RESUMO
Objective:To systematically evaluate the intelligence-assisted endoscopic diagnosis system based on deep learning (DL-IEDS) for early cancer of the upper digestive tract.Methods:Literature on the value of DL-IEDS for diagnosis of early cancer of the upper digestive tract was searched in English (PubMed, Embase, Web of Science and Cochrane Library)and Chinese databases (Sinomed, CNKI, Wanfang and VIP). The quality of literatures was evaluated according to Quality Assessment of Diagnostic Accuracy Studies-2. The Rev Man 5.3, Meta-Disc 1.4 and Stata 15.1 were used for the meta-analysis.Results:Eight studies were included with a total of 9 675 images (including 2 748 images of early cancer). Meta-analysis results showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and comprehensive diagnostic ratio of DL-IEDS in the diagnosis of early cancer of the upper digestive tract were 0.920, 0.874, 6.824, 0.103 and 71.109, respectively. The area under the curve (AUC) of summary receiver operating characteristics was 0.958 7. Five studies reported the results of DL-IEDS in the diagnosis of early gastric cancer, and the combined analysis showed that the pooled sensitivity and specificity were 0.840 and 0.845 respectively, and the AUC was 0.919. Four studies reported the accuracy rate of endoscopic experts and endoscopic novices in diagnosing early upper gastrointestinal cancer, and results showed that the pooled sensitivity, specificity and AUC were 0.693, 0.892 and 0.892 3, and 0.586, 0.860 and 0.754 5, respectively. Compared with endoscopy experts, the AUC of DL-IEDS in diagnosis of early upper gastrointestinal cancer showed no statistically significant difference ( Z=1.510, P=0.131), while compared with endoscopy novices, the difference was statistically significant ( Z=6.841, P<0.001). Conclusion:The DL-IEDS has high diagnostic accuracy for early upper digestive tract cancer, and can significantly improve the diagnostic ability of endoscopy novices.
RESUMO
Objective To investigate the effects of telmisartan on the expression of angiotensin converting enzyme2 (ACE2) mRNA in monocyte-derived macrophages of hypertensive patients companied with diabetes.Methods 62 essential hypertensive patients companied with diabetes were randomly divided into two groups:regular treatment group,and telmisartan group.Then the content of ACE and ACE2 in serum was detected by ELISA,and the expression of ACE mRNA and ACE2 mRNA in monocyte-derived macrophages of patients was detected by RT-PCR before and after having been treated.Results (1) After having been treated for 4 weeks and 12 weeks,the blood pressure of the patients in two groups were decreased significantly,Comparing with regular group,telmisartan group seemed to have more obvious therapeutic effect (P ＜ 0.05) ; (2) After having been treated for 12 weeks,glycosylated hemoglobin diseased in both group,but there was no significant difference between the two group (P ＞ 0.05) ; (3) In telmisartan group,the content of ACE2 in serum was increased after having been treated for 12 weeks than that in regular treatment group,[(23.9 ± 8.2) U/L vs (16.3 ± 8.9) U/L,P ＜ 0.05] ; and the expression of ACE2 mRNA in monocyte-derived macrophages in telmisartan group was obviously increased after 12 weeks comparing with regular treatment group (0.73 ±0.06 vs 0.51 ±0.04,P ＜0.01).Conclusion The role of telmisartan in decreasing blood pressure and it's advantage to the metabolism of glucose are partly related with the up-regulation of ACE2 mRNA.