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

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

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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

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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

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

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

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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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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

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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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Impact of hospital size on healthcare information system effectiveness: evidence from healthcare data analytics

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Journal of Management Analytics 2022年第2期9卷 211-231页

作者： Liuliu Fu Ling Li Lusi Li Wenlu Zhang Zihao Luo CIS Department California State UniversityLos AngelesCAUSA IS Department Old Dominion UniversityNorfolkVAUSA IS Department California State UniversityLong BeachCAUSA Accounting Department Zhongnan University of Economics and LawWuhanPeople’s Republic of China

With the rapid development of information technology, the increasing use ofmobile digital devices and efforts from the whole society, the healthcareinformation systems (HISs) are moving towards a new era. However, there isstill a lack of clear understanding of the benefits of HIS at the hospital leveland the influential factors for HIS effectiveness. In this study, we propose aresearch framework to explain how HIS implementation improves hospitalperformance. Our results reinforce the positive effect of HIS on hospitalperformance. In particular, we found that HIS implementation increases boththe cost and revenue of the hospitals, but the increasing effect in revenue ismuch bigger than the increasing effect in cost. We also found that althoughboth small and big hospitals benefit from the implementation of HIS, the effectof size is different. Size has a positive effect on hospital performance for smallhospitals but has a negative effect on big hospitals. This indicates that thecompetitive advantage of economies of scale disappears for big hospitalsbecause the level of information transparency becomes lower and transactioncosts become higher as size increases.

关键词： healthcare healthcare information systems HIS hospital performance size

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Sedated vs unsedated colonoscopy:A prospective study

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World Journal of Gastroenterology 2014年第17期20卷 5113-5118页

作者： Abdulrahman M Aljebreen Majid A Almadi Felix W Leung Gastroenterology Division King Khalid University HospitalKing Saud UniversityRiyadh 11461Saudi Arabia Gastroenterology Division McGill University Health Center McGill University MontrealQuebec H3G 1A4Canada Research and Medical Services Sepulveda Ambulatory Care CenterVeterans Affairs Greater Los Angeles Healthcare Systemand David Geffen School of Medicine at UCLALos AngelesCaliforniaCA 91343United States

AIM:To compare sedated to unsedated colonoscopy in terms of duration,pain and the patient’s willingness to repeat the ***:Consecutive patients who underwent colonoscopies over a 2-year period were invited to *** patients who were to undergo our endoscopy unit were offered sedation with standard intravenous sedatives and analgesics,or an unsedated colonoscopy was *** details were *** patient anxiety level prior to the procedure,time to reach the cecum,total discharge time,patient and endoscopist pain assessments,satisfaction after the examination and the patient’s willingness to return for the same procedure in the future were ***:Among the 403 observed patients,more males were observed in the unsedated group(66.2%vs 55.2%,P=0.04).Additionally,the unsedated group patients were less anxious prior to the procedure(5.1vs 6.0,P<0.01).The colonoscopy completion rates were comparable between the 2 groups(85.9%vs84.2%,P=0.66).The time to reach the cecum was also comparable(12.2 min vs 11.8 min);however,the total discharge times were shorter in the unsedated group(20.7 min vs 83.0 min,P<0.01).Moreover,the average patient pain score(3.4 vs 5.7,P<0.01)was lower in the sedated group,while the satisfaction score(8.8 vs 7.8,P<0.01)was significantly *** was no significant difference,however,between the groups in terms of willingness to repeat the procedure if another was required in the future(83.3%vs 77.3%,P=0.17).CONCLUSION:Unsedated colonoscopy is feasible in willing *** option saves the endoscopy units up to one hour per patient and does not affect the patient willingness to return to the same physician again for additional colonoscopies if a repeated procedure is needed.

关键词： Sedation Colonoscopy Unsedated Screening Endoscopy

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WJSC 6^(th) Anniversary Special Issues(2):Mesenchymal stem cells “Ins” and “Outs” of mesenchymal stem cell osteogenesis in regenerative medicine

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World Journal of Stem Cells 2014年第2期6卷 94-110页

作者： Dean T Yamaguchi Research Service Veteran Administration Greater Los Angeles Healthcare System and David Geffen School of Medicine at University of California at Los Angeles

Repair and regeneration of bone requires mesenchymal stem cells that by self-renewal,are able to generate a critical mass of cells with the ability to differentiate into osteoblasts that can produce bone protein matrix(osteoid)and enable its *** number of human mesenchymal stem cells(hMSCs)diminishes with age and ex vivo replication of hMSCs has limited *** propagating hMSCs under hypoxic conditions may maintain their ability to self-renew,the strategy of using human telomerase reverse transcriptase(hTERT)to allow for hMSCs to prolong their replicative lifespan is an attractive means of ensuring a critical mass of cells with the potential to differentiate into various mesodermal structural tissues including ***,this strategy must be tempered by the oncogenic potential of TERT-transformed cells,or their ability to enhance already established cancers,the unknown differentiating potential of high population doubling hMSCs and the source of hMSCs(e.g.,bone marrow,adipose-derived,muscle-derived,umbilical cord blood,etc.)that may provide peculiarities to self-renewal,differentiation,and physiologic function that may differ from non-transformed native *** engineering approaches to use hMSCs to repair bone defects utilize the growth of hMSCs on three-dimensional scaffolds that can either be a base on which hMSCs can attach and grow or as a means of sequestering growth factors to assist in the chemoattraction and differentiation of native *** use of whole native extracellular matrix(ECM)produced by hMSCs,rather than individual ECM components,appear to be advantageous in not only being utilized as a three-dimensional attachment base but also in appropriate orientation of cells and their differentiation through the growth factors that native ECM harbor or in simulating growth factor *** origin of native ECM,whether from hMSCs from young or old individuals is a critical factor in"rejuvenating"hMSCs from older individuals

关键词： Mesenchymal stem cell Telomerase reverse transcriptase Extracellular matrix Osteogenesis Regenerative medicine Tissue engineering Proliferation Differentiation

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Dynamic responses of bridge-approach embankment transition section of high-speed rail

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Journal of Central South University 2013年第10期20卷 2830-2839页

作者：杨长卫孙海玲张建经朱传彬颜利平 Civil Engineering School Southwest Jiaotong University Department of Engineering Management Henan University of Urban Construction Geotechnical Engineering Group Los Angeles Department of Water and Power

Based on the vehicle track coupling dynamics theory, a new spatial dynamic numerical model of vehicle track subgrade coupling system was established considering the interaction among different structural layers in the subgrade system. The dynamic responses of the coupled system were analyzed when the speed of train was 350 km/h and the transition was filled with graded broken stones mixed with 5% cement. The results indicate that the setting form of bridge-approach embankment section has little effect on the dynamic responses, thus designers can choose it on account of the practical circumstances. Because the location about 5 m from the bridge abutment has the greatest deformation, the stiffness within 0 5 m zone behind the abutment should be specially designed. The results of the study from vehicle track dynamics show that the maximum allowable track deflection angle should be 0.09% and the coefficient of subgrade reaction(K30) is greater than 190 MPa within the 0 5 m zone behind the abutment and greater than 150 MPa in other zones.

关键词： high-speed rail bridge-approach embankment section numerical model track deflection angle

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