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.

OBJECTIVES: Gastrointestinal endoscopy plays an important role in the diagnosis and treatment of gastrointestinal diseases. The satisfaction degree of gastrointestinal endoscopy can directly affect the patient's compliance and further impact the treating effect. At present, there is no scale to evaluate the satisfaction degree of gastrointestinal endoscopy in China. This study aims to develop a satisfaction scale of gastrointestinal endoscopy suitable for national conditions and to evaluate its reliability and validity, which provides a tool for clinic to evaluate patients' satisfaction with gastrointestinal endoscopy. METHODS: The original gastrointestinal endoscopy satisfaction scale was compiled by literature review, consulting senior endoscopists and experts. Through the first round of survey about 120 patients, the original scale was analyzed and modified according to the results to get the gastrointestinal endoscopy satisfaction scale (formal scale). The formal scale was used to conduct the second round of survey about 200 patients. The reliability and validity of the scale were analyzed and evaluated according to the survey results. RESULTS: The reliability of the original scale was good but the validity was poor. The formal scale had 2 dimensions and 10 items, the Cronbach's alpha and split-half reliability were 0.889 and 0.823. The structure validity index χ²/df was 2.513, root mean square error of approximation (RMSEA) was 0.094, goodness of fit index (GFI) was 0.914, adjusted goodness of fit index (AGFI) was 0.861, comparative fit index (CFI) was 0.946, normed fit index (NFI) was 0.915. The aggregate validity was general, the discriminative validity was good, and the direct score of patients was strongly correlated with the total score of the scale. CONCLUSIONS The gastrointestinal endoscopy satisfaction scale has good reliability and validity, which can be used as a tool to evaluate patients' satisfaction with gastrointestinal endoscopy in China.
Humans ; Reproducibility of Results ; China ; Endoscopy, Gastrointestinal ; Patient Compliance ; Personal Satisfaction

ABSTRACT: Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients. REGISTRATION Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234.
Humans ; Meningioma/pathology* ; Consensus ; Neurosurgical Procedures ; Meningeal Neoplasms/pathology*

Objective:To investigate the predictive value of cerebroplacental ratio (CPR) for adverse perinatal outcomes of induction of labor in prolonged pregnancy.Methods:This retrospective study recruited 315 singleton pregnant women who had induced labor due to prolonged pregnancy (≥41 gestational weeks) in the First Affiliated Hospital of Chongqing Medical University from January 1, 2019 to April 30, 2020. Based on the occurrence of adverse perinatal outcomes (emergency delivery due to persistent abnormal fetal heart rate monitoring, umbilical artery blood pH at birth <7.2, 5 min Apgar scores<7, transferring to neonatal intensive care unit after birth, chorioamnionitis and vaginal delivery converted to cesarean section), they were divided into two groups: case group ( n=76) and normal group ( n=239). Clinical features and umbilical artery blood flow, middle cerebral artery (MCA) flow and CPR measured in the last ultrasound scan before induction were compared between the two groups using student's t-test, Mann-Whitney U test and Chi-square test. Receiver operating characteristic (ROC) curve was used to analyze the predictive values of umbilical artery blood flow, MCA flow and CPR for the adverse perinatal outcomes. Multivariate logistic regression analysis was used to screen the meaningful predictors. Results:Compared with the normal group, the umbilical artery pulsatility index (PI) (0.9±0.1 vs 0.8±0.1, t=-5.458, P<0.001) and the percentage of abnormal CPR (<1.0) increased significantly [21.1%(16/76) vs 6.3%(15/239), χ2=14.190, P<0.001] in the case group, while the MCA-PI and CPR decreased significantly (1.1±0.2 vs 1.3±0.3, t=5.658, P<0.001; 1.2±0.3 vs 1.6±0.5, t=8.940, P<0.001). The areas under the ROC curves of umbilical artery PI, MCA-PI and CPR for predicting adverse perinatal outcomes were 0.71, 0.71 and 0.77, respectively. CPR had the highest sensitivity (0.74) compared with umbilical artery PI (0.68) and MCA-PI (0.71), but the specificity of them were similar (0.67, 0.66 and 0.66). Multivariate logistic regression analysis showed that only CPR was the independent risk factor for adverse perinatal outcomes ( OR=0.028, 95% CI: 0.010-0.080, P<0.001). Conclusions:As an indicator for early prediction of adverse perinatal outcomes of induction of labor in prolonged pregnancy, CPR was more sensitive but less specific.

A total of 120 patients with intermediate coronary artery disease who were admitted to Ankang Hospital of Traditional Chinese Medicine from October 2017 to October 2019 were enrolled in the study (study group), and 120 patients who had ischemic changes on ECG, but no definite angiographic stenosis served as the control group. The SUA and S1P levels were measured, and Gensini scores were evaluated. Coronary blood flow reserve fraction (FFR)≤0.8 was used as the gold standard for diagnosis of functional myocardial ischemia. Patients in the observation group with functional myocardial ischemia and no-functional myocardial ischemia were evaluated. The correlation between variables was analyzed using the Pearson method. The levels of SUA [(492.52±35.47)μmol/L], S1P [(386.42±46.19)nmol/L] and Gensini score (69.42±7.81) in the study group were significantly higher than those in the control group ( t=51.218, 35.227, 60.237; P<0.05).In the study group, patients with functional myocardial ischemia had higher SUA[(678.23±54.21)μmol/L], SIP[(483.45±34.64)nmol/L] and Gensini score[(83.22±5.34) points], and higher incidence of drinking, hypertension, diabetes, and hyperlipidemia compared with no-functional myocardial ischemia patients ( t=24.764, 18.858, 17.888, respectively; χ 2=55.883, 53.684, 27.819, 71.070, 31.111, respectively; P<0.05). Pearson analysis showed that levels of SUA and S1P in patients with coronary artery lesions were positively correlated with Gensini score ( r=0.653, 0.715; P<0.01). The levels of SUA and S1P in patients with intermediate coronary artery lesions are correlated with the severity of coronary stenosis, the combination of the two indicators has better efficacy in predicting functional myocardial ischemia.

Aging is a major risk factor for diseases such as osteoarthritis (OA) and osteoporosis. However, they are not necessarily the results of aging, and the relationship between changes in bone and cartilage associated with aging and disease progression is still unclear. Studies have shown that the development and progression of OA is not a simple cartilage wear process, while its occurrence involves complex biological, chemical and mechanical changes in the tissues of the entire joint, especially the interaction of mechanics and biochemistry between cartilage and subchondral bone. Aging contributes to the occurrence and development of OA, but it is not the cause of OA. Changes associated with aging provide a foundation for OA to start, making joints more susceptible to other factors such as abnormal biomechanics and biochemistry, thereby promoting the development of OA. Therefore, understanding the basic mechanisms by which aging affects joint tissue may provide new targets for slowing or preventing the development of OA. In this paper, the related research progresses are reviewed from three aspects, i.e. age-related changes in cartilage and subchondral bone, mechanical conduction and angiogenesis.

Objective:To explore the risk factors of bacterial infections in patients with decompensated hepatitis B cirrhosis and to construct a risk prediction model.Methods:The clinical data of 198 patients with decompensated hepatitis B cirrhosis admitted in Zhejiang Provincial People’s Hospital from January 2014 to April 2020 were retrospectively analyzed. There were 86 patients with bacterial infection (infection group) and 112 patients without bacterial infections (non-infection group). The risk factors of bacterial infections were analyzed by multivariate Logistic regression. R language was used to establish a nomogram model to predict the risk of bacterial infection in patients with decompensated hepatitis B cirrhosis. Receiver operating characteristic (ROC) curve was used to explore the prediction efficiency of the nomogram model for bacterial infection.Results:Multivariate logistic regression analysis showed that previous smoking history, prothrombin time, neutrophil count and hypersensitive C protein were independent risk factors for bacterial infection in patients with decompensated hepatitis B cirrhosis ( P<0.05 or <0.01), while regular antiviral treatment and high-density lipoprotein were protective factors ( P<0.05 or <0.01). ROC curve showed that the area under the curve (AUC) of risk prediction model for bacterial infections was 0.872 (95% CI 0.820-0.924, P<0.01), and AUC of MELD score for predicting bacterial infections was 0.670 (95% CI 0.599-0.735, P<0.01); the risk prediction model was superior to MELD score in prediction ( Z=4.89, P<0.01). Conclusions:The established risk prediction model in this study can more accurately predict the occurrence of bacterial infections in patients with decompensated hepatitis B cirrhosis.

Objective To observe among stroke survivors the timing of muscle activation at the stance phase during walking using the surface electromyography ( sEMG) combined with 3D gait analysis. Methods Twenty stroke survivors assessed as at Brunnstrom stages Ⅲ, Ⅳ and Ⅴ were assigned to groups designated Ⅲ, Ⅳ and V. sEMG and 3D gait analysis were used to assess the activation timing of the bilateral rectus femoris ( RF) and biceps femoris ( BF) , the tibialis anterior ( TA) and the gastrocnemius medialis ( GM) . The activation timing and the dura-tion of activation of the muscles were compared among the 3 groups, as well as with those of healthy muscles. Results The onset time of the RF on the affected side was significantly later than on the healthy side, while that of the GM was significant earlier. The durations of BF and GM activation on the affected side were significantly shorter than on the unaffected side in group III. The onset times of the TA and GM on the affected side were significantly ear-lier than on the healthy side in group IV, as was the onset time of the TA of the affected side in group V. The average RF and BF onset times on the affected side in group Ⅳ were significantly earlier than in group Ⅲ. The onset time of the TA on the unaffected side and the average BF onset time on the affected side in group Ⅴ were significantly later than in group IV. The onset time of the RF and TA on the unaffected side in group Ⅳ and the onset time of the GM on the affected side were significantly later than in group III, while the onset time of the BF and TA on the affected side was significantly earlier. The average duration of BF activation on the unaffected side in group Ⅳ was significant-ly shorter than that of group Ⅲ. The average duration of TA activation on the unaffected side in group Ⅴ was signifi-cantly shorter than that of group IV. The duration of RF activation on the affected side in group Ⅴ was significantly shorter than that in group Ⅲ, and the same was true of the RF, BF, TA and GM activation times on the healthy side. Conclusions There are significant differences in the onset and duration of muscle activation when stroke survivors at different stages of recovery walk. Some muscles are activated too early and others are over-activated. These abnormali-ties gradually disappear with the recovery of motor function.

Objective:To investigate the effects of mindfulness based stress reduction on irritable bowel syndrome.Methods:PubMed,EMBASE,Cochrane Library,Web of Science,CNKI,Wanfang Data was searched and randomized clinical trials of MBSR treatment in irritable bowel disease were involved.At last two reviewers extracted the data independently.According to Cochrane Handbook5.1.0 handbook,a quality assessment was made.All the data would be analyzed with meta-analysis by the software of Stata.Results:Totally 5 randomized controlled trials were eligible,including 461 participants.Meta-analysis showed that MBSR would be better therapy method to improve the symptom severity of irritable bowel syndrome in 3 months,[SMD =-0.60,95％ CI:-0.86 ～-0.34,P ＜0.01],and the pain index at the 3 months and 6 months was relieved compared to the baseline [SMD =-1.11,95％ CI:-1.45 ～-0.76,P ＜ 0.01,SMD =-0.14,95％ CI:-0.43 ～ 0.14,P ＜ 0.05].Conclusion:Mindfulness based stress reduction therapy could be a adjunctive therapy method in treatment of irritable bowel syndrome.

Objective To investigate CT features of primary ileocecum lymphoma (PIL),to improve the ability of CT diagnosis for the disease.Methods CT data of 12 patients with PIL confirmed by surgery and pathology were analyzed retrospectively.All of the patients underwent plain CT, and 8 cases of them also underwent enhanced CT.Results Among the 12 cases of PIL, there were mass type in 2 and diffused thickness type in 10.The length of the intestinal lesions ranged from 7.8 to 18.5 cm (mean 10.2 cm).Lumen was irregular or aneurysmal dilation in 9, and obvious stenosis in 3.Intestinal wall was soft in 10,and rigid in 2.Plain CT showed that the thickened intestinal wall was soft tissue density.Among the 8 cases performed enhanced CT,6 were approximately homogeneous enhancement, and 2 had small necrosis area without enhancement.Maximum intensity projection(MIP) displayed the lesion had blood supply from the branches of the superior mesenteric artery.Enlarged lymph nodes were detected around the lesions, in root of the mesentery, and in the retroperitoneum in 9.1 case was accompanied with intestinal obstruction,1 case was accompanied with intestinal perforation.Conclusion If CT examination found a homogeneous soft tissue mass in ileocecum with long extent, lumen dilation, soft intestinal wall,mild-to-moderate delayed homogeneous enhancement, PIL should be considered.