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Objective To evaluate the value of endoscopic ultrasonography ( EUS) combined with conventional endoscopy for prediction of invasion depth of early gastric cancer and its therapeutic decision-making. Methods Patients with biopsy-proven gastric cancer underwent EUS and conventional endoscopy from July 2011 to January 2018 in Ningbo No. 2 Hospital. A total of 129 patients with early gastric cancer confirmed by postoperative pathology were enrolled in the study. The sensitivity, specificity, positive predictive value, negative predictive value, consistency ( the value of Kappa ) and area under receiver operating characteristic curve ( AUC) of EUS, conventional endoscopy and combination of two methods to assess the accuracy of tumor infiltration depth were analyzed. The accuracy of therapeutic decision-making based on the EUS, conventional endoscopy and combination of two methods were assessed. Results In intramucosal cancer, the sensitivity, specificity, positive predictive value, negative predictive value, the value of Kappa and AUC of EUS were 75. 00％, 82. 22％, 88. 73％, 63. 79％, 0. 536 and 0. 797, respectively, and for conventional endoscopy, these statistical values were 61. 9％, 93. 33％, 94. 55％, 56. 76％, 0. 481, and 0. 801, respectively. For the combination of two methods, these statistical values were 85. 71％, 82. 22％, 90. 00％, 75. 51％, 0. 666 and 0. 850, respectively. In submucosal cancer, the sensitivity, specificity, positive predictive value, negative predictive value, the value of Kappa and AUC of EUS were 51. 11％, 86. 91％, 67. 65％, 76. 84％, 0. 403 and 0. 697, respectively, and for conventional endoscopy, these statistical values were 57. 78％, 73. 81％, 54. 17％, 76. 54％, 0. 311 and 0. 678, respectively. For the combination of two methods, these statistical values were 71. 11％, 90. 48％, 80. 00％, 85. 39％, 0. 632 and 0. 817, respectively. The accuracies of therapeutic decision-making of EUS, conventional endoscopy and the combination of two methods were 83. 72％, 68. 22％ and 92. 25％, respectively. Conclusion Patients who are diagnosed as intramucosal caner by conventional endoscopy should not be recommended to undergo EUS. For those whose invasion depth is unclear, or diagnosed as submucosal cancer or deeper by conventional endoscopy, EUS should be performed for reassessment. The combination of two methods can improve the accuracy of distinguishing intramucosal and submucosal caners and therapeutic decision-making. Trial registration Chinese Clinical Trial Registry, ChiCTR-DDT-13003299.
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Objective By comparing the tone recognition rates for different cochlear implant (CI) analog sounds ,the effects of the temporal coding strategy on tone recognition were investigated .Methods The professional announcer read 6 vowel (/a/,/o/,/e/,/i/,/u/,/ü/) of 4 different tones at a normal speed .After adjusting the am-plitude envelope and increasing the fine structure ,the audios with different sampling accuracy below 500 Hz(125 ,250? ?1500 pps) were obtained ,including 288 audio amplitude envelope adjusted and 288 not adjusted .Thirty young participants of normal hearing had tone recognition tests .The results and the tone recognition rates under two dif-ferent temporal properties were compared .Results When the temporal fine structures were combined in considera-tion ,the amplitude envelope as adjusted to match the fundamental frequency (F0) had a significant effect on the tone recognition .The tone recognition rate after amplitude envelope adjusted (80 .22％ ± 16 .32％ ) was higher than before (74 .83％ ± 20 .24％ ) [F(1 ,9)=16 .91 ,P=0 .002] .When the amplitude envelopes were combined in consider-ation ,changing the fine structure of the frequency below 500 Hz had a significant effect on the tone recognition [F (11 ,99)=38 .86 ,P<0 .001] .When the sampling precision was <375 pps ,the tone recognition had improved re-markably with the improvement of sampling precision (P<0 .004) .When the sampling precision was ≥375 pps , the effect on the tone recognition was not significant (P>0 .004) .The interaction between changing amplitude en-velopes and increasing the fine structure had a significant effect on the tone recognition [ F(11 ,99 )= 3 .78 , P<0 .001] .When the fine structure ≤375 pps ,adjustment on the amplitude envelope to increase the information of F0 had a significant impact on the tone recognition (P<0 .05) .When the fine structure was >375 pps ,the difference of the tone recognition before and after the adjustment tended to 0 (P>0 .05) .Conclusion In the CI coding strate-gy ,adjusting the amplitude envelope to get more F0 information improves tone recognition .To a certain degree ,the tone recognition improves when the sampling precision of frequency below 500 Hz is improved .Adjusting the ampli-tude envelope to F0 and increasing the temporal fine structure below 500 Hz can be combined in the same speech coding strategy to optimize the tone recognition .
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Objective To analyze the predictive value of combination of endoscopic ultrasound (EUS)and 64-slice dual-source computed tomography(DSCT)in regional clinical staging and peritoneal metastases of gastric cancer.Methods From July 2011 to May 2017,365 patients with gastric cancer diagnosed by endoscopic biopsy were enrolled.The patients received EUS and DSCT examination with the gold standard of postoperative pathological diagnosis,the accuracies of EUS alone,DSCT alone and the combination of EUS and DSCT were evaluated in original gastric tumor,regional lymph nodes and peritoneal metastases.The accuracy,sensitivity,specificity,the positive predictive value,the negative predictive value,consistency(the value of K ap pa)and area under curve(AUC)of receiver operating characteristic(ROC)curve were calculated.Results A total of 263 patients were enrolled into the study on the depth of tumor invasion and clinical staging of regional lymph nodes and 289 patients were recruited into the clinical prediction study on peritoneal metastasis.The accuracy of EUS in clinical staging of the depth of tumor invasion was 75.29% and the sensitivity,specificity,the value of Kappaand AUC of EUS in clinical staging of regional lymph nodes were 86.26%,81.81%,0.681 and 0.840,respectively.The sensitivity,specificity,the value of Kappaand AUC of DSCT in clinical staging of regional lymph nodes were 74.81%,87.12%,0.620 and 0.813,respectively.The sensitivity,specificity,the value of Kappa and AUC of EUS in the prediction of peritoneal metastases were 38.24%,97.25%,0.432 and 0.668, respectively.The sensitivity,specificity,the value of Kappa and AUC of DSCT in the prediction of peritoneal metastases were 41.18%,100.00%,0.553 and 0.706,respectively.The accuracy and the value of Kappaof the combination of EUS and DSCT in clinical staging of the depth of tumor invasion were 75.29% and 0.639;the sensitivity,specificity,positive predictive value,negative predictive value, Kappa,AUC in clinical staging of regional lymph nodes were 93.13%,87.88%,88.41%,92.80%, 0.810 and 0.905,respectively;and the sensitivity,specificity,positive predictive value,negative predictive value,Kappa,AUC in the prediction of peritoneal metastases were 58.82%,97.25%, 74.07%,94.66%,0.616 and 0.774,respectively.Conclusions The combination of EUS and DSCT which is superior to single examination is very helpful in the depth of gastric cancer invasion and regional lymph nodes,and is helpful in the prediction of peritoneal metastasis. The combination of two complementary examinations can improve the accuracy of the depth of gastric cancer invasion,clinical staging of regional lymph nodes,and the prediction of peritoneal metastasis.
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Objective To investigate the effect of esomeprazole combined with quinolones in the treatment of Hp positive gastric ulcer in patients in serum inflammatory factors.Methods 90 cases of Hp positive gastric ulcer were selected and randomly divided into two groups, the control group received omeprazole based triple therapy, the experiment group received esomeprazole plus quinolone based triple therapy,two groups were treated for 14 days.Gastric function, inflammatory factors and related indexes were detected by blood and the clinical effect were compared after the treatment .Results Compared with before treatment,scores of abdominal pain, abdominal distension, belching, acid reflux symptom decreased in two groups after treatment, levels of GAS, PG I and PG II decreased,levels of CRP,IL-1,IL-6 decreased,levels of TNF-β1 decreased, and the levels of α-resistin increased (P<0.05).Compared with the control group after the treatment, scores of abdominal pain, abdominal distension, belching, acid reflux symptom in the experiment group were lower, levels of GAS,PG I and PG II were lower,levels of CRP,IL-1,IL-6 were lower, levels of TNF-β1 were lower, and levels of α-resistin were higher (P<0.05).The negative rate in the experiment group 91.11%was higher than the control group 71.11%(P<0.05),and the effective rate in the experiment group 91.11%was higher than the control group 73.33%( P<0.05 ) .Conclusion Esomeprazole combined with quinolones in the treatment of Hp positive gastric ulcer was effective ,and it reduce inflammation,improve gastric function.
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Objective To study the Mandarin long-term average speech spectrum (LTASS),the effects of gender,language and region material on LTASS were explored.This research would provide reference for clinical and academic use of Mandarin LTASS.Methods One hundred and sixty subjects from eight major dialectic regions of China,aging 16~30 (average 22.3±3.3),were asked to read two materials (storybook,newspaper)in Manda-rin at a steady speed and conversational level inside a standard soundproof booth.Ten males and ten females were in each dialectic region.A microphone (B&K 4192)was used to monitor each subject's speech which was analyzed with a real-time spectrum analyzer to obtain the long-term spectrum (B&K PULSE 3560C).Results Different Man-darin LTASS spectra were obtained based on gender,material and regions.The spectra were tested with profile a-nalysis.Language material had no significant effects on the Mandarin LTASS (F =2.52,P =0.11 ).There was, however,significant gender difference (F =116.39,P =0.00).Males had spoken with intensity levels higher than females at 100 Hz to 200 Hz.There was also a dialectic difference in the Mandarin LTASS (F =1.29,P =0.02). Speakers from Guangdong had the lowest intensity levels compared to those from other regions.Conclusion Genders and regions are factors that need to be considered when LTASS is used for clinical purpose and academic study.
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Metabolic syndrome is a condition associated with multiple metabolic abnormalities.With improvement in economic situation,increasing prevalence of metabolic syndrome is seen in adults and children.Fetal origins of adult disease is one of the hot topics.In this paper,the relationship between intrauterine environment,birth weight and metabolic syndrome are reviewed.
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Objective To observe the clinical feasibility of the acceptable noise level (ANL) test ,analyze the effect of different test instructions to the result of Mandarin acceptable noise level test .Methods Twelve young peo-ple (24 ears) with normal pure-tone test and acoustic immittance test (threshold≤15 dB HL) were included in this study .They were randomly divided into two groups with 12 ears in each group .Group A received the same test in-struction firstly and then received different instructions depended on the different translation of English instruction by tester .Group B received the reverse test order .The acceptable noise level(ANL) ,most comfortable level(MCL) and back groud noise level(BNL) were analyzed .Results The average value of ANL was 7 .5 ± 6 .61 and 8 .29 ± 6 .54 dB SPL ;the average value of most comfortable level (MCL) was 83 .58 ± 8 .57 and 85 .41 ± 8 .89 dB SPL ;the average value of background noise level (BNL) were 78 .92 ± 10 .56 and 77 .13 ± 7 .91 dB SPL respectivoly .The difference of MCL ,BNL ,ANL in these two groups were not statistically significant (P>0 .05) .Test method 1 re-sulted in great individual differences in ANL ,which it ranged from -6 .4 to 20 .12 dB S/N .While ANL from test method 2 ranged from 2 .50~20 .12 dB S/N .Conclusion Different test instruction do not correlated to the results of acceptable noise level ,testers can translate the English instruction by different ways so that it is convenient to the application and clinical research of ANL test .
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Objective To compare the effects of speech recognition scores in young normal hearing adults using single-channel adaptive microphone and multi-channel microphone paradigm.Methods 30 normal hearing young adults,15 females and 15 males with a total of 60 ears were fitted binaurally with Diva 9(single-channel adaptive directional microphone mode)and Inteo 9(multi-channel adaptive directional microphone mode).The speech recognition scores were compared as a function of different signal to noise ratios in a diffuse environment.Results The SNR of L50 of single-channel adaptive directional microphone mode was 0.63 dB and that of multi-channel adaptive directional microphone mode was-4.63 dB.There was significant difference between the two microphone setups.Conclusion Multi-channel adaptive directional microphone mode can improve the speech recognition score in noise.
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Objective To compare the speech recognition by severe - to - profound hearing - impaired children using digital hearing aids and microlink FM system.Methods Hearing - impaired children were given respectively bilateral 100% omnidirection digital hearing aids, bilateral 100% omnidirection digital hearing aids and lateral FM system, bilateral 100% omnidirection digital hearing aids and bilateral FM system in noise and quiet environment. Speech recognition of these children was tested using different intensity.Results There was significant difference between children using microlink FM system and none FM system ( P