Intestinal anisakiasis treated successfully with conservative therapy:Importance of clinical diagnosis

Intestinal anisakiasis is not only a rare parasitic disease,but is also difficult to diagnose.The symptoms are not specific and are often very severe and abrupt,and the findings of clinical imaging are very remarkable.Therefore,intestinal anisakiasis is often misdiagnosed as acute abdomen or intestinal obstruction and is treated surgically.However,if intestinal anisakiasis could be diagnosed correctly,it is well treated conservatively.We experienced three cases of intestinal anisakiasis,which were diagnosed correctly and treated successfully with conservative therapy.A correct clinical history and imaging interpretation helped us diagnose intestinal anisakiasis correctly and thus treat the patients successfully with conservative therapy.

On information field of clinical diagnosis

“Field” is a universal phenomenon existing in both nature and society, and determines the existence and significance of all materials or information. The man being has always been generating and carrying a large quantity of life information in his whole life. Each piece of life information has an independent information field. The life information field includes such three subfields as bioinformation field, psychoinformation field and psycho-bioinformation field. The clinical diagnosis information field which is a specific information field within the information field of human activities consists of all information concerning man’s health. Only after we have cognized and ascertained the clinic diagnosis information field, can we accurately utilize its function to serve the human being.

Applications of artificial intelligence in, early detection of cancer, clinical diagnosis and personalized medicine

Artificial intelligence(AI)refers to the simulation of human intelligence in machines programmed to convert raw input data into decision-making actions,like humans.AI programs are designed to make decisions,often using deep learning and computer-guided programs that analyze and process raw data into clinical decision making for effective treatment.New techniques for predicting cancer at an early stage are needed as conventional methods have poor accuracy and are not applicable to personalized medicine.AI has the potential to use smart,intelligent computer systems for image interpretation and early diagnosis of cancer.AI has been changing almost all the areas of the medical field by integrating with new emerging technologies.AI has revolutionized the entire health care system through innovative digital diagnostics with greater precision and accuracy.AI is capable of detecting cancer at an early stage with accurate diagnosis and improved survival outcomes.AI is an innovative technology of the future that can be used for early prediction,diagnosis and treatment of cancer.

PERFORMANCE COMPARISON OF ECG COMPRESSION ALGORITHMS BASED ON CLINICAL DIAGNOSIS

This paper reviewed the recent progress in the field of electrocardiogram (ECG) compression and compared the efficiency of some compression algorithms. By experimenting on the 500 cases of ECG signals from the ECG database of China, it obtained the numeral indexes for each algorithm. Then by using the automatic diagnostic program developed by Shanghai Zhongshan Hospital, it also got the parameters of the reconstructed signals from linear approximation distance threshold (LADT), wavelet transform (WT), differential pulse code modulation (DPCM) and discrete cosine transform (DCT) algorithm. The results show that when the index of percent of root mean square difference(PRD) is less than 2.5%, the diagnostic agreement ratio is more than 90%; the index of PRD cannot completely show the damage of significant clinical information; the performance of wavelet algorithm exceeds other methods in the same compression ratio (CR). For the statistical result of the parameters of various methods and the clinical diagnostic results, it is of certain value and originality in the field of ECG compression research.

Relationship between fever and early clinical diagnosis and treatment in mild COVID-2019 patients

Objective:To investigate the relationship between clinical manifestations,blood testing,chest CT,treatment and fever of 457mild cases of COVID-19.Methods:A tatal of 457cases of mild COVID-19 diagnosed in Wuhan Jianghan module Hospital from February 6,2020 to February 26,2020 were gathered,and the cases with/without fever were retrospectively analyzed in epidemiology,clinical manifestation,blood routing,hypersensitive C-reactive protein(hs-CRP),pathogens serological testing,chest CT and drugs treatment.Results:For 312 fever cases,the average age was(47.6±10.9)years old,male was 128 cases(41%),the mean peak fever was 38(36.8,38.6)℃,fever lasting was 2(0,3)days,131cases(28.7%)had Huanan seafood market exposure history,90 cases(28.8%)had closely contact with COVID-19 patients,20cases(6.4%)had hypertension history,10 cases(3.2%)had diabetes,5cases(1.6%)had coronary heart disease.Main symptoms of fever group including dry cough of 260cases(83.3%),of 104cases(33.3%),blood sputum of 9cases(2.9%),chest tightness 20cases(19.6%),shortness of breath of 87cases(27.9%),weak of 105cases(33.7%),diarrhea of 43cases(13.8%),sleep disorders of 61cases(19.6%),among fever cases with sputum and shortness of breath more rather without fever,and two groups were statistically significantly difference(P<0.05).In fever group,WBC(109/L)[4.34(3.69,5.26)than 5.11(4.22,6.22),P<0.001],NEUT(109/L)[2.67(2.1,3.49)than 2.88(2.37,3.9),P<0.05],LYM(109/L)[0.9(0.8,1.1)than 1.36(1.03,1.85),P<0.001),PLT(109/L)/(106,188)134-189(132,224),P<0.001)were lower than normal group,while WBC<4.0×109/L[108(34.6%)than 24(16.6%),P<0.001)],LYM<1.0×109/L[189(60.6%)than 31(21.4%),P<0.001)],PLT<100×109/L[45(14.4%)than in 2(1.4%),P<0.001)and hs-CRP(mg/L)[14(6.83,32)than 3.4(0.96,10.75),P<0.001)were higher than normal group,and pathogens serological examination of 36cases shown influenzaⅠ/Ⅱvirus IgM antibody positive in 3cases(8.3%),respiratory syncytial virus IgM antibody positive in 2 cases(5.6%),mycoplasma pneumoniae IgM antibody positive(11.1%),4 cases of adenovirus IgM antibody positive(11.1%),but 4 pathogens of fever group and normal group were no statistical difference(P>0.05).According to early onset of chest CT examination,there were no change of 11cases(2.4%),unilateral lung lesions of 93cases(20.4%),bilateral lung lesions of 353 cases(77.2%),ground glass shadow of 228 cases(73.1%),high density shadow patch of 65 cases(20.8%),consolidation shadow of 6 cases(1.9%),while fever group compared with normal group,there were no statistically significant difference(P>0.05).Logistic regression analysis showed that LYM(OR=0.24,95%CI=0.139~0.415,P<0.001),LYM<1.0 x 109/L(OR=5.12,95%CI=3.07~8.65,P<0.001),PLT<100×109/L(OR=6.1,95%CI=1.36~27.33,P<0.05),and the hs-CRP(OR=1.03,95%CI=1.02~1.05,P<0.001)were fever independent impact factors in mild COVID-19.Aiming at COVID-19 treatment,Chinese medicine usage had 416cases(91%),antiviral drugs had 328cases(71.8%),and antibiotics had 172cases(37.6%),furthermore,fever group using antiviral and antibiotic drugs was higher than normal group(P<0.05),and compared to low fever group,high fever group used more antibiotic drugs(P<0.05).Conclusions:Mild COVID-19 patients with early onset had epidemiological characteristics,and fever,dry cough,expectoration and shortness of breath were main symptoms,and chest CT often involved bilateral lung lesions,ground glass shadow and patch density shadow.The fever patients in WBC,LYM,PLT,hs-CRP index changed significantly and could affect on anti-infective therapy selection.

A Robust N-Terminal Pro-Brain Natriuretic Peptide Assay for Clinical Diagnosis of Heart Failure in Elderly Patients

Heart failure(HF)is a clinical hallmark of cardiovascular syndrome leading to substantial morbidity,repeated hospitalization,and enormous healthcare expenditure.As elderly populations continue to increase,biomarker-guided diagnosis and treatment for age-related cardiac decline have become essential.Accumulating evidence demonstrates that N-terminal proBNP(NT-proBNP)can provide a unique window into the diagnosis and risk stratification with HF.Herein,a simple yet robust aptasensor is developed for on-site recognizing the NT-proBNP by its targeting aptamer,thus achieving the accurate diagnosis of HF.This aptasensing system is prepared by absorbing the fluorophore-labeled aptamer strand onto the graphene oxide(GO),leading to efficient quenching without possible off-site signal leakage.The aptamer strand can specifically identify target NT-proBNP molecules via a versatile conformational transformation,resulting in the desorption of the aptamer-NTproBNP complexes from GO and re-generation fluorescence signal,thus allowing sensitive detection of NT-proBNP in 37 clinical blood samples.Taking advantage of the high specificity of aptamer-guaranteed recognitions of NT-proBNP,this aptasensor system readily achieves better diagnostic performance for HF than commercially adopted chemiluminescence immunoassay(Siemens,CLIA)in hospitals in terms of accuracy(89.2%vs 83.8%),specificity(89.5%vs 84.2%),and positive predictive value(88.9%vs 83.3%).This work provides a stable option for the diagnosis and treatment of elderly HF-related diseases inclinics.

Consensus on the clinical diagnosis and treatment of grade 3 pancreatic neuroendocrine tumors

The World Health Organization(WHO)2017 classifications for neuroendocrine neoplasms(NENs)subdivided grade 3 pancreatic neuroendocrine neoplasms(pNENs)into G3 well-differentiated pancreatic neuroendocrine tumors(G3 pNETs)and poorly differentiated pancreatic neuroendocrine carcinomas(pNECs),according to the mitotic count,Ki-67 index,and cell differentiation.As a new category,G3 pNETs remain a challenging group of tumors to manage by lacking large randomized trials and consensus to support its clinical practice.Therefore,the Chinese Pancreatic Surgery Association,Chinese Society of Surgery,Chinese Medical Association gathered experts in this field to formulate this consensus for the diagnosis and treatment of G3 pNETs.

Targeting amyloid proteins for clinical diagnosis of neurodegenerative diseases

Abnormal aggregation and accumulation of pathological amyloid proteins such as amyloid-β,Tau,and𝛼α-synuclein play key pathological roles and serve as histological hallmarks in different neurodegenerative diseases(NDs)such as Alzheimer’s disease(AD)and Parkinson’s disease(PD).In addition,various post-translational modifications(PTMs)have been identified on pathological amyloid proteins and are subjected to change during disease progression.Given the central role of amyloid proteins in NDs,tremendous efforts have been made to develop amyloid-targeting strategies for clinical diagnosis and molecular classification of NDs.In this review,we summarize two major strategies for targeting amyloid aggregates,with a focus on the trials in AD diagnosis.The first strategy is a positron emission tomography(PET)scan of protein aggregation in the brain.We mainly focus on introducing the development of small-molecule PET tracers for specifically recognizing pathological amyloid fibrils.The second strategy is the detection of PTM biomarkers on amyloid proteins in cerebrospinal fluid and plasma.We discuss the pathological roles of different PTMs in diseases and how we can use the PTM profile of amyloid proteins for clinical diagnosis.Finally,we point out the potential technical challenges of these two strategies,and outline other potential strategies,as well as a combination of multiple strategies,for molecular diagnosis of NDs.

Consensus of clinical diagnosis and treatment for non-functional pancreatic neuroendocrine neoplasms with diameter<2 cm

In clinical practice,pancreatic neuroendocrine neoplasms(pNENs)with a diameter smaller than 2 cm are commonly referred to as small pNENs.Due to their generally favorable biological characteristics,the diagnosis and treatment of small pNENs differ from other pNENs and are somewhat controversial.In response to this,the Chinese Pancreatic Surgery Association,Chinese Society of Surgery,Chinese Medical Association have developed a consensus on the diagnosis and treatment of small pNENs,which is based on evidence-based medicine and expert opinions.This consensus covers various topics,including concepts,disease assessment,treatment selection,follow-up,and other relevant aspects.

A novel machine learning-assisted clinical diagnosis support model for early identification of pancreatic injuries in patients with blunt abdominal trauma:a cross-national study

Background:The recognition of pancreatic injury in blunt abdominal trauma is often severely delayed in clinical practice.The aim of this study was to develop a machine learning model to support clinical diagnosis for early detection of abdominal trauma.Methods:We retrospectively analyzed of a large intensive care unit database(Medical Information Mart for Intensive Care[MIMIC]-IV)for model development and internal validation of the model,and performed outer validation based on a cross-national data set.Logistic regres-sion was used to develop three models(PI-12,PI-12-2,and PI-24).Univariate and multivariate analyses were used to determine variables in each model.The primary outcome was early detection of a pancreatic injury of any grade in patients with blunt abdominal trauma in the first 24 hours after hospitalization.Results:The incidence of pancreatic injuries was 5.56%(n=18)and 6.06%(n=6)in the development(n=324)and internal validation(n=99)cohorts,respectively.Internal validation cohort showed good discrimination with an area under the receiver operator characteristic curve(AUC)value of 0.84(95%confidence interval[CI]:0.71–0.96)for PI-24.PI-24 had the best AUC,specificity,and positive predictive value(PPV)of all models,and thus it was chosen as the final model to support clinical diagnosis.PI-24 performed well in the outer validation cohort with an AUC value of 0.82(95%CI:0.65–0.98),specificity of 0.97(95%CI:0.91–1.00),and PPV of 0.67(95%CI:0.00–1.00).Conclusion:A novel machine learning-based model was developed to support clinical diagnosis to detect pancreatic injuries in patients with blunt abdominal trauma at an early stage.

Value of autopsy in the modern age:Discrepancy between clinical and autopsy diagnoses

BACKGROUND Autopsy is a medical procedure that consists of the examination of the corpse to determine the cause of death and obtain information on pathological conditions or injuries.In recent years,there has been a reduction in hospital autopsies and an increase in forensic autopsies.AIM To evaluate the utility of autopsy in the modern age and the discrepancy between clinical and autopsy diagnoses.METHODS A retrospective observational study was conducted on the reports of all 645 hospital autopsies performed at Polyclinic of Bari from 2006 to 2021.RESULTS Group A,2006-2009,174 cases were studied:58%male,58%adults,55%neonatology;pulmonary disease was the cause of death in 23%of cases;and there was a discrepancy between clinical and autopsy diagnosis in 55%of cases.Group B,2010-2013,119 cases:52%male,46%infants,48%neonatology;pulmonary disease was the cause of death in 25%of cases;and there was a discrepancy between clinical and autopsy diagnosis in 56%of cases.Group C,2014-2017,168 cases:sex equality,37%infants,25%gynecology;pulmonary disease was the cause of death in 24%of cases;and there was a discrepancy between clinical and autopsy diagnosis in 58%of cases.Group D,2018-2021,184 cases:56%male,38%adult,32%gynecology;pulmonary disease was the cause of death in 27%of cases;and there was a discrepancy between clinical and autopsy diagnosis in 58%of cases.CONCLUSION The study of hospital autopsies reveals a 56.75%discrepancy between clinical diagnosis and autopsy,highlighting the importance of autopsies,especially for fetal and neonatal diseases,which represent 59%of cases.

Study on the Application Value of Liver Function and Serological Index Levels in the Diagnosis of Fatty Liver

Objective:To explore the application value of liver function and serological index detection in diagnosing fatty liver.Methods:Ninety patients with fatty liver disease(disease group)and ninety healthy subjects(healthy group)were selected as the subjects of this study.They all underwent liver function index testing and serological index testing.Test results were compared,and the diagnostic accuracy of single and combined tests was evaluated.Results:Liver function indicators of patients in the disease group were higher than those in the healthy group,with severe patients exhibiting higher levels than moderate patients and mild patients(P<0.05).Serological indicators in patients in the disease group were higher than those in the healthy group,with severe patients showing higher levels than moderate patients and mild patients(P<0.05).The diagnostic accuracy of liver function index testing was higher than that of serological index testing,and the accuracy of combined testing was higher than that of single testing(P<0.05).Conclusion:In diagnosing fatty liver,combining liver function testing and serological testing enables the initial diagnosis of the disease and facilitates the accurate assessment of its severity.

Investigation of the Clinical Diagnostic Significance of the T-Cell Test for Tuberculosis combined with Erythrocyte Sedimentation Test in Pulmonary Tuberculosis

Objective:To investigate the clinical diagnostic significance of peripheral blood T-cell test(T-spot test)for tuberculosis(TB)infection combined with erythrocyte sedimentation rate(ESR)in pulmonary TB.Methods:41 patients with a clinical diagnosis of TB during hospitalization from January 2020 to April 2023 in our hospital were selected as the experimental group,and 45 patients without TB(bronchopneumonia patients)were selected as the control group.The diagnostic specificity,sensitivity,and accuracy of the T-spot TB test,ESR test,and the combined test of the two were calculated respectively.Results:The sensitivity,specificity,and accuracy of the T-spot TB test combined with ESR for the diagnosis of TB in the experimental group were significantly higher than the individual results of the T-spot TB test and ESR test alone(P<0.05).Conclusion:The T-spot TB test combined with the ESR test for TB diagnosis has greater clinical value than carrying out the tests individually.

Nanozyme:A promising tool from clinical diagnosis and environmental monitoring to wastewater treatment

Natural enzymes,owing to their outstanding catalytic efficiency and substrate specificity,have been used in a variety of applications including clinical diagnosis,environmental monitoring and wastewater treatment.However,they face inevitable problems such as relatively high cost and lack of stability,dramatically hindering their practical applications in the industry.Recently,a class of nanomaterial that possesses intrinsic enzyme-like properties,nanozyme,has emerged exhibiting numerous advantages over its natural counterpart and has been used as a viable enzyme alternative.In the past decade there are many reviews on nanozyme.The previous discussions tend to view nanozyme as a type of nanomaterial rather than an enzyme.However,it is the enzyme-like activity of nanozymes that provides foundation for their application and nanozymes with the same enzymatic activity usually have some regularity in application.Herein,in this review,we attempt to classify nanozymes by their enzyme-like activity to explain the application principle and relevant cases of nanozymes in clinical diagnosis,environmental monitoring and wastewater treatment,expecting to promote deeper thinking of nanozymes as enzyme mimics and provide useful guidance for future research.

The Clinical Value of NLR, D-D and CRP/ALB Ratio in the Diagnosis of Pulmonary Thromboembolism

Objective: To evaluate the clinical diagnostic value of C-reactive protein/albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR) and D-dimer (D-D) in patients with pulmonary thromboembolism (PTE). Methods: We conducted a retrospective analysis comparing hematology and coagulation in 362 PTCA-confirmed PTE patients with the control group and analyzing their relationships with CAR, NLR, and D-D. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic threshold, area under the curve (AUC), diagnostic sensitivity and specificity of CAR, NLR and D-D for PTE. Results: 1) CAR, NLR and D-D levels in PTE patients were 2.13 ± 2.08, 8.96 ± 1.94 and 9.69 ± 8.61 respectively, significantly higher than those in control group (CAR = 0.03 ± 0.01, t = 20.7736, P < 0.01;NLR = 1.76 ± 0.53, t = 2.4281, P < 0.05 and PTE = 0.20 ± 0.11, t = 3.0066, P < 0.01 respectively). 2) NLR was positively correlated with CAR (r = 0.2111, t = 4.0971, P < 0.01) and D-D (r = 0.1065, t = 2.0481, P < 0.05), but CAR was not correlated with D-D (r = 0.0975, P > 0.05). 3) The levels of HB, LY, PLT and AT in PTE patients were significantly lower than those in control group, while WBC, NE and FB were significantly higher than those in control group. 4) CAR was negatively correlated with Hb and AT (P all < 0.01), but positively correlated with WBC, NE, MO and FB (P all < 0.01). NLR was negatively correlated with LY and AT (P all < 0.01), but positively correlated with WBC, NE and FB (P all < 0.01). DD was negatively correlated with Hb and PLT (P all < 0.05), but positively correlated with WBC, NE and MO (P all < 0.01). Conclusion: The levels of Hb, LY, PLT and AT were significantly decreased in PTE patients, while WBC, NE and FB were significantly increased. CAR, NLR and D-D were highly expressed in PTE patients, and were closely correlated with Hb, AT and FB. Combined detection of CAR, NLR and D-D can improve the diagnostic value of PTE.

Accuracy between clinical and radiological diagnoses compared to surgical orbital biopsies

AIM:To assess the concordance between diagnosing orbital lesions by clinical examination,orbital imaging,and histological evaluation,in order to help guide future research and clinical practice.METHODS:A retrospective analysis was undertaken at a large regional tertiary referral centre of all surgical orbital biopsies performed over a 5-year period,from 1st January 2015 until 31st December 2019.Accuracy and concordance between clinical,radiological and histological diagnoses are reported as percentage sensitivity and positive predictive value.RESULTS:A total of 128 operations involving 111 patients were identified.Overall,sensitivities of 47.7%for clinical and 37.3%for radiological diagnoses were found when compared to the histological gold standard.Vascular lesions that have characteristic clinical and radiological features had the highest sensitivity at 71.4%and 57.1%,respectively.Inflammatory conditions showed the lowest sensitivity in both clinical(30.3%)and radiological(18.2%)diagnoses.The PPV for inflammatory conditions were 47.6%for clinical and 30.0%for radiological diagnoses.CONCLUSION:Accurate diagnoses are difficult to reach by relying on clinical examination and imaging alone.Surgical orbital biopsy with histological diagnosis should remain the gold standard approach for definitively identifying orbital lesions.Although larger scale prospective studies would help further refine concordance and guide future research avenues.

CLINICAL EVALUATION OF MONOCLONAL ANTIBODIES AGAINST ALDOLASE-A IN THE DIAGNOSIS OF HEPATO-CELLULAR CARCINOMA

Serum ALD-A of 57 patients with HCC and 43 of other diseases were measured by ALD-A-McAb linked with 425I-staphylococcus A protein. The results showed that the ALD-A in patient with HCC was significantly elevated as compared with controls and that in patients with cholangiocarcinoma, gastrointestinal cancer without hepatic metastasis, cirrhosis. CAH and benign GI diseases. There was no statistical difference between ALD-A in patients with HCC and that in cases of cirrhosis with liver failure and that in cases of metastatic liver carcinoma. It was noted that diagnostic sensitivity of ALD-A in AFP (+) HCC was 73.9% and that in AFP (-) HCC was 81.8% 1-6 patients with HCC were treated by hepatic arterial embolization combined with chemotherapy. ALD-A in patients after the treatment decreased significantly than that before treatment, furthermore, advantages of the method are discussed.

Clinical study and differential diagnosis of intracranial hemangiopericytomas

Objective Intracranial hemangiopericytomas (HPCs) were rare neoplasms with relatively high rates of recurrence and extracranial metastasis.The differential diagnoses from angiomatous meningiomas and solitary fibrous tumors(SFTs) are very important. This study aimes to reveal differences in the specific immunohistochemical features of HPCs,angiomatous meningiomas and SFTs by newly

Research progress on the effect of pyroptosis on the occurrence,development,invasion and metastasis of colorectal cancer

Pyroptosis is a type of programmed cell death mediated by gasdermines(GSDMs).The N-terminal domain of GSDMs forms pores in the plasma membrane,causing cell membrane rupture and the release of cell contents,leading to an inflammatory response and mediating pyrodeath.Pyroptosis plays an important role in inflammatory diseases and malignant tumors.With the further study of pyroptosis,an increasing number of studies have shown that the pyroptosis pathway can regulate the tumor microenvironment and antitumor immunity of colorectal cancer and is closely related to the occurrence,development,treatment and prognosis of colorectal cancer.This review aimed to explore the molecular mechanism of pyroptosis and the role of pyroptosis in the occurrence,development,treatment and prognosis of colorectal cancer(CRC)and to provide ideas for the clinical diagnosis and treatment of CRC.