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Background: Computer-aided diagnosis based on deep learning technology is a research hotspot in the field of gastroenterology, and computer-aided diagnosis of colorectal polyps has received more and more attention. Aims: To validate a model based on deep learning for the automatic identification of colorectal polyps, and to analyze its auxiliary learning function for helping novice endoscopists. Methods: A total of 1 200 colonoscopy images (600 colorectal polyp images and 600 normal images) in the endoscopy center database of Qingdao Municipal Hospital (East) from January 2019 to January 2020 were retrospectively collected. Deep learning model was used to identify the 1 200 images. The sensitivity, specificity, accuracy and diagnosis time of deep learning model and 5 novice endoscopists for diagnosis of colorectal polyps were compared. Results: The deep learning model showed a sensitivity of 93.2%, specificity of 98.7%, accuracy of 95.9% for detecting colorectal polyps, and the diagnosis time of each image was (0.20±0.03) second. The sensitivity, accuracy, and diagnosis time of the model were superior to 5 novice endoscopists, and the specificity was superior to some novice endoscopists. The accuracies of model for polyps with size ≤5 mm and 6~9 mm were 88.1% and 96.8%, respectively, and were superior to 5 novice endoscopists; the accuracy of model for polyps with size ≥10 mm was 100%, and was similar to 5 novice endoscopists. The accuracy of model for polyps with protrude type was 94.8%, and was superior to some novice endoscopists; the accuracy of model for polyps with flat type was 91.7%, and was superior to 5 novice endoscopists. Missing the polyps with flat type (38.8%), polyps at mucosal folds (32.7%), and mistaking the mucosal folds as polyps (12.2%) were the main causes of false negative or false positive results of the model. Conclusions: The deep learning model has a high accuracy, sensitivity, specificity and shorter diagnosis time for diagnosis of colorectal polyps, and can be used to assist novice endoscopists in diagnosing small polyps and flat polyps.
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Background:Family history of gastric cancer is an important indicator of genetic susceptibility.Studies have shown that the family history of gastric cancer might have impact on Helicobacter pylori (Hp) infection and clinicopathological manifestations in patients with chronic gastritis.Aims:To investigate the correlation of family history of gastric cancer with Hp infection and pathological changes of gastric mucosa in patients with chronic gastritis.Methods:A total of 312 patients with chronic gastritis were enrolled to study the relationship between family history of gastric cancer and Hp infection,degree of gastric mucosal inflammation,activity of inflammation,and degree of atrophy and intestinal metaplasia.Results:In the 312 patients with chronic gastritis,165 (52.9％) had family history of gastric cancer,and 147 (47.1％) without family history of gastric cancer.Incidence of Hp infection,degree of gastric mucosal atrophy and intestinal metaplasia in patients with family history of gastric cancer were significantly higher than those without (P ＜ 0.05),but no significant differences in degree and activity of inflammation were found between the two groups (P ＞ 0.05).Conclusions:The incidence of Hp infection is higher in chronic gastritis patients with family history of gastric cancer.Family history of gastric cancer may aggravate gastric mucosal atrophy and intestinal metaplasia.
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Objective To investigate the dynamic abnormality of anorectum in elderly patients with chronic constipation.Methods Anorectal perfusion manometry was performed to detect the change of anal canal pressure and the rectal sensation capacity in 58 elderly patients and 36 non-elderly adults with chronic constipation.The results were compared retrospectively.Results Anal resting pressure in a chronic constipation was significantly lower in elderly patients than in non-elderly adults,with statistically significant difference [(59.74 ± 2.31) mmHg vs.(68.22 ± 2.37) mmHg,t =2.430,P =0.017].The incidence of paradoxical motility of anal sphincter was significantly higher in elderly patients with three abnormalities(incomplete defecation,Bristol stool scale type 3-5 and straining at defecation) than in elderly patients without above three abnormalities (x2 =8.880、11.540、6.070,P =0.003、0.001、0.014).Maximal tolerable volume was significant lower in elderly patients with straining at defecation and abdominal pain than in control group (t =2.140,2.260,both P ＜ 0.05).No correlation was observed between sex and anorectal motility in elderly patients with chronic constipation.Conclusions Anorectal motility in elderly patients with chronic constipation is different from that in non-elderly patients with chronic constipation.The dynamic abnormalities of anorectum in chronic constipation are different in elderly patients with different symptoms.
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Chronic gastritis has varied clinical symptoms and prolonged course,and seriously affects the life quality of patients.Studies have shown that mood disorders might affect the pathogenesis of chronic gastritis.Aims:To investigate the incidence of anxiety and depression and its relationship with digestive symptoms,Helicobacter pylori (Hp) infection,degree and activity of inflammation in patients with chronic gastritis.Methods:A total of 235 patients with chronic non-atrophic gastritis were enrolled.Anxiety,depression,gastrointestinal symptoms,gastric mucosal inflammation and activity were evaluated,and infection of Hp was detected.Results:In the 235 patients,144 (61.3%)were accompanied by anxiety and/or depression:108 patients (46.0%)were accompanied by anxiety,129 patients (54.9%) were accompanied by depression,93 patients (39.6%)were accompanied by anxiety and depression.Incidence of abdominal pain,abdominal distention and early satiety,scores of digestive symptoms,positive rate of Hp infection and incidence of severe inflammation in patients accompanied by anxiety and/or depression were significantly higher than those in patients without anxiety and depression (P0.05).Conclusions:Incidence of anxiety and depression in patients with chronic gastritis is high.Anxiety and depression are associated with abdominal pain,abdominal distention and early satiety,and can affect the inflammatory degree of gastric mucosa.Patients with anxiety and depression are susceptible to Hp infection.
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Objective To investigate the condition of exercise, medicine compliance and the rehabilitation of patients with arteriosclerosis obliterans (ASO) in lower extremity after the surgery, and also to study the influence of self-efficiency and social support to their rehabilitation. Methods The questionnaire survey was performed in 102 patients who had surgical or interventional therapy of arteriosclerosis obliterans in the lower extremity in our hospital, investigated the general information of the patients, their knowledge of postoperative rehabilitation, medicine compliance, exercise condition, general self-efficiency and social support. Results The postoperative time for the patients with arteriosclerosis obliterans was 2 to 22months, the knowledge rate for postoperative rehabilitation was 7.8%-46.1%.The Morisky score for the patients of taking medicine for the treatment of vascular disease was 2.0,and there was only 6 patients(5.9%)with good medicine compliance. There were 22 patients(21.0%) had completed the ambulation training according to the guidelines, and there were 25 patients(24.5%) had completed the Buerger training. The self-efficiency score of the patients was 2.78 ± 0.76, and the gross score of social support was 32.38 ± 7.89. Spearman correlation analysis shows that the Morisky score for the patients of taking medicine for the treatment of vascular disease was in positive correlation with self-efficiency (r=0.289, P=0.003), but in negative correlation with social support (r=–0.286, P=0.006). Conclusions Most of the patients with arteriosclerosis obliterans have poor medicine compliance, and do not do exercise as required by the guidelines. Patients with high self-efficiency demonstrates medicine noncompliance, however the enhancement of social support will help patients improve their medicine compliance.
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Objective To summarize the clinical characteristics and management of eosinophilic esophagitis (EoE) in China and improve the recognition of clinical doctor for this disease.Methods Electronic database was searched from 1993 to 2012 for case reports of EoE in Chinese patients.Data were enrolled according to the admission criterion,which included relatively complete medical records and cases confirmed by endoscopic biopsy and/or operation pathology.Results Data of 38 patients with EoE from 6 studies were included and analyzed.There were 24 males and 14 females.The age of onset was (47.2 ± 10.9)years.The process of the disease was (1.5 ± 1.8) years.The main symptoms included dysphagia (24/38,63％) and retrostemal pain (22/38,58％).Total 19 patients (83％,19/23) had allergy history and 20 patients (80％,20/25) had elevated blood eosinophil count.Lesions located at the mid-inferior esophagus mainly.Endoscopic manifestation included hyperaemia,erosion and fragile mucosa,and others such as mucosal nodular,ulcer,plaque and white exudates (18/38,47％).Eosinophil count in esophageal mucosa was (45.8 ± 34.1) numbers/HPF.Main treatment included corticosteroid and acid inhibitory medicine.Conclusions EoE is rare in Chinese people.EoE is more common in middle-aged males with chronic onset.Dysphagia and retrosternal pain is the common symptoms.Endoscopy and biopsy pathology are the methods for definition diagnosis.Corticosteroid and acid inhibitory medicine are the main treatment.
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Cat scratch coIon( CSC ) is a new term for an endoscopicaIIy characteristic Iesion identified under coIonoscopy,which appears as bright red Iinear mucosaI tear commonIy seen in cecum and ascending coIon. The pathogenesis is considered to be the barotrauma of coIonic mucosa secondary to coIonoscopic insuffIation, and other mechanisms may aIso be impIicated in this process. CSC can be found in coIIagenous coIitis,diversion coIitis or in combination with other non-intestinaI diseases or conditions. With the recognition of CSC by cIinicians,reIated reports have increased. In this articIe,reIated Iiteratures were reviewed for a better understanding of this Iesion.
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Objective To explore quality of life and coping style of autistic children' s parents, and correlation between them. Methods 68 parents of children with autism and 64 healthy children' s parents were tested with comprehensive assessment questionnaire of the quality of life and coping style questionnaire. Data were analyzed by t -test and multivariate regression analysis. Results The scores of material life and mental health dimensions in study group(48.18 ± 12.80,60.63 ± 10.18 ) were lower than that in control group(52.71±9.84,65.79±8.64) and the difference was significant( t= -2.04, P＜0.05; t= -3.09, P＜0.01 ). The scores of "problem solving" coping style in study group were slower than in control group; the scores of fantasy and wincing coping style in study group were higher than that in control group. By multivariate regression analysis showed that the scores of "problem solving" coping style were positively correlated with total score of life quality,physical health,mental health and social function dimensions; the scores of "fantasy" coping style had negative correlation with the total score of life quality; the scores of "wincing" coping style had negative correlation with mental health dimension. Conclusion Parents of autistic children were more susceptible to problems of physical life and mental health. Compared to parents of normal children they are more in "fantasy and wineing style and less in" problem solving style to cope with stress, so it would affect the quality of life and mental health badly and need early intervention.
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Background and purpose: Syndecan-1 and HPA-1 may be involved in the progression of invasion and metastasis of many malignant tumors, but there are few reports about the relationship between the two gene expressions in gastric carcinomas. This study was aimed to explore the expression of Syndecan-1 and HPA-1 mRNA in gastric carcinoma and their relationship with the invasion and metastasis of gastric carcinoma. Methods: Real-time polymerase chain reation (RT-PCR) was used to detect mRNA of Syndecan-1 and HPA-1 in 58 cases of gastric carcinoma, 58 paired adjacent gastric carcinoma (2 cm from carcinoma), and 58 surgical marginal normal gastric mucosa tissues (5 cm from carcinoma). Then we analyzed their relationship with clinico-pathological characteristics of gastric carcinoma. Results: The upregulation of Syndecan-1 mRNA was significantly higher in normal gastric mucosa (98.3%) than that in paired adjacent mucosa (25.9%) and gastric carcinoma (5.2%) (all P<0.001).The upregulation of Syndecan-1 mRNA was significantly higher in paired adjacent mucosa than that in gastric carcinoma (all P<0.05). The upregulation of HPA-1 mRNA was significantly higher in gastric carcinoma (86.2%) than that in paired adjacent gastric carcinoma (27.6%) and normal gastric mucosa (5.2%) (P<0.001). The upregulation of HPA-1 mRNA was significantly higher in paired adjacent gastric carcinoma than that in normal gastric mucosa (all the same P<0.05). The downregulation of Syndecan-1 and the upregulation of HPA-1 had relationship with the degree of differentiation, depth of infiltration, lymph node metastasis, distant metastasis and TNM staging of gastric carcinoma (P<0.05). Conclusion: The upregulation of Syndecan-1 mRNA was significantly higher in normal gastric mucosa. The upregulation of HPA-1 mRNA was significantly higher in gastric carcinoma. Also, the expression of Syndecan-1 and HPA-1 could predict the invasion and metastasis of gastric carcinoma. Determination of Syndecan-1 and HPA-1 may be of value in the treatment as well as in the prediction for prognosis of gastric cancer.
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Objective To investigate the characteristics of attention in children with comorbid attention deficit hyperactivity disorder (ADHD) and tic disorder (TD) (CAT). Methods 60 children with comorbid ADHD and TD (CAT), 79 children with ADHD, 60 children with TD and 71 normal control children (NG) were collected. All of those cases were evaluated with the integrated visual and auditory continuous performance test (IVA-CPT). Results It was slightly higher for visual response control quotient (VRCQ) in CAT group(85.15 ±21.10) than those in ADHD group(78.52 ± 21.85) (P ＜ 0.05), there was no significant different in the other five scores between CAT group and ADHD group (P＞0.05). It was significantly lower for the full response control quotient (FRCQ), auditory response control quotient (ARCQ) ,visual response control quotient (VRCQ), full attention quotient (FAQ), auditory attention quotient (AAQ) and visual attention Quotient (VAQ) in CAT group (83.43 ± 20.98,86.12 ± 19.88,85.15 ± 21. 10,64.88 ± 16.88,67.92 ± 17. 11 ,67.97 ± 20.04) than those in TD group(96.47 ± 17.83,97.50 ± 17.62,95.72 ± 18.87,85.37 ± 18.54,86.47 ± 17.32,87.43 ± 19.89) and those in normal control group(98.42 ± 12.67,101.50 ± 15.39,95.92 ± 11.79,99.33 ± 12.98,98.50 ± 12.09,100.00 ± 16.12) (P＜0.01). Conclusion There have serious reduced control ability and attention deficit in children with CAT. The attention deficit is attributed to the existence of ADHD.
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@#ObjectiveTo evaluate the intelligence profile,personality and behaviour disorders of children with primary generalized tonic and/or clonic seizures.MethodsUsing Chinese modification of Wechsler Intelligence Scale for Children,Eysenk Personality Questionnaire(EPQ),and Achenbach Child Behaviour Check List,neuropsychological assessment of 35 cases aged 6-14 years and the normals with the similar age and sex were makenand compared.ResultsExcept picture completion ,all the subtests scales of children with epilepsy were significantly lower than those of the controls (P<0.01). A significant difference of average FIQ(P<0.001) was observed between experimental group (85.86) and control group (103.60).There were 13 cases(37.14%) in experimental group whose FIQ were in broderline range, FIQ of 5 cases(14.29%) was in lower range,while none abnormal in the controls.The children with epilepsy had more abnormal behaviours than that of the controls(abnormal rates were 38.71% and 6.45% respectively).Statistical analysis showed no difference of EPQ scales between the two groups.Conclusions Children with primary generalized epilepsy maybe complicate with cognitive deficit and behaviour disorder.