Objective :To investigate relationship between the glossoscopy objectivised image and kidey-biopsy pathology type of patients with primary glomerulopathy.Methods: The tongue image(including color clustering of tongue images and tongue shapes) of 66 patients with primary glomerulopathy were taken by Snakes Algorithm of Tongue Image Handling System and pathology diagnosis of kidney was also done in the same time,t-test was adopted to analyse the correlation of the glossoscopy objectivised image and kidey-biopsy pathology type of patients.Result: The result show that there are significant differences among tongue images of different pathology types(P

Eighteen patients with early cancer and precancerous lesions of esophagogastric junction underwent multiband mucosectomy (MBM) in Yangzhou First People's Hospital from January 2013 to February 2014.The clinicopathological data of patients were analyzed retrospectively and the short-term efficacy and safety of MBM were evaluated.Operations were successful in all 18 cases.The mean operative time was 35.8 min.Intraoperative bleeding occurred in 3 cases and successfully managed by endoscopic hemostasis.Small perforation occurred in 1 patient and was closed by metal clips.Pathological examination showed mucosal cancer in 5 cases,high-grade intraepithelial neoplasia in 8 cases and low-grade intraepithelial neoplasia in 5 cases.No relapse of cancer was found during follow-up.Results indicate that MBM is an effective and safe method in treatment of early cancer and precancerous lesions in the esophagogastric junction.

Objective To evaluate the therapeutic efficacy of a combination of proton pump inhibitor(PPI) and hydrotalcite for endoscopic submucosal dissection (ESD) induced ulcer.Methods Eightyone consecutive patients who underwent ESD were randomly assigned to either the group of PPI and hydrotalcite therapy ( drug combination group,n =41 ) or the PPI group ( n =40).Delayed bleeding rates were monitored and compared.The main upper abdomen symptoms 1-wk later and ulcer healing rates and ulcer diameter 4-wk later were compared between the two groups.Results There was no significant difference in delayed bleeding rate (P ＞ 0.05 ).At the end of first week after ESD,the combination therapy was significantly more effective than the PPI alone in reducing frequencies and severity of upper abdominal pain and upper abdominal distention,while there was no significant difference between the two groups in relieving belch and nausea.A better ulcer healing rates and a smaller ulcer diameter were observed in the combination group at the end of 4 weeks ( P ＜ 0.05 ).Conclusion The combination therapy of hydrotalcite and PPI can relieve upper abdominal symptoms and improve the healing rate of ESD induced ulcer.

Objective To compare 18F-FDG、11C-MET and 11C-CHO PET/CT in rat C6 glioma and inflammation models and observe their correlations with HIF-1α and VEGF expressions.Methods Thirtytwo male Wistar rats were included to bear both C6 glioma and turpentine oil-induced acute inflammation (AI).18F-FDG,11C-MET and 11C-CHO PET/CT were performed on rats.The SUVmax ratios of tumor-tomuscle (T/M),AI-to-muscle (AI/M) and tumor selectivity index (SI) were calculated.One-way analysis of variance and two-sample t test were used for statistical analyses.HIF-1α and VEGF expression was detected by immunohistochemical staining.Spearman correlation analysis was performed to evaluate the relationship between T/M ratios and the expressions of HIF-1α or VEGF.Results T/M ratios of 18F-FDG,11 C-MET and 11C-CHO in C6 glioma were 6.89±2.53,2.75±0.87,2.73±1.01,and the AI/M were 4.77±2.21,1.75±0.66,2.23±0.90 respectively.The 18F-FDG and 11C-MET uptake between C6 glioma and AI were significantly different(tFDG =2.133,tMET =3.267,both P＜0.05).The SIMET was significantly higher than SIFDG(t =2.600,P＜0.05).The 11C-CHO uptake between tumor and inflammation showed no significant difference(t=1.537,P＞0.05).T/M ratios of 18F-FDG and 11C-MET were positively related to HIF-1α and VEGF expressions(rs =0.725,0.637,0.621,0.764,all P＜0.05).The T/M ratio of 11C-CHO related only to VEGF (rs =0.682,P＜0.05).Conclusions 18F-FDG and 11 C-MET PET/CT may differentiate C6 glioma from AI,and 11 C-MET PET/CT seems more tumor-selective.11C-CHO PET is less valuable for the differential diagnosis.The 18F-FDG and 11 C-MET uptake of C6 glioma may be related to tumor hypoxia.All the three tracers could reflect tumor angiogenesis,but with different sensitiveness.

Objective:To investigate the correlation between gallbladder polyps and colon polyps of different locations.Methods:Healthy subjects who underwent colonoscopy in the Physical Examination Center of the Affiliated Hospital of Yangzhou University from January 2020 to October 2022 were included. They were divided into the proximal colon group and the distal colon group according to the location of colon polyps. Gallbladder polyps were compared with other known risk factors for colon cancer. Different parts and types of polyps were further explored.Results:A total of 2 811 patients had colon polyps, including 1 668 males and 1 143 females, with an average age of 47.3 years. One hundred and seventy-one (6.1%) had gallstones, and 459 (16.3%) had gallbladder polyps. The incidence of gallbladder polyps was higher in the proximal colon polyp group (21.7%, 93/429). Gallbladder polyps were independently associated with proximal colon polyps, including hyperplastic polyps ( OR=1.525, P=0.029) and adenomatous polyps ( OR=1.425, P=0.017). There was no significant correlation between gallbladder polyps and distal colon polyps. Conclusion:Gallbladder polyps are associated with proximal colon polyps, and colonoscopy screening is recommended for people with gallbladder polyps.

OBJECTIVETo investigate the impact of intestinal spasmolytic on colon polyps and adenoma detection rate during colonoscopy.

METHODSLiteratures related to the effect of intestinal spasmolytic on colon polyp or adenoma detection rate were retrieved from PubMed, Medline, EBSCO, High Wire Press, OVID, EMBASE, and the China National Knowledge Articles, etc. published before July 2014. Unified data were extracted by two researchers independently and organized using Jadad scale to evaluate the quality of the enrolled studies through Review manager 5.2 Meta-analysis software.

RESULTSSix articles were enrolled with total 47,509 cases, including 16,867 cases in the scopolamine group and 30,642 cases in the placebo group. Meta analysis showed spasmolytic could increase the detective rate of polyps (OR=1.24, 95% CI:1.19-1.30), adenoma (OR=1.25, 95% CI:1.19-1.30) and high-risk adenoma (OR=1.22, 95% CI:1.16-1.29).

CONCLUSIONUsing colonoscopy spasmolytic scopolamine can increase the detection rate of colonic polyp and adenoma.

Objective To develop a model of malignant risk prediction of solitary pulmonary nodules(SPN) with the metabolic characteristics of the lesion.Methods A total of 362 patients (291 malignant cases and 71 benign cases;194 males,168 females;median age:61 years) who underwent PET/CT imaging from January 2013 to July 2017 were analyzed.The diagnosis of malignant SPN was based on pathological results,and that of benign SPN was based on pathological or follow-up results.Differences of clinical/imaging characteristics in patients with benign and those with malignant SPN were analyzed.Risk factors were screened by multivariate non-conditional logistic regression analysis.The self-verification of the model was done by the receiver operating characteristic (ROC) curve analysis,out-of-group verification was performed by k-fold cross-validation.Results There were statistically significant differences in age,maximum standardized uptake value (SUVmax),size,lobulation,spiculation,pleural traction,vessel connection,calcification,vacuole,and emphysema between patients with benign and malignant nodules (all P＜0.05).The risk factors for malignant nodules included age,SUVmax,size,lobulation,calcification and vacuole.The odds ratio (OR) values (95％ CI) were 1.040(1.007-1.075),1.612(1.287-2.017),1.149(1.074-1.230),4.650(2.138-10.115),0.216(0.085-0.548),and 3.043(1.302-7.111),respectively.The logistic regression model was as follows:P=1/(1+e-x),x=-5.583+0.039×age+0.477×SUVmaxx+0.139×size+1.537×lobulation-1.532×calcification+ 1.1 13×vacuole.The estimated area under the curve (AUC) for the model was 0.915(95％ CI:0.883-0.947),sensitivity was 89.7％,specificity was 78.9％.K-fold cross-validation showed that the training accuracy was 0.899±0.011,the predictive accuracy was 0.873±0.053.Conclusions The risk factors for malignant nodules included age,SUVmax,size,lobulation,calcification and vacuole.After verification,the model has a satisfactory accuracy.It may help clinics make accurate decisions.

Objective To evaluate the significance of AFP-IgM, this is one of new tumor markers, in the diagnosis of primary hepatocellular carcinoma (PHC). Methods The contents of AFP-IgM and AFP in serum of 103 healthy subjects, 74 patients suffered primary hepatic carcinoma, 27 patients affected by liver cirrhosis and 63 patients affected by chronic hepatitis were detected by means of enzyme linked immunosorbent assay and electrochemiluminescence. No-PHC is comprised of liver cirrhosis,chronic hepatitis and health subjects as control group. Results The area under ROC curve of AFP was larger than that of AFP-IgM (0.85 vs 0.72, Z=3.21) and the best cut-off value of AFP-IgM and AFP was 3×105-AU/L and 10 ug/L respectively, which was determined by ROC curve. Under the cut-off value, the sensitivity of AFP- lgM and AFP for PHC were 64.9% and 79.7%, and the specificity were 75.6% and 80.3%, yet their efficacies were similar. However, for early diagnosis of liver cancer (stage Ⅰ and Ⅱ), the area under ROC curve of AFP-IgM was larger than that of AFP (0.91 vs 0.82,Z=1.73). The sensitivity of AFP-IgM andAFP were 94.4% and 72. 2%, and the specificity were 81.9% and 79.9%. The differences of AFP-IgMand AFP for early diagnosis of liver cancer were statistically significant. When both of the test results combined AFP-IgM with AFP are positive, it can be diagnosed as liver cancer. The specificity of combineddetermination of the two forms was 89.1%, and the efficacy was 79. 0%. Conclusions Both of thesensitivity and specificity of the AFP-IgM test were higher than that of the AFP for early diagnosis of livercancer. We also found that combined determination of the two forms significantly increased the specificityand the positive predictive value for the diagnosis of PHC, thus AFP-IgM was of especially significance forearly diagnosis of liver cancer.

Objective:To investigate the safety and feasibility of endoscopic cholecystolithotomy after endoscopic ultrasonography (EUS)-guided lumen-apposing metal stent (LAMS) implantation in animals.Methods:Six miniature pigs of 30-35 kg were selected to laparotomy under intravenous anesthesia. Two to four sterile human stones with diameter of 0.8-2.0 cm were implanted in their gallbladder. After successful modeling, LAMS was implanted between the stomach and gallbladder under the guidance of EUS. Ultrafine endoscope was used to search and remove stones after passing the gastric stent into the gallbladder. Endoscopic sphincterotomy (EST) and endoscopic retrograde biliary drainage (ERBD) was performed to prevent bile leakage. And then ordinary endoscope was used to remove LAMS and close the wound. The success rate, operation time, and incidence of complications were analyzed.Results:Five pigs were successfully implanted with LAMS, and the ultrafine endoscope entered the gallbladder smoothly. Small stones were removed from the stone basket, and large stones were completely removed after laser lithotripsy. The total operation time was 87-128 min. No postoperative complications such as bleeding, perforation, infection, or biliary fistula were observed. Failure in 1 pig was due to the first EST plus ERBD, resulting in rapid reduction of gallbladder volume and away from the gastric cavity leading to puncture difficulties.Conclusion:Endoscopic cholecystolithotomy after EUS-guided LAMS implantation is safe and feasible, and may provide animal experimental evidence for potential therapeutic approach for patients with difficulty in cholecystectomy.

Objective:To explore the relationship between lipid accumulation product (LAP) and disease activity, nutritional status in patients with Crohn disease (CD).Methods:The clinical data of 74 patients with CD in the Affiliated Hospital of Yangzhou University from July 2020 to June 2021 were retrospectively analyzed. The patients were divided into active group (32 cases) and remission group (42 cases) according to simplified Crohn disease activity index (CDAI). The general clinical data, laboratory examination results and body fat indexes were recorded, body fat indexes including body mass index (BMI), waist circumference, waist-to-height ratio, LAP and nutritional risk screening 2002 (NRS2002) score. Spearman method was used for correlation analysis; the receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of LAP in predicting the disease activity and nutritional status in patients with CD.Results:The proportion of males, body weight, hemoglobin, albumin, total cholesterol, triglyceride and high-density lipoprotein cholesterol in active group were significantly lower than those in remission group: 46.9% (15/32) vs. 71.4% (30/42), (53.58 ± 8.13) kg vs. (61.05 ± 9.38) kg, (109.94 ± 23.70) g/L vs. (134.19 ± 18.03) g/L, (34.01 ± 5.71) g/L vs. (39.15 ± 4.27) g/L, (3.23 ± 0.68) mmol/L vs. (3.66 ± 0.74) mmol/L, (1.12 ± 0.36) mmol/L vs. (1.34 ± 0.55) mmol/L and (0.91 ± 0.23) mmol/L vs. (1.04 ± 0.33) mmol/L, the nutritional risk rate, platelet count, C-reactive protein and erythrocyte sedimentation rate were significantly higher than those in remission group: 68.8% (22/32) vs. 19.0% (8/42), (317.97 ± 130.19) ×10 9/L vs. (194.00 ± 51.91) × 10 9/L, 14.15 (6.15, 41.35) mg/L vs. 1.51 (0.22, 5.58) mg/L and 40.00 (20.50, 64.25) mm/1 h vs. 9.00 (3.00, 20.00) mm/1 h, and there were statistical differences ( P<0.01 or <0.05); there were no statistical difference in age, height, total protein and low-density lipoprotein cholesterol between the two groups ( P>0.05). The BMI, waist circumference, waist-to-height ratio and LAP in active group were significantly lower than those in remission group: 19.46 (17.70, 21.45) kg/m 2 vs. 21.08 (18.87, 23.12) kg/m 2, (72.51 ± 5.92) cm vs. (77.67 ± 7.27) cm, 0.44 ± 0.03 vs. 0.46 ± 0.04, 13.42 (5.07, 17.72) cm·mmol/L vs. 15.49 (9.37, 31.71) cm·mmol/L, the NRS2002 was significantly higher than that in remission group: 3.00 (1.00, 3.75) scores vs. 1.00 (0, 2.00) scores, and there were statistical differences ( P<0.01 or <0.05). Spearman correlation analysis result showed that LAP was positively correlated with BMI, waist circumference and waist-to-height ratio ( r = 0.701, 0.766 and 0.829; P<0.01); LAP was negatively correlated with NRS2002 score, platelet count and erythrocyte sedimentation rate ( r =- 0.609, - 0.249 and - 0.243; P<0.01 or<0.05). ROC curve analysis result showed that the areas under the curve of LAP predicting disease remission and nutritional status improvement in patients with CD were 0.645 and 0.832 (95% CI 0.520 to 0.770 and 0.739 to 0.925), the best cut-off values were 20.89 and 12.86 cm·mmol/L, the sensitivities were 45.2% and 81.8%, and the specificities were 87.5% and 73.3%. Conclusions:LAP has good predictive value for disease remission and nutritional status improvement in patients with CD.