1.Comparative analysis of small shadow morphology between chest CT and DR images of patients with occupational pneumoconiosis
Zhongxue LI ; Xiazi ZHAO ; Yongzhong TANG ; Qianchang LI ; Shiwen HUANG ; Feifei LI ; Xiaoping LI ; Kunhai QIU
China Occupational Medicine 2024;51(3):303-307
Objective To compare the morphology differences in small shadows of occupational pneumoconiosis (hereinafter referred to as "pneumoconiosis") between computed tomography (CT) and digital radiography (DR) imaging. Methods A total of 1 010 pneumoconiosis patients were selected as the research subjects using a judgment sampling method. Chest DR imaging and CT imaging were performed on patients, and the differences in small shadow morphology between the two images were compared. Results In both DR and CT images of patients, circular small shadows identified as p, q, and r shapes accounted for 76.2%, 11.5%, and 1.3%, respectively, while irregular small shadows were identified in 1.8% of cases. There was medium high consistency between DR and CT in detecting these four types of small shadow morphology (Kappa=0.72, P<0.01). The detection rate of irregular small shadows (including interlobular septal thickening, ground-glass opacity, and/or centrilobular emphysema) by CT images was 54.0% (545/1 010), with 88.6% (483/545) of these cases also showing small circular shadows. Irregular small shadows in CT images were mostly identified as p small circular shadows in DR images, accounting for 88.8% (484/545). The results of DR and CT images for p/p, p/q, q/p, q/q, q/r, r/q and r/r in small circular shadows showed medium high consistency (Kappa =0.52, P<0.01). Conclusion The results of CT and DR imaging for pneumoconiosis with small shadow were of medium high consistency, with CT demonstrating advantages in detecting irregular small shadow morphology of pneumoconiosis. CT images can be used to describe the shape of circular small shadow as DR images, and irregular small shadow can be described as interlobular septal thickening, ground-glass opacity, and/or centrilobular emphysema.
2.Naturally occurring resistance-associated variants to NS3/4A protease and NS5A inhibitors in patients with HIV/HCV co-infection or HCV infection alone
Haohui DENG ; Shuifeng LI ; Qianchang FENG ; Linghua LI
Journal of Clinical Hepatology 2022;38(2):328-333
Objective To investigate the difference in naturally occurring resistance-associated variants (RAVs) between the patients with HIV/HCV co-infection and those with HCV infection alone by detecting the drug resistance loci associated with HCV NS3/4A protease and NS5A inhibitors. Methods A total of 246 patients with HIV/HCV co-infection or HCV infection alone who were hospitalized or attended the outpatient service in Guangzhou Eighth People's Hospital, Guangzhou Medical University, from January 2016 to January 2020 were enrolled in this study. Serum samples were collected and next-generation sequencing (Illumina platform, PE250) was used for sequencing. The two groups of patients were compared in terms of RAVs associated with NS3/4A protease and NS5A inhibitors approved in China, and the drugs for analysis included asunaprevir/daclatasvir (ASV/DCV) and elbasvir/grazoprevir (EBR/GZR) for HCV genotype 1b and glecaprevir/pibrentasvir (GLE/PIB) for pan-genotypes. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results Among the 246 serum samples included in this study, 239 samples (97.2%) were successfully amplified by PCR and sequenced, with 102 samples from the patients with HIV/HCV co-infection and 137 from the patients with HCV infection alone. The analysis of RAVs associated with ASV/DCV and EBR/GZR showed that Y56F, Q80K/L, and S122N/R/T associated with ASV and GZR and L31M and Y93H associated with DCV and EBR were observed in patients with HIV/HCV (genotype 1b) co-infection or HCV (genotype 1b) infection alone; 2 patients with HIV/HCV co-infection had the RAVs of Y56F+Y93H associated with EBR/GZR, and 2 with HCV infection alone had the RAVs of Q80L+L31M and Y56F+Y93H, respectively, associated with EBR/GZR, with no significant difference in RAVs between the two groups (both P > 0.05). The analysis of RAVs associated with GLE/PIB for pan-genotypes showed that 3 patients with PIB-associated Y93H RAV were observed among the patients with HCV genotype 3a infection, among whom 2 had HIV/HCV co-infection and 1 had HCV infection alone ( P =0.590), and in addition, no RAVs associated with GLE/PIB were observed. Conclusion There is no significant difference in naturally occurring RAVs associated with HCV NS3/4A protease and NS5A inhibitors between the patients with HIV/HCV co-infection and those with HCV infection alone.
3. Dynamic observation on changes of chest imaging in pneumoconiosis patients in tin smelting workers
Zhongxue LI ; Xiaoping LI ; Qianchang LI ; Yongzhong TANG ; Ming DEND ; Shaose YE
China Occupational Medicine 2017;44(05):576-579
OBJECTIVE: To observe the changes of chest imaging and prognosis in pneumoconiosis patients in tin smelting workers. METHODS: Ten pneumoconiosis patients working with tin smelting were examined by chest X-ray,computed tomography( CT) photography and dynamic observation on pulmonary imaging to analyze their characteristics and prognosis. RESULTS: There were mild clinical manifestations and no tuberculosis in these 10 cases of tin smelting pneumoconiosis patients. There was no obvious change on the pulmonary ventilation function change. The high k V X-ray chest observation results showed that the circular shadow was the primary small shadow of the two lungs,that were mostly distributed in the medium and upper lung zones of both lungs. In most cases,we found lung texture distortion,deformation or increase,blurred,hilar shadow increased thickening,lymph node calcification,individualized eggshell. There was no pleural changes and emphysema changes. There was no significant change found in 5-10 years of dynamic observation except for 1 case of increased small shadow. The chest CT examination in 2011 showed 2-5 mm nodular shadows. Among them,we found 7 cases of small nodules from the upper lobe evenly distributed to the middle of the lobe,the lower back lobe of the lungs,lower basal ganglia lesions decreased,lesions were diffuse distribution of the whole lung,and the small nodules in 3 cases. Interval lobular thickening at varying degrees were found in 5 cases,lobular central or apoptotic pulmonary emphysema were found in 4 cases,and 1 case of pulmonary bullae formation was found. The results of chest CT examination in 2016 showed 2 cases of diffuse pulmonary nodules,3 cases of thickening of lobular septum and 2 cases of pulmonary emphysema compared with the CT result in 2011. CONCLUSION: There was no obvious lung small shadow absorption found in tin smelting pneumoconiosis patients after 5 to 10 years of X-ray dynamic observation,and progress of lesions could be seen. CT examination is helpful for follow-up observation in tin smelting pneumoconiosis.