BACKGROUND Crohn’s disease(CD)is often misdiagnosed as intestinal tuberculosis(ITB).However,the treatment and prognosis of these two diseases are dramatically different.Therefore,it is important to develop a method t...BACKGROUND Crohn’s disease(CD)is often misdiagnosed as intestinal tuberculosis(ITB).However,the treatment and prognosis of these two diseases are dramatically different.Therefore,it is important to develop a method to identify CD and ITB with high accuracy,specificity,and speed.AIM To develop a method to identify CD and ITB with high accuracy,specificity,and speed.METHODS A total of 72 paraffin wax-embedded tissue sections were pathologically and clinically diagnosed as CD or ITB.Paraffin wax-embedded tissue sections were attached to a metal coating and measured using attenuated total reflectance fourier transform infrared spectroscopy at mid-infrared wavelengths combined with XGBoost for differential diagnosis.RESULTS The results showed that the paraffin wax-embedded specimens of CD and ITB were significantly different in their spectral signals at 1074 cm^(-1) and 1234 cm^(-1) bands,and the differential diagnosis model based on spectral characteristics combined with machine learning showed accuracy,specificity,and sensitivity of 91.84%,92.59%,and 90.90%,respectively,for the differential diagnosis of CD and ITB.CONCLUSION Information on the mid-infrared region can reveal the different histological components of CD and ITB at the molecular level,and spectral analysis combined with machine learning to establish a diagnostic model is expected to become a new method for the differential diagnosis of CD and ITB.展开更多
This editorial provides commentary on an article titled"Potential and limitationsof ChatGPT and generative artificial intelligence(AI)in medical safety education"recently published in the World Journal of Cl...This editorial provides commentary on an article titled"Potential and limitationsof ChatGPT and generative artificial intelligence(AI)in medical safety education"recently published in the World Journal of Clinical Cases.AI has enormous potentialfor various applications in the field of Kawasaki disease(KD).One is machinelearning(ML)to assist in the diagnosis of KD,and clinical prediction models havebeen constructed worldwide using ML;the second is using a gene signalcalculation toolbox to identify KD,which can be used to monitor key clinicalfeatures and laboratory parameters of disease severity;and the third is using deeplearning(DL)to assist in cardiac ultrasound detection.The performance of the DLalgorithm is similar to that of experienced cardiac experts in detecting coronaryartery lesions to promoting the diagnosis of KD.To effectively utilize AI in thediagnosis and treatment process of KD,it is crucial to improve the accuracy of AIdecision-making using more medical data,while addressing issues related topatient personal information protection and AI decision-making responsibility.AIprogress is expected to provide patients with accurate and effective medicalservices that will positively impact the diagnosis and treatment of KD in thefuture.展开更多
Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions.One of the most important position papers in the field of gastro-esophageal reflux dis...Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions.One of the most important position papers in the field of gastro-esophageal reflux disease(GERD)is the one produced by the Lyon Consensus.Recently an updated second version has been released.Mean nocturnal baseline impedance(MNBI)was proposed by the first Consensus to act as supportive evidence for GERD diagnosis.Originally a cut-off of 2292 Ohms was proposed,a value revised in the second edition.The updated Consensus recommended that an MNBI<1500 Ohms strongly suggests GERD while a value>2500 Ohms can be used to refute GERD.The proposed cut-offs move in the correct direction by diminishing the original cut-off,nevertheless they arise from a study of normal subjects where cut-offs were provided by measuring the mean value±2SD and not in symptomatic patients.However,data exist that even symptomatic patients with inconclusive disease or reflux hypersensitivity(RH)show lower MNBI values in comparison to normal subjects or patients with functional heartburn(FH).Moreover,according to the data,MNBI,even among symptomatic patients,is affected by age and body mass index.Also,various studies have proposed different cut-offs by using receiver operating characteristic curve analysis even lower than the one proposed.Finally,no information is given for patients submitted to on-proton pump inhibitors pH-impedance studies even if new and extremely important data now exist.Therefore,even if MNBI is an extremely important tool when trying to approach patients with reflux symptoms and could distinguish conclusive GERD from RH or FH,its values should be interpreted with caution.展开更多
BACKGROUND Traditional esophagogastroduodenoscopy(EGD),an invasive examination method,can cause discomfort and pain in patients.In contrast,magnetically controlled capsule endoscopy(MCE),a noninvasive method,is being ...BACKGROUND Traditional esophagogastroduodenoscopy(EGD),an invasive examination method,can cause discomfort and pain in patients.In contrast,magnetically controlled capsule endoscopy(MCE),a noninvasive method,is being applied for the detection of stomach and small intestinal diseases,but its application in treating esophageal diseases is not widespread.AIM To evaluate the safety and efficacy of detachable string MCE(ds-MCE)for the diagnosis of esophageal diseases.METHODS Fifty patients who had been diagnosed with esophageal diseases were pros-pectively recruited for this clinical study and underwent ds-MCE and conven-tional EGD.The primary endpoints included the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for patients with esophageal diseases.The secondary endpoints consisted of visualizing the esophageal and dentate lines,as well as the subjects'tolerance of the procedure.RESULTS Using EGD as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for esophageal disease detection were 85.71%,86.21%,81.82%,89.29%,and 86%,respectively.ds-MCE was more comfortable and convenient than EGD was,with 80%of patients feeling that ds-MCE examination was very comfortable or comfortable and 50%of patients believing that detachable string v examination was very convenient.CONCLUSION This study revealed that ds-MCE has the same diagnostic effects as traditional EGD for esophageal diseases and is more comfortable and convenient than EGD,providing a novel noninvasive method for treating esophageal diseases.展开更多
As a common hyperglycemic disease,type 1 diabetes mellitus(T1DM)is a complicated disorder that requires a lifelong insulin supply due to the immunemediated destruction of pancreaticβcells.Although it is an organ-spec...As a common hyperglycemic disease,type 1 diabetes mellitus(T1DM)is a complicated disorder that requires a lifelong insulin supply due to the immunemediated destruction of pancreaticβcells.Although it is an organ-specific autoimmune disorder,T1DM is often associated with multiple other autoimmune disorders.The most prevalent concomitant autoimmune disorder occurring in T1DM is autoimmune thyroid disease(AITD),which mainly exhibits two extremes of phenotypes:hyperthyroidism[Graves'disease(GD)]and hypothyroidism[Hashimoto's thyroiditis,(HT)].However,the presence of comorbid AITD may negatively affect metabolic management in T1DM patients and thereby may increase the risk for potential diabetes-related complications.Thus,routine screening of thyroid function has been recommended when T1DM is diagnosed.Here,first,we summarize current knowledge regarding the etiology and pathogenesis mechanisms of both diseases.Subsequently,an updated review of the association between T1DM and AITD is offered.Finally,we provide a relatively detailed review focusing on the application of thyroid ultrasonography in diagnosing and managing HT and GD,suggesting its critical role in the timely and accurate diagnosis of AITD in T1DM.展开更多
BACKGROUND The importance of age on the development of ocular conditions has been reported by numerous studies.Diabetes may have different associations with different stages of ocular conditions,and the duration of di...BACKGROUND The importance of age on the development of ocular conditions has been reported by numerous studies.Diabetes may have different associations with different stages of ocular conditions,and the duration of diabetes may affect the development of diabetic eye disease.While there is a dose-response relationship between the age at diagnosis of diabetes and the risk of cardiovascular disease and mortality,whether the age at diagnosis of diabetes is associated with incident ocular conditions remains to be explored.It is unclear which types of diabetes are more predictive of ocular conditions.AIM To examine associations between the age of diabetes diagnosis and the incidence of cataract,glaucoma,age-related macular degeneration(AMD),and vision acuity.METHODS Our analysis was using the UK Biobank.The cohort included 8709 diabetic participants and 17418 controls for ocular condition analysis,and 6689 diabetic participants and 13378 controls for vision analysis.Ocular diseases were identified using inpatient records until January 2021.Vision acuity was assessed using a chart.RESULTS During a median follow-up of 11.0 years,3874,665,and 616 new cases of cataract,glaucoma,and AMD,respectively,were identified.A stronger association between diabetes and incident ocular conditions was observed where diabetes was diagnosed at a younger age.Individuals with type 2 diabetes(T2D)diagnosed at<45 years[HR(95%CI):2.71(1.49-4.93)],45-49 years[2.57(1.17-5.65)],50-54 years[1.85(1.13-3.04)],or 50-59 years of age[1.53(1.00-2.34)]had a higher risk of AMD independent of glycated haemoglobin.T2D diagnosed<45 years[HR(95%CI):2.18(1.71-2.79)],45-49 years[1.54(1.19-2.01)],50-54 years[1.60(1.31-1.96)],or 55-59 years of age[1.21(1.02-1.43)]was associated with an increased cataract risk.T2D diagnosed<45 years of age only was associated with an increased risk of glaucoma[HR(95%CI):1.76(1.00-3.12)].HRs(95%CIs)for AMD,cataract,and glaucoma associated with type 1 diabetes(T1D)were 4.12(1.99-8.53),2.95(2.17-4.02),and 2.40(1.09-5.31),respectively.In multivariable-adjusted analysis,individuals with T2D diagnosed<45 years of age[β95%CI:0.025(0.009,0.040)]had a larger increase in LogMAR.Theβ(95%CI)for LogMAR associated with T1D was 0.044(0.014,0.073).CONCLUSION The younger age at the diagnosis of diabetes is associated with a larger relative risk of incident ocular diseases and greater vision loss.展开更多
Behçet's disease(BD)is a chronic inflammatory disorder prone to frequent re-currences,with a high predilection for intestinal involvement.However,the ef-ficacy and long-term effects of surgical treatment for ...Behçet's disease(BD)is a chronic inflammatory disorder prone to frequent re-currences,with a high predilection for intestinal involvement.However,the ef-ficacy and long-term effects of surgical treatment for intestinal BD are unknown.In the current issue of World J Gastrointest Surg,Park et al conducted a retrospec-tive analysis of 31 patients with intestinal BD who received surgical treatment.They found that elevated C-reactive protein levels and emergency surgery were poor prognostic factors for postoperative recurrence,emphasizing the adverse impact of severe inflammation on the prognosis of patients with intestinal BD.This work has clinical significance for evaluating the postoperative condition of intestinal BD.The editorial attempts to summarize the clinical diagnosis and treatment of intestinal BD,focusing on the impact of adverse factors on surgical outcomes.We hope this review will facilitate more precise postoperative management of patients with intestinal BD by clinicians.展开更多
Drug-induced interstitial lung disease(DILD)is the most common pulmonary adverse event of anticancer drugs.In recent years,the incidence of anticancer DILD has gradually increased with the rapid development of novel a...Drug-induced interstitial lung disease(DILD)is the most common pulmonary adverse event of anticancer drugs.In recent years,the incidence of anticancer DILD has gradually increased with the rapid development of novel anticancer agents.Due to the diverse clinical manifestations and the lack of specific diagnostic criteria,DILD is difficult to diagnose and may even become fatal if not treated properly.Herein,a multidisciplinary group of experts from oncology,respiratory,imaging,pharmacology,pathology,and radiology departments in China has reached the“expert consensus on the diagnosis and treatment of anticancer DILD”after several rounds of a comprehensive investigation.This consensus aims to improve the awareness of clinicians and provide recommendations for the early screening,diagnosis,and treatment of anticancer DILD.This consensus also emphasizes the importance of multidisciplinary collaboration while managing DILD.展开更多
GTD (Gestational Trophoblastic Disease) is a pathology that encompasses benign and malignant clinical forms, affects women of childbearing age, has a variable incidence and is more frequent in developing or underdevel...GTD (Gestational Trophoblastic Disease) is a pathology that encompasses benign and malignant clinical forms, affects women of childbearing age, has a variable incidence and is more frequent in developing or underdeveloped countries, colliding with the economic barrier. The frequent absence of clear protocols and guidelines for the correct diagnosis of the pathology results in inadequate classification, imprecise treatment and failed post-therapeutic observation, increasing the risk of relapses, morbidity and mortality. The present study aims to point out updated national and international practice protocols of diagnosis of GTD, through an integrative review. Seven articles were selected and it was observed that the main international reference centers are agreed with the management suggested by the IFGO (International Federation of Gynecology and Obstetrics), being the conduct in the Hydatidiform Mole (HM): evacuation by suction and curettage under ultrasound guidance, followed by hCG monitoring every 1 - 2 weeks until normalized (usually one month for Partial Hydatidiform Mole six months for Complete Hydatidiform Mole and one year for Gestational Trophoblastic Neoplasia). Unfortunately, regarding the diagnosis of MH, the guidelines of some countries show the absence or difficulty of access to the karyotype test and ploid p57 or pelvic ultrasound accompanying the uterine curettage, contrary to what is proposed by the IFGO guideline. Establishing and complying with consistent guidelines can improve patient care, with early diagnosis of the pathology and its complications, reducing the rate of recurrence, morbidity and mortality, especially in less developed countries.展开更多
Over the past three decades, genomic and epigenetic sciences have identified more than 70 genes involved in the molecular pathophysiology of Alzheimer’s disease (AD). DNA methylation, abnormal histone and chromatin r...Over the past three decades, genomic and epigenetic sciences have identified more than 70 genes involved in the molecular pathophysiology of Alzheimer’s disease (AD). DNA methylation, abnormal histone and chromatin regulation and the action of various miRNAs induce AD. The identification of mutated genes has paved the way for the development of diagnostic kits and the initiation of gene therapy trials. However, despite major advances in neuroscience research, there is yet no suitable treatment for AD. Therefore, the early diagnosis of this neurodegenerative disease raises several ethical questions, including the balance between the principle of non-maleficence and the principle of beneficence. The aims of this research were to present the genomic and ethical aspects of AD, and to highlight the ethical principles involved in its presymptomatic diagnosis and therapy. A systematic review of the literature in PubMed, Google Scholar and Science Direct was carried out to outline the genomic aspects and ethical principles relating not only to the presymptomatic diagnosis of AD, but also to its gene therapy. A total of 16 publications were selected. AD is a multifactorial disease that can be genetically classified into Sporadic Alzheimer’s Disease and Familial Alzheimer’s Disease based on family history. Gene therapy targeting specific disease-causing genes is a promising therapeutic strategy. Advancements in artificial intelligence applications may enable the prediction of AD onset several years in advance. While early diagnosis of AD may empower patients with full decision competence for early decision-making, it also carries implications for the patient’s family members, who are at risk of developing the disease, potentially becoming a source of confusion or anxiety. AD has a significant impact on the life of individuals at risk and their families. Given the absence of disease modifying therapy, genetic screening and early diagnosis for this condition raise ethical issues that must be carefully considered in the context of fundamental bioethical principles, including autonomy, beneficence, non-maleficence, and justice.展开更多
BACKGROUND Shear wave speed(SWS),shear wave dispersion(SWD),and attenuation imaging(ATI)are new diagnostic parameters for non-alcoholic fatty liver disease.To differentiate between non-alcoholic steatohepatitis(NASH)a...BACKGROUND Shear wave speed(SWS),shear wave dispersion(SWD),and attenuation imaging(ATI)are new diagnostic parameters for non-alcoholic fatty liver disease.To differentiate between non-alcoholic steatohepatitis(NASH)and non-alcoholic fatty liver(NAFL),we developed a clinical index we refer to as the“NASH pentagon”consisting of the 3 abovementioned parameters,body mass index(BMI),and Fib-4 index.AIM To investigate whether the area of the NASH pentagon we propose is useful in discriminating between NASH and NAFL.METHODS This non-invasive,prospective,observational study included patients diagnosed with fatty liver by abdominal ultrasound between September 2021 and August 2022 in whom shear wave elastography,SWD,and ATI were measured.Histological diagnosis based on liver biopsy was performed in 31 patients.The large pentagon group(LP group)and the small pentagon group(SP group),using an area of 100 as the cutoff,were compared;the NASH diagnosis rate was also investigated.In patients with a histologically confirmed diagnosis,receiveroperating characteristic(ROC)curve analyses were performed.RESULTS One hundred-seven patients(61 men,46 women;mean age 55.1 years;mean BMI 26.8 kg/m2)were assessed.The LP group was significantly older(mean age:60.8±15.2 years vs 46.4±13.2 years;P<0.0001).Twenty-five patients who underwent liver biopsies were diagnosed with NASH,and 6 were diagnosed with NAFL.On ROC curve analyses,the areas under the ROC curves for SWS,dispersion slope,ATI value,BMI,Fib-4 index,and the area of the NASH pentagon were 0.88000,0.82000,0.58730,0.63000,0.59333,and 0.93651,respectively;the largest was that for the area of the NASH pentagon.CONCLUSION The NASH pentagon area appears useful for discriminating between patients with NASH and those with NAFL.展开更多
In agricultural engineering,the main challenge is on methodologies used for disease detection.The manual methods depend on the experience of the personal.Due to large variation in environmental condition,disease diagn...In agricultural engineering,the main challenge is on methodologies used for disease detection.The manual methods depend on the experience of the personal.Due to large variation in environmental condition,disease diagnosis and classification becomes a challenging task.Apart from the disease,the leaves are affected by climate changes which is hard for the image processing method to discriminate the disease from the other background.In Cucurbita gourd family,the disease severity examination of leaf samples through computer vision,and deep learning methodologies have gained popularity in recent years.In this paper,a hybrid method based on Convolutional Neural Network(CNN)is proposed for automatic pumpkin leaf image classification.The Proposed Denoising and deep Convolutional Neural Network(CNN)method enhances the Pumpkin Leaf Pre-processing and diagnosis.Real time data base was used for training and testing of the proposed work.Investigation on existing pre-trained network Alexnet and googlenet was investigated is done to evaluate the performance of the pro-posed method.The system and computer simulations were performed using Matlab tool.展开更多
Tongue image analysis is an efficient and non-invasive technique to determine the internal organ condition of a patient in oriental medicine,for example,traditional Chinese medicine(TCM),Japanese traditional herbal me...Tongue image analysis is an efficient and non-invasive technique to determine the internal organ condition of a patient in oriental medicine,for example,traditional Chinese medicine(TCM),Japanese traditional herbal medicine,and traditional Korean medicine(TKM).The diagnosis procedure is mainly based on the expert’s knowledge depending upon the visual inspec-tion comprising color,substance,coating,form,and motion of the tongue.But conventional tongue diagnosis has limitations since the procedure is inconsistent and subjective.Therefore,computer-aided tongue analyses have a greater potential to present objective and more consistent health assess-ments.This manuscript introduces a novel Simulated Annealing with Transfer Learning based Tongue Image Analysis for Disease Diagnosis(SADTL-TIADD)model.The presented SADTL-TIADD model initially pre-processes the tongue image to improve the quality.Next,the presented SADTL-TIADD technique employed an EfficientNet-based feature extractor to generate useful feature vectors.In turn,the SA with the ELM model enhances classification efficiency for disease detection and classification.The design of SA-based parameter tuning for heart disease diagnosis shows the novelty of the work.A wide-ranging set of simulations was performed to ensure the improved performance of the SADTL-TIADD algorithm.The experimental outcomes highlighted the superior of the presented SADTL-TIADD system over the compared methods with maximum accuracy of 99.30%.展开更多
microRNA(miRNA)is a type of single-stranded small molecule non-coding RNA that interacts with the 3'untranslated region of the target gene to achieve negative regulation of the target gene and participate in multi...microRNA(miRNA)is a type of single-stranded small molecule non-coding RNA that interacts with the 3'untranslated region of the target gene to achieve negative regulation of the target gene and participate in multiple links of cell proliferation and apoptosis.At present,there is evidence that miRNA-155 is involved in the occurrence and development of a variety of liver diseases.By consulting relevant literature reports,this article summarizes the effects of miRNA-155 in non-alcoholic fatty liver disease,alcoholic liver disease,viral hepatitis,acute liver failure,and liver disease.The research progress of fibrosis and liver cancer in a variety of liver diseases,and the potential of miRNA-155 as a non-invasive biomarker is analyzed to provide a reference for exploring the diagnosis and treatment of liver diseases.展开更多
Aging is a natural process that leads to debility,disease,and dependency.Alzheimer’s disease(AD)causes degeneration of the brain cells leading to cognitive decline and memory loss,as well as dependence on others to f...Aging is a natural process that leads to debility,disease,and dependency.Alzheimer’s disease(AD)causes degeneration of the brain cells leading to cognitive decline and memory loss,as well as dependence on others to fulfill basic daily needs.AD is the major cause of dementia.Computer-aided diagnosis(CADx)tools aid medical practitioners in accurately identifying diseases such as AD in patients.This study aimed to develop a CADx tool for the early detection of AD using the Intelligent Water Drop(IWD)algorithm and the Random Forest(RF)classifier.The IWD algorithm an efficient feature selection method,was used to identify the most deterministic features of AD in the dataset.RF is an ensemble method that leverages multiple weak learners to classify a patient’s disease as either demented(DN)or cognitively normal(CN).The proposed tool also classifies patients as mild cognitive impairment(MCI)or CN.The dataset on which the performance of the proposed CADx was evaluated was sourced from the Alzheimer’s Disease Neuroimaging Initiative(ADNI).The RF ensemble method achieves 100%accuracy in identifying DN patients from CN patients.The classification accuracy for classifying patients as MCI or CN is 92%.This study emphasizes the significance of pre-processing prior to classification to improve the classification results of the proposed CADx tool.展开更多
Objective:To evaluate the diagnostic efficacy of chronic viral hepatitis B(CHB)with significant liver fibrosis(S2)in patients with nonalcoholic fatty liver disease(NAFLD)by using noninvasive diagnosis and their combin...Objective:To evaluate the diagnostic efficacy of chronic viral hepatitis B(CHB)with significant liver fibrosis(S2)in patients with nonalcoholic fatty liver disease(NAFLD)by using noninvasive diagnosis and their combined models,and to explore their clinical features.Methods:A total of 104 inpatients with CHB diagnosed and complicated with NAFLD(hepatic steatosis suggested by liver biopsy)were retrospectively collected from January 2018 to January 2023 in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University.Liver biopsy was performed in all patients.General data,laboratory test results,liver hardness(LSM),FIB-4,APRI,GGT/PLT,AST/PLT and other results of patients were collected and grouped according to different fibrosis stages(S)to explore the clinical and pathological characteristics of patients with<S2 and S2 stages.Receiver operating characteristic curve was used to evaluate the diagnostic value of LSM,FIB-4,APRI,GGT/PLT,AST/PLT and their combined models in patients with significant liver fibrosis in CHB patients with NAFLD.Results:Among the 104 patients,there were 55 patients had S1 fibrosis,32 patients had S2 fibrosis,11 patients had S3 fibrosis and 6 patients had S4 fibrosis.Patients had<S2 fibrosis,ALT 33.75±17.15 U/L,AST 24.00(19.77,29.00)U/L,inflammation above G2 stage accounted for 92.72%,GGT/PLT 0.07(0.10,0.15),AST/PLT 0.09(0.10,0.15),LSM 8.70(6.80,10.10)kPa,FIB-41.07±0.51,APRI 0.26(0.22,0.28).In patients S2 fibrosis,ALT 42.14±21.39 U/L,AST 29.04(24.00,40.32)U/L,inflammation above G2 stage accounted for 97.95%,GGT/PLT 0.15(0.10,0.28),AST/PLT 0.14(0.10,0.26),GGT/PLT 0.15(0.10,0.28),AST/PLT 0.14(0.10,0.26).LSM 11.80(8.50,16.65)kPa,FIB-41.39±0.72,APRI 0.35(0.26,0.66),the difference between the two groups was statistically significant(P<0.05).The area under the receiver operator characteristic curves of the subjects of LSM,FIB-4,APRI,GGT/PLT and AST/PLT were 0.716,0.623,0.669,0.644 and 0.669(P<0.05),respectively.In the combined model,the area under the receiver operator characteristic curves of LSM combined with FIB-4,LSM combined with APRI,LSM combined with GGT/PLT and LSM combined with AST/PLT were 0.712,0.719,0.715 and 0.719,respectively(P<0.05).Conclusion:Although the currently commonly used Noninvasive diagnosis of liver fibrosis has certain diagnostic efficacy for significant liver fibrosis in CHB complicated with NAFLD,it cannot replace liver biopsy.Noninvasive Diagnosis can be used as an auxiliary method for regular clinical evaluation of liver biopsy.展开更多
BACKGROUND Perianal fistulising Crohn's disease(PFCD)and glandular anal fistula have many similarities on conventional magnetic resonance imaging.However,many patients with PFCD show concomitant active proctitis,b...BACKGROUND Perianal fistulising Crohn's disease(PFCD)and glandular anal fistula have many similarities on conventional magnetic resonance imaging.However,many patients with PFCD show concomitant active proctitis,but only few patients with glandular anal fistula have active proctitis.AIM To explore the value of differential diagnosis of PFCD and glandular anal fistula by comparing the textural feature parameters of the rectum and anal canal in fat suppression T2-weighted imaging(FS-T2WI).METHODS Patients with rectal water sac implantation were screened from the first part of this study(48 patients with PFCD and 22 patients with glandular anal fistula).Open-source software ITK-SNAP(Version 3.6.0,http://www.itksnap.org/)was used to delineate the region of interest(ROI)of the entire rectum and anal canal wall on every axial section,and then the ROIs were input in the Analysis Kit software(version V3.0.0.R,GE Healthcare)to calculate the textural feature parameters.Textural feature parameter differences of the rectum and anal canal wall between the PFCD group vs the glandular anal fistula group were analyzed using Mann-Whitney U test.The redundant textural parameters were screened by bivariate Spearman correlation analysis,and binary logistic regression analysis was used to establish the model of textural feature parameters.Finally,diagnostic accuracy was assessed by receiver operating characteristic-area under the curve(AUC)analysis.RESULTS In all,385 textural parameters were obtained,including 37 parameters with statistically significant differences between the PFCD and glandular anal fistula groups.Then,16 texture feature parameters remained after bivariate Spearman correlation analysis,including one histogram parameter(Histogram energy);four grey level co-occurrence matrix(GLCM)parameters(GLCM energy_all direction_offset1_SD,GLCM entropy_all direction_offset4_SD,GLCM entropy_all direction_offset7_SD,and Haralick correlation_all direction_offset7_SD);four texture parameters(Correlation_all direction_offset1_SD,cluster prominence_angle 90_offset4,Inertia_all direction_offset7_SD,and cluster shade_angle 45_offset7);five grey level run-length matrix parameters(grey level nonuniformity_angle 90_offset1,grey level nonuniformity_all direction_offset4_SD,long run high grey level emphasis_all direction_offset1_SD,long run emphasis_all direction_offset4_SD,and long run high grey level emphasis_all direction_offset4_SD);and two form factor parameters(surface area and maximum 3D diameter).The AUC,sensitivity,and specificity of the model of textural feature parameters were 0.917,85.42%,and 86.36%,respectively.CONCLUSION The model of textural feature parameters showed good diagnostic performance for PFCD.The texture feature parameters of the rectum and anal canal in FS-T2WI are helpful to distinguish PFCD from glandular anal fistula.展开更多
Oral diseases, such as periodontitis, salivary gland diseases, and oral cancers, significantly challenge health conditions due to their detrimental effects on patient's digestive functions, pronunciation, and esth...Oral diseases, such as periodontitis, salivary gland diseases, and oral cancers, significantly challenge health conditions due to their detrimental effects on patient's digestive functions, pronunciation, and esthetic demands. Delayed diagnosis and non-targeted treatment profoundly influence patients' prognosis and quality of life. The exploration of innovative approaches for early detection and precise treatment represents a promising frontier in oral medicine.展开更多
The differential diagnosis of neurodegenerative diseases is complex and relies on clinical assessment,biomarker levels in cerebrospinal fluid,neuroimaging and neuropsychological assessment.The efforts of the scientifi...The differential diagnosis of neurodegenerative diseases is complex and relies on clinical assessment,biomarker levels in cerebrospinal fluid,neuroimaging and neuropsychological assessment.The efforts of the scientific community are focused on two aspects:a)the discovery of minimally invasive biomarkers;b)the discovery of early biomarkers that can predict the progression to clinical disease in the presymptomatic stage of a disease.Considering the impact of the number of patients affected by chronic neurodegenerative diseases on public health expenditures,early diagnosis seems to be a primary need of our society.展开更多
Pneumoconiosis is a group of heterogeneous fibrotic lung diseases caused by inorganic mineral dust and includes coal workers’pneumoconiosis and silicosis.Silicosis involves diffuse or nodular interstitial pulmonary f...Pneumoconiosis is a group of heterogeneous fibrotic lung diseases caused by inorganic mineral dust and includes coal workers’pneumoconiosis and silicosis.Silicosis involves diffuse or nodular interstitial pulmonary fibrosis caused by exposure to asbestos or silica dust.China is thought to have the highest number of silicosis cases,with 6,000 new cases reported annually^([1]).Currently,the clinical diagnosis and monitoring of silicosis relies mainly on a history of occupational exposure and radiological abnormalities^([2]).Therefore,determining further indicators is crucial to reflect the severity of silicosis.展开更多
基金the National Natural Science Foundation of China,No.61975069 and No.62005056Natural Science Foundation of Guangxi Province,No.2021JJB110003+2 种基金Natural Science Foundation of Guangdong Province,No.2018A0303131000Academician Workstation of Guangdong Province,No.2014B090905001Key Project of Scientific and Technological Projects of Guangzhou,No.201604040007 and No.201604020168.
文摘BACKGROUND Crohn’s disease(CD)is often misdiagnosed as intestinal tuberculosis(ITB).However,the treatment and prognosis of these two diseases are dramatically different.Therefore,it is important to develop a method to identify CD and ITB with high accuracy,specificity,and speed.AIM To develop a method to identify CD and ITB with high accuracy,specificity,and speed.METHODS A total of 72 paraffin wax-embedded tissue sections were pathologically and clinically diagnosed as CD or ITB.Paraffin wax-embedded tissue sections were attached to a metal coating and measured using attenuated total reflectance fourier transform infrared spectroscopy at mid-infrared wavelengths combined with XGBoost for differential diagnosis.RESULTS The results showed that the paraffin wax-embedded specimens of CD and ITB were significantly different in their spectral signals at 1074 cm^(-1) and 1234 cm^(-1) bands,and the differential diagnosis model based on spectral characteristics combined with machine learning showed accuracy,specificity,and sensitivity of 91.84%,92.59%,and 90.90%,respectively,for the differential diagnosis of CD and ITB.CONCLUSION Information on the mid-infrared region can reveal the different histological components of CD and ITB at the molecular level,and spectral analysis combined with machine learning to establish a diagnostic model is expected to become a new method for the differential diagnosis of CD and ITB.
文摘This editorial provides commentary on an article titled"Potential and limitationsof ChatGPT and generative artificial intelligence(AI)in medical safety education"recently published in the World Journal of Clinical Cases.AI has enormous potentialfor various applications in the field of Kawasaki disease(KD).One is machinelearning(ML)to assist in the diagnosis of KD,and clinical prediction models havebeen constructed worldwide using ML;the second is using a gene signalcalculation toolbox to identify KD,which can be used to monitor key clinicalfeatures and laboratory parameters of disease severity;and the third is using deeplearning(DL)to assist in cardiac ultrasound detection.The performance of the DLalgorithm is similar to that of experienced cardiac experts in detecting coronaryartery lesions to promoting the diagnosis of KD.To effectively utilize AI in thediagnosis and treatment process of KD,it is crucial to improve the accuracy of AIdecision-making using more medical data,while addressing issues related topatient personal information protection and AI decision-making responsibility.AIprogress is expected to provide patients with accurate and effective medicalservices that will positively impact the diagnosis and treatment of KD in thefuture.
文摘Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions.One of the most important position papers in the field of gastro-esophageal reflux disease(GERD)is the one produced by the Lyon Consensus.Recently an updated second version has been released.Mean nocturnal baseline impedance(MNBI)was proposed by the first Consensus to act as supportive evidence for GERD diagnosis.Originally a cut-off of 2292 Ohms was proposed,a value revised in the second edition.The updated Consensus recommended that an MNBI<1500 Ohms strongly suggests GERD while a value>2500 Ohms can be used to refute GERD.The proposed cut-offs move in the correct direction by diminishing the original cut-off,nevertheless they arise from a study of normal subjects where cut-offs were provided by measuring the mean value±2SD and not in symptomatic patients.However,data exist that even symptomatic patients with inconclusive disease or reflux hypersensitivity(RH)show lower MNBI values in comparison to normal subjects or patients with functional heartburn(FH).Moreover,according to the data,MNBI,even among symptomatic patients,is affected by age and body mass index.Also,various studies have proposed different cut-offs by using receiver operating characteristic curve analysis even lower than the one proposed.Finally,no information is given for patients submitted to on-proton pump inhibitors pH-impedance studies even if new and extremely important data now exist.Therefore,even if MNBI is an extremely important tool when trying to approach patients with reflux symptoms and could distinguish conclusive GERD from RH or FH,its values should be interpreted with caution.
基金the Science and Technology Commission of Shanghai,No.18DZ1930309.
文摘BACKGROUND Traditional esophagogastroduodenoscopy(EGD),an invasive examination method,can cause discomfort and pain in patients.In contrast,magnetically controlled capsule endoscopy(MCE),a noninvasive method,is being applied for the detection of stomach and small intestinal diseases,but its application in treating esophageal diseases is not widespread.AIM To evaluate the safety and efficacy of detachable string MCE(ds-MCE)for the diagnosis of esophageal diseases.METHODS Fifty patients who had been diagnosed with esophageal diseases were pros-pectively recruited for this clinical study and underwent ds-MCE and conven-tional EGD.The primary endpoints included the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for patients with esophageal diseases.The secondary endpoints consisted of visualizing the esophageal and dentate lines,as well as the subjects'tolerance of the procedure.RESULTS Using EGD as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for esophageal disease detection were 85.71%,86.21%,81.82%,89.29%,and 86%,respectively.ds-MCE was more comfortable and convenient than EGD was,with 80%of patients feeling that ds-MCE examination was very comfortable or comfortable and 50%of patients believing that detachable string v examination was very convenient.CONCLUSION This study revealed that ds-MCE has the same diagnostic effects as traditional EGD for esophageal diseases and is more comfortable and convenient than EGD,providing a novel noninvasive method for treating esophageal diseases.
文摘As a common hyperglycemic disease,type 1 diabetes mellitus(T1DM)is a complicated disorder that requires a lifelong insulin supply due to the immunemediated destruction of pancreaticβcells.Although it is an organ-specific autoimmune disorder,T1DM is often associated with multiple other autoimmune disorders.The most prevalent concomitant autoimmune disorder occurring in T1DM is autoimmune thyroid disease(AITD),which mainly exhibits two extremes of phenotypes:hyperthyroidism[Graves'disease(GD)]and hypothyroidism[Hashimoto's thyroiditis,(HT)].However,the presence of comorbid AITD may negatively affect metabolic management in T1DM patients and thereby may increase the risk for potential diabetes-related complications.Thus,routine screening of thyroid function has been recommended when T1DM is diagnosed.Here,first,we summarize current knowledge regarding the etiology and pathogenesis mechanisms of both diseases.Subsequently,an updated review of the association between T1DM and AITD is offered.Finally,we provide a relatively detailed review focusing on the application of thyroid ultrasonography in diagnosing and managing HT and GD,suggesting its critical role in the timely and accurate diagnosis of AITD in T1DM.
基金Supported by National Natural Science Foundation of China,No.32200545The GDPH Supporting Fund for Talent Program,No.KJ012020633 and KJ012019530Science and Technology Research Project of Guangdong Provincial Hospital of Chinese Medicine,No.YN2022GK04。
文摘BACKGROUND The importance of age on the development of ocular conditions has been reported by numerous studies.Diabetes may have different associations with different stages of ocular conditions,and the duration of diabetes may affect the development of diabetic eye disease.While there is a dose-response relationship between the age at diagnosis of diabetes and the risk of cardiovascular disease and mortality,whether the age at diagnosis of diabetes is associated with incident ocular conditions remains to be explored.It is unclear which types of diabetes are more predictive of ocular conditions.AIM To examine associations between the age of diabetes diagnosis and the incidence of cataract,glaucoma,age-related macular degeneration(AMD),and vision acuity.METHODS Our analysis was using the UK Biobank.The cohort included 8709 diabetic participants and 17418 controls for ocular condition analysis,and 6689 diabetic participants and 13378 controls for vision analysis.Ocular diseases were identified using inpatient records until January 2021.Vision acuity was assessed using a chart.RESULTS During a median follow-up of 11.0 years,3874,665,and 616 new cases of cataract,glaucoma,and AMD,respectively,were identified.A stronger association between diabetes and incident ocular conditions was observed where diabetes was diagnosed at a younger age.Individuals with type 2 diabetes(T2D)diagnosed at<45 years[HR(95%CI):2.71(1.49-4.93)],45-49 years[2.57(1.17-5.65)],50-54 years[1.85(1.13-3.04)],or 50-59 years of age[1.53(1.00-2.34)]had a higher risk of AMD independent of glycated haemoglobin.T2D diagnosed<45 years[HR(95%CI):2.18(1.71-2.79)],45-49 years[1.54(1.19-2.01)],50-54 years[1.60(1.31-1.96)],or 55-59 years of age[1.21(1.02-1.43)]was associated with an increased cataract risk.T2D diagnosed<45 years of age only was associated with an increased risk of glaucoma[HR(95%CI):1.76(1.00-3.12)].HRs(95%CIs)for AMD,cataract,and glaucoma associated with type 1 diabetes(T1D)were 4.12(1.99-8.53),2.95(2.17-4.02),and 2.40(1.09-5.31),respectively.In multivariable-adjusted analysis,individuals with T2D diagnosed<45 years of age[β95%CI:0.025(0.009,0.040)]had a larger increase in LogMAR.Theβ(95%CI)for LogMAR associated with T1D was 0.044(0.014,0.073).CONCLUSION The younger age at the diagnosis of diabetes is associated with a larger relative risk of incident ocular diseases and greater vision loss.
文摘Behçet's disease(BD)is a chronic inflammatory disorder prone to frequent re-currences,with a high predilection for intestinal involvement.However,the ef-ficacy and long-term effects of surgical treatment for intestinal BD are unknown.In the current issue of World J Gastrointest Surg,Park et al conducted a retrospec-tive analysis of 31 patients with intestinal BD who received surgical treatment.They found that elevated C-reactive protein levels and emergency surgery were poor prognostic factors for postoperative recurrence,emphasizing the adverse impact of severe inflammation on the prognosis of patients with intestinal BD.This work has clinical significance for evaluating the postoperative condition of intestinal BD.The editorial attempts to summarize the clinical diagnosis and treatment of intestinal BD,focusing on the impact of adverse factors on surgical outcomes.We hope this review will facilitate more precise postoperative management of patients with intestinal BD by clinicians.
基金supported by grants from CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2021-I2M-1-014)and National Key R&D Program of China(No.2021YFC2500700).
文摘Drug-induced interstitial lung disease(DILD)is the most common pulmonary adverse event of anticancer drugs.In recent years,the incidence of anticancer DILD has gradually increased with the rapid development of novel anticancer agents.Due to the diverse clinical manifestations and the lack of specific diagnostic criteria,DILD is difficult to diagnose and may even become fatal if not treated properly.Herein,a multidisciplinary group of experts from oncology,respiratory,imaging,pharmacology,pathology,and radiology departments in China has reached the“expert consensus on the diagnosis and treatment of anticancer DILD”after several rounds of a comprehensive investigation.This consensus aims to improve the awareness of clinicians and provide recommendations for the early screening,diagnosis,and treatment of anticancer DILD.This consensus also emphasizes the importance of multidisciplinary collaboration while managing DILD.
文摘GTD (Gestational Trophoblastic Disease) is a pathology that encompasses benign and malignant clinical forms, affects women of childbearing age, has a variable incidence and is more frequent in developing or underdeveloped countries, colliding with the economic barrier. The frequent absence of clear protocols and guidelines for the correct diagnosis of the pathology results in inadequate classification, imprecise treatment and failed post-therapeutic observation, increasing the risk of relapses, morbidity and mortality. The present study aims to point out updated national and international practice protocols of diagnosis of GTD, through an integrative review. Seven articles were selected and it was observed that the main international reference centers are agreed with the management suggested by the IFGO (International Federation of Gynecology and Obstetrics), being the conduct in the Hydatidiform Mole (HM): evacuation by suction and curettage under ultrasound guidance, followed by hCG monitoring every 1 - 2 weeks until normalized (usually one month for Partial Hydatidiform Mole six months for Complete Hydatidiform Mole and one year for Gestational Trophoblastic Neoplasia). Unfortunately, regarding the diagnosis of MH, the guidelines of some countries show the absence or difficulty of access to the karyotype test and ploid p57 or pelvic ultrasound accompanying the uterine curettage, contrary to what is proposed by the IFGO guideline. Establishing and complying with consistent guidelines can improve patient care, with early diagnosis of the pathology and its complications, reducing the rate of recurrence, morbidity and mortality, especially in less developed countries.
文摘Over the past three decades, genomic and epigenetic sciences have identified more than 70 genes involved in the molecular pathophysiology of Alzheimer’s disease (AD). DNA methylation, abnormal histone and chromatin regulation and the action of various miRNAs induce AD. The identification of mutated genes has paved the way for the development of diagnostic kits and the initiation of gene therapy trials. However, despite major advances in neuroscience research, there is yet no suitable treatment for AD. Therefore, the early diagnosis of this neurodegenerative disease raises several ethical questions, including the balance between the principle of non-maleficence and the principle of beneficence. The aims of this research were to present the genomic and ethical aspects of AD, and to highlight the ethical principles involved in its presymptomatic diagnosis and therapy. A systematic review of the literature in PubMed, Google Scholar and Science Direct was carried out to outline the genomic aspects and ethical principles relating not only to the presymptomatic diagnosis of AD, but also to its gene therapy. A total of 16 publications were selected. AD is a multifactorial disease that can be genetically classified into Sporadic Alzheimer’s Disease and Familial Alzheimer’s Disease based on family history. Gene therapy targeting specific disease-causing genes is a promising therapeutic strategy. Advancements in artificial intelligence applications may enable the prediction of AD onset several years in advance. While early diagnosis of AD may empower patients with full decision competence for early decision-making, it also carries implications for the patient’s family members, who are at risk of developing the disease, potentially becoming a source of confusion or anxiety. AD has a significant impact on the life of individuals at risk and their families. Given the absence of disease modifying therapy, genetic screening and early diagnosis for this condition raise ethical issues that must be carefully considered in the context of fundamental bioethical principles, including autonomy, beneficence, non-maleficence, and justice.
文摘BACKGROUND Shear wave speed(SWS),shear wave dispersion(SWD),and attenuation imaging(ATI)are new diagnostic parameters for non-alcoholic fatty liver disease.To differentiate between non-alcoholic steatohepatitis(NASH)and non-alcoholic fatty liver(NAFL),we developed a clinical index we refer to as the“NASH pentagon”consisting of the 3 abovementioned parameters,body mass index(BMI),and Fib-4 index.AIM To investigate whether the area of the NASH pentagon we propose is useful in discriminating between NASH and NAFL.METHODS This non-invasive,prospective,observational study included patients diagnosed with fatty liver by abdominal ultrasound between September 2021 and August 2022 in whom shear wave elastography,SWD,and ATI were measured.Histological diagnosis based on liver biopsy was performed in 31 patients.The large pentagon group(LP group)and the small pentagon group(SP group),using an area of 100 as the cutoff,were compared;the NASH diagnosis rate was also investigated.In patients with a histologically confirmed diagnosis,receiveroperating characteristic(ROC)curve analyses were performed.RESULTS One hundred-seven patients(61 men,46 women;mean age 55.1 years;mean BMI 26.8 kg/m2)were assessed.The LP group was significantly older(mean age:60.8±15.2 years vs 46.4±13.2 years;P<0.0001).Twenty-five patients who underwent liver biopsies were diagnosed with NASH,and 6 were diagnosed with NAFL.On ROC curve analyses,the areas under the ROC curves for SWS,dispersion slope,ATI value,BMI,Fib-4 index,and the area of the NASH pentagon were 0.88000,0.82000,0.58730,0.63000,0.59333,and 0.93651,respectively;the largest was that for the area of the NASH pentagon.CONCLUSION The NASH pentagon area appears useful for discriminating between patients with NASH and those with NAFL.
文摘In agricultural engineering,the main challenge is on methodologies used for disease detection.The manual methods depend on the experience of the personal.Due to large variation in environmental condition,disease diagnosis and classification becomes a challenging task.Apart from the disease,the leaves are affected by climate changes which is hard for the image processing method to discriminate the disease from the other background.In Cucurbita gourd family,the disease severity examination of leaf samples through computer vision,and deep learning methodologies have gained popularity in recent years.In this paper,a hybrid method based on Convolutional Neural Network(CNN)is proposed for automatic pumpkin leaf image classification.The Proposed Denoising and deep Convolutional Neural Network(CNN)method enhances the Pumpkin Leaf Pre-processing and diagnosis.Real time data base was used for training and testing of the proposed work.Investigation on existing pre-trained network Alexnet and googlenet was investigated is done to evaluate the performance of the pro-posed method.The system and computer simulations were performed using Matlab tool.
文摘Tongue image analysis is an efficient and non-invasive technique to determine the internal organ condition of a patient in oriental medicine,for example,traditional Chinese medicine(TCM),Japanese traditional herbal medicine,and traditional Korean medicine(TKM).The diagnosis procedure is mainly based on the expert’s knowledge depending upon the visual inspec-tion comprising color,substance,coating,form,and motion of the tongue.But conventional tongue diagnosis has limitations since the procedure is inconsistent and subjective.Therefore,computer-aided tongue analyses have a greater potential to present objective and more consistent health assess-ments.This manuscript introduces a novel Simulated Annealing with Transfer Learning based Tongue Image Analysis for Disease Diagnosis(SADTL-TIADD)model.The presented SADTL-TIADD model initially pre-processes the tongue image to improve the quality.Next,the presented SADTL-TIADD technique employed an EfficientNet-based feature extractor to generate useful feature vectors.In turn,the SA with the ELM model enhances classification efficiency for disease detection and classification.The design of SA-based parameter tuning for heart disease diagnosis shows the novelty of the work.A wide-ranging set of simulations was performed to ensure the improved performance of the SADTL-TIADD algorithm.The experimental outcomes highlighted the superior of the presented SADTL-TIADD system over the compared methods with maximum accuracy of 99.30%.
基金National Natural Science Foundation of China(81860790)Guangxi Science and Technology Planning Project(Guike AB20297002)+3 种基金Guangxi Natural Science Foundation(2020GXNSFAA297160)Guangxi first-class discipline training discipline of integrated traditional Chinese and Western medicine(2019XK159)Graduate Education Innovation Project(YCBXJ2021020)Guangxi Special expert Special fund[Guangxi talent general character(2019)NO.13]。
文摘microRNA(miRNA)is a type of single-stranded small molecule non-coding RNA that interacts with the 3'untranslated region of the target gene to achieve negative regulation of the target gene and participate in multiple links of cell proliferation and apoptosis.At present,there is evidence that miRNA-155 is involved in the occurrence and development of a variety of liver diseases.By consulting relevant literature reports,this article summarizes the effects of miRNA-155 in non-alcoholic fatty liver disease,alcoholic liver disease,viral hepatitis,acute liver failure,and liver disease.The research progress of fibrosis and liver cancer in a variety of liver diseases,and the potential of miRNA-155 as a non-invasive biomarker is analyzed to provide a reference for exploring the diagnosis and treatment of liver diseases.
基金The authors extend their appreciation to the Deputyship for Research&Innovation,Ministry of Education in Saudi Arabia for funding this research work through the project number(IF-PSAU-2021/01/18596).
文摘Aging is a natural process that leads to debility,disease,and dependency.Alzheimer’s disease(AD)causes degeneration of the brain cells leading to cognitive decline and memory loss,as well as dependence on others to fulfill basic daily needs.AD is the major cause of dementia.Computer-aided diagnosis(CADx)tools aid medical practitioners in accurately identifying diseases such as AD in patients.This study aimed to develop a CADx tool for the early detection of AD using the Intelligent Water Drop(IWD)algorithm and the Random Forest(RF)classifier.The IWD algorithm an efficient feature selection method,was used to identify the most deterministic features of AD in the dataset.RF is an ensemble method that leverages multiple weak learners to classify a patient’s disease as either demented(DN)or cognitively normal(CN).The proposed tool also classifies patients as mild cognitive impairment(MCI)or CN.The dataset on which the performance of the proposed CADx was evaluated was sourced from the Alzheimer’s Disease Neuroimaging Initiative(ADNI).The RF ensemble method achieves 100%accuracy in identifying DN patients from CN patients.The classification accuracy for classifying patients as MCI or CN is 92%.This study emphasizes the significance of pre-processing prior to classification to improve the classification results of the proposed CADx tool.
基金Natural Science Foundation of Xinjiang Uygur Autonomous Region (No.2022D01C173)National Natural Science Foundation of China (No.81760832)。
文摘Objective:To evaluate the diagnostic efficacy of chronic viral hepatitis B(CHB)with significant liver fibrosis(S2)in patients with nonalcoholic fatty liver disease(NAFLD)by using noninvasive diagnosis and their combined models,and to explore their clinical features.Methods:A total of 104 inpatients with CHB diagnosed and complicated with NAFLD(hepatic steatosis suggested by liver biopsy)were retrospectively collected from January 2018 to January 2023 in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University.Liver biopsy was performed in all patients.General data,laboratory test results,liver hardness(LSM),FIB-4,APRI,GGT/PLT,AST/PLT and other results of patients were collected and grouped according to different fibrosis stages(S)to explore the clinical and pathological characteristics of patients with<S2 and S2 stages.Receiver operating characteristic curve was used to evaluate the diagnostic value of LSM,FIB-4,APRI,GGT/PLT,AST/PLT and their combined models in patients with significant liver fibrosis in CHB patients with NAFLD.Results:Among the 104 patients,there were 55 patients had S1 fibrosis,32 patients had S2 fibrosis,11 patients had S3 fibrosis and 6 patients had S4 fibrosis.Patients had<S2 fibrosis,ALT 33.75±17.15 U/L,AST 24.00(19.77,29.00)U/L,inflammation above G2 stage accounted for 92.72%,GGT/PLT 0.07(0.10,0.15),AST/PLT 0.09(0.10,0.15),LSM 8.70(6.80,10.10)kPa,FIB-41.07±0.51,APRI 0.26(0.22,0.28).In patients S2 fibrosis,ALT 42.14±21.39 U/L,AST 29.04(24.00,40.32)U/L,inflammation above G2 stage accounted for 97.95%,GGT/PLT 0.15(0.10,0.28),AST/PLT 0.14(0.10,0.26),GGT/PLT 0.15(0.10,0.28),AST/PLT 0.14(0.10,0.26).LSM 11.80(8.50,16.65)kPa,FIB-41.39±0.72,APRI 0.35(0.26,0.66),the difference between the two groups was statistically significant(P<0.05).The area under the receiver operator characteristic curves of the subjects of LSM,FIB-4,APRI,GGT/PLT and AST/PLT were 0.716,0.623,0.669,0.644 and 0.669(P<0.05),respectively.In the combined model,the area under the receiver operator characteristic curves of LSM combined with FIB-4,LSM combined with APRI,LSM combined with GGT/PLT and LSM combined with AST/PLT were 0.712,0.719,0.715 and 0.719,respectively(P<0.05).Conclusion:Although the currently commonly used Noninvasive diagnosis of liver fibrosis has certain diagnostic efficacy for significant liver fibrosis in CHB complicated with NAFLD,it cannot replace liver biopsy.Noninvasive Diagnosis can be used as an auxiliary method for regular clinical evaluation of liver biopsy.
文摘BACKGROUND Perianal fistulising Crohn's disease(PFCD)and glandular anal fistula have many similarities on conventional magnetic resonance imaging.However,many patients with PFCD show concomitant active proctitis,but only few patients with glandular anal fistula have active proctitis.AIM To explore the value of differential diagnosis of PFCD and glandular anal fistula by comparing the textural feature parameters of the rectum and anal canal in fat suppression T2-weighted imaging(FS-T2WI).METHODS Patients with rectal water sac implantation were screened from the first part of this study(48 patients with PFCD and 22 patients with glandular anal fistula).Open-source software ITK-SNAP(Version 3.6.0,http://www.itksnap.org/)was used to delineate the region of interest(ROI)of the entire rectum and anal canal wall on every axial section,and then the ROIs were input in the Analysis Kit software(version V3.0.0.R,GE Healthcare)to calculate the textural feature parameters.Textural feature parameter differences of the rectum and anal canal wall between the PFCD group vs the glandular anal fistula group were analyzed using Mann-Whitney U test.The redundant textural parameters were screened by bivariate Spearman correlation analysis,and binary logistic regression analysis was used to establish the model of textural feature parameters.Finally,diagnostic accuracy was assessed by receiver operating characteristic-area under the curve(AUC)analysis.RESULTS In all,385 textural parameters were obtained,including 37 parameters with statistically significant differences between the PFCD and glandular anal fistula groups.Then,16 texture feature parameters remained after bivariate Spearman correlation analysis,including one histogram parameter(Histogram energy);four grey level co-occurrence matrix(GLCM)parameters(GLCM energy_all direction_offset1_SD,GLCM entropy_all direction_offset4_SD,GLCM entropy_all direction_offset7_SD,and Haralick correlation_all direction_offset7_SD);four texture parameters(Correlation_all direction_offset1_SD,cluster prominence_angle 90_offset4,Inertia_all direction_offset7_SD,and cluster shade_angle 45_offset7);five grey level run-length matrix parameters(grey level nonuniformity_angle 90_offset1,grey level nonuniformity_all direction_offset4_SD,long run high grey level emphasis_all direction_offset1_SD,long run emphasis_all direction_offset4_SD,and long run high grey level emphasis_all direction_offset4_SD);and two form factor parameters(surface area and maximum 3D diameter).The AUC,sensitivity,and specificity of the model of textural feature parameters were 0.917,85.42%,and 86.36%,respectively.CONCLUSION The model of textural feature parameters showed good diagnostic performance for PFCD.The texture feature parameters of the rectum and anal canal in FS-T2WI are helpful to distinguish PFCD from glandular anal fistula.
基金supported by the National Natural Science Foundation of China Grants(82370945, 82171001, 82222015 and 82370915)Research Funding from West China School/Hospital of Stomatology Sichuan University(RCDWJS2023-1)。
文摘Oral diseases, such as periodontitis, salivary gland diseases, and oral cancers, significantly challenge health conditions due to their detrimental effects on patient's digestive functions, pronunciation, and esthetic demands. Delayed diagnosis and non-targeted treatment profoundly influence patients' prognosis and quality of life. The exploration of innovative approaches for early detection and precise treatment represents a promising frontier in oral medicine.
基金supported by grants from the Italian Ministry of Health(Ricerca Corrente to FRB,DG,GMT)。
文摘The differential diagnosis of neurodegenerative diseases is complex and relies on clinical assessment,biomarker levels in cerebrospinal fluid,neuroimaging and neuropsychological assessment.The efforts of the scientific community are focused on two aspects:a)the discovery of minimally invasive biomarkers;b)the discovery of early biomarkers that can predict the progression to clinical disease in the presymptomatic stage of a disease.Considering the impact of the number of patients affected by chronic neurodegenerative diseases on public health expenditures,early diagnosis seems to be a primary need of our society.
基金supported by the scientific research project of Hunan Prevention and Treatment Institute for Occupational Diseases in 2021(Y2021-013)。
文摘Pneumoconiosis is a group of heterogeneous fibrotic lung diseases caused by inorganic mineral dust and includes coal workers’pneumoconiosis and silicosis.Silicosis involves diffuse or nodular interstitial pulmonary fibrosis caused by exposure to asbestos or silica dust.China is thought to have the highest number of silicosis cases,with 6,000 new cases reported annually^([1]).Currently,the clinical diagnosis and monitoring of silicosis relies mainly on a history of occupational exposure and radiological abnormalities^([2]).Therefore,determining further indicators is crucial to reflect the severity of silicosis.