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Serious Myasthenia at the Department of Internal Medicine of point g university teaching hospital: A clinical Case

Neuroscience & Medicine 2019年第3期10卷 207-212页

作者： Assétou Kaya Soukho Djenebou Traoré Adramé Keita Djibril Sy guida Landouré Seybou Hassane Diallo Youssouf Fofana Kaly Keita Mamadou Mallé Ibrahima Amadou Dembélé Drissa Sangaré Mamadou Cissoko Barry Boubacar Sangaré Mamadou Dembélé Abdel Kader Traoré Hamar Alassane Traoré Department of Internal Medicine Point G University Teaching Hospital Bamako Mali Department of Neurology Point G University Teaching Hospital Bamako Mali Department of Neurology GABRIEL TOURE University Teaching Hospital Bamako Mali Department of Internal Medicine Mother-Child Hospital “Luxembourg” Bamako Mali

Introduction: Myasthenia is a rare and disabling autoimmune disease. Few studies were devoted to this pathology. We report a clinical case of myasthenia in the Department of Internal Medicine at the point g university teaching hospital. Observation: This is a 41-year-old patient of Malian origin, a trader with a history of hemorrhoidectomy in 2011 and familial hypertension, was admitted on August 19, 2014, for muscle weakness, dysphonia, and dysphagia. The disease started 1 year before admission at the department with progressive muscle weakness of the upper limbs aggravated by repetitive movements and spreading to the head “drooping head” and inferior limbs, associated with general fatigue, dysphonia and selective dysphagia for solid foods. The diagnosis of myasthenia was maintained based on the clinical signs such as ptosis, bilateral diplopia, and weakness with lower limbs muscle strength rated at 3/5, and confirmed with confirmatory exams;a positive anti-acetylcholine receptor antibody (RIA), the post-synaptic neuromuscular conduction block at ENMg and the positive neostigmine pharmacological test. The patient received Neostigmine (prostagmine) 0.5 mg one ampoule in IM/day and Prednisone at a dosage of 1 mg/kg/day. The evolution was marked by a moderate improvement of the symptomatology afterward the patient was evacuated to Tunisia on family request where he received a course of immunoglobulin 2 g/kg in 2 days. The evolution in Tunisia was favorable. The patient returned in Mali and death occurred after 2 months in a context of respiratory distress. Conclusion: Myasthenia is a rare but serious disease requiring careful management and monitoring to reduce respiratory complications.

关键词： Myasthenia Immunoglobulin Internal Medicine point g hospital

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Bidirectional regulation of the brain-gut-microbiota axis following traumatic brain injury

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Neural Regeneration Research 2025年第8期20卷 2153-2168页

作者： Xinyu You Lin Niu Jiafeng Fu Shining ge Jiangwei Shi Yanjun Zhang Pengwei Zhuang National Key laboratory of Chinese Medicine Modernization Tianjin University of Traditional Chinese MedicineTianjinChina Haihe laboratory of Modern Chinese Medicine Tianjin University of Traditional Chinese MedicineTianjinChina First teaching hospital of Tianjin university of Traditional Chinese Medicine TianjinChina National clinical Research Center for Chinese Medicine Acupuncture and Moxibustion TianjinChina

Traumatic brain injury is a prevalent disorder of the central nervous *** addition to primary brain parenchymal damage,the enduring biological consequences of traumatic brain injury pose long-term risks for patients with traumatic brain injury;however,the underlying pathogenesis remains unclear,and effective intervention methods are *** dysfunction is a significant consequence of traumatic brain *** the most densely innervated peripheral tissue in the body,the gut possesses multiple pathways for the establishment of a bidirectional“brain-gut axis”with the central nervous *** gut harbors a vast microbial community,and alterations of the gut niche contribute to the progression of traumatic brain injury and its unfavorable prognosis through neuronal,hormonal,and immune pathways.A comprehensive understanding of microbiota-mediated peripheral neuroimmunomodulation mechanisms is needed to enhance treatment strategies for traumatic brain injury and its associated *** comprehensively reviewed alterations in the gut microecological environment following traumatic brain injury,with a specific focus on the complex biological processes of peripheral nerves,immunity,and microbes triggered by traumatic brain injury,encompassing autonomic dysfunction,neuroendocrine disturbances,peripheral immunosuppression,increased intestinal barrier permeability,compromised responses of sensory nerves to microorganisms,and potential effector nuclei in the central nervous system influenced by gut ***,we reviewed the mechanisms underlying secondary biological injury and the dynamic pathological responses that occur following injury to enhance our current understanding of how peripheral pathways impact the outcome of patients with traumatic brain *** review aimed to propose a conceptual model for future risk assessment of central nervous system-related diseases while elucidating novel insights into the bidirectional effec

关键词： traumatic brain injury brain-gut-microbiome axis gut microbiota neuroimmune immunosuppression host defense vagal afferents bacterial infection dorsal root ganglia nociception neural circuitry

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Exploring the performance of large language models on hepatitis B infection-related questions:A comparative study

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World Journal of gastroenterology 2025年第3期31卷 103-112页

作者： Yu Li Chen-Kai Huang Yi Hu Xiao-Dong Zhou Cong He Jia-Wei Zhong Department of gastroenterology Jiangxi Provincial Key Laboratory of Digestive DiseasesJiangxi Clinical Research Center for GastroenterologyDigestive Disease HospitalThe First Affiliated HospitalJiangxi Medical CollegeNanchang UniversityNanchang 330006Jiangxi ProvinceChina HuanKui Academy Nanchang UniversityNanchang 330006Jiangxi ProvinceChina

BACKgROUND Patients with hepatitis B virus(HBV)infection require chronic and personalized care to improve *** language models(LLMs)can potentially provide medical information for *** To examine the performance of three LLMs,ChatgPT-3.5,ChatgPT-4.0,and google gemini,in answering HBV-related *** LLMs’responses to HBV-related questions were independently graded by two medical professionals using a four-point accuracy scale,and disagreements were resolved by a third *** question was run three times using three *** was assessed via the gunning Fog index and Flesch-Kincaid grade *** Overall,all three LLM chatbots achieved high average accuracy scores for subjective questions(ChatgPT-3.5:3.50;ChatgPT-4.0:3.69;google gemini:3.53,out of a maximum score of 4).With respect to objective questions,ChatgPT-4.0 achieved an 80.8%accuracy rate,compared with 62.9%for ChatgPT-3.5 and 73.1%for google *** the six domains,ChatgPT-4.0 performed better in terms of diagnosis,whereas google gemini demonstrated excellent clinical ***,in the readability analysis,the mean gunning Fog index and Flesch-Kincaid grade level scores of the three LLM chatbots were significantly higher than the standard level eight,far exceeding the reading level of the normal *** Our results highlight the potential of LLMs,especially ChatgPT-4.0,for delivering responses to HBV-related *** may be an adjunctive informational tool for patients and physicians to improve ***,current LLMs should not replace personalized treatment recommendations from physicians in the management of HBV infection.

关键词： ChatgPT-3.5 ChatgPT-4.0 google gemini Hepatitis B infection Accuracy

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Drosophila models used to simulate human ATP1A1 gene mutations that cause Charcot-Marie-Tooth type 2 disease and refractory seizures

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Neural Regeneration Research 2025年第1期20卷 265-276页

作者： Yao Yuan Lingqi Yu Xudong Zhuang Dongjing Wen Jin He Jingmei Hong Jiayu Xie Shengan Ling Xiaoyue Du Wenfeng Chen Xinrui Wang Institute of Life Sciences College of Biological Science and EngineeringFuzhou UniversityFuzhouFujian ProvinceChina NHC Key laboratory of Technical Evaluation of Fertility Regulation for Non-human Primate(Fujian Maternity and Child Health hospital) FuzhouFujian ProvinceChina Medical Research Center Fujian Maternity and Child Health HospitalCollege of Clinical Medicine for Obstetrics&Gynecology and PediatricsFujian Medical UniversityFuzhouFujian ProvinceChina Department of Neurology and Institute of Neurology of The First Affiliated hospital Institute of Neuroscienceand Fujian Key Laboratory of Molecular NeurologyFujian Medical UniversityFuzhouFujian ProvinceChina

Certain amino acids changes in the human Na^(+)/K^(+)-ATPase pump,ATPase Na^(+)/K^(+)transporting subunit alpha 1(ATP1A1),cause Charcot-Marie-Tooth disease type 2(CMT2)disease and refractory *** develop in vivo models to study the role of Na^(+)/K^(+)-ATPase in these diseases,we modified the Drosophila gene homolog,Atpα,to mimic the human ATP1A1 gene mutations that cause *** located within the helical linker region of human ATP1A1(I592T,A597T,P600T,and D601F)were simultaneously introduced into endogenous Drosophila Atpαby CRISPR/Cas9-mediated genome editing,generating the Atpα^(TTTF)*** addition,the same strategy was used to generate the corresponding single point mutations in flies(Atpα^(I571T),Atpα^(A576T),Atpα^(P579T),and Atpα^(D580F)).Moreover,a deletion mutation(Atpα^(mut))that causes premature termination of translation was generated as a positive *** these alleles,we found two that could be maintained as homozygotes(Atpα^(I571T)and Atpα^(P579T)).Three alleles(Atpα^(A576T),Atpα^(P579)and Atpα^(D580F))can form heterozygotes with the Atpαmut *** found that the Atpαallele carrying these CMT2-associated mutations showed differential phenotypes in *** heterozygous for Atpα^(TTTF)mutations have motor performance defects,a reduced lifespan,seizures,and an abnormal neuronal *** Drosophila models will provide a new platform for studying the function and regulation of the sodium-potassium pump.

关键词： ATP1A1 Atpα bang-sensitive paralysis Charcot-Marie-Tooth disease type 2 CRISPR/Cas9 homology-directed repair Na^(+)/K^(+)-ATPase point mutation seizures sodium pump

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Assessing healthcare workers’knowledge and confidence in the diagnosis,management and prevention of Monkeypox

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World Journal of clinical Cases 2025年第1期13卷 38-47页

作者： Epipode Ntawuyamara Thierry Ingabire Innocent Yandemye Polycarpe Ndayikeza Bina Bhandari Yan-Hua Liang Department of Dermatology Cosmetology and VenereologyShenzhen Hospital of Southern Medical UniversityShenzhen 518101Guangdong ProvinceChina Department of Dermatology and Venereology Kamenge Teaching HospitalUniversity of BurundiBujumbura 1020Burundi Department of Infectious Diseases Kamenge Teaching HospitalUniversity of BurundiBujumbura 1020Burundi general Directorate of Healthcare Supply Modern and Traditional MedicineNutrition and RegistrationMinistry of Public Health and Fight Against HIV/AIDSBujumbura 1055Burundi Department of Epidemiology National Institute of Public HealthBujumbura 350Burundi general Directorate of Planification Ministry of Public Health and Fight Against HIV/AIDSBujumbura 1055Burundi

BACKgROUND Monkeypox(Mpox),is a disease of global public health concern,as it does not affect only countries in western and central *** To assess Burundi healthcare workers(HCWs)s’level of knowledge and confidence in the diagnosis and management of *** We conducted a cross-sectional study via an online survey designed mainly from the World Health Organization course distributed among Burundi HCWs from June-July *** questionnaire comprises 8 socioprofessional-related questions,22 questions about Mpox disease knowledge,and 3 questions to assess confidence in Mpox diagnosis and *** data were analyzed via SPSS software version 25.0.A P valueg Mpox knowledge had at least 50%correct responses.A very low number of HCWs(17.4%)knew that Mpox has a *** confidence level to diagnose(21.20%),treat(18.00%)or prevent(23.30%)Mpox was low among *** confidence level in the diagnosis of Mpox was associated with the HCWs’age(P value=0.009),sex(P valuegnificantly associated with the HCWs’age(P value=0.050),sex(P valuege regarding Mpox and a lack of confidence in the ability to diagnose,treat or prevent *** is an urgent need to organize continuing medical education programs on Mpox epidemiology and preparedness for Burundi *** encourage future researchers to assess potential hesitancy toward Mpox vaccination and its asso

关键词： Monkeypox Public health emergency of international concern Healthcare workers Epidemic Preparedness Knowledge Confidence

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Prevalence and clinical Relevance of Schistosoma mansoni Co-Infection with Mycobacterium tuberculosis: A Systematic Literature Review

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Open Journal of Epidemiology 2023年第1期13卷 97-111页

作者： Bocar Baya Bourahima Kone Amadou Somboro Ousmane Kodio Anou Moise Somboro Bassirou Diarra Fah gaoussou Traore Drissa Kone Mama Adama Traore Mahamadou Kone Antieme georges Togo Yeya Sadio Sarro Almoustapha Maiga Mamoudou Maiga Yacouba Toloba Souleymane Diallo Robert L. Murphy Seydou Doumbia university clinical Research Center (UCRC) of the university of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali Service of Pneumopthisiology of the university teaching hospital of point g Bamako Mali clinical laboratory of the university teaching hospital of point g Bamako Mali Havey Institute for global Health (Havey IgH) Northwestern University (NU) Chicago USA

Tuberculosis disease stands for the second leading cause of death worldwide after COVID-19, most active tuberculosis cases result from the reactivation of latent TB infection through impairment of immune response. Several factors are known to sustain that *** mansoni, a parasite of the helminth genus that possesses switching power from an immune profile type Th1 to Th2 that favors reactivation of latent TB bacteria. The aim of the study was to assess the prevalence of the co-infection between the two endemic infections. Systematic literature was contacted at the university clinical Research Center at the university of Sciences, Techniques, and Technologies of Bamako in Mali. Original articles were included, and full texts were reviewed to assess the prevalence and better understand the immunological changes that occur during the co-infection. In total, 3530 original articles were retrieved through database search, 53 were included in the qualitative analysis, and data from 10 were included in the meta-analysis. Prevalence of the co-infection ranged from 4% to 34% in the literature. Most of the articles reported that immunity against infection with helminth parasite and more specifically Schistosoma mansoni infection enhances latent TB reactivation through Th1/Th2. In sum, the impact of Schistosoma mansoni co-infection with Mycobacterium tuberculosis is under-investigated. Understanding the role of this endemic tropical parasite as a contributing factor to TB epidemiology and burden could help integrate its elimination as one of the strategies to achieve the END-TB objectives by the year 2035.

关键词： Schistosoma mansoni Tuberculosis Co-Infections LTBI Reactivation

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Distinct but correct: generating diversified and entity-revised medical response

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Science China(Information Sciences) 2024年第3期67卷 94-113页

作者： Bin LI Bin SUN Shutao LI Encheng CHEN Hongru LIU Yixuan WENg Yongping BAI Meiling HU College of Electrical and Information Engineering Hunan University School of Mathematics Sun Yat-sen University JD Technology National laboratory of Pattern Recognition Institute of AutomationChinese Academy of Sciences Xiangya hospital of Central South university teaching and Research Section of clinical Nursing Xiangya Hospital of Central South University

Medical dialogue generation(MDg) is applied for building medical dialogue systems for intelligent consultation. Such systems can communicate with patients in real time, thereby improving the efficiency of clinical diagnosis. However, predicting correct entities and correctly generating distinct responses remain a great challenge. Inspired by actual doctors’ responses to patients, we consider MDg a two-stage task: entity prediction and dialogue generation. For entity prediction, we design an ent-mac post pre-training strategy by leveraging external medical entity knowledge to enhance the pre-trained model. For dialogue generation, we propose an entity-aware fusion MDg method in which predicted entities are integrated into the dialogue generation model through different encoding fusion mechanisms, using information from different sources. Because the diverse beam search algorithm can produce responses with entities that deviate from the predicted entities, an entity-revised diverse beam search is proposed to correct the entities entailed in the generated responses and make the generated responses more distinct. The experimental results on the China Conference on Knowledge graph and Semantic Computing 2021(A/B tests) and the International Conference on Learning Representations 2021(online test) datasets show that the proposed method outperforms several state-of-the-art methods, which demonstrates its practicability and effectiveness.

关键词： medical entity prediction ent-mac post pre-training strategy entity-aware fusion medical dialogue generation encoding fusion mechanism entity-revised diverse beam search

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Hemoglobinopathy and Systemic Lupus: A Rare Association

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Open Journal of Internal Medicine 2019年第3期9卷 72-77页

作者： Assétou Kaya Soukho Ibrahima Amadou Dembele Djenebou Traore Nounga Romuald Nyanke Djibril Sy Abasse Sanogo Mamadou Cissoko Barry Boubacar Sangare Mamadou Malle Sékou Mamadou Cisse Abdramane Traore Mahamadou Saliou Nanko Doumbia Brehima Boly Berthe Kaly Keita Boubacar Zoumana Cisse Drissa Sangare Youssouf Fofana Kokou Tbah Tighankpa Adramé Keita Mamadou Keita Mamadou Dembele Abdel Kader Traore Hamar Alassane Traore Department of Internal Medicine Point G University Teaching Hospital Bamako Mali

The authors report a case of systemic lupus associated with a composite heterozygosis SC with thalassemic component in a 19-year-old patient hospitalized for anemia and polyarthralgia who has a staturoponderal delay, macular erythematous lesions in butterfly wings on the face and ears, photosensitivity, puffy face, alopecia, pubic and axillary hair loss, scalp dermatophytosis, painful swelling of the interphalangeal joints, wrists and knees. The hemoglobin electrophoresis showed a compound heterozygote SC associated with β thalassemia. Antinuclear antibodies were positive with an anti-Sm positive antibody. Conclusion: The diagnosis of both diseases can be difficult when symptoms are concomitant and look alike.

关键词： Hemoglobinopathy Lupus university teaching hospital point g

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Instant evaluation of contrast enhanced endoscopic ultrasound helps to differentiate various solid pancreatic lesions in daily routine

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World Journal of clinical Cases 2019年第1期7卷 19-27页

作者： Klaus Kannengiesser Reiner Mahlke Frauke Petersen Anja Peters Torsten Kucharzik Christian Maaser Department of general Internal Medicine and gastroenterology University Teaching Hospital Lueneburg Department of Pathology University Teaching Hospital Lueneburg

BACKgROUND Contrast enhanced harmonic endoscopic ultrasound(CEH-EUS) is a spreading technique; some studies have shown its value in the diagnosis of pancreatic adenocarcinoma using quantitative *** To examine the value of CEH-EUS for differentiating various pancreatic lesions in everyday routine with qualitative and quantitative *** Data of 55 patients with pancreatic lesions who underwent CEH-EUS were analysed retrospectively. Perfusion characteristics were classified by the investigator qualitatively immediately upon investigation, quantitative analysis was performed later on. Samples from fine needle aspiration(EUS-FNA) or surgical specimen served as gold *** CEH-EUS showed 39 hypoenhanced lesions, 3 non-enhanced and 13 hyperenhanced lesions. Concordance of the investigators qualitative classification of peak contrast enhancement with quantitative analysis later on was 100%, while other parameters such as arrival time, time to peak or area under the curve did not show additional value. 34 of 39 hypoenhanced lesions were pancreatic adenocarcinoma; of the hyperenhanced lesions 4 were inflammatory, 3 neuroendocrine carcinomas, 1 lymphoma, 1 insulinoma and 4 metastases(2 of renal cell carcinoma, 2 of lung cancer). Non-enhanced lesions showed up as necroses. Sensitivity for the detection of pancreatic adenocarcinoma was 100%,specificity 87.2% for hypoenhancement alone; in otherwise healthy pancreatic tissue all hypoenhanced lesions were pancreatic adenocarcinoma(sensitivity and specificity 100%, PPV and NPV for adenocarcinoma 100%).CONCLUSION This study again shows the excellent value of CEH-EUS in everyday routine for diagnostics of various focal pancreatic lesions suggesting that qualitatively assessed hypoenhancement is highly predictive for adenocarcinoma. Additional quantitative analysis of perfusion parameters does not add diagnostic yield. In case of the various hyperenhanced pancreatic lesions in our data set, histologic samp

关键词： Endoscopic ultrasound Contrast enhanced endoscopic ultrasound Pancreatic adenocarcinoma Neuroendocrine carcinoma Pancreatic metastases Lymphoma

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Effect of electroacupuncture at Ximen(PC 4) and Hegu(LI 4) on expression of Akt in rats with myocardial ischemia-reperfusion injury

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Journal of Traditional Chinese Medicine 2017年第6期37卷 835-840页

作者： Tian Yuefeng gao Haining Li Leiyong Wang Jun Zhai Chuntao College of Acupuncture and Moxibustion Shanxi University of Traditional Chinese Medicine clinical laboratory The Second Hospital of Shanxi Medical University

OBJECTIVE: To investigate the effect of electroacupuncture(EA) at acupoints on the pericardium meridian on the expression of phosphorylated Akt(p-Akt) protein in rat myocardium after ischemia and ***: Seventy Wistar rats were evenly randomized into seven groups: the sham operation group(group A), ischemia-reperfusion model Ⅰgroup(group B), ischemia-reperfusion model Ⅱgroup(group C), EA at Neiguan(PC 6) group(group D), EA at Ximen(PC 4) group(group E), EA at Hegu(LI 4) group(group F), and LY294002 + EA at Neiguan(PC 6) group(group g). All processes were monitored by electrocardiography. In group A, the left anterior descending coronary artery was only threaded without ligation for 100 min. In group B,the left anterior descending coronary artery was ligated for 40 min and reperfused for 60 min. The left anterior descending coronary artery in group C was ligated for 40 min and reperfused for 100 *** D, E, and F received EA for 20 min before undergoing ischemia for 40 min, and then received EA for 20 min before undergoing reperfusion for 60 min. Before modeling, group g was injected with LY294002(0.3 mg/kg) into the tail vein, and then underwent the same intervention as the other EA groups. After reperfusion, myocardial tissue from the left cardiac ventricle was collected to enable Western blot analysis of the p-Akt level, and analysis of electrocardiographic ***: In groups B and C, electrocardiography showed obvious elevation of the ST-segment Ⅱlead(ECg-STⅡ), while the ECg-STⅡvalues were significantly lower in groups D, E, and g(P groups D and E were significantly greater than those in groups B and C(P groups, group g showed a significantly different expression of p-Akt(P gnificantly greater in rats that were injected with LY294002 and received EA at Ximen(PC 4) compared with all other *** su

关键词： Reperfusion injury Electroacupunc-ture point PC 4 (Ximen) point LI 4 (Hegu) Onco-gene protein v-akt

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