Objective To investigate concentration of plasma neutrophil gelatinase -associated lipocalin ( NGAL) and its clinical significance in ICU populations with sepsis.Methods Fourteen ICU patients diagnosed with sepsis and twenty-four patients with non-sepsis were enrolled in the study,and seventeen healthy adults were selected as healthy control.Blood samples were drawn from patients to measure NGAL, and Acute Physiology and Chronic Health Evaluation ( APACHE ) II and Sequential Organ Failure Assessment ( SOFA ) were performed, the outcome was recorded.Plasma NGAL concentration was measured by enzyme -linked immunosorbent assay ( ELISA) .Results On admission to ICU, the pNGAL concentrations of septic and non -septic patients were (131.4 ±116.4)ng/mL and (48.7 ±30.8)ng/mL respectively,which of healthy control was (39.07 ±12.74)ng/mL.The pNGAL was significantly higher in sepsis than non-sepsis and healthy control ( t=-3.280,3.313,P=0.003,0.021 respectively).Otherwise,no differences of white blood cell (WBC) count [(12.6 ±5.7) ×109/L vs (15.6 ±5.8) ×109/L] and SOFA scores [(7.7 ±3.3)points vs (8.6 ±3.4)points] were found in septic and non-septic patients (t=-1.554,-0.802,P=0.129,0.428).On the admission to ICU,areas under the receiver oper-ating characteristic curves ( ROC curves) of NGAL and WBC for predicting sepsis were 0.740 [95%confident inter-val(CI) 0.566,0.913,P =0.015] and 0.345 ( 95%CI 0.158,0.533,P =0.116) respectively.If pNGAL of 99.4ng/mL as the threshold for predicting sepsis, the sensitivity and the specificity was 50.0% and 85.2%. Conclusion The concentrations of NGAL in septic patients significantly increased compared with that in non-sepsis and in healthy adults.And the NGAL levels maybe another sensitive biochemical marker for predicting infection.

Objective:To compare the dose and image quality of selected photon shield (SPS) technique, organ-based tube current modulation (OBTCM) technique and the combination of these two techniques for reducing the organ dose in head CT examination for infants.Methods:Two anthropomorphic head phantoms (CIRS 1-yr-old and 5-yr-old) were scanned by using Reference mode, Reference + OBTCM mode, SPS mode and SPS + OBTCM mode, respectively. Radiation doses to the lens of the eye, the anterior of the brain, the posterior of the brain, noise level and CNR of orbit and brain in different phantoms were measured and compared by using different scanning modes.Results:Compared with Reference mode, the doses to the lens of the eye in 1-yr-old and 5-yr-old phantom decreased by (21.89 ± 0.01)% and (28.33 ± 0.34)%, respectively. In SPS mode, the reduction in doses to the lens of the eye in 1-yr-old and 5-yr-old phantom were (71.38 ± 1.30)% and (53.72 ± 2.42)%, respectively. In SPS + OBTCM mode, the reduction was (71.12 ± 2.54)% and (55.73 ± 1.90)%, respectively. There was significant difference in the noise level of orbit and brain in different phantoms under various scanning modes ( F=5.67-85.47, P< 0.05). The noise level in OBTCM mode compared with reference mode increased slightly (<1.45 HU) in various phantoms. SPS and SPS + OBTCM mode resulted in a small noise increase (<2.58 HU). There was no significant difference in CNR of different phantoms under various scanning modes ( P>0.05). Conclusions:SPS and SPS + OBTCM mode can significantly reduce the radiation dose of lens and the whole image plane in the head CT scan for infants, with maintaining the image quality.

Background::Dual-energy computed tomography (DECT) is purported to accurately distinguish uric acid stones from non-uric acid stones. However, whether DECT can accurately discriminate ammonium urate stones from uric acid stones remains unknown. Therefore, we aimed to explore whether they can be accurately identified by DECT and to develop a radiomics model to assist in distinguishing them.Methods::This research included two steps. For the first purpose to evaluate the accuracy of DECT in the diagnosis of uric acid stones, 178 urolithiasis patients who underwent preoperative DECT between September 2016 and December 2019 were enrolled. For model construction, 93, 40, and 109 eligible urolithiasis patients treated between February 2013 and October 2022 were assigned to the training, internal validation, and external validation sets, respectively. Radiomics features were extracted from non-contrast CT images, and the least absolute shrinkage and selection operator (LASSO) algorithm was used to develop a radiomics signature. Then, a radiomics model incorporating the radiomics signature and clinical predictors was constructed. The performance of the model (discrimination, calibration, and clinical usefulness) was evaluated.Results::When patients with ammonium urate stones were included in the analysis, the accuracy of DECT in the diagnosis of uric acid stones was significantly decreased. Sixty-two percent of ammonium urate stones were mistakenly diagnosed as uric acid stones by DECT. A radiomics model incorporating the radiomics signature, urine pH value, and urine white blood cell count was constructed. The model achieved good calibration and discrimination {area under the receiver operating characteristic curve (AUC; 95% confidence interval [CI]), 0.944 (0.899–0.989)}, which was internally and externally validated with AUCs of 0.895 (95% CI, 0.796–0.995) and 0.870 (95% CI, 0.769–0.972), respectively. Decision curve analysis revealed the clinical usefulness of the model.Conclusions::DECT cannot accurately differentiate ammonium urate stones from uric acid stones. Our proposed radiomics model can serve as a complementary diagnostic tool for distinguishing them in vivo.