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Development of an artificial intelligence diagnostic model based on dynamic uncertain causality graph for the differential diagnosis of dyspnea

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Frontiers of Medicine 2020年第4期14卷 488-497页

作者： Yang Jiao Zhan Zhang Ting Zhang Wen Shi Yan Zhu Jie Hu Qin Zhang Department of General Internal Medicine Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Institute of Nuclear and New Energy Technology Tsinghua UniversityBeijing 100084China Department of Pulmonary and Critical Care Medicine Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Department of Gastroenterology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Institute of Internet Industry Tsinghua UniversityBeijing 100084China Department of Medical Administration Suining Central HospitalSuining 629000China Department of Computer Science and Technology Tsinghua UniversityBeijing 100084China

dyspnea is one of the most common manifestations of patients with pulmonary disease,myocardial dysfunction,and neuromuscular disorder,among other *** the causes of dyspnea in clinical practice,especially for the general practitioner,remains a *** pilot study aimed to develop a computeraided tool for improving the efficiency of differential *** disease set with dyspnea as the chief complaint was established on the basis of clinical experience and epidemiological *** diagnosis approaches were established and optimized by clinical *** artificial intelligence(AI)diagnosis model was constructed according to the dynamic uncertain causality graph knowledge-based ***-eight diseases and syndromes were included in the disease *** model contained 132 variables of symptoms,signs,and serological and imaging *** records from the electronic hospital records of Suining Central Hospital were randomly selected.A total of 202 discharged patients with dyspnea as the chief complaint were included for verification,in which the diagnoses of 195 cases were coincident with the record certified as *** overall diagnostic accuracy rate of the model was 96.5%.In conclusion,the diagnostic accuracy of the AI model is promising and may compensate for the limitation of medical experience.

关键词： knowledge representation uncertain causality graphical model artificial intelligence diagnosis dyspnea

High serum lactate dehydrogenase and dyspnea:Positive predictors of adverse outcome in critical COVID-19 patients in Yichang

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World Journal of Clinical Cases 2020年第22期8卷 5535-5546页

作者： Xiao-Ting Lv Yong-Ping Zhu Ai-Guo Cheng Yong-Xu Jin Hai-Bo Ding Cai-Yun Wang Shu-Yu Zhang Gong-Ping Chen Qing-Quan Chen Qi-Cai Liu Department of Respiratory and Critical Care Medicine the First Affiliated Hospital of Fujian Medical UniversityFuzhou 350005Fujian ProvinceChina Institute of Respiratory Disease Fujian Medical UniversityFuzhou 350005Fujian ProvinceChina Department of Cardiovascular Surgery Fujian Medical University Attached Union HospitalFuzhou 350001Fujian ProvinceChina Department of Critical Medicine the Third People's Hospital of YichangYichang 443000Hubei ProvinceChina Department of Laboratory Medicine Fujian Medical UniversityFuzhou 350004Fujian ProvinceChina Department of Reproductive Medicine Centre First Affiliated Hospital of Fujian Medical UniversityFuzhou 350005Fujian ProvinceChina

BACKGROUND Coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)outbreak in China,constitutes a Public Health Emergency of International *** is well known that COVID-19 patients may have increased serum lactate dehydrogenase(LDH)levels in the early *** clinical changes in LDH may have predictive value in disease evolution and prognosis in critically ill COVID-19 *** To examine serum LDH and clinical characteristics in patients with COVID-19 and their predictive value for *** This retrospective study analyzed the clinical data of forty-seven critical COVID-19 patients in the intensive care unit of the Third People's Hospital of Yichang City from January 27 to March 25,2020 and divided them into survivors and *** patients were diagnosed according to the World Health Organization interim guidance and critical cases met any one of the following criteria:Respiratory failure and required mechanical ventilation,the occurrence of shock,and the combined failure of other organs that required intensive care unit monitoring and treatments,according to the diagnostic criteria of critical *** data including symptoms,detection of SARS-CoV-2,chest computed tomography(CT)images,changes in serum LDH in different clinical phases,and prognosis were *** analysis of the data was *** variables were expressed as median(interquartile range)and compared with the Mann-Whitney U *** variables were compared with the Chi-square *** data were analyzed using Kaplan-Meier survival curves and log-rank *** According to chest CT images,we observed the alveolitis and fibrosis stages in all critical patients in this *** non-survivors died in the fibrosis *** had fewer days of hospitalization,shorter disease duration,shorter duration of alveolitis and fibrosis,and had dyspnea symptoms at disease onset

关键词： COVID-19 SARS-CoV-2 Lactate dehydrogenase Pulmonary fibrosis dyspnea Overall survival

Blockage of the habenular nucleus can eliminate dyspnea induced by electrostimulation of the insular cortex

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Neural Regeneration Research 2010年第13期5卷 1025-1029页

作者： Mingxian Li Jinghua Wang Min Huang Weihong Lin Min Wang Lei Yu Shao Wang Department of Respiratory Medicine First Hospital Jilin University Changchun 130021 Jilin Province China Department of Physiology Bethune School of Medicine Jilin University Changchun 130021 Jilin Province China Department of Neurology First Hospital Jilin University Changchun 130021 Jifin Province China

BACKGROUND： The insular cortex and habenular nucleus may be a regulatory center for obstructive sleep apnea syndrome, and dyspnea may be caused by insular cortex activity. The insular cortex is a cortical representation of obstructive sleep apnea syndrome. The habenular nucleus is a station for descending insular cortex activity. OBJECTIVE： Through actively stimulating the rat insular cortex, to observe rat respiratory movement, myoelectric activities of genioglossus, arterial partial pressure of oxygen, partial pressure of carbon dioxide and acidity-alkalinity, and to verify a hypothesis that the insular cortex is a superior-position regulation center, and the habenular nucleus is an inferior-position nervous nuclei of the insular cortex in patients with obstructive sleep apnea syndrome. DESIGN, TIME AND SETTING： The randomized, controlled animal study was performed at the Laboratory of Electrophysiology, Department of Physiology, Norman Bathune College of Medicine, Jilin University, China from September 2004 to June 2008. MATERIALS： We used L-glutamic acid （Dingguo Biological Product Research Center, Beijing, China）, lidocaine hydrochloride （Seventh Pharmacy Co., Ltd., Wuxi, China）, electric stimulator （Nihon Kohden, Japan）, and an AVL-OPTI blood gas analyzer （AVL Scientific Co., Roswell, GA, USA）. METHODS： The insular cortex of healthy adult Wistar rats underwent electrostimulation and L-glutamic acid stimulation to record changes in the myoelectric activity of genioglossus and respiratory movement. Some rats were injected with lidocaine to block the habenular nucleus before electrostimulation or L-glutamic acid stimulation. L-glutamic acid and lidocaine were injected by microelectrodes embedded in nuclear groups. MAIN OUTCOME MEASURES： Myoelectric activities of genioglossus, arterial partial pressure of oxygen, partial pressure of carbon dioxide and acidity-alkalinity were measured following apnea in rats undergoing electrostimulation in the insular cortex and f

关键词： dyspnea habenular nucleus insular cortex genioglossus neuroelectrophysiology neural regeneration

Acute neck tendonitis with dyspnea:A case report

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World Journal of Clinical Cases 2023年第18期11卷 4419-4424页

作者： Hao Wu Wen Liu Lei Mi Qi Liu Department of Neurosurgery Graduate School of Dalian Medical UniversityDalian 116044Liaoning ProvinceChina Department of Imaging The First Hospital of Yu LinYulin 718000Shaanxi ProvinceChina Department of Neurosurgery The First Hospital of Yu LinYulin 718000Shaanxi ProvinceChina

BACKGROUND Longus colli tendinitis(LCT)with dyspnea is a relatively less-reported condition in the literature,and physicians should be aware of its *** of this condition may cause unnecessary treatment for *** SUMMARY Herein,we report the case of a 40-year-old man with acute neck *** patient presented to the pneumology department clinic with a complaint of acute neck tendonitis with *** emergency cervical magnetic resonance examination was performed,and the preliminary diagnosis was“acute longus cervicalis tendinitis.”After aggressive medical treatment,the symptoms obviously *** LCT is a self-limiting disease that usually improves after three to seven days of conservative treatment following a definite ***,owing to its insidious onset and complex clinical manifestations,most relevant personnel are not fully *** definite diagnosis of LCT is based on a comprehensive understanding of the triad,rare symptoms,and the clear identification of cervical 1 and 2 levels calcification and prevertebral edema by medical imaging examination,especially magnetic resonance imaging and computed tomography.

关键词： Longus colli tendonitis dyspnea Nimesulide dispersible tablets Prednisolone acetate tablets Treatment Case report

The occurrence mechanism,assessment,and non-pharmacological treatment of dyspnea

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Medical Review 2024年第5期4卷 395-412页

作者： Beiyao Gao Siyuan Wang Shan Jiang Department of Rehabilitation Medicine China-Japan Friendship HospitalBeijing100029China

dyspnea is a subjective sensation often described as a feeling of respiratory effort,tightness,or air *** underlying mechanisms of this symptom are multifaceted and involve factors such as respiratory centers,cardiovas-cular system,airways,neuromuscular components,and metabolic factors,although not fully *** classical theory of imbalance between inspiratory neural drive(IND)and the simultaneous dynamic responses of the respiratory system posits that the disruption of a normal and harmo-nious relationship fundamentally shapes the expression of respiratory *** and comprehensive treatment of dyspnea are crucial for patient rehabilitation,including subjective self-reporting and objective clinical ***-pharmacological interventions,such as pulmonary rehabilitation,fan therapy,exercise,chest wall vibration,virtual reality technology,traditional Chinese medicine(acupuncture and acupressure),and yoga,have shown promise in alleviating dyspnea ***-ally,oxygen therapy,has demonstrated short-term beneﬁts for patients with pre-hospital respiratory distress and *** review provides a comprehensive overview of dyspnea,emphasizing the importance of a multifaceted approach for its assessment and management,with a focus on non-pharmacological interventions that contribute to enhanced patient outcomes and quality of life.

关键词： dyspnea assessment interventions

Treatment of Cough and dyspnea due to Acute Bronchitis by Plaster for Cough and dyspnea——A Report of 735 Cases

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Journal of Traditional Chinese Medicine 2002年第1期22卷 5-8页

作者：陈振甫周文秀高举先孙江桥周永生 Zhongxiang Municipal Hospital of Traditional Chinese Medicine Zhongxiang City 431900Hubei Province Zhongxiang Municipal People's Hospital Zhongxiang CityHubei Province Hubei College of Traditional Chinese Medicine WuhanHubei Province

In the light of the theory of treating the internal disease externally, an externally used plaster for treating cough and dyspnea due to acute bronchitis (Ke Chuan Yi Tie Kang [symbol: see text]-[symbol: see text]) was successfully applied to 735 cases of acute bronchitis (the treatment group), with the other 423 cases treated with routine western drugs as controls. The results showed that the cure rate in the treatment group was significantly higher than that in the control group (P

关键词： Acupuncture Points Acute Disease Administration, Cutaneous Adolescent Adult Bronchitis Child Child, Preschool Comparative Study Cough Drugs, Chinese Herbal dyspnea Female Humans Infant Male Middle Aged

A new method for rating dyspnea during exercise in patients with chronic obstructive pulmonary disease

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Chinese Medical Journal 2013年第19期126卷 3616-3620页

作者： WANG Hao-yan XU Qiu-fen YUAN Wei NIE Shan HE Xin ZHANG Jian KONG Yuan-yuan AI Sperry David Guan Department of Respiratory Medicine Capital Medical University Beijng 100050 China

Background The Borg scale is most commonly used to measure dyspnea in ***,many patients that find it is difficult to distinguish the labeled numbers corresponding to different dyspnea *** developed a new method to rate dyspnea,which we call the count scale （CS）.It includes the count scale number （CSN） and count scale time （CST）.The aims of the present study were to determine the reproducibility and sensitivity of the CS during exercise in patients with chronic obstructive pulmonary disease （COPD）.Methods Fourteen male patients with COPD （aged 58.00±7.72 years） participated in this study.A progressive incremental exercise and a 6-minute constant work exercise test were performed every 2 to 3 days for a total of 3 *** CS results were evaluated at rest and at 30% and 70% of maximal workload （Wmax） and *** Borg scales were obtained during *** No significant differences occurred across the three trials during exercise for the CS and Borg *** CSN and CST were more varied at Wmax （coefficient of variation （CV）=（22.28±16.96）% for CSN,CV=（23.08±19.11）% for CST） compared to 30% of Wmax （CV=（11.92±8.78）% for CSN,CV=（11.16±9.96）% for CST） and 70% of Wmax （CV=（9.08±7.09）% for CSN,CV=（12.19±12.32）% for CST）.dyspnea ratings with either CSN or CST tended to decrease at the higher workload compared to the lower *** and CST scores were highly correlated （r=0.861,P 〈0.001）.CSN was negatively correlated with Borg scores （r=0.363,P=0.001）.Similar results were obtained for the relationship between CST and Borg scores （r=0.345,P=0.003）.Conclusion We concluded that the CS is simple and reproducible when measuring dyspnea during exercise in patients with COPD.

关键词： dyspnea exercise chronic obstructive pulmonary disease

Fearful imagery induces hyperventilation and dyspnea in medically unexplained dyspnea

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Chinese Medical Journal 2008年第1期121卷 56-62页

作者： HAN Jiang-na ZHU Yuan-jue LUO Dong-mei LI Shun-wei Ilse Van Diest Omer Van den Bergh KarelP Van de Woestijne Department of Pneumology Peking Union Medical CollegeHospital Chinese Academy of Medical Sciences Beijing 100730China Department of Psychology University of Leuven B-3000 LeuvenBelgium Department of Pneumology U Z Gasthuisberg B-3000 LeuvenBelgium

Background Medically unexplained dyspnea refers to a condition characterized by a sensation of dyspnea and is typically applied to patients presenting with anxiety and hyperventilation without underlying cardiopulmonary pathology. We were interested to know how anxiety triggers hyperventilation and elicits subjective symptoms in those patients. Using an imagery paradigm, we investigated the role of fearful imagery in provoking hyperventilation and in eliciting symptoms, specifically dyspnea. Methods Forty patients with medically unexplained dyspnea and 40 normal subjects matched for age and gender were exposed to scripts and asked to imagine both fearful and restful scenarios, while end-tidal PCO2 （PetCO2） and breathing frequency were recorded and subjective symptoms evaluated. The subject who had PetCO2 falling more than 5 mmHg from baseline and persisting at this low level for more than 15 seconds in the imagination was regarded as a hyperventilation responder. Results In patients with medically unexplained dyspnea, imagination of fearful scenarios, being blocked in an elevator in particular, induced anxious feelings, and provoked a significant fall in PetCO2 （P〈0.05）. Breathing frequency tended to increase. Eighteen out of 40 patients were identified as hyperventilation responders compared to 5 out of 40 normal subjects （P〈0.01）. The patients reported symptoms of dyspnea, palpitation or fast heart beat in the same fearful script imagery. Additionally, PetCO2 fall was significantly correlated with the intensity of dyspnea and palpitation experienced during the mental imagery on one hand, and with anxiety symptoms on the other. Conclusions Fearful imagery provokes hyperventilation and induces subjective symptoms of dyspnea and palpitation in patients with medically unexplained dyspnea.

关键词： medically unexplained dyspnea hyperventilation anxiety dyspnea mental imagery

Chronic obstructive pulmonary disease assessment test score correlated with dyspnea score in a large sample of Chinese patients

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Chinese Medical Journal 2013年第1期126卷 11-15页

作者： ZHOU Qing-tao MEI Jing-jing HE Bei HUANG Shao-guang SHI Yi WEN Fu-qiang ZHAO Ming-wu Department of Respiratory Medicine Peking University ThirdHospital Beijing 100191 China Department of Respiratory Medicine Ruijin Hospital ShanghaiJiaotong University School of Medicine Shanghai 200025 China Department of Respiratory Medicine Nanjing General Hospital ofNanjing Military Command Nanjing Jiangsu 210002 China Department of Respiratory Medicine West China HospitalSichuan University Chengdu S ichuan 610041 China

Background The chronic obstructive pulmonary disease assessment test （CAT） is an easy to use health-related quality of life questionnaire, the modified Medical Research Council （mMRC） dyspnea scale is a classic dyspnea scale which is widely used, while the correlation between them is still not clear. This study investigated the use of the Chinese translation of CAT in chronic obstructive pulmonary disease patients and its correlation with the mMRC dyspnea scale. Methods The multicenter cross-sectional study was conducted in 329 hospitals throughout China from March 1 to April 30, 2010. Chronic obstructive pulmonary disease patients completed both the assessment test and the dyspnea scale during a single study visit. Results Six thousand, four hundred and thirty-seven patients were evaluated; 74.9% were male and the mean age was （64.9±10.0） years. Median test scores in dyspnea grades 0 to 4 were 14, 16, 22, 26 and 32, respectively; these differences were statistically significant. The CAT score was moderately correlated with mMRC dyspnea grade （r=0.579, P 〈0.001）. There was no significant difference in mean CAT score between males and females, and patients of high and low socioeconomic status. Primary analysis suggested that CAT scores were higher in older patients （〉65 years） than in younger patients （〈65 years） and increased with duration of formal education, but these findings were repudiated by further analysis of subgroups according to mMRC dyspnea grade. Conclusions There was no obvious confounding factor influencing use of the CAT in Chinese patients. CAT scores were moderately correlated with the mMRC dyspnea scale.

关键词： chronic obstructive pulmonary disease dyspnea quality of life questionnaire