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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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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 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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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.