is found that the welding .speed, wire feeding speed and torch oscillating amplitude hare significant effects on the dopth-to-width ratio （D/W） of welds. The D/W ratio of welds increases significantly with the increase of welding speed without the oscillating of welding torch. It increased （from 0. 14 to 0. 26 ） with the increase of wire feeding speed while the torch oscillating. And it decreased linearly with the increase of torch oscillating amplitude. However, the influelwe of oscillating speed, wire extension and welding voltage on the D/W ratio of welds was not obvious.展开更多
Bed morphology is the result of a dynamic response to a complex meandering river system. It is an important factor for the further development of river. Based on the meandering river characterized by a large depth-to-...Bed morphology is the result of a dynamic response to a complex meandering river system. It is an important factor for the further development of river. Based on the meandering river characterized by a large depth-to-width ratio, a theoretical model is established with the coupling of Navier-Stokes （N-S）~ sediment transport, and bed deformation equations. The flow characteristics and bed response of river are obtained with the perturbation method. The research results show that, under the effect of two- dimensional flow disturbance, the bars and pools present the regular response. For a given sinuousness, the amplitude of the bed response can be used as a criterion to judge the bedform stability. The effects of the Reynolds number, disturbance wavenumber, sinuousness, and bed morphology gradient on the bed response development are described.展开更多
Based on the volume constancy with equal flow-per-second and elastic sheet stability theory, a coupling relationship among lateral thickness difference, width-to-thickness ratio of cold rolling strip steel under ideal...Based on the volume constancy with equal flow-per-second and elastic sheet stability theory, a coupling relationship among lateral thickness difference, width-to-thickness ratio of cold rolling strip steel under ideal and actual working conditions, and shape is concluded according to the comprehensive influence principle of various factors on the critical instable shape analyzed in-depth. Firstly, the influence model under actual working condition is developed by referring to the basic relationship between lateral thickness difference and shape under ideal condition. The test results prove that for thin strips with thickness below 0.3 mm, their lateral thickness differences have significant effect on the shape. After then, the combined influence of lateral thickness difference and width-to-thickness ratio on the critical instable shape is concluded according to the elastic sheet stability model, with the synthetic effect of these three factors analyzed. Test data indicate that for cold rolling strip steel with width-to-thickness ratio above 3 000, the critical instability stress difference decreases significantly. Actual measurements are conducted on the lateral thickness differences of two rolls of typical strip manufactured by a sixhigh cold mill, with the influence law of lateral thickness variation and width-to-thickness ratio comprehensively investigated. It is demonstrated that during the production of ultrathin strip steel with different width-to-thickness ratios, the loading roll shapes should be fine adjusted according to the lateral thickness difference of input strips.Therefore, the variation of lateral thickness difference of output strips can meet the requirement of shape stability,so as to obtain fine shape.展开更多
Bumps in coal mines have been recognized as a major hazard for many years. These sudden and violent failures around mine openings have compromised safety, ventilation and access to mine workings.Previous studies showe...Bumps in coal mines have been recognized as a major hazard for many years. These sudden and violent failures around mine openings have compromised safety, ventilation and access to mine workings.Previous studies showed that the violence of coal specimen failure depends on both the interface friction and width-to-height（W/H） ratio of coal specimen. The mode of failure for a uniaxially loaded coal specimen or a coal pillar is a combination of both shear failure along the interface and compressive failure in the coal. The shear failure along the interface triggered the compressive failure in coal. The compressive failure of a coal specimen or a coal pillar can be controlled by changing its W/H ratio. As the W/H ratio increases, the ultimate strength increases. Hence, with a proper combination of interface friction and the W/H ratio of pillar or coal specimen, the mode of failure will change from sudden violent failure which is brittle failure to non-violent failure which is ductile failure. The main objective of this paper is to determine at what W/H ratio and interface friction the mode of failure changes from violent to non-violent. In this research, coal specimens of W/H ratio ranging from 1 to 10 were uniaxially tested under two interface frictions of 0.1 and 0.25, and the results are presented and discussed.展开更多
The air-turbo-rocket(ATR)engine is a promising propulsion plant for achieving numerous surface and air launched missile missions.The application of lobed mixer in the ATR combustor can promote the mixing of the fuelri...The air-turbo-rocket(ATR)engine is a promising propulsion plant for achieving numerous surface and air launched missile missions.The application of lobed mixer in the ATR combustor can promote the mixing of the fuelrich gas and the air,thus improving the engine performance significantly.The numerical simulation method was conducted to explore the effects of lobe peak-to-trough width ratio on mixing and combustion performance in ATR combustors.Results show that:For a given peak lobe width b1,the combustion efficiency and total pressure loss decrease with the increase of trough lobe width b2;For a given b2,the combustion efficiency and total pressure loss decrease with the increase of b1;The fan-type lobed mixer with smaller b2has a better effect on promoting the combustion efficiency in the region near the ATR combustor center line than that with a pair of parallel side walls.The total pressure recovery coefficient reaches more than 0.99 at the exit of combustor in nonreactive combustion while the total pressure loss reaches more than 4%in the reacting combustion.Compared with the mixing process,more than80%of the total pressure loss is caused during combustion.展开更多
BACKGROUND Accumulating clinical evidence has shown that diabetes mellitus(DM)is a serious risk factor for cardiovascular disorders and an important factor for adverse cardiovascular events.AIM To explore the value of...BACKGROUND Accumulating clinical evidence has shown that diabetes mellitus(DM)is a serious risk factor for cardiovascular disorders and an important factor for adverse cardiovascular events.AIM To explore the value of the combined determination of the neutrophil-lymphocyte ratio(NLR)and red blood cell distribution width(RDW)in the early diagnosis and prognosis evaluation of DM complicated with heart failure(HF).METHODS We retrospectively analyzed clinical data on 65 patients with type 2 DM(T2DM)complicated with HF(research group,Res)and 60 concurrent patients with uncomplicated T2DM(control group,Con)diagnosed at Zhejiang Provincial People’s Hospital between January 2019 and December 2021.The NLR and RDW values were determined and comparatively analyzed,and their levels in T2DM+HF patients with different cardiac function grades were recorded.The receiver operating characteristic(ROC)curves were plotted to determine the NLR and RDW values(alone and in combination)for the early diagnosis of HF.The correlation between NLR and RDW with the presence or absence of cardiac events was also investigated.RESULTS Higher NLR and RDW levels were identified in the Res vs the Con groups(P<0.05).The NLR and RDW increased gradually and synchronously with the deterioration of cardiac function in the Res group,with marked differences in their levels among patients with grade II,III,and IV HF(P<0.05).ROC curve analysis revealed that NLR combined with RDW detection had an area under the curve of 0.915,a sensitivity of 76.9%,and a specificity of 100%for the early diagnosis of HF.Furthermore,HF patients with cardiac events showed higher NLR and RDW values compared with HF patients without cardiac events.CONCLUSION NLR and RDW were useful laboratory indicators for the early diagnosis of DM complicated with HF,and their joint detection was beneficial for improving diagnostic efficiency.Additionally,NLR and RDW values were directly proportional to patient outcomes.展开更多
Background: It has been postulated that elliptical cutaneous excisions must possess a length-to-width ratio of 3 to 4 and a vertex angle of 30o or less in order to be closed primarily without creating a “dog ear”. T...Background: It has been postulated that elliptical cutaneous excisions must possess a length-to-width ratio of 3 to 4 and a vertex angle of 30o or less in order to be closed primarily without creating a “dog ear”. These dimensions became axiomatic in cutaneous surgery and have been taught in the apprenticeship model for years. The present article examines the validity of that paradigm. Methods: We collected data from two sources: ellipses described in the literature (57 cases);and elliptical excisions performed at the authors’ outpatient clinic (83 cases). The surgical ellipse lengths, widths, and vertex angles were analyzed, and the data were compared to a mathematical formula used to generate a fusiform ellipse. Results: The length-to-width ratio of 3 - 4 was found to be inconsistent with the recommended vertex angle of 30o. In fact, a length-to-width ratio of 3 - 4 determines a vertex angle of 48o - 63o. A 30o vertex angle is only feasible with long length-to-width ration of about 7.5. Conclusions: The paradigm that surgical ellipses should have a vertex angle of 30o with length-to-width ratio of 3 - 4 is incorrect. Evidence from actual surgical practice and from mathematical formulation shows that either the length-to-width ratio must be larger than 3 - 4 or the vertex angle must be larger than 30 degrees.展开更多
Understanding and predicting droplet breakup is essential in droplet-based microfluidic systems,as it enables precise control over droplet manipulation for various applications.In this study,droplet breakup behavior i...Understanding and predicting droplet breakup is essential in droplet-based microfluidic systems,as it enables precise control over droplet manipulation for various applications.In this study,droplet breakup behavior in a T-junction microchannel is investigated under the influence of microchannel geometry using three-dimensional numerical simulations.A theoretical model is developed based on the balance between surface tension and viscous drag forces acting on the droplet,incorporating the effects of geometric parameters on droplet length.This model predicts the critical Capillary number required for breakup to occur.The theoretical predictions are validated using both previous research data and the present numerical simulations.The results show that the model accurately predicts the transition between breakup and non-breakup regimes.Specifically,an increase in sidearm length ratio inhibits droplet breakup and leads to an asymmetric breakup regime.Furthermore,increasing the outlet-to-inlet width ratio also reduces the likelihood of droplet breakup.These findings provide a predictive framework for understanding and controlling droplet dynamics in microfluidic T-junctions,with potential applications in lab-on-a-chip technologies.展开更多
文摘BACKGROUND The hemoglobin-to-red cell distribution width ratio(HRR)is a recently intro-duced,easily accessible marker that provides insights into inflammation and the tumor vascular microenvironment.It has been suggested to have prognostic value for overall survival in various types of cancer,including urothelial carcinoma,lung cancer,and hepatocellular carcinoma.It has not yet been sufficiently invest-igated in colorectal cancers(CRC).AIM To investigate the prognostic significance of the HRR and other inflammation-based hematological markers in patients with metastatic CRC.Additionally,the study evaluated the impact of surgical interventions,particularly metastasectomy,and multiple clinical and laboratory parameters on overall survival.By iden-tifying low-cost,accessible prognostic indicators,this research seeks to support clinicians in optimizing treatment strategies and risk stratification for patients with CRC.METHODS In this retrospective study,patients diagnosed with CRC between January 2020 and December 2024 were analyzed.The impact of HRR in conjunction with inflammatory markers and a total of 22 different clinical and laboratory para-meters on overall survival were evaluated using univariate Cox regression and a multivariate model.Survival curves were visualized using Kaplan-Meier analysis.RESULTS A total of 155 patients with CRC were included in the study.The median age was 60 years,and 61.9%presented with de novo metastasis.In the receiver operating characteristic curve and area under the curve analysis performed to determine the optimal cutoff,the values were found to be 6.10 for carcinoembryonic antigen(CEA)(P=0.036),18.85 for platelet-to-red cell distribution width ratio(P=0.028),and 10.87 for platelet distribution width-to-lymphocyte ratio(P=0.028).For neutrophil-to-lymphocyte ratio,systemic immune-inflammation index(SII),platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio,HRR,and carbohydrate antigen 19-9,an optimal cutoff could not be determined using the receiver operating characteristic-area under the curve analysis.Therefore,the median values were adopted as the cutoffs(3.09,835.96,177.50,0.380,0.824,and 21.6,respectively).Univariate analysis identified male gender(P=0.045),being under 65 years of age(P=0.001),history of metastas-ectomy(P=0.001),low serum CEA level(P=0.010),low PLR(P=0.024),low SII(P=0.010),and high HRR(P=0.025)as favorable prognostic factors for overall survival.In the multivariate model,being under 65 years of age[hazard ratio(HR)=1.59,95%confidence interval(CI):1.06-2.39,P=0.025],metastasectomy(HR=0.49,95%CI:0.29-0.85,P=0.011),CEA(HR=1.51,95%CI:1.0-2.28,P=0.048),and PLR(HR=1.63,95%CI:1.09-2.44,P=0.018)emerged as independent prognostic factors for overall survival,whereas gender,SII,and HRR did not retain statistical significance.CONCLUSION In conclusion,low HRR alone was a prognostic indicator.However,when modelled with other inflammatory and clinical parameters,it did not provide a sufficiently strong marker feature.
基金Supported by Tianjin Natural Science Foundation(No.23JCZXJC00140).
文摘AIM:To assess and compare the utility of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic inflammation index(SII),and red blood cell distribution width(RDW)as potential biomarkers to predict the severity of diabetic retinopathy(DR)in the United States population.METHODS:The observational study enlisted patients diagnosed with DR from the National Health and Nutrition Examination Survey(NHANES)database,spanning the period from 2005 to 2008.The severity of DR was defined according to Early Treatment for Diabetic Retinopathy Study(ETDRs).The effect of NLR,PLR,SII,and RDW on proliferative diabetic retinopathy(PDR)were explored using multivariable logistic regression analysis model.Subgroup analysis and restricted cubic splines(RCS)were conducted to assess the robustness of the correlations across subgroups and to explore nonlinear relationships between four indices and PDR.The receiver operating characteristic(ROC)analysis was employed for the purpose of assessing and evaluating the predictive efficacy of NLR,PLR,SII,and RDW in determining the severity of DR.RESULTS:After adjusting for other confounders(age,gender,race,body mass index,diabetes duration,and HbA1c)in multivariable analysis,a unit increase of PLR×0.1,SII×0.01,and RDW would raise the risk for PDR by 15.6%,22.2%,and 33%,respectively.Particularly,there was a 2.208-fold greater risk of PDR in individuals with an elevated NLR(OR=2.208,95%CI,1.348-3.617,P<0.001).RCS analyses showed positive relationships of four indices and PDR after segmented regression based on their own turning points.The results of ROC analysis revealed that PLR+RDW[area under the curve(AUC)=0.772,95%CI:0.669-0.874]had the best predictive value for PDR,compared with NLR+PLR+SII(AUC=0.697,95%CI:0.570-0.825)or RDW alone(AUC=0.736,95%CI:0.646-0.826).CONCLUSION:The combination of RDW and NLR demonstrates a promising ability to predict the severity of DR across the United States population,and it could be promisingly used in clinics for monitoring the progress of DR.
基金Supported by Ankara Numune Education and Research Hospital
文摘AIM: To evaluate the accuracy of red cell distribution width (RDW) to platelet ratio (RPR) to predict in-hospital mortality in acute pancreatitis (AP).
文摘BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.
文摘BACKGROUND In spite of developing medical technologies to discover the etiopathogenesis of diseases and developments in the treatment of coronary artery disease, acute coronary syndromes(ACS) continue to be the main cause of mortality and morbidity worldwide. New cardiac biomarkers and techniques are needed to help provide rapid diagnosis in order to evaluate risk in coronary artery patients.AIM To evaluate the effects of R to S ratio(RSR) in the electrocardiograph of patients with ACS, from the point of the arising complication after myocardial infarction(MI), to three-vessel disease(TVD) and mortality.METHODS The data of 1,296 patients with ACS, who presented to the emergency department of our hospital with chest pain between January 2014 and December2018 and were admitted to the cardiology clinic, were retrospectively included in this cross-sectional cohort study. Patients with an RSR value less than I were assigned to group Ⅰ, while those with an RSR value greater than Ⅰ were assigned to group Ⅱ.RESULTS In our study, 466(35.9%) of the 1,296 patients, 357(38.3%) in group 1 and 109(29.9%) in group 2, were female, with a mean age of 61.56 ± 9.42. ST-elevation MI 573(44.2%), unstable angina(UA) 502(38.7%) and non ST-elevation MI 220(17%)were more prevalent in group Ⅰ. Acute anterior MI 263(20.3) in group Ⅰ, and acute inferior MI 184(14.2) in group Ⅱ was higher. Ischemic heart failure was the most common complication. In group Ⅱ, the red cell distribution width(RDW) was 15.42 ± 1.82, the gensini score was 48.39 ± 36.44, the left ventricular ejection fraction was 41.17 ± 10.41, the TVD was 111(8.5), and the mortality rate was 72(5.6), which was significantly higher than group Ⅰ RDW; in MI with ST and nonST-elevation, in TVD, mortality and complications were high and low in UA. In single and multivariate regression analyses, the variables were associated with ACS risk.CONCLUSION RSR levels may be an auxiliary predictive value in ACS in terms of complications developing after MI, TVD, and mortality.
文摘The effects of process parameters on the depth-to-width ratio （D/W） of flux-cored wire underwater wet welding with a certain type of homemade .flux-cored wire are studied. It is found that the welding .speed, wire feeding speed and torch oscillating amplitude hare significant effects on the dopth-to-width ratio （D/W） of welds. The D/W ratio of welds increases significantly with the increase of welding speed without the oscillating of welding torch. It increased （from 0. 14 to 0. 26 ） with the increase of wire feeding speed while the torch oscillating. And it decreased linearly with the increase of torch oscillating amplitude. However, the influelwe of oscillating speed, wire extension and welding voltage on the D/W ratio of welds was not obvious.
文摘Bed morphology is the result of a dynamic response to a complex meandering river system. It is an important factor for the further development of river. Based on the meandering river characterized by a large depth-to-width ratio, a theoretical model is established with the coupling of Navier-Stokes （N-S）~ sediment transport, and bed deformation equations. The flow characteristics and bed response of river are obtained with the perturbation method. The research results show that, under the effect of two- dimensional flow disturbance, the bars and pools present the regular response. For a given sinuousness, the amplitude of the bed response can be used as a criterion to judge the bedform stability. The effects of the Reynolds number, disturbance wavenumber, sinuousness, and bed morphology gradient on the bed response development are described.
基金the Special Research Fund for the National Major Science and Technology Achievement Transformation Project(No.2012GG01)the National Natural Science Foundation of China(No.51305387)the Provincial Natural Science Foundation of Hebei of China(No.E2015203103)
文摘Based on the volume constancy with equal flow-per-second and elastic sheet stability theory, a coupling relationship among lateral thickness difference, width-to-thickness ratio of cold rolling strip steel under ideal and actual working conditions, and shape is concluded according to the comprehensive influence principle of various factors on the critical instable shape analyzed in-depth. Firstly, the influence model under actual working condition is developed by referring to the basic relationship between lateral thickness difference and shape under ideal condition. The test results prove that for thin strips with thickness below 0.3 mm, their lateral thickness differences have significant effect on the shape. After then, the combined influence of lateral thickness difference and width-to-thickness ratio on the critical instable shape is concluded according to the elastic sheet stability model, with the synthetic effect of these three factors analyzed. Test data indicate that for cold rolling strip steel with width-to-thickness ratio above 3 000, the critical instability stress difference decreases significantly. Actual measurements are conducted on the lateral thickness differences of two rolls of typical strip manufactured by a sixhigh cold mill, with the influence law of lateral thickness variation and width-to-thickness ratio comprehensively investigated. It is demonstrated that during the production of ultrathin strip steel with different width-to-thickness ratios, the loading roll shapes should be fine adjusted according to the lateral thickness difference of input strips.Therefore, the variation of lateral thickness difference of output strips can meet the requirement of shape stability,so as to obtain fine shape.
基金sponsored by Coal and Energy Research Bureau and CDC-NIOSH under Grant No.R01OH009532
文摘Bumps in coal mines have been recognized as a major hazard for many years. These sudden and violent failures around mine openings have compromised safety, ventilation and access to mine workings.Previous studies showed that the violence of coal specimen failure depends on both the interface friction and width-to-height（W/H） ratio of coal specimen. The mode of failure for a uniaxially loaded coal specimen or a coal pillar is a combination of both shear failure along the interface and compressive failure in the coal. The shear failure along the interface triggered the compressive failure in coal. The compressive failure of a coal specimen or a coal pillar can be controlled by changing its W/H ratio. As the W/H ratio increases, the ultimate strength increases. Hence, with a proper combination of interface friction and the W/H ratio of pillar or coal specimen, the mode of failure will change from sudden violent failure which is brittle failure to non-violent failure which is ductile failure. The main objective of this paper is to determine at what W/H ratio and interface friction the mode of failure changes from violent to non-violent. In this research, coal specimens of W/H ratio ranging from 1 to 10 were uniaxially tested under two interface frictions of 0.1 and 0.25, and the results are presented and discussed.
基金supported by the National Science and Technology Major Project(No.J2019-Ⅲ-0001-0044)。
文摘The air-turbo-rocket(ATR)engine is a promising propulsion plant for achieving numerous surface and air launched missile missions.The application of lobed mixer in the ATR combustor can promote the mixing of the fuelrich gas and the air,thus improving the engine performance significantly.The numerical simulation method was conducted to explore the effects of lobe peak-to-trough width ratio on mixing and combustion performance in ATR combustors.Results show that:For a given peak lobe width b1,the combustion efficiency and total pressure loss decrease with the increase of trough lobe width b2;For a given b2,the combustion efficiency and total pressure loss decrease with the increase of b1;The fan-type lobed mixer with smaller b2has a better effect on promoting the combustion efficiency in the region near the ATR combustor center line than that with a pair of parallel side walls.The total pressure recovery coefficient reaches more than 0.99 at the exit of combustor in nonreactive combustion while the total pressure loss reaches more than 4%in the reacting combustion.Compared with the mixing process,more than80%of the total pressure loss is caused during combustion.
基金Supported by Zhejiang Province Traditional Chinese Medicine Science and 158 Technology Project,No.2023ZL008.
文摘BACKGROUND Accumulating clinical evidence has shown that diabetes mellitus(DM)is a serious risk factor for cardiovascular disorders and an important factor for adverse cardiovascular events.AIM To explore the value of the combined determination of the neutrophil-lymphocyte ratio(NLR)and red blood cell distribution width(RDW)in the early diagnosis and prognosis evaluation of DM complicated with heart failure(HF).METHODS We retrospectively analyzed clinical data on 65 patients with type 2 DM(T2DM)complicated with HF(research group,Res)and 60 concurrent patients with uncomplicated T2DM(control group,Con)diagnosed at Zhejiang Provincial People’s Hospital between January 2019 and December 2021.The NLR and RDW values were determined and comparatively analyzed,and their levels in T2DM+HF patients with different cardiac function grades were recorded.The receiver operating characteristic(ROC)curves were plotted to determine the NLR and RDW values(alone and in combination)for the early diagnosis of HF.The correlation between NLR and RDW with the presence or absence of cardiac events was also investigated.RESULTS Higher NLR and RDW levels were identified in the Res vs the Con groups(P<0.05).The NLR and RDW increased gradually and synchronously with the deterioration of cardiac function in the Res group,with marked differences in their levels among patients with grade II,III,and IV HF(P<0.05).ROC curve analysis revealed that NLR combined with RDW detection had an area under the curve of 0.915,a sensitivity of 76.9%,and a specificity of 100%for the early diagnosis of HF.Furthermore,HF patients with cardiac events showed higher NLR and RDW values compared with HF patients without cardiac events.CONCLUSION NLR and RDW were useful laboratory indicators for the early diagnosis of DM complicated with HF,and their joint detection was beneficial for improving diagnostic efficiency.Additionally,NLR and RDW values were directly proportional to patient outcomes.
文摘Background: It has been postulated that elliptical cutaneous excisions must possess a length-to-width ratio of 3 to 4 and a vertex angle of 30o or less in order to be closed primarily without creating a “dog ear”. These dimensions became axiomatic in cutaneous surgery and have been taught in the apprenticeship model for years. The present article examines the validity of that paradigm. Methods: We collected data from two sources: ellipses described in the literature (57 cases);and elliptical excisions performed at the authors’ outpatient clinic (83 cases). The surgical ellipse lengths, widths, and vertex angles were analyzed, and the data were compared to a mathematical formula used to generate a fusiform ellipse. Results: The length-to-width ratio of 3 - 4 was found to be inconsistent with the recommended vertex angle of 30o. In fact, a length-to-width ratio of 3 - 4 determines a vertex angle of 48o - 63o. A 30o vertex angle is only feasible with long length-to-width ration of about 7.5. Conclusions: The paradigm that surgical ellipses should have a vertex angle of 30o with length-to-width ratio of 3 - 4 is incorrect. Evidence from actual surgical practice and from mathematical formulation shows that either the length-to-width ratio must be larger than 3 - 4 or the vertex angle must be larger than 30 degrees.
基金funded by the Master,Ph D Scholarship Programme of Vingroup Innovation Foundation(VINIF),code VINIF.2023.Th S.118。
文摘Understanding and predicting droplet breakup is essential in droplet-based microfluidic systems,as it enables precise control over droplet manipulation for various applications.In this study,droplet breakup behavior in a T-junction microchannel is investigated under the influence of microchannel geometry using three-dimensional numerical simulations.A theoretical model is developed based on the balance between surface tension and viscous drag forces acting on the droplet,incorporating the effects of geometric parameters on droplet length.This model predicts the critical Capillary number required for breakup to occur.The theoretical predictions are validated using both previous research data and the present numerical simulations.The results show that the model accurately predicts the transition between breakup and non-breakup regimes.Specifically,an increase in sidearm length ratio inhibits droplet breakup and leads to an asymmetric breakup regime.Furthermore,increasing the outlet-to-inlet width ratio also reduces the likelihood of droplet breakup.These findings provide a predictive framework for understanding and controlling droplet dynamics in microfluidic T-junctions,with potential applications in lab-on-a-chip technologies.
