Smooth motion parallax method for 3D light-field displays with a narrow pitch based on optimizing the light beam divergence angle.

The three-dimensional (3D) light field display (LFD) with dense views can provide smooth motion parallax for the human eye. Increasing the number of views will widen the lens pitch, however, resulting in a decrease in view resolution. In this paper, an approach to smooth motion parallax based on optimizing the divergence angle of the light beam (DALB) for 3D LFD with narrow pitch is proposed. DALB is controlled by lens design. A views-fitting optimization algorithm is established based on a mathematical model between DALB and view distribution. Subsequently, the lens is reversely designed based on the optimization results. A co-designed convolutional neural network (CNN) is used to implement the algorithm. The optical experiment shows that a smooth motion parallax 3D image is achievable through the proposed method.

Vertically spliced tabletop light field cave display with extended depth content and separately optimized compound lens array.

Tabletop three-dimensional light field display is a kind of compelling display technology that can simultaneously provide stereoscopic vision for multiple viewers surrounding the lateral side of the device. However, if the flat panel light field display device is simply placed horizontally and displayed directly above, the visual frustum will be tilted and the 3D content outside the display panel will be invisible, the large oblique viewing angle will also lead to serious aberrations. In this paper, we demonstrate what we believe to be a new vertical spliced light field cave display system with an extended depth content. A separate optimization of different compound lens array attenuates the aberration from different oblique viewing angles, and a local heating fitting method is implemented to ensure the accuracy of fabrication process. The image coding method and the correction of the multiple viewpoints realize the correct construction of spliced voxels. In the experiment, a high-definition and precisely spliced 3D city terrain scene is demonstrated on the prototype with a correct oblique perspective in 100-degree horizontal viewing range. We envision that our research will provide more inspiration for future immersive large-scale glass-free virtual reality display technologies.

Pneumocystis jirovecii Pneumonia Secondary to Blinatumomab Therapy: A Case Report.

INTRODUCTION: With the increasing use of blinatumomab in relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL), including minimal residual disease (MRD)-positive cases, awareness of its adverse effects has gradually improved. Pneumocystis jirovecii pneumonia (PCP) associated with blinatumomab therapy is rare. CASE PRESENTATION: We present a case of PCP in a patient undergoing blinatumomab therapy. A 70-year-old female diagnosed with Philadelphia-like CRLF2 overexpression B-cell precursor ALL received blinatumomab as consolidation therapy after achieving complete remission with prior induction chemotherapy. On the second day of blinatumomab infusion, she developed intermittent low-grade fever, and chest computed tomography (CT) revealed subtle infiltrates and nodules. Despite empiric trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis, she progressed to significant shortness of breath and type I respiratory failure, with increased lactate dehydrogenase and ß-D-glucan assays. Chest CT showed diffuse ground-glass opacities with scattered small nodules. The dry cough prompted next-generation sequencing of peripheral blood, which tested positive for pneumocystis jirovecii without evidence of other pathogens. Consequently, the patient was diagnosed with PCP. The first cycle of blinatumomab had to be discontinued, and therapeutic dosages of TMP-SMX and dexamethasone were administered, resulting in full recovery and stable condition during follow-ups. CONCLUSION: PCP is rare in B-cell precursor ALL patients receiving blinatumomab therapy but manifests with early onset and rapid disease progression. Despite prophylaxis, PCP infection cannot be ignored during blinatumomab therapy. Therefore, heightened attention is warranted when using blinatumomab therapy.

[A Survey of the Current Status and the Needs of Medical Imaging Technicians in China]. / ä¸­å›½åŒ»å­¦å½±åƒæŠ€æœ¯ä»Žä¸šäººå‘˜çŽ°çŠ¶å’Œéœ€æ±‚è°ƒæŸ¥ç ”ç©¶.

Objective: To investigate the status quo and the needs of medical imaging technicians (MITs) in the radiology department of secondary and tertiary hospitals in China, so as to provide references and support for the development of the medical imaging technology industry and the relevant policymaking by health administrative departments. Methods: The questionnaire was developed by the Chinese Society of Imaging Technology. The radiology department of each hospital involved in the survey recommended one MIT to fill out the online questionnaire. The contents included: (a) the basic information of the hospital; (b) a general overview of the MITs in the hospital; (c) daily work; (d) career development and promotion; (e) research status and needs, etc. Differences in the number of MIT staff were compared using the Mann-Whitney U test and the chi-square test was used to compare the differences in the selected numbers of MITs in need between regions or between different levels of hospitals. Results: In this investigation, valid questionnaires were finally obtained from a total of 5403 hospitals in 31 provinces in China. The total number of MITs of the hospitals covered in the sample was 67481. The number of MITs in each hospital was 9 (5, 16). The male-to-female ratio was 1.41:1. MITs who were 20 to 40 years old accounted for 78%. The proportions of MITs who had completed doctorate, master's, undergraduate, junior college, and technical secondary school or lower level education were 0.6%, 3.3%, 60.7%, 30.8%, and 4.55%, respectively. The proportions of chief MITs, deputy chief MITs, supervisor MITs, primary MITs, assistant technician and those below were 1.0%, 4.21%, 22.1%, 51.8%, and 20.9%, respectively. The overall professional satisfaction of MITs was good. "Lack of opportunities for learning and communication" was quoted as the main problem MITs encountered in regard to improving their job-related competency. 59.2% of the respondents had not published any academic papers in the past five years, and only 7.0% of the respondents had published in journals included in the Science Citation Index (SCI) in the past five years. Conclusion: MITs in China are on average relatively young and the number of MITs has greatly increased. At this stage, more attention should be given to the cultivation of talents and continuing education of MITs and the construction of the discipline should be further strengthened, so as to provide strong support for the development of the medical imaging technology industry in China.

Image edge smoothing method for light-field displays based on joint design of optical structure and elemental images.

Image visual quality is of fundamental importance for three-dimensional (3D) light-field displays. The pixels of a light-field display are enlarged after the imaging of the light-field system, increasing the graininess of the image, which leads to a severe decline in the image edge smoothness as well as image quality. In this paper, a joint optimization method is proposed to minimize the "sawtooth edge" phenomenon of reconstructed images in light-field display systems. In the joint optimization scheme, neural networks are used to simultaneously optimize the point spread functions of the optical components and elemental images, and the optical components are designed based on the results. The simulations and experimental data show that a less grainy 3D image is achievable through the proposed joint edge smoothing method.

Curved fiber compound eye camera inspired by the Strepsiptera vision.

The Strepsiptera vision possesses intriguing features of a large field of view (FOV) and relatively high resolution compared to normal compound eyes. However, it presents a significant challenge of the mismatch between the curved compound eyelet lens array and the planar image sensor to image in a large FOV for artificial compound eyes (ACE). We propose what we believe to be a novel curved fiber compound eye camera (CFCEC) here, which employs coherent fiber bundles as the optical relay system to transmit sub-images curvilinearly. A total of 106 eyelets are arranged based on a scheme similar to the Goldberg polyhedron, with the advantages of uniform interval and minor edge blindness. Then, a prototype of the CFCEC is fabricated and assembled. A series of experiments are conducted to assess the FOV, contrast, resolution, and overlap rate of FOV of the prototype. The results prove that the CFCEC has a total FOV of up to 160°×160° and a total overlap rate of FOV of approximately 65%, demonstrating the promising potential of the CFCEC in various applications, such as panoramic surveillance, 3D detection, and motion tracking.

The Tunable and Efficient Nanoporous CuAg Alloy Catalysts Toward Methanol Oxidation Reaction Synthesized by Electrochemical Dealloying of Metallic Glassy Precursors.

Three-dimensional (3D) nanoporous CuAg (NPCuAg) alloy catalysts with various Cu/Ag ratios are prepared by electrochemical dealloying of metallic glassy (MG) precursors. All dealloyed samples exhibit homogenous nanoporous structure and element composition distribution. After systematically evaluating their electrocatalytic performance toward MOR, it was found that the catalytic activity of the NPCuAg catalysts is enhanced along with the increase of Cu/Ag ratio, which may be attributed to the more exposed active reaction sites derived from high surface area of nanoporous structure and the optimal synergistic effect. Thus, the NPCu1.75 Ag alloy catalyst presents the best methanol electro-oxidation properties, including a high current density of 397.2 mA cm-2 and good operation stability that retaining 84.5 % catalytic activity even after 7200 s. These results outperform most reported copper-based MOR catalysts in alkaline methanol solution. Considering these advantages, the designed electrodes are expected to be promising catalysts for alkaline DMFCs applications.

Rapid fabrication of nanoporous iron by atmospheric plasma for efficient wastewater treatment.

Nanoporous (NP) iron with large surface area is highly desired for wastewater degradation catalysis. However, it remains a challenge for the fabrication of NP-Fe because the conventional aqueous dealloying or liquid metal dealloying are not applicable. Herein, a novel and universal plasma-assisted electro-dealloying technique was utilized to fabricate NP-Fe. The NP-Fe demonstrates evenly distributed pore structure. The pore density can be tuned by the variation of the ratio of Fe and Zn in the precursor, and the average pore size can be tuned by the processing time. Owing to its large specific surface area, the NP-Fe shows excellent wastewater degradation performance, which is 26 times better than that of commercial zero-valent iron catalysts. This study provides a useful approach to fabricate NP active metals with enhanced catalytic performance.

Distribution of problematic localized facial infantile haemangiomas and their response to propranolol: a retrospective cohort study.

BACKGROUND: The distribution and response to propranolol of problematic facial infantile haemangiomas (IHs) has rarely been described in the literature. AIM: To map problematic facial IHs and observe their response to propranolol. METHODS: Eligible patients were categorized according to focal location and cohorts corresponding to these (buccal, medial, zygomatic, lateral and multiregional) were created. The primary efficacy variable was regression score ranging from 1 to 4, calculated using results of colour Doppler ultrasonography. RESULTS: In total, 104 patients met the inclusion criteria. There were 32 (30·8%) IHs located in the buccal area, 12 (11·5%) in the medial area, 49 (47·1%) in the lateral area and 1 (1·0%) in the zygomatic area, with 10 (9·6%) IH cases having multiregional lesions. We found that the distribution pattern of most IHs matched the surface projection of the trunk of the external carotid and the facial arteries. Further analysis showed that the median regression score in the buccal and medial groups were significantly lower than those in the lateral and multiregional groups. CONCLUSION: Treatment of buccal and medial haemangiomas tends to be more challenging and their distribution pattern mainly reflects the direction of the facial vessels.

Aberration correction based on a pre-correction convolutional neural network for light-field displays.

Lens aberrations degrade the image quality and limit the viewing angle of light-field displays. In the present study, an approach to aberration reduction based on a pre-correction convolutional neural network (CNN) is demonstrated. The pre-correction CNN is employed to transform the elemental image array (EIA) generated by a virtual camera array into a pre-corrected EIA (PEIA). The pre-correction CNN is built and trained based on the aberrations of the lens array. The resulting PEIA, rather than the EIA, is presented on the liquid crystal display. Via the optical transformation of the lens array, higher quality 3D images are obtained. The validity of the proposed method is confirmed through simulations and optical experiments. A 70-degree viewing angle light field display with the improved image quality is demonstrated.

Responses of fungal communities along a chronosequence succession in soils of a tailing dam with reclamation by Heteropogon contortus.

Phytoremediation can obviously change the fungal communities in the soils, which will significantly impact carbon (C) and nitrogen (N) cycling in ecological system. So far, the relationship between soil fungal communities and environmental factors is still poorly understood along a long chronosequence. In this study, fungal communities in the surface and rhizosphere soils of a tailing dam with Heteropogon contortus phytoremediation were investigated to explore the evolution of fungal community in a span of 50 years. The results showed that microbial community diversity increases along with time series of Heteropogon contortus phytoremediation. The dominant Dothideomycetes (20.86%), Agaricomycetes (18.09%), and Arthoniomycetes (1.69%) in rhizosphere soils were relatively higher than those in topsoil (13.9%, 2.65%, and 0.20%) at class level. Spearman correction analysis by phylum level was conducted to detect whether microflora was related to soil Physico-chemical properties, which affecting the composition of fungal communities along with the Heteropogon contortus phytoremediation. The nitrogen cycle indicators represented good linear correlations as chronosequence goes on, the indexes in the rhizosphere soil were much higher than those in the surface soils and the highest level has occurred in the 47-year-old Heteropogon contortus phytoremediation. The relative abundance of plant pathogen, wood saprotroph, dung saprotroph, and Arbuscular Mycorrhizal showed an upward tendency in rhizosphere soils along with the Heteropogon contortus phytoremediation. The highest soil fungal communities abundance and diversity were possibly attributed to the high-quality Heteropogon contortus litter returning to the ground and artificial disturbance treatments. Such changes in soil fungal communities might demonstrate a significant step forward and provided theoretical support for the biological governance of Heteropogon contortus phytoremediation in 50 years. Our study provides an insight on microbial communities connecting with soil C, N, P and S cycles and community functions in a complex plant-fungal-soil system along a long chronosequence in mine micro-ecology.

Gut microbiota from coronary artery disease patients contributes to vascular dysfunction in mice by regulating bile acid metabolism and immune activation.

BACKGROUND: The gut microbiota was shown to play a crucial role in the development of vascular dysfunction, and the bacterial composition differed between healthy controls and coronary artery disease patients. The goal of this study was to investigate how the gut microbiota affects host metabolic homeostasis at the organism scale. METHODS: We colonized germ-free C57BL/6 J mice with faeces from healthy control donors (Con) and coronary artery disease (CAD) patients and fed both groups a high fat diet for 12 weeks. We monitored cholesterol and vascular function in the transplanted mice. We analysed bile acids profiles and gut microbiota composition. Transcriptome sequencing and flow cytometry were performed to evaluate inflammatory and immune response. RESULTS: CAD mice showed increased reactive oxygen species generation and intensive arterial stiffness. Microbiota profiles in recipient mice clustered according to the microbiota structure of the human donors. Clostridium symbiosum and Eggerthella colonization from CAD patients modulated the secondary bile acids pool, leading to an increase in lithocholic acid and keto-derivatives. Subsequently, bile acids imbalance in the CAD mice inhibited hepatic bile acids synthesis and resulted in elevated circulatory cholesterol. Moreover, the faecal microbiota from the CAD patients caused a significant induction of abnormal immune responses at both the transcriptome level and through the enhanced secretion of cytokines. In addition, microbes belonging to CAD promoted intestinal inflammation by contributing to lamina propria Th17/Treg imbalance and worsened gut barrier permeability. CONCLUSIONS: In summary, our findings elucidated that the gut microbiota impacts cholesterol homeostasis by modulating bile acids. In addition, the CAD-associated bacterial community was shown to function as an important regulator of systemic inflammation and to influence arterial stiffness.

Phylogeography, speciation and demographic history: Contrasting evidence from mitochondrial and nuclear markers of the Odorrana graminea sensu lato (Anura, Ranidae) in China.

Understanding the process of speciation and the factors driving the geographical distribution patterns of species is of great interest in ecology and evolutionary biology. Herein, we investigated the phylogeographic patterns, speciation, demographic history and genetic structure of the widespread endemic Odorrana graminea sensu lato in Southern China and adjacent areas. A total of 439 specimens from 68 localities were sequenced and analyzed for both mitochondrial (12S and 16S rRNA) and nuclear markers (RAG-1 and ten microsatellite loci). Phylogenetic analyses of the concatenated mtDNA data revealed five major highly divergent lineages within the O. graminea sensu lato in Southern China, and these divergent lineages were highly concordant with five geographical regions. The nuclear data showed a discordant genetic structure compared to the mtDNA lineages (Clades A, B, and C) for O. graminea sensu stricto, with an admixed pattern in the RAG-1 data and two structure clusters in the microsatellite data. The species delimitation analyses, based on three methods, supported the species status of Odorrana zhaoi and Odorrana rotodora, and revealed the existence of putative cryptic species in the O. graminea sensu stricto. In addition, one statistically significant gene flow event was detected from Clade B to Clade C based on mtDNA and RAG-1 data, and the microsatellite data suggested gene flow within the O. graminea sensu stricto. Bayesian skyline plotting analyses and ecological niche modeling supported demographic and range expansions during the LGM for Clades A and C of the O. graminea sensu stricto. In addition, ecological niche models suggested the existence of ecological divergence among the three Clades (Clades A, B and C) of the O. graminea sensu stricto. The intense uplifting of the Qinghai-Tibetan Plateau, the Quaternary climate oscillations, and drainage changes may have driven the speciation, genetic structure and phylogeoraphic patterns of the O. graminea sensu lato.

Enhanced electro-catalytic performance of Pd-based hierarchical nanoporous structures fabricated by micropatterning and dealloying of Pd-Ni-P metallic glass.

Pd-based catalysts are of significance for their application in direct alcohol fuel cells, due to the superior electro-catalytic performance and CO poisoning resistance. In this work, using Pd32Ni48P20 metallic glassy ribbon as precursor, micro/nano hierarchical nanoporous structure was constructed by the hybrid approach of thermal plastic micropatterning and subsequently electrochemical dealloying at 0.88 V for 120 min in 0.5 M H2SO4 and 0.5 M H3PO4. This hierarchical structure was composed of the periodical micro-rods and nanoporous structure, where the chemical constituent was 80.33 at% Pd, 4.87 at% Ni, 4.96 at% P, and 9.84 at% O. The nanoporous structures showed an enhanced methanol electro-oxidation performance in alkaline medium, owing to their enlarged specific surface area. Compared to single nanoporous structure, the hierarchical nanoporous structure exhibited much better electro-catalysis, mainly attributed to the large surface area and high mass transfer efficiency, indicating a promising perspective for the application in alkaline direct alcohol fuel cells.

Ultrasound for Measuring the Cross-Sectional Area of Biceps Brachii Muscle in Sarcopenia.

Background: Ultrasound is emerging as an effective method for measuring muscle mass in elderly people. It has been applied in numerous studies to obtain measurement of lower limbs. The study aims to explore the relationship between sarcopenia and ultrasound measurements of biceps brachii. Methods: Participants (n=179) aged over 60 years were enrolled from the first affiliated hospital of Zhejiang University. The muscle thickness (MT), cross-sectional area (CSA) and fat thickness (FT) of these participants were recorded. Spearman test and partial correlation test was used to determine the correlation between indicators. Mann-Whitney U test was performed to compare ultrasonic parameters between sarcopenia group and non-sarcopenia group. The binary logistic regression analysis was employed to detect the potential indicators and prediction equation of sarcopenia. Receiver operating characteristic (ROC) curve analysis was performed for the accuracy of equation. Results: The prevalence of sarcopenia were 16.3% and 10.8% respectively in men and women. CSA was significantly lower in sarcopenia group than non-sarcopenia group in women (P<0.05). CSA was positively correlated with skeletal muscle mass index (SMI) and grip strength (men: r=0.460, 0.433; women: r=0.267, 0.392). After controlling of age and BMI, these correlations disappeared. Binary logistic regression analysis showed that age (OR=1.149, 95%CI: 1.060-1.246; P=0.001) and CSA (OR=0.465, 95%CI: 0.225-0.963; P=0.039) was significant indicators associated with sarcopenia. Area Under Curve was 0.822 (95%CI: 0.725-0.919, P<0.001) for the prediction equation composed of age, gender and CSA for sarcopenia. Conclusion: CSA of the biceps brachii measured with ultrasound is an important indicator associated with sarcopenia.

The association between gut butyrate-producing bacteria and non-small-cell lung cancer.

BACKGROUND: Recently, it has been found that the gut microbiota may affect the development of lung cancer through the "gut-lung axis." To investigate this relationship, we performed this study to determine whether the gut microbiota in non-small-cell lung cancer (NSCLC) patients is different from that in healthy adults. METHODS: Quantitative PCR (qPCR) was used to detect the expression levels of eight gut butyrate-producing bacteria in healthy adults and NSCLC patients. We enrolled 30 patients with NSCLC and 30 subjects from 100 healthy adults after matching for age and sex. RESULTS: Compared to healthy adults, most of the gut butyrate-producing bacteria in NSCLC patients were significantly decreased; these included Faecalibacterium prausnitzii, Clostridium leptum, Clostridial cluster I, Ruminococcus spp., Clostridial Cluster XIVa, and Roseburia spp. Among the gut butyrate-producing bacteria, we analyzed Clostridial cluster IV and Eubacterium rectale were not decreased in NSCLC patients. CONCLUSIONS: We conclude that NSCLC patients had gut butyrate-producing bacteria dysbiosis. Further studies should be performed to investigate the underlying mechanisms of how these specific bacteria affect lung cancer progression and prognosis.

Ice/Salt-Assisted Synthesis of Ultrathin Two-Dimensional Micro/Mesoporous Iron and Nitrogen Co-Doped Carbon as an Efficient Electrocatalyst for Oxygen Reduction.

An ice/salt-assisted strategy has been developed to achieve the green and efficient synthesis of ultrathin two-dimensional (2D) micro/mesoporous carbon nanosheets (CNS) with the dominant active moieties of Fe-N4 (Fe-N-CNS) as high-performance electrocatalysts for the oxygen reduction reaction (ORR). The strategy involves freeze-drying a mixture of iron porphyrin and KCl salt using ice as template followed by a confined pyrolysis with KCl as an independent sealed nanoreactor to facilitate the formation of 2D carbon nanosheets, N incorporation, and porosity creation. The well-defined assembly of ultrathin 2D carbon nanosheets ensures high utilization of D1 and D3 Fe-N4 active sites, and effectively promotes the mass transport of ORR reactants by virtue of the pronounced mesoporous structure. The resulting Fe-N-CNS electrocatalyst was shown to exhibit superior ORR activity, better electrochemical durability, and methanol tolerance towards ORR in alkaline electrolyte relative to the commercial Pt/C electrocatalyst.

THE ASSOCIATION OF SERUM BILIRUBIN ON KIDNEY CLINICOPATHOLOGIC FEATURES AND RENAL OUTCOME IN PATIENTS WITH DIABETIC NEPHROPATHY: A BIOPSY-BASED STUDY.

Objective: To explore the relationship between serum bilirubin concentration and clinicopathologic features and renal outcome in biopsy-diagnosed diabetic nephropathy (DN) in patients with type 2 diabetes mellitus. Methods: In this retrospective study, 118 patients with DN were enrolled. Participants were divided into two groups according to their median baseline serum bilirubin concentration: Group 1 (serum bilirubin ≤7.5 µmol /L); Group 2 (serum bilirubin >7.5 µmol /L). Basic clinical parameters were measured at the time of renal biopsy, and the relationships between serum bilirubin and the clinicopathologic features and renal outcome were analyzed. Results: Patients in Group 1 often had inferior renal function. Compared with Group 2, the glomerular classification and interstitial inflammation were more severe in subjects of Group 1, while arteriolar hyalinosis and interstitial fibrosis and tubular atrophy (IFTA) were comparable between the groups. Serum bilirubin was negatively correlated with the severity of the glomerular classification, interstitial inflammation, and IFTA. In the prognostic analysis, higher serum bilirubin level was associated with a lower risk of progression to end-stage renal disease, which was independent of the effects of age, gender, duration of diabetes, anemia, serum glucose, and hypertension but not of estimated glomerular filtration rate (hazard ratio, 0.406; 95% confidence interval, 0.074 to 2.225; P = .299). Conclusion: Our study showed a negative correlation between serum bilirubin level and renal pathologic lesions in patients with DN; serum bilirubin showed an inverse association with DN progression, but this was not independent. Abbreviations: CI = confidence interval; CKD = chronic kidney disease; DM = diabetes mellitus; DN = diabetic nephropathy; DR = diabetic retinopathy; eGFR = estimated glomerular filtration rate; ESRD = end-stage renal disease; HbA1c = glycated hemoglobin; HO-1 = heme oxygenase 1; HR = hazard ratio; IFTA = interstitial fibrosis and tubular atrophy; log-BIL = log-transformed baseline serum bilirubin; T2DM = type 2 diabetes mellitus.

Thyroid hormones and diabetic nephropathy: An essential relationship to recognize.

AIMS: Although abnormal thyroid hormone metabolism is common in patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN), the relationship between thyroid hormones and DN is unclear and has been ignored during clinical practice. This study aimed to investigate the relationship between thyroid hormones and clinicopathologic changes in biopsy-proven DN patients. METHODS: Clinical and pathological data for 146 biopsy-proven DN patients were collected. The patients were divided into four groups: euthyroid group, high-thyroid stimulating hormone (TSH) group (SCH), low-free triiodothyronine (FT3) group (with normal levels of TSH and FT4), and high-TSH + low-FT3 group (with normal levels of FT4). The clinicopathologic features among the four groups were investigated. We evaluated the risks of abnormal thyroid hormone levels on DN by logistic regression with multivariable adjustments for other risk factors. We also performed quarterback and eight-point analyses of TSH and FT3 levels to determine their influences on DN. RESULTS: The overt proteinuria (>5 g/24 h) (P = 0.008) and severity of glomerular lesions (P = 0.011) differed between euthyroid group and high-TSH group significantly. Moreover, the levels of estimated glomerular filtration rate (P =0.019), serum creatinine (P =0.014), and severity of glomerular lesions (P =0.003) differed between the euthyroid group and low-FT3 group significantly. There were also significant differences between high-TSH, low-FT3 and high-TSH + low-FT3 patients, respectively. Respective correlations between high-TSH, low-FT3 and renal clinicopathologic changes were found to be significant according to logistic regression analyses. Quarterback and eight-point analyses indicated that patients with TSH levels of 4.54-5.67 mU/L had the most severe renal clinicopathologic changes, and the severity of renal changes decreased with increased FT3 levels. CONCLUSIONS: Diabetic nephropathy patients with high-TSH and/or low-FT3 had more severe proteinuria, renal insufficiency, and glomerular lesions, suggesting that regulating thyroid hormones might have a renoprotective effect.

Effects of neutrophil-lymphocyte ratio on renal function and histologic lesions in patients with diabetic nephropathy.

AIM: Chronic low-grade inflammation related to diabetic nephropathy (DN) may affect the serum neutrophil-lymphocyte ratio (NLR). We aimed to examine the cross-sectional relationships of NLR with renal function and structural lesions of DN in patients with type 2 diabetes mellitus (T2DM). METHODS: The study retrospectively included 247 patients with T2DM and biopsy-proven DN. The severity of different pathological lesions was evaluated based on the criteria of Renal Pathology Society. The patients were divided into two groups based on the median (2.42) of NLR level, group 1: NLR < 2.42 (n = 122) and group 2: NLR ≥ 2.42 (n = 125). Renal dysfunction was defined by estimated glomerular filtration rate less than 60 mL/min per 1.73 m2 . The influence of NLR on renal dysfunction was evaluated using logistic regression analysis. RESULTS: The spearman's rank-correlation test indicted that NLR was positively correlated with interstitial fibrosis and tubular atrophy (r = 0.170, P = 0.007) and serum fibrinogen (r = 0.261, P < 0.001), whereas negatively related with estimated glomerular filtration rate (r = -0.233, P < 0.001). However, the NLR level demonstrated no association with glomerular lesions, interstitial inflammation and arteriolar hyalinosis. A multivariate logistic regression analysis showed that higher level of NLR (≥2.42) was significantly associated with renal dysfunction when adjusting for some important baseline clinical and pathological variables (odds ratio, 2.46; 95% confidence interval, 1.21-4.97; P = 0.012). CONCLUSION: Increased NLR affects renal function and histologic lesions in patients with T2DM and may be an important factor for the progression of DN.