Objective:To investigate the clinical efficacy of radical gastrectomy with mesan-gientization via the inferior margin of the pancreas approach (GMIP).Methods:The retrospective cohort study was conducted. The clinicopathological data of 255 patients of Siewert Ⅱ and (or) Ⅲ adenocarcinoma of esophagogastric junction (AEG) who were admitted to Cancer Hospital Affiliated to Shanxi Medical University from March 2024 to March 2025 were collected. There were 191 males and 64 females, aged (62 ±7)years. Of 255 patients, 152 cases undergoing GMIP were allocated into the mesangientization radical resection group, 103 cases undergoing D 2 radical resection of gastric cancer were allocated into D 2 radical resection group. Observation indicators: (1) surgical and post-operative situations; (2) lymph node dissection status. Comparison of measurement data with normal distribution between groups was conducted using the t test. Comparison of measurement data with skewed distribution between groups was conducted using the Wilcoxon test. Comparison of count data between groups was conducted using the chi-square test or corrected chi-square test. Compari-son of ordinal data was conducted using the rank sum test. Results:(1) Surgical and postoperative situations. In the mesangientization radical resection group, the time of lymph node dissection was (115±14)minutes, volume of intraoperative blood loss was (81±37)mL. In the D 2 radical resection group, the above indicators were (97±13)minutes, (104±39)mL, respectively. There were significant differences in the above indicators between the two groups ( t=-8.68, -4.64, P<0.05). In the mesan-gientization radical resection group, the total number of examined lymph node was 40.00(10.00), the number of lymph node dissected (the total number of each group) was 29.00(5.00), the number of lymph node metastasis (the total number of each group) was 2.00(1.00). In the D 2 radical resection group, the above indicators were 27.00(9.00), 8.00(4.00), 1.00(1.00), respec-tively. There were significant differences in the above indicators between the two groups ( Z=-10.68, -13.57, -6.80, P<0.05). (3) Lymph node dissection status. There were significant differences in number of lymph node dissected of No.14v, 12a, 12p, 11d, 11p, 10, postgastric, 9, 8a, 8p lymph node between the mesangientization radical resection group and the D 2 radical resection group ( P<0.05). There were significant differences in number of lymph node metastasis of No.11d and postgastric lymph node between the mesangientization radical resection group and the D 2 radical resection group ( P<0.05). Conclusion:Compared with D 2 radical resection, the GMIP for Siewert Ⅱ or Ⅲ AEG has less volume of intraoperative blood loss and more complete lymph node dissection.

Objective:To summarize the clinicopathological features, evolving trends in treatment and surgical approaches, and survival outcomes of patients who underwent D2 radical gastrectomy for gastric cancer in Shanxi Provincial Cancer Hospital over the past 11 years with the goal of providing a reference for the clinical practice of gastric cancer in this region.Methods:A retrospective observational study was conducted to analyze the clinicopathological data of patients who underwent D2 radical gastrectomy for pathologically confirmed gastric malignancy at the Department of Gastrointestinal Surgery, Shanxi Provincial Cancer Hospital from January, 2013 to December, 2023. Exclusion criteria consisted of: (1) residual gastric cancer or recurrent gastric cancer after surgery; (2) emergency gastric cancer resection due to bleeding, perforation, obstruction, or other causes; (3) comorbidity with other primary malignant tumors; (4) severe preoperative cardiopulmonary insufficiency or hepatic and renal insufficiency who cannot tolerate radical surgery; and (5) inconsistent main diagnosis information across the medical record system, pathological system, and gastric cancer-specific database. Patients were divided into three groups based on treatment methods: the surgery-only group, the perioperative chemotherapy group, and the adjuvant chemotherapy group. Endpoints included: (1) baseline patient characteristics; (2) trends in tumor location and pathological features; (3) evolution of treatment modalities; and (4) survival outcomes.Results:A total of 15,644 patients were included in the analysis, with 12,591 males and 3,053 females, the male-to-female gender ration was approximately 4∶1; the mean age was (61.2±9.5) years. The tumor sites were mainly concentrated in the esophagogastric junction (EGJ) (57.4%), followed by the antrum (25.9%). The incidence of EGJ cancer initially rose and then declined. However, gastric antrum tumors remained stable, and gastric body tumors showed a slow upward trend after 2020, accounting for 16.7%. In terms of pathological types, poorly differentiated carcinoma was the most prevalent, accounting for 55.9%, followed by moderately differentiated carcinoma (24.2%), mucinous adenocarcinoma (or signet ring cell carcinoma,14.1%), neuroendocrine carcinoma (4.8%), and well-differentiated carcinoma (0.9%). The proportion of poorly differentiated adenocarcinoma showed a significant upward trend overall as well, peaking at 65.6% in 2022 and decreasing to 57.5% in 2023. Mucinous adenocarcinoma (or signet ring cell carcinoma) exhibited fluctuations with a first increase followed by a decrease: it peaked at 17.3% in 2018, dropped sharply to 8.4% in 2022, and rose back to 13.8% in 2023. The proportions of well-differentiated adenocarcinoma, moderately differentiated adenocarcinoma, and neuroendocrine tumors remained stable year by year. In terms of pathological staging, the overall proportions of gastric cancer at Stage 0, Stage I, Stage II, Stage III, and Stage IVa were 0.5%, 17.3%, 25.1%, 54.9%, and 2.3%, respectively. For Stage III, its proportion was 74.6% in 2013, which decreased to 46.4% by 2023. Stages I and II gastric cancer showed an upward trend, with their proportions rising from 10.2% and 12.1% in 2013 to nearly 21.0% and 29.6% in 2023, respectively. Between 2013 and 2023, the proportion of patients who received surgery alone continued to decrease, with this proportion dropping to 34.7% in 2023. In contrast, the number of patients who received adjuvant chemotherapy increased year by year, reaching 54.2% in 2023. Since 2017, the application of perioperative chemotherapy has gradually increased, rising to 11.1% in 2023. Immunotherapy showed an almost synchronous growth trend with perioperative chemotherapy. However, targeted therapy exhibited a downward trend after a period of growth. There were 10,704 cases of open surgery (68.4%), 4,744 cases of laparoscopic surgery (30.3%), and 193 cases of transthoracic surgery (1.2%). Pathological margin positivity was observed in 443 cases (2.8%), and the volume of gastric cancer surgeries gradually increased, peaked in 2021 before subsequently decreasing gradually. However, the volume of laparoscopic surgeries did not decrease; instead, it showed an upward trend. The main resection method for EGJ tumors was total gastrectomy, accounting for 78.5% of the total, followed by proximal gastrectomy, which accounted for 21.5%. After total gastrectomy, esophagojejunal Roux-en-Y anastomosis was the primary anastomotic method, and for proximal gastrectomy, the main anastomotic method was esophagogastric anastomosis, which accounted for 68.0% of the total. For distal gastrectomy, Billroth II anastomosis was the most common anastomotic technique, accounting for 92.7% of these procedures. The overall incidence of postoperative complications was 14.5% (2,264/15,644), among which the incidence of severe complications (grades III-IV) was 4.5% (706/15,644). The entire cohort was followed up with for (47.1±36.8) months, and the 1-year, 3-year, and 5-year overall survival rates were 86.4%, 65.9%, and 58.1%, respectively. For patients with stage 0, I, II, III, and IV gastric adenocarcinoma, the 1-year overall survival rates were 95.7%, 98.0%, 89.4%, 81.0%, and 49.1%, respectively; the 3-year overall survival rates were 92.1%, 94.6%, 81.9%, 51.4%, and 14.7%, respectively; and the 5-year overall survival rates were 89.4%, 91.7%, 75.1%, 41.5%, and 10.0%, respectively. For patients with stage I, II, III, and IV gastric neuroendocrine carcinoma, the 1-year overall survival rates were 96.7%, 91.1%, 73.8%, and 52.6%, respectively; the 3-year overall survival rates were 87.2%, 69.6%, 46.1%, and 32.1%, respectively; and the 5-year overall survival rates were 87.2%, 62.2%, 36.7%, and 32.1%, respectively.Conclusions:Gastric cancer in Shanxi Province is characterized by a male predominance, a high prevalence of tumors at the esophagogastric junction, a large proportion of poorly differentiated adenocarcinoma, and presentation at advanced stages (predominantly Stage III). The detection rate of early gastric cancer has been increasing year by year, the volume of laparoscopic surgeries has been on the rise annually, and the treatment model has shifted from single surgery to comprehensive treatment.

Objective:To investigate the clinical efficacy of radical gastrectomy with mesan-gientization via the inferior margin of the pancreas approach (GMIP).Methods:The retrospective cohort study was conducted. The clinicopathological data of 255 patients of Siewert Ⅱ and (or) Ⅲ adenocarcinoma of esophagogastric junction (AEG) who were admitted to Cancer Hospital Affiliated to Shanxi Medical University from March 2024 to March 2025 were collected. There were 191 males and 64 females, aged (62 ±7)years. Of 255 patients, 152 cases undergoing GMIP were allocated into the mesangientization radical resection group, 103 cases undergoing D 2 radical resection of gastric cancer were allocated into D 2 radical resection group. Observation indicators: (1) surgical and post-operative situations; (2) lymph node dissection status. Comparison of measurement data with normal distribution between groups was conducted using the t test. Comparison of measurement data with skewed distribution between groups was conducted using the Wilcoxon test. Comparison of count data between groups was conducted using the chi-square test or corrected chi-square test. Compari-son of ordinal data was conducted using the rank sum test. Results:(1) Surgical and postoperative situations. In the mesangientization radical resection group, the time of lymph node dissection was (115±14)minutes, volume of intraoperative blood loss was (81±37)mL. In the D 2 radical resection group, the above indicators were (97±13)minutes, (104±39)mL, respectively. There were significant differences in the above indicators between the two groups ( t=-8.68, -4.64, P<0.05). In the mesan-gientization radical resection group, the total number of examined lymph node was 40.00(10.00), the number of lymph node dissected (the total number of each group) was 29.00(5.00), the number of lymph node metastasis (the total number of each group) was 2.00(1.00). In the D 2 radical resection group, the above indicators were 27.00(9.00), 8.00(4.00), 1.00(1.00), respec-tively. There were significant differences in the above indicators between the two groups ( Z=-10.68, -13.57, -6.80, P<0.05). (3) Lymph node dissection status. There were significant differences in number of lymph node dissected of No.14v, 12a, 12p, 11d, 11p, 10, postgastric, 9, 8a, 8p lymph node between the mesangientization radical resection group and the D 2 radical resection group ( P<0.05). There were significant differences in number of lymph node metastasis of No.11d and postgastric lymph node between the mesangientization radical resection group and the D 2 radical resection group ( P<0.05). Conclusion:Compared with D 2 radical resection, the GMIP for Siewert Ⅱ or Ⅲ AEG has less volume of intraoperative blood loss and more complete lymph node dissection.

Objective:To summarize the clinicopathological features, evolving trends in treatment and surgical approaches, and survival outcomes of patients who underwent D2 radical gastrectomy for gastric cancer in Shanxi Provincial Cancer Hospital over the past 11 years with the goal of providing a reference for the clinical practice of gastric cancer in this region.Methods:A retrospective observational study was conducted to analyze the clinicopathological data of patients who underwent D2 radical gastrectomy for pathologically confirmed gastric malignancy at the Department of Gastrointestinal Surgery, Shanxi Provincial Cancer Hospital from January, 2013 to December, 2023. Exclusion criteria consisted of: (1) residual gastric cancer or recurrent gastric cancer after surgery; (2) emergency gastric cancer resection due to bleeding, perforation, obstruction, or other causes; (3) comorbidity with other primary malignant tumors; (4) severe preoperative cardiopulmonary insufficiency or hepatic and renal insufficiency who cannot tolerate radical surgery; and (5) inconsistent main diagnosis information across the medical record system, pathological system, and gastric cancer-specific database. Patients were divided into three groups based on treatment methods: the surgery-only group, the perioperative chemotherapy group, and the adjuvant chemotherapy group. Endpoints included: (1) baseline patient characteristics; (2) trends in tumor location and pathological features; (3) evolution of treatment modalities; and (4) survival outcomes.Results:A total of 15,644 patients were included in the analysis, with 12,591 males and 3,053 females, the male-to-female gender ration was approximately 4∶1; the mean age was (61.2±9.5) years. The tumor sites were mainly concentrated in the esophagogastric junction (EGJ) (57.4%), followed by the antrum (25.9%). The incidence of EGJ cancer initially rose and then declined. However, gastric antrum tumors remained stable, and gastric body tumors showed a slow upward trend after 2020, accounting for 16.7%. In terms of pathological types, poorly differentiated carcinoma was the most prevalent, accounting for 55.9%, followed by moderately differentiated carcinoma (24.2%), mucinous adenocarcinoma (or signet ring cell carcinoma,14.1%), neuroendocrine carcinoma (4.8%), and well-differentiated carcinoma (0.9%). The proportion of poorly differentiated adenocarcinoma showed a significant upward trend overall as well, peaking at 65.6% in 2022 and decreasing to 57.5% in 2023. Mucinous adenocarcinoma (or signet ring cell carcinoma) exhibited fluctuations with a first increase followed by a decrease: it peaked at 17.3% in 2018, dropped sharply to 8.4% in 2022, and rose back to 13.8% in 2023. The proportions of well-differentiated adenocarcinoma, moderately differentiated adenocarcinoma, and neuroendocrine tumors remained stable year by year. In terms of pathological staging, the overall proportions of gastric cancer at Stage 0, Stage I, Stage II, Stage III, and Stage IVa were 0.5%, 17.3%, 25.1%, 54.9%, and 2.3%, respectively. For Stage III, its proportion was 74.6% in 2013, which decreased to 46.4% by 2023. Stages I and II gastric cancer showed an upward trend, with their proportions rising from 10.2% and 12.1% in 2013 to nearly 21.0% and 29.6% in 2023, respectively. Between 2013 and 2023, the proportion of patients who received surgery alone continued to decrease, with this proportion dropping to 34.7% in 2023. In contrast, the number of patients who received adjuvant chemotherapy increased year by year, reaching 54.2% in 2023. Since 2017, the application of perioperative chemotherapy has gradually increased, rising to 11.1% in 2023. Immunotherapy showed an almost synchronous growth trend with perioperative chemotherapy. However, targeted therapy exhibited a downward trend after a period of growth. There were 10,704 cases of open surgery (68.4%), 4,744 cases of laparoscopic surgery (30.3%), and 193 cases of transthoracic surgery (1.2%). Pathological margin positivity was observed in 443 cases (2.8%), and the volume of gastric cancer surgeries gradually increased, peaked in 2021 before subsequently decreasing gradually. However, the volume of laparoscopic surgeries did not decrease; instead, it showed an upward trend. The main resection method for EGJ tumors was total gastrectomy, accounting for 78.5% of the total, followed by proximal gastrectomy, which accounted for 21.5%. After total gastrectomy, esophagojejunal Roux-en-Y anastomosis was the primary anastomotic method, and for proximal gastrectomy, the main anastomotic method was esophagogastric anastomosis, which accounted for 68.0% of the total. For distal gastrectomy, Billroth II anastomosis was the most common anastomotic technique, accounting for 92.7% of these procedures. The overall incidence of postoperative complications was 14.5% (2,264/15,644), among which the incidence of severe complications (grades III-IV) was 4.5% (706/15,644). The entire cohort was followed up with for (47.1±36.8) months, and the 1-year, 3-year, and 5-year overall survival rates were 86.4%, 65.9%, and 58.1%, respectively. For patients with stage 0, I, II, III, and IV gastric adenocarcinoma, the 1-year overall survival rates were 95.7%, 98.0%, 89.4%, 81.0%, and 49.1%, respectively; the 3-year overall survival rates were 92.1%, 94.6%, 81.9%, 51.4%, and 14.7%, respectively; and the 5-year overall survival rates were 89.4%, 91.7%, 75.1%, 41.5%, and 10.0%, respectively. For patients with stage I, II, III, and IV gastric neuroendocrine carcinoma, the 1-year overall survival rates were 96.7%, 91.1%, 73.8%, and 52.6%, respectively; the 3-year overall survival rates were 87.2%, 69.6%, 46.1%, and 32.1%, respectively; and the 5-year overall survival rates were 87.2%, 62.2%, 36.7%, and 32.1%, respectively.Conclusions:Gastric cancer in Shanxi Province is characterized by a male predominance, a high prevalence of tumors at the esophagogastric junction, a large proportion of poorly differentiated adenocarcinoma, and presentation at advanced stages (predominantly Stage III). The detection rate of early gastric cancer has been increasing year by year, the volume of laparoscopic surgeries has been on the rise annually, and the treatment model has shifted from single surgery to comprehensive treatment.

ObjectiveTo analyze the prevalence and influencing factors of mental health problems among hypertensive patients in Ya'an city five years after the Lushan earthquake， so as to provide references for promoting the mental health of hypertensive patients in earthquake-stricken areas. MethodsStratified random cluster sampling method was adopted to select 800 hypertensive patients in Ya'an city in December 2018. The general information of patients were collected via a self-designed questionnaire， and their mental health problems were assessed via the 12-item General Health Questionnaire （GHQ-12）.Then Logistic regression analysis was applied to explore the influencing factors. ResultA total of 744 valid questionnaires （93.00%） were obtained， and mental health problems were detected in 79 cases （10.62%）. Univariate analysis denoted that the detection rate of mental health problems yielded statistical difference among patients of different marital status （P<0.01）， family per capita monthly income （P=0.012） and social assistance recipients （χ²=25.194， P<0.01）. Logistic regression analysis indicated that the unmarried/separated/divorced/widowed status （OR=3.879， P=0.015） and social assistance recipients （OR=4.705， P<0.01） were risk factors for mental health problems among hypertensive patients. ConclusionThe detection rate of mental health problems is low among hypertensive patients in Ya'an city， while the unmarried/separated/divorced/widowed and social assistance recipients may suffer more serious mental health problems.

ObjectiveTo explore the effect of modified constraint-induced movement therapy (mCIMT) based on Chinese version of Quality of Upper Extremity Skills Test (Ch-QUEST) on upper limb function in children with hemiplegic cerebral palsy. MethodsFrom January to November, 2021, 40 children with hemiplegic cerebral palsy in Xuzhou Rehabilitation Hospital were recruited and randomly divided into control group (n = 20) and observation group (n = 20). The control group received routine upper limb function training, and the observation group received mCIMT based on Ch-QUEST additionally, for twelve weeks. They were assessed with Ch-QUEST, Peabody Developmental Motor Scale-Fine Motor (PDMS-FM) and Function Independence Measure for Children (WeeFIM) before and after treatment. ResultsAfter treatment, the scores of Ch-QUEST, DMS-FM (raw score) and WeeFIM significantly increased in both groups (|t| > 3.432, P < 0.01), and were higher in the observation group than in the control group (t > 2.032, P < 0.05). ConclusionmCIMT based on Ch-QUEST could improve the upper limb function of children with hemiplegic cerebral palsy.

OBJECTIVE：To optim ize the water extraction-ethanol precipitation technology of polysaccharide from Litchi chinensis seed，and to evaluate its hypoglycemic activity in vitro . METHODS ：The content of polysaccharides was determined by phenol-sulfuric acid colorimetry ，and the extraction rate of polysaccharides was calculated. Single factor test and response surface methodology were used to optimize the water extraction technology with the ratio of material to liquid ，extraction times and extraction time as factors ，and the extraction rate of polysaccharide as index. Single factor test was used to screen the concentration volume fraction of water extract and ethanol precipitation Using acarbose as contro l，4-nitrophenol-α-D-glucopyranoside method was used to investigate in vitro inhibitory activity of polysaccharide from L. chinensis seed to α-glucosidase. RESULTS ：The optimal technology was the ratio of material to liquid 1∶19 （g/mL），decocting for 3 times，1 h for each time ，concentrating the water extract to 40％ of original volume ，and adding ethanol to 80％ volume fraction. After deproteinization by Sevage method ，the crude polysaccharide of L. chinensis seed was obtained. The results of 3 times of validation tests showed that ，extraction rates of polysaccharide were 7.61％，7.89％，7.99％，average extraction rate was 7.83％（RSD＝2.52％，n＝3）. The contents of polysaccharide were 55.57％，55.83％ and 56.66％，average content was 56.02％（RSD＝1.81％，n＝3）. The inhibitory activity of the polysaccharide from L. chinensis seed to α-glucosidase were increased as concentration ；its IC 50 was 0.056 mg/mL，which was lower than positive control acarbose （0.196 mg/mL）. CONCLUSIONS：The optimal water extraction-ethanol precipitation technology of polysaccharide from L. chinensis seed is stable and feasible. The polysaccharide from L. chinensis seed show significant in vitro inhibitory effect on α-glucosidase，which is better than that of acarbose.

Objective To evaluate the effect of aminophylline on monophasic action potential (MAP) during remifentanil-induced negative chronotropic effect in the isolated rabbit hearts.Methods Eighteen healthy adult rabbits,weighing 2.0-2.5 kg,wereused in the study.Their hearts were excised and retrogradely perfused in a Langendorff apparatus.After 15 min of stabilization with K-H solution,the isolated hearts were randomly divided into 3 groups (n =6 each) using a random number table:control group (group C),remifentanil group (R group),and remifentanil + aminophylline group (RA group).Group C was perfused with 37 ℃ K-H solution for 60 min.Group R was perfused with K-H solution containing remifentanil 12 ng/ml for 60 min.Group RA was perfused with K-H solution containing remifentanil 12 ng/ml and aminophylline 30 μg/ml for 60 min.At 15 min of stabilization and 15,30 and 60 min of perfusion,HR and MAP in the myardium of left ventricle were recorded:MAP duration at 90％ and 50％ repolarization (MAPD90,MAPD50) was calculated.The early after depolarization,delay after depolarization and arrhythmia were recorded.Results Compared with group C,HR was significantly decreased at 15,30 and 60 min of perfusion,and MAPD50 and MAPD90 were prolonged in goup R,and HR was increased in group RA.HR was significantly higher,and MAPD50 and MAPD90 were shorter in RA group than in group R.No early after depolarization,delay after depolarization or arrhythmia developed in each group.Conclusion Aminophylline antagonizes remifentanil-induced negative chronotropic effect through shortening monophasic action potential duration in the myocardium of left ventricle of the isolated rabbit hearts.

Objective To study the occurrence site characteristics of middle cerebral artery aneurysm (MCAA ) in volume CT digital subtraction angiograhy(VCTDSA) .Methods The image characteristics in 72 cases of MCAA from May 2009 to January 2011 were retrospectively analyzed ,according to the running of middle cerebral artery ,the occurrence sites of aneurysm were divided into four categories :M1 segment ,M2 bifurcation ,M2 distal and M3-M5 segment ,the aneurysm number was conducted the statistics and the image characteristics were analyzed ;two neuroradiologists adopted the double-blind method to measure the MCAA angle in bifurcation of M2 segment and compared it with the bifurcation angle in the normal middle cerebral artery ,the difference between them were statistically analyzed .Results (1)M1 segment aneurysms were 7 cases(9 .70% ) ,M2 bifurcation aneurysms were 58 ca-ses(80 .56% ) ,M2 distal aneurysms were 5 cases(6 .94% ) and M3-M5 segment aneurysms were 2 cases(2 .78% ) .(2)The angle in M2 bifurcation of the normal middle cerebral artery was(99 .30 ± 22 .96)° ,M2 bifurcation aneurysm angle was(139 .26 ± 27 .61)° , the difference between them showing statistical significance (P<0 .01) .(3)The difference between left and right of M 2 bifurcation angle in the normal middle cerebral artery had no statistical significance (P>0 .05) .(4)The M2 bifurcation angle in ruptured aneu-rysm was(133 .98 ± 30 .24)° ,which in unruptured aneurysms was(144 .53 ± 21 .81)° ,the difference between them had no statistical significance(P>0 .05) .Conclusion MCAA mainly occurred in M2 bifurcation .There is significant difference in M2 bifurcation an-gle between the aneurysm group and non-aneurysm group ,M2 bifurcation angle is increased ,the probability of aneurysm occurrence is increased .

Objective To evaluate the quality of literatures and the accuracy of ultrasonography in diagnosis of deeply infiltrating endometriosis(DIE).Methods The database of Medline (1966 to 2009), the excerpta medica database (EMBASE, 1980 to 2009), Chinese biological medicine on disc (CBMdisc, 1978 to 2009), China national knowledge infrastructure (CNKI, 1979 to 2009) and VIP for Chinese technology periodical database (VIP, 1989 to 2009) Cochrane library of studies about the diagnosis of ultrasound for DIE were searched and analyzed.Quality assessment of diagnostic accuracy studies (QUADAS) items were used to evaluate the quality of literatures.The sensitivity, specificity, positive likelihood ratio(+ LR), negative likelihood ratio (-LR) ,diagnostic test odds ratio (DOR) for the pooled analysis and heterogeneity test were analyzed for transvaginal ultrasonography(TVUS), transrectal ultrasonography (TRUS) and rectal endoscopic sonography(EUS) by Meta-disc software, and drew the summary receiver operating characteristic (SROC) curves for those without heterogeneity.Results Totally 15 literatures in English were enrolled into this study.The positive rate of 10 items of QUADAS were above 60%, whereas that of the 11th item "Were the reference standard results interpreted without knowledge of the results of the index test" was 46.7% ;none of studies had mentioned the 13th item " Were uninterpretable/intermediate test results reported".All researches had no heterogeneity by explored threshold effect.The results of pooled sensitivity, specificity, + LR, - LR, DOR were 0.925,0.986, 30.036,0.107, 299.25 for TRUS, 0.799,0.944,11.972,0.187, 69.126 for transvaginal ultrasonography (TVUS), and 0.635,0.928,8.022, O.320, 39.606 for EUS, respectively.Area under the curve of EUS was 0.9479, and that of TVUS was 0.9246.Conclusions TRUS,TVUS and EUS all showed optimal value in diagnosis of DIE.The bias identified from the 15 studies might be mainly resulted from reference standard review bias.