A completely precious metal-free alkaline fuel cell with enhanced performance using a carbon-coated nickel anode.

SignificanceWe present a groundbreaking advance in completely nonprecious hydrogen fuel cell technologies achieving a record power density of 200 mW/cm2 with Ni@CNx anode and Co-Mn cathode. The 2-nm CNx coating weakens the O-binding energy, which effectively mitigates the undesirable surface oxidation during hydrogen oxidation reaction (HOR) polarization, leading to a stable fuel cell operation for Ni@CNx over 100 h at 200 mA/cm2, superior to a Ni nanoparticle counterpart. Ni@CNx exhibited a dramatically enhanced tolerance to CO relative to Pt/C, enabling the use of hydrogen gas with trace amounts of CO, critical for practical applications. The complete removal of precious metals in fuel cells lowers the catalyst cost to virtually negligible levels and marks a milestone for practical alkaline fuel cells.

Catalytic Peculiarity of Alkali Metal Cation-Free Electrode/Polyelectrolyte Interfaces Toward CO2 Reduction.

A prominent feature of modern electrochemical technologies, such as fuel cells and electrolysis, is the employing of polyelectrolytes instead of liquid electrolytes. Unlike the well-studied electrode/liquid electrolyte interfaces, however, the catalytic characteristics of electrode/polyelectrolyte interfaces remain largely unexplored, mostly due to the lack of reliable probing methods. Herein, we report a universally applicable approach to investigating electrocatalytic reactions at electrode/polyelectrolyte interfaces under normal electrochemical conditions. By coating a thin layer of anion-exchange membrane (AEM) onto the electrode surface, solutions with bulky organic cations were well separated, thus a pure electrode/polyelectrolyte interface can be established in a regular electrochemical setup and studied using in situ spectroscopies, e.g., attenuated total reflectance surface-enhanced infrared absorption spectroscopy (ATR-SEIRAS). We found that the blank Au surface was inert toward the CO2 reduction reaction (CO2RR) in the absence of alkali metal cations, whereas coating with an AEM can dramatically turn on the catalytic activity. ATR-SEIRAS revealed that the hydrogen bond network of water at the Au/AEM interface was enhanced in comparison to that on the blank Au surface, which facilitated the hydrogenation process of the CO2RR. These findings further our fundamental understanding of the catalytic behavior of electrode/polyelectrolyte interfaces and benefit the development of relevant electrochemical technologies.

The lncRNA TRG-AS1 promotes the growth of colorectal cancer cells through the regulation of P2RY10/GNA13.

BACKGROUND: The lncRNA TRG-AS1 and its co-expressed gene P2RY10 are important for colorectal cancer (CRC) occurrence and development. The purpose of our research was to explore the roles of TRG-AS1 and P2RY10 in CRC progression. METHODS: The abundance of TRG-AS1 and P2RY10 in CRC cell lines (HT-29 and LoVo) and normal colon cells FHC was determined and difference between CRC cells and normal cells was compared. LoVo cells were transfected with si-TRG-AS1 and si-P2RY10 constructs. Subsequently, the viability, colony formation, and migration of the transfected cells were analyzed using cell counting kit-8, clonogenicity, and scratch-wound/Transwell® assays, respectively. Cells overexpressing GNA13 were used to further explore the relationship between TRG-AS1 and P2RY10 along with their downstream functions. Finally, nude mice were injected with different transfected cell types to observe tumor formation in vivo. RESULTS: TRG-AS1 and P2RY10 were significantly upregulated in HT-29 and LoVo compared to FHC cells. TRG-AS1 knockdown and P2RY10 silencing suppressed the viability, colony formation, and migration of LoVo cells. TRG-AS1 knockdown downregulated the expression of P2RY10, GNA12, and GNA13, while P2RY10 silencing downregulated the expression of TRG-AS1, GNA12, and GNA13. Additionally, GNA13 overexpression reversed the cell growth and gene expression changes in LoVo cells induced by TRG-AS1 knockdown or P2RY10 silencing. In vivo experiments revealed that CRC tumor growth was suppressed by TRG-AS1 knockdown and P2RY10 silencing. CONCLUSIONS: TRG-AS1 knockdown repressed the growth of HT-29 and LoVo by regulating P2RY10 and GNA13 expression.

Electrocatalysis in Alkaline Media and Alkaline Membrane-Based Energy Technologies.

Hydrogen energy-based electrochemical energy conversion technologies offer the promise of enabling a transition of the global energy landscape from fossil fuels to renewable energy. Here, we present a comprehensive review of the fundamentals of electrocatalysis in alkaline media and applications in alkaline-based energy technologies, particularly alkaline fuel cells and water electrolyzers. Anion exchange (alkaline) membrane fuel cells (AEMFCs) enable the use of nonprecious electrocatalysts for the sluggish oxygen reduction reaction (ORR), relative to proton exchange membrane fuel cells (PEMFCs), which require Pt-based electrocatalysts. However, the hydrogen oxidation reaction (HOR) kinetics is significantly slower in alkaline media than in acidic media. Understanding these phenomena requires applying theoretical and experimental methods to unravel molecular-level thermodynamics and kinetics of hydrogen and oxygen electrocatalysis and, particularly, the proton-coupled electron transfer (PCET) process that takes place in a proton-deficient alkaline media. Extensive electrochemical and spectroscopic studies, on single-crystal Pt and metal oxides, have contributed to the development of activity descriptors, as well as the identification of the nature of active sites, and the rate-determining steps of the HOR and ORR. Among these, the structure and reactivity of interfacial water serve as key potential and pH-dependent kinetic factors that are helping elucidate the origins of the HOR and ORR activity differences in acids and bases. Additionally, deliberately modulating and controlling catalyst-support interactions have provided valuable insights for enhancing catalyst accessibility and durability during operation. The design and synthesis of highly conductive and durable alkaline membranes/ionomers have enabled AEMFCs to reach initial performance metrics equal to or higher than those of PEMFCs. We emphasize the importance of using membrane electrode assemblies (MEAs) to integrate the often separately pursued/optimized electrocatalyst/support and membranes/ionomer components. Operando/in situ methods, at multiscales, and ab initio simulations provide a mechanistic understanding of electron, ion, and mass transport at catalyst/ionomer/membrane interfaces and the necessary guidance to achieve fuel cell operation in air over thousands of hours. We hope that this Review will serve as a roadmap for advancing the scientific understanding of the fundamental factors governing electrochemical energy conversion in alkaline media with the ultimate goal of achieving ultralow Pt or precious-metal-free high-performance and durable alkaline fuel cells and related technologies.

Multidimensional Electrochemistry Decodes the Operando Mechanism of Hydrogen Oxidation.

Being an efficient approach to the utilization of hydrogen energy, the hydrogen oxidation reaction (HOR) is of particular significance in the current carbon-neutrality time. Yet the mechanistic picture of the HOR is still blurred, mostly because the elemental steps of this reaction are rapid and highly entangled, especially when deviating from the thermodynamic equilibrium state. Here we report a strategy for decoding the HOR mechanism under operando conditions. In addition to the wide-potential-range I-V curves obtained using gas diffusion electrodes, we have applied the AC impedance spectroscopy to provide independent and complementary kinetic information. Combining multidimensional data sources has enabled us to fit, in mathematical rigor, the core kinetic parameter set in a 5-D data space. The reaction rate of the three elemental steps (Tafel, Heyrovsky, and Volmer reactions), as a function of the overpotential, can thus be distilled individually. Such an undocumented kinetic picture unravels, in detail, how the HOR is controlled by the elemental steps on polarization. For instance, at low polarization region, the Heyrovsky reaction is relatively slow and can be ignored; but at high polarization region, the Heyrovsky reaction will surpass the Tafel reaction. Additionally, the Volmer reaction has been the fastest within overpotentials of interest. Our findings not only offer a better understanding of the HOR mechanism, but also lay the foundation for the development of improved hydrogen energy utilization systems.

Study on the Correlation between 7-joint Ultrasound Score and Disease Activity in Patients with Rheumatoid Arthritis.

Background: The objective of this study was to investigate the correlation between the 7-joint ultrasound score (US7) and disease activity in patients with rheumatoid arthritis (RA). Methods: Forty-four patients with active RA were assessed, and the correlation between US7 and disease activity indicators such as the disease activity score (DAS28), rheumatoid factor (RF), the erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) was analyzed. In addition, the proportions of US7 points accounted for by different joint regions and joint surfaces were analyzed. Results: RF, CRP, and ESR were significantly increased in the RA group compared with the control group (P < 0.05). In the RA group, DAS28 (r = 0.0.561, P < 0.01), RF (r = 0.635, P < 0.01), ESR (r = 0.585, P < 0.01), and CRP (r = 0.492, P < 0.01) were positively correlated with US7. In terms of contributions to US7, the most susceptible joint surface is the dorsal surface, and the most susceptible joint area is the dorsal wrist. Conclusion: US7 is positively correlated with disease activity indicators of RA, which can objectively reflect disease activity in RA patients and provide a reference for clinical diagnosis and efficacy evaluation.

Dynamic modulation of a surface-enhanced Raman scattering signal by a varying magnetic field.

Surface-enhanced Raman scattering (SERS) signals are fundamental for spectroscopy applications. However, existing substrates cannot perform a dynamically enhanced modulation of SERS signals. Herein, we developed a magnetically photonic chain-loading system (MPCLS) substrate by loading magnetically photonic nanochains of Fe3O4@SiO2 magnetic nanoparticles (MNPs) with Au nanoparticles (NPs). We achieved a dynamically enhanced modulation by applying an external stepwise magnetic field to the randomly dispersed magnetic photonic nanochains that gradually align in the analyte solution. The closely aligned nanochains create a higher number of hot spots by new neighboring Au NPs. Each chain represents a single SERS enhancement unit with both a surface plasmon resonance (SPR) effect and photonic property. The magnetic responsivity of MPCLS enables a rapid signal enhancement and tuning of the SERS enhancement factor.

Chemical physics of electrochemical energy materials.

Probing the chemistry and materials science of electrochemical energy materials is a central topic in both chemical physics and energy chemistry due to the increasingly important role of energy devices in the current and future energy system and industry. Especially, understanding the chemical physics of electrochemical energy materials is the key to enhance the performance of energy storage and conversion devices such as batteries, fuel cells, electrolyzers, and supercapacitors. This special topic focuses on the fundamental understanding of electrochemical energy applications, including electrochemistry fundamentals, structural dynamics and degradation mechanism of materials, optimization strategies for improving electrochemical performance of energy devices, and emerging simulation and characterization methods applied to advanced energy materials.

Clinical Evaluation of Comfort Nursing in Gynecological Patients Undergoing Laparoscopic Surgery.

Background: Laparoscopic surgery is a standard procedure for gynecological patients but can be associated with discomfort and anxiety. Comfort nursing interventions have been proposed as a potential approach to improve the well-being and outcomes of patients undergoing such surgeries. Objective: This study aimed to assess the impact of comfort nursing on patient comfort, anxiety, and depression levels during the postoperative period of laparoscopic surgery. Methods: A total of 90 gynecological patients with ovarian cysts were randomly assigned to either the control group (n = 45), receiving conventional nursing, or the experimental group (n = 45), receiving comfort nursing. The General Comfort Questionnaire (GCQ) and the Hospital Anxiety and Depression (HAD) scale were utilized to measure patient comfort and psychological well-being. Data analysis was performed using t tests, Fisher's exact test, and chi-square tests. Results: The results demonstrated that the experimental group receiving comfort nursing had significantly higher scores in the environment domain and total GCQ score than the control group (P < .05). However, there were no statistically significant differences between the two groups in the physiology, psychology, and society domains of the GCQ. Moreover, the experimental group had better HAD scores compared to the control group (P < .05). Conclusions: This study provides evidence that comfort nursing is an effective approach to improving patient comfort and reducing anxiety in gynecological patients undergoing laparoscopic surgery for ovarian cysts. Implementing comfort nursing interventions can enhance the overall care experience for these patients and potentially contribute to better surgical outcomes.

A comparison of special intrauterine balloons and intrauterine contraceptive devices in the treatment of intrauterine adhesions.

PURPOSE: This study aimed to compare the efficacy of a special kind of intrauterine balloon (IUB) and that of an intrauterine contraception device (IUD) for patients with intrauterine adhesions (IUAs) after transcervical resection of adhesion (TCRA). METHODS: In this retrospective cohort study, after TCRA, 31 patients received a special IUB, and 38 patients received an IUD. The Fisher exact test, logistic regression method, Kaplan-Meier method and Cox proportional hazards regression model were used for statistical analysis. A two-sided value of P < 0.05 was considered statistically significant. RESULTS: The readhesion rate significantly differed between the IUB group and IUD group, at 15.39% and 54.06%, respectively (P = 0.002). For recurrent moderate IUA, patients in the IUB group had lower scores than patients in the IUD group (P = 0.035). There was a significant difference in the intrauterine pregnancy rate of IUA patients in the IUB group and IUD group after treatment, with rates of 55.56% and 14.29%, respectively (P = 0.015). CONCLUSION: Patients in the special IUB group had better outcomes than those in the IUD group, which has a certain guiding significance for clinical work.

Maternal and neonatal outcomes in women with twin pregnancies based on gestational weight gain: An updated systematic review and meta-analysis.

Objective: This updated systematic review and meta-analysis aimed to assess maternal and fetal outcomes of pregnancies based on the Institute of Medicine (IOM) guidelines of gestational weight gain (GWG). Methods: PubMED, SCOPUS, EMBASE and Web of Science were searched up to 30th July 2022. All studies evaluating maternal and/or neonatal outcomes of twin pregnancies based on the IOM guidelines of gestational weight gain were included. Results: Twenty two studies were included. Mothers with twin pregnancies experiencing inadequate GWG showed higher incidence of gestational diabetes with the risk ratio (RR) 1.22 95% CI (0.95,1.57), p=0.0005, i2= 69% and premature rupture of membrane (PROM) with RR 1.14 95% CI (0.99, 1.30), p=0.07; i2=0% that coincided with higher rates of preterm birth, low birth weight, small for gestational age (SGA) and admission to NICU in neonates. Mothers with excessive GWG had higher risk of developing gestational hypertension with RR 1.59 95% CI (1.22, 2.07), p=0.0006, i2=75% and extremely preterm delivery (<32 weeks). Conclusion: Within the limitations of this review, GWG was found to be a predictable risk factor for adverse maternal and neonatal outcomes of twin pregnancies.

Accelerating Gas Escape in Anion Exchange Membrane Water Electrolysis by Gas Diffusion Layers with Hierarchical Grid Gradients.

At high current densities, gas bubble escape is the critical factor affecting the mass transport and performance of the electrolyzer. For tight assembly water electrolysis technologies, the gas diffusion layer (GDL) between the catalyst layer (CL) and the flow field plate plays a critical role in gas bubble removal. Herein, we demonstrate that the electrolyzer's mass transport and performance can be significantly improved by simply manipulating the structure of the GDL. Combined with 3D printing technology, ordered nickel GDLs with straight-through pores and adjustable grid sizes are systematically studied. Using an in situ high-speed camera, the gas bubble releasing size and resident time have been observed and analyzed upon the change of the GDL architecture. The results show that a suitable grid size of the GDL can significantly accelerate mass transport by reducing the gas bubble size and the bubble resident time. An adhesive force measurement has further revealed the underlying mechanism. We then proposed and fabricated a novel hierarchical GDL, reaching a current density of 2 A/cm2 at a cell voltage of 1.95 V and 80 °C, one of the highest single-cell performances in pure-water-fed anion exchange membrane water electrolysis (AEMWE).

Dual-Role of Polyelectrolyte-Tethered Benzimidazolium Cation in Promoting CO2 /Pure Water Co-Electrolysis to Ethylene.

Electrochemical CO2 reduction reaction (CO2 RR), as a promising route to realize negative carbon emissions, is known to be strongly affected by electrolyte cations (i.e., cation effect). In contrast to the widely-studied alkali cations in liquid electrolytes, the effect of organic cations grafted on alkaline polyelectrolytes (APE) remains unexplored, although APE has already become an essential component of CO2 electrolyzers. Herein, by studying the organic cation effect on CO2 RR, we find that benzimidazolium cation (Beim+ ) significantly outperforms other commonly-used nitrogenous cations (R4 N+ ) in promoting C2+ (mainly C2 H4 ) production over copper electrode. Cyclic voltammetry and in situ spectroscopy studies reveal that the Beim+ can synergistically boost the CO2 to *CO conversion and reduce the proton supply at the electrocatalytic interface, thus facilitating the *CO dimerization toward C2+ formation. By utilizing the homemade APE ionomer, we further realize efficient C2 H4 production at an industrial-scale current density of 331 mA cm-2 from CO2 /pure water co-electrolysis, thanks to the dual-role of Beim+ in synergistic catalysis and ionic conduction. This study provides a new avenue to boost CO2 RR through the structural design of polyelectrolytes.

Oxygen-Inserted Top-Surface Layers of Ni for Boosting Alkaline Hydrogen Oxidation Electrocatalysis.

Precisely tailoring the electronic structures of electrocatalysts to achieve an optimum hydroxide binding energy (OHBE) is vital to the alkaline hydrogen oxidation reaction (HOR). As a promising alternative to the Pt-group metals, considerable efforts have been devoted to exploring highly efficient Ni-based catalysts for alkaline HOR. However, their performances still lack practical competitiveness. Herein, based on insights from the molecular orbital theory and the Hammer-Nørskov d-band model, we propose an ingenious surface oxygen insertion strategy to precisely tailor the electronic structures of Ni electrocatalysts, simultaneously increasing the degree of energy-level alignment between the adsorbed hydroxide (*OH) states and surface Ni d-band and decreasing the degree of anti-bonding filling, which leads to an optimal OHBE. Through the pyrolysis procedure mediated by a metal-organic framework at a low temperature under a reducing atmosphere, the obtained oxygen-inserted two atomic-layer Ni shell-modified Ni metal core nanoparticle (Ni@Oi-Ni) exhibits a remarkable alkaline HOR performance with a record mass activity of 85.63 mA mg-1, which is 40-fold higher than that of the freshly synthesized Ni catalyst. Combining CO stripping experiments with ab initio calculations, we further reveal a linear relationship between the OHBE and the content of inserted oxygen, which thus results in a volcano-type correlation between the OH binding strength and alkaline HOR activity. This work indicates that the oxygen insertion into the top-surface layers is an efficient strategy to regulate the coordination environment and electronic structure of Ni catalysts and identifies the dominate role of OH binding strength in alkaline HOR.

Suppression of phosphodiesterase IV enzyme by roflumilast ameliorates cognitive dysfunction in aged rats after sevoflurane anaesthesia via PKA-CREB and MEK/ERK pathways.

Postoperative cognitive dysfunction (POCD) is a prevalent disorder after anaesthesia in the elderly patients. Roflumilast (RF), a phosphodiesterase 4 (PDE-4) inhibitor, could improve cognition with no side effects. Here, we sought to explore the efficacy of RF in the improvement of cognitive dysfunction caused by sevoflurane (Sev). Sprague-Dawley rats were anaesthetized, and the hippocampal neurons were treated with Sev to develop in vivo and in vitro POCD models, followed by RF administration. The mechanism of the PKA-CREB and MEK/ERK pathways in the pathogenesis of POCD was explored. Sev impaired the cognitive functions of rats, significantly reduced cyclic adenosine monophosphate (cAMP) concentrations and blocked the PKA-CREB and MEK/ERK pathways. Moreover, the Sev-treated rats and neurons exhibited enhanced apoptosis and reactive oxygen species (ROS). After treatment with RF, rats had better learning and memory function, and the activity of neurons in hippocampus and cortex was improved. Loss-of-function assay indicated that PKA-CREB and MEK/ERK signalling impairment reduced cAMP levels and promoted apoptosis and ROS in rat hippocampus and neurons. Generally, RF promotes neuronal activity in rats after Sev treatment by maintaining cAMP levels and sustaining the activation of PKA-CREB and MEK/ERK pathways. This might offer novel sights for POCD therapy.

Electronic Modulation of Ru Nanosheet by d-d Orbital Coupling for Enhanced Hydrogen Oxidation Reaction in Alkaline Electrolytes.

The alkaline polymer electrolyte fuel cells (APEFCs) hold great promise for using nonnoble metal-based electrocatalysts toward the cathodic oxygen reduction reaction (ORR), but are hindered by the sluggish anodic hydrogen oxidation reaction (HOR) in alkaline electrolytes. Here, a strategy is reported to promote the alkaline HOR performance of Ru by incorporating 3d-transition metals (V, Fe, Co, and Ni), where the conduction band minimum (CBM) level of Ru can be rationally tailored through strong d-d orbital coupling. As expected, the obtained RuFe nanosheet exhibits outstanding HOR performance with the mass activity of 233.46 A gPGM -1 and 23-fold higher than the Ru catalyst, even threefold higher than the commercial Pt/C. APEFC employing this RuFe as anodic catalyst gives a peak power density of 1.2 W cm-2 , outperforming the documented Pt-free anodic catalyst-based APEFCs. Experimental results and density functional theory calculations suggest the enhanced OH-binding energy and reduced formation energy of water derived from the downshifted CBM level of Ru contribute to the enhanced HOR activity.

In situ surface enhanced Raman spectroscopy study of electrode-polyelectrolyte interfaces.

As polyelectrolytes play a more and more important role in electrochemical fields, further understanding of the electrode-polyelectrolyte interface is in high demand. Surface-enhanced Raman spectroscopy (SERS) is utilized widely in electrode-solution interface research due to its ultra-high sensitivity, but is still rarely in the study of the electrode-polyelectrolyte interface due to difficulties in constructing appropriate electrochemical in situ devices. Additionally, the reported electrochemical in situ Raman works on the electrode-polyelectrolyte interface have a common problem of the coexistence of electrode-solution interfaces and electrode-polyelectrolyte interfaces. Here, we used screen printing electrodes (SPE) with a compact planar three-electrode structure to carry out a new electrochemical in situ SERS test method, which was suitable for the study of the electrode-polyelectrolyte interface. Polyelectrolyte membranes can be conveniently and closely coated on the SPE's planar three electrodes to achieve isolated electrode-polyelectrolyte interfaces without electrode-solution interfaces coexisting. Strongly potential-dependent signals were obtained from the Pt-Nafion™ interface directly across the Nafion™ membrane, which verifies that this method is practical for the electrochemical in situ SERS study of the electrode-polyelectrolyte interface.

lncRNA ZNF667-AS1 (NR_036521.1) inhibits the progression of colorectal cancer via regulating ANK2/JAK2 expression.

Long noncoding RNAs (lncRNAs) participate in many biological processes by affecting gene expression at the posttranscriptional level. lncRNAs are dysregulated in colorectal cancer (CRC) and this dysregulation is closely related to tumorigenesis, metastasis, and prognosis. Although many lncRNAs have been identified in CRC, the relation between ZNF667 antisense RNA 1 (head to head; ZNF667-AS1, accession: NR_036521.1) and CRC remains unclear. In this study, a total of 2,218 differentially expressed genes and 428 differentially expressed lncRNAs were identified between tumor and pericarcinous tissues. They were mainly enriched in cancer pathways, chemokine signaling, phosphoinositide 3-kinase-protein kinase B signaling pathway, and others. Key lncRNAs, including ZNF667-AS1, and their corresponding genes, such as ankyrin 2 (ANK2), were downregulated in CRC tumor tissues. In addition, downregulated ZNF667-AS1 (NR_036521.1) expression is associated with poor prognosis and disease progression. Overexpression of ZNF667-AS1 (NR_036521.1) inhibited the proliferation, migration, and invasion of VOLO cells both in vitro and in vivo. Moreover, Janus kinase 2 (JAK2) and ANK2 were significantly down- and upregulated in the overexpressed ZNF667-AS1 VOLO cells compared to those in the negative-control group. Knockdown of ANK2 or overexpression of JAK2 significantly counteracted the inhibitory effects of overexpression of ZNF667-AS1 on LOVO cell proliferation and migration. Taken together, it is indicated in our research that ZNF667-AS1 interaction with ANK2/JAK2 maybe important in CRC progression. Overexpression of ZNF667-AS1 could inhibit the proliferation, migration, and invasion of CRC cells, which may be related with the high ANK2 and low JAK2 levels.

Dynamic Nature of High-Pressure Ice VII.

Starting from Shannon's definition of dynamic entropy, we propose a theory to describe the rare-event-determined dynamic states in condensed matter and their transitions and apply it to high-pressure ice VII. A dynamic intensive quantity named dynamic field, rather than the conventional thermodynamic intensive quantities such as temperature and pressure, is taken as the controlling variable. The dynamic entropy versus dynamic field curve demonstrates two dynamic states in the stability region of ice VII and dynamic ice VII. Their microscopic differences were assigned to the dynamic patterns of proton transfer. This study puts a similar dynamical theory used in earlier studies of glass models on a simpler and more fundamental basis, which could be applied to describe the dynamic states of more realistic condensed matter systems.

The value of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as complementary diagnostic tools in the diagnosis of rheumatoid arthritis: A multicenter retrospective study.

BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have drawn attention in recent years as novel non-specific inflammatory markers; however, only a few studies have been conducted to investigate their value in RA. OBJECTIVE: To investigate the value of the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) as complementary diagnostic tools in rheumatoid arthritis (RA). METHOD: This study included 1009 patients with RA, 170 patients with other rheumatic diseases, and 245 healthy individuals from four medical centers. The patients' general data, including complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF), were retrospectively analyzed, and the NLR and PLR were calculated. Potential effective indicators were screened by logistic regression analysis, and a receiver operating characteristic (ROC) curve was plotted to evaluate their diagnostic value for RA. RESULTS: (a) The NLR and PLR were significantly higher in the RA group than in the non-RA group and the control group (P < .05). (b) Spearman's Rho showed that the NLR was positively correlated with the PLR (r = .584, P < .05), RF (r = .167, P < .01), and CRP (r = .280, P < .01) but was not significantly correlated with ESR (r = .100, P > .05). The PLR was positively correlated with RF (r = .139, P < .01), CRP (r = .297, P < .01), and ESR (r = .262, P < .05). (c) Logistic analysis showed that RF, CRP, ESR, and the NLR had diagnostic value for RA. (d) For the NLR, the area under the curve (AUC) of the ROC curve was 0.831; at the cutoff value of 2.13, the diagnostic sensitivity, specificity, accuracy, and Youden index were 76.7%, 75.9%, 76.4%, and 0.5424, respectively. CONCLUSION: The NLR was less effective than CRP and RF but was superior to ESR in the diagnosis of RA. The NLR can thus be used as a complementary diagnostic indicator in the diagnosis of RA.