BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis an...BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.展开更多
The authors report a case of deficient sensory neuropathy secondary to vitamin B12 deficiency, diagnosed in the neurology department of the Sino-Central African Friendship University Hospital in Bangui. The diagnosis ...The authors report a case of deficient sensory neuropathy secondary to vitamin B12 deficiency, diagnosed in the neurology department of the Sino-Central African Friendship University Hospital in Bangui. The diagnosis was made possible by electroneuromyography which showed subclinical neurological damage associated with hematological damage (anemia). Through this observation, we recall the diagnostic criteria of the disease in a context of difficult medical practice. .展开更多
Electroencephalography(EEG)analysis extracts critical information from brain signals,enabling brain disease diagnosis and providing fundamental support for brain–computer interfaces.However,performing an artificial i...Electroencephalography(EEG)analysis extracts critical information from brain signals,enabling brain disease diagnosis and providing fundamental support for brain–computer interfaces.However,performing an artificial intelligence analysis of EEG signals with high energy efficiency poses significant challenges for electronic processors on edge computing devices,especially with large neural network models.Herein,we propose an EEG opto-processor based on diffractive photonic computing units(DPUs)to process extracranial and intracranial EEG signals effectively and to detect epileptic seizures.The signals of the EEG channels within a second-time window are optically encoded as inputs to the constructed diffractive neural networks for classification,which monitors the brain state to identify symptoms of an epileptic seizure.We developed both free-space and integrated DPUs as edge computing systems and demonstrated their applications for real-time epileptic seizure detection using benchmark datasets,that is,the Children’s Hospital Boston(CHB)–Massachusetts Institute of Technology(MIT)extracranial and Epilepsy-iEEG-Multicenter intracranial EEG datasets,with excellent computing performance results.Along with the channel selection mechanism,both numerical evaluations and experimental results validated the sufficiently high classification accuracies of the proposed opto-processors for supervising clinical diagnosis.Our study opens a new research direction for utilizing photonic computing techniques to process large-scale EEG signals and promote broader applications.展开更多
BACKGROUND Ulcerative colitis(UC)is an idiopathic,chronic inflammatory bowel disease(IBD)most often located in the rectum,but may involve the entire colon.Extra intestinal manifestations(EIMs)occur with varying freque...BACKGROUND Ulcerative colitis(UC)is an idiopathic,chronic inflammatory bowel disease(IBD)most often located in the rectum,but may involve the entire colon.Extra intestinal manifestations(EIMs)occur with varying frequency depending on the affected organ.The most common ones are musculoskeletal EIMs,affecting up to 33%-40%of IBD patients.These include,among others,inflammatory back pain,tendinitis,plantar fasciitis and arthritis.Only a few case reports in literature discuss Achilles tendinitis.CASE SUMMARY This report describes a patient with UC and Achilles tendinitis in whom after many unsuccessful attempts of treatment with sulfasalazine,mesalazine,glucocorticosteroids,infliximab and tofacitinib,a complete UC remission and resolution of Achilles tendinitis were achieved with the use of dual biologic therapy(DBT)-ustekinumab and adalimumab(ADA).CONCLUSION This case mentions rare EIMs of UC and suggests that DBT may be an alternative for patient with ulcerative colitis and EIMs.展开更多
The analysis of microstates in EEG signals is a crucial technique for understanding the spatiotemporal dynamics of brain electrical activity.Traditional methods such as Atomic Agglomerative Hierarchical Clustering(AAH...The analysis of microstates in EEG signals is a crucial technique for understanding the spatiotemporal dynamics of brain electrical activity.Traditional methods such as Atomic Agglomerative Hierarchical Clustering(AAHC),K-means clustering,Principal Component Analysis(PCA),and Independent Component Analysis(ICA)are limited by a fixed number of microstate maps and insufficient capability in cross-task feature extraction.Tackling these limitations,this study introduces a Global Map Dissimilarity(GMD)-driven density canopy K-means clustering algorithm.This innovative approach autonomously determines the optimal number of EEG microstate topographies and employs Gaussian kernel density estimation alongside the GMD index for dynamic modeling of EEG data.Utilizing this advanced algorithm,the study analyzes the Motor Imagery(MI)dataset from the GigaScience database,GigaDB.The findings reveal six distinct microstates during actual right-hand movement and five microstates across other task conditions,with microstate C showing superior performance in all task states.During imagined movement,microstate A was significantly enhanced.Comparison with existing algorithms indicates a significant improvement in clustering performance by the refined method,with an average Calinski-Harabasz Index(CHI)of 35517.29 and a Davis-Bouldin Index(DBI)average of 2.57.Furthermore,an information-theoretical analysis of the microstate sequences suggests that imagined movement exhibits higher complexity and disorder than actual movement.By utilizing the extracted microstate sequence parameters as features,the improved algorithm achieved a classification accuracy of 98.41%in EEG signal categorization for motor imagery.A performance of 78.183%accuracy was achieved in a four-class motor imagery task on the BCI-IV-2a dataset.These results demonstrate the potential of the advanced algorithm in microstate analysis,offering a more effective tool for a deeper understanding of the spatiotemporal features of EEG signals.展开更多
Background: The Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease, also named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which can cause various systemic manifestations that po...Background: The Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease, also named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which can cause various systemic manifestations that pose a threat to human life. Oral lesions in patients with COVID-19 may appear during or after the illness and may or may not be a consequence of the viral infection. Objective: In this case series we compare the oral manifestations in hospitalized COVID-19 positive patients and COVID-19 negative dental outpatients. Methods: 60 hospitalized COVID-19 patients and 41 control patients, were examined for oral signs and symptoms. The controls were dental patients who visited the hospital for dental care without complaining of any problems related to the oral cavity itself. Results: We have observed a strong association between certain clinical findings and COVID-19, including alterations in taste (ageusia, dysgeusia, and hypogeusia), anosmia, hairy tongue, tongue imprints, red tongue, erythematous candidiasis, pseudomembranous candidiasis, and exfoliative cheilitis. A trend but not statistically significant association at the level of 5% was also noted for colored tongue, linea alba, and pale mucosa. On the contrary, fissured tongue and oral mucosa pigmentation were more frequent in the controls, statistically significant at the level of 5%. Conclusion: COVID-19 has been found to impact the oral cavity, resulting in various oral lesions that can be attributed to either the direct action of the virus or the patient’s immune response.展开更多
基金Supported by National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-022 and No.2022-PUMCH-D-002CAMS Innovation Fund for Medical Sciences,No.2021-1-I2M-003+1 种基金Undergraduate Innovation Program,No.2023-zglc-06034National Key Clinical Specialty Construction Project,No.ZK108000。
文摘BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.
文摘The authors report a case of deficient sensory neuropathy secondary to vitamin B12 deficiency, diagnosed in the neurology department of the Sino-Central African Friendship University Hospital in Bangui. The diagnosis was made possible by electroneuromyography which showed subclinical neurological damage associated with hematological damage (anemia). Through this observation, we recall the diagnostic criteria of the disease in a context of difficult medical practice. .
基金supported by the National Major Science and Technology Projects of China(2021ZD0109902 and 2020AA0105500)the National Natural Science Fundation of China(62275139 and 62088102)the Tsinghua University Initiative Scientific Research Program.
文摘Electroencephalography(EEG)analysis extracts critical information from brain signals,enabling brain disease diagnosis and providing fundamental support for brain–computer interfaces.However,performing an artificial intelligence analysis of EEG signals with high energy efficiency poses significant challenges for electronic processors on edge computing devices,especially with large neural network models.Herein,we propose an EEG opto-processor based on diffractive photonic computing units(DPUs)to process extracranial and intracranial EEG signals effectively and to detect epileptic seizures.The signals of the EEG channels within a second-time window are optically encoded as inputs to the constructed diffractive neural networks for classification,which monitors the brain state to identify symptoms of an epileptic seizure.We developed both free-space and integrated DPUs as edge computing systems and demonstrated their applications for real-time epileptic seizure detection using benchmark datasets,that is,the Children’s Hospital Boston(CHB)–Massachusetts Institute of Technology(MIT)extracranial and Epilepsy-iEEG-Multicenter intracranial EEG datasets,with excellent computing performance results.Along with the channel selection mechanism,both numerical evaluations and experimental results validated the sufficiently high classification accuracies of the proposed opto-processors for supervising clinical diagnosis.Our study opens a new research direction for utilizing photonic computing techniques to process large-scale EEG signals and promote broader applications.
文摘BACKGROUND Ulcerative colitis(UC)is an idiopathic,chronic inflammatory bowel disease(IBD)most often located in the rectum,but may involve the entire colon.Extra intestinal manifestations(EIMs)occur with varying frequency depending on the affected organ.The most common ones are musculoskeletal EIMs,affecting up to 33%-40%of IBD patients.These include,among others,inflammatory back pain,tendinitis,plantar fasciitis and arthritis.Only a few case reports in literature discuss Achilles tendinitis.CASE SUMMARY This report describes a patient with UC and Achilles tendinitis in whom after many unsuccessful attempts of treatment with sulfasalazine,mesalazine,glucocorticosteroids,infliximab and tofacitinib,a complete UC remission and resolution of Achilles tendinitis were achieved with the use of dual biologic therapy(DBT)-ustekinumab and adalimumab(ADA).CONCLUSION This case mentions rare EIMs of UC and suggests that DBT may be an alternative for patient with ulcerative colitis and EIMs.
基金funded by National Nature Science Foundation of China,Yunnan Funda-Mental Research Projects,Special Project of Guangdong Province in Key Fields of Ordinary Colleges and Universities and Chaozhou Science and Technology Plan Project of Funder Grant Numbers 82060329,202201AT070108,2023ZDZX2038 and 202201GY01.
文摘The analysis of microstates in EEG signals is a crucial technique for understanding the spatiotemporal dynamics of brain electrical activity.Traditional methods such as Atomic Agglomerative Hierarchical Clustering(AAHC),K-means clustering,Principal Component Analysis(PCA),and Independent Component Analysis(ICA)are limited by a fixed number of microstate maps and insufficient capability in cross-task feature extraction.Tackling these limitations,this study introduces a Global Map Dissimilarity(GMD)-driven density canopy K-means clustering algorithm.This innovative approach autonomously determines the optimal number of EEG microstate topographies and employs Gaussian kernel density estimation alongside the GMD index for dynamic modeling of EEG data.Utilizing this advanced algorithm,the study analyzes the Motor Imagery(MI)dataset from the GigaScience database,GigaDB.The findings reveal six distinct microstates during actual right-hand movement and five microstates across other task conditions,with microstate C showing superior performance in all task states.During imagined movement,microstate A was significantly enhanced.Comparison with existing algorithms indicates a significant improvement in clustering performance by the refined method,with an average Calinski-Harabasz Index(CHI)of 35517.29 and a Davis-Bouldin Index(DBI)average of 2.57.Furthermore,an information-theoretical analysis of the microstate sequences suggests that imagined movement exhibits higher complexity and disorder than actual movement.By utilizing the extracted microstate sequence parameters as features,the improved algorithm achieved a classification accuracy of 98.41%in EEG signal categorization for motor imagery.A performance of 78.183%accuracy was achieved in a four-class motor imagery task on the BCI-IV-2a dataset.These results demonstrate the potential of the advanced algorithm in microstate analysis,offering a more effective tool for a deeper understanding of the spatiotemporal features of EEG signals.
文摘Background: The Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease, also named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which can cause various systemic manifestations that pose a threat to human life. Oral lesions in patients with COVID-19 may appear during or after the illness and may or may not be a consequence of the viral infection. Objective: In this case series we compare the oral manifestations in hospitalized COVID-19 positive patients and COVID-19 negative dental outpatients. Methods: 60 hospitalized COVID-19 patients and 41 control patients, were examined for oral signs and symptoms. The controls were dental patients who visited the hospital for dental care without complaining of any problems related to the oral cavity itself. Results: We have observed a strong association between certain clinical findings and COVID-19, including alterations in taste (ageusia, dysgeusia, and hypogeusia), anosmia, hairy tongue, tongue imprints, red tongue, erythematous candidiasis, pseudomembranous candidiasis, and exfoliative cheilitis. A trend but not statistically significant association at the level of 5% was also noted for colored tongue, linea alba, and pale mucosa. On the contrary, fissured tongue and oral mucosa pigmentation were more frequent in the controls, statistically significant at the level of 5%. Conclusion: COVID-19 has been found to impact the oral cavity, resulting in various oral lesions that can be attributed to either the direct action of the virus or the patient’s immune response.
