Objective To evaluate the performance of HbA1C in diagnosis of pre-diabetes in Chinese adolescents.Methods A total of 933 students(aged 13-16 year,46.5% female)without known history of diabetes were selected from junior and senior middle schools in Liaoyang city.HbA1C and fasting plasma glucose(FPG)levels were determined in all participants.Pre-diabetes was diagnosed as according to 2010 American Diabetes Association (ADA)criteria[HbA1C 5.7%-6.4%,FPG(5.6-6.9)mmol/L].The individuals with HbA1C ≥5.7% underwent oral glucose tolerance test(OGTT)and were classified into impaired glucose tolerance(IGT)and impaired fasting glucose(IFG)according to 1999 World Health Organization(WHO)criteria.The performance of HbA1C in diagnosing pre-diabetes by the new criteria was evaluated by the traditional OGTT results based on receiver operating characteristic(ROC)curves.Results Among all participants,213(22.8%)individuals were diagnosed as prediabetic subjects.72.3% of individuals with pre-diabetes were identified by HbA1C alone,23.0% by FPG alone,and only 4.7% by both tests simultaneously.The ROC curve for HbA1C to identify impaired fasting glucose diagnosed by new criteria had an area under the curve(AUC)of 0.50 without statistical significance(P = 0.97).Of the 164 participants with HbA1C 5.7% -6.4%,68 individuals received OGTT,among which 18 subjects were diagnosed as IGT(n= 14)or IFG(n = 4).The ROC curve for HbA1C to identify pre-diabetes diagnosed by OGTT had an AUC of 0.53,without statistical significance(P = 0.69).Conclusion In Chinese adolescents,HbA1C is not suitable for diagnosis or screening of pre-diabetes.

A kind of focal lesions called focal nodular hyperplasia-like nodules (FNH-LNs) was found in liver cirrhosis, especially in alcoholic cirrhosis, which is similar to focal nodular hyperplasia in histology. The imaging features of FNH-LNs show hyperenhancement in arterial phase, hypoenhancement in portal venous phase or delayed phase. FNH-LNs are easily misdiagnosed as hepatocellular carcinoma (HCC). With reviewing the relating articles in China and abroad, this article summarizes the etiology, clinicopathological features and imaging manifestations of FNH-LNs, so as to distinguish FNH-LNs and HCC in cirrhosis and guide selection of treatment.

Objective:Digestive endoscopy is an important diagnostic and therapeutic tool for digestive system diseases.The artificial intelligence(AI)-assisted system in endoscopy(hereinafter referred to as AI in digestive endoscopy)has broad application prospects in the field of digestive endoscopy.The trust and acceptance of endoscopic subjects are the cornerstone of the research,application,and promotion of AI in digestive endoscopy.Currently,the tools for measuring the acceptance of AI in digestive endoscopy by subjects are limited at home and abroad.This study aims to develop a scale for measuring the acceptance of AI in digestive endoscopy by subjects,then to evaluate its reliability and validity. Methods:By conducting literature research,an item pool and dimensions were constructed,and a preliminary scale was constructed using Delphi method.Through the first stage of the survey on the subjects,the reliability and validity of the scale were tested,and the revised scale was used for the second stage of survey on the subjects to further verify the structural validity of the scale. Results:The acceptance scale for AI in digestive endoscopy included 11 items in 3 dimensions:accuracy,ethics,benefit and willingness.In the first stage of the survey,351 valid questionnaires were collected,and the Cronbach's α was 0.864.The correlation coefficient between the total score of the scale and the score of the test item was 0.636,and the Kaiser-Meyer-Olkin(KMO)value in exploratory factor analysis was 0.788.In the second stage of the survey,335 valid questionnaires were collected,and in confirmatory factor analysis,the χ2/df was 3.774,while the root mean squared error of approximation(RMSEA)was 0.091. Conclusion:Acceptance scale for AI in digestive endoscopy by subjects developed in this study has good reliability and validity.

Objective: To observe the efficacy and safety of rifabutin and furazolidone included triple regimen and minocycline plus furazolidone included quadruple regimen in eradicating refractory H. pylori infection. Methods: A total of 146 patients who failed (≥two times) to treat H. pylori with standard anti-H.pylori therapy were selected and divided into esomeprazole, rifabutin and furazolidone treatment group (ERF group, n=74) and esomeprazole, minocycline, furazolidone and bismuth potassium citrate group (EMFB group, n=72). The duration of treatment were both 10 days. Liver and renal functions were examined within three days after therapy. ¹³C or ¹⁴C-urease breath test was performed one month after the medication withdrawal. The patients were followed up once every two weeks during the treatment period. The medication and adverse reactions were recorded in detail. The compliance and rates of adverse events in two groups were compared and analyzed. The eradication rates of the two groups and subgroups were compared by intention-to-treat (ITT) and per-protocol (PP) analyses. The cost-effectiveness of the two groups was evaluated with cost effectiveness analysis (CEA). The cost/effectiveness (C/E) ratio was calculated by PP. Chi-square test and t test were used for statistical analysis. Results: There was no significant difference in complicance between ERF group and EMFB group (90.5% vs. 90.3%, P>0.05). There was no significant difference in H. pylori eradication rate between ERF group and EMFB group analyzed by ITT (82.4% vs. 84.7%, P>0.05). Analyzed by PP, there were no significant differences in H. pylori eradication rate between ERF group and EMFB group (91.0% vs. 93.8%), between male subgroup and female subgroup of ERF group (87.9% vs. 94.1%), between subgroup with age less than 60 years and subgroup with age over 60 years of ERF group (89.7% vs. 92.9%), between male subgroup and female subgroup of EMFB group (89.7% vs. 97.2%) and between subgroup with age less than 60 years and subgroup with age over 60 years of EMFB group (93.6% vs. 94.4%) (all P>0.05). There were no statistically significant differences in the rate of adverse events between ERF group and EMFB group (20.3% vs. 22.2%), between male subgroup and female subgroup of ERF group (25.0% vs. 15.8%), between subgroup with age less than 60 years and subgroup with age over 60 years of ERF group (26.2% vs. 12.5%), between male subgroup and female subgroup of EMFB group (19.4% vs. 24.4%) and between subgroup with age less than 60 years and subgroup with age over 60 years of EMFB group (24.5% vs. 15.8%) (all P>0.05). Fixed daily cost, total cost and C/E of ERF group was RMB 59.0 yuan, RMB 590.5 yuan and 648.9, respectively; and the eradication rate was 91.0%(61/67). Fixed daily cost, total cost and C/E of EMFB group was RMB 32.9 yuan, RMB 329.1 yuan and 350.9, respectively; and the eradication rate was 93.8%(61/65). Conclusions Rifabutin and furazolidone included triple regimen and minocycline plus furazolidone included quadruple regimen both have good efficacy, safety and compliance in the eradication of refractory H. pylori infection, and the latter is better.

Clinically, there are still substantial differences between hepatocellular carcinoma (HCC) and non-HCC liver malignancies in terms of risk factors, pathogenesis, biological behaviors, treatment selections, prognosis, and prevention measurement. The liver imaging reporting and data system (LI-RADS) M (LR-M) classification criteria in the contrast-enhanced ultrasound LI-RADS (CEUS LI-RADS) can help differentiate HCC from non-HCC malignancies. This review discussed and summarized recent advancements in differential diagnosis of HCC from non-HCC using the LR-M criteria and speculated future directions in the field, i.e., how CEUS LI-RADS distinguish HCC from intrahepatic cholangiocarcinoma, mixed hepatocellular carcinoma cholangiocarcinoma, and liver metastasized and benign tumors. It also discussed differences between CEUS LI-RADS and CT/MRI LI-RADS in diagnosis of liver neoplasms and Sonazoid Ⓡ modified CEUS LI-RADS in differential diagnosis of HCC from non-HCC.

In this article, methods of measuring and evaluating treatment adherence, based on whether they are objective and subjective, are reviewed upon literature examination, and the advantages and disadvantages of each method for different population segments are also discussed.It is intended to provide medical professionals and researchers with a general framework about adherence assessment methods.During treatment and research, medical professionals and researchers should select the most appropriate methods for their purposes and provide effective and personalized evaluation methods to ultimately evaluate and improve patients' medication adherence.

OBJECTIVE To explore the effects of ADRB1 Arg389Gly polymorphisms on the efficacy of bisoprolol， thus providing some information for individualized drug therapy. METHODS A systematic search was conducted in PubMed， Embase， Cochrane Library， CBM， CNKI， and Wanfang Data to retrieve and find out all relevant literature about bisoprolol and ADRB1 Arg389Gly polymorphism from the inception to May 2023. The retrieved literature was screened and selected according to the inclusive and exclusive criteria， thereafter quality assessment was conducted. RevMan 5.4 software was utilized to perform the meta- analysis for the outcome index. RESULTS Overall 7 literature with 1 339 cases were included. Among them， 4 studies provided the changes in systolic blood pressure （SBP）， diastolic blood pressure （DBP） （ΔSBP and ΔDBP）； 4 involving the change （ΔLVEF） of left ventricular ejection fraction （LVEF）. Results of the study showed that there was no statistical significance in the improvement of blood pressure between wild-type group （AA） and mutation group （AG+GG） of ADRB1 Arg389Gly treated with bisoprolol {ΔSBP [SMD＝0.17，95%CI （－0.97，1.31）， P＝0.77]， ΔDBP [SMD＝－0.01，95%CI （－0.65，0.62）， P＝0.97]}； there was no statistical significance in the improvement of ΔLVEF [SMD＝－0.61， 95%CI （－2.74，1.53）， P＝0.58] between 2 groups. CONCLUSIONS ADRB1 Arg389Gly gene polymorphism has no significant influence on the improvement of SBP， DBP， and LVEF in cardiovascular patients who use bisoprolol.

OBJECTIVE To conduct rapid health technology assessment （HTA） of ulinastatin （UTI）， and to evaluate the efficacy， safety and cost-effectiveness of UTI in the treatment of acute pancreatitis （AP）. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI， Wanfang database， CBM and official websites of HTA institutions， the systematic review （SR）/meta-analysis， economic evaluation and HTA reports of UTI in the treatment of AP were collected from the inception to Apr. 2024. Two researchers independently conducted screening， quality evaluation and data extraction according to the admission and exclusion criteria， and descriptive analysis was adopted to analyze and summarize the data. RESULTS A total of 19 studies were included， involving 15 SR/meta-analysis and 4 economic studies， and no HTA report was retrieved. In the treatment of AP， UTI showed clear advantages over conventional treatment alone in terms of improving the overall effective rate， shortening the recovery time of amylase， reducing the time required to relieve abdominal pain and distension， lowering the mortality rate， and decreasing the average hospital stay. Compared to other positive drugs （carbendate mesylate， octreotide， somatostatin， etc.）， its efficacy is similar， with a favorable safety profile. As far as the current research was concerned， UTI had obvious economic advantages over other positive drugs. CONCLUSIONS UTI is safe and effective in the treatment of AP， and has economic advantages.