ABSTRACT CONTEXT: Scrub typhus, caused by Orientia tsutsugamushi, has a wide range of clinical manifestations, including meningoencephalitis, acute renal failure, pneumonitis, myocarditis, and septic shock. However, there are no documented cases of scrub typhus with hypokalemia. In this report, we present a case of scrub typhus with hypokalemia and multiple organ failure syndrome, highlighting the importance of electrolyte imbalance in patients with scrub typhus. CASE REPORT: A 59-year-old woman presented to the emergency department with abdominal pain that had been present for 1 day. On admission, the physical examination and laboratory test results indicated that the patient had renal, liver, and circulatory failure, and hypokalemia. She developed meningitis and disseminated intravascular coagulation during hospitalization. She recovered with appropriate management, and was discharged on day 17. CONCLUSION: This report highlights the potential for atypical presentations of scrub typhus, including a previously undocumented association with hypokalemia. Although the contribution of hypokalemia to the patient’s clinical course remains uncertain, this case underscores the importance of considering electrolyte imbalance in the management of patients with scrub typhus. Further research is warranted to better understand the relationship between scrub typhus and electrolyte imbalance. CONTEXT tsutsugamushi manifestations meningoencephalitis pneumonitis myocarditis shock However syndrome REPORT 59yearold yearold 59 year old admission liver hospitalization 17 CONCLUSION s uncertain 5

ABSTRACT Despite good hepatitis B virus (HBV) inhibition by nucleoside analogs (NAs), cases of hepatocellular carcinoma (HCC) still occur. This study proposed a non-invasive predictive model to assess HCC risk in patients with chronic hepatitis B (CHB) receiving NAs treatment. Data were obtained from a hospital-based retrospective cohort registered on the Platform of Medical Data Science Academy of Chongqing Medical University, from 2013 to 2019. A total of 501 patients under NAs treatment had their FIB-4 index updated semiannually by recalculation based on laboratory values. Patients were divided into three groups based on FIB-4 index values: < 1.45, 1.45–3.25, and ≥ 3.25. Subsequently, HCC incidence was reassessed every six months using Kaplan-Meier curves based on the updated FIB-4 index. The median follow-up time of CHB patients after receiving NAs treatment was 2.5 years. HCC incidences with FIB-4 index < 1.45, 1.45–3.25, and ≥ 3.25 were 1.18%, 1.32%, and 9.09%, respectively. Dynamic assessment showed that the percentage of patients with FIB-4 index < 1.45 significantly increased semiannually (P < 0.001), and of patients with FIB-4 index ≥ 3.25 significantly decreased (P < 0.001). HCC incidence was the highest among patients with FIB-4 index ≥ 3.25. The FIB-4 index effectively predicted HCC incidence, and its dynamic assessment could be used for regular surveillance to implement early intervention and reduce HCC risk. HBV (HBV NAs, , (NAs) (HCC occur noninvasive non invasive (CHB hospitalbased hospital University 201 2019 50 FIB4 FIB 4 FIB- values 145 1 45 145325 3 25 1.45–3.25 325 Subsequently KaplanMeier Kaplan Meier followup follow up 2 5 2. years 3.2 118 18 1.18% 132 32 1.32% 909 9 09 9.09% respectively 1.4 P 0.001, 0001 0.001 0 001 0.001) 0.001. . (NAs 20 14 14532 1.45–3.2 3. 11 1.18 13 1.32 90 9.09 1. 000 0.00 00 1453 1.45–3. 1.1 1.3 9.0 0.0 1.45–3 9. 0. 1.45–

Abstract Objective To explore whether Cyclic Adenosine Monophosphate (cAMP)-Epac1 signaling is activated in 1-Desamino-8-D-arginine-Vasopressin-induced Endolymphatic Hydrops (DDAVP-induced EH) and to provide new insight for further in-depth study of DDAVP-induced EH. Methods Eighteen healthy, red-eyed guinea pigs (36 ears) weighing 200-350 g were randomly divided into three groups: the control group, which received intraperitoneal injection of sterile saline (same volume as that in the other two groups) for 7 consecutive days; the DDAVP-7d group, which received intraperitoneal injection of 10 mg/mL/kg DDAVP for 7 consecutive days; and the DDAVP-14d group, which received intraperitoneal injection of 10 μg/mL/kg DDAVP for 14 consecutive days. After successful modeling, all animals were sacrificed, and cochlea tissues were collected to detect the mRNA and protein expression of the exchange protein directly activated by cAMP-1 and 2 (Epac1, Epac2), and Repressor Activator Protein-1 (Rap1) by Reverse Transcription (RT)-PCR and western blotting, respectively. Results Compared to the control group, the relative mRNA expression of Epac1, Epac2, Rap1A, and Rap1B in the cochlea tissue of the DDAVP-7d group was significantly higher (p< 0.05), while no significant difference in Rap1 GTPase activating protein (Rap1gap) mRNA expression was found between the two groups. The relative mRNA expression of Epac1, Rap1A, Rap1B, and Rap1gap in the cochlea tissue of the DDAVP-14d group was significantly higher than that of the control group (p< 0.05), while no significant difference in Epac2 mRNA expression was found between the DDAVP-14d and control groups. Comparison between the DDAVP-14d and DDAVP-7d groups showed that the DDAVP-14d group had significantly lower Epac2 and Rap1A (p< 0.05) and higher Rap1gap (p < 0.05) mRNA expression in the cochlea tissue than that of the DDAVP-7d group, while no significant differences in Epac1 and Rap1B mRNA expression were found between the two groups. Western blotting showed that Epac1 protein expression in the cochlea tissue was the highest in the DDAVP-14d group, followed by that in the DDAVP-7d group, and was the lowest in the control group, showing significant differences between groups (p< 0.05); Rap1 protein expression in the cochlea tissue was the highest in the DDAVP-7d group, followed by the DDAVP-14d group, and was the lowest in the control group, showing significant differences between groups (p< 0.05); no significant differences in Epac2 protein expression in the cochlea tissue were found among the three groups. Conclusion DDAVP upregulated Epac1 protein expression in the guinea pig cochlea, leading to activation of the inner ear cAMP-Epac1 signaling pathway. This may be an important mechanism by which DDAVP regulates endolymphatic metabolism to induce EH and affect inner ear function. Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence Level 5. cAMPEpac1 cAMPEpac cAMP Epac (cAMP)-Epac 1Desamino8DarginineVasopressininduced DesaminoDarginineVasopressininduced 1 Desamino 8 D arginine Vasopressin induced DDAVPinduced indepth depth healthy redeyed red eyed 36 (3 ears 200350 200 350 200-35 same days DDAVP7d DDAVPd 7d d mgmLkg mg mL kg DDAVP14d 14d μgmLkg μg modeling sacrificed cAMP1 cAMP- (Epac1 , Epac2) Protein1 Protein Protein- Rap (Rap1 RTPCR RT PCR respectively RapA A RapB B p< p 0.05, 005 0.05 0 05 Rapgap gap (Rap1gap cAMP-Epac pathway function EvidenceBased Based 201 5 DarginineVasopressininduced 3 ( 20035 20 35 200-3 (Epac (Rap 00 0.0 2003 200- 0.

Abstract This study looked at the inhibitory effects of Apocynum venetum tea flavonoids extract (AVTFE) on mouse glioma G422 cells. Through the use of high performance liquid chromatography, the flavonoids in AVTFE were examined (HPLC). Meanwhile, mice were injected with glioma G422 cells to create a mouse model of a transplanted tumor. AVTFE might significantly (P < 0.05) lower serum sIL-2R content and raise serum IFN-γ content in tumor-bearing mice, according to an analysis of mouse serum. In addition to reducing the rise in spleen weight and spleen index in mice brought on by transplanted tumors, AVTFE can limit the development of transplanted tumors in G422 cell mice. AVTFE can also boost immunity by encouraging T and B lymphocyte proliferation in tumor-bearing animals. AVTFE was therefore verified to have immunomodulatory properties and to limit the proliferation of glioma G422 cells.

Abstract A number of complications have been ascribed to shoulder arthroscopy, but pulmonary edema is rarely reported. A 64-year-old female underwent right shoulder arthroscopic repair for supraspinatus and subscapular tears under intermuscular sulcus brachial plexus block (ISBPB) and general anesthesia. Finishing suture of torn tendon, and acromion and distal clavicle plasty, the patient represented the symptoms of dyspnea, and oxygen saturation quickly dropped to 80% without oxygen supply. After inhaled oxygen, the oxygen saturation quickly returned to 95%, while dyspnea didn’t improve. Noticing swelling in neck and chest, left movement of the trachea, low breath sounds and wet rales during auscultation, ultrasound examination was performed and found the obvious pleural slip, and a large number of b-lines in the lung, indicating pulmonary edema. After injection of furosemide and dexamethasone (i.v.), the outcome of patient was satisfactory. This is the first report of pulmonary edema as a complication of shoulder arthroscopy, which also reviews the relevant factors of fluid extravasation, and highlights the good use of the equipment at hand to quickly judge the patient's condition.

ABSTRACT Low light levels during rice (Oryza sativa L.) growing seasons may lead to significant reductions in grain yield and quality. The effect of shading stress on remobilization of nonstructural carbohydrates (NSC) from the stem plus sheath (SPS) to the grain, a process crucial to rice grain formation, was investigated. Field shading experiments were conducted in Hanyuan and Wenjiang, China, using two rice varieties (Huanghuazhan and Guichao II) subjected to shading stress after heading. Stored NSC of 60.00-159.15 g m-2 were remobilized from SPS after heading, contributing 9.63%-23.63% to grain dry weight at maturity. Shading stress resulted in the 23.99%-50.30% and 31.65%-61.33% reduction in NSC content of SPS at 20 d after heading (DAH20) and maturity stages, respectively. This contributed to the 13.80%-89.00% increase in the remobilization of stored NSC from SPS to the grain (RASN) and 15.86%-73.30% increase in remobilization percentage of removed NSC from SPS to the grain (RPRN). The effect of shading stress on remobilization differed between sites and varieties. Owing to a greater sink capacity, shading stress led to a higher RASN and RPRN from heading to DAH20 for ‘Huanghuazhan’ in Hanyuan. To compensate for photosynthate deficiency under shading stress, rice is adapted to remobilize stored NSC during early grain filling stages. Consequently, grain yield loss caused by shading could be reduced by increasing the SPS remobilization ability (especially in low light areas). Increasing NSC accumulation in SPS before heading for later remobilization may be a feasible way to alleviate rice yield loss under adverse light conditions.

The prognosis of COVID-19 (coronavirus disease 2019) is usually poor when it occurs in aged adults or in patients with chronic diseases, which brought a great challenge to clinical practice. Furthermore, widespread depression, anxiety, and panic related to SARS-CoV-2 (severe acute respiratory syndrome-coronavirus 2) infection affected treatment compliance and recovery. Here we report the successful treatment of a 57-year-old male with severe COVID-19, schizophrenia, hypertension, and type 2 diabetes. The patient's negative emotions (such as tension, panic, and anxiety), particularly his aggression and paranoia, seriously hindered treatment, leading to a deteriorating condition. Psychological counseling and supportive psychotherapy were given but the effect was weak. To improve adherence, risperidone and quetiapine fumarate were replaced by olanzapine for anti-schizophrenic treatment to reduce insomnia and anxiety side effects, associated with sedative-hypnotic drugs as well as psychological counseling. The treatment compliance of the patient improved significantly. The patient's serum alanine aminotransferase increased abnormally in the late stage of hospitalization, suggesting potential liver damage after complex medication strategies. We also monitored the changes of lymphocyte subsets and retrospectively analyzed the virus-specific antibody response. The results suggested that dynamic monitoring of lymphocyte subsets and virus-specific antibody response could facilitate disease progression evaluation and timely treatment plan adjustments. An effective psychotropic drug intervention associated with psychological counselling and psychotherapy are essential for the successful adherence, treatment, and rehabilitation of psychiatric disorders in COVID-19 patients.

Abstract Rock materials are often subjected to cyclic loads during construction. A full understanding of the deformation behavior of rock under cyclic loads is of great significance in engineering. In this study, by using the endochronic constitutive model proposed by Valanis, the reinforcement function form and constitutive parameters of the endochronic model are improved. An endochronic plasticity constitutive program for rock based on the finite element method is used to study the mechanical properties of rock under different cyclic loading conditions (of maximum loading stress, amplitude, and confining pressure), and through the use of red sandstone, marble, and basalt, experimental and simulation results are compared to verify the model. The results show that the theory can better simulate the hysteresis loop width and cumulative plastic strain of rock under cyclic loading and, under different loading conditions, the numerical simulation results are consistent with the actual rock experimental law. Therefore, the endochronic plasticity constitutive model in this study can be applied to investigate the influence of cyclic loading on the dynamic deformation behavior of rock.

RESUMO Para explorar o Impacto Da formação funcional Na qualidade de conclusão Da dificuldade do corpo, OS ginastas rítmicos 24.o com Dez Anos de idade 10-11 foram aleatoriamente divididos EM Grupo de formação funcional Ou Grupo de controlo e EM formação contínua 2h/dia para um mês.A dificuldade do corpo, incluindo dificuldades de equilíbrio, dificuldades de rotação, dificuldades de Salto foram medidas antes e depois Da formação.Os resultados mostraram pontuação total, pontuação Da rotação de Passos de 360°e Salto Split no Grupo de treinamento funcional FOI respectivamente 1.87, 0.77 e 0.42 Pontos Mais elevados do que aqueles no Grupo de controle (todos P<0.05) após o treinamento de um mês. Por conseguinte, Pode concluir-se que a formação funcional baseada no SGF Pode obviamente melhorar a qualidade de conclusão Da dificuldade corporal Da ginástica rítmica juvenil num curto período de tempo.

ABSTRACT To explore the impact of functional training on completion quality of body difficulty, 24 rhythmic gymnasts aged 10-11 years old were randomly and averagely divided into functional training and control group and trained 2h/day for 1 month. Body difficulty – including balance, rotation, and leap difficulties – was measured before and after training. The results showed that the total score, the score of 360° passé pivot and the score of split leap for the functional training group was respectively 1.87, 0.77, and 0.42 points higher than those for the control group (P<0.05) after 1 month of training. Therefore, it can be concluded that functional training based on Functional Movement Screen (FMS) can clearly improve completion quality of body difficulty in juvenile rhythmic gymnastics within a short period of time.

RESUMEN Los resultados mostraron que el grupo de control y el grupo de gimnasia rítmica de 10 a 11 años de edad fueron de dos horas de entrenamiento al día durante un mes. Las dificultades físicas, incluidas las dificultades de equilibrio, rotación y salto, se miden antes y después del entrenamiento. Los resultados mostraron que la puntuación total, la puntuación de 360°passe pivot y la puntuación de split-jump fueron respectivamente 1,87, 0,77 y 0,42 mayores en el grupo de entrenamiento funcional que en el grupo control después de 1 mes de entrenamiento (P< 0,05). Los resultados muestran que el entrenamiento funcional basado en la detección de movimiento funcional (FMS) puede mejorar significativamente la calidad de la realización de las dificultades físicas en la gimnasia rítmica de los adolescentes en un corto período de tiempo.

This study aimed to investigate whether the routine administration of escitalopram for three months would improve the prognosis of patients with ischemic stroke and decrease the plasma copeptin level. A total of 97 patients with acute cerebral infarction were randomly allocated to receive escitalopram (5-10 mg once per day, orally; n=49) or not to receive escitalopram (control group; n=48) for 12 weeks starting at 2-7 days after the onset of stroke. Both groups received conventional treatments, including physiotherapy and secondary prevention of stroke. The National Institutes of Health Stroke Scale (NIHSS) score was used to evaluate the disability of patients at the initial evaluation and at the monthly follow-up visits for three months. Impairment in the daily activities was assessed using the Barthel Index (BI), while cognitive impairment was assessed using Mini-Mental State Examination (MMSE) score. The psychiatric assessment included the administration of the Present State Examination modified to identify Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) symptoms of depression. The severity of depression was measured using the 17-item Hamilton Rating Scale for Depression (HAMD). During the 3-month follow-up period, 95 patients were included in the analysis (two patients withdrew from the escitalopram group). NIHSS and BI improvement at the 90th day were significantly greater in the escitalopram group (P<0.05), while HAMD and plasma copeptin levels significantly decreased, compared to the control group (P<0.01). In patients with acute ischemic stroke, the earlier administration of escitalopram for three months may improve neurological functional prognosis and decrease copeptin level.

ABSTRACT Purpose: To systematically assess the effectiveness and safety of retrograde flexible ureteroscopy (FURS) versus percutaneous nephrolithotomy (PCNL) in treating intermediate-size renal stones (2-3cm). Materials and Methods: PubMed, Ovid MEDLINE, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE were researched to identify relevant studies up to May 2018. Article selection was performed through the search strategy based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. The Newcastle-Ottawa Scale was applied to assess the methodological quality of case-control studies. Results: Six retrospective case-controlled trials were included for meta-analysis. The pooled results showed that PCNL was associated with a higher initial stone-free rate (SFR). After more complementary treatments, FURS provided a final SFR (OR: 1.69; 95% CI, 0.93-3.05; P = 0.08) comparable to that achieved by PCNL. PCNL was associated with a higher rate of overall intraoperative complications (OR: 1.48; 95% CI, 1.01-2.17; P = 0.04) and longer hospital stay (MD: 2.21 days; 95% CI, 1.11 to 3.30; P < 0.001). Subgroup analysis by Clavien-graded complication showed PCNL had significantly higher rates of minor complications (OR: 1.58; 95% CI, 1.04-2.41; P = 0.03). No significant difference was noted in major complications (OR: 1.14; 95% CI, 0.53-2.45; P = 0.73) or operative times (MD: −9.71 min; 95% CI, −22.02 to 2.60; P = 0.12). Conclusions: Multisession FURS is an effective and safe alternative to PCNL for the management of intermediate-size renal stones (2-3cm). It is advisable to balance the benefits and risks according to the individual characteristics of patients and to decide with patients by discussing the advantages and disadvantages of each procedure.

RESUMO Racional: As características clínicas são fundamentais para melhorar a identificação e o tratamento da doença de Crohn (DC), de modo que a análise da amostra seja de grande valor. Objetivo: Explorar as características clínicas da DC fistulizante perianal. Métodos: Análise de 139 casos focados em seus dados clínicos. Resultados: A proporção de homens e mulheres foi de 3,3: 1; a média de idade de 28,2 anos; 47,5% dos pacientes tiveram fístula anal antes do diagnóstico de DC. Pacientes com cirurgia perianal prévia e medicação representaram 64,7% e 74,1%, respectivamente. O tipo de lesão L3 estava presente em 49,6% e os tipos B1 e B2, em 51,8% e 48,2%, respectivamente; fístula anal complexa foi diagnosticada em 90,6%. Sintomas de diarréia foram encontrados em 46% e lesões perianais isoladas em 29,5% dos pacientes. Valores anormais de IMC estavam presentes em 44,6%; índice de atividade DC ativa em 64,7%; e 94,2% tinham índice de atividade de doença perianal ativo. Proporção significativa de pacientes tinha proteína-C reativa, taxa de sedimenta do eritrócito, plaquetas hemoglobina e albumina anormais. Conclusão: Sugere-se que pacientes com fístula anal associada às essas características clínicas alertem a equipe médica para a possibilidade de DC, que deve ser investigada por endoscopia e exame de imagem do trato digestivo para evitar dano na função anal pela operação que rotineiramente é realizada no tratamento da fístula anal.

ABSTRACT Background: Clinical characteristics are keys to improve identification and treatment of Crohn´s disease (CD) so that large sample analysis is of great value. Aim: To explore the clinical characteristics of perianal fistulising CD. Methods: Analysis of 139 cases focused on their clinical data. Results: The proportion of males and females is 3.3:1; the mean age is 28.2 years; 47.5% of patients had anal fistula before CD diagnosis. Patients with prior perianal surgery and medication accounted for 64.7% and 74.1% respectively. The L3 type of lesion was present in 49.6% and the B1 and B2 types for 51.8% and 48.2% respectively; complex anal fistula was diagnosed in 90.6%. Symptoms of diarrhea were found in 46% and perianal lesions alone in 29.5% of patients. Abnormal BMI values was present in 44.6%; active CD activity index in 64.7%; and 94.2% had active perianal disease activity index. A proportion of patients manifest abnormal C-reactive protein, erythrocyte sedimentation rate, platelet, hemoglobin and albumin. Conclusion: We suggest that patients with anal fistula associated to these clinical features should alert the medical team to the possibility of CD, which should be further investigated through endoscopy and imaging examination of alimentary tract to avoid the damage of anal function by routine anal fistula surgery.

RESUMEN La influencia de la composición de lutitas en la capacidad de absorción del metano y el contenido de gas se analiza en este trabajo a partir de 14 muestras del pozo YS8 en la cuenca de Sichuan, al suroeste de China. Los resultados muestran que la capacidad de absorción Langmuir para las lutitas de Longmaxi es principalmente una función del contenido de Carbono Orgánico Total (TOC, del inglés Total Organic Carbon). Cuando el índice TOC es el 50 % del CH4 (capacidad máxima de absorción de la función Langmuir) es absorbido por la superficie de materia orgánica. El contenido mineral tiene un control limitado en la capacidad de absorción de las lutitas de Longmaxi. La materia orgánica también tiene un control mayor en el contenido de gas cuando el índice TOC es <1.0 %. Cuando el TOC es >1.0 %, el contenido del gas es constante, lo que indica que la preservación del gas es más importante que la generación del gas, y la capacidad de absorción de la roca. Diagramas de dispersión del TOC frente al contenido de Gas y de la capacidad de absorción Langmuir muestran que el TOC es <2.0 %, que el CH4 se alcanza tanto en gas libre como en gas absorbido y que este ocurre principalmente cuando el gas absorbido tiene un nivel TOC de >2.0 %.

ABSTRACT The influence of shale composition on methane adsorption capability and gas content is investigated using 14 samples from Well YS8 in the southern Sichuan Basin, China. The results show that the Langmuir adsorption capacity of the Longmaxi shale is mainly a function of the total organic carbon (TOC) content. When TOC is ~1.1%, 50% CH4 is adsorbed onto the surface of the organic matter. The mineral content has limited control on the adsorption capacity of the Longmaxi shales. Organic matter is also a major control on gas content when TOC content is <1.0%. When TOC is >1.0%, gas content remains constant, indicating that gas preservation is more important than gas generation and rock adsorption capacity. Scatter plots of TOC versus gas content and, Langmuir adsorption capacity shows that when TOC is <2.0%, CH4 occurs both as free and absorbed gas, and CH4 occurs mainly as absorbed gas when TOC is >2.0%.

This meta-analysis was designed to elucidate whether preoperative signal intensity changes could predict the surgical outcomes of patients with cervical spondylosis myelopathy on the basis of T1-weighted and T2-weighted magnetic resonance imaging images. We searched the Medline database and the Cochrane Central Register of Controlled Trials for this purpose and 10 studies meeting our inclusion criteria were identified. In total, 650 cervical spondylosis myelopathy patients with (+) or without (-) intramedullary signal changes on their T2-weighted images were examined. Weighted mean differences and 95g% confidence intervals were used to summarize the data. Patients with focal and faint border changes in the intramedullary signal on T2 magnetic resonance imaging had similar Japanese Orthopaedic Association recovery ratios as those with no signal changes on the magnetic resonance imaging images of the spinal cord did. The surgical outcomes were poorer in the patients with both T2 intramedullary signal changes, especially when the signal changes were multisegmental and had a well-defined border and T1 intramedullary signal changes compared with those without intramedullary signal changes. Preoperative magnetic resonance imaging including T1 and T2 imaging can thus be used to predict postoperative recovery in cervical spondylosis myelopathy patients.

OBJECTIVE: To determine the associations of liver lobe-based magnetic resonance diffusion-weighted imaging findings using multiple b values with the presence and Child-Pugh class of cirrhosis in patients with hepatitis B. METHODS: Seventy-four cirrhotic patients with hepatitis B and 25 healthy volunteers underwent diffusion-weighted imaging using b values of 0, 500, 800 and 1000 sec/mm2. The apparent diffusion coefficients of individual liver lobes for b(0,500), b(0,800) and b(0,1000) were derived from the signal intensity averaged across images obtained using b values of 0 and 500 sec/mm2, 0 and 800 sec/mm2, or 0 and 1000 sec/mm2, respectively, and were statistically analyzed to evaluate cirrhosis. RESULTS: The apparent diffusion coefficients for b(0,500), b(0,800) and b(0,1000) inversely correlated with the Child-Pugh class in the left lateral liver lobe, the left medial liver lobe, the right liver lobe and the caudate lobe (r=-0.35 to -0.60, all p<0.05), except for the apparent diffusion coefficient for b(0,1000) in the left medial liver lobe (r=-0.17, p>0.05). Among these parameters, the apparent diffusion coefficient for b(0,500) in the left lateral liver lobe best differentiated normal from cirrhotic liver, with an area under the receiver operating characteristic curve of 0.989. The apparent diffusion coefficient for b(0,800) in the right liver lobe best distinguished Child-Pugh class A from B-C and A-B from C, with areas under the receiver operating characteristic curve of 0.732 and 0.747, respectively. CONCLUSION: Liver lobe-based apparent diffusion coefficients for b(0,500) and b(0,800) appear to be associated with the presence and Child-Pugh class of liver cirrhosis.