RESUMO
OBJECTIVE: To explore the correlations of neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) with renal function and prognosis in patients with lupus nephritis (LN). METHODS: A total of 115 patients with LN (research group) admitted to the Second Affiliated Hospital of Shandong First Medical University during January 2018 and January 2021 and 60 healthy controls (control group) who concurrently underwent physical examination were included in this study. Peripheral blood NLR and LMR were recorded in both arms. According to the estimated glomerular filtration rate (eGFR) at admission, patients with LN were assigned to a normal renal function group and a renal insufficiency group to compare their NLR and LMR values. Further, the cases were divided into good and poor prognosis groups based on the follow-up results, and the NLR and LMR were observed. Pearson test was used to analyze the relationship between NLR, LMR, and eGFR. Independent risk factors for poor prognosis of renal function were analyzed by multivariate logistic analysis. RESULTS: The cases showed higher NLR and lower LMR than the controls (P<0.001). The NLR was lower in patients with normal renal function than in those with renal insufficiency (P<0.001). Patients with poor prognosis presented with significantly higher NLR and lower LMR than those with good prognosis (P<0.001). In cases, eGFR decreased with the increase of NLR, presenting an inverse association (r=-0.572, P<0.001). eGFR increased as the LMR increased, showing a positive correlation (r=0.582, P<0.001). Multivariate logistic analysis identified that infection, hypoproteinemia, moderate or above lupus disease activity, high NLR, and low LMR were independent risk factors for poor prognosis in LN. CONCLUSIONS: Peripheral blood NLR and LMR are plausible biologic indicators to predict renal function and prognosis in patients with LN.
RESUMO
The outbreak of COVID-19 has spreaded rapidly across the world. To control the rapid dispersion of the virus, China has imposed national lockdown policies to practise social distancing. This has led to reduced human activities and hence primary air pollutant emissions, which caused improvement of air quality as a side-product. To investigate the air quality changes during the COVID-19 lockdown over the YRD Region, we apply the WRF-CAMx modelling system together with monitoring data to investigate the impact of human activity pattern changes on air quality. Results show that human activities were lowered significantly during the period: industrial operations, VKT, constructions in operation, etc. were significantly reduced, leading to lowered SO2, NOx, PM2.5 and VOCs emissions by approximately 16-26%, 29-47%, 27-46% and 37-57% during the Level I and Level II response periods respectively. These emission reduction has played a significant role in the improvement of air quality. Concentrations of PM2.5, NO2 and SO2 decreased by 31.8%, 45.1% and 20.4% during the Level I period; and 33.2%, 27.2% and 7.6% during the Level II period compared with 2019. However, ozone did not show any reduction and increased greatly. Our results also show that even during the lockdown, with primary emissions reduction of 15%-61%, the daily average PM2.5 concentrations range between 15 and 79 µg m-3, which shows that background and residual pollutions are still high. Source apportionment results indicate that the residual pollution of PM2.5 comes from industry (32.2-61.1%), mobile (3.9-8.1%), dust (2.6-7.7%), residential sources (2.1-28.5%) in YRD and 14.0-28.6% contribution from long-range transport coming from northern China. This indicates that in spite of the extreme reductions in primary emissions, it cannot fully tackle the current air pollution. Re-organisation of the energy and industrial strategy together with trans-regional joint-control for a full long-term air pollution plan need to be further taken into account.
