Laparoscopic continuous seromuscular circumsuture for myomectomy: a real-world, retrospective, East-Asian cohort study.

OBJECTIVE: This study aimed to introduce a novel laparoscopic haemostasis for myomectomy and investigate the independent risk factors for uterine fibroid recurrence. DESIGN: A retrospective cohort study. SETTING: Following strengthening the reporting of observational studies in epidemiology (STROBE) criteria, a retrospective study of prospectively collected available data of the consecutive patients who underwent the myomectomy in the department of obstetrics and gynaecology of the single centre between February 2018 and December 2020. PARTICIPANTS: 177 patients who underwent laparoscopic myomectomy resection were enrolled in the present cohort study. MATERIALS AND METHODS: Patients were classified into two groups according to their different methods of haemostasis in laparoscopic surgery. Recurrence-free survival was compared between the groups during an average follow-up of nearly 2 years. RESULTS: Of the 177 patients from 672 consecutive patients in the retrospective cohort, laparoscopic circular suture and baseball suture were carried out in 102 (57.6%) and 75 (42.4%) patients, respectively. The total amount of blood lost during surgery varied significantly (37.6 vs 99.5 mL) (p<0.001). Univariable analyses identified that age ≥40 years, position at intramural myoma, multiple fibroids and largest fibroid volume ≥50 mm3 (HR 2.222, 95% CI 1.376 to 3.977, p=0.039; HR 3.625, 95% CI 1.526 to 6.985, p=0.003; HR 3.139, 95% CI 1.651 to 5.968, p<0.001; HR 2.328, 95% CI 0.869 to 3.244, p=0.040, respectively) are independent risk factor of the recurrence of uterine fibroids. The formula of the nomogram prediction model was established as the practical clinical tool. CONCLUSION: The laparoscopic continuous seromuscular circumsuture for myomectomy can effectively reduce the amount of surgical bleeding and accelerate the perioperative recovery for surgical safety. The main factors affecting the recurrence of uterine fibroids were age, location, number and volume of uterine fibroids. The nomogram can more straightforwardly assist clinicians to determine the risk of recurrence after laparoscopic myomectomy.

An online-predictive model of acute kidney injury after pancreatic surgery.

OBJECTIVE: Acute kidney injury(AKI) after pancreatic surgery is associated with increased mortality, longer hospital stays and poor prognosis. This study aims to identify the risk factors and establish an easy-to-use prediction calculator by the nomogram to predict the risk of AKI after pancreatic surgery. METHODS: From January 2016 to June 2018, 1504 patients who underwent pancreatic surgery in our center were included in this retrospective analysis and randomly assigned to primary (1054 patients) and validation (450 patients) cohorts. The independent risk factors of AKI were identified using univariate and multivariate analyses. A risk-predicted nomogram for AKI was developed through multivariate logistic regression analysis in the primary cohort while the nomogram was evaluated in the validation cohort. Nomogram discrimination and calibration were assessed using C-index and calibration curves in the primary and validation cohorts. The clinical utility of the final nomogram was evaluated using decision curve analysis. RESULTS: The overall incidence of AKI after pancreatic surgery was 5.3% (79/1504). Independent risk factors including smoking history, cardiovascular disease, ASA score, baseline eGFR, bilirubin＞2 â€‹mg/dL, undergoing pancreaticoduodenectomy, and intraoperative blood loss＞400 â€‹mL were identified by multivariate analysis. Nomogram revealed moderate discrimination and calibration in estimating the risk of AKI, with an unadjusted C-index of 0.79 (95 %CI, 0.73-0.85). Application of the nomogram in the validation cohort provided moderate discrimination (C-index,0.80 [95% CI, 0.72-0.88]) and good calibration. Besides, the decision curve analysis (DCA) confirmed the clinical usefulness of the nomogram. CONCLUSIONS: An easy-to-use online prediction calculator comprised of preoperative and intraoperative factors was able to individually predict the occurrence risk of AKI among patients with pancreatic surgery, which may help identify reasonable risk judgments and develop proper treatment strategies to a certain extent.

Insight into the Inhibitory Mechanisms of Hesperidin on α-Glucosidase through Kinetics, Fluorescence Quenching, and Molecular Docking Studies.

The α-glucosidase inhibitor is of interest to researchers due to its association with type-II diabetes treatment by suppressing postprandial hyperglycemia. Hesperidin is a major flavonoid in orange fruit with diverse biological properties. This paper evaluates the effects of hesperidin on α-glucosidase through inhibitory kinetics, fluorescence quenching, and molecular docking methods for the first time. The inhibition kinetic analysis shows that hesperidin reversibly inhibited the α-glucosidase activity with an IC50 value of 18.52 µM and the inhibition was performed in an uncompetitive type. The fluorescence quenching studies indicate that the intrinsic fluorescence of α-glucosidase was quenched via a static quenching process and only one binding site was present between the hesperidin and α-glucosidase. The interaction between them was spontaneous and mainly driven by hydrogen bonds, as well as hydrophobic forces. Furthermore, the molecular docking results suggest that hesperidin might bond to the entrance or outlet part of the active site of α-glucosidase through a network of five hydrogen bonds formed between hesperidin and the four amino acid residues (Trp709, Arg422, Asn424, and Arg467) of α-glucosidase and the hydrophobic effects. These results provide new insight into the inhibitory mechanisms of hesperidin on α-glucosidase, supporting the potential application of a hesperidin-rich orange product as a hypoglycemic functional food.

Copper-Promoted Intramolecular Oxidative Dehydrogenation for Synthesizing Dihydroisocoumarins and Isocoumarins.

Isocoumarins and dihydroisocoumarins are important skeletons with a wide range of biological activities, such as anti-bacterial, anti-allergy, anti-fungal, anti-tumor, and anti-HIV properties. Herein, we demonstrated divergent syntheses of isocoumarins and 3,4-dihydroisocoumarins by intramolecular dehydrogenative cyclization of 2-(3-oxobutyl) benzoic acids. This transformation undergoes Csp3-H bonds and O-H bonds coupling in air using copper salt. The reactions may undergo free radical process.

Home monitoring for clinically suspected obstructive sleep apnea in pregnancy.

STUDY OBJECTIVES: To determine if a home sleep apnea test (HSAT) using a type III portable monitor (PM), Nox-T3 (Nox Medical, Inc., Reykjavik, Iceland), detects obstructive sleep apnea in pregnant women. METHODS: Ninety-two pregnant women (34.5 ± 4.3 years; gestational age 25.4 ± 8.9 weeks; body mass index 29.9 ± 4.7 kg/m2) with suspected obstructive sleep apnea underwent HSAT with the Nox-T3 PM followed by overnight polysomnography (PSG) and PM recording simultaneously in the laboratory within 1 week. PMs were scored automatically and manually using a 3% criteria and compared with PSGs scored by following guidelines. RESULTS: Apnea-hypopnea indexes were 8.56 ± 10.42, 8.19 ± 13.79, and 8.71 ± 14.19 events/h on HSAT, in-laboratory PM recording, and PSG (P = .955), respectively. Bland-Altman analysis of the apnea-hypopnea index on PSG vs HSAT showed a mean difference (95% confidence interval) of -0.15 (-1.83, 1.53); limits of agreement (± 2 SD) were -16.26 to 16.56 events/h. Based on a threshold apnea-hypopnea index ≥ 5 events/h, HSAT had 91% sensitivity, 85% specificity, 84% positive-predictive value, and 92% negative-predictive value compared with PSG. When comparing the simultaneous recordings, closer agreement was observed. Automated vs manual analysis of PM showed no significant difference. CONCLUSIONS: A type III PM had an acceptable failure rate and high diagnostic performance operating as a reasonable alternative for in-laboratory PSG in pregnant women. CITATION: Wang J, Zhang C, Xu L, et al. Home monitoring for clinically suspected obstructive sleep apnea in pregnancy. J Clin Sleep Med. 2023;19(11):1951-1960.

Evaluation of antibacterial activity of compounds isolated from the peel of Newhall navel orange.

Fifteen compounds including one flavanone hesperitin (1), two cinnamic acid derivatives as (E)-4-hydroxycinnamic acid (2) and (E)-ferulic acid (3), eight polymethoxyflavones (PMFs) (4-11), and four hydroxylated PMFs (12-15) isolated from orange peel were subjected to antibacterial evaluation. Compounds 1-3 exhibited wide-spectrum antibacterial effects against four test strains involving Bacillus subtilis, Staphylococcus aureus, Xanthomonas citri subsp. citri (Xcc), and Meticillin-resistant Staphylococcus aureus (MRSA) with minimum inhibitory concentrations (MICs) ranging from 0.0312 to 0.125 mg/mL. In contrast, all PMFs showed weak antibacterial activity against these four strains with MICs being equal to or more than 0.125 mg/mL. Hydroxylated PMFs demonstrated better antibacterial effect against Xcc relative to PMFs. In addition, the synergistic effect against Xcc was obtained when compounds 1 and 3 were combined. Furthermore, the scanning electron microscopy (SEM) results of Xcc treated with both compounds 2 and 3 showed shrunken and rough surface morphologies, indicative of the cell membrane damage.

Precipitation Behavior during Aging Operations in an Ultrafine-Grained Al-Cu-Mg Alloy Produced by High-Strain-Rate Processing.

An ultrafine-grained (UFG) Al-Cu-Mg alloy (AA2024) was produced by surface mechanical grinding treatment (SMGT) with a high strain rate, and the precipitation behavior inside the grain and at the grain boundary was investigated. During SMGT, element segregation at the boundary was rarely observed, since the solute atoms were impeded by dislocations produced during SMGT. During early aging, the atomic fraction of Cu at the grain boundary with SMGT alloys was approximately 2.4-fold larger than that without SMGT alloys, the diffusion rate of Cu atoms from the grain toward the grain boundaries was accelerated with SMGT alloys, because a higher local elastic stress and diffusion path were provided by high-density dislocations. The combined action, in terms of the composition of the alloy, the atomic radius, the diffusion path, and the diffusion driving force provided by high-density dislocations with SMGT alloys, led to a Cu/Mg atomic ratio of approximately 6.8 at the grain boundary. The average size of the precipitates inside the grain was approximately 2- and 10-fold larger than that formed after later aging with and without SMGT alloys, due to more nucleation sites at dislocation located inside the grain with SMGT alloys having attracted and captured numerous solute atoms during the aging process.

Generation of a X-linked juvenile retinoschisis patient-derived induced pluripotent stem cell line ZOCi004-A.

X-linked juvenile retinoschisis (XLRS), caused by the mutation of RS1 gene, is one of the most common causes of macular degeneration for male adolescents. The mutations and clinical manifestations of the disease are diverse. Neither the relationship between the genotypes and phenotypes, nor the radical treatment like gene therapy has been found by now. Retrospective studies have shown that carbonic anhydrase inhibitors can help reduce cysts. However, the specifically pharmacological mechanism remains unknown. Here, we culture induced pluripotent stem cells by drawing peripheral blood from a patient with XLRS, which are supposed to facilitate related researches.

Testis-specific protein Y-encoded 1 regulates androgen receptor expression through the MAPK/ERK pathway in male hepatocellular carcinoma.

OBJECTIVES: To analyze the mechanism of testis-specific protein Y-encoded 1 (TSPY1) in male hepatocellular carcinoma (HCC). METHODS: This experimental study was carried out at Guangxi Medical University's First Affiliated Hospital, Guangxi, China, between January 2016 and December 2019. The expression of TSPY1, androgen receptor (AR), messenger ribonucleic acids (mRNAs), and proteins were detected by qRT-PCR and Western blotting. The co-localization and interaction of TSPY1 and AR were observed by immunofluorescence assay and co-immunoprecipitation. Hepatocellular carcinoma cells overexpressing and silencing TSPY1 were constructed, and the expression and phosphorylation levels of TSPY1, AR, and mitogen-activated protein kinases/extracellular signal-regulated kinases (MAPK/ERK) signaling pathway-related key molecules ERK1/2, p38, and JNK were also detected. RESULTS: The expression levels of TSPY1, AR mRNAs, and proteins were highly positively correlated in HCC cells in different metastatic potentials with a high correlation coefficient of R=0.929 and R=0.884. Testis-specific protein Y-encoded 1 and AR were then co-localized in the nucleus of HCC cells, and TSPY1 and AR can interact with each other. In addition, the expression of AR and phosphorylation of ERK1/2 were enhanced in TSPY1 overexpressed Huh7 cells. They were reduced in HCCLM3 cells with TSPY1 knockdown expression. In addition, in response to blocking MAPK/ERK signaling activity, AR was reduced in expression. CONCLUSION: These findings suggested that there was a positive correlation between TSPY1 expression and AR in male HCC cells, and high TSPY1 expression stimulates AR expression, MAPK/ERK signaling pathway may be involved in its mechanism.

Variations of Bioactive Phytochemicals and Antioxidant Capacity of Navel Orange Peel in Response to Different Drying Methods.

The effects of five different drying methods, namely, freeze drying (FD), shade drying (SD), hot-air oven drying at 50 °C (OD50), 70 °C (OD70), and microwave drying (MD) on the bioactive phytochemicals and antioxidant capacity of navel orange peel were assessed and comprehensively discussed in detail. Compared with other drying methods, MD-treated peel contained the lowest total phenolic content (TPC) and total flavonoid content (TFC). The peel subjected to OD70 treatment was superior in TPC relative to other treatments and the highest TFC was found in the peels treated with FD. HPLC analysis identified thirteen flavonoids involving three flavanone glycosides (FGs) and ten polymethoxyflavones (PMFs) in navel orange peel and revealed that PMFs in peel were stable under all these drying methods, whereas the three major FGs (narirutin, hesperidin, and didymin) in peel significantly degraded in response to MD treatment. The peels subjected to OD50/OD70 treatments had the most potent antioxidant capacity when compared to other drying methods. Furthermore, Pearson's correlation analysis was performed. The results revealed here allow us to recommend the use of OD50 or OD70 for the drying of orange peel, both of which help the maintenance of bioactive compounds in the peel and improve its antioxidant capacity.

Ocular manifestations of Chinese patients with copy number variants in the NDP gene.

Purpose: Familial exudative vitreoretinopathy (FEVR) and Norrie disease (ND) are genetic disorders that can be caused by mutations in the NDP gene and affect retinal vasculature growth and development. This study aimed to describe the copy number variations (CNVs) in the NDP gene in Chinese FEVR families and the associated phenotypes. Methods: This study recruited 651 FEVR families. SeqCNV was used to analyze the CNVs in the families without mutations in known FEVR-associated genes. Multiplex ligation-dependent probe amplification and semiquantitative multiplex PCR were performed to verify the NDP CNVs. The probands and family members underwent complete ocular examinations. Results: NDP CNVs were identified in four patients from three unrelated families, accounting for 15% of the patients with NDP mutations and 0.46% of the entire FEVR cohort. Exon 2 deletions were detected in two families, and whole gene deletion was identified in one family. The affected individuals were born blind with total retinal detachment. Conclusions: The findings confirm that CNVs are a common NDP mutation type. The CNV-associated phenotype is congenital blindness with total retinal detachment. Antenatal genetic analyses and fetal ultrasound can facilitate early diagnosis and interventions in patients with NDP mutations.

Oxygen Vacancy Induced Boosted Visible-Light Driven Photocatalytic CO2 Reduction and Electrochemical Water Oxidation Over CuCo-ZIF@Fe2 O3 @CC Architecture.

Herein, the obtained Cu0.5 Co0.5 -ZIF@Fe2 O3 @CC-150 heterojunction (termed as Cu1- x Cox -ZFC-150) showed high hydrogen and oxygen evolution reaction (HER and OER) activities with low overpotential small Tafel slope. When employed to be the bifunctional anode and cathode, they only needed a cell voltage of 1.62 V. The composite also exhibited excellent photocatalytic performance on CO2 evolution into CO and CH4 . The enhanced OER kinetics and Z-scheme charge transfer model for photocatalytic property have been discussed based on the experiments and density functional theory (DFT) analysis. The optimized phase interfaces, abundant active sites, optional oxygen vacancy, and adjusted Gibbs free energy were beneficial for the fast electron/ion transport enhancing the water splitting performance.

Static Electro-Mechanical Response of Axisymmetric One-Dimensional Piezoelectric Quasicrystal Circular Actuator.

The piezoelectric effect of piezoelectric quasicrystalline materials is coexcited by phonon and phason fields. Piezoelectric quasicrystalline materials have excellent properties of both piezoelectric materials and quasicrystalline materials, which are expected to be used as actuators in the fields of aerospace, automotive, and intelligent manufacturing. Based on the three-dimensional elastic theory of piezoelectric quasicrystals, the state space equation for axisymmetric piezoelectric quasicrystal circular plate actuators is derived by using the state space method. Afterwards, the finite Hankel transformation is performed on the state equation, and a system of ordinary differential equations and corresponding boundary conditions are obtained. Finally, the exact solution of axisymmetric bending of one-dimensional hexagonal piezoelectric quasicrystal circular actuators under generalized elastic simply supported boundary conditions is obtained by using the propagator matrix method. Numerical results are given to compare the degradation results in this paper with those in the literature, and present the influences of the thickness-to-span ratio and stacking sequence on the phonon, phason, and electric fields when the surface of the laminated circular actuators is subjected to mechanical load. The exact solution obtained does not introduce any deformation assumption; therefore, the exact solution can provide references for numerical calculations of the mechanical behavior of piezoelectric quasicrystals.

Diagnostic value of combined prealbumin-to-fibrinogen and albumin-to-fibrinogen ratios in Hp-negative gastric cancer.

BACKGROUND: This study aimed to investigate the diagnostic value of prealbumin-to-fibrinogen ratio (PFR) and albumin-to-fibrinogen ratio (AFR) alone or in combination in Helicobacter pylori-negative gastric cancer (Hp-NGC) patients. METHODS: This study included 171 healthy controls, 180 Hp-NGC patients, and 215 Helicobacter pylori-negative chronic gastritis (HpN) patients. We compared the differences of various indicators and pathological characteristics between groups with Mann-Whitney U test and Chi-square test. The diagnostic value of PFR and AFR alone or in combination for Hp-NGC patients was assessed by the receiver operating characteristic (ROC) curve. RESULTS: PFR and AFR were related to the progression and clinicopathological characteristics of Hp-NGC. As the disease progressed, PFR and AFR values gradually decreased and were negatively related to the tumor size and depth of invasion. In addition, the area under the curves (AUCs) that resulted from combining PFR and AFR to distinguish Hp-NGC patients from healthy controls and HpN patients were 0.908 and 0.654, respectively. When combined with PFR and AFR in the differential diagnosis of tumors with a maximum diameter ≥ 5 cm and the T3 + T4 stage, the AUCs were 0.949 and 0.922; the sensitivity was 86.32% and 80.74%; and the specificity was 94.74% and 92.98%, respectively. CONCLUSIONS: PFR and AFR may be used as diagnostic biomarkers for Hp-NGC. The combination of PFR and AFR was more valuable than each indicator alone in the diagnosis of Hp-NGC.

Characterization and bioassays of extracellular vesicles extracted by tangential flow filtration.

Aim: To evaluate the efficiency of tangential flow filtration (TFF) in improving the yield of human umbilical cord mesenchymal stem cell (hucMSC)-derived extracellular vesicles (EVs) while promoting cell regeneration under oxidative stress. Methods: HucMSC-EVs were extracted from supernatants by ultracentrifugation (UC-EVs) and TFF (TFF-EVs), followed by feature characterization and bioactivity assays. Results: The yield of TFF-EVs increased 18-times compared with that of UC-EVs. TFF-EVs displayed proliferation-promoting ability similar to that of UC-EVs in the damaged HaCaT cell model with ultraviolet radiation B (UVB) and H2O2. Furthermore, the antiapoptotic effects of TFF-EVs were improved, whereby the apoptosis rate exhibited a 3.7-fold decrease. Conclusion: HucMSC-EVs extracted by TFF show a higher yield and rejuvenate the damaged HaCaT cells induced by oxidative stress.

Plain language summary The progresses in regenerative medicine will enable a perfect repair of burns. Stem cells release extracellular vesicles around injured tissues to improve its structural and functional repair. But the current methods for vesicles enrichment are not efficient enough to meet the needs of investigation. Here we isolated the vesicles from the stem cells supernatants by either traditional method or ultrafiltration. We found that the vesicles isolated with ultrafiltration method displayed a similar cell proliferation ability of that with the traditional one. The output of the vesicles or its anti-aging capability has increased 18- or 3.7-times respectively. Therefore, the scalable and effective isolation method described here may facilitate the successful medical translation of the vesicles for clinical use.

Meningitis patients with pneumonia: correlation between blood parameters and clinical features.

Background: This research aimed to explore the possible relationship between the main experimental parameters and clinical status in meningitis patients with pneumonia infection. Methods: A retrospective analysis of the demographic characteristics, clinical features and laboratory parameters of meningitis patients was performed. Results: D-dimer, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) exhibited good diagnostic ability for meningitis complicated with pneumonia. Additionally, we observed a positive correlation between D-dimer and CRP in cases of meningitis with pneumonia infection. D-dimer, ESR and Streptococcus pneumoniae (S. pneumoniae) were independently associated with meningitis patients with pneumonia infection. Conclusion: D-dimer, CRP, ESR and S. pneumoniae infection may effectively anticipate disease progression and adverse consequences in meningitis patients with pneumonia infection.

D-dimer has an early and rapid diagnostic value for the hypercoagulation state. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) have been widely used laboratory parameters for inflammatory diseases. In our study, we observed increased D-dimer, CRP and ESR levels in patients with meningitis, which were more pronounced in patients with meningitis complicated with pneumonia. It is worth noting that D-dimer and CRP showed a positive correlation in patients with meningitis. D-dimer, CRP and ESR in patients with meningitis can effectively monitor disease progression.

Generation of induced pluripotent stem cell (iPSC) line ZOCi003-A derived from peripheral blood mononuclear cells of X-linked juvenile retinoschisis harboring a hemizygous mutation in RS1 gene.

X-linked juvenile retinoschisis (XLRS) is an inherited disease characterized by splitting within inner retinal layers and impaired vision, which begins in childhood and occurs mostly in males. Peripheral blood mononuclear cells (PBMCs) were isolated from a seven-year-old boy carrying a hemizygous mutation in RS1 gene, and were reprogrammed into human induced pluripotent stem cells (iPSCs) using non-integrative episomal vectors. The cell line, ZOCi003-A, had normal karyotype, expressed pluripotency markers, and could differentiate into three germ layers in vivo. This IPSC line may be used for studying the molecular basis of XLRS and selecting potential therapeutic targets and drugs.

D-Dimer Combined With CRP Can Improve the Differential Value of Bacterial Meningitis and Tuberculous Meningitis.

OBJECTIVE: To explore the diagnostic value of the coagulation marker D-dimer and its combination with the traditional marker C-reactive protein (CRP) in distinguishing bacterial meningitis (BM) from tuberculous meningitis (TM). METHODS: We performed a retrospective study on specimens from 173 patients with meningitis who were hospitalized at the First Affiliated Hospital of Guangxi Medical University, Guangxi, China, from 2012 through 2020. The patient records were divided into the BM group and the TM group, and hematological parameters D-dimer and CRP were evaluated for the 2 groups. RESULTS: The levels of D-dimer and CRP in the BM group were significantly higher than those levels in the TM group (P ˂.001 for each), and the sensitivity and specificity of the combined detection of the 2 markers was 86.3% to 100%; the area under the receiver operating characteristic (ROC) curve reached 0.983 (95% confidence interval [CI], 0.966-0.999). CONCLUSION: D-dimer testing has high specificity in distinguishing between BM and TM; CRP testing also has high sensitivity. The combined diagnosis of the 2 biomarkers helps to distinguish TM from BM.

Whole-Gene Deletions of FZD4 Cause Familial Exudative Vitreoretinopathy.

Familial exudative vitreoretinopathy (FEVR) is an inherited disorder characterized by abnormalities in the retinal vasculature. The FZD4 gene is associated with FEVR, but the prevalence and impact of FZD4 copy number variation (CNV) on FEVR patients are unknown. The aim of this study was to better understand the genetic features and clinical manifestations of patients with FZD4 CNVs. A total of 651 FEVR families were recruited. Families negative for mutations in FEVR-associated genes were selected for CNV analysis using SeqCNV. Semiquantitative multiplex polymerase chain reaction and multiplex ligation-dependent probe amplification were conducted to verify the CNVs. Four probands were found to carry whole-gene deletions of FZD4, accounting for 5% (4/80) of probands with FZD4 mutations and 0.6% (4/651) of all FEVR probands. The four probands exhibited similar phenotypes of unilateral retinal folds. FEVR in probands with CNVs was not more severe than in probands with FZD4 missense mutations (p = 1.000). Although this is the first report of FZD4 CNVs and the associated phenotypes, the interpretation of FZD4 CNVs should be emphasized when analyzing the next-generation sequencing data of FEVR patients because of their high prevalence.

Diagnostic Values of the Prealbumin-to-Fibrinogen, Albumin-to-Fibrinogen, and Monocyte-to-Lymphocyte Ratios in Gastric Cancer.

OBJECTIVE: This study aimed to assess the diagnostic value of the prealbumin-to-fibrinogen ratio (PFR), monocyte-to-lymphocyte ratio (MLR), and albumin-to-fibrinogen ratio (AFR) as single or combined indicators of gastric cancer. METHODS: The study included 162 healthy controls and 155 patients with gastric adenocarcinoma. The differences in the experimental indicators and pathological characteristics between the groups were compared using the Kruskal-Wallis H test and Mann-Whitney U test. We evaluated the independent risk factors for gastric cancer through logistic regression and assessed the diagnostic values of PFR, AFR, and MLR for gastric cancer using receiver operating characteristic (ROC) curves. RESULTS: PFR, AFR, and MLR were different between the healthy control and gastric cancer groups. PFR and AFR were related to the pathological characteristics of gastric cancer, such as tumor size, TNM stage, and clinical stage (P<0.05). PFR, MLR, and AFR were not related to age, tumor site, or degree of differentiation (P>0.05). Regression analysis suggested that PFR, MLR, and AFR might be independent factors predictive of gastric cancer. When combining PFR, MLR, and AFR, the area under the curve (AUC) was 0.951, and the sensitivity and specificity were 87.10% and 95.06%, respectively. This combination had the highest diagnostic value for gastric cancer patients. CONCLUSION: The combination of PFR, MLR, and AFR is more valuable than each indicator alone in the diagnosis of gastric cancer.