[Comparison of the Prognostic Value of C-Reactive Protein to Albumin Ratio and Glasgow Prognostic Score in Patients with Diffuse Large B-Cell Lymphoma].

OBJECTIVE: To compare the prognostic value of two predictive models based on C-reactive protein (CRP) and albumin (ALB), namely the CRP to ALB ratio (CAR) and the Glasgow prognostic score (GPS), in newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL). METHODS: The data of newly diagnosed DLBCL patients admitted to our center from May 2014 to January 2022 were reviewed. A total of 111 patients who completed at least 4 cycles of R-CHOP or R-CHOP-like chemotherapy with detailed clinical, laboratory data and follow-up information were included. The receiver operating characteristic (ROC) curve was performed to evaluate the predictive value of pre-treatment CAR on disease progression and survival. Furthermore, the association between CAR and baseline clinical, laboratory characteristics of patients was evaluated, and progression-free survival (PFS) and overall survival (OS) were compared between different CAR and GPS subgroups. Finally, the univariate and multivariate COX propor-tional hazard regression models were used to analyze the factors affecting disease outcomes. RESULTS: ROC curve showed that the area under the curve (AUC) of CAR predicting PFS and OS in DLBCL patients was 0.687 (P =0.002) and 0.695 (P =0.005), respectively, with the optimal cut-off value of 0.11 for both predicting PFS and OS. Compared with the lower CAR (<0.11) group, the higher CAR (≥0.11) group had more clinical risk factors, including age >60 years (P =0.025), ECOG score ≥2 (P =0.004), Lugano stage III-IV (P < 0.001), non-germinal center B-cell-like (non-GCB) subtype (P =0.035), elevated lactate dehydrogenase (LDH) ( P < 0.001), extranodal involved site >1 (P =0.004) and IPI score >2 (P < 0.001). The interim response evaluation of patients showed that the overall response rate (ORR) and complete response rate (CRR) in the lower CAR group were both significantly better than those in the higher CAR group (ORR: 96.9% vs 80.0%, P =0.035; CRR: 63.6% vs 32.5%, P =0.008). With a median follow-up of 24 months, patients with lower CAR had significantly longer median PFS and OS than those with higher CAR (median PFS: not reached vs 67 months, P =0.0026; median OS: not reached vs 67 months, P =0.002), while there was no statistical difference in PFS (P =0.11) and OS (P =0.11) in patients with GPS of 0, 1, and 2. Multivariate Cox regression analysis indicated that only sex (male) and IPI score >2 were independent risk factors for both PFS and OS. CONCLUSION: CAR is significantly correlated with disease progression and survival in DLBCL patients; And compared with GPS, CAR has more advantages in predicting disease outcomes in DLBCL patients.

[Prognostic Value of Pre-treatment Albumin/Fibrinogen Ratio in Patients with Diffuse Large B-cell Lymphoma].

OBJECTIVE: To investigate the value of pre-treatment albumin/fibrinogen ratio (AFR) on the prognosis of patients with diffuse large B-cell lymphoma (DLBCL). METHODS: The data of DLBCL patients in the Affiliated Hospital of North Sichuan Medical College from April 2014 to March 2021 were retrieved, and 111 newly diagnosed patients who completed at least 4 cycles of R-CHOP or R-CHOP-like chemotherapy with complete data were included in the study. The clinical, laboratory examination and follow-up data of the patients were collected, and the receiver operating characteristic curve (ROC) was drawn according to patients' AFR before treatment and the survival status at the end of the follow-up, which could be used to preliminarily evaluate the predictive value of AFR for disease progression and patients' survival outcome. Furthermore, the correlation of AFR with the clinical and laboratory characteristics, progression-free survival (PFS) and overall survival (OS) was analyzed, and finally, univariate and multivariate Cox proportional hazard regression models were used to analyze factors affecting PFS and OS of DLBCL patients. RESULTS: The ROC curve indicated that AFR level had a moderate predictive value for PFS and OS in DLBCL patients, with the area under the curve (AUC) of 0.616 (P =0.039) and 0.666 (P =0.004), respectively, and the optimal cut-off values were both 9.06 for PFS and OS. Compared with high-AFR (≥9.06) group, the low-AFR (<9.06) group had a higher proportion of patients with Lugano III-IV stage ( P <0.001), elevated lactate dehydrogenase (P =0.007) and B symptoms (P =0.038). The interim analysis of response showed that the overall response rate (ORR) in the high-AFR group was 89.7%, which was significantly higher than 62.8% in the low-AFR group (P =0.001). With a median follow-up of 18.5 (3-77) months, the median PFS of the high-AFR group was not reached, which was significantly superior to 17 months of the low-AFR group (P =0.009). Similarly, the median OS of high-AFR group was not reached, either, which was significantly superior to 48 months of the low-AFR group (P < 0.001). In multivariate Cox regression analysis, AFR <9.06 was an independent risk factor both for PFS and OS (HR PFS=2.047, P =0.039; HR OS=4.854, P =0.001). CONCLUSION: Pre-treatment AFR has a significant value for the prognosis evaluation in newly diagnosed DLBCL patients.

Anticipated Regret, Entrepreneurial Cognition, and Entrepreneurial Persistence.

Based on the regret regulation theory and entrepreneurial cognition theory, this study aims to investigate the relationship between entrepreneurs' anticipated regret and entrepreneurial persistence through the mediator of entrepreneurial cognition. To that end, we distributed surveys to entrepreneurs who were supported by the "Xing Chuang Tian Di" project and used 248 questionnaire data to examine the hypotheses. The results show that entrepreneurs' anticipated regret has a significant and direct impact on entrepreneurial persistence. Also, entrepreneurship cognition plays a mediating role between anticipated regret and entrepreneurial persistence. In addition, the entrepreneurial environment plays a positive role in moderating the relationship between anticipated regret and entrepreneurial persistence.

[Development and assessment of Schistosoma japonicum antibody test kit (IHA)].

OBJECTIVE: To develop a Schistosoma japonicum antibody test kit (IHA). METHODS: According to the requirement of Good Manufacturing Practice (GMP) and Quality Control (QC) of drugs, the components of kit as well as its preparation method and procedure were studied, and the test kit was assembled and its diagnostic effect was assessed. RESULTS: The sensitivity and specificity were up to 94.49% and 97.14% when testing the serum samples of chronic schistosomiasis patients and normal serum samples by the kit, respectively. The Youden Index of the Kit was 0.92. The cross reaction rates with paragonimus and trichina were 15.00% and 10.00%, respectively. Compared with ELISA and another IHA kit produced by An'Ji company which were used to test schistosome antibody in residents of endemic areas at the same time, the coincident rates of the developed kit were 93.06% and 92.25%, respectively. CONCLUSION: The IHA kit for Schistosomajaponicum antibody has a high sensitivity and specificity, and has the value of application and popularization in the field.

[Research and demonstration of comprehensive measures of schistosomiasis prevention and control technology. II. Longitudinal evaluation on control effect].

OBJECTIVE: To evaluate the effect of comprehensive measures of schistosomiasis prevention and control technique. METHODS: The comprehensive measures including forbidding grazing on marshlands, renovating latrines and supplying safe water, and health education were carried out in a demonstrative area, and the schistosomiasis endemic situation and other relative factors were investigated. RESULTS: After the control measures were carried out for 3 years, the prevalence of schistosomiasis in human decreased from 3.57% to 0.83%, and the infection rates of cattle decreased from 17.14% to 0. No infected Oncomelania snails were found on the marshlands in the demonstration area. CONCLUSION: The comprehensive measures aforementioned are effective in the control of schistosomiasis in Poyang Lake region.

[Diagnostic efficiency of Indirect Hemagglutination Assay Kit for antibody detection of schistosomiasis japonica].

OBJECTIVE: To evaluate the clinical diagnostic efficiency of Indirect Hemagglutination Assay Kit (IHA kit) for antibody detection of schistosomiasis japonica. METHODS: Schistosomiasis examinations by parasitological method were conducted in the schistosomiasis endemic areas in Jiangxi, Anhui and Hubei provinces, respectively. A total of 371 serum samples of schistosomiasis patients and 761 serum samples of non-patients without history of schistosome infection and infested water contact were collected. All the sera were detected by using IHA Kit. The diagnostic efficiency indicators of the kit, including sensitivity, specificity, positive predicted value, negative predicted value etc. were calculated. RESULTS: The sensitivity and specificity of the kit were 95.1% (95% confidence interval was between 92.9% and 97.3%) and 97.8% (95% confidence interval was between 96.8% and 98.8%), respectively; the positive and negative predicted values were 95.4% and 97.6%, respectively. No statistically significant difference was found in the prevalence of IHA positive detecting by the kit among the groups with different EPG levels (< or = 40, 41-100, > 100). Also, no significant difference was observed in sensitivity and specificity among the different age groups. CONCLUSIONS: The IHA kit shows a relative high efficiency for diagnosis and can be used for mass screening of schistosomiasis in field sites.

[Evaluation on application of common diagnosis methods for schistosomiasis japonica in endemic areas of China. III. Analysis and evaluation of underestimation of prevalence of Schistosoma japonicum infection by routine Kato-Katz technique].

OBJECTIVE: To understand the rates of underestimation of Schistosoma japonicum infection by Kato-Katz technique with different stool samples and different smears in field site. METHODS: With 27 Kato-Katz thick smears (3 stool samples with 9 thick smears each) for 3 consecutive years as a "gold standard", the rates of underestimation of schistosome infection by Kato-Katz technique with different stool samples and different smears were evaluated in a schistosomiasis endemic village. RESULTS: The examined rates of schistosome infection increased and the rates of underestimation decreased gradually with the increase of the number of Kato-Katz thick smears examined. The rates of underestimation of 3 smears were 40.98%-50.80% and the rates of underestimation of 6 smears were 25.48%-32.39%. The rates of schistosome infection based on the reading of 27 Kato-Katz thick smears were 10.96% in 2008, 8.54% in 2009 and 3.73% in 2010 respectively, but the rates of underestimation of various Kato-Katz thick smears were similar. There were no significant differences among the readings of 3, 6, and 9 smears of 1 stool sample, 3, 6 and 9 smears of 3 stool samples, 6 smears of 2 stool samples, 6 smears of 1 stool sample, and 6 smears of 3 stool samples. CONCLUSIONS: In a community with low-intensity of schistosome infection, the rate of underestimation is big by Kato-Katz technique with the reading of 3 smears of 1 stool sample. It suggested that it is better to increase smears rather than the number of stool samples examined.

[Correlations between serum interleukin-18 (IL-18) level, IL-18 gene promoter polymorphisms and the development of sepsis in children].

OBJECTIVE: To investigate the correlations of serum interleukin-18 (IL-18) level and IL-18 gene promoter polymorphisms to the development of sepsis in children. METHOD: Using enzyme-linked immunosorbent assay (ELISA), the authors tested the serum IL-18 level in 90 patients with sepsis and 123 normal controls, and their single nucleotide polymorphisms of the promoter region of IL-18 gene at position -607C/A and -137G/C were detected using polymerase chain reaction with sequence specific primers method and sequencing technique. RESULT: (1) The serum IL-18 level in sepsis groups was (196.56 +/- 157.32) pg/ml that was significantly higher than (66.16 +/- 41.63) pg/ml in normal controls (P < 0.01), the more severe the degree of sepsis was, the more significantly higher the serum IL-18 level was. The serum IL-18 level in non serious sepsis group was (152.87 +/- 114.96) pg/ml that was significantly higher than (66.16 +/- 41.63) pg/ml in normal controls, the serum IL-18 level in serious sepsis group was (191.98 +/- 169.72) pg/ml that was significantly higher than that in non serious sepsis group, and the serum IL-18 level in extremely serious sepsis patients was (323.89 +/- 159.35) pg/ml, the difference was highly significant (P = 0.000). The difference was significant among the groups with different severity of sepsis (P < 0.01). There was a negative correlation between PCIS (pediatric critical illness score) of sepsis and the serum IL-18 level (P < 0.01). (2) There were polymorphisms in IL-18 gene promoter of matched healthy children and sepsis in children. The GG genotype frequency (61.8%) of IL-18-137G/C in healthy children was the highest, followed by GC genotype (35.8%) and CC genotype (2.4%) in sequence. The G allele frequency (79.7%) was higher in IL-18-137G/C of healthy children than C allele (20.3%). The GG genotype frequency (71.1%) of IL-18-137G/C in septic children was the highest, the next were GC genotype (26.7%) and CC genotype (2.2%). The G allele frequency (84.4%) was higher in IL-18-137G/C of septic children than C allele (15.6%). The CA genotype frequency (61.0%) of IL-18-607C/A in healthy children was the highest, followed by CC genotype (26.8%) and AA genotype (12.2%). The C allele frequency (57.3%) was higher in IL-18-607C/A of healthy children than A allele (42.7%). The CA genotype frequency (76.7%) of IL-18-607C/A in septic children was the highest, followed by CC genotype (21.1%) and AA genotype (2.2%) in sequence. The C allele frequency (59.4%) was higher in IL-18-607C/A of septic children than A allele (40.6%). (3) The genotype frequency of IL-18-607 CA was 76.7% in sepsis groups that was significantly higher than 61.0% in normal controls, and the genotype frequency of -607 AA was 2.2% in sepsis groups that was significantly lower than 12.2% in normal controls, the difference was significant (P < 0.05). (4) In the order of -137CC, -137GC, -137GG, the serum IL-18 level in normal controls were as follows: (45.67 +/- 28.36) pg/ml, (53.27 +/- 37.91) pg/ml, (76.91 +/- 42.44) pg/ml, and with (140.50 +/- 60.10) pg/ml, (184.42 +/- 157.33) pg/ml, (237.02 +/- 161.76) pg/ml respectively in sepsis groups. In the order of -607AA, -607CA, -607CC, the serum IL-18 level in normal controls were: (48.80 +/- 32.11) pg/ml, (68.41 +/- 42.53) pg/ml, (70.17 +/- 43.87) pg/ml; and with (141.50 +/- 64.35) pg/ml, (151.21 +/- 121.19) pg/ml, (211.16 +/- 163.64) pg/ml respectively in sepsis groups. The difference was not significant among different groups (P > 0.05). CONCLUSION: The serum IL-18 level in sepsis groups was significantly higher than that in normal controls, which was related to the severity of sepsis. It was possible that the genotype of -607CA carriers was susceptible to sepsis, which mean that the genotype of -607CA might be susceptible genotype of sepsis. However, the genotype of -607AA might play an oppose role in the risk of sepsis.

[Comparative evaluation of five test kits for antibody detection in Schistosoma japonicum endemic areas of Poyang Lake region].

OBJECTIVE: To evaluate the efficacy of five diagnostic test kits for the detection of antibodies to Schistosoma japonicum in endemic areas of Poyang Lake. METHODS: Residents over 5 years old in three schistosomiasis-endemic administrative villages in the lake region were simultaneously examined by modified Kato-Katz thick smears and nylon bag sedimentation/hatching method. At the same time, five sero-diagnostic test kits for detection of IgG antibody against soluble egg antigen of S. japonicum were carried out. RESULTS: The distribution of seropositive rates of S. japonicum IgG antibodies determined by sero-diagnostic tests showed similar trends with that of egg positive rates in different age groups, but the seropositive rate (33.1%-57.1%) was significantly higher than that of egg positive rate (5.0%-8.2%), both reached a peak in 40-49-year-old group. The antibody positive rates determined by each test increased with the infection intensity. The sensitivity of the evaluated test kits ranged from 81.2%-94.5%. 26.9% to 46.1% among those egg negatives were antibody positive by the kits. Furthermore, 5.5%-18.8% of the egg positives were antibody negative by the kits. CONCLUSION: The five sero-diagnostic kits can be used for epidemiological survey in schistosomiasis endemic areas at community level. Among them, enzyme-linked immunosorbent assay shows higher sensitivity.