Efficacy of NICE classification with non-magnified endoscopy on diagnosis of colorectal tumor / 中华消化内镜杂志

Objective To evaluate the diagnostic efficacy of narrow band imaging (NBI) international colorectal endoscopic (NICE) classification in distinguishing neoplastic from non-neoplastic colorectal polyps during routine clinical practice. Methods A total of 224 lesions detected by white light colonoscopy by non-expert endoscopists were collected in this retrospective study. Each lesion was assessed by NBI and classified by NICE classification. The results were compared with pathological findings from endoscopic or surgical resected specimen. Results Among these 224 polyps, there were 59 of type 1, 159 of type 2 and 6 of type 3 according to NICE classification. There were 58 non-tumorous and 166 tumorous polyps according to pathological diagnosis. The total diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy of NICE classification for colorectal tumor were 91. 6%, 77. 6%, 92. 1%,76. 3%and 87. 9%, respectively.Diagnostic sensitivity and accuracy in big (＞10 mm in diameter), small (＞5-10 mm in diameter) and mini (≤5 mm in diameter) polyp groups were 100. 0%, 97. 0% and 80. 9%, as well as 95. 7%, 87. 8%, and 83. 3%, respectively. Diagnostic accuracy showed a decreasing tendency on polyp size, without significant difference between the three groups ( P＝0. 694). Conclusion NICE classification with non-magnified NBI is effective in distinguishing neoplastic and non-neoplastic colorectal polyps by non-expert endoscopists and is potentially worth popularizing for routine clinical practice.

The related factors of the application of standardized patients in the clinical skills examination of medical practitioners / 基础医学与临床

There are several special advantages of the application of standardized patients ( SPs) in the assessments of clinical skills examination of medical practitioners .However , this application in China is restricted by some limit factors, such as the shortage of SP trainers and SPs , the huge funds needed and the imbalance of regional develop-ment.The suggestion to overcome those limitation and to promote SPs be applied to the clinical skills examination of medical practitioners are as follow: the preparatory of regional university union of SPs , the introduction of social capital to participate in and the adoption of the mode of scale operation .