低剂量CT视觉亚型联合定量参数预测慢性阻塞性肺疾病的价值

目的探讨低剂量CT视觉亚型联合定量参数预测慢性阻塞性肺疾病(COPD)的价值。方法回顾性分析2021年1月至2022年3月在厦门大学附属第一医院因咳嗽、咳痰或呼吸短促/困难就诊的吸烟或既往吸烟172例患者的临床及影像资料。所有患者均接受肺功能检测及CT检查。根据全球慢性阻塞性肺疾病倡议诊断标准,172例患者分为非COPD组(79例)和COPD组(93例)。分析患者的影像视觉亚型分级并测量CT图像上肺密度低于-950 HU的百分比(LAA-950)、支气管壁厚度(WT)、支气管腔面积百分比(WA%)。2组间视觉亚型分级及CT参数的比较使用Mann-Whitney U检验,将差异有统计学意义的指标纳入多因素logistic回归分析,筛选出预测COPD的独立危险因素。最终建立临床特征联合CT影像特征的logistic预测模型,并采用受试者操作特征曲线的曲线下面积(AUC)分析模型预测COPD的效能。结果COPD组患者年龄及咳嗽、咳痰比例高于非COPD组,体重指数低于非COPD组(P<0.05)。在影像学特征中,COPD组与非COPD组间的影像视觉亚型、LAA-950、WT、WA%差异均具有统计学意义(P<0.001)。多因素logistic回归分析中,年龄(OR=1.06,95%CI 1.02~1.10,P=0.002)、咳痰(OR=2.86,95%CI 1.37~5.97,P=0.005)、影像视觉亚型(OR=1.73,95%CI 1.30~2.30,P<0.001)是预测COPD的独立危险因素。最终以年龄、体重指数、咳嗽/咳痰、影像视觉亚型分级、LAA-950、WA%联合构建logistic预测模型,其预测COPD的AUC为0.903,灵敏度为82.8%,特异度为81.0%。结论基于低剂量CT的LAA-950、视觉亚型分级和WA%联合临床特征诊断COPD具有良好的临床价值。

The National Monument in Indonesia： The Visual Art in Sacred Space

The paper is a part of the dissertation to reveal the psyche of the Ruler as the authorized man created the ＂space＂ in the Monument National in Indonesia, through investigation related metaphysically data as a process to having qualities becoming to ＂Indonesia＂. By using the Grounded Theory research method, which refers to Glaser and Strauss, phenomenological observations and Hermeneutic-lnterpretive method of Ricouer, the process of deriving quality form an architectural presence is revealed. By connecting the Spatial Archetype Theory of LobeU, the paper reveals the ＂inflated ego of the Ruler as Leader＂ was manifested by symbol rays of Radiant Axes civilization through Soekarno＇s unconsciousness thought of space. The presence of architecture the National Monument serves not merely as a city landmark, but more than that, it roles as the center of orientation and development for a Jakarta Master plan conceived 50 years ago and still maintained to this day as the basic of the Jakarta City Planning 2030 In effect, this means that the National Monument plays the role as the axis of Indonesia＇s modem civilization.