Colorectal polyps are eminence lesions that protruded from mucosa into lumen,including adenomatous polyps and non-adenomatous polyps. Early detection and resection of adenoma has significance in prevention of colorectal cancer,and the surveillance afterwards is also crucial. Interval cancer is the colorectal cancer that develops between initial negative colonoscopy or all the polyps having cleared and the next colonoscopy. It is an important duty for endoscopists to reduce the incidence of interval cancer. This article reviewed the advances in studies on surveillance after resection of colorectal adenoma and the development of interval cancer.

Objective To evaluate the diagnostic efficacy of non-magnified NBI in distinguishing neoplastic from non-neoplastic colorectal polyps,using a simple classification system(NBI international colo-rectal endoscopic[NICE]classification).Methods A total of 181 lesions detected by white light colonosco-py were enrolled in this prospective study.Each lesion was assessed by NBI,and the histology was predicted according to characteristics of lesion color,microvascular architecture,and surface pattern.The results were compared with actual histologic findings.Results The diagnostic sensitivity,specificity,PPV,NPV,and accuracy of NBI were 95. 8%(114/119),91. 9%(57/62),95. 8%(114/119),91. 9%(57/62),and 94. 5%(171/181),respectively.Diagnostic accuracy was 90. 0%(72/80)in the 1 to 5 mm group,95. 9%(47/49)in the 6 to 9 mm group,98. 1%(51/52)in the more than 10 mm group,with no statistically sig-nificant differences(P=0. 175).The sensitivity,specificity,PPV,NPV,and accuracy of NBI for diminu-tive rectosigmoid neoplasms were 87. 5%(14/16),95. 2%(20/21),93. 3%(14/15),90. 9%(20/22), and 91. 9%(34/37).Conclusion NICE classification with non-magnified NBI is effective in distinguishing neoplastic from non-neoplastic colorectal lesions.

Objective To investigate the technique and effect of CT-guided implantation of ~(125)I seeds for patients with brain glioma.Methods A total of 60 cases of brain glioma,that had been diagnosed by CT,MRI,or enhanced MRI,were enrolled in this study.Among the patients,20 were primary cases,and 40 were recurrent cases after surgical treatment (23) or radiotherapy (17).Before implanting the ~(125)I seeds,we pathologically comfirmed the diagnosis by using CT-guided percutaneous puncture. According to the pathological results,we determined the number and distribution of ~(125)I seeds,matched peripheral dose (MPD),and PTV;and then implanted the seeds (4 to 46 seeds per patient) under the guidance of CT.The radioactivity per seed was set at 26, 30,or 33 Mbp,thus the total radioactivity ranged from 132 to 1196 Mbp.The distance between the seeds was 0.5 to 1.0 cm.And the MPD ranged from 80 to 119 Gy.In each patient,percutaneous puncture was performed at one or two sites,and the direction of the needle was changed for 2 to 5 times at each punctural site.The outcomes of the implantation was confirmed by CT scan immediately after the procedure.The patients were followed up by using CT.Results The criteria of curative effect recommended by WHO was adopted.According to these criteria,the effective rate of the procedure was 48.3% (29/60),55.0% (33/60),67.3%(37/55), and 70.0% (35/50) in 1,2,3,and 6 months after the operation,and the rate of hydrocephalus relief was 55.0% (33/60),65.0% (39/60),76.4%(42/55),and 78.0% (39/50) respectively.The patients achieved 1-and 2-years rates of 63.8%(30/47) and 55.2% (16/29) during the follow-up.The median survival time was 18 months in this series (28 months in the patients withⅠanⅡgrades glioma,and 16 months forⅢtoⅣgrades).The total 1-and 2-year survival rate was 78.3% (47/60) and 48.3% (29/60) in our patients,among whichⅠandⅡgrades glioma cases achieved 90.0% (27/30) and 80.0% (24/30),respectively,while those who hadⅢandⅣgrades tumor had lower survival rates [66.7% (20/30) and 16.7% (5/30)].Four patients developed puncture site bleeding,3 had replacement of the particles,and 6 suffered from local necrosis of the brain tissues.No surgery-related death occurred in the patients.Conclusions CT-guided implantation of ~(125)I seeds is effective for the local control of brain glioma.By using the procedure,the brain edema and other symptoms can be relieved,and the survival rate can be increased.

ObjectiveTo investigate the correlation between any two of Capsule Endoscopy ScroringIndex (Lewis score),simplified Crohn Disease Activity Index (CDAI) and C-reactive protein (CRP) in small bowel Crohn disease (CD).MethodsA total of 58 consecutive patients with known small bowel CD were enrolled. We evaluated disease activity with Lewis score and simplified CDAI. Correlations among CRP,simplified CDAI and Lewis score were calculated with Spearman's rank order correlation coefficient.The optimal CRP cut-off value was calculated using the ROC curve.ResultsThe Lewis score showed inactive,mild and moderate-severe patients were 13,21 and 24,respectively.CRP of moderate-severe group was significantly higher than that in mild and inactive groups ( P ＜ 0.05 ).The optimal CRP cut-off value that differentiated patients with moderate to severe disease from the others was 13.50 mg/L with sensitivity of 87.5％ and specificity of 82.4％.The area under the ROC curve to analyze the cut-off was 0.849.Lewis score was moderately correlated with CRP (r =0.58,P ＜ 0.01 ),and weakly correlated with the simplified CDAI (r =0.40,P ＜ 0.01 ).ConclusionSerum CRP and the simplified CDAI cannot replace Lewis score for capsule endoscopy in the assessment of disease activity in small bowel CD.However,CRP may be considered as an inflammatory marker for evaluating the moderate to severe capsule endoscopic activity.

Objective:To study the effects of sulforaphane(SFN)on the proliferation and apoptosis of salivary adenoid cystic carci-noma ACC-Mcells in vitro.Methods:ACC-Mcells were treated with SFN at the doses(μmol/L)of 5,10,20,30,40,60,80 and 100 for 24,48 and 72 hours,respectively.The growth inhibition was examined with MTT assay and typan blue exclusion assay.Morpholo-gy of ACC-M cells was observed with phase contrast microscope,giemsa staining and transmission electron microscope.Flow cytome-try with Annexin-V-FITC/PI double staining was used to detect the apoptosis of ACC-M cells.Results:SFN inhibited the prolifera-tion of ACC-Mcells,the IC50 values(μmol/L)after 24,48 and 72 h treatment were 75.6,21.3 and 16.5 respectively.The highest inhibition rate was 89.2%.The growth inhibition rate of SFN on ACC-Mcells was positively correlated with concentrations of SFN and treatment time.SFN induced the apoptosis of ACC-Mcells in a dose and time dependent manner(P<0.01).Conclusion:SFN can inhibit proliferation and induce apoptosis of salivary adenoid cystic carcinoma ACC-M cells time and dose-dependently.

Objective To investigate the incidence rate, onset time and electrophysiological characteristics of rapid eye movement sleep behavior disorder (RBD) and the relationship between RBD and synucleinopathies as well as the electrophysiological diagnostic criteria of RBD in Parkinson' s disease (PD) and multiple system atrophy (MSA). Methods Sleep survey and night video-polysomnography (NPSG)were used to study sleep disturbance of PD and MSA. (1) Subjective sleep assessments: All subjects,including 66 PD patients, 65 age and sex matched healthy controls and 30 MSA patients, completed the sleep questionnaires, and the RBD incidence rate and onset time were got. (2) Objective sleep assessments: 8 PD patients, 13 MSA patients, and 15 age and sex matched healthy controls underwent video-NPSG recording on two consecutive nights. Sleep architect were analyzed. The NPSG characteristics of RBD accompany with PD and MSA were analyzed, and the electrophysiological diagnostic varameters of it were determined. Results Patients with PD or MSA had a higher prevalence of RBD. RBD was found in 59. 1% (39/66) PD patients and 86. 6% (26/30) MSA patients, among those, 46. 2% ( 18/39 ) and 84.6% (22/26) had the waking symptoms of MSA and PD. The main NPSG characteristics of RBD of PD or MSA were chin REM without atonia (RWA) and increased movement. Conclusions The relatively higher RBD prevalence in MSA and PD patients indicates that RBD has close relationship with PD and MSA.Part of patients with RBD preceding neurology disease indicates that RBD may be the early marker of PD and MSA. The main NPSG characteristics of RBD accompany with PD and MSA are chin RWA and the motor manifestations. RWA and phasic EMG activity density are supposed to be the NPSG diagnostic parameters.

Objective To improve the management of dyspepsia by evaluating the potential role of pretreatment gastric histology as predictive factors on the symptomatic response after Helicobacter pylori (H. pylori) eradication in patients with functional dyspepsia (FD).Methods 240 FD patients with H. pylori infection out of 920 consecutive patients receiving gastroendoscopy due to dyspepsia were investigated, including 190 patients enrolled as the therapy group and administered with anti-H. pylori triple therapy. In addition, 50 patients were enrolled as the control group, in which omeprazole was an alternative to the triple therapy. The course of therapy in both groups was 7 days. Pretreatment gastric histology was evaluated by the updated Sydney system. C~ 13 urea breath test was performed to evaluate the H. pylori eradication results one month (both therapy group and control group) and six months (therapy group) after therapy. For each patient, the baseline, month 1 and month 6 symptom scores were assessed by a questionnaire of dyspepsia, including 12 symptom items of dyspepsia with scoring of severity. The relationship between pretreatment gastric histology and good symptom responses after H. pylori eradication was then analyzed.Results Of 35.3% and 42.6% patients with successful H. pylori eradication in the therapy group had a good symptomatic response one month and six months after the triple therapy respectively, higher than those from the patients who failed H. pylori eradication (month 1:35.3% vs 12.2%, P

OBJECTIVE: To investigate the liver T1rho values for detecting fibrosis, and the potential impact of fatty liver on T1rho measurements. MATERIALS AND METHODS: This study included 18 healthy subjects, 18 patients with fatty liver, and 18 patients with liver fibrosis, who underwent T1rho MRI and mDIXON collections. Liver T1rho, proton density fat fraction (PDFF) and T2* values were measured and compared among the three groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the T1rho values for detecting liver fibrosis. Liver T1rho values were correlated with PDFF, T2* values and clinical data. RESULTS: Liver T1rho and PDFF values were significantly different (p < 0.001), whereas the T2* (p = 0.766) values were similar, among the three groups. Mean liver T1rho values in the fibrotic group (52.6 ± 6.8 ms) were significantly higher than those of healthy subjects (44.9 ± 2.8 ms, p < 0.001) and fatty liver group (45.0 ± 3.5 ms, p < 0.001). Mean liver T1rho values were similar between healthy subjects and fatty liver group (p = 0.999). PDFF values in the fatty liver group (16.07 ± 10.59%) were significantly higher than those of healthy subjects (1.43 ± 1.36%, p < 0.001) and fibrosis group (1.07 ± 1.06%, p < 0.001). PDFF values were similar in healthy subjects and fibrosis group (p = 0.984). Mean T1rho values performed well to detect fibrosis at a threshold of 49.5 ms (area under the ROC curve, 0.855), had a moderate correlation with liver stiffness (r = 0.671, p = 0.012), and no correlation with PDFF, T2* values, subject age, or body mass index (p > 0.05). CONCLUSION: T1rho MRI is useful for noninvasive detection of liver fibrosis, and may not be affected with the presence of fatty liver.
Body Mass Index ; Fatty Liver* ; Fibrosis ; Healthy Volunteers ; Humans ; Liver Cirrhosis* ; Liver* ; Magnetic Resonance Imaging ; Prospective Studies* ; Protons ; ROC Curve

Objective:To investigate the efficacy of a machine learning model based on radiomics of brain lesions on T 2WI in differentiating multiple sclerosis (MS) from neuromyelitis optica spectrum disorders (NMOSD). Methods:Totally 223 MS and NMOSD patients who were treated from January 2009 to September 2018 in Beijing Tiantan Hospital Affiliated to Capital Medical University, Donghu Branch of the First Affiliated Hospital of Nanchang University, Tianjin Medical University General Hospital, and Xuanwu Hospital of Capital Medical University were analyzed retrospectively, and according to the proportion of 7∶3, 223 patients were completely randomly divided into training set (156 cases) and test set (67 cases). A total of 74 patients with MS and NMOSD who were treated in Huashan Hospital Affiliated to Fudan University and China-Japan Friendship Hospital of Jilin University from January 2009 to September 2018 and in Xianghu Branch of the First Affiliated Hospital of Nanchang University from March 2020 to September 2021 were collected as an independent external validation set. All patients underwent brain cross-sectional MR T 2WI, radiomics features were extracted from T 2WI, and features were selected by max-relevance and min-redundancy and least absolute shrinkage and selection operator algorithms. Then various machine learning classifier models (logistic regression, decision tree, AdaBoost, random forest or support vector machine) were constructed to differentiate MS from NMOSD. The area under curve (AUC) of receiver operating characteristics was used to evaluate the performance of each classifier model in the training set, test set and external validation set. Results:Based on multi-center T 2WI, a total of 11 radiomics features related to the discrimination between MS and NMOSD were extracted and classifier models were constructed. Among them, the random forest model had the best efficiency in distinguishing MS from NMOSD, and its AUC values for distinguishing MS from NMOSD in the training set, test set and external validation set were 1.000, 0.944 and 0.902, with specificity of 100%, 76.9% and 86.0%, and sensitivity of 100%, 92.1% and 79.7%, respectively. Conclusion:The random forest model based on the radiomic features of T 2WI of brain lesions can effectively distinguish MS from NMOSD.

Objective To investigate the clinical,endoscopic and pathological features of gastritis cystica profunda (GCP).Methods A total of 40 patients with GCP confirmed by pathology who received endoscopic or surgical treatment at Renji Hospital,School of Medicine,Shanghai Jiaotong University from May 2013 to May 2018,were included in the retrospective analysis.The clinical data such as population composition,clinical manifestations,endoscopic findings and pathological results were summarized and analyzed.Results Among the 40 patients were predominantly males (75.0％,30/40),and the mean age of onset was 61.2 years.The most common sites were cardia (32.5％,13/40) and gastric antrum (30.0％,12/40).The clinical symptoms of the patients were atypical and it was difficult to diagnose GCP with routine endoscopy examination.The endoscopic findings were mostly type 0-Ⅱ (50.0％,20/40).GCP with neoplastic lesions accounted for 55％ (22/40).Unconditional logistic regression analysis showed that male (P =0.013,OR =31.093,95％ CI:2.079-464.976) and Helicobacter pylori infection (P =0.041,OR =10.225,95％ CI:1.096-95.411) were risk factors for GCP with neoplastic lesions.Conclusion GCP commonly occurs in middle-aged and elderly men,and varies in different manifestations under white light endoscopy.GCP is not a benign lesion,but can also coexist with neoplastic lesions,which are mostly differentiated intramucosal cancer.