AIM： To investigate the roles of mucin histochemistry, cytokeratin 7/20 （CK7/20） immunoreactivity, clinical characteristics and endoscopy to distinguish short- segment Barrett＇s esophageal （SSBE） from cardiac in...AIM： To investigate the roles of mucin histochemistry, cytokeratin 7/20 （CK7/20） immunoreactivity, clinical characteristics and endoscopy to distinguish short- segment Barrett＇s esophageal （SSBE） from cardiac intestinal metaplasia （CIM）. METHODS： High iron diamine/Alcian blue （HID/AB） mucin-histochemical staining and immunohistochemical staining were used to classify intestinal metaplasia （IN） and to determine CK7/20 immunoreactivity pattern in SSBE and CIM, respectively, and these results were compared with endoscopical diagnosis and the positive rate of gastroesophageal reflux disease （GERD） symptoms and H pylori infection. Long-segment Barrett＇ s esophageal and IM of gastric antrum were designed as control. RESULTS： The prevalence of type III IM was significantly higher in SSBE than in CIM （63.33% vs 23.08%, P〈0.005）. The CK7/20 immunoreactivity in SSBE showed mainly Barrett＇s pattern （76.66%）, and the GERD symptoms in most cases which showed Barrett＇ s pattern were positive, whereas H pylori infection was negative. However, the CK7/20 immunoreactivity in CIM was gastric pattern preponderantly （61.54%）, but there were 23.08% cases that showed Barrett＇s pattern. H pylori infection in all cases which showed gastric pattern was significantly higher than those which showed Barrett＇ s pattern （63.83% vs 19.30%, P〈0.005）, whereas the GERD symptoms in gastric pattern were significantly lower than that in Barrett＇s pattern （21.28% vs 85.96%,P〈O.O05）. CONCLUSION： Distinction of SSBE from CIM should not be based on a single method; however, the combination of clinical characteristics, histology, mucin histochemistry, CK7/20 immunoreactivity, and endoscopic biopsy should be applied. Type III IM, presence of GERD symptoms, and Barrett＇s CK7/20 immunoreactivity pattern may support the diagnosis of SSBE, whereas non-type III IM, positive H pylori infection, and gastric CK7/20 immunoreactivity pattern may imply CIM.展开更多
AIM:To determine whether magnified observation of short-segment Barrett’s esophagus(BE)is useful for the detection of specialized intestinal metaplasia(SIM).METHODS:Thirty patients with suspected short-segment BE und...AIM:To determine whether magnified observation of short-segment Barrett’s esophagus(BE)is useful for the detection of specialized intestinal metaplasia(SIM).METHODS:Thirty patients with suspected short-segment BE underwent magnifying endoscopy up to×80.The magnified images were analyzed with respect to their pit-patterns,which were simultaneously classified into five epithelial types[Ⅰ(small round),Ⅱ(straight),Ⅲ(long oval),Ⅳ(tubular),Ⅴ(villous)]by Endo’s classification.Then,a 0.5%solution of methylene blue(MB)was sprayed over columnar mucosa.The patterns of the magnified image and MB staining were analyzed.Biopsies were obtained from the regions previously observed by magnifying endoscopy and MB chromoendoscopy.RESULTS:Three of five patients with a typeⅤ(villous)epithelial pattern had SIM,whereas 21 patients with a non-typeⅤepithelial patterns did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of pit-patterns in detecting SIM were 100%,91.3%,92.3%,60%and100%,respectively(P=0.004).Three of the 12 patients with positive MB staining had SIM,whereas 14patients with negative MB staining did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MB staining in detecting SIM were 100%,60.9%,65.4%,25%and100%,respectively(P=0.085).The specificity and accuracy of pit-pattern evaluation were significantly superior compared with MB staining for detecting SIM by comparison with the exact McNemar’s test(P=0.0391).CONCLUSION:The magnified observation of a shortsegment BE according to the mucosal pattern and its classification can be predictive of SIM.展开更多
Objective:To determine the characteristics of postprandial proximal gastric acid pockets(PPGAPs)and their association with gastroesophageal acid reflux in patients with Barrett’s esophagus(BE).Methods:Fifteen patient...Objective:To determine the characteristics of postprandial proximal gastric acid pockets(PPGAPs)and their association with gastroesophageal acid reflux in patients with Barrett’s esophagus(BE).Methods:Fifteen patients with BE(defined by columnar lined esophagus of≥1 cm)and 15 healthy individuals that were matched for age,gender,and body mass index,were recruited.The fasting intragastric p H and the appearance time,length,lowest p H,and mean p H of the PPGAP were determined using a single p H electrode pull-through experiment.For BE patients,a gastroesophageal reflux disease questionnaire(Gerd Q)was completed and esophageal 24-h p H monitoring was carried out.Results:The PPGAP was significantly longer(5(3,5)cm vs.2(1,2)cm)and the lowest p H(1.1(0.8,1.5)vs.1.6(1.4,1.9))was significantly lower in patients with short-segment BE than in healthy individuals.The PPGAP started to appear proximally from the gastroesophageal p H step-up point to the esophageal lumen.The acidity of the PPGAP was higher in the distal segment than in the proximal segment.In short-segment BE patients,there were significant correlations between the acidity and the appearance time and length of the PPGAP.The length and acidity of the PPGAP were positively associated with gastroesophageal acid reflux episodes.The acidity of the PPGAP was associated with the De Meester scores,the Gerd Q scores,and the fasting intragastric p H.Conclusions:In patients with short-segment BE,a PPGAP is commonly seen.Its length and acidity of PPGAP are associated with gastroesophageal acid reflux,the De Meester score,and the Gerd Q score in patients with short-segment BE.展开更多
Background： The appropriate elbow position of short-segment nerve conduction study （SSNCS） to diagnose cubital tunnel syndrome （CubTS） is still controversial. The goal of this study was to determine the effect of...Background： The appropriate elbow position of short-segment nerve conduction study （SSNCS） to diagnose cubital tunnel syndrome （CubTS） is still controversial. The goal of this study was to determine the effect of different elbow positions at full extension and 70° flexion on SSNCS in CubTS. Methods： In this cross-sectional study, the clinical data of seventy elbows from 59 CubTS patients between September, 2011 and December, 2014 in the Peking University First Hospital were included as CubTS group. Moreover, thirty healthy volunteers were included as the healthy group. SSNCS were conducted in all subjects at elbow fhll extension and 70° elbow flexion. Paired nonparametric test, bivariate correlation, Bland-Altman, and Chi-squared test analysis were used to compare the effectiveness of elbow full extension and 70° flexion elbow positions on SSNCS in CubTS patients. Results： Data of upper limit was calculated from healthy group, and abnormal latency was judged accordingly. CubTS group＇s latency and compound muscle action potential （CMAP） of each segment at 70° elbow flexion by SSNCS was compared with lull extension position, no statistically significant difference were found （all P 〉 0.05）. Latency and CMAP of each segment at elbow full extension and 70° flexion were correlated （all P 〈 0 elbow （P - 0.43）, and the latency （P = 0.15） and the CMAP （P = 01）, except the latency of segment of 4 cm to 6 cm above 0.06） of segment of 2 cm to 4 cm below elbow. Bivariate correlation and Bland-Altman analysis proved the correlation between elbow full extension and 70° flexion. Especially in segments across the elbow （2 cm above the elbow and 2 cm below it）, latency at elbow full extension and 70° flexion were strong direct associated（r=0.83, P〈0.01;r=0.55, P〈0.01）,andsodidtheCMAP（r 0.49, P〈0.01;r=0.72, P〈0.01）.Therewasno statistically significant difference in abnormality of each segment at full extension as measured by SSNCS compared with that at 70° flexion （P 〉 0.05, respectively）. Conclusions： There was no statistically significant difference in the diagnosis of CubTS with the elbow at full extension compared with that at 70° flexion during SSNCS. We suggest that elbow positon at full extension can also be used during SSNCS.展开更多
针对畜禽疫病文本语料匮乏、文本内包含大量疫病名称及短语等未登录词问题,提出了一种结合词典匹配的BERT-BiLSTM-CRF畜禽疫病文本分词模型。以羊疫病为研究对象,构建了常见疫病文本数据集,将其与通用语料PKU结合,利用BERT(Bidirectiona...针对畜禽疫病文本语料匮乏、文本内包含大量疫病名称及短语等未登录词问题,提出了一种结合词典匹配的BERT-BiLSTM-CRF畜禽疫病文本分词模型。以羊疫病为研究对象,构建了常见疫病文本数据集,将其与通用语料PKU结合,利用BERT(Bidirectional encoder representation from transformers)预训练语言模型进行文本向量化表示;通过双向长短时记忆网络(Bidirectional long short-term memory network,BiLSTM)获取上下文语义特征;由条件随机场(Conditional random field,CRF)输出全局最优标签序列。基于此,在CRF层后加入畜禽疫病领域词典进行分词匹配修正,减少在分词过程中出现的疫病名称及短语等造成的歧义切分,进一步提高了分词准确率。实验结果表明,结合词典匹配的BERT-BiLSTM-CRF模型在羊常见疫病文本数据集上的F1值为96.38%,与jieba分词器、BiLSTM-Softmax模型、BiLSTM-CRF模型、未结合词典匹配的本文模型相比,分别提升11.01、10.62、8.3、0.72个百分点,验证了方法的有效性。与单一语料相比,通用语料PKU和羊常见疫病文本数据集结合的混合语料,能够同时对畜禽疫病专业术语及疫病文本中常用词进行准确切分,在通用语料及疫病文本数据集上F1值都达到95%以上,具有较好的模型泛化能力。该方法可用于畜禽疫病文本分词。展开更多
基金Supported by the grant from Clinical Key Project of the Healthy Congress, No. 20012130
文摘AIM： To investigate the roles of mucin histochemistry, cytokeratin 7/20 （CK7/20） immunoreactivity, clinical characteristics and endoscopy to distinguish short- segment Barrett＇s esophageal （SSBE） from cardiac intestinal metaplasia （CIM）. METHODS： High iron diamine/Alcian blue （HID/AB） mucin-histochemical staining and immunohistochemical staining were used to classify intestinal metaplasia （IN） and to determine CK7/20 immunoreactivity pattern in SSBE and CIM, respectively, and these results were compared with endoscopical diagnosis and the positive rate of gastroesophageal reflux disease （GERD） symptoms and H pylori infection. Long-segment Barrett＇ s esophageal and IM of gastric antrum were designed as control. RESULTS： The prevalence of type III IM was significantly higher in SSBE than in CIM （63.33% vs 23.08%, P〈0.005）. The CK7/20 immunoreactivity in SSBE showed mainly Barrett＇s pattern （76.66%）, and the GERD symptoms in most cases which showed Barrett＇ s pattern were positive, whereas H pylori infection was negative. However, the CK7/20 immunoreactivity in CIM was gastric pattern preponderantly （61.54%）, but there were 23.08% cases that showed Barrett＇s pattern. H pylori infection in all cases which showed gastric pattern was significantly higher than those which showed Barrett＇ s pattern （63.83% vs 19.30%, P〈0.005）, whereas the GERD symptoms in gastric pattern were significantly lower than that in Barrett＇s pattern （21.28% vs 85.96%,P〈O.O05）. CONCLUSION： Distinction of SSBE from CIM should not be based on a single method; however, the combination of clinical characteristics, histology, mucin histochemistry, CK7/20 immunoreactivity, and endoscopic biopsy should be applied. Type III IM, presence of GERD symptoms, and Barrett＇s CK7/20 immunoreactivity pattern may support the diagnosis of SSBE, whereas non-type III IM, positive H pylori infection, and gastric CK7/20 immunoreactivity pattern may imply CIM.
文摘AIM:To determine whether magnified observation of short-segment Barrett’s esophagus(BE)is useful for the detection of specialized intestinal metaplasia(SIM).METHODS:Thirty patients with suspected short-segment BE underwent magnifying endoscopy up to×80.The magnified images were analyzed with respect to their pit-patterns,which were simultaneously classified into five epithelial types[Ⅰ(small round),Ⅱ(straight),Ⅲ(long oval),Ⅳ(tubular),Ⅴ(villous)]by Endo’s classification.Then,a 0.5%solution of methylene blue(MB)was sprayed over columnar mucosa.The patterns of the magnified image and MB staining were analyzed.Biopsies were obtained from the regions previously observed by magnifying endoscopy and MB chromoendoscopy.RESULTS:Three of five patients with a typeⅤ(villous)epithelial pattern had SIM,whereas 21 patients with a non-typeⅤepithelial patterns did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of pit-patterns in detecting SIM were 100%,91.3%,92.3%,60%and100%,respectively(P=0.004).Three of the 12 patients with positive MB staining had SIM,whereas 14patients with negative MB staining did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MB staining in detecting SIM were 100%,60.9%,65.4%,25%and100%,respectively(P=0.085).The specificity and accuracy of pit-pattern evaluation were significantly superior compared with MB staining for detecting SIM by comparison with the exact McNemar’s test(P=0.0391).CONCLUSION:The magnified observation of a shortsegment BE according to the mucosal pattern and its classification can be predictive of SIM.
基金Project supported by the Natural Science Foundation of Inner Mongolia Autonomous Region(Nos.2019LH08042 and 2018MS08050)the Natural Science Foundation of Baotou Medical College(No.BYJJ-YF-2018024),China。
文摘Objective:To determine the characteristics of postprandial proximal gastric acid pockets(PPGAPs)and their association with gastroesophageal acid reflux in patients with Barrett’s esophagus(BE).Methods:Fifteen patients with BE(defined by columnar lined esophagus of≥1 cm)and 15 healthy individuals that were matched for age,gender,and body mass index,were recruited.The fasting intragastric p H and the appearance time,length,lowest p H,and mean p H of the PPGAP were determined using a single p H electrode pull-through experiment.For BE patients,a gastroesophageal reflux disease questionnaire(Gerd Q)was completed and esophageal 24-h p H monitoring was carried out.Results:The PPGAP was significantly longer(5(3,5)cm vs.2(1,2)cm)and the lowest p H(1.1(0.8,1.5)vs.1.6(1.4,1.9))was significantly lower in patients with short-segment BE than in healthy individuals.The PPGAP started to appear proximally from the gastroesophageal p H step-up point to the esophageal lumen.The acidity of the PPGAP was higher in the distal segment than in the proximal segment.In short-segment BE patients,there were significant correlations between the acidity and the appearance time and length of the PPGAP.The length and acidity of the PPGAP were positively associated with gastroesophageal acid reflux episodes.The acidity of the PPGAP was associated with the De Meester scores,the Gerd Q scores,and the fasting intragastric p H.Conclusions:In patients with short-segment BE,a PPGAP is commonly seen.Its length and acidity of PPGAP are associated with gastroesophageal acid reflux,the De Meester score,and the Gerd Q score in patients with short-segment BE.
文摘Background： The appropriate elbow position of short-segment nerve conduction study （SSNCS） to diagnose cubital tunnel syndrome （CubTS） is still controversial. The goal of this study was to determine the effect of different elbow positions at full extension and 70° flexion on SSNCS in CubTS. Methods： In this cross-sectional study, the clinical data of seventy elbows from 59 CubTS patients between September, 2011 and December, 2014 in the Peking University First Hospital were included as CubTS group. Moreover, thirty healthy volunteers were included as the healthy group. SSNCS were conducted in all subjects at elbow fhll extension and 70° elbow flexion. Paired nonparametric test, bivariate correlation, Bland-Altman, and Chi-squared test analysis were used to compare the effectiveness of elbow full extension and 70° flexion elbow positions on SSNCS in CubTS patients. Results： Data of upper limit was calculated from healthy group, and abnormal latency was judged accordingly. CubTS group＇s latency and compound muscle action potential （CMAP） of each segment at 70° elbow flexion by SSNCS was compared with lull extension position, no statistically significant difference were found （all P 〉 0.05）. Latency and CMAP of each segment at elbow full extension and 70° flexion were correlated （all P 〈 0 elbow （P - 0.43）, and the latency （P = 0.15） and the CMAP （P = 01）, except the latency of segment of 4 cm to 6 cm above 0.06） of segment of 2 cm to 4 cm below elbow. Bivariate correlation and Bland-Altman analysis proved the correlation between elbow full extension and 70° flexion. Especially in segments across the elbow （2 cm above the elbow and 2 cm below it）, latency at elbow full extension and 70° flexion were strong direct associated（r=0.83, P〈0.01;r=0.55, P〈0.01）,andsodidtheCMAP（r 0.49, P〈0.01;r=0.72, P〈0.01）.Therewasno statistically significant difference in abnormality of each segment at full extension as measured by SSNCS compared with that at 70° flexion （P 〉 0.05, respectively）. Conclusions： There was no statistically significant difference in the diagnosis of CubTS with the elbow at full extension compared with that at 70° flexion during SSNCS. We suggest that elbow positon at full extension can also be used during SSNCS.
文摘针对畜禽疫病文本语料匮乏、文本内包含大量疫病名称及短语等未登录词问题,提出了一种结合词典匹配的BERT-BiLSTM-CRF畜禽疫病文本分词模型。以羊疫病为研究对象,构建了常见疫病文本数据集,将其与通用语料PKU结合,利用BERT(Bidirectional encoder representation from transformers)预训练语言模型进行文本向量化表示;通过双向长短时记忆网络(Bidirectional long short-term memory network,BiLSTM)获取上下文语义特征;由条件随机场(Conditional random field,CRF)输出全局最优标签序列。基于此,在CRF层后加入畜禽疫病领域词典进行分词匹配修正,减少在分词过程中出现的疫病名称及短语等造成的歧义切分,进一步提高了分词准确率。实验结果表明,结合词典匹配的BERT-BiLSTM-CRF模型在羊常见疫病文本数据集上的F1值为96.38%,与jieba分词器、BiLSTM-Softmax模型、BiLSTM-CRF模型、未结合词典匹配的本文模型相比,分别提升11.01、10.62、8.3、0.72个百分点,验证了方法的有效性。与单一语料相比,通用语料PKU和羊常见疫病文本数据集结合的混合语料,能够同时对畜禽疫病专业术语及疫病文本中常用词进行准确切分,在通用语料及疫病文本数据集上F1值都达到95%以上,具有较好的模型泛化能力。该方法可用于畜禽疫病文本分词。
