Objective To explore the value of whole-lesion method measuring hepatic abscess lesions in ADC map.Methods 13 cases with hepatic abscess were measured by using three methods,drawing the outline of the lesion by manual operation,and placing the round ROI in the central area and the peripheral area in ADC map,respectively.The differences of the ADC values measured by the three methods were compared.The Friedman test was used for the mean of ADC values.The value differences of the groups were compared by the Bonferroni test.Results Among the 17 lesions,6 lesions located in the anterior segment of right lobe of liver,7 lesions in the posterior segment of right lobe of liver,1 lesion in the caudate lobe,1 lesion in the junction zone between the anterior segment of right lobe and the medial segment of left lobe,1 lesion in the medial segment of left lobe and 1 lesion in the lateral segment of left lobe of liver.The mean values from the three methods(×10-3 mm2/s) and the 95％ confidence intervalwere:1.27±0.33,1.23± 0.84,1.29±0.44 and (1.21,1.34),(1.06,1.40),(1.20,1.38),respectively.The results of the Friedman test were x2=2.176,P=0.337,and there was no statistical significance between the differences.There were also no statistical significance by the Bonferroni test (P values ＞0.05/3=0.017).The 95 ％ confidence interval of the whole-lesion method was the narrowest,and the accuracy was the highest.The 95％ confidence interval of the central method was the widest,and the accuracy was the lowest.Conclusion The whole-lesion measurement may be used as an analytical method for hepatic abscess in ADC map.

Objective To explore the predictive value of serum cathepsin S(CTSS),progranulin(PGRN)and chemo-kine ligand 12(CXCL12)for acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A total of 202 patients with COPD who were admitted to the Tongling Municipal Hospital from January 2020 to February 2023 were selected as the research subjects.The patients were divided into an acute exacerbation group(n=64)and a non-acute exacerbation group(n=138)according to whether acute exacerbation occurred.Clinical data such as serum CTSS,PGRN and CXCL12 levels,age,gender,body mass index(BMI),disease course,smoking history,forced expiratory volume in one second/forced vital capacity ratio(FEV1％),and COPD assessment test(CAT)score in the stable period were collected.Univariate analysis was made to compare the differences in relevant indicators between the two groups,and multivariate logistic regression analysis was made to identify the independent risk factors for acute exacerbation in COPD patients.The Pearson correlation method was used to analyze the correlation between serum CTSS,PGRN,CXCL12 levels and FEV1％,CAT score.Relative risk analysis was used to evaluate the influence of different CTSS,PGRN and CXCL12 levels on acute exacerbation in COPD patients.The predictive efficacy of serum CTSS,PGRN and CXCL12 levels on acute exacerbation in COPD patients was evaluated by receiver operating characteristic(ROC)curve.Results Univariate analysis showed that there was no significant difference in age,sex,BMI and disease course of patients between the two groups(P＞0.05),while there were significant differences in the propor-tion of patients with smoking history,FEV1％,CAT score,and serum CTSS,PGRN and CXCL12 levels between the two groups(P＜0.05).Multivariate logistic regression analysis showed that elevated serum CTSS,PGRN and CXCL12 levels were risk factors for acute exacerbation in COPD patients(P＜0.05).There were significant differences in serum CTSS,PGRN and CXCL12 levels among patients with different FEV1％and CAT scores(P＜0.05).Pearson correlation analysis showed that serum CTSS,PGRN and CXCL12 levels were negatively correlated with FEV1％and positively correlated with CAT score(P＜0.05).Risk analysis showed that the risk of acute exacerbation in COPD patients with high serum CTSS,PGRN and CXCL12 levels was 2.089 times[95％confidence interval(CI):1.341-3.253],2.294 times(95％CI:1.363-3.862)and 2.359 times(95％CI:1.459-3.815)of the COPD patients with low serum CTSS,PGRN and CXCL12 levels.ROC analysis indica-ted that the area under the curve for predicting the risk of acute exacerbation in COPD patients based on serum CTSS,PGRN and CXCL12 levels alone was 0.780,0.811 and 0.755,respectively;the area under the curve for predicting the risk of acute exacerbation in COPD patients based on the combination of serum CTSS,PGRN and CXCL12 levels was 0.923.Conclusion Serum CTSS,PGRN and CXCL12 levels are risk factors for acute exacerbation of COPD.Abnormal elevation of serum CTSS,PGRN and CXCL12 levels can significantly increase the risk of acute exacerbation of COPD.The combination of serum CTSS,PGRN and CXCL12 levels is more effective in predicting the risk of acute exacerbation of COPD.

Objective:To explore the application value of the method of judging the density of small shadows in the lung area by using CT and CT reference films for pneumoconiosis.Methods:The chest imaging data of 244 employees of a large copper company in Tongling City, Anhui Province who underwent occupational physical examination at Tongling Municipal Hospital in Anhui Province from January 2016 to December 2019 were retrospectively analyzed. Totally 244 cases underwent chest CT scan and chest DR radiography at the same time. The shape and size of the small shadows (the size of the circular and quasi-circular nodules in the lung area were represented by p, q, r, and the size of the irregular small shadows were represented by s, t, u), the overall density, the density of small shadows in each lung area, the large shadows, and the diagnosis stage were observed and compared. The small shadow density of each lung area was judged by the method of judging the small shadow density of CT lung area and the reference film, and other observation indicators were judged according to GBZ70-2015 Diagnosis of Occupational Pneumoconiosis. Results:There was a significant difference between CT and DR in judging s-shaped small shadows and no small shadows ( P<0.05), and there was no statistically significant difference in judging p, q, r, t, and u-shaped small shadows ( P>0.05). CT and DR had medium to high consistency in the judgment of the overall density of small shadows (Kappa=0.692, P=0.001), and the diagnostic coincidence rate was 82.38% (201/244). There was moderate to high agreement between CT and DR in the density of small shadows shown in the right upper, right lower, left upper, left middle, and left lower lung regions (Kappa ranged from 0.40 to 0.75, P<0.05), and the consistency in the right middle lung region was poor (Kappa=0.381, P=0.001). Eleven large shadows were detected in 8 cases by DR, 31 large shadows were detected in 23 cases by CT, and 20 (8.20%) large shadows were detected more frequently by CT than DR. The agreement between CT and DR for the diagnosis and staging of silicosis was excellent (Kappa=0.843, P=0.001), and the diagnostic coincidence rate was 91.80% (224/244). Conclusion:Applying the method of determining the density of small shadows in the lung area of pneumoconiosis and reference films, combined with GBZ70-2015 Diagnosis of Occupational Pneumoconiosis, can make a more accurate diagnosis of silicosis.