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Biopsy-free in vivo virtual histology of skin using deep learning

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Light(Science & Applications) 2021年第12期10卷 2421-2442页

作者： Jingxi Li Jason Garfinkel Xiaoran Zhang Di Wu Yijie Zhang Kevin de Haan Hongda Wang Tairan Liu Bijie Bai Yair Rivenson Gennady Rubinstein Philip O.Scumpia Aydogan Ozcan Electrical and Computer Engineering Department University of CaliforniaLos AngelesCA 90095USA Bioengineering Department University of CaliforniaLos AngelesCA 90095USA California Nanosystems Institute(CNSI) University of CaliforniaLos AngelesCA 90095USA Dermatology and Laser Centre Studio CityCA 91604USA Computer Science Department University of CaliforniaLos AngelesCA 90095USA Division of Dermatology University of CaliforniaLos AngelesCA 90095USA Department of Dermatology Veterans Affairs Greater Los Angeles Healthcare SystemLos AngelesCA 90073USA Department of Surgery University of CaliforniaLos AngelesCA 90095USA

An invasive biopsy followed by histological staining is the benchmark for pathological diagnosis of skin *** process is cumbersome and time-consuming,often leading to unnecessary biopsies and *** noninvasive optical technologies such as reflectance confocal microscopy(RCM)can provide label-free,cellular-level resolution,in vivo images of skin without performing a *** RCM is a useful diagnostic tool,it requires specialized training because the acquired images are grayscale,lack nuclear features,and are difficult to correlate with tissue ***,we present a deep learning-based framework that uses a convolutional neural network to rapidly transform in vivo RCM images of unstained skin into virtually-stained hematoxylin and eosin-like images with microscopic resolution,enabling visualization of the epidermis,dermal-epidermal junction,and superficial dermis *** network was trained under an adversarial learning scheme,which takes ex vivo RCM images of excised unstained/label-free tissue as inputs and uses the microscopic images of the same tissue labeled with acetic acid nuclear contrast staining as the ground *** show that this trained neural network can be used to rapidly perform virtual histology of in vivo,label-free RCM images of normal skin structure,basal cell carcinoma,and melanocytic nevi with pigmented melanocytes,demonstrating similar histological features to traditional histology from the same excised *** application of deep learning-based virtual staining to noninvasive imaging technologies may permit more rapid diagnoses of malignant skin neoplasms and reduce invasive skin biopsies.

关键词： network vivo virtual

颈动脉狭窄报告标准的巨大差异性:127名退伍军人事务医疗中心的回顾性研究

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国际医学放射学杂志 2013年第2期 168-169页

作者： E.M. Cheng D.M. Bravata S. El-Saden S.D. vassar S. Ofner L.S. Williams 李宁 Departments of Neurology VA Greater Los Angeles Healthcare System 11301 Wilshire Blvd ML 127 Los Angeles CA 90073

目的确定放射学报告在描述临床上明显的颈动脉狭窄时是否采用可供临床医师参考的一致的标准。材料与方法本研究符合HIPAA。免除知情同意。本回顾性图表分析经机构审查委员会批准,包括2006—2007年间退伍军人医疗中心的127例缺血性中风... 详细信息

目的确定放射学报告在描述临床上明显的颈动脉狭窄时是否采用可供临床医师参考的一致的标准。材料与方法本研究符合HIPAA。免除知情同意。本回顾性图表分析经机构审查委员会批准,包括2006—2007年间退伍军人医疗中心的127例缺血性中风的住院病人的颈动脉成像的放射学报告。临床显著结果是指狭窄至少50%或者至少中度狭窄,不包括完全闭塞。评估临床显著结果报告为确切狭窄分数(例如,60%),范围(例如,50%～69%)或分级(例如,中度)的频率。评估当结果报告为一个范围时,该范围被界定为50%和70%的临床阈值的频率(通常用于确定合适的颈动脉血运重建)。结果在2675例病人的6618个颈动脉成像结果中,1015个(15%)结果被认为具有显著临床意义。超声显示的695个临床显著结果中,348个(50%)被描述为一个范围,另外314个(45%)报告为一个确切的狭窄百分数。在348个报告为一个范围的具有显著临床意义的超声结果中,259个(74%)结果阈值被界定为50%～70%。对于MR血管成像,48%(106/221)的临床显著结果定性描述为一个分级,38%(84/221)描述为确切的狭窄百分数,14%(31/221)描述为一个范围。结论对于临床显著的颈动脉狭窄的报告方式在国家医疗服务系统中存在巨大差别。

关键词：颈动脉狭窄放射学医疗中心退伍军人

Epistaxis in end stage liver disease masquerading as severe upper gastrointestinal hemorrhage

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World Journal of Gastroenterology 2014年第38期20卷 13993-13998页

作者： Marine Camus Dennis M Jensen Jason D Matthews Gordon V Ohning Thomas O Kovacs Rome Jutabha Kevin A Ghassemi Gustavo A Machicado Gareth S Dulai CURE Hemostasis Research Group CURE Digestive Diseases Research CenterDavid Geffen School of Medicine at University of California Division of Digestive Diseases at University of California Los AngelesRonald Reagan Medical Center Department of Gastroenterology Lariboisiere Hospital CURE Hemostasis Research Group CURE Digestive Diseases Research CenterDavid Geffen School of Medicine at University of CaliforniaLos AngelesLos AngelesCA 90095United States Gastroenterology Division at va greater los angeles healthcare system Hunterdon Gastrointestinal Associates

AIM:To describe the prevalence,diagnosis,treatment,and outcomes of end stage liver disease(ESLD) patients with severe epistaxis thought to be severe upper gastrointestinal hemorrhage(UGIH).METHODS:This observational single center study included all consecutive patients with ESLD and epistaxis identified from consecutive subjects hospitalized with suspected UGIH and prospectively enrolled in our databases of severe UGIH between 1998 and ***:A total of 1249 patients were registered for severe UGIH in the data basis,461(36.9%) were cirrhotics. Epistaxis rather than UGIH was the bleeding source in 20 patients. All patients had severe coagulopathy. Epistaxis was initially controlled in all cases. Fifteen(75%) subjects required posterior nasal packing and 2(10%) embolization in addition to correction of coagulopathy. Five(25%) patients died in the hospital,12(60%) received orthotopic liver transplantation(OLT),and 3(15%) were discharged without OLT. The mortality rate was 63% in patients without ***:Severe epistaxis in patients with ESLD is(1) a diagnosis of exclusion that requires upper endoscopy to exclude severe UGIH;and(2) associated with a high mortality rate in patients not receiving OLT.

关键词： Epistaxis Upper gastrointestinal bleeding End stag

Concepts and opportunities for repair in cerebral microvascular disease and white matter stroke

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Neural Regeneration Research 2016年第9期11卷 1398-1400页

作者： Guanxi Xiao Jason D.Hinman Department of Neurology David Geffen School of MedicineUniversity of California Los Angeles

Diffuse changes in white matter resulting from cerebral microvascular disease contribute to cognitive impairment （Jokinen et al., 2011）, declines in global functionality （Inzitari et al., 2009）, and even death （Debette and Markus, 2010）. Twenty years ago, estimations of the clinical incidence of ce- rebral microvascular disease approached 11 million per year in the US alone （Leary and Saver, 2003）. More recent estima- tions suggest the prevalence of diffuse white matter disease and silent brain infarction approaches 20% and increases dramatically in the presence of cardiovascular risk factors （Fanning et al., 2014）.

关键词： Concepts and opportunities for repair in cerebral microvascular disease and white matter stroke

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Novel use of esophageal overtube and water flushes as a safety indicator and facilitator for the push technique in esophageal food impaction

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Discussion of Clinical Cases 2020年第1期7卷 8-11页

作者： Paul P Shao Jasleen K Grewal Adam M Custer va greater los angeles healthcare system UCLA David Geffen School of MedicineUSA

Esophageal food impaction requires urgent endoscopic intervention either by extraction or pushing into the *** to risks of perforation,controversy exists between when to extract verses when to push the food *** are no clear guidelines on when it is safe to push a food bolus;endoscopists rely on their subjective experiences and *** present a case with a novel use of an esophageal overtube and water flushes to determine the safety of pushing a food bolus and facilitate passage into the stomach.

关键词： Esophageal food impaction Esophageal foreign body EGD Dysphagia EGD push technique

The influence of thyroid hormone and COUP-TF1 on cortical neuronal differentiation

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The influence of thyroid hormone and COUP-TF1 on cortical ne...

XIAP抑制剂Embelin体外对人胰腺癌细胞株的抑制效应与机制研究

中华医学会第十二次全国内分泌学学术会议

作者： xiaochun teng Yanyun liu Weiping teng Gregory A.Brent Department of Endocrinology and Metabolism Institute of EndocrinologyLiaoning Provincial Key Laboratory of Endocrine DiseasesThe First Affiliated Hospital of China Medical University Molecular Endocrinology Laboratory Veterans Affairs Greater Los Angeles Healthcare SystemDepartments of Medicine & PhysiologyDavid Geffen School of Medicine at UCLALos AngelesCA 90073

Normal brain development requires thyroid hormone at specific *** hypothyroidism during neonatal development leads to irreversible impairment in neural differentiation

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山西医科大学学报 2009年第1期40卷 20-23页

作者：郑玲吕寒静 Mouad Edderkaoui Stephen J Pandol 同济大学附属同济医院呼吸科上海200065 Department of Medicine Veterans Affairs Greater Los Angeles Healthcare System and University of CaliforniaLos Angeles

目的探讨XIAP小分子抑制剂Embelin体外对人胰腺癌细胞株MIAPaCa-2的抑制效应与机制。方法将生长至第4-12代之间的MIAPaca-2细胞分为DMSO对照组与Embelin实验组,在实验组细胞中加入不同浓度的Embelin共孵育72h,收集细胞并裂解后取上清液... 详细信息

目的探讨XIAP小分子抑制剂Embelin体外对人胰腺癌细胞株MIAPaCa-2的抑制效应与机制。方法将生长至第4-12代之间的MIAPaca-2细胞分为DMSO对照组与Embelin实验组,在实验组细胞中加入不同浓度的Embelin共孵育72h,收集细胞并裂解后取上清液用细胞凋亡试剂盒检测组蛋白(凋亡指标)的OD值水平。MIAPaca-2细胞加入不同浓度的Embelin共孵育60h后再加入3H胸腺嘧啶继续孵育12h,取细胞裂解液用同位素γ闪烁计数仪检测3H-CPM数值以判断细胞增殖程度。对DMSO对照组与Embelin实验组的组蛋白OD值与3H-CPM数值分别进行比较分析。结果Embelin实验组的MIAPaCa-2细胞株组蛋白OD值显著高于DMSO对照组而3H-CPM数值明显低于DMSO对照组(P<0.01),且实验组Embe-lin的作用浓度与组蛋白OD值呈正相关(r=0.996,P<0.01),而与3H-CPM数值呈负相关(r=-0.993,P<0.01)。结论Embelin呈剂量依赖性地诱导人胰腺癌细胞株MIAPaCa-2凋亡并抑制其增殖,有肿瘤抑制效应。

关键词： Embelin 人胰腺癌细胞株凋亡增殖

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A Class Effect Network Meta-analysis of Lipid Modulation in Non-alcoholic Steatohepatitis for Dyslipidemia

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Journal of Clinical and Translational Hepatology 2022年第6期10卷 1042-1049页

作者： Jieling Xiao Cheng-Han Ng Yip-Han Chin Darren Jun Hao Tan Wen-Hui Lim Grace Lim Jingxuan Quek Ansel Shao Pin Tang Kai-En Chan Rou-Yi Soong Nicholas Chew Benjamin Tay Daniel Q.Huang Nobuharu Tamaki Roger Foo Mark Y.Chan Mazen Noureddin Mohammad Shadab Siddiqui Arun J.Sanyaland Mark D.Muthiah Yong Loo Lin School of Medicine National University of SingaporeSingapore Lee Kong Chian School of Medicine Nan-yang Technological UniversitySingapore Department of Cardiology National University Heart CenterNational University HospitalSingapore Division of Gastroenterology and Hepatology Department of MedicineNational University HospitalSingaporeSingapore National University Center for Organ Transplantation National University Health SystemSingapore NAFLD Research Center Division of Gastroenterology and HepatologyDepartment of MedicineUniversity of California at San DiegoLa JollaCAUSA Department of Gastroenterology and Hepatology Musashino Red Cross HospitalTokyoJapan Cedars-Sinai Fatty Liver Program Division of Digestive and Liver DiseasesDepartment of MedicineComprehen-sive Transplant CenterCedars-Sinai Medical CenterLos AngelesCAUSA Division of Gastroenterology Hepatology and NutritionDepartment of Internal MedicineVirginia Commonwealth UniversityRichmondVAUSA

Background and Aims:Pharmaceutical therapy for NASH is associated with lipid modulation,but the consensus on drug treatment is limited and lacks comparative analysis of effectiveness.A network meta-analysis was conducted to compare NASH drug classes in lipid ***:Online databases were searched for randomized controlled trails(RCTs)evaluating NASH treatments in biopsy-proven NASH *** were classified into four groups:(1)inflammation,(2)energy,(3)bile acids,and(4)fibro-sis based on the mechanism of action.A Bayesian network analysis was conducted with outcome measured by mean difference(MD)with credible intervals(Crl)and surface un-der the cumulative ranking curve(SUCRA).Results:Forty-four RCTs were included in the *** acid modulat-ing treatments(MD:0.05,Crl:0.03-0.07)were the best treatment for improvement in high-density lipid(HDL)cho-lesterol,followed by treatments modulating energy(MD:0.03,Crl:0.02-0.04)and fibrosis(MD:0.01,Crl:−0.12 to 0.14)compared with *** top three treatments for reduction in triglycerides were treatments modulating energy(MD:−0.46,Crl:−0.49 to−0.43),bile acids(MD:−0.22,Crl:−0.35 to−0.09),and inflammation(MD:−0.08,Crl:−0.13 to−0.03)compared with *** found treatment modulating fibrosis(MD:−1.27,Crl:−1.76 to−0.79)was the best treatment for reduction in low-density lipid(LDL)cholesterol followed by treatment modulating in-flammation(MD:−1.03,Crl:−1.09 to−0.97)and energy(MD:−0.37,Crl:−0.39 to−0.34)compared with placebo,but LDL cholesterol was worsened by treatments modulat-ing bile ***:Network analysis comparing the class effects of dyslipidemia modulation in NASH found that treatment targets can include optimization of athero-genic *** studies are required to evaluate the cardiovascular outcomes.

关键词： Lipid modulation NASH Dyslipidemia

Foregut bypass *** bariatric procedures for nonalcoholic fatty liver disease:a meta-analysis of 3,355 individuals

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Hepatobiliary Surgery and Nutrition 2023年第5期12卷 658-670,I0001-I0003页

作者： Wen Hui Lim Snow Yunni Lin Cheng Han Ng Darren Jun Hao Tan Jieling Xiao Jie Ning Yong Phoebe Wen Lin Tay Nicholas Syn Yip Han Chin Kai En Chan Chin Meng Khoo Nicholas Chew Roger S.Y.Foo Asim Shabbir Eunice X.Tan Daniel Q.Huang Mazen Noureddin Arun J.Sanyal Mohammad Shadab Siddiqui Mark D.Muthiah Yong Loo Lin School of Medicine National University of SingaporeSingaporeSingapore Division of Endocrinology Department of MedicineNational University HospitalSingaporeSingapore Department of Cardiology National University Heart CentreNational University HospitalSingaporeSingapore Division of General Surgery(Upper Gastrointestinal Surgery) Department of SurgeryNational University HospitalSingaporeSingapore Division of Gastroenterology and Hepatology Department of MedicineNational University HospitalSingaporeSingapore National University Centre for Organ Transplantation National University Health SystemSingaporeSingapore Cedars-Sinai Fatty Liver Program Division of Digestive and Liver DiseasesDepartment of MedicineComprehensive Transplant CenterCedars-Sinai Medical CentreLos AngelesCAUSA Division of Gastroenterology Hepatology and NutritionDepartment of Internal MedicineVirginia Commonwealth UniversityRichmondVAUSA

Background:Bariatric surgery represents an important treatment option for severely obese patients with nonalcoholic fatty liver disease(NAFLD).However,there remains inadequate data regarding the effects of different bariatric procedures on various NAFLD parameters,especially for histological ***,this meta-analysis aimed to compare the effects of restrictive bariatric procedures and foregut bypass on the metabolic,biochemical,and histological parameters for patients with ***:Medline and Embase were searched for articles relating to bariatric procedures and *** meta-analysis was conducted to compare efficacy of bariatric procedures ***-procedure with subgroup analysis to further compare restrictive against foregut bypass ***:Thirty-one articles involving 3,355 patients who underwent restrictive bariatric procedures(n=1,460)and foregut bypass(n=1,895)were *** foregut bypass(Pvantages and comparable improvements in biochemical outcomes support the choice of foregut bypass over restrictive bariatric procedures in NAFLD management.

关键词： Bariatric surgery non-alcoholic fatty liver disease(NAFLD) obesity fibrosis endoscopy