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BackgroundRosacea is a chronic inflammatory disease with variable clinical presentations, including transient flushing, fixed erythema, papules, pustules, and phymatous changes on the central face. Owing to the diversity in the clinical manifestations of rosacea, the lack of objective biochemical examinations, and nonspecificity in histopathological findings, accurate identification of rosacea is a big challenge. Artificial intelligence has emerged as a potential tool in the identification and evaluation of some skin diseases such as melanoma, basal cell carcinoma, and psoriasis. ObjectiveThe objective of our study was to utilize a convolutional neural network (CNN) to differentiate the clinical photos of patients with rosacea (taken from 3 different angles) from those of patients with other skin diseases such as acne, seborrheic dermatitis, and eczema that could be easily confused with rosacea. MethodsIn this study, 24,736 photos comprising of 18,647 photos of patients with rosacea and 6089 photos of patients with other skin diseases such as acne, facial seborrheic dermatitis, and eczema were included and analyzed by our CNN model based on ResNet-50. ResultsThe CNN in our study achieved an overall accuracy and precision of 0.914 and 0.898, with an area under the receiver operating characteristic curve of 0.972 for the detection of rosacea. The accuracy of classifying 3 subtypes of rosacea, that is, erythematotelangiectatic rosacea, papulopustular rosacea, and phymatous rosacea was 83.9%, 74.3%, and 80.0%, respectively. Moreover, the accuracy and precision of our CNN to distinguish rosacea from acne reached 0.931 and 0.893, respectively. For the differentiation between rosacea, seborrheic dermatitis, and eczema, the overall accuracy of our CNN was 0.757 and the precision was 0.667. Finally, by comparing the CNN diagnosis with the diagnoses by dermatologists of different expertise levels, we found that our CNN system is capable of identifying rosacea with a performance superior to that of resident doctors or attending physicians and comparable to that of experienced dermatologists. ConclusionsThe findings of our study showed that by assessing clinical images, the CNN system in our study could identify rosacea with accuracy and precision comparable to that of an experienced dermatologist.

The impedance matching characteristic parameters (IMCPs) of microwave absorbing materials for specular reflection under oblique incidence and surface wave attenuation are first proposed and defined. A microwave absorbing sheet was fabricated and its electromagnetic parameters were measured. The specular reflection suppression characterized by reflection loss and non-specular scattering suppression described by surface wave attenuation constants were studied with the change in thickness, polarization, and incident angle. The present results demonstrate that the definition of IMCPs for both specular reflection and non-specular scattering is effective. Meanwhile, the curves of IMCPs share the same shape and have the same peak frequency in specular reflection and non-specular scattering cases. In addition, Brewster angle properties are also consistent with the IMCPs under oblique incidence. Thus, this work develops a pathway for the design of microwave absorbing sheets suppressing both the specular reflection and non-specular scattering by adjusting the IMCPs. [ABSTRACT FROM AUTHOR]

AIM: To investigate the expression of copeptin and midkine(MK)in patients with diabetic retinopathy and their clinical significance. METHODS: Totally 180 patients with type 2 diabetes mellitus(T2DM)admitted to our hospital from June 2016 to October 2017 were divided into three groups according to the criteria of diabetic retinopathy staging. Among them, there were no retinopathy group(68 cases), non-proliferative retinopathy group(72 cases), proliferative retinopathy group(40 cases)and 90 healthy subjects in the same period as the control group. The copeptin level was detected by double antibody immunosorbent assay and the MK level by ELISA. The glycosylated hemoglobin(HbA1c)was detected by TOSOH automatic glycosylated hemoglobin analyzer and the whole blood hs-CRP was detected by using blood routine instrument. Fasting plasma glucose(FPG), triglyceride(TG), cholesterol(TC), low density lipoprotein(LDL-C)and high density lipoprotein(HDL-C)were detected by automatic biochemical analyzer and the systolic blood pressure(SBP)and diastolic blood pressure(DBP)of each group were recorded. The relationship between copeptin and MK levels and blood lipid, blood pressure, biochemical parameters and the course of diabetes mellitus were also analyzed. RESULTS: The levels of copeptin and MK in patients with diabetic retinopathy were significantly higher than those in controls, and the levels of copeptin and MK were gradually increased with the progress of disease(PPP>0.05). CONCLUSION: The copeptin and MK levels are closely related to the course of diabetic retinopathy and the severity of the disease, both of which may be involved in the development of diabetic retinopathy.

Patients with refractory erythema of rosacea have limited treatment options. To evaluate the efficacy and safety of a 12-week course of paroxetine for moderate-to-severe erythema of rosacea. In a multicenter, randomized, double-blinded, placebo-controlled trial, patients with refractory erythema of rosacea were randomly assigned (1:1) to receive paroxetine 25 mg daily or placebo for 12 weeks. Overall, 97 patients completed the study (paroxetine: 49; placebo: 48). The primary end point was the proportion of participants achieving Clinical Erythema Assessment success (defined as Clinical Erythema Assessment score of 0, 1, or ≥2-grade improvement from baseline) at week 12; this was significantly greater in the paroxetine group than in the placebo group (42.9% vs 20.8%, P =.02). Some secondary end points were met, such as flushing success with point reductions ≥2 (44.9% vs 25.0%, P =.04) and improvement in overall flushing (2.49 ± 3.03 vs 1.68 ± 2.27, P =.047), burning sensation (46.9% vs 18.8%, P =.003), and depression (P =.041). The most reported adverse events associated with paroxetine were dizziness, lethargy, nausea, dyspepsia, and muscle tremors. Only a single-dosage regimen of paroxetine within a 12-week study was evaluated. Paroxetine is an effective and well-tolerated alternative treatment for moderate-to-severe erythema of rosacea. [ABSTRACT FROM AUTHOR]