ABSTRACT
Paraquat poisoning has become a serious public health problem in some Asian countries because of misuse or suicide. We sought to develop and validate a radiomics nomogram incorporating radiomics signature and laboratory bio-markers, for differentiating bacterial pneumonia and acute paraquat lung injury. 180 patients with pneumonia and acute paraquat who underwent CT examinations between December 2014 and October 2017 were retrospectively evaluated for testing and validation. Clinical information including demographic data, clinical symptoms and laboratory test were also recorded. A prediction model was built by using backward logistic regression and presented on a nomogram. The radiomics-based features yielded areas under the receiver operating characteristic curve of 0.870 (95% CI 0.757-0.894), sensitivity of 0.857, specificity of 0.804, positive predictive value of 83.3%, negative predictive value of 0.818 in the primary cohort, while in the validation cohort the model showed similar results (0.865 (95% CI 0.686-0.907), 0.833, 0.792, 81.5%, respectively). The individualized nomogram included radiomics signature, body temperature, nausea and vomiting, and aspartate transaminase. We have developed a radiomics nomogram that combination of the radiomics features and clinical risk factors to differentiate paraquat lung injury and pneumonia for patients with an unclear medical history of exposure to paraquat poisoning, providing appropriate therapy decision support.
Subject(s)
Nomograms , Pneumonia/diagnosis , Pulmonary Edema/diagnosis , Tomography, X-Ray Computed , Acute Disease , Acute Lung Injury , Adult , Algorithms , Calibration , Clinical Decision-Making , Cohort Studies , Diagnosis, Differential , Female , Humans , Male , Pneumonia/diagnostic imaging , Pulmonary Edema/diagnostic imaging , ROC Curve , Reproducibility of ResultsABSTRACT
Objective To investigate the effect of electroacupuncture on acupoint local extracellular ionized atom concentrations under physiological status and provide a basis for exploring the mechanism of action of electroacupuncture. Method Twenty male SD rats were selected. Rat point Zusanli (ST36) was given electroacupuncture (1 mA, 0.2 ms and 2 Hz) for 60 min. Meanwhile, local tissue fluid was collected at point Zusanli and non-acupoints using a microdialyzer. The collection by molecular probe membrane sampling lasted 4 hrs: 60 min physiological status before electroacupuncture, 60 min electroacupuncture, 60 min after electroacupuncture and 120 min after electroacupuncture. Real-time analysis of the sample was made by electrolyte analysis to observe local changes in concentrations of Ca﹢﹢, K﹢, Na﹢and Cl- at point Zusanli. Result Local Ca﹢﹢concentrations at point Zusanli increased significantly during electroacupuncture (P=0.003, vs before electroacupuncture), rose gradually afterwards and reached the peak at 60 min after electroacupuncture (P=0.75, vs during electroacupuncture). Ca﹢﹢concentrations decreased at 120 min after electroacupuncture; there was a statistically significant difference comparedwith during electroacupuncture (P=0.04). Acupoint local extracellular concentrations of Na ﹢ and Cl- also increased significantly during electroacupuncture (P0.05). Conclusion Rat point Zusanli electroacupuncture can induce significant increases in acupoint local extracellular concentrations of Ca﹢﹢, K﹢, Na﹢and Cl- . Ionized atom concentrations decrease in different degrees after electroacupuncture. These provide an experimental basis for studying the physiological mechanism of electroacupuncture treatment.