ObjectiveTo investigate the effect of different cytopathological grading standards on the efficiency of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis of pancreatic cancer. MethodsRelated clinical data and pancreatic cytopathological results were collected from 256 patients with pancreatic space-occupying lesions who underwent EUS-FNA in The First Affiliated Hospital of Anhui Medical University from May 2011 to March 2019, and the influencing factors for the diagnostic efficiency of EUS-FNA were analyzed based on surgical pathology and follow-up results. The independent samples t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The receiver operating characteristic (ROC) curve was used to evaluate the value of different cytopathological grading standards in the diagnosis of pancreatic cancer. ResultsA total of 67 patients who were lost to follow-up were excluded, and a total of 189 patients were included in the study. According to the Papanicolaou cytopathological standard, there were 47 cases of heterotypic cells, 25 cases of suspected cancer cells, 20 cases of cancer cells, and 97 cases without tumor cells based on EUS-FNA. A total of 133 patients were confirmed to have pancreatic cancer by postoperative pathology and follow-up results, among whom 52 had no tumor cells, 36 had heterotypic cells, 25 had suspected cancer cells, and 20 had cancer cells based on cytopathological results. EUS-FNA had a true positive rate of 6090% (81 patients) and a false negative rate of 39.10% (52 patients) in the diagnosis of pancreatic cancer; for the 56 patients without pancreatic cancer, EUS-FNA had a false positive rate of 19.64% (11 patients) and a true negative rate of 80.36% (45 patients). EUS-FNA had an area under the ROC curve of 0.643 (95% confidence interval: 0.561-0.724) in the diagnosis of pancreatic cancer. In combination with different cytopathological grading standards and with the diagnostic criteria of “the identification of heterotypic cells or suspected cancer cells or cancer cells was considered positive”, “the identification of suspected cancer cells or cancer cells was considered positive”, and “the identification of cancer cells was considered positive”, the results showed that the diagnostic criteria of “the identification of heterotypic cells or suspected cancer cells or cancer cells was considered positive” improved the efficiency of EUS-FNA in the diagnosis of pancreatic cancer, with a sensitivity of 50.38% and a specificity of 75.00%. Among the 189 patients, 13 (6.88%) experienced complications after EUS-FNA, which included hyperamylasemia and abdominal pain. ConclusionThe combination of different cytopathological grading standards can help improve the efficiency of EUS-FNA in the diagnosis of pancreatic cancer.

Objective:To evaluate the calf muscle cross-sectional area (CSA) and fat fraction (FF) in amateur marathon runners based on T 2WI-Flex fat-suppression sequence and iterative decomposition of water and fat with echo asymmetrical and least-squares estimation quantitation sequence (IDEAL-IQ) technique, and to explore the correlation between them and age, body mass index (BMI), running age, speed exercise, and monthly exercise. Methods:From September to November 2022, 37 amateur marathon group (marathon group) and 12 healthy volunteers (control group) who did not often exercise were recruited in Shijiazhuang. T 2WI-Flex fat-suppression sequence and IDEAL-IQ sequence were performed on all subjects. The anterior group of the right calf (tibialis anterior, extensor hallucis longus, extensor digital longus), external group of the calf (peroneus longus, peroneus brevis), soleus, medial head and lateral head of the gastrocnemius were delineated along the edge of the muscle contour as regions of interest, and the CSA and FF values of the muscles were obtained. Twelve subjects matched with the clinical data of the control group were selected from the marathon group (marathon matched group), and the differences in CSA and FF were compared by independent sample t test or Mann-Whitney U test. Spearman correlation analysis was used to evaluate the correlation between CSA and FF values of the right calf and running-related indicators including age, BMI, running age, speed exercise, and monthly exercise in 37 amateur marathon runners. Results:The CSA of the right calf soleus muscle in the marathon matched matched group was larger than that in the control group ( t=-2.09, P=0.048). There was no significant difference in CSA of other calf muscles between the two groups ( P>0.05). The FF values of the right calf anterior group, the outer group, the soleus muscle, the medial head and the lateral head of the gastrocnemius muscle in the marathon matched group were lower than those in the control group ( P<0.05). The BMI of 37 amateur marathon runners was positively correlated with the CSA and FF values of the anterior group, the outer group, the soleus, the medial head and the lateral head of the gastrocnemius muscle (CSA: r=0.628, 0.468, 0.680, 0.566, 0.615, respectively, all P<0.05; FF value: r=0.395, 0.567, 0.631, 0.482, 0.516, respectively, all P<0.05). The FF values of the anterior group, the outer group, the soleus, the medial head and the lateral head of the gastrocnemius muscle were negatively correlated with monthly exercise ( r=-0.337, -0.405, -0.437, -0.338, -0.446, respectively, all P<0.05). Conclusions:Long-term running training can reduce the FF value of each calf muscle group, and the FF value of calf muscles is negatively correlated with the amount of running each month. Long-term running training has the greatest effect on the CSA of soleus muscle.

Objective To investigate the endoscopic ultrasound (EUS) features of distal biliary stricture (DBS), and to provide a clinical basis for the evaluation of DBS by EUS. Methods Related clinical data were collected from 175 patients with DBS who underwent EUS examination in The First Affiliated Hospital of Anhui Medical University from April 2016 to March 2020 to analyze their clinical manifestation, laboratory examination results, imaging findings, and EUS findings, and the patients were followed up to summarize the EUS features of DBS. The chi-square test was used for comparison of categorical data between groups, and the t -test was used for comparison of continuous data between groups. Results Among the 175 patients with DBS, 85(48.57%) had benign DBS and 90(51.43%) had malignant DBS. Compared with the patients with benign DBS, the patients with malignant DBS had a significantly longer length of stricture on EUS (14.1±3.0 mm vs 7.9±3.0 mm, t =13.358, P < 0.001) and significantly higher incidence rates of the characteristic changes on EUS such as hypoechoic space-occupying lesions in lumen (57.8% vs 34.1%, χ 2 =9.843, P =0.002), peripheral lymph node enlargement (26.7% vs 12.9%, χ 2 =5.147, P =0.023), and pancreatic duct dilatation (51.1% vs 28.2%, χ 2 =9.532, P =0.002). EUS combined with magnetic resonance cholangiopancreatography had a sensitivity of 70.6% in the diagnosis of benign DBS and a sensitivity of 92.2% in the diagnosis of malignant DBS. Conclusion The characteristic EUS features of DBS, such as long length of stricture, hypoechoic lesion, peripheral lymph node enlargement, and pancreatic duct dilatation, may help with the differential diagnosis of DBS in clinical practice.