Inflammatory bowel disease (IBD) is a chronic, nonspecific inflammatory disease of the intestine. In recent years, the treatment goals for IBD have evolved from symptom control and endoscopic remission to histological remission, which is associated with significantly better prognoses. Current parameters for histological evaluation include the Nancy histological index (NHI), Geboes score (GS), Robarts histological index (RHI), and global histological activity score (GHAS). However, the evaluation of clinical histological remission remains limited by the lack of standardized criteria and poor reproducibility, hindering its widespread application. With the development of artificial intelligence (AI) technology, AI tools have been increasingly applied in histological evaluation of IBD and can be integrated with endoscopic and multi-omics approaches. This article reviews the current applications, research progress, and associated challenges of AI in the histological evaluation of IBD.

Objective To explore the influencing factors of somatic symptom disorder(SSD)in patients with epilepsy,and to construct a nomogram prediction model.Methods Using structured interviews,according to the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders(Fourth Edition),206 patients with epilepsy included in this study were divided into SSD group and non-SSD(n-SSD)group.The clinical data of the two groups were compared.The quality of life in epilepsy inventory(QOLIE-31),general anxiety disorder-7(GAD-7),neurological disorders depression inventory for epilepsy(NDDI-E)and Pittsburgh sleep quality index(PSQI)were used to evaluate the anxiety,depression and sleep of patients.LASSO regression was used for variable screening,and Logistic regression model was used to explore the risk factors of SSD in patients with epilepsy.Based on these factors,a nomogram was constructed and the area under the ROC curve(AUC)was calculated and verified internally.Calibration curve and decision curve analysis were used to evaluate the calibration and clinical utility of the nomogram,respectively.Results Compared with those in the n-SSD group,there were significant differences in age,age of onset,educational background,place of residence,number of physical diseases and negative life events in the SSD group(all P＜0.05).Compared with those in the n-SSD group,GAD-7 score,NDDI-E score,PSQI score,total score of QOLIE-31 and the scores of seizure worry,drug influence,energy/fatigue,life satisfaction,social function and emotion in the SSD group were significantly lower(all P＜0.05).Multivariate Logistic regression analysis showed that age(OR=1.076,95％CI:1.015-1.141),negative life events(OR=6.624,95％CI:2.130-20.606),seizure worry(OR=0.945,95％CI:0.895-0.999),energy/fatigue(OR=0.923,95％CI:0.872-0.977),GAD-7 score(OR=1.274,95％CI:1.037-1.565),NDDI-E score(OR=1.233,95％CI:1.038-1.442),PSQI score(OR=1.375,95％CI:1.097-1.723)were independent predictors of SSD.According to the variables in the results of multivariate Logistic regression analysis and their corresponding regression coefficients,the nomogram of SSD in patients with epilepsy was established.The AUC of the nomogram was 0.939(95％CI:0.904-0.975),the best cut-off value was 0.200,the sensitivity was 0.847,the specificity was 0.953,and the discrimination was good.The decision curve risk threshold showed that the model provides significant clinical net benefits.Conclusions Age,negative life events,seizure concerns,energy/fatigue,GAD-7 score,NDDI-E score and PSQI score are risk factors for epileptic SSD.The columniogram model constructed based on the above factors can effectively predict the risk of epileptic SSD.

Inflammatory bowel disease (IBD) is a chronic, nonspecific inflammatory disease of the intestine. In recent years, the treatment goals for IBD have evolved from symptom control and endoscopic remission to histological remission, which is associated with significantly better prognoses. Current parameters for histological evaluation include the Nancy histological index (NHI), Geboes score (GS), Robarts histological index (RHI), and global histological activity score (GHAS). However, the evaluation of clinical histological remission remains limited by the lack of standardized criteria and poor reproducibility, hindering its widespread application. With the development of artificial intelligence (AI) technology, AI tools have been increasingly applied in histological evaluation of IBD and can be integrated with endoscopic and multi-omics approaches. This article reviews the current applications, research progress, and associated challenges of AI in the histological evaluation of IBD.

Objective To explore the influencing factors of somatic symptom disorder(SSD)in patients with epilepsy,and to construct a nomogram prediction model.Methods Using structured interviews,according to the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders(Fourth Edition),206 patients with epilepsy included in this study were divided into SSD group and non-SSD(n-SSD)group.The clinical data of the two groups were compared.The quality of life in epilepsy inventory(QOLIE-31),general anxiety disorder-7(GAD-7),neurological disorders depression inventory for epilepsy(NDDI-E)and Pittsburgh sleep quality index(PSQI)were used to evaluate the anxiety,depression and sleep of patients.LASSO regression was used for variable screening,and Logistic regression model was used to explore the risk factors of SSD in patients with epilepsy.Based on these factors,a nomogram was constructed and the area under the ROC curve(AUC)was calculated and verified internally.Calibration curve and decision curve analysis were used to evaluate the calibration and clinical utility of the nomogram,respectively.Results Compared with those in the n-SSD group,there were significant differences in age,age of onset,educational background,place of residence,number of physical diseases and negative life events in the SSD group(all P＜0.05).Compared with those in the n-SSD group,GAD-7 score,NDDI-E score,PSQI score,total score of QOLIE-31 and the scores of seizure worry,drug influence,energy/fatigue,life satisfaction,social function and emotion in the SSD group were significantly lower(all P＜0.05).Multivariate Logistic regression analysis showed that age(OR=1.076,95％CI:1.015-1.141),negative life events(OR=6.624,95％CI:2.130-20.606),seizure worry(OR=0.945,95％CI:0.895-0.999),energy/fatigue(OR=0.923,95％CI:0.872-0.977),GAD-7 score(OR=1.274,95％CI:1.037-1.565),NDDI-E score(OR=1.233,95％CI:1.038-1.442),PSQI score(OR=1.375,95％CI:1.097-1.723)were independent predictors of SSD.According to the variables in the results of multivariate Logistic regression analysis and their corresponding regression coefficients,the nomogram of SSD in patients with epilepsy was established.The AUC of the nomogram was 0.939(95％CI:0.904-0.975),the best cut-off value was 0.200,the sensitivity was 0.847,the specificity was 0.953,and the discrimination was good.The decision curve risk threshold showed that the model provides significant clinical net benefits.Conclusions Age,negative life events,seizure concerns,energy/fatigue,GAD-7 score,NDDI-E score and PSQI score are risk factors for epileptic SSD.The columniogram model constructed based on the above factors can effectively predict the risk of epileptic SSD.

Objective To explore the effect of digital delivery of cognitive behavioral therapy for insomnia(dCBT-I)based on internet technology on anxiety and sleep quality in patients with generalized anxiety disorder(GAD).Methods A total of 82 GAD patients treated in Huzhou Third Municipal Hospital from April to October 2023 were selected as study objects,and were divided into intervention group and control group according to random number table method,with 41 cases in each group.The intervention group received dCBT-I based on internet technology,and the control group received offline cognitive behavioral therapy for insomnia.The anxiety and sleep quality of two groups were compared.Results After the intervention,the scores of Hamilton anxiety scale and Pittsburgh sleep quality index in intervention group were significantly lower than those in control group,and the score of dysfunctional beliefs and attitudes about sleep was significantly higher than those in control group(P<0.05).Conclusion dCBT-I based on internet technology can effectively relieve the anxiety of GAD patients and improve the quality of sleep.

Objective:To investigate the expression of serum human phosphatidylethanolamine-binding protein 4 (hPEBP4) in patients with multiple myeloma (MM) and its clinical significance.Methods:A total of 59 symptomatic MM patients admitted to West Branch of Beijing Chaoyang Hospital from September 2016 to September 2018 were selected as the research objects. According to the CRAB symptoms [elevated serum calcium (C), kidney injury (R), anemia (A), bone lesions (B)], all patients were divided into 2 groups, including the active group of 44 patients with CRAB symptoms, and the response group of 15 patients who achieved at least partial remission after chemotherapy and symptom relief of CRAB. According to the degree of bone lesions (BL), 30 patients with severe bone-related events were grouped as the severe bone lesions (SBL) group, and 14 patients were grouped as the non-severe bone lesions (NSBL) group. According to the revised international prognostic staging system (R-ISS), patients in the active group were divided into three subgroups: stage Ⅰ, stage Ⅱ, and stage Ⅲ, including 26, 11 and 7 patients, respectively. A total of 15 healthy examination people whose gender and age matched those of the patients were treated as the healthy control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of hPEBP4, tumor necrosis factor ligand superfamily member 14 (LIGHT/TNFSF14) and activin A of patients in different groups. Pearson was used to analyze the relationship of the expressions of multiple factors in the active group. The optimal cut-off value of multiple factors diagnosing MM was determined by using receiver operating characteristic (ROC) curve, and according to the cut-off value, the differences in overall survival (OS) of patients with different stratification were compared.Results:In the active group, the respond group, the healthy control group, the level of hPEBP4 was (1.48±0.64) μg/L, (1.49±0.75) μg/L, (0.31±0.10) μg/L, respectively; the level of LIGHT/TNFSF14 was (169±112) ng/L, (256±132) ng/L, (44±27) ng/L,respectively; the level of activin A was (383±266) ng/L, (223±79) ng/L, (234±85) ng/L, respectively; and the differences were statistically significant (all P<0.05). In the active group, the level of hPEBP4 was (1.06±0.60) μg/L, (1.15±0.50) μg/L, (1.73±0.68) μg/L, respectively in patients with stage R-ISSⅠ, R-ISSⅡ and R-ISS Ⅲ, and the difference was statistically significant ( F=3.287, P=0.032). The level of activin A was (219±55) ng/L, (247±117) ng/L, (450±215) ng/L, respectively among patients in stage R-ISSⅠ, R-ISSⅡ, R-ISS Ⅲ, and the level of activin A in stage R-ISS Ⅲ was higher than that in stage R-ISSⅠand R-ISSⅡ (all P < 0.05). The levels of LIGHT/TNFSF14 and activin A of SBL patients were higher than those of NSBL patients [(174±101) ng/L vs. (98±53) ng/L; (467±238) ng/L vs. (189±71) ng/L, all P < 0.05]. The level of hPEBP4 was positively correlated with the levels of M protein ( r=0.694, P < 0.01) and activin A ( r=0.252, P < 0.01) of IgG patients in the active group. ROC curve analysis showed that the optimal cut-off value of hPEBP4, LIGHT/TNFSF14, activin A diagnosing MM was 1.04 μg/L, 97.0 μg/L, 156.2 ng/L. The median overall survival (OS) time of patients with hPEBP4 >1.04 μg/L and hPEBP4 ≤ 1.04 μg/L was 57 months (95% CI 22-92 months) and not reached, respectively, and the difference was statistically significant ( P < 0.05); while the median OS time of patients with activin A ≥ 156.2 ng/L and activin A < 156.2 ng/L was 61 months (95% CI 24-98 months) and not reached, respectively, and the difference was statistically significant ( P < 0.05). Conclusions:High expression level of hPEBP4 is related with the progression of MM. It is positively related with the level of M protein and negatively with the OS of MM patients. It is suggested that hPEBP4 may be used as an important marker to judge disease progression and tumor burden in MM. LIGHT/TNFSF14 and activin A cooperate with hPEBP4 to participate in the pathological processes of tumor microenvironment of MM.

Chromosome microarray analysis (CMA) has become the first-tier testing for chromosomal abnormalities and copy number variations (CNV). This review described the clinical validation of CMA, the development and updating of technical standards and guidelines and their diagnostic impacts. The main focuses were on the development and updating of expert consensus, practice resources, and a series of technical standards and guidelines through systematic review of case series with CMA application in the literature. Expert consensus and practice resource supported the use of CMA as the first-tier testing for detecting chromosomal abnormalities and CNV in developmental and intellectual disabilities, multiple congenital anomalies and autism. The standards and guidelines have been applied to pre- and postnatal testing for constitutional CNV and tumor testing for acquired CNV. CMA has significantly improved the diagnostic yields but still needs to overcome its technical limitations and face challenges of new technologies. Guiding and governing CMA through expert consensus, practice resource, standards and guidelines in the United States has provided effective and safe diagnostic services to patients and their families, reliable diagnosis on related genetic diseases for clinical database and basic research, and references for clinical translation of new technologies.
Child ; Chromosome Aberrations ; Chromosomes ; DNA Copy Number Variations ; Developmental Disabilities/genetics* ; Humans ; Intellectual Disability/genetics* ; Microarray Analysis ; United States

A 49-year-old woman was admitted to hospital with intermittent dizziness and fatigue for 7 years. The symptoms were aggravated and accompanied by bone pain for more than 4 months. She was referred to our hospital. Laboratory tests and imaging findings suggested that acquired Fanconi Syndrome (FS) was associated with smoldering multiple myeloma (MM). Renal biopsy and electron microscopy confirmed the diagnosis of proximal light chain tubular disease (LCPT). LCPT causes proximal tubular dysfunction, which is characterized by the cytoplasmic crystal deposition usually kappa monoclonal light chain in the proximal tubule. MM with FS and LCPT is less common in clinical practice because it is difficult to diagnose. This is a typical case focusing on the differential diagnosis of monoclonal gammopathy of renal significance(MGRS) such as LCPT and plasma cells diseases.

Objective To investigate the effect of agomelatine in treating first-episode depression and its influnce on cognitive function. Methods 100 patients with first-episode depression who were admitted in our hospital from January 2015 to January 2017 were selected as study subjects and randomly divided into observation group and control group with 50 cases in each group according to different treatment methods. The control group was treated with paroxetine hydrochloride and the observation group was given agomelatine. After treatment, the clinical efficacy between the two groups was evaluated. At the same time, the scores of visual space and executive, naming, memory, attention, language, abstraction, delay memory and orientation in the cognitive function between two groups before and after treatment were compared. Results After treatment, the clinical efficacy of the two groups was evaluated. The results showed that the total effective rate in the observation group and that in the control group was 88. 0％ and 80. 0％ after treatment. There was no significant difference in the total efficiency between the two groups(P＞0. 05). Before treatment, there was no significant difference between the two groups in cognitive function in terms of visual space and executive, naming, memory, attention, language, abstraction, delayed memory, and directional score. After treatment, visual space and executive, naming, memory, attention, language, abstraction, delayed memory and directed score in cognitive function in two groups were significantly higher than those before treatment. And the scores of cognitive function in the observation group were significantly higher than those in the control group. There was significant difference between the groups P＜0. 05). Conclusion Agomelatine has significant clinical efficacy in the treatment of patients with first-episode depression and can improve the cognitive function of patients and improve the quality of life of patients, which is worthy of widely clinical application.

Objective To explore the effects of escitalopram on coagulation function in depression patients. Methods This was a self-controlled prospective study. The subjects were depression patients (Hamilton Depression Scale(HAMD)score>17)who presented to or hospitalized in the Department of Psychosomatic Disorders in the Third People′s Hospital of Huzhou City from June 1,2016 to June 1,2017. The patients in accordance with inclusion criteria were treated with escitalopram(initial dose was 5 mg/d and increased to 10-20 mg/d within 2 weeks). HAMD rating scale were performed,prothrombin time (PT),activated partial thromboplastin time(APTT),thrombin time(TT)and fibrinogen(FIB)were detected before treatment and 4 weeks after treatment. Response was defined as a 50% reduction in HAMD score. Results A total of 95 patients finished the 4 weeks treatment with escitalopram. Of them,38 patients were male with ages from 21 to 64 years and mean age of(39 ± 12)years,with illness duration from 14 to 60 months and mean illness duration of(32 ± 12)years;57 cases were female with ages from 20 to 64 years and mean age of(38 ± 13)years,with illness duration from 12 to 54 and mean illness duration of (28 ± 12)years. HAMD score were(21.8 ± 3.4)and(9.1 ± 3.3)before and after 4 weeks treatment, respectively(t=26.125,P<0.001). The levels of PT,APTT,and TT in patients after 4 weeks treatment were significantly higher than those before treatment[(11.14 ±1.22)s vs.(11.66 ±1.41)s,(29.45 ± 5.24)s vs.(31.28 ± 5.64)s,(20.32 ± 2.08)s vs.(21.15 ± 2.21)s,respectively,all P<0.05]. However, the FIB level after 4 weeks treatment was significantly decreased than that before treatment[(1.92 ± 0.28) g/L vs.(2.01 ± 0.34)g/L,P <0.05]. There were no significant differences among the indexes of coagulation function among the patients with different sex(P>0.05). After treatment,the increased values of PT and TT levels and the decreased value of FIB level in female patients were significantly higher than those in male patients(all P<0.05). After treatment,there were no significant differences in the increased value of PT,TT and APTT and the decreased value of FIB between the response group(80 cases)and the non-response group(15 cases)(all P >0. 05). One 24-year-old female patient presented with upper gastrointestinal bleeding after more than 1 month of escitalopram treatment at a dose of 15 mg/d. Conclusion Escitalopram has an influence on coagulation function in depression patients,especially in female patients,which may increase the risk of bleeding.