Objective To investigate the prognostic value of alanine aminotransferase(ALT)/alkaline phosphatase(ALP)ratio,platelet(PLT)count/lymphocyte(LYM)ratio(PLR)in elderly patients with septic shock complicated with liver injury.Methods The clinical data of 116 patients with septic shock complicated with liver injury were retrospectively analyzed.According to the degree of liver injury,patients were divided into the mild group(39 cases),the moderate group(47 cases)and the severe group(30 cases).According to the survival of patients 28 days after admission,patients were divided into the death group(69 cases)and the survival group(47 cases).Acute physiological score,chronic healthⅡ(APACHE Ⅱ)score and sequential organ failure(SOFA)score were collected.PLT and LYM in peripheral blood were detected,and PLR was calculated.ALT and ALP were measured and ALT/ALP ratio was calculated.White blood cell count,blood lactic acid,C-reactive protein and other laboratory indicators were detected.Multivariate Logistic regression was used to analyze prognostic factors of patients with septic shock complicated with liver injury.The predictive values of ALT/ALP ratio and PLR on the prognosis of patients with septic shock complicated with liver injury were analyzed by receiver operating characteristic(ROC)curve.Results Serum ALT and ALP levels,ALT/ALP ratio,PLT and PLR were increased successively in the mild group,the moderate group and the severe group,while LYM was decreased successively in the three groups(P＜0.05).The age,APACHE Ⅱ score,SOFA score,PLR,ALT/ALP ratio and blood lactic acid level were higher in the death group than those in the survival group(P＜0.05).There was no significant difference in liver injury degree between the two groups(P＜0.05).Multivariate Logistic regression analysis showed that high SOFA score,high PLR,high ALT/ALP ratio and moderate to severe liver injury were risk factors for death in patients with septic shock complicated with liver injury.ROC curve analysis showed that the combined ALT/ALP ratio and PLR prediction efficiency[area under the curve 0.915(95%CI:0.849-0.959),sensitivity and specificity 94.20%and 89.36%,respectively]was superior to single prediction(P＜0.05).Conclusion Increased ALT/ALP ratio and PLR are associated with aggravation of liver injury and poor prognosis in patients with septic shock.ALT/ALP ratio and PLR can be used as prognostic markers.

OBJECTIVETo apply low-dose multi spiral computed tomography (MSCT) chest scans in the early diagnosis and differential diagnosis of pneumoconiosis.

METHODSOne hundred and twenty dust-exposed volunteers were examined by MSCT chest scans at conventional dose and low dose, and the results of conventional-dose scans were set as the gold standard. Comparative analysis was performed on the major CT findings and quality of post-processing images, including 1.5 mm and 5.0∼10.0 mm thick high -resolution reconstructed images, multiplanar reformat images, and maximum intensity projection images.

RESULTSOne hundred and twenty cases of small circular shadows, 36 cases of ribbon shadows in pulmonary parenchyma, 1 case of honeycombing shadow, and 13 cases of big shadows were all showed on low -dose MSCT. But 94 (95.9%) of 98 cases of interlobular septal thickening shadows and 98 (93.3%) of 105 cases of short branched shadows were detected on low-dose MSCT. There were no significant differences in display of the mentioned large and small shadows between low-dose scans and conventional-dose scans (P > 0.05). Eighty-five cases of small airway disease, 8 cases of pulmonary inflammatory lesions, and 47 cases of hilar and mediastinal lymph node swelling were all detected by MSCT. As for the 46 cases of emphysema, 38 (82.6%) were shown. The low-dose MSCT images of 1.5 mm thickness had more artifacts than those of other thickness. The radiation dose of low-dose MSCT was about 1/3-1/5 of that in the conventional-dose MSCT.

CONCLUSIONThere is no difference in display of pneumoconiosis between low-dose and conventional-dose MSCT chest scans. With lower radiation dose, low-dose MSCT can be applied in the diagnosis of pneumoconiosis.

Adult ; Aged ; Dust ; Female ; Humans ; Lung ; diagnostic imaging ; Male ; Middle Aged ; Occupational Exposure ; Pneumoconiosis ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Objective To investigate the concentration of Golgi glycoprotein 73(GP73) in ascites, then study the value of GP73 and alpha fetal protein(AFP)in the differential diagnosis of ascites.Methods Totally 96 malignant ascites specimens , 35 benign ascites specimens and their paired serum specimens were collected in the Tumor Hospital Affiliated to Xinjiang Medical University from November 2012 to November 2013.GP73 in serum and ascites were detected by ELISA and AFP in ascites was measured by electrochemical luminescence.The application values of GP 73 and AFP were evaluated through ROC curve.Results In benign ascites group , the difference of GP73 between the ascites ( 16.06 ±9.53 ) ng/ml and the serum (13.69 ±8.87) ng/ml was statistically significant (t=5.026,P<0.001), which showed a good linear correlation (r=0.966,P<0.001).In malignant ascites group, the difference between the ascites (28.37 ±12.02) ng/ml and the serum (16.06 ±9.53) ng/ml was statistically significant (t=10.641,P<0.001), and also showed a good linear correlation (r=0.933,P<0.001).The cutoff values of GP73, AFP and GP73*AFP (GP73 multiplied AFP) for diagnosing the malignant ascites were 17.1 ng/ml, 13.1 ng/ml and 321.The area under ROC curve ( AUC) were 0.795, 0.753 and 0.902 respectively.The AUC of GP73*AFP is the largest.The sensitivity of three index diagnosing the ascites , were 89.6%( 86/96 ) , 88.5%(85/96) and 86.4%(83/96); and the specificity were 60.0%(21/35), 54.2%(19/35) and 85.7%( 30/35 ) respectively.Conclusions Detection of GP73 in ascites specimens has clinical value , GP73*AFP was the best indicators for differential diagnosis of benign and malignant ascites compared to GP73 and AFP.