Construction of a computer-assisted polyp detection system under colonoscopy / 中华消化杂志

Objective To set up a computer-assisted polyp detection system under colonoscopy,and to preliminarily verify its effectiveness.Methods Based on Faster R-CNN algorithm and the open source implementation of the open source framework tensorflow and Faster R-CNN,a computer-assisted polyp detection system under colonoscopy was constructed.According to the size and difficulty of the training set,five test groups were set up:test group one,two,three and four contained 1 000,2 000,4 000 and 6 000 training samples,respectively.Test group five increased the probability of selecting the difficult samples based on 6 000 training samples.In different training sets,the sensitivity,specificity,other classification evaluation parameters,and the evaluation parameters of target detection such as recall and precision of this polyps detection system were calculated.Results Classification evaluation parameters showed that the sensitivities of test group one,two,three,four and five were 90.1％,93.3％,93.3％,93.3 ％ and 93.5 ％,respectively,and the difference was statistically significant (x2 =25.324,P＜0.01).The sensitivities of test group two,three,four and five were all higher than that of test group one,and the differences were statistically significant (x2 =13.964,13.508,13.508 and 13.386,all P＜ 0.006 25).There were no significant differences in specificity and positive predictive value among test groups (both P＞0.05).The negative predictive values of test group one,two,three,four and five were 90.4％,93.3％,93.3％,93.3％ and 93.5％,respectively,and the differences were statistically significant (x2 =21.862,P＜0.01).The negative predictive values of test group two,three,four and five were higher than that of test group one,and the differences were statistically significant (x2=11.447,11.564,11.755,13.760;all P＜0.006 25).As the training sample size increased from 1 000 to 2 000,the area under curve (AUC) increased by 2％,and further increased the sample size to 6 000,AUC increased by less than 1 ％.At this point maintaining the same sample size while increasing the proportion of difficult samples,AUC increased by 0.4％.The results of evaluation parameters of target detection showed that the recall rate of each test group was 73.6％,79.8％,79.5％,79.8％ and 83.3％,respectively,and the differences were statistically significant (x2 =71.936,P＜0.01).Among them,the recall rates of test group two,three and four were higher than that of test group one,and the differences were statistically significant (x2 =25.960,23.492 and 25.960,all P＜0.006 25),and the recall rate of test group five was higher than those of test group one,two,three and four,and the differences were statistically significant (x2=67.361,9.899,11.527 and 9.899;all P＜0.006 25).In addition,the precision rates of test group one,two,three,four and five were 87.9％,85.3％,90.2％,91.4％ and 89.2％,respectively,and the difference was statistically significant (x2=48.194,P＜0.01).The precision rates of test group three and five were higher than that of test group two,and the differences were statistically significant (x2 =24.508 and 15.223,both P＜0.006 25),and the precision rate of test group four was higher than those of test group one and two,and the differences were statistically significant (x2=13.524 and 39.120,both P＜0.006 25).As samples size and training difficulty increased,the values of F1-score and mean average precision increased steadily.Conclusions This study initially constructed a computer-assisted polyp detection system under colonoscopy.Currently the maximum sensitivity reached 93.5％,and the maximum recall rate reached 83.3％.Increasing the training set size may improve the polyp detection result to a certain degree,however it will reach a bottleneck.At this time,increasing the training difficulty can further improve the detection scores,especially the recall rate.

Efficacy of sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy and the factors associated with the prognosis / 中国内镜杂志

Objective To explore the efficacy of sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy and the factors associated with the prognosis.Methods 106 cases with esophageal varices in control group was treated with drugs alone;study group had 113 cases, was given endoscopic therapy add drugs, The study group randomly divided into two groups, one was treated with endoscopic variceal ligation all the time (EVL group), another was treated with sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy (sequential group). After the treatment, the rate of removal of varicose veins, the rate of rebleeding, the number of total treatment,mortality and intra-operative complications and postoperative complications were compared. And compared rebleeding rate and mortality with the control group and study groups with different CTP and MELD, analyze the factors of prognosis, and evaluate their prognostic value.Results Rebleeding, rate in control group, EVL group and sequential group were 41.51%,10.53% and 10.64%,sequential group was significantly better than control group (P = 0.000); mortality in control group, EVL group and sequential group were 15.09%, 5.26% and 2.13%, sequential group was also significantly better than control group (P = 0.001); rate of recurrence in EVL group and sequential group within half a year were 73.68% and 44.68%, sequential group was significantly better than EVL group (P = 0.021). In all control group and EVL group and the sequential group, rebleeding rate and mortality of the liver function Child-Turcotte-Pugh (CTP) class C was significantly higher than that of calss A; In MELD model, AUC area under the ROC curve of rebleeding rate in control group and sequential group were 0.944 and 0.851, mortality of the two groups were 0.881 and 0.984, while the rate of recurrence in the EVL group and sequential group were respectively 0.914 and 0.765, the MELD score has the important value to the prediction of rebleeding and death.Conclusion The rebleeding rate and mortality in cirrhotic patients with esophageal varices treated with sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy were significantly decreased and the recurrence rate was lower than that of the patients with endoscopic variceal ligation all the time. Liver function Child-Turcotte-Pugh (CTP) score and the MELD score have important value in prediction of rebleeding and death, ligation and sclerosing sequential therapy can significantly reduced rebleeding and mortality in CTP class B and C, and improve the MELD threshold of rebleeding and death.

Expression and significance of p-Stat3 and its downstream gene c-myc in laryngeal squamous cell carcinoma tissue and cell line / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To detect the expressions of p-Stat3 and c-myc in human laryngeal squamous cell carcinoma (LSCC) tissue and Hep2 cell line, and to find the relationship between them.@*METHOD@#Immunohistochemistry was used to detect the expressions of p-Stat3 and c-myc in 60 cases of LSCC and 30 cases of vocal cord polyp tissue. The protein levels of p-Stat3 and c-myc in Hep2 cell line was determined by immunocytochemistry. Western blotting was used to determine the protein levels of p-Stat3 and c-myc in Hep2 after treating with different concentrations of Stattic.@*RESULT@#The positive rates of p-Stat3 and c-myc were 65% and 70% in the LSCC tissue, compared with that in the vocal cord polyp tissue, with significant difference (P < 0.05). The expression of p-Stat3 in LSCC tissue was associated with that of c-myc (r = 0.273, P < 0.05). The protein levels of p-Stat3 and c-myc were detected in the Hep2 cell line. Stattic inhibited Stat3 phosphorylation and c-myc in the Hep2 cell line in a concentration-dependent manner.@*CONCLUSION@#p-Stat and c-myc were up regulated in the tissue of laryngeal squamous cell carcinoma and the Hep2 cell line. Stattic inhibits the constitutively active p-Stat3 signaling pathway, and downregulats the expression of c-myc. The strong constitutive p-Stat3 signaling pathway in LSCC makes p-Stat3 a target for the development of novel therapeutic strategies.

Observation on therapeutic effect of octreotide combined with omeprazole in the treatment of liver cirrhosis with upper gastrointestinal bleeding / 中国生化药物杂志

Objective To observe and study the therapeutic effect of ctreotide combined with omeprazole in the treatment of liver cirrhosis with upper gastrointestinal bleeding.Methods 76 cases of patients with upper gastrointestinal bleeding caused by liver cirrhosis were selected in our hospital from January 2013 to December 2014 to be separated into the observation group and control group randomly, with each group having 38 patients.Patients in two groups were all given symptomatic treatment first.Patients in control group were given 0.1 mg octreotide dissolved 20 mL 0.9% sodium chloride solution by intravenous injection in the first administration.And the rest octreotide was given by intravenous drip at the speed of 25μg/h.The treatment lasted for 72 h.On the base of control group, patients in observation group were given 40 mg omeprazole dissolved 100 mL 0.9%sodium chloride solution additionally, twice daily, for 3 d.Then the therapeutic effect, hemostatic time, blood transfusion, rebleeding rate and adverse reactions of patients in two groups were observed.Results The total effective rate of observation group 89.47%was much more than control group 63.16% (P<0.05).And the apparent rate of observation group 55.26%was also more than control group 31.58% ( P <0.05 ) .Both the hemostatic time and blood transfusion of observation group is less than control group ( P <0.05 ) .Besides, the rebleeding rate of observation group 5.26% is much less than control group 21.05% ( P<0.05 ) ., Incidence rates of adverse reactions in two groups were 10.53% and 7.89%, with no statistically significant difference. Conclusions Treatment of octreotide combined with omeprazole on patients with upper gastrointestinal bleeding caused by liver cirrhosis can improve the therapeutic effect, shorten the hemostatic time and decrease the blood transfusion with low rebleeding rate and few adverse reaction.

Research on risk factors of depression symptoms in 1 327 patients with obstructive sleep apnea-hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the comorbidity rate of depression symptoms in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) in Henan province and to ascertain the risk factors.</p><p><b>METHODS</b>One thousand three hundred and twenty-seven patients with OSAHS determined by overnight polysomnogram (PSG) were enrolled in this study. After screening the Symptom Checklist 90 (SCL-90) and Self-rating Depression Scale (SDS), the patients were divided into two groups: OSAHS (control group, n = 698) and OSAHS+depression (n = 629). The correlation was explored between the depression symptoms in patients with OSAHS and the sociodemographic variables and health status including smoking, drinking, marital status, apnea hyponea index (AHI), anoxicity, Family Burden Scale of Disease (FBS), Family APGAR Index (APGAR), Perceived Social Support Scale (PSSS) and so on. Furthermore, In-depth analyses were carried out between the depression symptoms in patients with OSAHS and the social and family factor items (FBS, APGAR and PSSS).</p><p><b>RESULTS</b>The comorbidity rate of depression symptoms in patients with OSAHS in Henan province was 47.4%, and was correlated with the gender, marital status, FBS, APGAR, AHI, PSSS and anoxicity. Logistic regression analysis indicated that single marital status, APGAR, AHI, PSSS, hypoxemia and heart disease were all independent risk factors for depression in OSAHS patients. The total of the FBS score and three of its subfactors scores (family daily activities, family relationships and mental health of family members) were higher, and the total of the APGAR score and two of its subfactors scores (adaptabilith and affection) were lower in OSAHS with depression compared with the control group (P < 0.05). Besides, the total score for the PSSS AND Scores for its two subfactors (family support and social support) were all lower in OSAHS patients with depression than those of the control group (P < 0.05).</p><p><b>CONCLUSION</b>In patients with OSAHS, depression symptoms are common and are associated with marital status, AHI, anoxicity, concomitant diseases (hypertension, heart disease), concerns and supports from the family and society.</p>

NRP-1/shRNA silencing suppresses nasopharyngeal carcinoma cell growth in vitro and in vivo / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of RNA interference (RNAi) targeting NRP-1 gene on the growth and proliferation of nasopharyngeal carcinoma (NPC) CNE-2Z cells.</p><p><b>METHODS</b>Short hairpin RNA (shRNA) plasmids targeting NRP-1 were designed and synthesized. These plasmids were respectively transfected into human NPC CNE-2Z cells and xenograft tumors in nude mice. The expressions of Fluorescein-labeled plasmids in NPC CNE-2Z cells and xenograft tumors were observed by fluorescence microscopy. Cell proliferation was detected by MTT assay. The inhibitory effects on target genes were evaluated with RT-PCR and Western blotting, respectively. The inhibitory effect of plasmids with the most effective sequence on xenograft tumors in nude mice was observed.</p><p><b>RESULTS</b>CNE-2Z cell proliferation was significantly inhibited by NRP-1/shRNA silencing. RT-PCR showed NRP-1 mRNA expression was significantly decreased. Western blotting demonstrated the NRP-1/shRNA silencing can effectively inhibit the expression of target proteins in CNE-2Z cells. After six weeks, there were significant differences in the mean tumor volumes in nude mice between plasmid group and negative control group [(0.599±0.002) vs (1.141±0.013) cm(3), P<0.05] or blank control group [(0.599±0.002) vs (1.165±0.308) cm(3), P<0.05], and the inhibitory rate of tumor growth was 48.6%.</p><p><b>CONCLUSION</b>RNA interference targeting NRP-1 can remarkably inhibit the growth of CNE-2Z cells in vitro and in vivo.</p>

Inhibitory effect of NF-kappaB p65siRNA on human laryngeal carcinoma xenograft model in nude mice / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the inhibitory effect of NF-kappaB p65siRNA on human laryngeal carcinoma xenograft model in nude mice.@*METHOD@#Human laryngeal carcinoma cell line Hep-2 was seeded in the subcutaneous layer of 15 nude mice to build laryngeal carcinoma xenograft model. Then they were randomly divided into three groups. NF-kappaB p65siRNA was given in siRNA group and FAM-Control siRNA was given in negative control group while phosphoric-buffered saline (PBS) was used in normal control group for 3 weeks. Tumor size and body weight of the mice were measured. TUNEL method and immunohistochemical S-P method were used for detecting the expression of NF-kappaB p65 and Bcl-xL protein.@*RESULT@#The volume of tumors in siRNA group was reduced and the average weight of tumors in siRNA group was lower than the other two groups (P < 0.05). In siRNA group, the expression of NF-kappaB p65 and Bcl-xL protein was down-regulated and the apoptotic rate was increased obviously as compared with the negative control group and the normal control group.@*CONCLUSION@#NF-kappaB p65siRNA can significantly inhibit the expression of NF-kappaB p65 and the growth of human laryngeal carcinoma xenograft in nude mice. Its mechanism may be related to inducing the apoptosis in tumor cells by down-regulating the expression of Bcl-xL protein.

Expression and significances of FSCN1 and HGF in nasal inverted papilloma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the expressions of FSCN1 and HGF in nasal inverted papilloma (NIP) and explore their role in occurrence and development of this disease.@*METHOD@#Immunohistochemical method was used to determine the expression of FSCN1 and HGF in 12 cases of chronic hypertrophic rhinitis, 40 cases of NIP and 14 cases of NIP with malignant transformation.@*RESULT@#FSCN1 was expressed in 52.5% of NIP, 78.6% of NIP with malignant transformation and 8.3% of inferior turbinate of chronic hypertrophic rhinitis. Expression of FSCN1 was significantly higher in NIP and NIP with malignant transformation than in inferior turbinate (P<0.05). HGF was expressed in 85.7% of NIP with malignant transformation and 8.3% of inferior turbinate. Expression of HGF was significantly higher in NIP with malignant transformation than in inferior turbinate (P<0.05). HGF was expressed in 40.0% of NIP,which was higher than that of inferior turbinate. Expression of HGF was positively related to expression of FSCN1 in NIP and NIP with malignant transformation.@*CONCLUSION@#The abnormal expression of FSCN1 and HGF may be closely correlated with NIP and its malignant process. Analysis of FSCN1 and HGF expression in NIP may be useful in predicting malignant transformation.

The expression of c-myc in the tissues of human laryngeal squamous cell carcinoma and the effect of siRNA-mediated inhibition of c-myc on proliferation in laryngeal carcinoma Hep-2 cells / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To detect the expression of c-myc in the tissue of laryngeal squamous cell carcinoma. RNA interference(RNAi) was employed to inhibit the expression of c-myc in Hep-2 cells and to evaluate the effects of c-myc as a target for gene therapy in laryngeal carcinoma.@*METHOD@#Immunohistochemistry was used to determine the protein levels of c-myc and Rb in 80 cases of laryngeal squamous cell carcinoma and 30 cases of polyp of vocal cord. Hep-2 cells were transfected with c-myc siRNA, c-myc protein and mRNA levels were detected using Western Blotting and RT-PCR. Cell viability was detected by MTT after the Hep-2 cells were transfected with c-myc siRNA for different times or transfected with different concentrations c-myc siRNA. The sensitivity of Hep-2 cells to 5-Fu transfected with or without c-myc siRNA was evaluated also by MTT. Hep-2 cells were transfected with c-myc siRNA in combination with 5-Fu for 48 h and then analyzed cell apoptosis by flow cytometry.@*RESULT@#Immunohistochemical analysis showed that c-myc was highly expressed in the tissues of laryngeal squamous cell carcinoma while the expression of Rb was lower. The protein and mRNA levels of c-myc decreased after transfected with c-myc siRNA. The results of MTT showed that the c-myc siRNA inhibited Hep-2 cells growth in a concentration-dependent manner. When transfected with c-myc siRNA(50 nmol/L), the cells were inhibited in a time-dependent manner. Compared with the untransfected cells, the viability of transfected Hep-2 cells was significantly suppressed at the same concentration of 5-Fu (P < 0.05). C-myc siRNA combination with 5-Fu could obviously increase cell apoptosis, even in the low concentration of 5-Fu (P < 0.05).@*CONCLUSION@#The protein level of C-myc has highly expressed in tumor tissues. C-myc siRNA can effectively inhibit the expression of c-myc and has anti-proliferation effects, increasing the sensitivity of Hep-2 cells to 5-Fu. Therefore,c-myc might be a good target for cancer treatment.

Diagnosis and surgical approach of parapharyngeal space neoplasms / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the diagnosis and reasonable surgical approach for parapharyngeal space neoplasms.@*METHOD@#From July 2004 to July 2009, a retrospective review of 45 patients with neoplasms of parapharyngeal space was performed. Fourty-five cases were examined by CT, some of them were examined by MRI or DSA. Several surgical approaches were selected. The transcervical approach was used in 35 cases, the transparotid approach was used in 5 cases, the transmandible approach was used in 2 cases, and the transparotid and temporal approach was used in 3 cases.@*RESULT@#Among 45 patients, 37 cases (82.22%) were benign and 8 cases (17.78%) were malignant. Neurogenic neoplasms and salivary glands neoplasms were the most common tumors. Using CT, MRI or DSA could obtain useful information about the location, size, shape, density and degree of enhancement of the parapharyngeal space neoplasms, acquire their relationship with styloid and carotid, and make preoperative diagnosis. The diagnostic coincidence rate between preoperative diagnosis and pathological diagnosis was 80% (origin of tissue). All benign tumors were completely resected. A lymphangiomas had recurrence after 1 year,and the second operation had no recurrence. In the 45 cases, 8 cases were malignant tumors. Of 2 patients with malignant mixed tumors, 1 survived disease free after a follow-up of 4 years,and another was still alive with disease after a follow-up of 3 years; Of 2 patients with synovial sarcomas, 1 survived disease free for a follow-up of 3 years, the other one survived disease free after a follow-up of 2 years; 1 patient of nasopharyngeal carcinoma with metastasis in the parapharyngeal space had post-operative radical radiotherapy and survived disease free after a follow-up of 5 years. One patient with chordoma was still alive with disease after a follow-up of 3 years; 1 patient with poorly differentiated squamous cell carcinoma, died of pulmonary metastasis after a 4 year follow-up; 1 case with follicular dendritic cell sarcoma survived disease free after a follow-up of 2 years.@*CONCLUSION@#CT, MRI and DSA are essential for the diagnosis and differentiation of parapharyngeal space neoplasm. The transcervical approach is a simple, safe and minimal invasive procedure for resecting parapharyngeal space neoplasms. It is the best approach for treatment of parapharyngeal space neoplasms.

Treatment of mediastinal abscess caused by removal foreign bodies in esophagus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the clinical feature and treatment of Mediastinal Abscess caused by removal foreign bodies in esophagus.@*METHOD@#Retrospective analysis 12 patients of the last ten years, to observe the clinical manifestation and curative effect.@*RESULT@#Ten patients were cured and 2 patients died.@*CONCLUSION@#The clinical manifestation of mediastinal abscess caused by removal foreign bodies in esophagus is characteristic, should be operated in general anesthesia.

Effects of siRNA targeting NF-kappaBp65 against in proliferation of Hep-2 cells and the expression of mRNA and protein of NF-kappaBp65 / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study siRNA inhibited the expression of mRNA and protein of NF-kappaBp65 in the Hep -2 cell line.@*METHOD@#Hep-2 were transfected with p65SiRNA. Western blotting was used to examine the protein levels of NF-kappaBp65. RT-PCR method was adopted to determine the mRNA expression of NF-kappaBp65. MTT method was adopted to investigate the proliferation of the Hep-2 cells after the transfection of p65siRNA.@*RESULT@#The western blotting result showed that the level of NF-kappaBp65 protein was gradually declined after transfection of p65siRNA. The RT-PCR result showed that transfection with p65siRNA caused special degradation of the p65mRNA in Hep-2 cells at 24, 48 and 72 h. After transfection with p65siRNA.@*CONCLUSION@#p65siRNA has significant inhibition effects on the proliferation of the Hep-2 cells and expression of purpose gene mRNA and protein. The inhibition effects are time depended.

Clinical analysis on 500 children with tracheobronchial foreign bodies / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the opportunity and method of surgery for removing tracheobronchial foreign bodies. METHODS A retrospective study was carried out among 500 children with tracheobronchial foreign bodies treated in our hospital from June, 2005 to June, 2009. RESULTS The foreign bodies were successfully removed in 4(0.8%) patients with fiberoptic-bronchoscopy, 2(0.4%) patients with thoracotomy, 20(4%)patients with endoscope or rigid bronchoscopy via tracheostomy, 32(6.4%) patients with direct laryngoscopy, 436(87.2%)patients with rigid bronchoscopy . There were 6 patients (1.2%) need another operation to fully remove the foreign bodies. CONCLUSION Proper method should be choose for removing tracheobronchial foreign bodies according to the history, location and kind of the foreign bodies.