The correlation between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with nonalcoholic fatty liver disease: a cross-sectional study.

OBJECTIVE: The aim of this study is to investigate the correlation between neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with nonalcoholic fatty liver disease (NAFLD). METHODS: All subjects underwent medical check-ups, which included the measurement of basic clinical, biochemical tests and imaging tests. Univariate and multivariate logistic regression models and piece-wise linear regression were used to assess the relationship between NLR and PLR with NAFLD. RESULTS: All participants were divided into two groups: the Non-NAFLD group and the NAFLD group. Univariate analysis model indicated PLR was negatively correlated with NAFLD (P < 0.001) and NLR was not significantly associated with NAFLD (P > 0.05). Multiple logistic regression showed that no correlation between NLR and PLR with NAFLD after adjusting all covariates (P > 0.05). Interestingly, a nonlinear association was detected between NLR and PLR with NAFLD by piece-wise linear regression adjusting for all confounding factors. The inflection points of NLR and PLR were 1.23 and 42.29, respectively. On the left side of the inflection point (NLR < 1.23), a positive correlation was detected between NLR and NAFLD (ß = 2.35, 95% CI: 1.20~4.61, P = 0.013). And PLR was found to be negatively associated with NAFLD on the right side of the inflection point (ß = 0.99, 95% CI: 0.98~0.99, P < 0.001). CONCLUSION: This study demonstrated that the relationship between NLR and PLR with NAFLD was nonlinear after adjusting for potential confounding factors. The result suggested that PLR ≥ 42.29 might be a protective factor of NAFLD, while NLR < 1.23 might be a risk factor of NAFLD.

Metagenomic next-generation sequencing in diagnosing Pneumocystis jirovecii pneumonia: A case report.

It remains a huge challenge for clinicians to diagnose Pneumocystis jirovecii pneumonia (PJP) by a conventional method, which leads to delay in diagnosing PJP, accounting for higher mortality in patients with rheumatoid arthritis (RA). A 69-year-old woman, who suffered from RA for years, developed acute respiratory failure. The computed tomography scan showed diffused effusion and ground glass opacity in both lungs, which could not be differentiated from interstitial pneumonia. Metagenomic next-generation sequencing (mNGS) revealed P. jirovecii in both serum and bronchoalveolar lavage fluid with reads per million (RPM) of 17 and 437, while other diagnostic tests did not detect any pathogenic microorganism. The results were verified by quantitative polymerase chain reaction (mtSSU region) against the same samples. The DNA RPM of P. jirovecii declined notably after treatment with trimethoprim/sulfamethoxazole. The patient was discharged without treatment and finally passed away. This case fully highlights the sensitivity of mNGS in early diagnosis of PJP, which is of great significance for prognosis and treatment. Nonetheless, the clinical application of mNGS is worth further standardization and normalization.

Total cholesterol to high-density lipoprotein ratio and nonalcoholic fatty liver disease in a population with chronic hepatitis B.

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is characterized by hypertriglyceridemia, increased low-density lipoprotein cholesterol levels, and reduced high-density lipoprotein cholesterol (HDL-C) particles. Previous studies have shown that the total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C) was superior to other lipid metabolism biomarkers for predicting NAFLD risk and could be a new indicator of NAFLD. However, the association between TC/HDL-C and NAFLD in patients with hepatitis B virus (HBV) has not yet been determined. AIM: To investigate the association between TC/HDL-C and NAFLD in a population with chronic hepatitis B (CHB). METHODS: In this study, 183 HBV-infected patients were enrolled. All participants underwent blood chemistry examinations and abdominal ultrasound. Univariate and multivariate logistic regression models, curve fitting analysis, and threshold calculation were used to assess the relationship between TC/HDL-C and NAFLD. RESULTS: The overall prevalence of NAFLD was 17.49% (n = 32) in the 183 CHB participants. The TC/HDL-C of non-NAFLD and NAFLD patients were 3.83 ± 0.75 and 4.44 ± 0.77, respectively (P < 0.01). Logistic regression analysis showed that TC/HDL-C was not associated with NAFLD after adjusting for other pertinent clinical variables. However, at an optimal cutoff point of 4.9, a non-linear correlation between TC/HDL-C and NAFLD was detected. The effect size of the left and right sides of the inflection point were 5.4 (95% confidence interval: 2.3-12.6, P < 0.01) and 0.5 (95% confidence interval: 0.1-2.2, P = 0.39), respectively. On the left side of the inflection point, TC/HDL-C was positively associated with NAFLD. However, no significant association was observed on the right side of the inflection point. CONCLUSION: This study demonstrated a non-linear correlation between TC/HDL-C and NAFLD in a population with CHB. TC/HDL-C was positively associated with NAFLD when TC/HDL-C was less than 4.9 but not when TC/HDL-C was more than 4.9.

Study on the thermal reduction effect of organic components in spent ternary lithium battery cathode active materials.

To improve the adhesion between cathode materials and current collector, and increase the electronic conductivity among electroactive substances, a certain proportion of conductive agents (acetylene black) and agglomerant (PVDF) are usually added in the battery manufacturing process. However, these conductive agents have negative effects on the recovery of cathode materials by pyrolysis or calcination. Recognizing this issue, a method based on the concept of "treating spent with spent" was developed in this paper. Organic matters contained in cathode active materials functioned as the reduction reagents, which can reduce the valence state of transition metals, resulting in the breakdown of the strong chemical bond and the stable layered structure of cathode materials. In this study, the thermal reduction effect of different organic components on cathode active materials was analyzed respectively to evaluate the reduction function of each component. XRD, XPS and ICP-MS were used to compare and analyze changes of phase, element compound state and ion leaching efficiencies of different cathode materials before and after thermal reduction under different amounts of reducing agents. The results show that both PVDF and acetylene black reduced the high-valent metals to low-valent oxides or elemental substances, demonstrating their thermal reduction capabilities. Comparisons of the XRD, XPS analysis and ion leaching results of thermal reduced products suggest that acetylene black has a stronger thermal reduction ability than that of PVDF. The results also show that the reduction of the high nickel cathode material (NCM811) is easier than that of the low nickel cathode material (NCM111).

Experimental study on pretreatment effects of [BMIM]HSO4/ethanol on the thermal behavior of cellulose.

Ionic liquids (ILs) have been investigated to dissolve and/or pre-treat cellulose by combining with a low viscous co-solvent. Dissolution and pretreatment of cellulose by ILs are dynamic processes of dissolution and precipitation, which would caused the physical and chemical changes (such as crystallinity and thermal stability) of un-dissolved cellulose residues. Hence, this study focused on the thermal behavior of un-dissolved cellulose (PCEL) after pre-treatment using [BMIM]HSO4/ethanol. Ethanol was used as a green and cheap co-solvent of 1-butyl-3-methylimidazolium hydrogen sulfate ([BMIM]HSO4) to pre-treat cellulose under different conditions. The pretreatment effect on thermal behavior of PCEL was investigated by thermogravimetric analysis and the distributed activation energy model. [BMIM]HSO4/ethanol pretreatment efficiently lowered the thermal stability of cellulose, and promoted the thermal decomposition at low temperature. The thermal behavior of PCEL can be adjusted by the [BMIM]HSO4 mass concentration.

Effect of Oral Hydration on Contrast-Induced Acute Kidney Injury among Patients after Primary Percutaneous Coronary Intervention.

OBJECTIVES: The purpose of this study was to evaluate the protective effect of oral hydration volume to weight ratio (OHV/W) on contrast-induced acute kidney injury (CI-AKI) among patients with ST-elevation myocardial infarction (STEMI) following percutaneous coronary intervention (PCI). METHODS: A total of 754 patients with STEMI undergoing PCI were selected. Each patient was encouraged to drink as much water as possible 24 h after PCI. Total volume intake was recorded for all patients. The ratio of OHV/W was calculated. The occurrence of CI-AKI was defined as ≥0.5 mg/dL absolute or ≥25% relative increase in serum creatinine within 48-72 h following PCI. Logistic regression analysis and generalized additive model were performed to evaluate the relationship between OHV/W and CI-AKI. RESULTS: There was a nonlinear relationship between OHV/W and CI-AKI with an inflection point of 15.69 mL/kg. On the right side of the inflection point (OHV/W ≥15.69 mL/kg), a negative relationship was detected between OHV/W and CI-AKI (HR = 0.90, 95% CI: 0.82∼0.98, p = 0.0126). However, no relationship was observed between OHV/W and CI-AKI on the left of inflection point (HR = 1.19, 95% CI: 0.95∼1.49, p = 0.1302). Subgroup analysis showed that significant interactions were observed only for gender difference (p for interaction = 0.0155), male patients had a significantly lower risk of CI-AKI (HR = 0.84, 95% CI: 0.75∼0.93, p = 0.0012). CONCLUSION: OHV/W ≥15.6 mL/kg for 24 h post-procedure may be an effective preventive strategy of CI-AKI. In addition, male patients may particularly benefit from OHV to prevent CI-AKI.

Hydrometallurgical enhanced liberation and recovery of anode material from spent lithium-ion batteries.

The efficient recycling of spent anode material (SAM) from spent lithium-ion batteries (LIBs) is generally critical in terms of electronic waste recyclingas well as increasing resource shortage and environmental problems. This research reported a novel and green method to recycle lithium, copper foil, and graphite from SAM by water leaching treatment. The results indicated that 100% of graphite was exfoliated from the anode material and 92.82% leaching efficiency of lithium was obtained under the optimal conditions of 80 °C, 60 g/L, 300 rpm, and 60 min, respectively. This finding revealed that the SAM got a full liberation characteristic due to the removal of binder, which produced an ideal leaching lithium efficiency rivaling the acids' performance. The mechanism of the liberation of SAM and lithium leaching is presented based on the analysis of results. The graphite was purified and recovered after water leaching treatment. Besides, lithium was recovered in the form of lithium carbonate (Li2CO3), and the copper foil was recovered in a sheet. This study endeavors to develop an economical and environmentally feasible plan to recycle graphite, copper, and lithium from SAM.

Recent advances in pretreating technology for recycling valuable metals from spent lithium-ion batteries.

In recent years, the amount of spent lithium-ion batteries (LIBs) increase sharply due to the promotion of new energy vehicles and the limited service life. Recycling of spent LIBs has attracted much attention because of the serious environmental pollution and high economic value. Although some established techniques have been presented in spent LIBs recycling process, but most of them focus on cathode material recycling due to its high economic value. Therefore, preparation of high purity cathode material by a proper pretreating technology is an important procedure. In this paper, the technologies used in the pretreating process of spent LIBs are summarized systematically from three main points of discharging procedure, liberation, and separation. The collaborative application of multi-technologies is the key to realize efficient pretreating process, which can lay the foundation for the subsequent metallurgical process. In addition, an alternative pretreating flowchart of spent LIBs is proposed based on the multi-process collaboration. Pretreating procedures in this process are mainly based on the physical property difference, and they include "Discharging-Shredding-Crushing-Sieving-Separation".

A critical review of current technologies for the liberation of electrode materials from foils in the recycling process of spent lithium-ion batteries.

Proper disposal of spent lithium-ion batteries is beneficial for the resource recycling and pollution elimination. Full liberation of electrode materials, including the liberation between electrode material and current collector (copper/aluminum foils) and the liberation among electrode material particles, is the pivotal precondition for improving the recovery efficiency of electrode materials. In this article, authors attempt to carry out a summary of current technologies used in the liberation of electrode materials derived from spent lithium-ion batteries. However, specialized studies about the liberation of electrode materials are insufficient at present. This research clearly shows that: (1) Organic binder must be removed so as to improve the liberation and metallurgy efficiency of electrode materials; (2) A collaboration of varied technologies is the necessary process to achieve high liberation efficiency between electrode materials and copper/aluminum foils; (3) Pyrolysis may be a recommended technology for removal of organic binder because part of pyrolysis products can be recovered. Finally, an alternative recycling flowchart of spent LIBs is proposed.

A nomogram for estimating the probability of nonalcoholic fatty liver disease in a Chinese population: A retrospective cohort study.

Studies have showed that dyslipidemia is closely related to nonalcoholic fatty liver disease (NAFLD). However, less attention has been paid to the relationship between early dyslipidemia and long-term risk of NAFLD. Therefore, we aimed to develop a simple-to-use nomogram to predict early dyslipidemia and long-term risk of NAFLD onset.A retrospective cohort study including 3621 employees (including retirees) from 7 companies was conducted between 2012 and 2019. Anthropometric, potential laboratory parameters and abdominal ultrasound were performed at baseline and after a 5-year follow-up. Cox proportional hazards model was used to determine predictors for NAFLD onset. The effects of lipids, age, body mass index (BMI), and serum uric acid (UA) on NAFLD were evaluated with the use of Kaplan-Meier curves (log-rank test). A nomogram was developed based on the Cox proportional hazard model and a 2-piecewise linear regression model. The accuracy of model was evaluated according to the area under the receiver operating characteristic curves.A total of 1545 subjects were included in the final analysis. The mean follow-up time was 52 ±â€Š6.6 months. Of the total subjects, 77.61% were male and 22.39% were female. The mean age at the time of initial visit was 45.21 ±â€Š11.20 years. Five hundred fifty-five subjects (35.92% of all subjects) were finally diagnosed with NAFLD. Variables in the nomogram included age, BMI, triglycerides, high-density lipoprotein, low-density lipoprotein, and UA. The accuracy of the nomogram for predicting 5-year cumulative occurrence of NAFLD was 0.8135 (95% confidence interval: 0.7921-0.8349), and the sensitivity and specificity were 0.8108 and 0.6960, respectively.The combination of age, BMI, triglycerides, high-density lipoprotein, low-density lipoprotein, and UA translated into a nomogram can reliably estimate the incidence of NAFLD within 5 years. It may serve as a decision support tool to determine whether to intervene at an early stage.

Association between renal function and co-infection with Clonorchis sinensis and Helicobacter pylori: a cross-sectional study.

BACKGROUND: Studies have shown that liver fluke infections may be associated with kidney injury and that Helicobacter pylori (Hp) may be involved in the pathogenesis of kidney diseases. However, no studies have reported the relationship between co-infection with Clonorchis sinensis (Cs) and Hp and renal function. The aim of this study was to examine the relationship between co-infection with Cs and Hp and estimated glomerular filtration rate (eGFR) in a general population, and gender-related differences were also investigated. METHODS: In the cross-sectional study, 4122 subjects from the Health Examination Center of Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2017 to December 2018 were enrolled. All participants underwent stool examination for the diagnosis of Cs infection and 13C-urea breath test (UBT) for the diagnosis of Hp infection. Participants were categorized into four groups: (1) co-infection with Cs and Hp group comprising 207 cases (Hp(+) + Cs(+) group), (2) Cs infection group comprising 1392 cases (Hp(-) + Cs(+)group), (3) Hp infection group comprising 275 cases (Hp(+) + Cs(-) group), and (4) non-infection group comprising 2248 cases (Hp(-) + Cs(-) group). Multiple linear regression analysis was performed to evaluate the relationship between co-infection with Cs and Hp and eGFR. RESULTS: Hp infection without Cs infection was present in 6.67% (275/4122) of subjects, while Cs infection without Hp infection was present in 33.77% (1392/4122) of subjects. Co-infection with Hp and Cs were present in 5.02% (207/4122) of subjects. Median age of the participants was 43 years (IQR 35-51). Most of the participants were male (2955/4122, 71.69%). Median eGFR was 96.61 ml/min/1.73 m2 (IQR 85.05-106.24). Co-infection with Cs and Hp was negatively associated with eGFR after full adjusting (ß = - 1.89, 95% CI: - 3.33 to - 0.45, p = 0.01). The relationship remained significant in females (ß = - 9.37, 95% CI: - 11.60 to - 7.1, p < 0.001), but not in males. CONCLUSION: Our findings suggest that co-infection with Cs and Hp may be associated with reduced renal function in females, but not in males.

Organics removal combined with in situ thermal-reduction for enhancing the liberation and metallurgy efficiency of LiCoO2 derived from spent lithium-ion batteries.

Liberation and reduction of cathode material are the necessary procedures for improving the recycling efficiency of cathode material derived from spent lithium-ion batteries. In this research work, a pyrolysis technology was utilized to remove the organic binder and enhance liberation of electrode materials. At the same time, pyrolysis treatment can facilitate the thermal-reduction of Co3+ in LiCoO2 to Co2+ with surface organics, which lays a foundation for the subsequent reductant-free acid leaching. Results indicate that the crystal structure of pure LiCoO2 is not changed at a pyrolysis temperature of 600 °C, but LiCoO2 transforms to CoO, Li2CO3, LiF, and Li2O under the reduction action of HF, pyrolytic carbon, and additive carbon black. Water-impact crushing is synchronized with water-leaching to separate electrode materials from aluminum foil and recover Li element. Afterwards, reductant-free acid leaching technology can be utilized to recycle Li and Co from spent LiCoO2 batteries. Recovery efficiency of Li element in water-leaching process was up to 92.17% while the remaining 7.83% of Li and all Co elements were recovered during reductant-free acid leaching process. Based on the foundation analysis, the green chemical process for recovering valuable metals from spent lithium-ion batteries was proposed.

Enhancement in leaching process of lithium and cobalt from spent lithium-ion batteries using benzenesulfonic acid system.

Recycling of valuable metals from spent lithium ion batteries (LIBs) is of great significance considering the conservation of metal resources and the alleviation of potential hazardous effects on environment. Thus, the present work focuses on enhancing the efficiency of leaching process for the recovery of cobalt and lithium from the cathode active materials of spent LIBs. In this study, benzenesulfonic acid (C6H5SO3H) with a reducing agent hydrogen peroxide (H2O2) was innovatively used as leaching reagents, and the operating variables were optimized to obtain higher leaching efficiencies. Results show the optimized leaching recovery of 99.58% Li and 96.53% Co was obtained under the conditions of 0.75 M benzenesulfonic acid, 3 vol% H2O2, a solid to liquid (S/L) ratio of 15 g/L, 500 rpm stirring speed, and 80 min leaching time at 90 °C. Moreover, a new kinetic model was introduced to describe the leaching kinetics of LiCoO2 from the cathode material. The apparent activation energies Ea for leaching of lithium and cobalt are 41.06 and 35.21 kJ/mol, respectively, indicating that the surface chemical reaction is the rate-controlling step during this leaching process. Further, the proposed recovery mechanism for spent cathode material was raised by analyzing the experimental results and characterizing the morphological and chemical state (i.e. SEM-EDS, XPS and XRD) of raw material and leaching residues. In comparison with the previous leaching process, this research was found to be efficient, low energy consumption, and environmental friendly.

Separation Process of Fine Coals by Ultrasonic Vibration Gas-Solid Fluidized Bed.

Ultrasonic vibration gas-solid fluidized bed was proposed and introduced to separate fine coals (0.5-0.125 mm fraction). Several technological methods such as XRF, XRD, XPS, and EPMA were used to study the composition of heavy products to evaluate the separation effect. Results show that the ultrasonic vibration force field strengthens the particle separation process based on density when the vibration frequency is 35 kHz and the fluidization number is 1.8. The ash difference between the light and heavy products and the recovery of combustible material obtain the maximum values of 47.30% and 89.59%, respectively. The sulfur content of the heavy product reaches the maximum value of 6.78%. Chemical state analysis of sulfur shows that organic sulfur (-C-S-), sulfate-sulfur (-SO4), and pyrite-sulfur (-S2) are confirmed in the original coal and heavy product. Organic sulfur (-C-S-) is mainly concentrated in the light product, and pyrite-sulfur (-S2) is significantly enriched in the heavy product. The element composition, phase composition, backscatter imagery, and surface distribution of elements for heavy product show concentration of high-density minerals including pyrite, quartz, and kaolinite. Some harmful elements such as F, Pb, and As are also concentrated in the heavy product.

Removing inorganics from nonmetal fraction of waste printed circuit boards by triboelectric separation.

Metals recycling from WPCBs has been studied for a long time, which results in the appearance of many proven techniques. However, the nonmetal fraction in WPCBs has not been fully recycled due to hybridpropertiesof inorganic and organic composition. In order to improve the usability of the nonmetal fraction from WPCBs, nonmetal materials separation by using a laboratory triboelectric separation system was carried out to improve the reuse efficiency of WPCBs nonmetal fraction. The optimum tribocharger material was investigated by using the charge-mass ratio measurement system, and PMMA is the optimum tribocharger material compared with PVC, PPFT, PPR, SS. The effects of airflow, voltage and feed rate on triboelectric separation were investigated. The product LOI of positive plate is up to 77.26% with recovery rate of 25.49%, while the product LOI of negative plate is down to 47.35% with recovery rate of 35.37%, and the remove rate of inorganics is up to 43.02% by triboelectric separation. The analysis results of X-ray diffraction indicate that the main inorganic materials mixed in nonmetal fraction are SiO2, Al2O3, CaO, Cu, Fe, Sn. The X-ray fluorescence analysis shows that the triboelectric separation can effectively remove the content of SiO2 and Al2O3. The scanning electron microscope images show that inorganics tribocharge positively and distribute in product collection grooves that close to negative plate.

Effect of berberine on expressions of uncoupling protein-2 mRNA and protein in hepatic tissue of non-alcoholic fatty liver disease in rats.

OBJECTIVE: To observe the effect of berberine on uncoupling protein-2 (UCP2) mRNA and protein expressions in the hepatic tissue of non-alcoholic fatty liver disease (NAFLD) in rats, and to explore the molecular mechanism. METHODS: To establish the NAFLD rat model; the rats were fed by high fat forage and were randomly divided into four groups: normal group, model group, berberine high-dose group (324 mg/kg), and berberine low-dose group (162 mg/kg). After treatment for 12 weeks, the expression of UCP2 mRNA in the liver tissue was analyzed by semiquantitative reverse transcription polymerase chain reaction (RT-RTPCR). The expression level of UCP2 protein in the liver tissue was examined by immunohistochemistry. Total PCR). cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) contents in blood serum, and TG and TC contents in the liver were detected by an automatic biochemical analyzer. The other is to observe the axungia degree of the liver. RESULTS: The expression of UCP2 mRNA and positive cell numbers in the liver tissue were dramatically increased in the model group (P<0.01). Lipid in the serum and hepatic tissues increased significantly, and the liver was fatty. But in the treatment groups, the expression levels of mRNA and UCP2 proteins were significantly down-regulated (P<0.01). Liver steatosis was improved. CONCLUSIONS: Berberine can down-regulate the expression levels of UCP2 mRNA and UCP2 proteins of hepatic tissue in NAFLD rats. It can promote the recovery of hepatocyte steatosis and improve lipid metabolism disorder in NAFLD rats. Berberine shows a potential therapeutic effect on NAFLD.