Fusion of Region Extraction and Cross-Entropy SVM Models for Wheat Rust Diseases Classification

Wheat rust diseases are one of the major types of fungal diseases that cause substantial yield quality losses of 15%–20%every year.The wheat rust diseases are identified either through experienced evaluators or computerassisted techniques.The experienced evaluators take time to identify the disease which is highly laborious and too costly.If wheat rust diseases are predicted at the development stages,then fungicides are sprayed earlier which helps to increase wheat yield quality.To solve the experienced evaluator issues,a combined region extraction and cross-entropy support vector machine(CE-SVM)model is proposed for wheat rust disease identification.In the proposed system,a total of 2300 secondary source images were augmented through flipping,cropping,and rotation techniques.The augmented images are preprocessed by histogram equalization.As a result,preprocessed images have been applied to region extraction convolutional neural networks(RCNN);Fast-RCNN,Faster-RCNN,and Mask-RCNN models for wheat plant patch extraction.Different layers of region extraction models construct a feature vector that is later passed to the CE-SVM model.As a result,the Gaussian kernel function in CE-SVM achieves high F1-score(88.43%)and accuracy(93.60%)for wheat stripe rust disease classification.

Application of YLD Calculation in Assessing Disease Data──An Analysis of 4 Diseases in 2 Regions

The objective of the curtent study is to discuss the problems related to how data is used to calculate Yeare Lost with Disability (YLD) with the method recommended by the World Bank. The study includes collecting useful data, estimating disease duration and average age of disease onset,adjusting incidence and prevalence data by means of a software programme, DISMOD (Harvard University Incidence & Prevalence Model), and assessing the importance of YLD calculation for different diseases.Remission and fatality rates of 3 diseases were estimated by experts at 2 round consultations.Incidence rates, disease duration and average age of disease onset were calculated and adjusted by DISMOD. YLD due to schizothrenia is the highest among 4 diseases in two regions. YLD is 18. 88 % in disability adjusted life year for 4 diseases in Xiacheng District, and 19 .97 % in Fuyang County.Available data can be used for the calculation of YLD after being adjusted. DISMOD is a useful instrument to test the internal consistency of incidence, prevalence, rendssion and fatality rate. The adjusted data are acceptable to experts and DISMOD. To get rational remission and fatality rates, we can use a cohort method through expert consultations. To renect overall burden of disease, YLD calculation should be used.

Primary Screening for Breast Diseases among 17618 Women in Wufeng Area, a Region with High Incidence of Cervical Cancer in China

In this study, the current status for breast diseases in a region with high-incidence of cervical cancer were epidemiologically investigated. From March to August, 2009, 17618 women, from Wufeng area of Hubei province, China, were recruited to screen breast diseases by using breast infrared diagnostic apparatus. Other diagnostic methods, such as B-mode ultrasound, X-ray mammography, needle biopsy and pathological examination were, if necessary, used to further confirm the diagnosis. The screening showed that 5990 of 17618 cases (34.00%) had breast diseases, 5843 (33.16%) had mammary gland hyperplasia, 48 (0.27%) had breast fibroadenoma, 11 (0.06%) had breast carcinoma, and 88 (0.50%) had other breast diseases. The peak morbidity of breast cancer was found in the women aged 50–60 ages. The morbidity of breast cancer was significantly increased in women elder than or equal to 50 years old (n=8, 0.157%) in comparison with that in the subjects younger than 50 years old (n=3, 0.024%) (u=2.327, P<0.05). It was shown that the occurrence of breast diseases was concentrated in women aged 20–40 years, while the total morbidity reached its peak at the age of 30 years and then decreased sharply after age of 40. Compared with the patients elder than or equal to 40 years old (n=3289, 27.46%), the morbidity rate of breast diseases was significantly increased in women less than 40 years old (2648 cases, 47.18%; P<0.001). However, there was no significant difference in the morbidity of breast diseases between the age group of 20–29 years and that of 30–39 years (P=0.453), and both of them were high. There was no significant association between the morbidity of breast diseases and cervical cancer. Since the morbidity of breast diseases was higher among young women, more attention should be paid to the screening of breast diseases among young women for early diagnosis.

Neural stem cell-derived exosomes promote mitochondrial biogenesis and restore abnormal protein distribution in a mouse model of Alzheimer's disease

Mitochondrial dysfunction is a hallmark of Alzheimer’s disease.We previously showed that neural stem cell-derived extracellular vesicles improved mitochondrial function in the cortex of AP P/PS1 mice.Because Alzheimer’s disease affects the entire brain,further research is needed to elucidate alterations in mitochondrial metabolism in the brain as a whole.Here,we investigated the expression of several important mitochondrial biogenesis-related cytokines in multiple brain regions after treatment with neural stem cell-derived exosomes and used a combination of whole brain clearing,immunostaining,and lightsheet imaging to clarify their spatial distribution.Additionally,to clarify whether the sirtuin 1(SIRT1)-related pathway plays a regulatory role in neural stem cell-de rived exosomes interfering with mitochondrial functional changes,we generated a novel nervous system-SIRT1 conditional knoc kout AP P/PS1mouse model.Our findings demonstrate that neural stem cell-de rived exosomes significantly increase SIRT1 levels,enhance the production of mitochondrial biogenesis-related fa ctors,and inhibit astrocyte activation,but do not suppress amyloid-βproduction.Thus,neural stem cell-derived exosomes may be a useful therapeutic strategy for Alzheimer’s disease that activates the SIRT1-PGC1αsignaling pathway and increases NRF1 and COXIV synthesis to improve mitochondrial biogenesis.In addition,we showed that the spatial distribution of mitochondrial biogenesis-related factors is disrupted in Alzheimer’s disease,and that neural stem cell-derived exosome treatment can reverse this effect,indicating that neural stem cell-derived exosomes promote mitochondrial biogenesis.

Hybrid Convolutional Neural Network for Plant Diseases Prediction

Plant diseases prediction is the essential technique to prevent the yield loss and gain high production of agricultural products.The monitoring of plant health continuously and detecting the diseases is a significant for sustainable agri-culture.Manual system to monitor the diseases in plant is time consuming and report a lot of errors.There is high demand for technology to detect the plant dis-eases automatically.Recently image processing approach and deep learning approach are highly invited in detection of plant diseases.The diseases like late blight,bacterial spots,spots on Septoria leaf and yellow leaf curved are widely found in plants.These are the main reasons to affects the plants life and yield.To identify the diseases earliest,our research presents the hybrid method by com-bining the region based convolutional neural network(RCNN)and region based fully convolutional networks(RFCN)for classifying the diseases.First the leaf images of plants are collected and preprocessed to remove noisy data in image.Further data normalization,augmentation and removal of background noises are done.The images are divided as testing and training,training images are fed as input to deep learning architecture.First,we identify the region of interest(RoI)by using selective search.In every region,feature of convolutional neural network(CNN)is extracted independently for further classification.The plants such as tomato,potato and bell pepper are taken for this experiment.The plant input image is analyzed and classify as healthy plant or unhealthy plant.If the image is detected as unhealthy,then type of diseases the plant is affected will be displayed.Our proposed technique achieves 98.5%of accuracy in predicting the plant diseases.

The effect of zinc supplementation on diarrheal diseases in children in the Niger Delta Sub-Region of Nigeria

This study evaluated the trend of diarrheal diseases managed with zinc supplementation by comparing it with diarrheal diseases managed without zinc supplementation at the University of Port Harcourt Teaching hospital (UPTH), Nigeria. The study was a descriptive retrospective study done at the Diarrhea Training Unit (DTU) of UPTH to determine the effect of zinc supplementation in the management of diarrhea in children under 5 years. Out of the 134 case records studied, of children aged 0 to 59 months who presented with diarrhea at the DTU, 57 children did not receive zinc supplementation between October and December, 2007 and 77 children received zinc supplementation between October and December 2009. The results showed that (74) 96.1% of patients who received zinc supplementation, and (48) 84.2% of those who did not, had no repeat diarrheal episodes when seen at the follow up clinic. On the other hand, 1.3% of those who received zinc supplementation and 1.8% of those who did not, had increased episodes of diarrhea when seen at the follow up clinic. Of those who received, and those who did not receive zinc supplementation, 2.6% and 14% respectively, had reduced episodes of diarrhea. These findings clearly demonstrate the effectiveness of zinc supplementation in halting the course of diarrheal diseases in children aged 0 to 59 months. We therefore advocate for the use of zinc supplementation in the management of diarrhea in

gastrointestinal symptom prevalence depends on disease duration and gastrointestinal region in type 2 diabetes mellitus

AIM To unravel relationships between gastrointestinal(GI)symptoms impairing quality of life(QOL)and clinical profiles of diabetes mellitus(DM)patients. METHODS We enrolled 134 outpatients with type 2 DM.Mean age was 64.7 years,mean body mass index was 24.7 RESULTS Lower abdominal symptoms were found to be more frequent than those affecting the upper abdomen.Diabetic duration and medications showed associations with GI symptoms.We identified differences in peak prevalences of the five symptoms.Gastralgia(P=0.02vs 10-14 years)and total GI symptoms(P=0.01 and P=0.02 vs 5-9 years and 10-14 years,respectively)peaked at a diabetes duration of 15-19 years.Heartburn(P=0.004)and postprandial fullness(P=0.03)tended to increase with disease duration.Constipation and diarrhea showed bimodal peaks,with the first early and the second late(e.g.,P=0.03 at 15-19 years vs 10-14years for diarrhea)in the disease course.Finally,GI symptoms showed clustering that reflected the region of the GI tract affected,i.e.,constipation and diarrhea had similar frequencies(P<0.0001). CONCLUSION Our study highlights the importance of questioning patients about QOL impairment due to abdominal symptoms,especially in the early and the late periods of diabetes.

In-situ experiment investigations of hydrothermal process of highway in deep seasonal frozen soil regions of Inner Mongolia, China

To reveal the influencing factors and changing rules for the hydrothermal interaction process of highway subgrade, the field measurements of Shiwei-Labudalin Highway in Inner Mongolia, China was conducted for 3 years, based on which the freezing-thawing rules and water content changing characteristics were analyzed. The main results show the subgrade presents a frequent freezing-thawing alternation, and the water content of subgrade exhibits an obvious seasonal alternation. The subbase has the maximum water content, while the base has the minimum water content. The change of water flux is concentrated in the thawing period and consistent with the change of temperature gradient. The subbase layer has the most active water flux due to the heat absorption and impermeability of pavement that easily causes the water accumulation in this layer. Therefore, the prevention and treatment for the freezing-thawing disease should be started from heat insulation and water resistance.

Regional variation of pediatric inflammatory bowel disease in Saudi Arabia: Results from a multicenter study

BACKGROUND Incidence and severity variations of inflammatory bowel disease(IBD)have been reported from Western populations between continents and regions of the same countries.However,no data were available from other countries.AIM To investigate the regional differences in the IBD profiles of pediatric patients from the Kingdom of Saudi Arabia.METHODS Data from a national multicenter IBD study were used.The incidence,time trend,and clinical presentation of Crohn’s disease(CD)and ulcerative colitis(UC)in the Central region(CR),Western region(WR),and Eastern region(ER)were analyzed and compared.Statistical analysis included Poisson regression analysis for incidence variation and Chi-square test for demographic and clinical parameters.A P<0.05 was considered significant.RESULTS The prevalence of positive family history was lower in children with CD from the ER than the CR or the WR.Consanguinity rate was higher in children with CD and UC from the CR and the ER,respectively.The incidences and time trends of CD and UC were not significantly different between regions.In the ER,a significantly higher percentage of children with CD presented with abdominal pain(P<0.001),blood in stools(P=0.048),stricturing or penetrating disease(P=0.029),higher erythrocyte sedimentation rate(P<0.001),higher C-reactive protein(P<0.001),higher anemia(P=0.017),and lower albumin level(P=0.014).For children with UC from the ER,a significantly higher percentage presented with anemia(P=0.006)and a lower percentage with pancolitis(P<0.001).CONCLUSION The most important finding is the identification of significantly more severe presentation of CD in the ER of the Kingdom of Saudi Arabia.Prospective studies are needed to explain such variations.

Resolution of Crohn's disease and complex regional pain syndrome following treatment of paratuberculosis

A cohort of family members with various chronic diseases including Crohn's disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infection by Mycobacterium avium subsp. paratuberculosis(MAP) are described in this series of case reports. MAP was cultured from the blood of three members affected by the first five diseases and there was accompanying elevated anti-MAP Ig G in two members. The patient affected by the sixth disease has a markedly elevated anti-MAP titer. The two patients affected by the first four diseases have been treated with a combination of anti-MAP antibiotics and ultraviolet blood irradiation therapy with resolution of the disease symptomatology and inability to culture MAP in post treatment blood samples. These case reports of patients with MAP infections provide supportive evidence of a pathogenic role of MAP in humans.

Epidemiological Survey on Canine Parvovirus Disease in Taizhou Region,Jiangsu Province,China

The canine parvovirus disease is an acute infectious disease caused by canine parvovirus(CPV). It is clinically characterized by severe vomiting,hemorrhagic enteritis,significant reduction in white blood cells and myocarditis. The disease with high incidence,highly infectious and high mortality has become one of the serious infectious diseases threatening dog raising industry in China. In this research,260 cases of canine parvovirus case from an Aite Pet Clinic in Taizhou City during January 2010 and March 2011 were analyzed. This study discloses the epidemiology of CPV in Taizhou region of Jiangsu Province,i. e.,the incidence of CPV and canine motility are closely correlated with age,breed,immune inoculation and season. This study provides useful guide for the clinical treatment of CPV in the future.

Inflammatory bowel disease incidence in Czech children:A regional prospective study,2000-2015

AIM To examine the incidence and trends in pediatric inflammatory bowel diseases(IBDs) over 2000-2015 and project the incidence to 2018. METHODS A 16-year prospective study of IBD patients < 19 years of age was conducted in the Czech Republic(the Pilsen region). All incident IBD cases within a well-defined geographical area were retrieved from a prospectively collected computerized clinical database. Historical Czech data were used for comparison(1990-2001). Our catchment population was determined from the census data. We calculated the incidence by relating the number of newly diagnosed cases to the size of thepediatric population-at-risk in each calendar year. Age/sex, disease type, place of residence, and race/ethnicity were identified. RESULTS In total, 170 new IBD cases [105 Crohn's disease(CD), 48 ulcerative colitis(UC), and 17 IBD-unclassified(IBD-U)] were identified. The median age at IBD diagnosis was 14.2 years, 59.4% were males, and 97.1% were Caucasians. A male preponderance of IBD(P = 0.026) and CD(P = 0.016) was observed. With 109209 person-years in the catchment area, the average incidence of IBD per 100000 person-years was 10.0(6.2 for CD, 2.8 for UC, and 1.0 for IBD-U) for children aged 0 to 19 years; for those aged 0 to 15 years, the incidence rate was 7.3(4.6 for CD, 2.0 for UC, and 0.7 for IBD-U). An increase in incidence with age was observed(P = 0.0003). Over the 16-year period, the incidence increased for IBD patients(P = 0.01) and CD in particular(P < 0.0001), whereas the incidence for UC(P = 0.09) and IBD-U(P = 0.339) remained unchanged. IBD-projected data from 2016 to 2018 were 12.1, 12.3 and 12.6 per 100000 personyears, respectively.CONCLUSION Pediatric-onset IBD incidence is around its highest point. The increase, which is particularly pronounced for CD, may be challenging to relate to causes of pediatric disease.

Regional patterns of atrophy on MRI in Alzheimer’s disease: Neuropsychological features and progression rates in the ADNI cohort

Background: Discrete clinical and pathological subtypes of Alzheimer’s disease (AD) with variable presentations and rates of progression are well known. These subtypes may have specific patterns of regional brain atrophy, which are identifiable on MRI scans. Methods: To examine distinct regions which had distinct underlying patterns of cortical atrophy, factor analytic techniques applied to structural MRI volumetric data from cognitively normal (CN) (n = 202), amnestic mild cognitive impairment (aMCI) (n = 333) or mild AD (n = 146) subjects, in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database was applied. This revealed the existence of two neocortical (NeoC-1 and NeoC-2), and a limbic cluster of atrophic brain regions. The frequency and clinical correlates of these regional patterns of atrophy were evaluated among the three diagnostic groups, and the rates of progression from aMCI to AD, over 24 months were evaluated. Results: Discernable patterns of regional atrophy were observed in about 29% of CN, 55% of aMCI and 83% of AD subjects. Heterogeneity in clinical presentation and APOE ε4 frequency were associated with regional patterns of atrophy on MRI scans. The most rapid progression rates to dementia among aMCI subjects (n = 224), over a 24-month period, were in those with NeoC-1 regional impairment (68.2%), followed by the Limbic regional impairment (48.8%). The same pattern of results was observed when only aMCI amyloid positive subjects were examined. Conclusions: The neuroimaging results closely parallel findings described recently among AD patients with the hippocampal sparing and limbic subtypes of AD neuropathology at autopsy. We conclude that NeoC-1, Limbic and other patterns of MRI atrophy may be useful markers for predicting the rate of progression of aMCI to AD and could have utility selecting individuals at higher risk for progression in clinical trials.

Correlation of diseased region and area with neglect and other neuropsychological dysfunctions in patients with cerebral infarction

BACKGROUND: Previous studies reported that frontal-temporal-parietal-occipital pathological changes and diseased range in the right cerebral hemisphere were closely correlated with neglect. But studies on the correlation of neglect with diseased region and area in patients who suffer from initial attack of single focus of cerebral infarction (CI) in left and right cerebral hemispheres are few. OBJECTIVE: To observe the status of neglect in patients who suffer from single focus of CI in cerebral hemisphere, and analyze the correlation of neglect with diseased region and area of CI. DESIGN: Case analysis. SETTING: Treatment Center for Cardiocerebrovascular Disease, Second Hospital of Xiamen city; Department of Neurology, First Hospital Affiliated to Baotou Medical College. PARTICIPANTS: All the CI patients hospitalized in the Department of Neurology, First Hospital Affiliated to Baotou Medical College from June 1998 to May 2001 were retrieved. Inclusive criteria: ① Patients who suffered from initial attack of CI, which was confirmed by skull CT or MRI within 24 hours after onset and presented single focus in cerebral hemisphere. ② be conscious and could cooperate in the examination. ③ did not receive formal education, but could do accounts and some simple writing and reading. ④Patients with homonymous hemianopia were excluded through the examination of perimeter. ⑤ Informed consents were obtained from all the patients. Among 67 patients who met the inclusive criteria, 33 suffered from CI in the left cerebral hemisphere and 34 in the right cerebral hemisphere. METHODS: ① Patients received neglect supplement examination and Chinese aphasia examination within 2.5 to 3 months after the attack of CI . The diagnostic criteria of neglect in the tests of line cancellation, line bisection and copying the figures were as follows: In the line cancellation test based on the method of Albert, patients who could not cancel one or more lines were regarded as abnormal. In the line bisection test based on the method of Peter, patients who left deviated 1.16% or right deviated 2.51% were regarded as abnormal. In the test of copying the figures, round-shape, square, cruciform and other shapes were asked to be copied, defect appeared in the figure was regarded as abnormal. The diagnostic criteria of aphasia were according to the diagnostic method of Chinese aphasia examination and type identification flow-sheet of aphasia. Infarct area was calculated based on Palisino formula: infarct area=π/6×the longest diameter of infarct area×the widest diameter of infarct area×the number of CT positive layer. ② Chi-square test was used for comparing the difference of measurement data. MAIN OUTCOME MEASURES: Diseased region and area of CI and their correlations with neglect. RESULTS: Sixty-seven patients were involved in result analysis. ① The correlation of the occurrence of neglect with the diseased regions of CI: Neglect was not found in 33 patients with CI in left cerebral hemisphere, but was found in 7 of 34 patients with CI in right cerebral hemisphere. The diseased regions involved right temporoparietal region, temporal-parietal-occipital region, frontal-temporal-parietal region, frontal-temporal-parietal-occipital region, temporoparietal basal nucleus, basal nucleus and dorsal caudate putamen. ②The correlation of the occurrence of neglect with diseased area: infarct area ≤ 30 cm3 was found in 2 patients with neglect (12.5%), infarct area at 31 to 60 cm3 in 1 patient with neglect (14.3%),infarct area ≥ 61 cm3 in 4 patients with neglect (36.4%). There was no significant difference in infarct area among groups (P > 0.05). CONCLUSION: ① Right cerebral hemisphere takes advantage in spatial attention. ② Neglect is more possibly caused by the combined pathological changes in temporal and parietal lobe. Temporal and parietal lobes may not cause neglect independently, but the occurrence of neglect is not directly correlated with infarct area.

Study on Model Establishment of Regionalization Management of Specific Equine Disease-free Zone

[Objective]The model of regionalization management of specific equine disease-free zone were analysed and discussed. [Methods]International animal epidemics regionalization management experience and specific equine disease-free zone establishment were analysed and discussed based on the State and OIE principles. [Results]The regionalization management of specific equine disease-free zone with county administrative regions level of international recognition was established first in China,combined with the region＇s geographical barrier and animal health. [Conclusion]The aim is to to provide experience and reference for other areas to establish specific disease-free zone.

Females Had a Worse T-Score at Lumbar Region and Males Had a Worse T-Score at Femoral Region among Chronic Kidney Disease

Background: To evaluate bone-mineral-density-BMD determined by dual-energy X-ray absorptiometry-DEXA and bone turnover markers in chronic-kidney-disease-CKD patients. Method: An observational-clinical study of all patients who were scanned by DEXA-scan in 2018. All patients with low-bone-density or osteoporosis-based on World-Health-Organization-WHO definition were included. Results: 505 patients with abnormal-BMD, 87.3% were in early-stage CKD-stage I - II, 8.5% were in CKD-stage III - V and 4.2% did not have renal tests. 95 (18.8%) were male with a mean age of 57.0 years and 410 (81.2%) were females with a mean age of 55.8 years. Patients of ≥65 years had lower T-score than those who were younger than 65 years-old. Among CKD patients, those with late-CKD (stage III - V) had less BMD-measurements and lower T-score than those with early-CKD (stage I - II). A significant positive correlation exists between parathyroid hormone-PTH-level and the lower T-score. Female had a worse T-score at the lumbar-region whereas male had a worse T-score at the femoral-region. There was no significant difference between males and females for the T-score at hip-region. Conclusion: We observed a distribution of abnormal BMD among different age, sex and CKD groups. Measurements of BMD by DEXA might be a useful test to diagnose osteoporosis in CKD patients. Femoral and total hip areas were more affected, however DEXA might not be able to detect osteoporosis in the lumbar area of CKD patients. T-scores are lower in patients with more severe CKD and lower in elderly patients. PTH level is associated proportionally to the degree of bone loss. Early intervention and proper management must be implemented early among CKD patients with multidisciplinary team approach strategy. More studies are needed to determine if DEXA techniques are enough to distinguish the quantity of bone loss between different stages of CKD.

智慧化区域健康管理服务体系设计与构建

目的 探索构建覆盖漷县地区全人群、全生命周期、全病程的智慧化区域健康管理服务体系。方法 搭建以北京大学人民医院通州院区为核心的健联体,采集并整合漷县地区居民健康档案、就诊记录、居家自我健康监测等多模态健康医疗数据,建立区域健康管理智能数据平台及重点专科专病数据库。结果 构建数据驱动的智慧化区域健康管理服务体系实现了急诊急救、慢病管理、康复服务、智能养老、健康教育、公共卫生监测与预警等功能,形成全方位的区域健康管理闭环。结论 区域健康管理智能数据平台的建立为一体化、延续性的健康管理提供全生命周期、全病程的数据支撑;在此基础上构建的智慧化区域健康管理服务体系,能够满足全区域、全人口的健康管理与疾病防治需求,全方位提升以通州院区为核心的漷县地区居民健康保障能力。

7例头颈部Castleman病超声特征分析

目的:总结头颈部Castleman病(Castleman disease,CD)的超声特征,并阐明其诊断要点。方法:收集上海交通大学医学院附属第九人民医院经组织病理学证实的头颈部CD患者7例,对患者的临床特征和超声检查结果进行分析。结果:7例患者(男1例,女6例),平均诊断年龄31.4岁(7~60岁)。所有病例均为透明血管型CD。超声检查显示,3例(42.9%)病变位于腮腺,4例(57.1%)位于颈部。所有病灶均表现为孤立、边界清晰的实质性肿块,无钙化。1例(14.3%)回声强度为显著低回声,6例(85.7%)为低回声。7例患者中,4例(57.1%)为含有线性回声分隔的异质性肿块。彩色多普勒超声检查显示,所有病变的血管分布均呈混合模式。结论:头颈部CD通常表现为显著低回声或低回声病变,血流模式呈现混合型。肿瘤可能以肿块内线性回声分隔为特征。

以回盲部单发巨大溃疡为表现的克罗恩病的临床特点及文献复习

目的总结以回盲部单发巨大溃疡为表现的克罗恩病(Crohn’s disease,CD)的临床特点,为病变局限在回盲部的CD的临床诊疗和回盲部溃疡的病因鉴别提供参考。方法回顾性分析2013年7月至2021年12月福建医科大学附属第一医院收治的以回盲部单发巨大溃疡为表现的CD患者的临床特征及诊治过程,同时以“inflammatory bowel disease”、“Crohn′s disease”、“ileocecal ulcer”、“炎症性肠病”、“克罗恩病”、“回盲部溃疡”为检索词,检索PubMed、EmBase、中国知网、万方和维普等数据库1970年1月至2023年1月的文献,总结相关文献。结果我院6例患者均为男性,发病年龄(40.8±11.8)岁(29~59岁),从发现症状到确诊的中位时间为12.5个月。临床症状最主要是腹痛(6/6,100%)和体质量下降(6/6,100%),5例患者出现肠狭窄。CRP、ESR升高的比例均为66.7%(4/6),HGB、ALB降低的比例均为50.0%,2例T-SPOT阳性。结肠镜下回盲部溃疡以不规则形为主(3/6,50.0%),6例(100%)结肠镜组织活检病理均未见非干酪样肉芽肿。6例均接受手术治疗,1例术后病理见非干酪样肉芽肿。术后5例接受免疫抑制剂治疗,1例接受生物制剂治疗,随访时间为31~120个月,所有患者病情稳定,无激素临床缓解,无再次手术。文献系统检索结果显示,CD在回盲部溃疡性病变病因构成比占13.9%(297/2134),内镜确诊率为55.6%(90/162),组织活检确诊率为33.8%(49/145),内镜+组织活检确诊率为44.4%(67/151)。结论以回盲部单发巨大溃疡为表现的CD,首诊误诊率高,鉴别困难。内镜结合组织活检病理学对回盲部溃疡的病因确诊有重要意义,但存在一定的局限性,综合分析可提高诊断准确率。

中国新疆地区21例头颈部IgG4相关性疾病的临床分析

目的:分析头颈部IgG4相关性疾病的临床表现、诊断、治疗和预后。方法:选取2012年1月-2023年3月笔者医院收治的21例头颈部IgG4相关性疾病患者的临床资料,并复习相关文献。结果:头颈部IgG4相关性疾病是一种多器官系统疾病,以受累器官肿胀硬化、组织纤维化、血清IgG4升高、IgG4阳性淋巴细胞和浆细胞浸润为临床特征,CT和MRI也呈现特征性表现。激素为该疾病的一线治疗药物,视病情联合使用免疫抑制剂可控制疾病复发。结论:IgG4相关性疾病临床表现多样,临床医生应警惕该疾病,避免不必要的手术。