Objective: To investigate the clinical value of the serum new molecular markers, soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and soluble hemoglobin scavenger receptor(sCD163), in the diagnosis of sepsis in elderly patients with burns. Methods: A total of 58 inpatients with burns from Jun 2017 to June 2018 were enrolled in the study.Patients were divided into three groups: the sepsis group(n=12), the localized infection group(n=21)and the non-infection group(n=29). The levels of sTREM-1 and sCD163 were determined by enzyme-linked immunosorbent assays(ELISAs). The clinical diagnostic value of sTREM-1 and sCD163 was assessed by receiver operating characteristic(ROC)curve analysis. Results: There was a statistically significant difference in the levels of sTREM-1 and sCD163 at day 1 between the three groups(F=20.994 and 38.363, P<0.01). Serum levels of sTREM-1 and sCD163 were higher in the sepsis group than in the localized infection group and the non-infection group.Serum levels of sTREM-1 and sCD163 were higher in the localized infection group than in the non-infection group.Serum levels of sTREM-1 and sCD163 were lower at day 7 than those at day 1 in all groups(F=21.242 and 41.035, P<0.01). Serum sTREM-1 levels were positively correlated with serum sCD163 levels(r=0.609, P=0.000). The AUC of sTREM-1 and sCD163 for the diagnosis of sepsis was 0.880(95%CI: 0.816~0.926). Conclusions Serum levels of sTREM-1 and sCD163 are elevated with increasing degrees of infection.Monitoring serum sTREM-1 and sCD163 levels is helpful for the diagnosis of sepsis in elderly patients with burns.

Objective To evaluate the extent and anatomic distribution of air trapping in lung in young asymptomatic female subjects to achieve early diagnosis of small airway diseases.Methods Fifty young females with normal pulmonary function were included retrospectively in this study.All subjects underwent both inspiratory and expiratory CT scans,the percentage of the area of air trapping(AT)and the percentage of the area of emphysema(Emph)were quantitatively analyzed.Comparison between bilateral lungs was analyzed using independent-samples t test;Comparisons among lobes were done using one-way ANOVA or Kruskal-Wallis rank sum test;Pairwise comparisons between lobes were conducted using LSD test or paired comparison;The effects of each lobe on AT were analyzed using Spearman's rank correlation coefficient,simple linear regression and multiple stepwise regression.Results There was a certain degree of air trapping in lung and a small amount of emphysema in young asymptomatic females.Air trapping was mainly located in the right middle lobe (RML)and bilateral upper lobes.The ratio of air trapping to volume was the highest in RML and the change of air trapping in the bilateral upper lobes had the greatest influence on the air trapping degree of the whole lung.Conclusion There is a certain degree of air trapping in lung in young asymptomatic females.The occurrence and development of air trapping in RML may be a sensitive biomarker for the early detection of pathophysiological changes in small airway diseases using imaging procedures.

Objective To establish and validate a voxel-based method for the quantitative detection of air trapping (AT),and to explore its diagnostic value by preliminarily apply this method in chronic obstructive pulmonary disease (COPD) patients.Methods From March 2015 to February 2016,fifty healthy young volunteers and eighteen COPD patients who underwent both end-inspiratory and end-expiratory CT were included from the Digital Lung Multi-center Study.The quantitative parameters of AT and emphysema were measured by both the voxel-based quantitative method and the conventional threshold method,respectively.All subjects underwent pulmonary function examination within 3 days after CT examination.For healthy volunteers,paired sample rank-sum test was used to compare the difference of quantitative parameters between voxel-based method and threshold method,Spearman rank correlation analysis was used to investigate the correlation between quantitative parameters of the two methods and pulmonary function.For COPD patients,the distribution and extent of AT and emphysema in patients with similar degree of pulmonary function (PFT) injury were observed.Results There were varying degrees of AT in the asymptomatic youth,with a median value of 5.70％ for the voxel-based method and with a median value of 7.96％ for the conventional threshold method,there was significant difference(Z=-4.015,P＜0.001).The correlation between AT and emphysema parameters of the voxel-based method and PFT parameters (r=-0.399 and-0.494,-0.335 and-0.439 separately,P＜0.05) were higher than that of the conventional threshold method,respectively (r=-0.357 and-0.453,-0.284 and-0.391,respectively;all P＜0.05).Furthermore,the voxel-based method can classify COPD patients with similar degree of pulmonary function injury into three subtypes:AT-dominant,emphysema-dominant,and mixed.Conclusions The voxel-based AT quantitative measurement method not only has high sensitivity and accuracy,but also provides imaging phenotype for the diagnosis of COPD and provides assistant decision-making for clinical management.