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Objective To explore the clinical value of a new scoring system for gastric cancer screening in hospital visits.Methods A new scoring system for gastric cancer screening was used to retrospectively analyze data of patients who visited Wenzhou Central Hospital for various digestive symptoms from April 2017 to August 2018 and met the screening requirements.All patients were divided into three groups according to the grading results of the new scoring system:low-risk group (0-11 points),medium-risk group (12-16 points) and high-risk group (17-23 points).A comparative analysis was performed on the detection of gastric cancer and gastric precancerous conditions among the three groups.Results A total of 2 674 patients were included in this study,1 694(63.35％) in the low-risk group,833(31.15％) in the medium-risk group,and 147(5.50％) in the high-risk group.The total detection rate of gastric cancer was 2.73％ (73/2 674).The detection rates were 1.06％ (18/1 694),4.32％ (36/833) and 12.93％ (19/147) in the three groups,respectively.There were significant differences in the detection rate of gastric cancer between any two of the three groups (all P ＜ 0.05).The detection rates of early gastric cancer in medium-risk group [2.04％ (17/833)] and high-risk group [4.08 ％ (6/147)] were significantly higher than that in the low-risk group[0.35％(6/1 694),all P＜0.05].Conclusion The new gastric cancer screening scoring system can not only significantly improve the detection rate of gastric cancer in hospital visits,but also improve the diagnostic rate of early gastric cancer.
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Objective To investigate the in vitro quinolones resistance in Helicobacter pylori ( HP) strains isolated in Zhejiang province and to provide references for the clinical application of quinolones in the eradication of HP infection.Methods A total of 713 HP strains were isolated from several hospitals located in different regions of Zhejiang province from April to June 2013.Drug sensitivity test was performed to measure the resistance of those HP strains to levofloxacin and moxifloxacin by using the agar dilution method recommended by the Clinical and Laboratory Standards Institute ( CLSI) .The antibiotic solutions were added to the agar and diluted into corresponding critical concentrations.The mixed liquors were placed in dilution plates and added with the bacteria suspension.If there were bacterial expansion on the plates after incuba-tion, the strains were considered to be drug-resistant strains.Results The resistance rates of 713 HP strains to levofloxacin and moxifloxacin were 19.50%.In addition to the Jinhua area, drug resistance rates in the other 7 areas including Hangzhou, Wenzhou, Shaoxing, Jiaxing, Taizhou, Lishui and Zhoushan were above 15%.The highest drug resistance rate of HP was found in Wenzhou, which was significantly higher than that in Jinhua area (26.40%vs 9.52%, P<0.05).No significant differences in the resistance rate of HP to quinolone were found between Wenzhou area and the other regions in Zhejiang.Conclusion Com-pared with amoxicillin and furazolidone, higher resistance rates of HP to levofloxacin and moxifloxacin were observed in Zhejiang province.Because the mechanisms of drug resistance to levofloxacin and moxifloxacin were same and the drug targets within HP to which the two antibiotics binding were similar, levofloxacin and moxifloxacin shared common characteristics of drug resistance among HP strains, indicating that prescription of the two antibiotics in replacement should be avoided in clinical treatment of HP drug-resistant strains.
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Objective To compare the diagnostic efficacies of narrow-band imaging (NBI) in distinguishing neoplastic from non-neoplastic colorectal lesions with routine endoscopy and with magnifying endoscopy. Methods Patients with colorectal lesions detected by NBI from September 2008 to February 2010 were enrolled in the study. These lesions were classified by pit pattern and capillary pattern, which was then assessed by reference to histopathology. Results A total of 100 patients with colorectal lesions were enrolled, and the lesions were observed by NBI with ordinary endoscopy (n =64) and NBI with magnifying endoscopy (n =36), respectively, and 7 cases (5 in NBI with ordinary endoscopy and 2 in NBI with magnifying endoscopy) which did not meet the diagnostic criteria were excluded. The overall diagnostic accuracy of NBI endoscopy in distinguishing neoplastic from non-neoplastic colorectal lesions was 91.4% ( 85/93 ), in which NBI with ordinary endoscopy and magnifying endoscopy was 89. 8% (53/59) and 94. 1% (32/34),respectively, with both significantly higher than that of conventional colonoscopy reported in the literature (79. 1% ) (P ＜ 0. 05 ). However, no significant difference was detected between 2 methods ( P ＞ 0. 05 ).Conclusion Similar with NBI magnifying endoscopy, NBI endoscopy without high magnification may also be useful to distinguish neoplastic from non-neoplastic colorectal lesions.