Absolute blood lymphocytes/monocytes and lymphocytes/neutrophils in patients with neurosyphilis may affect the response to therapy and diagnostic efficacy

Absolute blood lymphocytes/monocytes and lymphocytes/neutrophils in patients with neurosyphilis may affect the response to therapy and diagnostic efficacy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Absolute blood lymphocytes/monocytes and lymphocytes/neutrophils in patients with neurosyphilis may affect the response to therapy and diagnostic efficacy Hongjing Guan, Xiaoyun Di, Mengqing Li, Nawei Yu, Rentian Cai, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4605969/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: To investigate the effects of absolute blood lymphocytes/absolute monocyte (LMR), absolute lymphocytes/absolute neutrophils (LNR) and sero-TRUST titers on treatment response after initial treatment in HIV-negative neurosyphilis (NS) patients, whether they can be used as auxiliary indicators for response after treatment. Methods: NS patients who were hospitalized in Nanjing Second Hospital from January 1, 2018 to December 31, 2022 for initial treatment ,complete treatment response will be taken as the study endpoint. COX regression was used to analyze the influencing factors of treatment response in NS patients. Evaluate the ability to respond by assessing baseline LMR and LNR, changes in LMR and LNR at different time points compared to baseline, and the multiple decrease in the toluidine red unheated serum test titer from baseline(sero-TRUST) using time-dependent ROC curves.The forest plot analyzed the influencing factors of the LNR difference between baseline and 3 months after treatment (LNR3), baseline sero-TRUST titer (sero-TRUST0), sero-TRUST decrease from baseline at 3 months or 6 months after treatment (sero-TRUST3 or sero-TRUST6). Results: A total of 249 patients were included in this study, including 200 in the response group and 49 in the non-response group.Univariate and multivariate COX regression analysis showed that baseline blood LMR> 1.93 (HR : 2.907, P=0.013), LNR > 0.3 (HR: 0.559, P= 0.013), and sero-TRUST titer >1:16 (HR: 1.760, P=0.002) affects the outcome of response after treatment. The AUC of LNR3 > 0.12 at 3M was 81.52 , the AUC of the baseline sero-TRUST titer was > 1:16 was 71.64, and the AUC of sero-TRUST3 titer decreased by more than 2 times at 3M was 72.85.The forest plot showed that if the blood was positive for syphilis ≥for 240 days before screening, the more likely the baseline sero-TRUST titer was less than 1:16. Conclusion: The complete response rate of patients with NS to initial treatment was low, and peripheral blood LMR ,LNR ,and sero-TRUST may affect treatment response.The increase in LNR3 > 0.12 ,the baseline sero-TRUST titer > 1:16 , and the sero-TRUST 3 >2 titer could be used as auxiliary indicators to evaluate the treatment response of patients. Neurosyphilis HIV-negative response to therapy absolute lymphocyte/monocyte ratio absolute lymphocyte/neutrophil ratio sero-TRUST Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction Treponema pallidum has a wide range of tissue-tropic properties, and neurosyphilis (NS) occurs when it invades the nervous system and causes damage. NS patients have a variety of clinical manifestations, including but not limited to ocular syphilis, otosyphilis, central nervous system damage, etc., which can manifest as visual impairment, hearing loss, memory loss, mental abnormalities, etc. [1–3] . However, at the same time, these patients can also be clinically asymptomatic, and if the diagnosis and treatment are not timely, they can experience sequelae and even life-threatening conditions. At present, the treatment of NS is the first choice of continuous intravenous infusion of 10~14 days of penicillin 18 million ~ 24 million U/d, and the clinical symptoms of NS patients may improve after treatment, but other neuropsychiatric symptoms still need to be treated symptomatically. Clinically, the treatment effect is usually judged based on cerebrospinal fluid (CSF) and the improvement of clinical symptoms, but it is impossible to prove whether the improvement of symptoms after symptomatic treatment is caused by plum removal treatment [2,3] . At the same time, the efficacy of treatment cannot be determined for some asymptomatic infections, so it is particularly important to recheck CSF after treatment [4] . Chinese guidelines recommend that treatment is effective when the number of nucleated cells and proteins in CSF returns to normal levels and the CSF nontreponemal titer (CSF-TRUST) decreases by ≥ 4-fold or becomes negative, but the invasive nature of lumbar puncture makes some patients refuse to undergo re-examination, and they prefer to choose a convenient and less risky blood test than patients with lumbar puncture [5] . The immune response to viruses is complex and involves innate immunity, cellular immunity, and humoral immunity. An animal experiment revealed that neutrophil and monocyte counts in the peripheral blood of rabbits inoculated with Treponema pallidum tended to increase and lymphocyte counts tended to decrease, respectively, compared to those in healthy rabbits [6] . However, changes in the LMR and LNR in posttreatment NS patients have not been reported. In this study, the treatment effect was determined by comparing the changes in CSF laboratory indices in NS patients after treatment, and the LMR and LNR were evaluated for efficacy in NS patients for the first time. The effects of the peripheral blood LMR and LNR on the response to therapy in NS patients were investigated to provide a basis for evaluating the prognosis of NS patients. Results 2.1 Study characteristics From January 1, 2018, to December 31, 2021, 764 patients with newly treated NS were hospitalized at Nanjing Second Hospital, and 518 patients were excluded according to the exclusion criteria; 191 patients had combined HIV infection, 20 patients had combined central nervous system infections, 304 patients had no CSF reexamination results within 2 years after treatment, and 249 patients were included in the study. The study population was mainly male (67.07%), and penicillin (93.16%) was the main treatment regimen after the diagnosis of NS, followed by ceftriaxone sodium (5.4%). At the follow-up of 74 patients, 139 patients and 144 patients with CSF at March, June and December, respectively, were re-examined. Among the 249 patients, 49 (19.68%) had no response, 200 (80.32%) had a response, 8 had a complete response, and 192 had a partial response. CSF-PRO levels in the responding group were significantly greater than those in the nonresponding group (507 (395; 652) mg/L vs. 591 (445; 771) mg/L, P=0.025), and the sero-TRUST titer was significantly greater than that in the nonresponse group (1:32 (1:16; 1:64) vs. 1:8 (1:4; 1:32), P<0.001); however, there was no significant difference in CSF-WBC between the two groups (5.00 (2.00; 15.2) vs. 17.0 (7.00; 43.0]), P=0.07). Although the CSF-TRSUT titer was greater than that of the nonresponse group, there was no significant difference between the groups (1:4 (1:2; 1:8) vs. 1:3 (1:1; 1:4), P=0.181). 2. 2 Clinical presentation Among the 249 NS patients, 67 (26.8%) had no NS-related clinical symptoms, and 182 (73.2%) had related clinical manifestations, of which memory loss was the most common (78 (31.2%), followed by personality changes43 (17.2%), limb numbness or weakness21 (8.400%), dizziness16 (6.400%), headache14 (5.600%), or vision loss12 (4.800%). The distribution of symptoms in the responder group and the nonresponder group was similar to that in the general population. PRORTIONS OF MEMORY LOSS (32.323% VS. 26.923, P=0.562), PERSONALITY CHANGE (18.68NN7% VS. 9.615%, P=0.177), DIZZINESS (7.0175 VS. 3.846, P=0.534), HEADACHE (6.091% VS. 3.846, P=0.740), AND VISION LOSS (6.091% VS. 0.000%, P=0.077). In the nonresponse group, the proportion of limb numbness in the nonresponse group was slightly greater than that in the response group (7.576% VS. 11.538%, P=0.399), but there was no significant difference. Among the 182 symptomatic patients, only 67 (36.813%) experienced one clinical symptom, 119 (65.385%) experienced two or more symptoms at the same time, and the two clinical symptoms were more common (see Table 2 and Fig. 1 for details). 2. 3 Factors influencing response after treatment in patients with NS The marital status (P<0.001), divorced status, widowed status (P=0.011), absolute monocyte status (P=0.007), LMR (P=0.044), LNR (P=0.036), MNR (P=0.019) and baseline sero-TRUST titer ≥1:16 (P=0.002) were included in the multivariate Cox regression analysis model. Multivariate analysis revealed that the likelihood of a response to therapy in patients with an LMR>1.93 was 2.907 times greater than that in patients with an LMR≤1.93 (HR: 2.907, 95% CI: 1.210- 3.632; P=0.013). Compared with patients with a baseline sero-TRUST titer < 1:16, patients with a baseline sero-TRUST titer ≥ 1:16 had a 2.037-fold greater probability of having a response to therapy (HR: 1.760, 95% CI: 1.241-2.497, P=0.002). Compared with patients with an LNR ≤0.3, patients with an LNR > 0.3 had a 0.559-fold lower likelihood of having a response to therapy (HR: 0.559, 95% CI: 0.356- 0.880; P= 0.013). Married patients (HR: 0.481, 95% CI: 0.306-0.756, P=0.002), divorced patients, widowed patients, or other patients (HR: 0.430, 95% CI: 0.186-0.992, P=0.048) were less likely to respond to treatment than unmarried patients (see Table 3). 2. 4 Changes in LMR, LNR and sero-TRUST titers after treatment The sero-TRUST titer in both the responding group and the nonresponding group showed a decreasing trend, and the sero-TRUST titer decreased faster in the responsive group than in the nonresponsive group. Specifically, the sero-TRUST titer decreased from 1:32 vs. 1:8 at baseline to 1:4 vs. 1:4 at 12 months in the response group and the nonresponse group, respectively (Figure. 2-A). The proportion of sero-TRUST titers in the response group gradually decreased by ≥ 4-fold compared with the baseline, from 57% at 3 months to 65% at 12 months. In the nonresponse group, the proportion of nonresponders who decreased by ≥ 4-fold from baseline gradually decreased, from 40% to 28% (Figure 2-B). The LNR and LMR in the responding group were not significantly greater than those in the nonresponding group at any of the time points (P>0.05). Regardless of whether there was an answer group or a nonanswer group, the LNR and LMR at 12 months were significantly greater than those at baseline (Figure 3). 2.5. Time-dependent ROC curves for LMR, LNR, and sero-TRUST titers The C index showed that the baseline sero-TRUST (sero-TRUST0), the 3-month sero-TRUST decrease from baseline (sero-TRUST3), the 6-month sero-TRUST decrease from baseline (sero-TRUST6) and the LNR difference between baseline and 3 months after treatment (LNR3) were better distinguished than others. The time-dependent ROC curves were used to compare baseline LNR (LNR0), LNR3, the LNR difference between baseline and 6 months after treatment (LNR6) , the LNR difference between baseline and 12 months after treatment (LNR12) , baseline LMR (LMR0), the LMR difference between baseline and 3 months after treatment (LMR3) , and the LMR difference between baseline and 6 months after treatment(LMR6) ,and the LMR difference between baseline and 12 months after treatment(LMR12).The AUCs of the response to therapy between sero-TRUST0 and sero-TRUST3 were 71.64 and 72.85, respectively, and the optimal cutoff values were 16 and 2, respectively(Figure 4 and Supplementary table 2). The specific AUC values and cutoff values of the C index and other variables are presented in the attached table (Supplementary table 1 and Table 2). 2.6 Forest plots of LNR3, seroTRUST0, seroTRUST3, and seroTRUST6 subgroup analysis of NS patients The results showed that the baseline sero-TRUST titer of neurosyphilis patients with neurosyphilis was less likely to be greater than 1:16 for more than 240 days before treatment (OR: 0.48, 95% CI: 0.23-1.00, P=0.049), and the sero-TRUST titer of neurosyphilis patients remained less than 1-fold after 6 months of treatment (OR: 0.28, 95% CI: 0.11-0.76, P=0.012). Sex (OR: 0.87, 95% CI: 0.27-2.75, P=0.807), age (OR: 1.60, 95% CI: 0.48-5.29, P=0.443), syphilis treatment (OR: 0.28, 95% CI: 0.06-1.24, P=0.094), and time to blood syphilis (OR: 1.35, 95% CI: 0.26-6.94, P=0.72) had no effect on the increase in the LNR3 or the fold decrease in the sero-TRUST titer from baseline after 3 months of treatment(see Figure 5 ). Materials and methods 2. 1 Clinical data Patients with newly treated NS who were hospitalized at Nanjing Second Hospital from January 1, 2018, to December 31, 2022, were selected as the study subjects, and demographic, clinical and laboratory data were collected for retrospective analysis. The participants were divided into a no response group and a response group (partial response and complete response) for analysis. Inclusion criteria: ① Patients who met the diagnostic criteria for NS; ② Age ≥ 18 years; Treatment compliance was good, and treatment was not interrupted. Exclusion criteria: ① Comorbid tumors; ② Infectious diseases of other organ systems. Patients with HIV infection and other central nervous system infections ④ There were no complete CSF reexamination results at 3 M to 24 M after treatment 2.2 NS diagnostic criteria If any of the following criteria are met, the diagnosis is NS: ① Patients with positive blood Treponema pallidum and non-Treponema pallidum with positive CSF-TRUST and cerebrospinal fluid treponemal titer (CSF-TPPA) and/or CSF-PRO>500 mg/L and/or CSF-WBC ≥5×106/L, with or without NS-related clinical symptoms. ② Positive for Treponema pallidum and non-Treponema pallidum, CSF-PRO> 500 mg/L and/or CSF-WBC ≥5×106/L if CSF-TRUST is negative and CSF-TPPA is positive, with or without NS-related clinical symptoms 2.3 Definition of response to therapy The type of response to therapy in patients with treatment-naive NS was determined according to the changes in CSF indicators within 3 M to 24 M after treatment. Patients who achieved a full response needed to meet the following criteria: ②, ③ and ④. Patients who achieved partial responses needed to meet the following criteria: ①, ②, ③ or ④. Patients who did not respond [7] . ① The CSF-TRUST titer decreased ≥ 4-fold ② The CSF-TRUST titer became negative. CSF-PROs decreased to CSF-PROs<500 mg/L ④ The number of nucleated cells decreased to 5×106/L < CSF-WBC 2.4 Data collection Patient demographic data and clinical and laboratory data at baseline (0 M), 3 months (3 M), 6 months (6 M), and 12 months (≥12 M) were collected, including clinical manifestations, CSF-TRUST titers, CSF-WBC and CSF-PRO, routine blood tests (absolute and percentage of lymphocytes, absolute and percentage of monocytes, absolute value and percentage of neutrophils,leukocytes, etc.), blood sero-TRUST, antibiotic medication regimen and high blood pressure. After treatment, patients are generally recommended to be rethecked every 3-6 months, the laboratory indicators are broadened to 1 month before and after the original time point, and the AUC changes are observed according to the ROC curve. The content of the study was approved by the Medical Ethics Committee of Nanjing Second Hospital, and the study met the medical ethics requirements (Ethics Approval No. 2023-LS-ky-033). 2..5 Statistical methods R Studio 4.3.0 was used for the statistical analysis, and the graphs were drawn with Origin 2018. Medians and interquartile ranges were used for quantitative data descriptions, and percentages were used for statistical data. For comparisons between groups, the t test was used for normally distributed continuous data, and the chi-square test or exact probability method was used for categorical data. If there is a nonnormal distribution, the K-W test is used. Univariate and multivariate Cox regression analyses were used to analyze the influencing factors of response after treatment, and factors with P<0.1 in the univariate analysis were included in the multivariate analysis. A final multivariate result of P<0.05 was considered to indicate statistical significance, and all factors were tested in equal proportions before being included in the Cox regression analysis model. The area under the curve (AUC) of the response of NS patients was evaluated according to the receiver operating characteristic (ROC) curve. The optimal cutoff value was calculated by using the Youden index, and the LNR difference between baseline and 3 months after treatment (LNR3), the baseline sero-TRUST titer (sero-TRUST0), the sero-TRUST titer decreased from baseline after 3 months of treatment (sero-TRUST3), and the sero-TRUST titer decreased from baseline after 6 months of treatment (sero-TRUST6). Discussion Neurosyphilis is a serious sexually transmitted disease that requires prompt and standardized treatment; otherwise, it can lead to poor clinical outcomes and even death. At present, the evaluation of treatment efficacy mainly depends on improvements in clinical symptoms and changes in laboratory indicators, especially CSF results. However, because some patients who undergo invasive lumbar puncture are reluctant to undergo regular CSF reexamination, it is necessary to find other valid, convenient and feasible indicators to assist in evaluating the treatment effect. In this study, after exploring the changes in the blood LMR and LNR in HIV-negative neurosyphilis patients before and after expressant therapy and their correlations with prognosis, it was found that the baseline LMR, LNR and sero-TRUST titer may influence the response to therapy; the LNR and LMR of NS patients increased after treatment; and the sero-TRUST titer decreased faster in the response group than in the nonresponse group. Additionally, the LNR3, sero-TRUST0, and sero-TRUST3 are associated with the response to therapy and may be an adjunct to the assessment of the response to therapy. Previous studies have shown that 15% to 30% of hemosyphilis-positive patients who undergo complete lumbar puncture have abnormal CSF, and up to 95% of patients with abnormal CSF are ultimately diagnosed with NS [1,8] . In this study, 182 (73.2%) of the 249 patients experienced symptoms, and the most common symptoms were memory loss, personality changes, limb numbness and weakness, etc., and two or more symptoms were common at the same time. When microglia differentiate into proinflammatory factors, they drive the accumulation of leukocytes dominated by neutrophils or monocytes/macrophages to the inflammatory area, and monocytes in the blood participate in the process of nerve injury [9,10] . Lymphocytes, on the other hand, have a protective effect on nervous system damage [11] . The Rosahn PD study revealed that an increase in absolute neutrophil and monocyte counts in peripheral blood was observed in neurosyphilis mice, resulting in a decrease in the LMR and LNR [6] . A lower LMR may be associated with a weakened immune response [12] . A lower LNR may be associated with an enhanced inflammatory response [13] . This study revealed that the LNR and LMR of patients increased after treatment, which may be related to a reduction in the inflammatory response and increased immune response in vivo. In recent years, there have been many studies on the prognosis of LMR and LNR in patients with several cancers, certain infectious diseases, brain injury, and depression, and they are very mature [14,15] . Some studies have shown that patients admitted to hospitals with COVID-19 have an increased risk of death with an LMR 5.56 in their peripheral blood, resulting in a poor prognosis [16] . Weijie Li et al. reported that the NLR in peripheral blood can predict the occurrence of neurosyphilis [17] . However, there are no studies on the ability of the LMR and LNR to predict treatment efficacy. In this study, the LMR and LNR of NS patients increased compared with those at baseline after treatment, suggesting that plum expulsion reduced the inflammatory response in vivo and enhanced the immune response. Although there were no significant differences in the LNR or LMR between the two groups at baseline or posttreatment follow-up, multivariate Cox regression analysis with response to therapy as the outcome showed that the baseline LMR and LNR were risk factors for response to therapy. Compared with patients with an LMR ≤1.93, NS patients with a baseline LMR >1.93 were more likely to respond to therapy, indicating that the stronger the immune response before treatment is, the more favorable the response to therapy. Compared with patients with an LNR ≤0.3, NS patients with a baseline LNR >0.3 were more likely to have treatment failure, indicating that a weak baseline inflammatory response was not conducive to the postresponse to therapy. To further determine the ability of each variable to predict the response to therapy, the ROC curve was used to calculate the sensitivity and specificity, as the ordinary ROC curve ignores the influence of time on the ability to discriminate variables. The time-dependent ROC curve was selected, and the AUC value of each time point could more accurately reflect the ability of the variables. The results showed that the LNR3 (the difference between the LNR and baseline after 3 months of treatment) was > 0.12, and the AUC value of 3 months of response to therapy was 81.52, indicating that the difference between the LNR and baseline after 3 months of treatment may be used as a potential auxiliary indicator to judge the response to therapy. Further forest plot analysis revealed that sex, age, syphilis treatment and duration of blood syphilis positivity did not affect the LNR3. Once Treponema pallidum infects the human body, the human body quickly responds to lipidoid substances released on the surface of damaged host cells and Treponema pallidum cells and produces anti-lipid antigen antibodies (also known as reagins) within 3~4 weeks. Sero-TRUST is a flocculent agglutination test that uses cardiolipin, lecithin and cholesterol as antigens and toluidine red particles as indicators and is one of the detection methods for nonspecific antibodies to syphilis. After treatment, the sero-TRUST titer can decrease or become negative, so it can be used for efficacy observation, cure, and recurrence or reinfection [18] . Previous studies have shown that the greater the sero-TRUST titer is, the greater the likelihood of neurosyphilis [19,20] . In this study, we found that the median titer of sero-TRUST in 249 patients with neurosyphilis was 1:16, and the sero-TRUST titer was greater before treatment and decreased faster after treatment. The proportion of NS patients decreased by 4 times or more with the extension of treatment time, and the proportion of NS patients in the treatment group was greater than that in the nonresponse group at each follow-up point, suggesting that the greater the sero-TRUST titer before treatment was, the faster the treatment declined, and the greater the likelihood that a response to therapy would occur. This view was further supported by the finding of a greater likelihood of a response to therapy at baseline sero-TRUST >1:16 in the Cox regression analysis. Xiao Y et al. reported that the serum rapid plasma reagin test (sero-RPR) titer decreased by ≥8 times after 6 months of treatment in NS patients, which can assist in judging the response to therapy [21] . However, in this study, the sero-TRUST titer decreased by >1 time after 6 months of treatment and decreased by >8 times after 12 months of treatment, and the efficacy of judging the occurrence of response to therapy was not high (AUC was only 42.24-60.98); however, the sero-TRUST titer decreased by > from baseline after 3 months of treatment. The AUC of the 2x judgment of response to therapy was 72.85, and it was not affected by age, sex, length of blood syphilis positive, or whether syphilis treatment was administered, so it is speculated that sero-TRUST 3 > 2x may be used as an adjunct indicator of response at the time of treatment. In this study, the commonly used clinical indicators LMR and LNR were used for the first time to evaluate the efficacy of posttherapy therapy in HIV-negative NS patients, and the results showed that the LMR and LNR increased after treatment. The baseline LMR and LNR may affect the response to therapy, and an increase >0.12 in the LNR3 and a >-fold decrease in the sero-TRUST3 level by 2-fold may be used as auxiliary indicators for the response to therapy. There are several shortcomings in this study. First, this was a single-center retrospective study, and because patients with invasive NS who underwent lumbar puncture cannot undergo regular CSF review, the sample size was small, and the follow-up data were missing. Second, there were too few complete responders to verify the efficacy of LMR, LNR, and sero-TRUST titers in assessing response to therapy in this population. Third, only the LMR, LNR, and sero-TRUST were evaluated for therapeutic efficacy. In the future, we will further expand the sample size to analyze complete response as an outcome measure and comprehensively analyze the efficacy of LMR, LNR, and sero-TRUST titers in assessing the occurrence of response to therapy based on the patient's disease stage and other variables that may affect efficacy. Conclusion The baseline blood LMR, LNR, and sero-TRUST in HIV-negative NS patients may affect the response to therapy, and the LNR3 and sero-TRUST3 may be used as auxiliary indicators to evaluate the response to therapy. Declarations Acknowledgments We are grateful to all the patients included in our study, as well as the investigators and site staff who put their efforts into the research. We are also grateful to the AIDS Healthcare Foundation for their support of our work. Funding This work was supported by the 2020 Annual Medical Research Project of Jiangsu Commission of Health to Hongxia Wei [Grant# ZDA 2020014], and the 2022 Annual Key Project supported by Medical Science and Technology Development Foundation, Nanjing Department of Health, awarded to Hongxia Wei (Grant# ZKX 22040). Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Ethics approval and consent to participate The studies involving human participants were reviewed and approved by the Ethics Committee of the Second Hospital of Nanjing (Nanjing, China). The patients/participants do not need provided their written informed consent to participate in this study Data and Materials availability The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. Author contribution HW, RC conceived and designed the study, and H Wei led at study implementation. JP, ML, XD, ChC, NY, HG, collected the study data. HG and ML analyzed the data and wrote the draft manuscript. All authors commented on previous versions of the manuscript. HW revised the manuscript. All authors contributed to the article and approved the submitted version. References Smibert O C, Jenney A W J, Spelman D W. Management of neurosyphilis: time for a new approach?[J]. Internal Medicine Journal, 2018, 48(2): 204-206. Ghanem K G, Moore R D, Rompalo A M, et al. Lumbar Puncture in HIV-Infected Patients with Syphilis and No Neurologic Symptoms[J]. Clin Infect Dis, 2009, 48(6): 816-821. Marra C M, Maxwell C L, Ramchandani M, et al. Hearing loss in individuals at risk for neurosyphilis[J]. International journal of STD & AIDS, 2020, 31(12): 1178-1185. Wilner E, Brody J. PROGNOSIS OF GENERAL PARESIS AFTER TREATMENT[J]. Lancet, 1968: 1370-1371. 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Tables Table 1 Comparison of baseline characteristics at treatment in different response groups All Non response to therapy Response to therapy P.value N=249 N=49 N=200 gender,n(%) 0.579 male 167 (67.1%) 35 (71.400%) 132 (66.000%) female 82 (32.9%) 14 (28.600%) 68 (34.000%) age(years) 50.4 (39.800;61.000) 53.000 (48.000;61.000) 52.000 (39.800;59.000) 0.089 marital status 0.065 unmarried 25 (10.0%) 1 (2.040%) 24 (12.000%) married 213 (85.5%) 45 (91.800%) 168 (84.000%) divorce、widowed 11 (4.42%) 3 (6.120%) 8 (4.000%) Cerebrospinal fluid test results Cl(mmol/L) 126 [124;128] 126 [123;128] 126 [124;128] 0.424 CSF-PRO(mg/L) 567 [430;739] 507 [395;652] 591 [445;771] 0.025 glucose(mmol/L) 3.28 [3.00;3.80] 3.50 [3.12;4.15] 3.23 [2.91;3.67]0) 0.017 lactate dehydrogenase(IU/L) 20.0 [16.0;25.0] 19.5 [16.0;27.0] 20.0 [16.0;24.0] 0.614 Adenosine deaminase(U/L) 1.00 [0.55;2.00] 1.00 [0.00;2.00] 1.00 [0.70;2.00] 0.273 CSF-WBC(×10 6 /L) 13.0 [5.00;38.0] 5.00 [2.00;15.2] 17.0 [7.00;43.0] 0.070 Multinucleated cells 0.07 [0.02;0.10] 0.07 [0.03;0.20] 0.08 [0.02;0.10] 0.789 monocyte 0.90 [0.80;0.97] 0.80 [0.45;0.94] 0.90 [0.88;0.97] 0.070 Blood test results Lymphocyte absolute value（×10 9/ L） 1.56 [1.15;2.00] 1.50 [1.04;2.22] 1.57 [1.20;1.95] 0.992 percentage of Lymphocyte (%) 21.9 [14.8;30.4] 22.5 [13.1;31.7] 21.7 [15.1;30.1] 0.939 Monocyte absolute value（×10 9/ L） 0.44 [0.34;0.57] 0.41 [0.32;0.54] 0.44 [0.34;0.58] 0.453 Percentage of monocytes(%) 6.10 [4.70;8.00] 5.80 [4.77;7.23] 6.30 [4.70;8.00] 0.251 Neutrophil absolute value（×10 9/ L） 4.80 [3.65;6.74] 4.77 [3.61;7.07] 4.81 [3.65;6.59] 0.804 percentage of Neutrophil (%) 69.1 [59.3;78.4] 68.4 [57.3;80.6] 69.3 [60.0;77.6] 0.935 LNR 0.32 [0.19;0.52] 0.33 [0.17;0.57] 0.31 [0.19;0.51] 0.947 LMR 3.48 [2.61;4.80] 3.80 [2.90;4.83] 3.48 [2.61;4.74] 0.404 MNR 0.09 [0.06;0.13] 0.09 [0.06;0.12] 0.09 [0.06;0.13] 0.332 white blood cell（×10 9/ L） 7.23 [5.91;8.95] 7.64 [6.23;9.72] 7.20 [5.82;8.89] 0.174 sero-TRUST titer(1:X) 16.0 [8.;64] 8 (4;32) 32(16;64) <0.001 CSF-TRUST titer(1:X) 4 [2;8] 3(1;4) 4(2;8) 0.181 CD4+T lymphocyte(cell/μL) 638 [401;886] 707 (496;927) 628 (393;875) 0.473 CD4/CD8 1.47 [1.10;2.12] 1.400 (1.170;2.020) 1.480 (1.100;2.150) 0.951 CD4% 36.5 [28.2;42.0] 41.000 (36.800;44.800) 35.000 (27.800;41.200) 0.074 Antibiotic regimens 0.307 penicillin 231 (92.77%) 45.(91.800%) 186 (93.000%) Ceftriaxone sodium 14 (5.62%) 2 (4.080%) 12 (6.000%) Cephalosporin is used in combination with penicillin 4 (1.61%) 2(4.080%) 2 (1.000%) Comorbid diabetes mellitus 0.398 No 227 (91.16%) 43 (87.800%) 184 (92.000%) Yes 22 (8.84%) 6 (12.200%) 16 (8.000%) Comorbid hypertension 0.662 No 206 (82.7%) 39 (79.600%) 167 (83.500%) Yes 43 (17.3%) 10 (20.400%) 33 (16.500%) Note: LMR,Lymphocyte absolute/monocyte absolute;LNR,Absolute lymphocytes/absolute neutrophils;MNR,Monocyte Absolute/Neutrophil Absolute Table 2 The specific clinical manifestations of NS patients All（n=249） Response to therapy（n=197） Non response to therapy (n=52) P.value asymptomatic 67(26.800%) 48(24.365%) 19(36.538%) 0.081 Memory loss 78(31.200%) 64(32.487%) 14(26.923%) 0.562 Personality changes 43(17.200%) 37(18.782%) 5(9.615%) 0.177 Down in the dumps 9(3.600%) 9(4.569%) 0(0.000%) 0.211 excited 5(2.000%) 4(2.030%) 1(1.923%) 1.000 Disordered speech and behavior 6(2.400%) 5(2.538%) 1(1.923%) 1.000 multilingual 8(3.200%) 8(4.061%) 0(0.000%) 0.211 irascible 4(1.600%) 2(1.015%) 2(3.846%) 0.192 Abnormal behavior 10(4.000%) 9(4.569%) 1(1.923%) 0.693 dizzy 16(6.400%) 14(7.107%) 2(3.846%) 0.534 headache 14(5.600%) 12(6.091%) 2(3.846%) 0.740 Numbness and weakness in the limbs 21(8.400%) 15(7.614%) 6(11.538%) 0.399 Cognitive decline in function 5(2.000%) 4(2.030%) 1(1.923%) 1.000 Unresponsive 10(4.000%) 9(4.569%) 1(1.923%) 0.693 Speech disorders 14(5.600%) 12(6.091%) 2(3.846%) 0.740 Decreased vision 12(4.800%) 12(6.091%) 0(0.000%) 0.077 hallucination 4(1.600%) 4(2.030%) 0(0.000%) 0.583 Table 3 Risk factors influencing response after treatment in NS patients - Cox regression variable Univariate analysis Multivariate analysis HR (95% CI) P.value HR (95% CI) P.value gender male 1.000 female 1.100 (0.780-1.400) 0.741 marital status unmarried 1.000 1.000 married 0.405 （ 0.261-0.630 ） 1.12×109/L 0.911 (0.643-1.321) 0.57 percentage of Lymphocyte (%) ≤31.9% 1.000 >31.9% 1.122 (0.771-1.500) 0.642 Monocyte absolute value（×10 9/ L） ≤0.48×109/L 1.000 1.000 >0.48×109/L 0.660 (0.492-0.891) 0.007 0.739（0.526-1.038） 0.081 percentage of Monocyte (%) ≤8.80% 1.000 >8.80% 0.762 (0.521-1.156) 0.180 Neutrophil absolute value（×10 9/ L） ≤2.71×109/L 1.000 >2.71×109/L 0.782 (0.484-1.322) 0.310 percentage of Neutrophil (%) ≤50.1×109/L 1.000 >50.1×109/L 1.222 (0.709-1.914) 0.532 white blood cell（×10 9/ L） ≤4.98×109/L 1.000 >4.98×109/L 0.750 (0.483-1.232) 0.211 LNR ≤0.30 1.000 1.000 >0.30 0.735(0.535-0.951) 0.036 0.559 （ 0.356-0.880 ） 0.013 LMR ≤1.93 1.000 1.000 >1.93 1.603(1.088-2.745 ） 0.044 2.097 （ 1.210-3.632 ） 0.008 MNR ≤0.083 1.000 1.000 >0.083 0.705(0.526-0.944) 0.019 1.558（0.991-2.448） 0.055 Antibiotic regimens penicillin 1.000 Ceftriaxone sodium 1.012（0.548-1.869） 0.969 Cephalosporin is used in combination with penicillin 0.449（0.111-1.811） 0.260 Baseline sero-TRUST titer <1:16 1.000 1.000 ≥1:16 1.722 (1.213-2.406) 0.002 1.760 （ 1.241-2.497 ） 0.002 Note: LMR,Lymphocyte absolute/monocyte absolute;LNR,Absolute lymphocytes/absolute neutrophils;MNR,Monocyte Absolute/Neutrophil Absolute Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4605969","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":320499203,"identity":"8c0e486a-6b1a-46be-8ced-9235c6c03d53","order_by":0,"name":"Hongjing Guan","email":"","orcid":"","institution":"Department of Infectious Diseases, The School of Public Health of Nanjing Medical University, The Second Hospital of Nanjing","correspondingAuthor":false,"prefix":"","firstName":"Hongjing","middleName":"","lastName":"Guan","suffix":""},{"id":320499204,"identity":"ff1dca60-2c16-421e-aeb2-0860a981c065","order_by":1,"name":"Xiaoyun Di","email":"","orcid":"","institution":"Department of Infectious Diseases, The School Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Xiaoyun","middleName":"","lastName":"Di","suffix":""},{"id":320499205,"identity":"8907403c-64e3-4816-a165-c965ebe90f3d","order_by":2,"name":"Mengqing Li","email":"","orcid":"","institution":"Department of Infectious Diseases, The School Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Mengqing","middleName":"","lastName":"Li","suffix":""},{"id":320499206,"identity":"9694de34-64aa-496f-94cd-da5183b7168d","order_by":3,"name":"Nawei Yu","email":"","orcid":"","institution":"Department of Infectious Diseases, The School Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Nawei","middleName":"","lastName":"Yu","suffix":""},{"id":320499207,"identity":"be643803-446d-480f-bf3e-fa32d8c0cd7f","order_by":4,"name":"Rentian Cai","email":"","orcid":"","institution":"Department of Infectious Diseases, The School Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Rentian","middleName":"","lastName":"Cai","suffix":""},{"id":320499208,"identity":"1fd6950a-2edc-4d9a-be15-4104bc5bcd6b","order_by":5,"name":"Chen Chen","email":"","orcid":"","institution":"Department of Infectious Diseases, The School Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Chen","middleName":"","lastName":"Chen","suffix":""},{"id":320499209,"identity":"c8301423-47a0-4bee-a6c8-10a718f1e830","order_by":6,"name":"Jingli Peng","email":"","orcid":"","institution":"Department of Infectious Diseases, The School Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Jingli","middleName":"","lastName":"Peng","suffix":""},{"id":320499210,"identity":"79b6f363-4bc3-43ee-a3fe-655df389038c","order_by":7,"name":"Zihao Xia","email":"","orcid":"","institution":"Department of Infectious Diseases, The School of Public Health of Nanjing Medical University, The Second Hospital of Nanjing","correspondingAuthor":false,"prefix":"","firstName":"Zihao","middleName":"","lastName":"Xia","suffix":""},{"id":320499211,"identity":"9c107cae-f428-4dab-a89a-33adfe98d579","order_by":8,"name":"Hongxia Wei","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAy0lEQVRIiWNgGAWjYFACHijJ3sBwgEQtPAdI1MLAIJFApAaD82sPPi74dViGf+bzh4cLahjk+cUIWGZw412y8cy+NB6J2zkGh2ccYzCcOZuAdWY3zphJ8/bY8DDczmE4zMPGkGBwmzgtEjzyN48/OMzzjxgt53vMpHl+2PAY3GAwOMzbRoQW+xs8xsa8DWk8hmeAfuHtkyDsF8n+M4aPef4ctpc7fvzxZ55vNvL80gS0gKODsQ3BJaAcBPgPAIk/RCgcBaNgFIyCkQsAVnBDsLASLCkAAAAASUVORK5CYII=","orcid":"","institution":"Department of Infectious Diseases, The School of Public Health of Nanjing Medical University, The Second Hospital of Nanjing","correspondingAuthor":true,"prefix":"","firstName":"Hongxia","middleName":"","lastName":"Wei","suffix":""}],"badges":[],"createdAt":"2024-06-19 12:45:41","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4605969/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4605969/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":60599918,"identity":"f7832dbc-c7b0-4388-bc61-daad30985269","added_by":"auto","created_at":"2024-07-18 16:00:23","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":56554,"visible":true,"origin":"","legend":"\u003cp\u003eComposition of clinical manifestations of symptomatic NS. (A) Thetypes of clinical manifestations in patients with responsive NS are shown. (B) Composition of clinical manifestations in patients with nonresponsive NS.\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4605969/v1/fb3889ebb34884406dffdaa5.jpg"},{"id":60601903,"identity":"1b173829-ab88-4e29-889b-1fe6dd208784","added_by":"auto","created_at":"2024-07-18 16:08:23","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":72022,"visible":true,"origin":"","legend":"\u003cp\u003eDecrease in the sero-TRUST titer from baseline in NS patients after treatment. (A) Changes in sero-TRUST titers at different time points after treatment. (B) Folds of the decrease in the sero-TRUST titer at different time points after treatment. The answer group is on the left, and the no answer group is on the right.\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4605969/v1/8c71a9a7528bdfedcaf90808.jpg"},{"id":60599920,"identity":"8df76c4a-a7d6-451f-961f-d66e687da820","added_by":"auto","created_at":"2024-07-18 16:00:23","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":112952,"visible":true,"origin":"","legend":"\u003cp\u003eChanges in the blood LNR and LMR in NS patients after treatment.(A) Changes in the LNR at different time points. (B) Changes in the LNR in response groups at different time points. (C) Changes in the LNR in the nonresponsive group at different time points. (D) Changes in the LMR at different time points. (E) Changes in the LMR in theresponse groups at different time points. (F) Changes in the LMR in the nonresponsive group at different time points\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4605969/v1/37301e3d7a824a3d6377f965.jpg"},{"id":60602448,"identity":"497e7992-4bb8-4ac5-8b6b-b864cb672754","added_by":"auto","created_at":"2024-07-18 16:16:23","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":60967,"visible":true,"origin":"","legend":"\u003cp\u003eDifferences among LMR, LNR, and seroTRUST at baseline (0 months); differences between LMR, LNR and baseline in March, June, and December; decreases in seroTRUST from baseline according to the time-dependent ROC curve of response to therapy in neurosyphilis patients; seroTRUST0, baseline seroTRUST titer; seroTRUST3, the baseline seroTRUST titer decreased by a fold from baseline at 3 months after treatment; seroTRUST6, the seroTRUST titer decreased by a fold from baseline at 6 months after treatment; seroTRUST12, the seroTRUST titer decreased by a fold from baseline at 12 months after treatment; LNR0, the baseline LNR; LNR3, the LNR difference between baseline and 3months after treatment ; LNR6, the LNR difference between baseline and 6 months after treatment ; LNR12, the LNR difference between baseline and 12 months after treatment ; LMR0, the baseline LNR; LMR3, ; LMR6, the difference between the LMR and baseline at 6 months after treatment; and LMR12, the LMR difference between baseline and 12 months after treatment\u003c/p\u003e","description":"","filename":"4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4605969/v1/45a092431791f3d5b280f049.jpg"},{"id":60599922,"identity":"e24e2067-7f55-4311-b5cd-ea79dc91978f","added_by":"auto","created_at":"2024-07-18 16:00:23","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":123558,"visible":true,"origin":"","legend":"\u003cp\u003eForest diagram of the subgroup analysis of NS patients stratified by LNR3, seroTRUST0, seroTRUST3 and seroTRUST6 expression. (A) SeroTRUST0 subgroup analysis. (B) SeroTRUST3 subgroup analysis. (C) SeroTRUST6 subgroup analysis. (D) LNR3 subgroup analysis. seroTRUST0, baseline seroTRUST titer; seroTRUST3, seroTRUST titer decreased from baseline at 3 months after treatment; seroTRUST6, seroTRUST titer decreased from baseline at 6 months after treatment; LNR3, change from baseline in the LNR at 3 months after treatment; 95% CI with 95% confidence interval; HR, risk ratio\u003c/p\u003e","description":"","filename":"5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4605969/v1/b936b3b8208d6573bc13acc6.jpg"},{"id":60786204,"identity":"5400b0c2-c1b6-400b-8b82-90bc671cf5a9","added_by":"auto","created_at":"2024-07-22 05:32:44","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1328531,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4605969/v1/cbbc2751-b3a5-48fe-aac8-a3907ab748c0.pdf"},{"id":60599924,"identity":"67e19173-f5c9-4579-91d2-8b6c569f19e0","added_by":"auto","created_at":"2024-07-18 16:00:23","extension":"docx","order_by":8,"title":"","display":"","copyAsset":false,"role":"supplement","size":16017,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix.docx","url":"https://assets-eu.researchsquare.com/files/rs-4605969/v1/82ecfe7c077418e77eacdb46.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Absolute blood lymphocytes/monocytes and lymphocytes/neutrophils in patients with neurosyphilis may affect the response to therapy and diagnostic efficacy","fulltext":[{"header":"Introduction","content":"\u003cp\u003eTreponema pallidum has a wide range of tissue-tropic properties, and neurosyphilis (NS) occurs when it invades the nervous system and causes damage.\u0026nbsp;NS patients have a variety of clinical manifestations, including but not limited to ocular syphilis, otosyphilis, central nervous system damage, etc., which can\u0026nbsp;manifest\u0026nbsp;as visual impairment, hearing loss, memory loss, mental abnormalities, etc.\u003csup\u003e[1\u0026ndash;3]\u003c/sup\u003e.\u0026nbsp;However, at the same time,\u0026nbsp;these patients\u0026nbsp;can also be clinically asymptomatic, and if the diagnosis and treatment\u0026nbsp;are\u0026nbsp;not timely,\u0026nbsp;they\u0026nbsp;can\u0026nbsp;experience\u0026nbsp;sequelae and even life-threatening\u0026nbsp;conditions.\u0026nbsp;At\u0026nbsp;present, the treatment of NS is the first choice of continuous\u0026nbsp;intravenous infusion of\u0026nbsp;10~14 days of penicillin 18 million ~ 24 million U/d, and the clinical symptoms of NS patients may\u0026nbsp;improve\u0026nbsp;after treatment, but other neuropsychiatric symptoms still need to be treated symptomatically.\u0026nbsp;Clinically, the treatment effect is usually judged based on cerebrospinal fluid (CSF) and the improvement of clinical symptoms, but it is impossible to prove whether the improvement of symptoms after symptomatic treatment is caused by plum removal treatment\u003csup\u003e[2,3]\u003c/sup\u003e.\u0026nbsp;At the same time,\u0026nbsp;the efficacy of treatment cannot be determined for some asymptomatic infections, so it is particularly important to recheck CSF after treatment\u003csup\u003e[4]\u003c/sup\u003e.\u0026nbsp;Chinese guidelines recommend that treatment is effective when the number of nucleated cells and proteins in CSF returns to normal levels and the CSF nontreponemal titer (CSF-TRUST) decreases by \u0026ge; 4-fold or\u0026nbsp;becomes\u0026nbsp;negative, but the invasive nature of lumbar puncture makes some patients refuse to undergo re-examination, and they prefer to choose a convenient and less risky blood test than patients with lumbar puncture\u003csup\u003e[5]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eThe immune response to\u0026nbsp;viruses\u0026nbsp;is complex and involves innate immunity, cellular immunity, and humoral immunity. An animal experiment\u0026nbsp;revealed\u0026nbsp;that neutrophil and monocyte counts in the peripheral blood of rabbits inoculated with Treponema pallidum\u0026nbsp;tended to increase and lymphocyte counts tended to decrease, respectively, compared to those in healthy rabbits\u003csup\u003e[6]\u003c/sup\u003e. However, changes in the LMR and LNR in posttreatment NS patients have not been reported. In this study, the treatment effect was determined by comparing the changes in CSF laboratory indices in NS patients after treatment, and the LMR and LNR were evaluated for efficacy in NS patients for the first time. The effects of the peripheral blood LMR and LNR on the response to therapy in NS patients were investigated to provide a basis for evaluating the prognosis of NS patients.\u003c/p\u003e"},{"header":"Results","content":"\u003ch3\u003e2.1 Study characteristics\u003c/h3\u003e\n\u003cp\u003eFrom January 1, 2018,\u0026nbsp;to December 31,\u0026nbsp;2021, 764 patients with newly treated NS were hospitalized\u0026nbsp;at\u0026nbsp;Nanjing Second Hospital, and 518\u0026nbsp;patients\u0026nbsp;were excluded according to the exclusion criteria;\u0026nbsp;191\u0026nbsp;patients had\u0026nbsp;combined HIV infection, 20\u0026nbsp;patients had\u0026nbsp;combined central nervous system infections, 304\u0026nbsp;patients\u0026nbsp;had no CSF reexamination results within 2 years after treatment, and 249 patients were included in the study.\u0026nbsp;The study population was mainly male (67.07%), and penicillin (93.16%) was the main treatment regimen after the diagnosis of NS, followed by ceftriaxone sodium (5.4%). At the follow-up of 74 patients, 139 patients and 144 patients with CSF at March, June and December, respectively,\u0026nbsp;were re-examined. Among the 249 patients, 49 (19.68%) had no response, 200 (80.32%) had\u0026nbsp;a response, 8 had\u0026nbsp;a\u0026nbsp;complete response, and 192 had\u0026nbsp;a\u0026nbsp;partial response. CSF-PRO\u0026nbsp;levels\u0026nbsp;in the responding group\u0026nbsp;were\u0026nbsp;significantly\u0026nbsp;greater\u0026nbsp;than\u0026nbsp;those\u0026nbsp;in the\u0026nbsp;nonresponding\u0026nbsp;group (507 (395; 652)\u0026nbsp;mg/L\u0026nbsp;vs. 591 (445; 771) mg/L, P=0.025),\u0026nbsp;and\u0026nbsp;the sero-TRUST titer was significantly\u0026nbsp;greater\u0026nbsp;than that in the\u0026nbsp;nonresponse\u0026nbsp;group (1:32 (1:16; 1:64)\u0026nbsp;vs.\u0026nbsp;1:8 (1:4; 1:32), P\u0026lt;0.001); however, there was no significant difference in CSF-WBC between the two groups (5.00 (2.00; 15.2)\u0026nbsp;vs. 17.0 (7.00; 43.0]), P=0.07). Although\u0026nbsp;the CSF-TRSUT titer was\u0026nbsp;greater\u0026nbsp;than that of the\u0026nbsp;nonresponse\u0026nbsp;group, there was no significant difference between\u0026nbsp;the\u0026nbsp;groups (1:4 (1:2; 1:8)\u0026nbsp;vs. 1:3 (1:1; 1:4), P=0.181).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.\u003c/strong\u003e\u003cstrong\u003e2 Clinical\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;presentation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the 249 NS patients, 67 (26.8%) had no NS-related clinical symptoms, and 182 (73.2%) had related clinical manifestations, of which memory loss was the most common (78 (31.2%), followed by personality changes43 (17.2%), limb numbness or weakness21 (8.400%), dizziness16 (6.400%), headache14 (5.600%), or vision loss12 (4.800%). The distribution of symptoms in the responder group and the\u0026nbsp;nonresponder\u0026nbsp;group was similar to that in the general population.\u0026nbsp;PRORTIONS\u0026nbsp;OF MEMORY LOSS (32.323% VS. 26.923, P=0.562), PERSONALITY CHANGE (18.68NN7% VS. 9.615%, P=0.177), DIZZINESS (7.0175 VS. 3.846, P=0.534), HEADACHE (6.091% VS. 3.846, P=0.740), AND VISION LOSS (6.091% VS. 0.000%, P=0.077).\u0026nbsp;In the\u0026nbsp;nonresponse\u0026nbsp;group,\u0026nbsp;the proportion of limb numbness in the\u0026nbsp;nonresponse\u0026nbsp;group was slightly\u0026nbsp;greater\u0026nbsp;than that in the\u0026nbsp;response\u0026nbsp;group\u0026nbsp;(7.576% VS. 11.538%, P=0.399),\u0026nbsp;but there was no significant difference.\u0026nbsp;Among the 182 symptomatic patients, only 67 (36.813%)\u0026nbsp;experienced\u0026nbsp;one clinical symptom, 119 (65.385%)\u0026nbsp;experienced\u0026nbsp;two or more symptoms at the same time, and the two clinical symptoms were more common (see Table 2 and Fig. 1 for details).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.\u003c/strong\u003e\u003cstrong\u003e3 Factors\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;influencing response after treatment in patients with NS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe marital status\u0026nbsp;(P\u0026lt;0.001), divorced\u0026nbsp;status, widowed\u0026nbsp;status\u0026nbsp;(P=0.011), absolute monocyte\u0026nbsp;status\u0026nbsp;(P=0.007), LMR (P=0.044), LNR (P=0.036), MNR (P=0.019) and baseline sero-TRUST titer \u0026ge;1:16 (P=0.002) were included in the multivariate\u0026nbsp;Cox\u0026nbsp;regression analysis model.\u0026nbsp;Multivariate\u0026nbsp;analysis revealed\u0026nbsp;that the likelihood of\u0026nbsp;a\u0026nbsp;response to therapy\u0026nbsp;in patients\u0026nbsp;with\u0026nbsp;an\u0026nbsp;LMR\u0026gt;1.93 was 2.907 times\u0026nbsp;greater than that in patients with an\u0026nbsp;LMR\u0026le;1.93 (HR: 2.907,\u0026nbsp;95% CI: 1.210- 3.632;\u0026nbsp;P=0.013). Compared with\u0026nbsp;patients with a\u0026nbsp;baseline sero-TRUST titer \u0026lt; 1:16,\u0026nbsp;patients with a baseline sero-TRUST titer \u0026ge; 1:16 had a 2.037-fold greater probability of having a response to therapy (HR: 1.760, 95% CI: 1.241-2.497, P=0.002). Compared with patients with an LNR \u0026le;0.3, patients with an LNR \u0026gt; 0.3 had a 0.559-fold lower likelihood of having a response to therapy (HR: 0.559, 95% CI: 0.356- 0.880; P= 0.013). Married patients (HR: 0.481, 95% CI: 0.306-0.756, P=0.002), divorced patients, widowed patients, or other patients (HR: 0.430, 95% CI: 0.186-0.992, P=0.048) were less likely to respond to treatment than unmarried patients (see Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.\u003c/strong\u003e\u003cstrong\u003e4 Changes\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;in LMR, LNR and sero-TRUST titers after treatment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe sero-TRUST titer in both the responding group and the\u0026nbsp;nonresponding\u0026nbsp;group showed a decreasing trend, and the sero-TRUST titer decreased faster in the responsive group than in the\u0026nbsp;nonresponsive\u0026nbsp;group.\u0026nbsp;Specifically, the sero-TRUST titer decreased from 1:32 vs. 1:8 at baseline to 1:4 vs. 1:4 at 12 months in the response group and the\u0026nbsp;nonresponse\u0026nbsp;group, respectively (Figure. 2-A). The\u0026nbsp;proportion of sero-TRUST titers in the response group\u0026nbsp;gradually\u0026nbsp;decreased by \u0026ge; 4-fold compared with the baseline, from 57% at 3 months to 65% at\u0026nbsp;12 months. In the nonresponse\u0026nbsp;group, the proportion of\u0026nbsp;nonresponders\u0026nbsp;who decreased by \u0026ge; 4-fold from baseline gradually decreased, from 40% to 28%\u0026nbsp;(Figure 2-B).\u0026nbsp;The LNR and LMR in the responding group were not\u0026nbsp;significantly greater\u0026nbsp;than those in the\u0026nbsp;nonresponding\u0026nbsp;group at\u0026nbsp;any of the\u0026nbsp;time points (P\u0026gt;0.05).\u0026nbsp;Regardless of whether there\u0026nbsp;was\u0026nbsp;an\u0026nbsp;answer\u0026nbsp;group or a nonanswer\u0026nbsp;group,\u0026nbsp;the LNR and LMR at\u0026nbsp;12 months were significantly greater\u0026nbsp;than those at baseline (Figure 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.5. Time-dependent ROC curves for LMR, LNR, and sero-TRUST titers\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe C index showed that the baseline sero-TRUST (sero-TRUST0), the 3-month sero-TRUST decrease from baseline (sero-TRUST3), the 6-month sero-TRUST decrease from baseline (sero-TRUST6) and the LNR difference between baseline and 3 months after treatment (LNR3) were better distinguished than others. The time-dependent ROC curves were used to compare baseline LNR (LNR0), LNR3, the LNR difference between baseline and 6 months after treatment (LNR6) , the LNR difference between baseline and 12 months after treatment (LNR12) , baseline LMR (LMR0), the LMR difference between baseline and 3 months after treatment \u0026nbsp;(LMR3) , and the LMR difference between baseline and 6 months after treatment(LMR6) ,and the LMR difference between baseline and 12 months after treatment(LMR12).The AUCs of the response to therapy between sero-TRUST0 and sero-TRUST3 were 71.64 and 72.85, respectively, and the optimal cutoff values were 16 and 2, respectively(Figure 4 and Supplementary table 2). The specific AUC values and cutoff values of the C index and other variables are presented in the attached table (Supplementary table 1 and Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.6 Forest plots of LNR3, seroTRUST0, seroTRUST3, and seroTRUST6 subgroup analysis of NS patients\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results showed that the baseline sero-TRUST titer of neurosyphilis patients with neurosyphilis was less likely to be greater than 1:16 for more than 240 days before treatment (OR: 0.48, 95% CI: 0.23-1.00, P=0.049), and the sero-TRUST titer of neurosyphilis patients remained less than 1-fold after 6 months of treatment (OR: 0.28, 95% CI: 0.11-0.76, P=0.012). Sex (OR: 0.87, 95% CI: 0.27-2.75, P=0.807), age (OR: 1.60, 95% CI: 0.48-5.29, P=0.443), syphilis treatment (OR: 0.28, 95% CI: 0.06-1.24, P=0.094), and time to blood syphilis (OR: 1.35, 95% CI: 0.26-6.94, P=0.72) had no effect on the increase in the LNR3 or the fold decrease in the sero-TRUST titer from baseline after 3 months of treatment(see Figure 5 ).\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003e\u003cstrong\u003e2.\u003c/strong\u003e\u003cstrong\u003e1 Clinical\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;data\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatients with newly treated NS who were hospitalized at Nanjing Second Hospital from January 1, 2018, to December 31, 2022, were selected as the study subjects, and demographic, clinical and laboratory data were collected for retrospective analysis. The participants were divided into a no response group and a response group (partial response and complete response) for analysis.\u003c/p\u003e\n\u003cp\u003eInclusion criteria:\u003c/p\u003e\n\u003cp\u003e① Patients who met the diagnostic criteria for NS;\u003c/p\u003e\n\u003cp\u003e② Age ≥ 18 years;\u003c/p\u003e\n\u003cp\u003e Treatment compliance was good, and treatment was not interrupted.\u003c/p\u003e\n\u003cp\u003eExclusion criteria:\u003c/p\u003e\n\u003cp\u003e① Comorbid tumors;\u003c/p\u003e\n\u003cp\u003e② Infectious diseases of other organ systems.\u003c/p\u003e\n\u003cp\u003e Patients with HIV infection and other central nervous system infections\u003c/p\u003e\n\u003cp\u003e④ There were no complete CSF reexamination results at 3 M to 24 M after treatment\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 NS diagnostic criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIf any of the following criteria are met, the diagnosis is NS:\u003c/p\u003e\n\u003cp\u003e① Patients with positive\u0026nbsp;blood Treponema pallidum and non-Treponema pallidum with positive CSF-TRUST and cerebrospinal fluid treponemal titer (CSF-TPPA) and/or CSF-PRO\u0026gt;500 mg/L and/or CSF-WBC ≥5×106/L, with or without NS-related clinical symptoms.\u003c/p\u003e\n\u003cp\u003e② Positive\u0026nbsp;for Treponema pallidum and\u0026nbsp;non-Treponema\u0026nbsp;pallidum, CSF-PRO\u0026gt; 500 mg/L and/or CSF-WBC ≥5×106/L if CSF-TRUST is negative and CSF-TPPA is positive, with or without NS-related clinical symptoms\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3 Definition of\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eresponse to therapy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe type of\u0026nbsp;response to therapy\u0026nbsp;in\u0026nbsp;patients\u0026nbsp;with treatment-naive NS was determined according to the changes in\u0026nbsp;CSF\u0026nbsp;indicators within 3 M to 24 M after treatment. Patients who achieved a full\u0026nbsp;response\u0026nbsp;needed\u0026nbsp;to meet\u0026nbsp;the following criteria: ②,\u0026nbsp;③ and\u0026nbsp;④. Patients who achieved partial responses needed to meet the following criteria: ①, ②, ③ or ④. Patients who did not respond \u003csup\u003e[7]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e①\u0026nbsp;The\u0026nbsp;CSF-TRUST titer decreased ≥ 4-fold\u003c/p\u003e\n\u003cp\u003e②\u0026nbsp;The\u0026nbsp;CSF-TRUST titer\u0026nbsp;became\u0026nbsp;negative.\u003c/p\u003e\n\u003cp\u003eCSF-PROs\u0026nbsp;decreased to CSF-PROs\u0026lt;500 mg/L\u003c/p\u003e\n\u003cp\u003e④\u0026nbsp;The\u0026nbsp;number of nucleated cells decreased to 5×106/L \u0026lt; CSF-WBC\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.4 Data\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ecollection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatient demographic data and clinical and laboratory data at baseline (0 M), 3 months (3 M), 6 months (6 M), and 12 months (≥12 M) were collected, including clinical manifestations, CSF-TRUST titers, CSF-WBC and CSF-PRO, routine blood tests (absolute and percentage of lymphocytes, absolute and percentage of monocytes, absolute value and percentage of neutrophils,leukocytes, etc.), blood sero-TRUST, antibiotic medication regimen and high blood pressure. After treatment, patients are generally recommended to be rethecked every 3-6 months, the laboratory indicators are broadened to 1 month before and after the original time point, and the AUC changes are observed according to the ROC curve.\u003c/p\u003e\n\u003cp\u003eThe content of the study was approved by the Medical Ethics Committee of Nanjing Second Hospital, and the study met the medical ethics requirements (Ethics Approval No. 2023-LS-ky-033).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2..5 Statistical methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eR Studio 4.3.0 was used for the statistical analysis, and the graphs were drawn with Origin 2018. Medians and interquartile ranges were used for quantitative data descriptions, and percentages were used for statistical data. For comparisons between groups, the t test was used for normally distributed continuous data, and the chi-square test or exact probability method was used for categorical data. If there is a nonnormal distribution, the K-W test is used. Univariate and multivariate Cox regression analyses were used to analyze the influencing factors of response after treatment, and factors with P\u0026lt;0.1 in the univariate analysis were included in the multivariate analysis. A final multivariate result of P\u0026lt;0.05 was considered to indicate statistical significance, and all factors were tested in equal proportions before being included in the Cox regression analysis model. The area under the curve (AUC) of the response of NS patients was evaluated according to the receiver operating characteristic (ROC) curve. The optimal cutoff value was calculated by using the Youden index, and the LNR difference between baseline and 3 months after treatment (LNR3), the baseline sero-TRUST titer (sero-TRUST0), the sero-TRUST titer decreased from baseline after 3 months of treatment (sero-TRUST3), and the sero-TRUST titer decreased from baseline after 6 months of treatment (sero-TRUST6).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eNeurosyphilis is a serious sexually transmitted disease that requires prompt and standardized treatment; otherwise, it can lead to poor clinical outcomes and even death. At present, the evaluation of treatment efficacy mainly depends on improvements in clinical symptoms and changes in laboratory indicators, especially CSF results. However, because some patients who undergo invasive lumbar puncture are reluctant to undergo regular CSF reexamination, it is necessary to find other valid, convenient and feasible indicators to assist in evaluating the treatment effect. In this study, after exploring the changes in the blood LMR and LNR in HIV-negative neurosyphilis patients before and after expressant therapy and their correlations with prognosis, it was found that the baseline LMR, LNR and sero-TRUST titer may influence the response to therapy; the LNR and LMR of NS patients increased after treatment; and the sero-TRUST titer decreased faster in the response group than in the nonresponse group. Additionally, the LNR3, sero-TRUST0, and sero-TRUST3 are associated with the response to therapy and may be an adjunct to the assessment of the response to therapy.\u003c/p\u003e\n\u003cp\u003ePrevious studies have\u0026nbsp;shown\u0026nbsp;that 15% to 30% of hemosyphilis-positive patients\u0026nbsp;who undergo\u0026nbsp;complete lumbar puncture have abnormal CSF, and up to 95% of patients with abnormal CSF are\u0026nbsp;ultimately\u0026nbsp;diagnosed with NS\u003csup\u003e[1,8]\u003c/sup\u003e.\u0026nbsp;In this study, 182 (73.2%) of the 249 patients\u0026nbsp;experienced\u0026nbsp;symptoms, and the most common symptoms were memory loss, personality changes, limb numbness and weakness, etc., and two or more symptoms were common at the same time.\u0026nbsp;When microglia differentiate into\u0026nbsp;proinflammatory\u0026nbsp;factors, they drive the accumulation of leukocytes dominated by neutrophils or monocytes/macrophages to the inflammatory area, and monocytes in the blood participate in the process of nerve injury\u003csup\u003e[9,10]\u003c/sup\u003e. Lymphocytes, on the other hand, have a protective effect on nervous system damage\u003csup\u003e[11]\u003c/sup\u003e.\u0026nbsp;The Rosahn PD study\u0026nbsp;revealed\u0026nbsp;that an increase in absolute neutrophil and monocyte\u0026nbsp;counts\u0026nbsp;in peripheral blood was observed in neurosyphilis mice, resulting in a decrease in\u0026nbsp;the\u0026nbsp;LMR and LNR\u003csup\u003e[6]\u003c/sup\u003e.\u0026nbsp;A lower LMR may be associated with a weakened immune response\u003csup\u003e[12]\u003c/sup\u003e. A lower\u0026nbsp;LNR may be associated with an enhanced inflammatory response\u003csup\u003e[13]\u003c/sup\u003e.\u0026nbsp;This study\u0026nbsp;revealed\u0026nbsp;that the LNR and LMR of patients increased after treatment, which may be related to\u0026nbsp;a\u0026nbsp;reduction\u0026nbsp;in the\u0026nbsp;inflammatory response and increased immune response in vivo.\u003c/p\u003e\n\u003cp\u003eIn recent years, there have been many studies on the prognosis of LMR and LNR in patients with\u0026nbsp;several\u0026nbsp;cancers, certain infectious diseases, brain injury, and depression, and they\u0026nbsp;are\u0026nbsp;very mature\u003csup\u003e[14,15]\u003c/sup\u003e.\u0026nbsp;Some studies have\u0026nbsp;shown\u0026nbsp;that patients admitted to\u0026nbsp;hospitals\u0026nbsp;with COVID-19 have an increased risk of death with\u0026nbsp;an\u0026nbsp;LMR \u0026lt; 2.23 and NLR\u0026gt;5.56 in their peripheral blood, resulting in a poor prognosis\u003csup\u003e[16]\u003c/sup\u003e.\u0026nbsp;Weijie Li et al.\u0026nbsp;reported\u0026nbsp;that\u0026nbsp;the\u0026nbsp;NLR in peripheral blood can predict the occurrence of neurosyphilis\u003csup\u003e[17]\u003c/sup\u003e.\u0026nbsp;However, there are no studies on the\u0026nbsp;ability\u0026nbsp;of\u0026nbsp;the\u0026nbsp;LMR and LNR\u0026nbsp;to predict treatment efficacy. In this study, the LMR and LNR of NS patients increased compared with\u0026nbsp;those at\u0026nbsp;baseline after treatment, suggesting that plum\u0026nbsp;expulsion\u0026nbsp;reduced the inflammatory response in vivo and enhanced the immune response.\u0026nbsp;Although there were no significant differences in\u0026nbsp;the\u0026nbsp;LNR\u0026nbsp;or\u0026nbsp;LMR between the two groups at baseline\u0026nbsp;or\u0026nbsp;posttreatment follow-up, multivariate\u0026nbsp;Cox\u0026nbsp;regression analysis with\u0026nbsp;response to therapy as the outcome showed that\u0026nbsp;the\u0026nbsp;baseline LMR and LNR were risk factors for\u0026nbsp;response to therapy.\u0026nbsp;Compared with\u0026nbsp;patients with an\u0026nbsp;LMR \u0026le;1.93, NS patients with\u0026nbsp;a\u0026nbsp;baseline LMR \u0026gt;1.93 were more likely to\u0026nbsp;respond\u0026nbsp;to therapy, indicating that the stronger the immune response before treatment\u0026nbsp;is, the more favorable the\u0026nbsp;response to therapy. Compared with\u0026nbsp;patients with an\u0026nbsp;LNR \u0026le;0.3, NS patients with\u0026nbsp;a\u0026nbsp;baseline LNR \u0026gt;0.3 were more likely to have treatment failure, indicating that a weak baseline inflammatory response was not conducive to\u0026nbsp;the postresponse\u0026nbsp;to therapy.\u003c/p\u003e\n\u003cp\u003eTo\u0026nbsp;further determine the\u0026nbsp;ability\u0026nbsp;of each variable\u0026nbsp;to predict the\u0026nbsp;response to therapy, the ROC curve was used to calculate the sensitivity and specificity,\u0026nbsp;as\u0026nbsp;the ordinary ROC curve\u0026nbsp;ignores\u0026nbsp;the influence of time on the ability to discriminate variables. The\u0026nbsp;time-dependent ROC curve was selected, and the AUC value of each time point could more accurately reflect the ability of the\u0026nbsp;variables. The\u0026nbsp;results showed that\u0026nbsp;the\u0026nbsp;LNR3 (the difference between\u0026nbsp;the\u0026nbsp;LNR and baseline after 3 months of treatment)\u0026nbsp;was\u0026nbsp;\u0026gt; 0.12, and the AUC value of 3 months of\u0026nbsp;response to therapy was 81.52, indicating that the difference between\u0026nbsp;the\u0026nbsp;LNR and baseline after 3 months of treatment may be used as a potential auxiliary indicator to judge the\u0026nbsp;response to therapy. Further forest plot analysis\u0026nbsp;revealed\u0026nbsp;that\u0026nbsp;sex, age, syphilis treatment and duration of blood syphilis positivity did not affect\u0026nbsp;the\u0026nbsp;LNR3.\u003c/p\u003e\n\u003cp\u003eOnce Treponema pallidum infects the human body, the human body quickly responds to lipidoid substances released on the surface of damaged host cells and Treponema pallidum cells and produces anti-lipid antigen antibodies (also known as reagins)\u0026nbsp;within\u0026nbsp;3~4 weeks.\u0026nbsp;Sero-TRUST is a flocculent agglutination test that uses cardiolipin, lecithin and cholesterol as antigens and toluidine red particles as indicators\u0026nbsp;and\u0026nbsp;is one of the detection methods for\u0026nbsp;nonspecific\u0026nbsp;antibodies to syphilis.\u0026nbsp;After treatment, the sero-TRUST titer can decrease or\u0026nbsp;become\u0026nbsp;negative, so it can be used for efficacy observation, cure, and recurrence or reinfection\u003csup\u003e[18]\u003c/sup\u003e.\u0026nbsp;Previous studies have\u0026nbsp;shown\u0026nbsp;that the\u0026nbsp;greater\u0026nbsp;the sero-TRUST titer\u0026nbsp;is, the greater the likelihood of neurosyphilis\u003csup\u003e[19,20]\u003c/sup\u003e.\u0026nbsp;In this study, we found that the median titer of sero-TRUST in 249 patients with neurosyphilis was 1:16, and the sero-TRUST titer was\u0026nbsp;greater\u0026nbsp;before treatment and decreased faster after treatment. The proportion of NS patients decreased by 4 times or more with the extension of treatment time, and the proportion\u0026nbsp;of NS patients in the treatment group was greater\u0026nbsp;than that\u0026nbsp;in\u0026nbsp;the\u0026nbsp;nonresponse\u0026nbsp;group at each follow-up point, suggesting that the\u0026nbsp;greater\u0026nbsp;the sero-TRUST titer before treatment\u0026nbsp;was, the faster the treatment\u0026nbsp;declined, and the\u0026nbsp;greater the likelihood that a\u0026nbsp;response to therapy would occur.\u0026nbsp;This view was further supported by the finding of a greater likelihood of\u0026nbsp;a\u0026nbsp;response to therapy at baseline sero-TRUST \u0026gt;1:16 in\u0026nbsp;the Cox\u0026nbsp;regression analysis. Xiao Y et al.\u0026nbsp;reported\u0026nbsp;that the serum rapid plasma reagin test (sero-RPR)\u0026nbsp;titer\u0026nbsp;decreased\u0026nbsp;by \u0026ge;8\u0026nbsp;times after 6 months of treatment in NS patients, which can assist in judging the\u0026nbsp;response to therapy\u003csup\u003e[21]\u003c/sup\u003e.\u0026nbsp;However, in this study, the sero-TRUST\u0026nbsp;titer\u0026nbsp;decreased by \u0026gt;1\u0026nbsp;time\u0026nbsp;after 6 months of treatment and decreased by\u0026nbsp;\u0026gt;8 times after 12 months of treatment, and the efficacy of judging the occurrence of\u0026nbsp;response to therapy was not high (AUC was only 42.24-60.98); however, the sero-TRUST\u0026nbsp;titer\u0026nbsp;decreased by \u0026gt; from baseline after 3 months of\u0026nbsp;treatment. The\u0026nbsp;AUC of the 2x\u0026nbsp;judgment\u0026nbsp;of\u0026nbsp;response to therapy was 72.85, and it was not affected by age, sex, length of blood syphilis positive,\u0026nbsp;or\u0026nbsp;whether syphilis treatment was administered, so it is speculated that sero-TRUST 3 \u0026gt; 2x may be used as an adjunct indicator of response at the time of treatment.\u003c/p\u003e\n\u003cp\u003eIn this study, the commonly used clinical indicators LMR and LNR were used for the first time to evaluate the efficacy of posttherapy\u0026nbsp;therapy in HIV-negative NS patients, and the results showed that\u0026nbsp;the\u0026nbsp;LMR and LNR increased after treatment.\u0026nbsp;The\u0026nbsp;baseline LMR and LNR may affect the response to therapy, and an increase \u0026gt;0.12 in\u0026nbsp;the\u0026nbsp;LNR3 and a \u0026gt;-fold decrease in\u0026nbsp;the\u0026nbsp;sero-TRUST3\u0026nbsp;level\u0026nbsp;by 2-fold\u0026nbsp;may be used as auxiliary indicators for the \u0026nbsp;response to therapy.\u003c/p\u003e\n\u003cp\u003eThere are several shortcomings in this study. First, this was a single-center retrospective study, and because patients with invasive NS who underwent lumbar puncture cannot undergo regular CSF review, the sample size was small, and the follow-up data were missing. Second, there were too few complete responders to verify the efficacy of LMR, LNR, and sero-TRUST titers in assessing response to therapy in this population. Third, only the LMR, LNR, and sero-TRUST were evaluated for therapeutic efficacy. In the future, we will further expand the sample size to analyze complete response as an outcome measure and comprehensively analyze the efficacy of LMR, LNR, and sero-TRUST titers in assessing the occurrence of response to therapy based on the patient\u0026apos;s disease stage and other variables that may affect efficacy.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe baseline blood LMR, LNR, and sero-TRUST in HIV-negative NS patients may affect the response to therapy, and the LNR3 and sero-TRUST3 may be used as auxiliary indicators to evaluate the response to therapy.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are grateful to all the patients included in our study, as well as the investigators and site staff who put their efforts into the research. We are also grateful to the AIDS Healthcare Foundation for their support of our work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the 2020 Annual Medical Research Project of Jiangsu Commission of Health to Hongxia Wei [Grant# ZDA 2020014], and the 2022 Annual Key Project supported by Medical Science and Technology Development Foundation, Nanjing Department of Health, awarded to Hongxia Wei (Grant# ZKX 22040).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that the research was conducted in the absence of any commercial or\u0026nbsp;financial relationships that could be construed as a potential conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe studies involving human participants were reviewed and approved by the Ethics Committee of the Second Hospital of Nanjing (Nanjing, China). The patients/participants do not need provided their written informed consent to participate in this study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData and Materials availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contribution\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHW, RC conceived and designed the study, and H Wei led at study implementation. JP, ML, XD, ChC, NY, HG, collected the study data. HG and ML analyzed the data and wrote the draft manuscript. All authors commented on previous versions of the manuscript. \u0026nbsp;HW revised the manuscript. All authors contributed to the article and approved the submitted version.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSmibert O C, Jenney A W J, Spelman D W. Management of neurosyphilis: time for a new approach?[J]. Internal Medicine Journal, 2018, 48(2): 204-206.\u003c/li\u003e\n\u003cli\u003eGhanem K G, Moore R D, Rompalo A M, et al. Lumbar Puncture in HIV-Infected Patients with Syphilis and No Neurologic Symptoms[J]. Clin Infect Dis, 2009, 48(6): 816-821.\u003c/li\u003e\n\u003cli\u003eMarra C M, Maxwell C L, Ramchandani M, et al. Hearing loss in individuals at risk for neurosyphilis[J]. International journal of STD \u0026amp; AIDS, 2020, 31(12): 1178-1185.\u003c/li\u003e\n\u003cli\u003eWilner E, Brody J. PROGNOSIS OF GENERAL PARESIS AFTER TREATMENT[J]. Lancet, 1968: 1370-1371.\u003c/li\u003e\n\u003cli\u003eCenter for STD Control of Chinese Center for Disease Control and Prevention, Venereology Group of Dermatology and Venereology Branch of Chinese Medical Association, Subspecialty Committee of Venereal Diseases of Dermatologist Branch of Chinese Medical Doctor Association. Guidelines for the diagnosis and treatment of syphilis, gonorrhea and genital \u003cem\u003eChlamydia trachomatis\u003c/em\u003e infection (2020)[J]. Chinese Journal of Dermatology, 2020, 053(003): 168-179.\u003c/li\u003e\n\u003cli\u003eRosahn PD, Pearce L, Casey AE. Observations on the blood cytology in experimental syphilis: I.the period of disease activity[J]. J Exp Med, 1934, 59(6): 711-720.\u003c/li\u003e\n\u003cli\u003eNational Institutes of Health, Centers for Disease Control and Prevention, HIV Medicine Association, and Infectious Diseases Society of America. Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV[M]//ClinicalInfo.HIV.gov [Internet]. US Department of Health and Human Services, 2023.\u003c/li\u003e\n\u003cli\u003eMills C H. Routine Examination of the Cerebro-Spinal Fluid in Syphilis: Its Value in Regard to More Accurate Knowledge, Prognosis, and Treatment[J]. British Medical Journal, 1927, 2(3481): 527-532.\u003c/li\u003e\n\u003cli\u003eWu S, Ye F, Wang Y, et al. Neurosyphilis: insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention[J]. Frontiers in Neurology, 2024, 14: 1340321.\u003c/li\u003e\n\u003cli\u003eZHANG Xiangqin. Correlation studies of neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and volume of acute cerebral infarction[D]. Guangzhou Medical University, 2022.\u003c/li\u003e\n\u003cli\u003eGong P, Liu Y, Gong Y, et al. The association of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and lymphocyte to monocyte ratio with postthrombolysis early neurological outcomes in patients with acute ischemic stroke.[J]. J Neuroinflammation., 2021, 18(1): 51.\u003c/li\u003e\n\u003cli\u003eMa J ying, Liu Q. Clinicopathological and prognostic significance of lymphocyte to monocyte ratio in patients with gastric cancer: A meta-analysis[J]. International Journal of Surgery, 2018, 50: 67-71.\u003c/li\u003e\n\u003cli\u003eHamill M M, Ghanem K G, Tuddenham S. State-of-the-Art Review: Neurosyphilis[J]. Clinical Infectious Diseases, 2024, 78(5): e57-e68.\u003c/li\u003e\n\u003cli\u003eEo W K, Jeong D W, Chang H J, et al. Absolute monocyte and lymphocyte count prognostic score for patients with gastric cancer[J]. World Journal of Gastroenterology, 2015, 21(9): 2668-2676.\u003c/li\u003e\n\u003cli\u003eFujiwara Y, Misawa T, Shiba H, et al. Postoperative Peripheral Absolute Blood Lymphocyte-to-Monocyte Ratio Predicts Therapeutic Outcome After Pancreatic Resection in Patients with Pancreatic Adenocarcinoma[J]. Anticancer Research, 2014, 34(9): 5163-5168.\u003c/li\u003e\n\u003cli\u003eDymicka-Piekarska V, Dorf J, Milewska A, et al. Neutrophil/Lymphocyte Ratio (NLR) and Lymphocyte/Monocyte Ratio (LMR) \u0026ndash; Risk of Death Inflammatory Biomarkers in Patients with COVID-19[J]. Journal of Inflammation Research, 2023, 16: 2209-2222.\u003c/li\u003e\n\u003cli\u003eLi W, Han J, Zhao P, et al. Predicting asymptomatic neurosyphilis using peripheral blood indicators[J]. BMC infectious diseases, 2021, 21(1): 1191.\u003c/li\u003e\n\u003cli\u003eInstitute of Infectious Disease Control and Prevention, Chinese Center for Disease Control and Prevention [EB/OL]. [2024-06-19]. https://icdc.chinacdc.cn/zcfgybz/bz/202112/t20211202_253309.html.\u003c/li\u003e\n\u003cli\u003eShi M, Peng R R, Gao Z, et al. Risk profiles of neurosyphilis in HIV-negative patients with primary, secondary and latent syphilis: implications for clinical intervention[J]. Journal of the European Academy of Dermatology and Venereology, 2016, 30(4): 659-666.\u003c/li\u003e\n\u003cli\u003eLi D, Huang X, Shi M, et al. Diagnostic role of CXCL13 and CSF serology in patients with neurosyphilis[J]. Sexually Transmitted Infections, 2021, 97(7): 485-489.\u003c/li\u003e\n\u003cli\u003eXiao Y, Tong M L, Lin L R, et al. Serological Response Predicts Normalization of Cerebrospinal Fluid Abnormalities at Six Months after Treatment in HIV-Negative Neurosyphilis Patients[J]. Scientific Reports, 2017, 7(1): 9911.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable\u0026nbsp;1\u0026nbsp;Comparison of baseline characteristics at treatment in different response groups\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"128%\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003eAll\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003eNon response to therapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003eResponse to therapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" rowspan=\"2\"\u003e\n \u003cp\u003eP.value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.666666666666668%\"\u003e\n \u003cp\u003eN=249\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35%\"\u003e\n \u003cp\u003eN=49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eN=200\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003egender,n(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.579\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 167 (67.1%)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e35 (71.400%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e132 (66.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003efemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 82 (32.9%)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e14 (28.600%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e68 (34.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eage(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e50.4 (39.800;61.000)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e53.000 (48.000;61.000)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e52.000 (39.800;59.000)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.089\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003emarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.065\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eunmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 25 (10.0%)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e1 (2.040%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e24 (12.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003emarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e213 (85.5%)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e45 (91.800%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e168 (84.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003edivorce、widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e11 (4.42%)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e3 (6.120%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e8 (4.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.292929292929294%\"\u003e\n \u003cp\u003eCerebrospinal fluid test results\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"70.70707070707071%\" colspan=\"4\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eCl(mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 126 [124;128]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e126 [123;128]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e 126 [124;128]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.424\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eCSF-PRO(mg/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e567 [430;739]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e 507 [395;652]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e591 [445;771]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eglucose(mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 3.28 [3.00;3.80]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e3.50 [3.12;4.15]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e3.23 [2.91;3.67]0)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003elactate dehydrogenase(IU/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 20.0 [16.0;25.0]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e19.5 [16.0;27.0]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e20.0 [16.0;24.0]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.614\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eAdenosine deaminase(U/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e1.00 [0.55;2.00]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e1.00 [0.00;2.00]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e1.00 [0.70;2.00]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.273\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eCSF-WBC(\u0026times;10\u003csup\u003e6\u003c/sup\u003e/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e13.0 [5.00;38.0]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e5.00 [2.00;15.2]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e17.0 [7.00;43.0]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.070\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eMultinucleated cells\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 0.07 [0.02;0.10]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e0.07 [0.03;0.20]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e0.08 [0.02;0.10]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.789\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003emonocyte\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e0.90 [0.80;0.97]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e0.80 [0.45;0.94]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e0.90 [0.88;0.97]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.070\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.292929292929294%\"\u003e\n \u003cp\u003eBlood test results\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"70.70707070707071%\" colspan=\"4\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eLymphocyte absolute value（\u0026times;10\u003csup\u003e9/\u003c/sup\u003eL）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 1.56 [1.15;2.00]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e1.50 [1.04;2.22]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e1.57 [1.20;1.95]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.992\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003epercentage of Lymphocyte (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e21.9 [14.8;30.4]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e22.5 [13.1;31.7]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e21.7 [15.1;30.1]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.939\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eMonocyte absolute value（\u0026times;10\u003csup\u003e9/\u003c/sup\u003eL）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e0.44 [0.34;0.57]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e0.41 [0.32;0.54]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e0.44 [0.34;0.58]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.453\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003ePercentage of monocytes(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e6.10 [4.70;8.00]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e5.80 [4.77;7.23]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e6.30 [4.70;8.00]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.251\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eNeutrophil absolute value（\u0026times;10\u003csup\u003e9/\u003c/sup\u003eL）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e4.80 [3.65;6.74]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e4.77 [3.61;7.07]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e4.81 [3.65;6.59]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.804\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003epercentage of Neutrophil (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 69.1 [59.3;78.4]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e68.4 [57.3;80.6]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e69.3 [60.0;77.6]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.935\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cpre\u003eLNR\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e0.32 [0.19;0.52]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e0.33 [0.17;0.57]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e0.31 [0.19;0.51]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cpre\u003e0.947\u003c/pre\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cpre\u003eLMR\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e3.48 [2.61;4.80]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e 3.80 [2.90;4.83]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e3.48 [2.61;4.74]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cpre\u003e0.404\u003c/pre\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cpre\u003eMNR\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e0.09 [0.06;0.13]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e0.09 [0.06;0.12]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e0.09 [0.06;0.13]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cpre\u003e0.332\u003c/pre\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003ewhite blood cell（\u0026times;10\u003csup\u003e9/\u003c/sup\u003eL）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e7.23 [5.91;8.95]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e7.64 [6.23;9.72]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e 7.20 [5.82;8.89]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.174\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003esero-TRUST titer(1:X)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e16.0 [8.;64]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e8 (4;32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e32(16;64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eCSF-TRUST titer(1:X)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 4 [2;8]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e3(1;4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e4(2;8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.181\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eCD4+T lymphocyte(cell/\u0026mu;L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 638 [401;886]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cpre\u003e707 (496;927)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cpre\u003e628 (393;875)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cpre\u003e0.473\u003c/pre\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eCD4/CD8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e1.47 [1.10;2.12]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e1.400 (1.170;2.020)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e1.480 (1.100;2.150)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.951\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eCD4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e36.5 [28.2;42.0]\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e41.000 (36.800;44.800)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e35.000 (27.800;41.200)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.074\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eAntibiotic regimens\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.307\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003epenicillin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 231 (92.77%)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e45.(91.800%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e186 (93.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eCeftriaxone sodium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 14 (5.62%)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2 (4.080%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e12 (6.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eCephalosporin is used in combination with penicillin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e4 (1.61%)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2(4.080%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e2 (1.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eComorbid diabetes mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.398\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 227 (91.16%)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e43 (87.800%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e184 (92.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 22 (8.84%)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e6 (12.200%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e16 (8.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eComorbid hypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e0.662\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e 206 (82.7%)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e39 (79.600%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e167 (83.500%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.896907216494846%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cpre\u003e43 (17.3%)\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e10 (20.400%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e33 (16.500%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: LMR,Lymphocyte absolute/monocyte absolute;LNR,Absolute lymphocytes/absolute neutrophils;MNR,Monocyte Absolute/Neutrophil Absolute\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2 The specific clinical manifestations of NS patients\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"618\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003eAll（n=249）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003eResponse to therapy（n=197）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003eNon response to therapy\u0026nbsp;(n=52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003eP.value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003easymptomatic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e67(26.800%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e48(24.365%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e19(36.538%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0.081\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003eMemory loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e78(31.200%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e64(32.487%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e14(26.923%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cpre\u003e0.562\u003c/pre\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003ePersonality changes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e43(17.200%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e37(18.782%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e5(9.615%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0.177\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003eDown in the dumps\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e9(3.600%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e9(4.569%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0(0.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0.211\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003eexcited\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e5(2.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e4(2.030%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e1(1.923%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003eDisordered speech and behavior\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e6(2.400%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e5(2.538%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e1(1.923%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003emultilingual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e8(3.200%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e8(4.061%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0(0.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0.211\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003eirascible\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e4(1.600%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e2(1.015%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e2(3.846%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0.192\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003eAbnormal behavior\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e10(4.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e9(4.569%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e1(1.923%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0.693\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003edizzy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e16(6.400%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e14(7.107%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e2(3.846%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0.534\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003eheadache\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e14(5.600%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e12(6.091%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e2(3.846%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0.740\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003eNumbness and weakness in the limbs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e21(8.400%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e15(7.614%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e6(11.538%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0.399\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003eCognitive decline in function\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e5(2.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e4(2.030%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e1(1.923%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003eUnresponsive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e10(4.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e9(4.569%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e1(1.923%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0.693\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003eSpeech disorders\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e14(5.600%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e12(6.091%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e2(3.846%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0.740\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003eDecreased vision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e12(4.800%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e12(6.091%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0(0.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0.077\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.271844660194176%\"\u003e\n \u003cp\u003ehallucination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.6084142394822%\"\u003e\n \u003cp\u003e4(1.600%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.932038834951456%\"\u003e\n \u003cp\u003e4(2.030%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0(0.000%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.093851132686083%\"\u003e\n \u003cp\u003e0.583\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3 Risk factors influencing response after treatment in NS patients -\u0026nbsp;Cox\u0026nbsp;regression\u003c/p\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"679\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\" rowspan=\"2\"\u003e\n \u003cp\u003evariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.383480825958703%\" colspan=\"2\"\u003e\n \u003cp\u003eUnivariate analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.710914454277287%\" colspan=\"2\"\u003e\n \u003cp\u003eMultivariate analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.723112128146454%\"\u003e\n \u003cp\u003eHR (95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.416475972540045%\"\u003e\n \u003cp\u003eP.value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.6613272311212817%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.80778032036613%\"\u003e\n \u003cp\u003eHR (95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.391304347826086%\"\u003e\n \u003cp\u003eP.value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003egender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003efemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.100 (0.780-1.400)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e0.741\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003emarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003eunmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003emarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e0.405\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e0.261-0.630\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.481\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e0.306-0.756\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003edivorce、widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e0.347\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e0.153-0.786\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e0.011\u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.430\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e0.186-0.992\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.048\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003eLymphocyte absolute value（\u0026times;10\u003csup\u003e9/\u003c/sup\u003eL）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026le;1.12\u0026times;109/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026gt;1.12\u0026times;109/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e0.911 (0.643-1.321)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e0.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003epercentage of Lymphocyte (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026le;31.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026gt;31.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.122 (0.771-1.500)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e0.642\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003eMonocyte absolute value（\u0026times;10\u003csup\u003e9/\u003c/sup\u003eL）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026le;0.48\u0026times;109/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026gt;0.48\u0026times;109/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.660 (0.492-0.891)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.007\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e0.739（0.526-1.038）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e0.081\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003epercentage of Monocyte (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026le;8.80%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026gt;8.80%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e0.762 (0.521-1.156)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e0.180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003eNeutrophil absolute value（\u0026times;10\u003csup\u003e9/\u003c/sup\u003eL）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026le;2.71\u0026times;109/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026gt;2.71\u0026times;109/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e0.782 (0.484-1.322)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e0.310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003epercentage of Neutrophil (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026le;50.1\u0026times;109/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026gt;50.1\u0026times;109/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.222 (0.709-1.914)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e0.532\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003ewhite blood cell（\u0026times;10\u003csup\u003e9/\u003c/sup\u003eL）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026le;4.98\u0026times;109/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026gt;4.98\u0026times;109/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e0.750 (0.483-1.232)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e0.211\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003eLNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026le;0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026gt;0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e0.735(0.535-0.951)\u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e0.036\u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.559\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e0.356-0.880\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.013\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003eLMR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026le;1.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e1.000\u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026gt;1.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e1.603(1.088-2.745\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e0.044\u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.097\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e1.210-3.632\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.008\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003eMNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026le;0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u0026gt;0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e0.705(0.526-0.944)\u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e0.019\u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e1.558（0.991-2.448）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003eAntibiotic regimens\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003epenicillin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003eCeftriaxone sodium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e1.012（0.548-1.869）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e0.969\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003eCephalosporin is used in combination with penicillin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e0.449（0.111-1.811）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e0.260\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003eBaseline sero-TRUST titer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;1:16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e1.000\u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cpre\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/pre\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.54572271386431%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026ge;1:16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.091445427728612%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.722 (1.213-2.406)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29203539823009%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.359882005899705%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.50147492625369%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.760\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e1.241-2.497\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.2094395280236%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eNote: LMR,Lymphocyte absolute/monocyte absolute;LNR,Absolute lymphocytes/absolute neutrophils;MNR,Monocyte Absolute/Neutrophil Absolute\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Neurosyphilis, HIV-negative, response to therapy, absolute lymphocyte/monocyte ratio, absolute lymphocyte/neutrophil ratio, sero-TRUST","lastPublishedDoi":"10.21203/rs.3.rs-4605969/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4605969/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003eTo investigate the effects of absolute blood lymphocytes/absolute monocyte (LMR), absolute lymphocytes/absolute neutrophils (LNR) and sero-TRUST titers on treatment response after initial treatment in HIV-negative neurosyphilis (NS) patients, whether they can be used as auxiliary indicators for response after treatment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eNS patients who were hospitalized in Nanjing Second Hospital from January 1, 2018 to December 31, 2022 for initial treatment ,complete treatment response will be taken as the study endpoint. COX regression was used to analyze the influencing factors of treatment response in NS patients. Evaluate the ability to respond by assessing baseline LMR and LNR, changes in LMR and LNR at different time points compared to baseline, and the multiple decrease in the toluidine red unheated serum test titer from baseline(sero-TRUST) using time-dependent ROC curves.The forest plot analyzed the influencing factors of the LNR difference between baseline and 3 months after treatment (LNR3), baseline sero-TRUST titer (sero-TRUST0), sero-TRUST decrease from baseline at 3 months or 6 months after treatment (sero-TRUST3 or sero-TRUST6).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eA total of 249 patients were included in this study, including 200 in the response group and 49 in the non-response group.Univariate and multivariate COX regression analysis showed that baseline blood LMR\u0026gt; 1.93 (HR : 2.907, P=0.013), LNR \u0026gt; 0.3 (HR: 0.559, P= 0.013), and sero-TRUST titer \u0026gt;1:16 (HR: 1.760, P=0.002) affects the outcome of response after treatment. The AUC of LNR3 \u0026gt; 0.12 at 3M was 81.52 , the AUC of the baseline sero-TRUST titer was \u0026gt; 1:16 was 71.64, and the AUC of sero-TRUST3 titer decreased by more than 2 times at 3M was 72.85.The forest plot showed that if the blood was positive for syphilis ≥for 240 days before screening, the more likely the baseline sero-TRUST titer was less than 1:16.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThe complete response rate of patients with NS to initial treatment was low, and peripheral blood LMR ,LNR ,and sero-TRUST may affect treatment response.The increase in LNR3 \u0026gt; 0.12 ,the baseline sero-TRUST titer \u0026gt; 1:16 , and the sero-TRUST 3 \u0026gt;2 titer could be used as auxiliary indicators to evaluate the treatment response of patients.\u003c/p\u003e","manuscriptTitle":"Absolute blood lymphocytes/monocytes and lymphocytes/neutrophils in patients with neurosyphilis may affect the response to therapy and diagnostic efficacy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-18 16:00:18","doi":"10.21203/rs.3.rs-4605969/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"658344eb-9fdd-4b67-bee4-08a3a9ee1490","owner":[],"postedDate":"July 18th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-07-22T05:24:37+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-18 16:00:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4605969","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4605969","identity":"rs-4605969","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}