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Objective:To explore the clinical value of heparin binding protein (HBP) in bronchoalveolar lavage fluid (BALF) for diagnosis and differential diagnosis of bacterial pneumonia.Methods:Eighty eight patients with pulmonary infection from the respiratory department of the Fourth Affiliated Hospital of Anhui Medical University from January 2019 to January 2021 were enrolled in the study, including 48 cases of bacterial pneumonia and 40 cases of non-bacterial pneumonia; meanwhile, 40 non-pulmonary infection patients were also enrolled as the control group. The BALF levels of HBP, procalcitonin (PCT), interleukin-6 (IL-6) were measured, and the clinical values of the above indexes in differential diagnosis of bacterial and non-bacterial pneumonia were analyzed.Results:The BALF levels of HBP and IL-6 in bacterial pneumonia group were significantly higher than those of the non-bacterial pneumonia group and the control group ( P<0.05). ROC curve showed that the areas under the curve (AUC) of HBP and IL-6 were 0.930 and 0.893 for the early diagnosis of bacterial pneumonia; and the sensitivity was 88.5% and 82.7%, the specificity was 92.5% and 92.5%, respectively. Combined detection of HBP and IL-6, the AUC was 0.942 and the sensitivity was 94.2% and the specificity was 95.0%. When they were used to distinguish bacterial pneumonia, the AUC of HBP and IL-6 were 0.890 and 0.777, and the sensitivities were 80.8% and 71.2%, and the specificity were 91.7% and 75.0%, respectively. Combined detection of HBP and IL-6, the AUC was 0.902, and the sensitivity was 96.2% and the specificity was 79.2%. Conclusions:BALF HBP and IL-6 have good clinical value in the early diagnosis and distinguishing bacterial pulmonary infection and the joint value of the two is better.
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Objective To explore the CT characteristics of mycobacteria intracellulare lung disease.Methods CT imaging data of 37 patients with mycobacteria intracellulare lung disease in our hospital were analyzed retrospectively.Results The main CT signs of mycobacteria intracellulare lung disease included centrilobular nodules (97.3%), bronchiectasis (73.0%) and patchy consolidation (54.1%).Fibrous lesion(43.2%), diameter≥1 cm nodules(35.1%)and thin-wall cavity(29.7%) were also common found in patients.Thick-wall cavity and pleural effusion were not common.The typical CT manifestation was bronchiectasis accompany by the centrilobular nodules occurred in the right middle lobe and (or) left lingular lobe.Conclusion CT manifestations of mycobacteria intracellulare lung disease have some characteristics, and CT examination has a certain value in the diagnosis of this disease.
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Objective To investigate the normal anatomy and variation of Willis circle by 64-slice volume CT digital subtraction angiography(VCTDSA).Methods VCTDSA data of 174 patients with cephalocervical and cephalic scanning in our hospital from February 2006 to September 2008 were analyzed.Developmental condition,shape,size,integrity,and perforating branches of Willis circle were observed.Results(1) Hypoplasia was displayed in any component vessels of Willis circle.Incidence rate of hypoplasia was 20.1% in left posterior communicating artery,16.1% in right posterior communicating artery,13.8% in right anterior cerebral artery A1,9.2% in right posterior cerebral artery P1,7.3% in anterior communicating artery,6.3% in left posterior cerebral artery P1,and 3.4% in left anterior cerebral artery A1.Congenital arterial absence occurred more frequently in right posterior communicating artery(54.6%),left posterior communicating artery(52.3%),and anterior communicating artery(15.8%).(2) Hypoplasia or congenital absence of posterior circulation and anterior-posterior circulation occurred with a rate of 55.8% and 29.8% respectively.Integrity of Willis circle was only 9.2%.There were 17 perforating branches and 26 heubner inversion arteries observed in 174 Willis circle,with an average diameter of 0.82 mm and 0.94 mm respectively.Conclusion VCTDSA can display Willis circle completely and clearly.Using three-dimensional rotation may detect all kinds of variation and perforating branches of Willis circle.